1. General Introduction of Community Health Services in the Hongkou District Amy Jiang, MPA Shanghai, China

2. Brief Introduction Jiang Songyun, Amy Jiang Bachelor of Preventive Medicine Master of Public Administration (MPA)

3. Work Experience 1995 ~2005  Shanghai Hongkou District CDC  Chief of Infectious Disease and Epidemiology Branch Disease outbreak investigations Analytic epidemiology

4. Working experience 2005 ~present:  Health Bureau of Shanghai Hongkou District, Shanghai, China  Vice Director, Department of Public Health

5. Work Responsibilities Recommend public health policy to the district government Implement national, municipal and district health policy Community Health Service (CHS) emergency response, chronic disease control health education and promotion mental, dental, maternal and child health care Supervise, evaluate and oversee quality of work accomplished by the core operating units

6. Projects Conducted Year 2006 Evaluated the Community Health Service in Hongkou District Year 2004 Developed and implemented immigrant communicable disease control Year 2002 HIV/AIDS community prevention and control program

7. The Bureau at Work Annual district-wide public health conference: attended by the chiefs of all the district departments. Delivering a lecture on HIV/AIDS prevention and control

8. A profile of Hongkou district ( 2005 ) Location: N ortheast of downtown Area: 23.4km 2 10 communities Life expectancy : Average: 81.29 Male : 79.44 Female: 83.12 Infant mortality 2.92‰ Percentage of people over 60 20.80% Resident people: 789, 000 migration: 150, 000

9. HongKou District Health Bureau Core Unit of Public Health in HongKou District HKCDC Hygiene supervision Mental Disease prevention Dental disease prevention Maternal and child health care WHO urban collaborating center Community health service & Different level hospital

10. WHO urban primary health care collaborating center Established in Oct, 1990 the sole WHO cooperating center in Shanghai downtown within the research field General Introduction to a Unique Characteristic of Hongkou District Public Health

11. Entrusted projects of the center To strengthen self-care capabilities through various health education activities, so as to improve living standard and quality of life; To study the policies of relevant departments to ensure that health is covered in the policies; To stress on developing the techniques required for the working staffs involved in urban primary health care; To provide the technical information related to urban primary health care in order to support the efforts of other cities and the activities planned by the WHO.

12. Network of Disease Control in Shanghai Family District District CDC h ealth Bureau District h ealth Bureau Community Health Services Center Governmen t Municipal Governmen t District Government Municipal Health Bureau Municipal SCDC Community G Community Government SchoolEnterprise and other Units ——Administrative relationship ……Professional supervision relationship

13. CHS in China — Background Community-based health care receive much attention; policies concerned are being developed, should integrate health management for population at community level. The change of disease pattern: chronic disease is the main type of disease among people. Completed health information is needed to make specific prevention programs and to deliver integrated health service, these information should be collected in the community.

14. The chief mission of the CHS in ShangHai Collect basic health information, and analysis of risk factors and predict trends of disease Identify target groups Deliver convenient, cost-effective and specific health services to community residents.

15. CHS work method — step 1 Collect health record -set up Family Health File  residential status,  individual health status  (age, sex, income, drinking, smoke, disease, symptom, health service utilization, etc)

16. CHS work model — step 2,3 Use health record  Stratify general population into different target group (patient, at risk, healthy)  Early detection for certain disease  Deliver health service upon their need Take measure on target people

18. Implementation -- Three level network  Community health service center:  Community mobilization and family infom  Visit families door by door and interview every member, set up Family Health File  Offer health service to target groups  Inner quality control and evaluation

19. Implementation -- Three level network  District CDC  Organize implementation  Train investigator  Establish local multi-sectional cooperation  Site direction and monitoring  Quality control and evaluation

20. Implementation -- Three level network  Shanghai CDC Design standard questionary and specific management forms Develop management guideline Develop software Establish multi-sectional cooperation Management, training, quality control and assessment

21. Development of CHS in Hongkou district Three phase Year 1990-1995  establishment of WHO urban primary health care collaborating center, building the basic model and team for community health service. Year 1996-1999  the health promotion project sponsored by World Bank (7th); progress is continuing Year 2000-now  solidify, research, cooperate with international institutions

22. Status of CHS in Hongkou district Already set up a steering committee, gaining strong commitment of the district and local government Assign the responsibilities and tasks for related government department Put up a work model: government leading, multi-department cooperating, citizen participating Establish a network, integrating the activities of the community and government departments Strengthen research and investigation, providing more scientific basis for policy-making

23. Having experienced 15 years of CHS development, we have achieved great progress by ourselves. In the year 2005, we gained the honored award of “National District for Community Health Service” which shows that we entered into a new phrase of CHS development.

24. health education

25. home service for elder people over 80health promotion

26. Challenge Optimize the CHS working model Lack of general practitioner ( GP ) Strengthen CHS work team

27. Educational Objectives in EHIB To learn public health education as it is practiced in the U.S. Attend seminars on other fields within public health English language study

28. The first sight in Asia

29. Shanghai bund