To develop an index system to assess the functioning of community (village) health committees and test its applicability through a pilot assessment.

A preliminary evaluation index system for community (village) public health committees was developed based on literature review and group discussions. A two-round Delphi expert consultation was conducted with 26 experts in relevant fields. The analytical hierarchy process was used to determine the weights of the indicators at different levels. Ten community/village public health committees from one of the four districts with different levels of economic development in Guangzhou city were selected by stratified random sampling for a questionnaire survey to evaluate the reliability and validity of the constructed index system.

For the two rounds of expert consultation, the positive coefficients were 100% and 92.3%, the authority coefficients were 0.83 and 0.85, and the Kendall′s W coefficients of expert′s opinions were 0.46 and 0.54 (both P<0.05), respectively. The coefficients of variation of the included indicators were 0.08–0.32 and 0.07–0.23, respectively, indicating good agreement among the experts. After two rounds of consultations, an index system for evaluating the functioning of community (village) health committees was developed, consisting of four primary indicators related to mechanism establishment, organizational guarantee, service delivery and management, and operational effectiveness, as well as 14 secondary indicators and 33 tertiary indicators. The combined weights ranged from 0.121 to 0.417 for the primary indicators, 0.016 to 0.163 for the secondary indicators, and 0.009 to 0.072 for the tertiary indicators. Analysis of data from a sample survey of 40 community (village) health committees showed that the established index system could effectively differentiate the functional levels of different committees, and the reliability and validity of the index system were good (Cronbach′s alpha was 0.864, and the cumulative variance contribution rate of common factors reached 87.721%).

The constructed three-level index system for evaluating community (village) public health committees passed the Kendall′s W coefficient and coefficient of variation tests, and the pilot evaluation showed good reliability and validity of the index system, which can provide a reference for relevant departments to improve relevant policies and conduct evaluations.