Objective: To assess the policies and programs on the capacity of prevention and control regarding non-communicable diseases (NCDs) at the Centers for Disease Control and Prevention (CDCs) at all levels and grass roots health care institutions, in China.
Methods: On-line questionnaire survey was adopted by 3 352 CDCs at provincial, city and county levels and 1 200 grass roots health care institutions.
Results: 1) On policies: 75.0% of the provincial governments provided special funding for chronic disease prevention and control, whereas 19.7% city government and 11.3% county government did so. 2) Infrastructure:only 7.1% county level CDCs reported having a department taking care of NCD prevention and control. 8 263 staff members worked on NCDs prevention and control, accounting for 4.2% of all the CDCs' personnel. 40.2% CDCs had special funding used for NCDs prevention and control. 3)Capacity on training and guidance:among all the CDCs, 96.9% at provincial level, 50.3% at city level and 42.1% at county level had organized training on NCDs prevention and control. Only 48.3% of the CDCs at county level provided technical guidance for grass-roots health care institutions. 4) Capacities regarding cooperation and participation: 20.2% of the CDCs had experience in collaborating with mass media. 5) Surveillance capacity: 64.6% of the CDCs at county level implemented death registration, compare to less than 30.0% of CDCs at county level implemented surveillance programs on major NCDs and related risk factors. In the grass roots health care institutions, 18.6% implemented new stroke case reporting system but only 3.0% implemented program on myocardial infarction case reporting. 6) Intervention and management capacity: 36.1% and 32.2% of the CDCs conducted individualized intervention on hypertension and diabetes, while less than another 20% intervened into other NCDs and risk factors. More than 50% of the grass roots health care institutions carried follow-up survey on hypertension and diabetes. Rates on hypertension and diabetes patient management were 12.0% and 7.9% , with rates on standard management as 73.8% and 80.1% and on control as 48.7% and 50.0%, respectively. 7) Capacity on Assessment: 13.3% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs in their respective jurisdiction. 8) On scientific research: the capacity on scientific research among provincial CDCs was apparently higher than that at the city or county level CDCs.
Conclusion: Policies for NCDs prevention and control need to be improved. We noticed that there had been a huge gap between county level and provincial/city level CDCs on capacities related to NCDs prevention and control. At the grass-roots health care institutions, both prevention and control programs on chronic diseases did not seem to be effective.