Policy Document Analysis of China's Primary-level Public Health Governance System：a Case Study of the Public Health Committee 后印本

Abstract: Background In China，the governance of public health by the public health committee，a grassroots mass autonomous organization，is a new approach managing public health services in primary care. Many regions are exploring governance models of public health by the public health committee，aiming to make it a key hub to realize the vertical connection and horizontal linkage grid management of grassroots communities. Objective To analyze the policy documents related to the construction of local public health committees of various regions in China using policy document analysis，so as to provide a reference for improving the primary-level public health governance system and governance capacity. Methods In March 2022，we searched policy documents related to the construction of public health committees on the official websites of the local governments and health commissions of eight sample regions（Beijing，Guangdong，Chongqing，Shandong，Anhui，Guizhou，Gansu，and Ningxia Hui Autonomous Region） in which village（residential） public health committees have been constructed using "public health committee" as the key search term. Through literature review and policy document analysis，an analytical framework for the governance system of the public health committee was constructed. Nvivo 11 plus was used for word frequency and coding analyses of the included policy literature. Results A total of 15 policy documents and 2 guidance manuals for the work of public health committees were ultimately included. Word frequency analysis showed that the five words，"hygiene" "public" "work" "committee" and "health"，appeared most frequently，indicating that the selected policy literature conformed to the research theme. By using the analytical framework，the st6ructural dimensions of the policy literature were determined，including four root nodes，namely，governance subjects，governance mechanisms，institutional guarantees，and capacity building，and 13 sub-nodes. There are 208 reference points for governance subjects，48 reference points for governance mechanisms，57 reference points for institutional guarantees，and 87 reference points for capacity building. Conclusion The local policy documents of the sample regions cover the contents of the four dimensions，but have different focuses. According to the framework in this study，further construction of the public health committee needs to set certain admission criteria with clear determination of rights and responsibilities for new committee members，establish an effective cooperation and communication mechanism，improve the system guarantee and provide financial and technical support.