The shortage of health workforce in rural and remote areas has been commonly concerned by every country around the word. It is one of world health issues, challenging the aspirations of achieving equity. In this regard, WHO developed the Global Policy Recommendations to improve the accessibility of the health workforce in rural and remote areas through improved retention. This article focuses on the key steps of the policy guideline developed from evidence-based medicine methodology and from angle of guideline development, mainly about background, issues, evidence retrieval and selection, quality grading of evidence, and the forming of recommendation plan, in order to further explore how to correctly understand, obtain, evaluate and apply currently available research evidence, and how to use the GRADE system to make scientific and feasible recommendations in the decision-making process, emphasizing the importance of evidence and the GRADE system in the evidence-based health decision-making.
Objective To investigate the situation of supplemental drugs to the national essential medicines list (EML) in primary health care facilities. Methods Supplemental essential medicine lists published by provincial governments around our country were identified. Characteristics of categories, names and quantities of the supplemental drugs were extracted and compared. Results Supplemental lists issued by 13 provinces were included. The number of the supplemental drugs of four provinces including Jiangsu, Guangdong, Inner Mongolia and Shandong surpassed 200. All the included lists contained chemicals and traditional Chinese medicine, as well as nine categories mentioned in the EML. The frequency of 17 drugs in the supplemental lists was over 10. Specific paediatrics drugs and antitumor drugs were considered by several provinces. Conclusion At present, EML cannot meet the requirements of the primary healthcare. Selection and amendment of EML may refer to the supplemental lists which reflect the demands of essential drugs in every area in our country.
The Campbell collaboration (C2) is an international research network that produces and disseminates systematic reviews of the effects of interventions in education, criminal justice, and social welfare. It aims to generate the best research evidence to support policy and practice in order to bring about positive social change. This issue introduces the experiences of the author while taking part in the ninth annual Campbell colloquium, and tries to increase awareness about C2.
Objective To provide evidence for establ ishing a health care system for pregnant women after disasters by evidence-based evaluation on the comparison of programs in different countries of the world. Methods We electronically searched The Cochrane Library (Issue 2, 2008), MEDLINE (1966 to June 2008), EMbase (1984 to June 2008), VIP ( 1989 to June 2008), CBM ( 1978 to June 2008), Wangfang database (1997 to June 2008), CNKI (1994 to June 2008) and handsearched Journals such as Chinese Journal of Obstetrics and Gynecology to identify l iteratures and guidel ines on pregnant women healthy care system after calamity. The qual ity of l iteratures and guidel ines was assessed. Results A total of 293 studies were searched, of which 25 studies were identified with the focuses on the consequence of pregnancy, development of fetus and first-aid of injuries of pregnant women. We found the studies on pregnant women’s health care were l imited, and most of them were retrospective and cohort studies, which was related to the paroxysmal ity, rarity and complexity of the disaster.? Conclusions The high proportion of pregnant women among displaced persons underscores the importance of examining how behavioral changes and difficulties in access to health care influencing the maternal and infant health, which needs comprehensive planning and arrangement.
Evidence-informed decision making is one of the most common, objective and important health policy research methods used by policy makers. Its purpose is to promote the application and dissemination of research knowledge on health policy and systems to change traditional and subjective models of health policy making in order to improve national and regional health systems. Three elements will influence the effectiveness of health policy making:research evidence, available health resources and the value of policy formulation. This paper introduces some pragmatic evidence-based approaches, especially systematic reviews, priority setting and a combined approach matrix (CAM). Systematic reviews have a b impact on the decision process for policy makers. We hope that the application and development of evidence-informed methods will increase in China’s health policy research.
Objective To provide scientific evidence for the establishment of medical specialist system in China by analyzing the current situation and problems, putting forward solution thoughts and countermeasures, from the angle of medical education system, residency training program and licensed physician management. Method Principle and method of evidence-based medicine were adopted. Retrospective investigation was conducted to gain information from 1996 to 2002 about enrollment and running form of medical education, current situation of residency and specialist training. Data was then extracted and analyzed for the benefit of corresponding countermeasures. Results By the end of 2001, there were totally 1 640 thousand physicians in China. The enrollment proportion of undergraduate and junior college student steadily increased from 1996 to 2002, while the situation quite the reverse as for medical secondary school. More than 300 thousand have taken part in the licensure exam, among whom less than 15% had university diploma. About 52 000 doctors have already completed the residency training program, and 65 700 are being trained. Standardized system of specialist training and admittance is not available in China. Conclusions It was three main tough problems that mainly account for the poor quality of doctor as a whole in China, which include diversity of educational system, insufficient software and hardware of residency training program, and absence of specialist training system. An allied funded program of "research on medical specialist training and admittance" has been on the way, and research outcomes will be published soon.