[Objective]To systematically assess the public health governance capacity in Zhejiang Province,to conduct an in-depth analysis of its strengths and weaknesses,so as to provide scientific basis and strategic recommendations for further enhancement.[Methods]A systematic collection of policy documents,public information reports,and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted(encompassing a total of 1 263 policy documents,138 pieces of information reports and 631 research articles).Based on the evaluation criteria suitable for public health systems previously developed by the research team,the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated.Additionally,normative gap analyses were employed to identify the strengths and weaknesses.[Results]Zhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points(1 000.0-point maximum).The province has effectively implemented the principle of health first(scoring 698.5 points in the assessment of health-first strategy implementation)and attached sufficient importance to health-related goals(scoring 658.2 points in the scientific rationality of goal setting).However,the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points,the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points,and the coverage of incentive mechanisms scored 286.0 points.[Conclusion]Zhejiang Province has effectively implemented its health first strategy and attached great importance to health targets,but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

ObjectiveTo analyze the changes in the degree of coordination of China's major epidemic prevention and control efforts before and after the outbreak of the Corona Virus Disease 2019 (COVID-19), so as to explore the impact of epidemic prevention and control measures on coordination dynamics.MethodsA total of 3 864 policy documents related to epidemic prevention and control from January 2000 to December 2020 across 31 provinces (autonomous regions, and municipalities) in China were systematically collected. Contents specific to collaborative and cooperative efforts were extracted, and the extent of interdepartmental coordination were quantified to assess the effectiveness of epidemic prevention and control efforts. Wilcoxon signed-rank test was adopted to statistically analyze the differences between the indicators before and after the epidemic.ResultsThe average overall coordination level for major epidemic prevention and control in 31 provinces (autonomous regions, and municipalities) increased from 43.06% to 97.62%, and the average coordination levels in the eastern, central, and western China soared from 42.29%, 37.50%, and 47.46%, to 98.81%, 96.20%, and 97.46%, respectively, with statistically significant differences (all P<0.05). In terms of department categorization, coordination levels in the professional departments and the key support departments peaked at 100.00%, while other support departments rose to 95.43%, with an increase of 77.15%, 181.85%, and 139.89%, respectively, exhibiting noteworthy statistically significant differences (all P<0.001).ConclusionThe scope of coordination departments of China’s major epidemic prevention and control exists a remarkable surge following the COVID-19 outbreak, notable heightened coordination is particularly observed among the key support departments. Future endeavors should prioritize the roles played by diverse departments in epidemic prevention and control, enhancing both the clarity of departmental responsibilities and the effectiveness of interdepartmental coordination.

ObjectiveTo systematically evaluate the public health governance capacity of 40 cities in Jiangsu, Zhejiang, and Anhui Provinces, providing a scientific evaluation basis for building a "Healthy Yangtze River Delta".MethodsA comprehensive collection of policy documents, public information reports, and research literature related to public health governance capacity in Jiangsu, Zhejiang, and Anhui Provinces was conducted, totaling 6 920 policy documents, 1 720 information reports, and 1 200 literature pieces. Based on the evaluation standards for an appropriate public health system established by the research team, the basic status of public health governance capacity was assessed to identify the strengths and weaknesses of the 40 cities.ResultsIn 2022, the public health governance capacity score for the 40 cities in Jiangsu, Zhejiang, and Anhui Provinces was (562.5±38.0) points. In terms of specific areas, the emergency response field received the highest score of (791.4±49.7) points, while the chronic disease prevention and control field received the lowest score of (368.2±29.6) points. The Jiangsu-Zhejiang-Anhui region has largely achieved the strategic priority of health, gradually improved public health legal regulations, and established a basic organizational framework with a solid foundation for information and data infrastructure. However, challenges still need to be addressed, such as unstable government funding for public health, unclear departmental responsibilities, and barriers to information interoperability.ConclusionThe public health governance capacity of the 40 cities in Jiangsu, Zhejiang, and Anhui Province has been at a moderate level, but disparities have still existed across regions and fields. In the future, while continuing to deepen existing advantages, it is essential to accurately identify the causes of problems, establish a long-term and stable investment mechanism, enhance information connectivity mechanisms, further clarify departmental responsibilities, and promote the achievement of the "Healthy Yangtze River Delta" goal.

