Performance evaluation in the primary public health service

In order to industriously monitor and assess local health departments, the Taiwan Department of Health (DOH) determines its performance evaluation criteria and conducts evaluation on site yearly. However, complicated evaluation details and multiple visits by various divisions of DOH have caused local agencies to invest excessive time and effort simply to meet the requirements. To simplify the system and process, DOH in 2002 consolidated the performance evaluation plans of its 10 divisions into one unified, comprehensive system with three major categories: national health policy implementation, local agency-initiated projects, public health involvement and reflection of public opinion. DOH also gradually and consistently re-evaluate the appropriateness of the new criteria while considering current health policy priorities of the year to better reflect local agencies' effectiveness in promoting and implementing public health tasks.

With the reform, the contents of the performance index were reduced from 472 items in 2003 to 67 in 2007 with an emphasis on quantitative indicators. Yet during this process, DOH has faced some challenges: inconsistent goals and demands towards performance evaluation restructuring posed by different divisions, disagreements in the new items and standards, regional differences that lead to difficulty utilizing a single evaluation system, and the occurrences of some duplicating assessments by various supervising agencies. This year, DOH again is reviewing its performance management system and transforming the structure into three independent focuses: disease prevention and protection, food and drug protection, and medical care. Evaluations will be conducted separately and then integrated for specific affairs.