Main themes

Supporting quotes

General perspectives of service providers

“Our screening process is in many instances limited by manpower and location.’’

“Aside from physicians, the vast majority of medical providers are contractors, meaning that we lack job security and salary requirements. This has also caused many of our colleagues to leave in search of more stable, long-term employment.’’

“Our program employs temps and interns from various industries who are not familiar with the service workflow of the program, leading to difficulties such as confusing the on-site screening process and giving the wrong instructions.’’

“We spend too much time waiting in line, and the entire process also takes too long.’’

Shortage of health care providers

“When we are understaffed, the program coordinator hires interns and temporary staff to make up the difference. However, the temporary staff (including the interns) does not fully understand the program, so we must spend time every week training them and correcting

their mistakes.’’

“The most common complaint from screening participants is long wait times, which is related to the screening experience. We believe that training for full-time and temporary staff and the entire workflow need improvement.’’

Lack of recall system

‘’I believe that most people are unwilling to answer phone calls from an unknown number for fear of being defrauded. At the same time, elderly people residing in rural areas seldom use mobile phones.’’

Biased registration mechanism

“Several residents mentioned the village representative as the reason for their inability to register for and participate in their community’s medical screenings: the village representative limits the screening quota to his friends and family even though it infringes on the rights of other locals.’’

“Every year we receive complaints by phone about the village representative monopolizing registration mechanics, resulting in service gaps.’’

Rural-urban disparity in health care services

“Provided services are usually limited by provider availability and the township screening site. Every year, participants ask if we will provide X-rays, ultrasound, and bone density exams (and often, we cannot).’’

“When residents learn that we cannot provide ultrasounds, they disappointedly tell us that without advanced equipment the screening cannot be called a comprehensive health checkup.’’

“In the course of my work, about half of women have asked why we do not provide pap smears? This is difficult to answer because we do not have a gynecologist.’’

Low education level and rurality

“On the whole, the participants are mostly elderly living in rural areas. According to my observations, the general education level of the elderly in the rural areas is low, and some of the participants seem to believe that the services we provide are not beneficial and make them feel uncomfortable. For example, most of the elderly only speak the Southern Min dialect, and communication barriers often leave them feeling lost.’’

“I believe a majority of participants, especially the elderly living in rural areas, trust and depend on us. At the same time, the majority of the elderly population, particularly the illiterate, remains uneducated about health. This is why it is difficult to adhere to the screening process, an indicator that we need additional assistance. Also, the more elderly in the screening area, the more time and manpower.”