Background:Pharmacovigilance is essential for ensuring patient safety, and hospital pharmacists play a key role in this system. However, their knowledge, attitudes, and practices (KAP) remain understudied in China. Objectives:To evaluate the KAP of hospital pharmacists toward pharmacovigilance in China. Design:Nationwide, cross-sectional study. Methods:This study evaluated the KAP of 9724 hospital pharmacists from 2145 hospitals across all 31 provinces of mainland China using a structured questionnaire and a multi-stage sampling approach. Descriptive statistics were used to summarize the KAP of the participants, and multivariable logistic regression was applied to explore the influencing factors of high KAP performance. Results:The proportions of respondents achieving high performance (score ⩾4 out of a maximum of 5) in knowledge, attitudes, and practices were 22.2%, 44.2%, and 68.0%, respectively, with significant correlations between these dimensions (p < 0.001). Misconceptions were prevalent, with 50.1% of pharmacists incorrectly attributing pharmacovigilance responsibility to medical institutions instead of marketing authorization holders (MAHs), and 36.2% misunderstanding pharmacovigilance as solely adverse drug reaction (ADR) reporting. A total of 95.5% of respondents expressed a willingness to participate in pharmacovigilance training. The reporting of ADEs/ADRs, medication errors, and drug quality problems to regulatory authorities is well-established nationwide, but 27.8% infrequently or never reported serious ADRs to pharmaceutical companies. Higher educational levels, hospital tiers, and leadership roles positively influenced knowledge and attitude, while male pharmacists showed superior practices compared to females. Clinical pharmacists and team leaders outperformed dispensing pharmacists in all KAP dimensions. Conclusion:Our study reveals a significant scope for enhancement in the KAP of hospital pharmacists pertaining to pharmacovigilance in China. Specifically, there is a critical need to improve the understanding of pharmacovigilance's scope and responsibilities, and fostering stronger collaborative efforts between medical institutions and MAH is imperative, particularly within targeted pharmacist groups.

Objective To analyze the change in service capacity against major epidemics before and after coronavirus disease 2019(COVID-19)in China for the promotion of the capacity.Methods Via systematic search on the official websites and the law documents website of Peking University(PKULAW),we collected totally 1 756 policy documents relevant to major epidemic prevention and control issued during 2002-2020 by government departments and professional public health institutions in 31 provincial-level administrative divisions of China.Contents about the coverage and assessability of service capacity of major epidemic prevention and control were extracted from the documents and indexes for evaluating national and regional coverage and assessability were calculated based on the extracted contents.Paired signed-rank test was used to analyze changes in the indexes before and during COVID-19 epidemic.Results The coverage of major epidemic prevention and control services has reached 100％in the Chinese mainland in 2019.In comparison to those in 2019 before the emergence of COVID-19 epidemic,the national assessability indexes(％)for service capability of major epidemic prevention and control of pre-,ongoing-and post-stage increased in 2020 by 29.78％(65.59％vs.50.54％),17.54％(72.04％vs.61.29％)and 4.34％(38.71％vs.37.10％).the assessment index for service capability of major epidemic prevention and control of pre-stage increased from 78.79％to 89.39％for eastern region and that of ongoing-stage increased from 65.00％to 76.67％for western region(both P＜0.05);but there was no significant increase in regional assessment index for service capability of major epidemic prevention and control of post-stage.The national assessment index for service capacity of major epidemic prevention and control of whole process increased significantly from 66.00％in 2019 to 73.78％in 2020 after the emergence of COVID-19 epidemic(P＜0.001).Conclusion The overall service capacity of major epidemic prevention and control has improved after the emergence of COVID-19 epidemic in the Chinese Mainland but the service capacity needs to be improved in central and western regions;in addition,the post-event assessment on the service capacity should be concerned for the promotion of the service capacity.

