摘要
背景 公共卫生委员会是我国基层群众性自治组织,作为一种新型的基层治理模式,各地正在进行公共卫生委员会治理模式的探索,以期使其成为实现基层社区纵向连接和横向联动网格化管理的关键枢纽。目的 基于政策文本分析法对我国各地公共卫生委员会建设相关政策文件进行分析,为完善基层公共卫生治理体系、提升基层公共卫生治理能力提供参考。方法 选取目前已开展村(居)公共卫生委员会建设的北京市、广东省、重庆市、山东省、安徽省、贵州省、甘肃省和宁夏回族自治区8个省份作为样本地区,于2022年3月在样本地区政府和卫生健康委员会官方网站,以“公共卫生委员会”为关键词进行公共卫生委员会建设相关政策文件的检索。通过文献研究和政策分析构建公共卫生委员会治理体系分析框架,采用Nvivo 11 Plus质性分析软件对纳入研究的政策文本进行词频和编码分析。结果 最终纳入15份政策文件和2份公共卫生委员会工作指导手册。词频结果显示“卫生”“公共”“工作”“委员会”“健康”5个词出现的频率最高,说明选取的政策文本符合研究主题。结合公共卫生委员会治理体系分析框架,确定出治理主体、治理机制、制度保障和能力建设4个根节点和13个子节点的政策内容结构分析维度。其中,治理主体共208个参考点,治理机制共48个参考点,制度保障共57个参考点,能力建设共87个参考点。结论 样本地区的政策文件对4个维度的内容均有所涉及,但侧重点不同。基于本研究的框架,公共卫生委员会在目前建设基础上,仍需对委员会人员设置一定准入条件并明晰其工作权责,建立有效的协作沟通机制,完善制度保障和给予经费、技术支持等。
Background In China,the governance of public health by the public health committee,a grassroots mass autonomous organization,is a new approach managing public health services in primary care.Many regions are exploring governance models of public health by the public health committee,aiming to make it a key hub to realize the vertical connection and horizontal linkage grid management of grassroots communities.Objective To analyze the policy documents related to the construction of local public health committees of various regions in China using policy document analysis,so as to provide a reference for improving the primary-level public health governance system and governance capacity.Methods In March 2022,we searched policy documents related to the construction of public health committees on the official websites of the local governments and health commissions of eight sample regions(Beijing,Guangdong,Chongqing,Shandong,Anhui,Guizhou,Gansu,and Ningxia Hui Autonomous Region) in which village(residential) public health committees have been constructed using "public health committee" as the key search term.Through literature review and policy document analysis,an analytical framework for the governance system of the public health committee was constructed.Nvivo 11 Plus was used for word frequency and coding analyses of the included policy literature.Results A total of 15 policy documents and 2 guidance manuals for the work of public health committees were ultimately included.Word frequency analysis showed that the five words,"hygiene" "public" "work" "committee" and "health",appeared most frequently,indicating that the selected policy literature conformed to the research theme.By using the analytical framework,the structural dimensions of the policy literature were determined,including four root nodes,namely,governance subjects,governance mechanisms,institutional guarantees,and capacity building,and 13 sub-nodes.There are 208 reference points for governance subjects,48 reference points for governance mechanisms,57 reference points for institutional guarantees,and 87 reference points for capacity building.Conclusion The local policy documents of the sample regions cover the contents of the four dimensions,but have different focuses.According to the framework in this study,further construction of the public health committee needs to set certain admission criteria with clear determination of rights and responsibilities for new committee members,establish an effective cooperation and communication mechanism,improve the system guarantee and provide financial and technical support.
作者
欧欣
杨佳
OU Xin;YANG Jia(School of Public Health,Capital Medical University,Beijing 100069,China)
出处
《中国全科医学》
CAS
北大核心
2023年第19期2346-2354,共9页
Chinese General Practice
基金
北京市社会科学基金决策咨询项目(20JCB004)
首都医科大学本科生科研创新项目(XSKY2022131)
首都医科大学公共卫生学院院级重点专项。
关键词
公共卫生管理
公共卫生委员会
基层公共卫生
治理体系
政策文本分析
Public health administration
Public health committee
Grassroots public health
Governance system
Policy text analysis
