Factors associated with the uptake of national essential public health service package for hypertension and type-2 diabetes management in China's primary health care system: a mixed-methods study

• DOI: 10.1016/j.lanwpc.2022.100664
• Publication Date: 2022-12-14T19:53:29Z
• Authors: Shangzhi Xiong; Wei Jiang; Ruilin Meng; Chi Hu; Hui Liao; Yongchen Wang; Chang Cai; Xinyi Zhang; Pengpeng Ye; Yanqiuzi Ma; Tingzhuo Liu; Dandan Peng; Jiajuan Yang; Li Gong; Qiujun Wang; David Peiris; Limin Mao; Maoyi Tian
• Keywords: 8.1 Organisation and delivery of services; 610; 32 Biomedical and Clinical Sciences; Cardiovascular; and research governance; anzsrc-for: 4206 Public Health; 8.3 Policy; 03 medical and health sciences; anzsrc-for: 32 Biomedical and Clinical Sciences; 0302 clinical medicine; Clinical Research; Non-communicable diseases; 3202 Clinical Sciences; Mixed-methods study; anzsrc-for: 42 Health Sciences; Diabetes; 42 Health Sciences; 3 Good Health and Well Being; Articles; Health Services; Primary health care system; 4203 Health Services and Systems; ethics; 3. Good health; anzsrc-for: 4203 Health Services and Systems; Hypertension; 4206 Public Health; anzsrc-for: 3202 Clinical Sciences; Generic health relevance

China launched the primary health care (PHC) system oriented National Essential Public Health Service Package (NEPHSP) in 2009, to combat challenges including increasing burden from hypertension and type-2 diabetes (T2DM). In this study, PHC was assessed understand factors influencing uptake of NEPHSP for T2DM management.A mixed-methods study conducted seven counties/districts five provinces across mainland China. Data included a facility level survey interviews with policy makers, administrators, providers, individuals and/or T2DM. The used World Organisation (WHO) service availability readiness assessment questionnaire. Interviews were thematically analysed using WHO systems building blocks.A total 518 surveys collected over 90% rural settings (n = 474). Forty-eight in-depth individual 19 focus-group discussions all sites. Triangulating quantitative qualitative data found that China's continuous political commitment strengthening led improvements workforce infrastructure. Despite this, many barriers identified, insufficient under-qualified personnel, remaining gaps medicines equipment, fragmented information systems, residents' low trust utilization PHC, coordinated care, lack cross-sectorial collaborations.The findings provided recommendation future strengthening, improving quality delivery, facilitating resource-sharing facilities, establishing integrated exploring mechanisms better engagement governance.The is supported by Medical Research Council (NHMRC) Global Alliance Chronic Disease funding (APP1169757).