ObjectiveTo analyze changes in the coverage of incentive measures for promoting major epidemic prevention and control in documents published by governmental and professional departments in the Chinese Mainland before and after coronavirus disease 2019 (COVID-19) epidemic of 2020.MethodsThrough systematically searching websites of government departments and professional institutions in 31 provincial-level administrative divisions (PLADs) of the mainland of China, we retrieved totally 3 864 documents (including laws, regulations, standards, rules, proposals, plans, and guidelines) relevant to major epidemic prevention and control published from 2000 through 2020. The paragraphs related to incentive and disciplinary measures for promoting the containment of major epidemic were extracted to calculate region- and institution-specific coverage of the measures in the retrieved documents. Wilcoxon paired rank sum test was adopted to evaluate differences in the coverage of the established measures before and after COVID-19 epidemic of 2020 among various economic regions and administrative/professional institutions. ResultsThe average coverage of disciplinary measures for the retrieved documents increased from 74.19% before 2020 to 76.34% in 2020, with a significant increase of 2.90% (P < 0.05); while, the average coverage incentive measures was 22.85% for the documents published in 2020, significantly increased in comparison with no incentive measure presented in all the documents published before 2020 (P < 0.001). Compared to those before 2020, the national average combined coverage of incentive and disciplinary measures increased significantly by 11.83%, 30.77%, 42.11%, and 89.66% in 2020, for the documents published by administrative departments, public health institutions, health care institutions, and primary health care institutions, respectively; the national average coverage increased from 37.10% before 2020 to 49.60% in 2020 for the documents published by all the institutions, with an increment of 33.70%; and for the documents published by all the institutions in the PLADs of eastern, central and western region, the coverage increased significantly by 47.47%, 27.54% and 25.00% (all P < 0.05). ConclusionAfter COVID-19 epidemic of 2020, the coverage of incentive and disciplinary measures for promoting major epidemic prevention and control increased significantly in the documents published by governmental and professional departments in the mainland of China and the increase was much higher for the coverage of incentive measures.

Objective To construct an evaluation index system in accordance with the practical implementation of county-level medical treatment and prevention integration in China,and to provide guiding principles and evaluation tools for its scientific development.Methods Using the rainbow model as a theoretical foundation,a theoretical framework and a pool of candidate indicators for evaluating county-level medical-preventive integration were established through policy analysis and literature review.The Delphi method and analytic hierarchy process(AHP)were used to determine the index system and corresponding weights.Results The response rates for the two rounds of expert consultation were 87％and 100％,respectively,with an average authority coefficient of 0.79.The coordination coefficients of the expert opinions were 0.222 and 0.359(both P＜0.05).After two rounds of expert consultation,an evaluation index system was established,which included 6 first-level,15 second-level,and 37 third-level indicators.Conclusions The construction of the index system was guided by appropriate theoretical principles,followed scientific methodology,adhered to systematic procedures,maintained rigorous processes,and produced reliable results to promote and enhance the development and sustainability of county-level medical-preventive integration in China.

