Establishing Post Competency Indicator System for Staff of Grassroots Center for Disease Prevention and Control in China

With the economic and social development, the public’s demand for public health services has increased in China, and the functions of the Center for Disease Control and Prevention have also been transformed. While most Centers for Disease Control and Prevention currently have some degree of reform in their staffing and distribution systems, there have been few changes in the appointment and selection of their staff. Through literature review, this article will demonstrate the importance of establishing the scientific and effective competency indicator system for grassroots public health practitioners, so as to provide reference for human resource management of district and county level CDC.


Introduction
The Center for Disease Control and Prevention (CDC) is the main body of China's public health system, especially the district-and county-level Center for there is no scientific experience to follow, let alone a systematic way to promote it [2]. In the grassroots CDC, the rational allocation of human resources not only affects the smooth realization of disease prevention and control measures, but also the basic conditions for the sustainable development of public health.
Therefore, this article will explain the importance of establishing the post competency indicator system for staff engaged in grassroots disease prevention and control work in China through literature review, with the purpose of providing a new means for human resource management and talent team construction of grassroots CDC.

Research Methods
The literature review was carried out through scientific databases, including  [4], such as imperfect public health policy system, insufficient government financial input, unbalanced allocation of health resources, and insufficient government attention to public health [5]. These prob- services, but also cause many adverse effects on the construction of talent team of grassroots CDC, For example, the staffing of departments is unstable, the mobility of personnel is increasing, the distribution between regions is large, and the quality of the staff is low, etc. [6]. Through literature research, it is found that human resource management in China's district and county level Centers for Disease Control and Prevention currently faces several problems. First, the total amount of human resources is insufficient and the turnover rate of personnel is high. By the end of 2013, the total number of personnel in China's CDC was 194,371, accounting for only 2.1% of the total number of people in all health care institutions [7]. From 2010 to 2014, the total number of people in the CDC has decreased year by year [8]. However, during the same period, the total number of health workers nationwide increased from 8,207,500 to 1,023,400 [2]. And the CDC suffers from serious staff turnover in China. The average annual outflow rate of county-level CDC personnel in China from 2012 to 2015 was as high as 2.27% [9]. The outflow of personnel is mainly the outflow of professional and technical personnel, and the management personnel flow in. At present, China has a high incidence of public health emergencies and emerging infectious diseases. And the grassroots CDC is responsible for many tasks such as health checkup, planned immunization, and disease surveillance. Therefore, the shortage of human resources will seriously affect the development of grassroots public health services in China. Second, the staffing structure of CDC has improved, but the aging trend is still very serious. Some studies have shown that the education level, professional title ratio and comprehensive quality of human resources in CDC have been improved, but the proportion of postgraduates with high academic degrees is still low. The county-level CDC is mainly based on undergraduate and junior college degrees [10]. In addition, Hu longjun et al. surveyed 257 county-level CDC in 9 provinces of China, and found that in the CDC, people aged 30 -35 accounted for the most. The proportion of people under 35 years old has been declining, while the proportion of people between 35 and 50 years old and over 50 years old has been increasing year by year [11], which indicates that China's county-level CDC has an aging trend, and the sustainable development of human resources has been greatly challenged. Third, there is a shortage of professional and technical personnel. The government stipulates that the professional and technical personnel of China's CDC should not be less than 85% of the total amount, and the health technicians must not be less than 70% [12]. In 2015, a survey by Chinese National Health Commission on 31 provincial-level CDC found that only 17 provinces have more than 85 percent of the professional and technical personnel, and only 24 provinces have 70 percent of the health technical personnel [13]. From 2016 to 2017, the professional and technical personnel of CDC accounted for 82.05% and 82.22% respectively, and the health technicians accounted for 74.34% and 74.51% respectively [14]. The proportion of health technicians is up to standard, while the proportion of professional and DOI: 10.4236/jss.2019.710024 294 Open Journal of Social Sciences technical personnel is not up to standard. Fourth, the regional distribution of human resources is unbalanced. The number of CDC institutions in the eastern region is higher than that in the western region [7]. In the central and western regions, especially at the grassroots CDC, the total number of personnel is small, low educational background, low professional title, serious aging, lack of public health professionals and other problems are more common [15]. Although the country has taken some measures in recent years to strengthen the capacity building of disease control system in the western region, and some achievements have been made, the development of the western region is still slow, and there is still a big gap between the eastern and western provinces. Therefore, the Chinese government proposed in the document "medium-and long-term talent development plan for medicine and health (2011-2020)" that it should strengthen the management of public health talent team [16], especially improve the staff management and team building of grassroots centers for disease control and prevention.

