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Bridging the Urban-Rural Continuum to Improve Services in Rural China

Bridging the Urban-Rural Continuum to Improve Services in Rural China. Virginia C. Li, PhD, MPH, Professor of Community Health Sciences UCLA School of Public Health and Songyuan Tang , MB, MPH, MA, Associate professor Lichun Tian , MB, M.P.H., Junior Lecturer

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Bridging the Urban-Rural Continuum to Improve Services in Rural China

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  1. Bridging the Urban-Rural Continuum to Improve Services in Rural China Virginia C. Li, PhD, MPH, Professor of Community Health Sciences UCLA School of Public Health and Songyuan Tang, MB, MPH, MA, Associate professor Lichun Tian, MB, M.P.H.,Junior Lecturer Kaining Zhang, M.B., M.S., Professor and Director, Institute for Health Studies and Development, Kunming Medical College, Yunnan, China. Roger Detels, M.D., M.S., is Professor of Epidemiology, UCLA School of Public Health

  2. Specific Objectives • Upgrade the quality of family planning and contraceptive programs, sexually transmitted disease services and services promoting safe motherhood in the rural areas. • Disseminate the necessary computer skills to 26 demonstration township health centers through development and evaluation of primary, secondary and tertiary workshops (“train-the-trainers”). • Develop a team at IHS to assist township health workers in developing strategies to disseminate the knowledge, strategies and policies from the IHS website to the rural residents. • Strengthen capacity for long-term institutional collaboration between IHS and the UCLA School of Public Health Bixby Program to enhance reproductive health research and practice in China.

  3. 服务提供者 Website Village Doctors/ Teachers/ Women’s Cadres Villagers/ Students Figure 1. Dissemination of information from IHSKMC Website to rural health professionals and the other target groups.

  4. Identify core areas Baseline Survey Site Selection Survey design Identify subject Training interviewers Identify central messages Develop questionnaires Finalize pretest Qs Field implementation Analysis Survey organization Supervision Website Development Domain application obtain hardware Install software Design tree diagram Upload web pages Pretest & modification Website Development, Maintenance and Management + Interactivities Figure 2. Website Development, Implementation, and Evaluation.

  5. Training Training IHS Team Primary target training Secondary target training 1. Communication and health promotion 2. Strategies for HIV/STD prevention and control in resource-poor and low prevalence settings 3. MCH: Nutrition for mother and infant 1. Overview of Project; 2. Role and responsibility; 3. Website use and management; 4. Computer skills; 5. Dissemination Plan; 6. Interactive skills; 7. Feedback from field; 8. Health education; 9. Record keeping of IMS; 10. Reporting. 1. Core Areas 2. Core Messages 3. Interactive activities 4. Educating villagers Trouble shooting Implementations Mobile monitoring team Participatory planning Meeting Plan for dissemination of website information, strategies and practices Evaluation Survey Survey design Organize survey team Training interviewers Reports/papers Analysis Implement in fields Figure 2. Website Development, Implementation, and Evaluation (Cont.).

  6. Figure 3. Frequency of browsing the reproductive health website and time spent on the website per week (July 1, 2003 to January 12, 2004).

  7. Table 1. Frequency of visiting and total time spent on the reproductive health website per week in minutes (July 1, 2003 to January 12, 2004). * *Log System Data

  8. Table 2. Utilization of the interactive functions of the reproductive health website (July 1, 2003 to January 12, 2004).

  9. Table 3. KAP of HIV/AIDS among health providers in three rural counties in Yunnan, China. *Statistical significance between baseline and 1 year followup with P<0.05 **Statistical significance between baseline and 1 year followup with P<0.01

  10. Table 4. KAP of HIV/AIDS among teachers and women’s cadres in three rural counties in Yunnan, China. *Statistical significance between baseline and 1 year followup with P<0.05 **Statistical significance between baseline and 1 year followup with P<0.01

  11. Table 5. Villagers knowledge and attitudes on HIV/AIDS and Hepatitis B in three rural counties, Yunnan, Chin * Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.05. ** Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.01.

  12. Table 6. Students knowledge on HIV/AIDS and Hepatitis B in three rural counties, Yunnan, China * Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.05. ** Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.01.

  13. Conclusion: • Using the website for information, education, and communication in remote area is feasible. • Impact can be achieved even with one computer per agency at the township level. • Logistic support and monitoring is a critical element to success. • There is urgent need for licensing and recertification of village doctors.

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