Objective To examine the variation in clearly documented assignment of departmental responsibilities for major epidemic prevention and control in the Chinese mainland before and after the outbreak of COVID-19.Methods Official policy documents related to major epidemic prevention and control issued by administrative agencies of 31 provincial level administrative divisions from 2000 through 2020 were systematically retrieved online from websites of the agencies.The extracted information on the coverage,clarification and assessability of the assigned departmental responsibilities for major epidemic prevention and control were analyzed;T-test and paired rank sum test were adopted in statistical analysis.Results Based on relevant information extracted from the 3 864 policy documents retrieved,the nationwide average proportion of the departments with officially assigned responsibility versus all departments at provincial level increased significantly from 80.93％(18.61/23.00)in 2019 to 89.62％(20.61/23.00)in 2020(P＜0.05);the average proportion of the departments with the assessable responsibility versus all departments with the assigned responsibility increased from 26.16％(4.81/18.61)to 30.93％(6.39/20.61)and the average proportion of the departments with the specified responsibility versus all departments with the assigned responsibility also increased significantly from 44.00％to 54.58％;but the average proportion of the departments with clearly specified responsibility was not significantly improved.In 2020,the nationwide average proportion of the provincial departments with officially assigned responsibility increased significantly to 87.10％and 20.97％for the professional departments and the key support departments(P＜0.05),while the proportion for other support departments was not significantly different from that in 2000.Conclusion The degree of clearly documented assignment of departmental responsibilities for major epidemic prevention and control in China has been significantly improved after the outbreak of COVID-19 epidemic but the assessability of the assigned departmental responsibilities need to be improved.

ObjectiveTo evaluate the current status of hypertension prevention and control management operation mechanisms in Chinese mainland, explore the impact of their improvement on hypertension prevention and control effects, and provide a reference for enhancing hypertension prevention and control management. MethodsPolicy documents related to hypertension prevention and control from January 1 2000 to December 31, 2018 in 31 provinces (municipalities and autonomous regions) in Chinese mainland were collected. The current status of hypertension prevention and control management operation mechanisms in Chinese mainland was systematically evaluated according to the appropriate public health system evaluation model and standard. A logistic regression model was used to analyze the impact of the improvement of management operation mechanisms on hypertension prevention and control effects. ResultsIn 2018, the appropriateness of hypertension prevention and control management operation mechanisms in Chinese mainland was 43.68%, with an increase of 21.64% compared to 2000, but there was still a gap of 48.61% from the appropriate standard. Among them, the appropriateness of coordination and incentive mechanisms was the lowest (14.03%), and the appropriateness of planning and evaluation mechanisms was the highest (63.04%). In terms of specific positioning, the coverage of medium and long-term plans (100.00%) and the completeness of content and form (94.45%) were relatively high, while the feasibility of management mechanisms was only 9.76%. The results of logistic regression analysis showed that the improvement of management operation mechanisms helped control blood pressure in hypertensive patients (OR = 1.012, P = 0.007) and maintain the stability of patients’ blood pressure (OR = 1.010, P = 0.029). Conclusion From 2000 to 2018, the construction of hypertension prevention and control management mechanisms in Chinese mainland tended to be improved, effectively promoting the improvement of hypertension prevention and control management levels. However, it is still necessary to further establish and improve coordination and incentive mechanisms and clarify the division of departmental responsibilities.

Objective To analyze changes in target setting for emergency response to major disease epidemics in China before and after the coronavirus disease 2019(COVID-19)pandemic,summarize strengths and weaknesses in target setting,and provide a basis for improving target setting for emergency response to major disease epidemics in China.Methods We systematically retrieved a total of 3 864 policy documents(including plans,laws and regulations,and work programs)related to the prevention and control of major epidemics issued by government agencies of 31 provincial-level administrative divisions(PLADs)in Chinese mainland from 2000 to 2020.Relevant target content was extracted and the degree of consistency between emergency response targets for major diseases and public demand was calculated(the newly added targets are calculated on a cumulative basis from the precious year,and no value is assigned for duplicates).Paired rank sum tests were used to statistically test for differences in indicators before and after the epidemic.Results The consistency between the overall goal of emergency response to major disease epidemics and public needs in China increased from 79.7％ by 2019(before COVID-19)to 91.3％ in by 2020(after COVID-19),with an increase of 14.6％ ,and the region-specific consistency increased from 81.2％ to 93％ for the eastern region and from 78.3％ to 90.1％ for the western region,with an increase of 14.5％ and 15.1％ ,respectively,and a significant difference between the regions(P＜0.05).National consistency between the primary prevention goal of emergency response to major disease epidemics and public needs increased from 36.9％ to 46.4％ ,with a significant difference between the periods before and after the COVID-19 epidemic(P＜0.05);there were no significant differences between periods in consistency between the secondary and tertiary prevention goals of emergency response to major disease epidemics and public needs at either the national or regional level.Conclusion Consistency between emergency response goals for major disease epidemics and public needs in China has increased,either at the national or regional level,especially for primary prevention goals.

