Responsibility division for health service institutions at township and village level in national basic public health service project

Objective To explore detailed responsibility division for health service institutions at the two-level of township and village in national basic public health service.Methods Literature review,expert consultation,and questionnaire survey were adopted in the study and logic test was used in data analysis.Totally 10 township hospitals and 22 village clinics in 4 provinces in central western region of China were included in the study.Results Among the 41 secondary project indicators of national basic public health service,24(58.53%)were recognized differently for the institutions at township and village level.The average difference value in the ratio of responsibility division for all the 41 secondary indicators perceived by the medical staff in township institutions versus those in village clinics was greater than zero and the difference values for 21 indicators(70.73%)were not less than 0.2.The responsibility division ratio perceived by the staff in township medical institutions for overall project at township and village level was 0.72 and 0.28,whereas that perceived by the staff in village clinics was 0.43 and 0.57,respectively.The results of this exploratory study suggested that national basic public health service project should be undertaken mainly by township medical institutions and assisted by village clinics with the responsibility division of 0.61 and 0.39.Conclusion There is an obvious difference in responsibility division for national basic public health service project perceived by the staff in township hospitals and village clinics.The first-level indicators of the project are lack of maneuverability and should be refined into secondary indicators for the assistant performance of village clinics in the implementation of the project.