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The Centers for Disease Control and Prevention System in China: Trends From 2002-2012
Chengyue Li1, Mei Sun1, Ying Wang1
1Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China.
Objectives:
To assess the improvements of the Chinese Centers for Disease Control and Prevention (CDCs) system between 2002 and 2012, and problems the system has encountered.
Methods:
We obtained data from 2 national cross-sectional surveys in 2006 and 2013, including 32 provincial, 139 municipal, and 489 county-level CDCs throughout China. We performed a pre-post comparative analysis to determine trends in resource allocation and service delivery.
Results:
The overall completeness of public health services significantly increased from 47.4% to 76.6%. Furthermore, the proportion of CDC staff with bachelor's or higher degrees increased from 14.6% to 32.6%, and governmental funding per CDC increased 5.3-fold (1.283-8.098 million yuan). The working area per CDC staff increased from 37.9 square meters to 63.3 square meters, and configuration rate of type A devices increased from 28.1% to 65.0%. Remaining problems included an 11.9% reduction in staff and the fact that financial investments covered only 71.1% of actual expenditures.
Conclusions:
China's CDC system has progressed remarkably, enabling quicker responses to emergent epidemics. Future challenges include establishing a sustainable financing mechanism and retaining a well-educated, adequately sized public health workforce.
