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Archives of Disease in Childhood 新千年发展目标时代中国儿童健康

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ChildhealthinChinaintheMillenniumDevelopmentGoalera

BoSun,1KunLiang,2BinYi,3LiZhang4

1LaboratoryofNeonatal

MedicineofNationalHealthandFamilyPlanningCommission,DepartmentsofPediatricsandNeonatology,Children’sHospitalofFudanUniversity,Shanghai,China2DepartmentsofPediatricsand

Neonatology,FirstHospitalofKunmingMedicalUniversity,Kunming,Yunnan,China3DepartmentofNeonatology,

GansuProvincialWomenandChildren’sHospital(GansuProvincialMaternityHospital),Lanzhou,Gansu,China4DepartmentofNeonatology,

NorthwestWomenandChildren’sHospital(ShaanxiProvincialMaternityHospital),Xi’an,Shaanxi,China

CorrespondencetoProfessorBoSun,DepartmentsofPediatricsandNeonatology,Children’sHospitalofFudanUniversity,andtheLaboratoryofNeonatalMedicineofNationalHealthandFamilyPlanningCommission,Shanghai201102,China;bsun@shmu.edu.cn

Received27August2014Revised3September2014Accepted4September2014

Tocite:SunB,LiangK,YiB,etal.ArchDisChild2015;100(Suppl1):s61–s62.

TheMillenniumDevelopmentalGoal(MDG)4,initiatedin1990aimingtoreducemortalityofchil-drenunder5yearsofage(U5M)bytwo-thirdin2015,wasachievedinChinatoanaveragelevellowerthan15/1000in20121–3(table1).Given

China’ssize(1.34billionpopulationwith16milliondeliveriesannually),thismilestonehasworldwideimplications.Thismilestonewasachievedthroughacombinationofefforts:social,economic,governmen-talandmedical.4Overthetwoandhalfdecades,

U5MhasundergonethreephasesofdramaticchangesinChina.First,thereductionofdiarrhoeaandpneumoniaoccurredbetween1990and1999asaresultofenhancedpublichealthpolicyineffectandlivingstandardimprovementwhenChinawasintransitionfromalow-incomecountrytowardsalow-to-middle-incomedevelopingcountry,accountedforbyimprovedpublichealthcaresystemthroughvaccinationininfancyandchildhood,housingandwatersupply,sanitationandessentialhealthcare.Anotherprominentadvancewassignificantreductionofmaternalandinfantmortalitybetween2000and2008,34achievedbyprenatalmonitoringofhigh-riskpregnancycomplicationandin-hospitaldelivery,byeradicationofneonataltetanusandalleviationofbirthasphyxiaandbypreventionandtreatmentofvariousneonataldiseases,includingprenataldiagnosisandneonatalsurgery.Ingeneral,inthisperiod,therewasrapidurbanisationsothatmaternalandinfanthealthcarewasmoreefficientthanthatinruralareasineachprovinceuntil2010whenurbanresidentsexceeded50%ofthetotalpopulation.Moreverypreterminfantssurvivedfromperinatalrisks,5anddisparitiesofmaternalandneonatalmortalitiesbetweenruralandurbanregionswerenarrowedfrom4–5timesto1–2times(table1),indicatingtheeffectivenessofsus-tainedpoliciesandprogrammeenforcement.Finally,in2009–2014,therewasanintroductionofwidelyestablishedhealthcaresystem,especiallyfornationwideruralresidentssubjectedtoNewRuralCooperativeMedicalSchemetotackleavail-abilityandaffordabilityofhealthcareinneonate,infantandchildhoodinlow-economicdevelop-mentprovincesandregions.1Thisuniversalhealth-careinsurancepolicyisbasedonvoluntaryparticipationforallruralfamiliesandindividualsthroughpaymentofpremiumtoachieveanaverageof300–350ChineseYuan(CNY)peryearperhead,andnationalandprovincialgovernmentfinancewillcover80%–85%ofit.Thispoolofhealthinsurancecollectedisintegratedtocovercostsonstratifiedtotalsumandhospitalservicelevels,reimbursingupto70%–80%ofthetotalpatienthospitalisedcarecosts,equivalentto4–6timesofthelocalruralfamilyannualtotalincome.Upto2013,alltheprovincesandmostoftheruralresidentswereenrolledandsubjectedtothisinsur-ance.Adjustmentswerealsomadetoenablethosetreatedbyprovincialpublichealthcareservicesatnon-residentregistryareaoreligibletospecialther-apiesforsevereandchronicdiseasestomaximisethebenefitfortheruralparticipants.Fornewborninfants,theirhospitalisedcostsarecoveredwiththeirmaternalinsuranceforupto50%ofthetotalsum.Incontrasttothecauseofdeathofneonatesandpostneonatalinfancy,theleadingcauseofU5Misassociatedwithpulmonaryinfection(pneumonia)andsepsis,butunexpectedasphyxia,trafficacci-dent,neardrowning,traumaandcausesotherthaninfectiontendedtobecomemajoronesimpactingonpaediatricemergencyandintensivecare.Congenitalheartdisease,tumourandmalignancy,congenitalmalformationandgeneticallyinheritedmetabolicdisorders,andtransmissibleviralinfec-tionremainimportantmorbiditiescontributingtoU5M,whichpromotedestablishmentandimprove-mentofpaediatricsurgicalandpaediatriccriticalcareinalmostallprovincialandmostsubprovincialcentralhospitals.Thiswasinitiatedbynationalandprovincialspecialfunds-basedprogrammestoeachcountygeneralormaternityhospitalsofmidlandandwestprovincestoupgradetheirpaediatriccrit-icalcareservicestandardthatmayserveforunex-pectedeventsofpandemicsofseveresystemicandrespiratoryviralinfectiousdiseasesandaccidentaltraumatichazardinchildren,inadditiontodailycareofneonatalandinfantemergencyneeds.Now,challengesforthepost-MDG4erawillbethegoaloftheso-called‘womenandchildren’shealthcareplan’,mainlyatprovincialandsubpro-vinciallevelsbyintegratedeffortsfrompublichealthandclinicalmedicalcare,socialdevelopmentandplanning,financeandsocialwelfareaspects,executedbytheofficefromprovincialcommissionofhealthandfamilyplanning(formerprovincialdepartmentofhealth)anditssubsidiariesatsub-provincial(cityandregional)andcountylevels.Theyear2014isalsodesignatedas‘theyearforwomenandchildren’shealthcareservice’bytheNationalHealthandFamilyPlanningCommission1