ObjectiveTo evaluate the capacity for hypertension prevention and control and to identify strengths, shortcomings and key control points of the capacity-building in 31 provincial-level administrative divisions (PLADs) in China.MethodsPolicy documents, information reports, and research literature on hypertension prevention and control in 31 PLADs of China published from January 1995 through December 2019 were systemically collected via searching relevant websites and statistical yearbooks for evaluating on hypertension prevention and control capacity across the 31 PLADs according to the standards for appropriate public health system. Normative gap analysis was used to explore strengths and shortcomings of the capacity-building and multiple linear regression and sensitivity analysis were used to clarify key control points of the capacity-building. ResultsThe average index for the appropriateness of hypertension prevention and control capacity-building was 47.10% among 31 PLADs of China in 2019, and the average annual increasing rate of the capacity-building was 18.75% from 2000 to 2019, showing a significant upward trend (Z = 6.067, P < 0.001). The strengths of hypertension prevention and control capacity-building for the PLADs include more complete organizational structure established, comprehensive coverage of medium- and long-term plans, and sound management and monitoring mechanisms; while the shortcomings are insufficient allocation of human and financial resources and low implementation of multi-dimensional management mechanisms such as management and coordination, medium- and long-term goals and evaluation criteria. The identified key control points for the five aspects in hypertension prevention and control capacity-building are effective motivation of personnel for resource allocation, the coordination for organizational framework, the coverage of incentive measures for management mechanism, practicable assessment criteria for management process evaluation, and the balance between supply and demand of medical service for service offering, with the estimated increment of 23.14%, 66.40%, 15.77%, 23.43% and 7.06%, respectively, in the indexes for the appropriateness of the capacity-building under the conditions of the five key control points being well managed. ConclusionThe capacity for hypertension prevention and control has been improved continuously in 31 PLADs of China during 2000 – 2019 but several aspects in hypertension prevention and control capacity-building still need to be improved for the promotion of the capacity-building.

疾病是人类共同的敌人,预防疾病是保护人类健康最重要的手段和措施.建立强大的疾病预防控制体系是保护人民健康,保障国家长治久安,实现健康中国目标的基础之策.文章从六个方面全面阐述了疾病预防控制是人类健康最经济有效的保护策略,包括疾病预防控制对人群健康的影响、对经济发展的影响、对社会稳定的影响、对国家安全的影响、对国家形象的影响和产生的国际影响.文章通过大量的实证进一步阐明了疾病预防控制已成为世界范围内重大的政治问题和全人类高度关注的重大公共卫生与社会问题,中国在疾病预防控制方面为世界各国提供的成功经验和有价值的方案,为构建"人类卫生健康共同体"做出了重大贡献.

Objective To explore the advantages and disadvantages of prevention and control capability of emerging infectious diseases of Heilongjiang, and provide a scientific references for improving it. Methods Policy documents, public information reports and research literature on the prevention and control of infectious diseases were collected until December 31, 2020. Based on the evaluation criteria and models of the suitable public health system, descriptive analysis and comparative analysis were used to systematically evaluate the level of prevention and control of emerging infectious diseases in Heilongjiang. Results Since 2002, the suitable degree of prevention and control of emerging infectious diseases has increased by 163.7 %. In 2020, the suitable degree score in Heilongjiang was 748.8, which was 7.3 % lower than the national average score. In terms of factors, Heilongjiang has a good basis for controlling health risk factors, which has the highest suitable degree score（724.1）. While the lowest suitable degree score of resource allocation（403.4） requires urgent attention. Conclusion The overall capability of prevention and control of emerging infectious diseases in Heilongjiang has gradually improved, but it is still at the middle and backward level, which needs to be improved. It is suggested to focus on public health literacy, resource allocation and management and operation mechanism.

Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research， we believe that five aspects need to be prioritized for a strong system. First， we should change the perspective on public health， using the word “gonggong jiankang” to replace “gonggong weisheng” and the word “gonggong jiankang tixi” to replace “gonggong weisheng tixi”， to lead the public health system development. Second， we should develop a suitable public health system and continuously improve the health capacity for governance. Third， we should make it clear that the goal of building a strong system is not far-fetched， and we need to consolidate the existing institutional advantages of China’s public health system： when encountering major problems， we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However， we need to make up for shortcomings one by one， especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth， we should pursue excellence and consolidate the “suitable” mechanism proven in the process of coping with the COVID-19， so that efficient mechanisms to deal with major issues can be used in routine work， and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response，so as to achieve the balanced development of regions categories and units.Finally， it is necessary to strengthen the coordination of government and research institutions， in the aspects of technological innovation， talent team building and accurate consulting services， and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.

ObjectiveTo analyze the status quo and balanced development of major chronic disease service provision capabilities in the Yangtze River Delta region of China, and to provide a reference for promoting high-quality and balanced development of major chronic disease prevention and control capabilities in the region. MethodsWe retrieved documents on prevention and control of major chronic diseases published by local administrations in the Yangtze River Delta region (including Shanghai municipality and three provinces of Jiangsu, Zhejiang and Anhui) during the period from January 2009 through December 2019. Taking a page from service provision elements for an appropriate public health system, service coverage rate (SCR) and assessable service coverage rate (ASCR) were constructed for quantitative analysis on major chronic disease service provision capability of the municipality and the three provinces in the region. Coupling coordination degree model was adopted to assess the balance of the service provision capacity development in the Yangtze River Delta region. ResultsThe overall SCR and ASCR of major chronic disease service provision for the Yangtze River Delta region increased from 21.2% and 10.0% in 2009 to 82.8% and 51.5% in 2019. In the year of 2019, the prevention level-specific SCR and ASCR were the highest for tertiary prevention; the administrative division-specific SCR of tertiary prevention was the highest (96.0%) for Shanghai municipality and the lowest (71.0%) for Anhui province, while, the administrative division-specific ASCR of tertiary prevention was the highest (71.0%) for Jiangsu province and the lowest (33.0%) for Zhejiang province. The overall index value for coupling coordination degree of SCR and ASCR of the Yangtze River Delta region increased from 38.97 and 11.58 in 2009 to 90. 73 and 70.72 in 2019; the overall scores of 2019 for the balance of SCR of primary, secondary and tertiary prevention in the region were 9, 9 and 10, and the overall scores for the balance of ASCR were 7, 7 and 8 respectively. ConclusionIn the Yangtze River Delta region during the period of 2009 – 2019, the major chronic disease service provision capacity and the balance for the capacity development increased yearly; the service provision capacity was higher for tertiary prevention than that for primary and secondary prevention and the development balance was higher for SCR than that for ASCR.

