Management on national basic public health service projects and its related issues in Hubei province

Objective To analyze the management on the national basic public health service (BPHS) projects and its related issues in Hubei province and to provide references for improving BPHS policies.

Methods We conducted a survey among health administrative agencies and primary health institutions (community health service centers and township hospitals) in 54 districts (counties) of 8 prefecture-level cities in Hubei province. Totally 868 BPHS-related key informants (one or two from each of the selected agencies or institutions) were asked to complete a self-administered questionnaire between June 2014 and January 2015.

Results Of all the participants, 70.1% considered that fund for BPHS was inadequate and the inadequateness was noticed by more participants form the urban institutions than from the rural institutions (P < 0.05); 85.2% believed that the fund allocation was reasonable and 74.5% thought that the fund allocation period was appropriate; 43.9% regarded using BPHS fund to pay medical staff's wages as an unreasonable approach but 76.2% regarded using the fund to offer staff's subsidies as a reasonable practice. There were 73.2% of the participants believing that some of the fund was utilized improperly; there were 80% of the participants regarding performance assessment as a proper way of management and 75.7% judging the policy for linking performance appraisal to fund allocation having been implemented strictly on the whole. Among the 13 BPHS projects assessed by the participants, the projects for management of elderly population, patients with chronic disease, maternal care, and child health were considered as costing too much fund but without a good implementation.

Conclusion For the national basic public health service projects implemented in Hubei province, the compensation fund was at a relatively low level and there were some deficiencies in fund management and performance appraisal. The results suggest that basic public health service related policies need to be amended and fund management should be improved.