乡镇卫生院管理权下放的条件初探

Study on the Condition of Devolution for the Township Health Center

对乡镇卫生院管理权由县卫生局下放到乡政府的有关条件进行研究,采取召开专题小组讨论、知情者访谈等定性研究的方法,调查3个不同经济状况县的乡镇卫生院管理权下放前后的变化。结果提示,不同经济状况的地区卫生主管部门、乡镇政府、乡镇卫生院对乡镇卫生院管理权下放态度明显不同。因此,提出乡镇卫生院管理权下放的必备条件是:乡镇经济发展到一定程度;乡镇政府分管领导必须学习必要的卫生管理知识;必须具备相应的配套政策。建议乡镇卫生院管理权“上收”应因时因地、区别对待,不搞“一刀切”。

This paper studied the condition of devolution for the township health center(THC)in Fujian province in order to provide the decision-making bases. It was taken by methods of the focus group discussion and key informants interview, and looking up the statistic almanacs for three counties. The results shows that devolution for THC in three different economic counties have produced different outcomes and the staff working in township health hospital ,township government and counties health bureau have different attitude for the devolution. The necessary conditions for devolution are suggested that the township economy has developed a higher degree;The leaders of the township government should be trained the health managing before devolution;The corresponding policies have to be set up;It is considered that devolution should be different in different time and areas and 'centralization'with the same manner should be avoid.