ObjectiveTo analyze operational effectiveness and mechanism of management system for severe mental disorder (SMD) prevention and control in China for providing references to subsequent policy formulation. MethodsThrough searching official websites, we retrieved policy documents relevant to management on SMDs issued by governmental departments and professional institutions as of December 31, 2018 in 31 provincial-level administrative divisions (PLADs) across mainland China and analyzed the completeness and operation mechanism of the management scheme from four perspectives: management and monitoring, planning and evaluation, financing and compensation, and coordination and motivation based on evaluation standards for effectiveness of a public health system. The indicator data on management of SMD from 2014 through 2018 were also collected from National Severe Mental Disorder Information System and research literatures. The relationships between management implementation and effectiveness were analyzed using fixed effects model. ResultsFor 31 PLADs in 2018, the average appropriate degree of SMD management scheme was 43.87%, with an increment of 22.08% to that in 2014 and a gap of 48.39% to the appropriate standard (85%). The dimensional appropriate degree of the SMD management scheme was the highest (64.96%) for financing and compensation mechanism but the lowest (23.69%) for coordination and motivation mechanism. For the dimension of management and monitoring in 2018 at national level, the completeness degree of content and form was relatively high (89.29%) but the degree of clarity for responsibility assignment was relatively low (24.91%), and the degree of management procedure feasibility was only 6.48%; for the dimension of planning and evaluation, the coverage of long-term planning was as high as 96.24%. The results of fixed effect model analysis showed that after adjusting for gross domestic product, significant increase of 1.00 % for completeness of regional SMD scheme, 1.54% for average standardized management rate, and 0.28% for average regular medication of SMD patients were observed (all P < 0.05). ConclusionThe management mechanism of severe mental disorders has been steadily improved in China from 2014 to 2018; for the management scheme, the coverage of management standards and medium and long-term planning were relatively high, but the coordination and motivation mechanism and t responsibility assignment need to be improved.

Background The World Health Organization has proposed an initiative to “end tuberculosis (TB).” Unfortunately, TB continues to endanger the health of people worldwide. We investigated the impact of public health services (PHS) in China on TB incidence. In this way, we provided policy ideas for preventing the TB epidemic. Methods We used the “New Public Management Theory” to develop two indicators to quantify policy documents: multisector participation (MP) and the Assessable Public Health Service Coverage Rate (ASCR). The panel data from 31 provinces in Chinese mainland were collected from 2005 to 2019 based on 1,129 policy documents and the China Statistical Yearbook. A fixed-effect model was used to determine the impact of MP and the ASCR on TB incidence. Results From 2005 to 2019, the average MP increased from 89.25 to 97.70%, and the average ASCR increased from 53.97 to 78.40% in Chinese mainland. However, the development of ASCR between regions was not balanced, and the average level in the western region was lower than that in the eastern coastal provinces. With an increase in MP and the ASCR, the TB incidence had been decreasing gradually in recent years. The panel analysis results showed that MP (β = −0.76, p < 0.05). and ASCR (β = −0.40, p < 0.01) had a negative effect on TB incidence, respectively. Even if the control variables were added, the negative effects of MP (β = −0.86, p < 0.05) and ASCR (β = −0.35, p < 0.01) were still statistically significant. Conclusions Promoting the participation of multiple departments, as well as emphasizing the quality of PHS delivery, are important ways to alleviate the TB epidemic. The settings of evaluation indices for PHS provision should be strengthened in the future.

ObjectiveTo analyze current situation, development trend and regional disparity about effective utilization of infectious disease surveillance system and the effect of the utilization on infectious disease prevention and control in China. MethodsRelevant literatures and reports on infectious disease risk monitoring and early warning issued during 2004 – 2019 by infectious disease surveillance system in 31 provincial-level administrative divisions in China were systemically retrieved through searching websites of governmental agencies, professional organizations, China National Knowledge Infrastructure and Web of Science. The data on infectious disease incidence were extracted from China Health Statistics Yearbook for years from 2005 to 2020. The information collected were quantitatively analyzed to assess effective utilization of the infectious disease monitoring system. Spearman correlation and linear regression were adopted to explore the association of effective utilization of surveillance systems and infectious disease morbidity. ResultsThe average index for countrywide effective utilization of infectious disease surveillance system was 9.64% in 2019, with an increment of 1 338.81% compared with that in 2004; the average index for eastern region was relatively higher (11.73%) than that for other regions of China. Correlation and regression analysis showed that there was a reverse correlation between the effective utilization of infectious disease surveillance system and the incidence of infectious diseases at regional and national level, with the nationwide correlation coefficient of − 0.88 (P < 0.01) and standardized regression coefficient of − 6.87 (P < 0.001). ConclusionThe utilization of infectious disease surveillance system has been improved steadily during 2004 – 2019 in China, but regional difference for the utilization still exists and continuous efforts should be made for effective utilization of the surveillance system.

