HEOA Group, West China School of Public Health, Sichuan University, No. 17 People's South Road, Chengdu, 610041, China.
Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, 610041, China.
Glob Health Res Policy. 2023 Sep 22;8(1):42. doi: 10.1186/s41256-023-00326-x.
Healthy China is a nationwide health strategy aiming at improving health from diverse dimensions, and strengthening high-quality assessment is essential for its stimulation. However, there is limited evidence in the surveillance of the actual performance of the initiative at regional levels. This study innovatively proposes a two-step surveillance process which comprehensively monitors Healthy China Initiative based on regional realities, thus provides guidance for policymaking.
A flexible indicator system was firstly developed basing on Delphi survey and focus group discussions. And then the Analysis Hierarchical Process and the TOPSIS method were used to determine the weights of indicators and calculate comprehensive indexes as the surveillance outcomes. A pilot study was conducted in a typical area in China to verify the applicability of the process.
Following the surveillance process and basing on the implementation of Healthy China Initiative in the target region, an indicator system comprised of 5 domains and 23 indicators with weights was first developed specifically for the pilot area. Then 1848 interagency data of the study area were collected from 8 provincial institutions/departments to calculate the indexes and ranks of the five domains which were health level, healthy living, disease prevention and control, health service, and healthy environment. The outcomes showed that Healthy China Initiative in the pilot area had been constantly improved since the strategy proposed, while there were still issues to be tackled such as the deficient monitoring mechanisms and unevenly development progress.
This study proposed a pragmatic surveillance process with indicators which could be tailored for specific context of target regions and produce meaningful surveillance outcomes to inform decision-making for policymakers, and also provided a theoretical foundation as well as empirical evidence for further health strategies and plannings assessment studies.
健康中国是一项全国性的卫生战略，旨在从多个维度改善健康状况，加强高质量评估对于推动这一战略至关重要。然而，在监测该倡议在区域层面的实际绩效方面，证据有限。本研究创新性地提出了一种两步监测流程，该流程基于区域实际情况全面监测健康中国倡议，从而为决策提供指导。
首先基于德尔菲调查和焦点小组讨论制定了一个灵活的指标体系。然后，采用层次分析法和逼近理想解排序法确定指标权重，并计算综合指数作为监测结果。在我国一个典型地区进行了试点研究，以验证该流程的适用性。
根据监测流程，并基于目标地区健康中国倡议的实施情况，首先为试点地区制定了一个由 5 个领域和 23 个指标组成的指标体系，这些指标具有权重。然后，从 8 个省级机构/部门收集了该研究地区的 1848 个机构间数据，以计算五个领域的指标和排名，这五个领域分别是健康水平、健康生活、疾病预防和控制、卫生服务和健康环境。结果表明，自该战略提出以来，试点地区的健康中国倡议不断得到改善，但仍存在一些问题需要解决，如监测机制不足和发展进度不均。
本研究提出了一种实用的监测流程，该流程使用的指标可以根据目标地区的具体情况进行定制，并产生有意义的监测结果，为决策者提供信息，同时也为进一步的卫生战略和规划评估研究提供了理论基础和经验证据。