What Is the Post Competency and Its Function
Competency is the knowledge, skill, ability, trait or motivation that connects people directly or indirectly to work or work performance or other important outcomes in life. It can be reliably measured or counted, and can clearly distinguish excellent performance and general performance. In 1973, proposed by David M. [17]. He believes that academic performance and intelligence can't predict a person's career or life achievement. Those who are good at work are because they have self-discipline, initiative, responsibility and other quality and behavioral characteristics, which make them achieve excellent achievements. Therefore, he proposed the post competency model method, recommended the use of competency to test the staff, and search for the key qualities and ability characteristics of the outstanding employees. Competency model refers to the integration of competency for a specific role and specific performance requirements (knowledge, skills, motivation, traits and self-concept), it can specify what knowledge, skills, abilities and qualities are required to meet the responsibilities of the position [18]. The competency model not only improves the working level of a specific position, but also be used for employee selection, training, and performance evaluation, etc. It is considered as a universal tool of human resource management. Research shows that the following three important characteristics of competency are recognized by experts [19]. According to the correlation analysis of human quality and disease prevention and control work completion degree [21], it is found that workers with high quality have higher work completion degree, while those with low quality have lower work completion degree. However, in the past, the management and selec-

Common Methods for Establishing Competency Model
There are many ways to establish a job competency model at home and abroad.

Competency Research Is Widely Used in Society
Since competency model for HR [25]. However, China did not begin to pay attention to competency until the 1990s. The research is still in its infancy [26], but the research on competency is paying more and more attention. In terms of research scope, it is focus on the human resources management system such as senior managers, marketing personnel and technical personnel of the company.

Competency Research in the Health Care System
Now, competency research has gradually entered the field of Clinical Medicine and Public Health. NHCL has established NCHL competency model for the managers of American health care institutions [27]. In 2010, the United States conducted a study on the competency characteristics of occupational health nurses [28]. Research on China's health care system competency can be traced back to 2001. Although the current research on competence in the medical field is still in its infancy, in recent years, the application of competency models in the Chinese medical field has become more and more extensive, mainly focusing on the executives of medical institutions [29], clinicians [30] and nursing staff [31]. At present, China's grassroots teaching base at the general practitioners has used the basic characteristics of general practitioners' competence established by the World Family Doctors Organization (WONCA) in Europe in 2005, which provides good advice for the general practitioner's diagnosis, treatment and community teaching [32]. In addition, competency research was introduced in the maternity and gynaecology nurse in China, and the Exploratory Factor Analysis (EAF) method was used to establish the competency model of obstetric nurses, which provided a scientific basis for their selection and evaluation [33].

Research of Post Competency Model in Public Health
The research on the post competency model in the field of public health is very mature abroad, and it is very useful for the study of the competency model of Health Doctors through Delphi method and expert group scoring method, which includes 54 competency characteristics in 5 disciplines [37]. In the same year, the European Public Health Association (ASPHER) also established a doctoral competency model for public health, with seven categories [38]. These studies have received wide attention from peers. In 2009, some experts in China proposed to introduce the post competency model into the human resources management of the CDC [39]. In recent years, many Chinese experts and scholars have devoted themselves to the study of the competency in the field of public health. They respectively established the competency models for the emergency response personnel in public health emergencies [40], director of the Center for Disease Control and Prevention [41], and public health physician [23]. In particular, Chang Wenjuan et al. [23]

Conclusion
In summary, the reform of human resources management in China's grassroots CDC is imminent, and the research on post competency is very extensive and widely used at home and abroad. Therefore, it is of great significance to introduce the post competency model into the reform of human resource management in China's grassroots CDC. Establishing the competency indicator system for the practitioners who engaged in the public health work at the district and county level CDC in China, which can not only clarify the knowledge and skills required by the staff to be competent for the essential public health service, but also clarify the internal qualities that the practitioners need in the grass-roots disease control work, and it will be helpful to the talent recruitment training and management of grassroots CDC.