Background Creating an enabling environment (EE) can help foster the development and health of children. The Chinese government implemented a new health care reform (NHR) in 2009 in a move to promote an EE for health. The purpose of this study was to evaluate the impact of the NHR on EE for children's health. Methods An interrupted time-series analysis was used to evaluate the changes in the EE before and after 2009 in China. This study analysed the EE through five quantitative indicators, including policy element coverage rate (PECR), service meeting with children's needs rate (SMCNR), multisector participation rate (MPR), and accountability mechanism clarity rate (AMCR), based on the content analysis of available public policy documents (updated as of 2019) from 31 provinces in mainland China, and the number of health care personnel of maternity and child care centres per 10 000 population (HP per 10000 population), based on the 2002-2019 China Health Statistical Yearbook and China Statistical Yearbook. Results The average values of PECR, SMCNR, and MPR increased rapidly to 90.96%, 82.46%, and 81.31%, respectively, in 2019, representing a higher value compared to the AMCR (7.38%). The NHR promoted the EE, in which HP per 10000 population showed the fastest increase (beta(1) =0.03, P< 0.01; beta(3) =0.10, P<0.01), followed by SMCNR (beta(1) =0.94, P<0.01; beta(3) =1.83, P<0.01), AMCR (beta(1) =0.13, P<0.01; beta(3) =0.24, P=0.14), MPR (beta(1) =1.35, P<0.01; beta(3) =2.47, P<0.01) and PECR (beta(1) =1.43, P<0.01; beta(3) =1.47, P<0.01). Conclusions The NHR has a positive impact on the EE, especially on the human resources and service provision for children. Efforts should be intensified to improve the clarity of the accountability mechanism of the health-related sectors.

Purpose The purpose of this study is to explore the competitive source of Chinese firms in an industrial sector of complex product systems. It helps to reveal the organizational innovation developed by Chinese firms in coping with international competition and technological challenges. Design/methodology/approach The study uses a qualitative method of research. The evidences are mainly collected through interviews, field observation and document analysis. Findings A pattern of engineer-centered organization is the source of competitiveness of Nanrui (NR) Electric (NREC) in this study. The firm equips its front project teams, and now its overseas branches with developmental human resources and authorizes them the power of decision-making to leverage R&D projects. It is an emerging challenge to the traditional multi-national companies (MNC) pattern, and enables the Chinese firms to build their capabilities on context-based knowledge. Research limitations/implications As a single-case study paper, there are limitations about the external validity of its argument. Through the in-depth discussion of the NREC case, this paper aims to generate some clues for future study in the relevant academic community, which can be a useful step to formal theorizing and modeling. That is why the authors develop the paper on a single case. As future directions of research, comparative studies covering more cases not only within the power system control and protection industry but also among different complex technology products industrial sectors are really needed. Practical implications For innovative firms from developing countries like China, they need to develop institutional arrangements to incentivize engineers in the frontline, which may help them to build competence upon successful interaction with customers. During the era of globalization, such a pattern may generate special competitiveness over giant multi-nationals or global production networks (GPNs). Originality/value The research provides an instructive case on the Chinese rise in industrial sectors of complex product systems. Its findings can not only provide enlightenment for industrial catch-up in developing countries through organizational innovation but also help to initiate a reconsideration of the traditional theorizing of MNC and GPN.