Barriers and Facilitators to Implementing the National Patient Safety Implementation Framework in Public Health Facilities in Tamil Nadu: A Qualitative Study

Improving primary healthcare quality in China through training needs analysis

The diagnosis and treatment capability levels of healthcare professionals directly affect the overall quality of medical services. Enhancing these capability levels requires strengthening the professional skill training of healthcare workers, especially those in primary care settings in economically underdeveloped areas. To understand the actual needs for professional skill training among primary healthcare workers, thereby providing data support for targeted training initiatives. An online survey was conducted using convenience sampling and subsequently, snowball sampling from May 10, 2023 to January 31, 2024. The survey included 3811 healthcare workers across China, and 3617 valid questionnaires were recovered. Descriptive analysis was used to compare the professional backgrounds and training needs of healthcare workers at different medical facility levels. Univariate and multivariate logistic regression analyses were employed to explore factors influencing the training of primary healthcare workers. The survey revealed that 70.1% of respondents were female, and 94.2% were from medical facilities below the provincial level, with 43.2% from township-level or lower medical facilities. Significant differences were found in age distribution, work experience, professional titles, educational levels, and training needs among provincial/national, prefectural/county, and township levels (P < 0.05). Busy clinical work schedules were the primary barrier to training participation. Most healthcare workers (78.7%) expected more than four training sessions per year, with the optimal frequency being quarterly. The most anticipated training topics among primary care workers were latest medical guidelines, new technologies/skills, and advanced management concepts, with over 80% interest. Compared with prefectural/county-level facilities, primary care workers at grassroots facilities are more significantly impacted by lower professional titles, lower education levels, weaker medical/technical skills, and insufficient specialized funding (odds ratio > 1, P < 0.001). Training should be tailored to the needs of healthcare workers at different medical facility levels. Particularly for primary care settings, providing special funding support and training in the latest medical guidelines, new technologies/skills, and advanced management concepts are important to improve the composition of titles, education, and professional technicians.