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出生太早 - WHO World Health Organization

出生太早 - WHO World Health Organization


东南亚 和大洋洲
n=11,200 13.5%
非洲撒 哈拉以 南国家
n=32,100 12.3%
南亚
n=38,700 13.3%
来源：Blencowe et al 2012
早产主要数据信息：
··每 年 有 1500万 婴 儿 过 早 出生，且该数据还在上升
··每 年 有 1 1 0 万 的 新 生 儿 死 于早产并发症
··不解决早产问题，就无法到2015年实现在儿童存活和健康 领域的全球进展目标。
··在妇女及孕产妇的健康和卫生保健领域进行投资，可减少 死胎率，并增进妇女和新生儿（尤其是早产儿）的健康。
必须强化对早产的预防
··开展计划生育，增强妇女尤其是少女的地位，并提高孕 前、孕期和两次怀孕之间的保健，有助于降低早产率。
1
信息要点
每年有１５００万儿童过早出生
··全球早产儿的数目占出生婴儿总数的十分之一以上，无数 家庭受到影响。
··一百多万早产儿死于早产并发症，许多存活下来的孩子也 终生面临残疾，包括学习困难或听视觉疾患。
早产发生率在上升
··有非常可靠的数据显示早产发生率在几乎所有国家呈现 增长趋势。
··早产是导致出生后四周内新生儿死亡的首要原因，亦是继 肺炎后造成五岁以下儿童死亡的第二大原因。
摄影： Michael Bisceglie/解救儿童
3
在有可靠趋势数据的65个国家中，62个国家过去20年早产率 升高。导致升高的可能原因包括，衡量工作的改进，健康状 况的改善，孕产妇年龄的增大，或孕产妇有其他疾患，如糖 尿病和高血压等，越来越多的辅助生育导致多胎妊娠，以及 产科做法的改变（例如未足月破宫产数目增加）等。
60%以上的早产发生在非洲和南亚（图1）。巴西、美国、 印度和尼日利亚位于早产率最高的10个国家之列，这说明 早产实际上是一个全球性问题。在早产率〉15％的11个国 家中，9个是撒哈拉以南非洲国家（图2）。低收入国家平 均早产率（12%）高于高收入国家（9%）。在一国内部，贫 困家庭面临较高风险。
健康和疾病的发育起源

健康和疾病的发育起源

健康和疾病的发育起源作者：李君李婷来源：《上海医药》2013年第06期摘要 20世纪90年代，基于临床流行病学的一些发现，英国学者David Barker教授最早提出健康和疾病的发育起源这一概念。

目前发现，几乎所有的成人慢性疾病，例如代谢性疾病、心血管疾病、肿瘤等都与发育早期的环境有关。

这个假说得到了大量临床流行病学和动物实验等基础研究的证实。

它的意义在于，在临床上，有这样一个“窗口期”，通过合理的规范孕妇的营养和行为，以及合理的出生后早期营养，能够避免胎儿和婴儿暴露于不良的环境中，从而降低他们成年后发生慢性疾病的风险。

