The Three Networks Framework to Deal with Public Health Emergencies in Guangxi, China

By Wen-kui, Geng; Jia-tong, Zhuo et al. | Canadian Journal of Public Health, September/October 2006 | Go to article overview

The Three Networks Framework to Deal with Public Health Emergencies in Guangxi, China


Wen-kui, Geng, Jia-tong, Zhuo, De-cheng, Liu, Yan-xia, Huang, et al., Canadian Journal of Public Health


ABSTRACT

Objective: To improve the detection and control of infectious diseases in Guangxi, China.

Setting/Participants: Guangxi province in southwest China has almost 50 million people, of whom approximately 30% reside in urban and 70% in rural areas. There are 12 minority nationality groups living in the region.

Intervention: A village doctor reports any infectious disease outbreak to the Reporting Network, which notifies the Service Network to organize the clinical response. This is supported by the Government Network that coordinates the response among the multiple layers of local governments.

Outcomes: Since 2002 when the Three Networks system was first started, the time from incidence to report has been shortened on average from 30.6 to 7.6 days and the number of cases has increased from slightly less than 5,000 cases/year (4,965) to almost 10,000 cases/year (9,873). Average mortality has decreased from 3.23% to 0.74%. The Three Networks system has been successful in controlling measles outbreaks; and during SARS, when 11 cases came to Guangxi from the neighbouring Guangdong province, there were only 11 additional new cases with no community spread and no spread to medical staff.

Conclusion: The Three Networks system has played an important role in infectious disease prevention and control in Guangxi province, and may be applicable to other areas with a similar situation.

MeSH terms: Public Health; community network; emergency; China

Guangxi Zhuang Autonomous Region is a mountainous province in the southwest of China. It has a total population of almost 50 million people with about 30% of the population in urban areas and almost 70% in rural areas. There are 12 minority nationality groups living in the region.

Public health emergencies are unexpected events and include such things as a serious infectious disease, unidentifiable disease, mass food and occupational poisoning or contamination of the water supply.1 Public health emergencies are typically widespread and complicated and pose a serious threat to people's health and safety. Public health emergencies have occurred frequently in Guangxi in recent years. To increase our preparedness and response capacity, we developed a public health emergency network in 2001. This included a government network, a reporting network, and a service network.2

The "Three Networks" system

To understand the framework, it is important to understand that in China, multiple villages form a county; multiple counties form a township; multiple townships form a city; and multiple cities form a province. Thus, there are multiple layers of local government, starting at the county level. Most villages in Guangxi, one province in China, have a village doctor who visits each family once a month.

The Government Network

This network includes the local governments of the province, cities, townships, and counties. It includes departments of health, finance, public security, industry and commerce, agriculture, civil affairs, and broadcast and television. It determines the responsibilities and roles of governments and departments during a public health emergency. Different levels of local governments are responsible to lead the public health emergency in their administrative territories, to establish a leadership team of the "Three Networks", and to ensure sufficient resources for the emergency. As a base, the provincial government should invest at least 1 million RMB yuan (CAN $144 thousand) each year. Moreover, it is also responsible for organizing meetings using video and telecommunication technology, making policies, taking measures, coordinating different departments, and coordinating the emergency management in the province. The government of the city, the county and the township should invest at least 100,000 RMB yuan (CAN $14.4 thousand), 50,000 RMB yuan (CAN $7.2 thousand), and 10,000 RMB yuan (CAN $1. …

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