贵州省少数民族贫困县村医队伍现状调查

Status of village health personnel in poverty-stricken minority counties,Guizhou province

目的了解少数民族贫困县村医队伍现状。方法 2010年1月选取贵州省黔西南布依族苗族自治州普安县14个乡镇77个村卫生室所有在岗村医172人进行面对面访谈。结果村医年龄22-68岁,平均年龄39岁;98.8%的村医无专业技术职称;执业资格以乡村医生资格证书为主,占81.4%,执业助理医师占18.6%;医学学历以中专或相当于中专水平（贵州省卫生厅授证）为主,占86.7%,大专及以上占1.2%,无任何医学学历占12.1%;平均每千农业人口乡村医生和卫生员0.48人,明显低于全国、西部地区及贵州省的平均水平（P〈0.01）;村医每人月均收入1 250元,低于当地民办小学教师收入水平;所有村医无养老保险,自费参加新农合;各乡镇村医农业人口分布的洛伦兹曲线紧靠绝对公平线。结论普安县村医年龄结构偏老化,技术素质较低;村医短缺;收入水平较低,未享受政府补助的社会保障;乡镇间村医分布公平性好。

Objective To describe the situation of village health personnel（VHP） in poverty-stricken minority counties.Methods A cross-sectional survey was conducted among 172 VHP at 77 village clinics in Puan minority county,Guizhou province in January 2010.Results The age of the VHP was from 22 to 68 years,with an average of 39 years.About 98.8% of respondents did not have any technical title;81.4% of the VHP were village doctors with occupational qualification and 18.6% were assistant doctor.For all VHP,86.7% completed technical secondary school or relevant certificate education;1.2% had junior college or above education,and 12.2% had no vocational education.There was an average of 0.48 village doctor or assistant doctor per 1 000 rural population,which was significantly lower than the average level of Guizhou province,the western areas of China,and China（P0.01）,respectively.Respondents reported an average monthly income of 1 250 RMB yuan,which was lower than that of village teachers at the primary school.All respondents did not have any endowment insurances,but had new type of rural cooperative medical care system with their own payment.Lorenz curve of VHP distribution was close to absolute equity line.Conclusion VHP in Puan minority county was in a shortage with an older age structure and a lower technical qualification.VHP distribution showed a good equity among towns in the county.