因此健康和疾病的发育起源这一概念有现实的临床意义。

关键词健康和疾病发育起源孕产妇中图分类号：R71 文献标识码：C 文章编号：1006-1533（2013）06-0016-05Health and developmental origins of diseaseLI Jun， LI Ting（First Maternity and Infant Health Care Hospital of Tongji University， Shanghai 200040，China）ABSTRACT Based on some findings of clinical epidemiology， the British professor David Barker proposed the concept of the developmental origins of health and disease （DOHaD） in the 1990s. Almost all the chronic diseases， such as metabolic diseases， cardiovascular diseases，cancers， are proved to be related with the early stage of development. DOHaD has been verified by the clinical epidemiological researches and animal experiments. It is important to know that we have a “window “ in the early stage， in which， if we care the pregnant women or new babies carefully to avoid them from harmful environment， we can reduced the morbidity of adult chronic disease of these babies when they grow up. Therefore， DOHaD has a clinical significance.KEY WORDS health and disease； developmental origin； pregnant women高血压、冠心病、2型糖尿病、肿瘤等慢性疾病一直被认为是基因和环境共同作用的结果，然而近十余年来的一系列流行病学和实验室研究发现，几乎所有的成人慢性疾病都与发育早期的环境相关，即健康与疾病的发育起源学说。

2024年全国儿童免疫疫苗规划与接种进度英文版

2024年全国儿童免疫疫苗规划与接种进度英文版

2024年全国儿童免疫疫苗规划与接种进度英文版National Children's Immunization Vaccine Plan and Schedule for 2024In 2024, the national children's immunization vaccine plan will continue to prioritize the health and well-being of children across the country. The schedule for vaccine administration will be carefully planned and implemented to ensure maximum protection against preventable diseases.The goal of the 2024 national children's immunization vaccine plan is to increase vaccination coverage among children of all ages. This will help to create herd immunity and reduce the spread of infectious diseases within the community.To achieve this goal, healthcare providers will be encouraged to promote the importance of vaccinations to parents and caregivers.Educational campaigns will also be conducted to raise awareness about the benefits of immunization and dispel any myths or misconceptions.The schedule for vaccine administration will be organized by age groups, with specific vaccines recommended at different stages of childhood development. This will ensure that children receive the necessary protection at the right time to safeguard their health.In addition to routine childhood vaccines, special attention will be given to high-risk populations and underserved communities. Efforts will be made to ensure that all children have equal access to vaccines, regardless of their socio-economic status.Overall, the 2024 national children's immunization vaccine plan aims to improve public health outcomes by preventing the spread of vaccine-preventable diseases. It is a crucial initiative that will benefit children, families, and communities across the country.。

集体儿童保健

集体儿童保健


提供便捷服务
优化服务流程，提高服务 质量，为家长提供便捷、 高效的儿童保健服务。
加强互动与沟通
建立良好的医患关系，加 强与家长的互动和沟通， 提高家长的信任度和满意 度。
优化资源分配的策略
加大财政投入
合理规划财政预算，加大 对儿童保健事业的投入， 确保必要的设备和人员配 备。
优化资源配置
根据地区和机构的实际需 求，优化资源配置，实现 资源利用的最大化。
，以满足不同儿童的需求。
制定个性化的营养和运动计划， 以促进儿童的健康成长。
提供个性化的心理健康和行为干 预，以帮助儿童建立积极的心态
和行为习惯。
数字化技术在集体儿童保健中的应用
利用数字化技术，如大数据、人工智能 等，对儿童健康数据进行收集、分析和 预测，以提高保健服务的精准性和有效
性。
通过数字化技术，实现远程监测和在线 咨询，为家长提供更加便捷的儿童保健
02
CATALOGUE
集体儿童保健服务内容
预防接种服务
预防接种是集体儿童保健服务中的重要内容，通过接种疫苗来预防常见的传染病， 如麻疹、百日咳、风疹等。
预防接种服务通常由专业的医疗机构提供，按照国家免疫规划的要求，对适龄儿童 进行接种。
家长应积极配合预防接种工作，确保孩子按时接种疫苗，以保障其健康和安全。
集体儿童保健
目 录
• 集体儿童保健概述 • 集体儿童保健服务内容 • 集体儿童保健的挑战与策略 • 集体儿童保健实践案例 • 未来集体儿童保健的发展趋势
01
CATALOGUE
集体儿童保健概述
定义与目标
定义
集体儿童保健是指通过组织、计 划和实施一系列的卫生保健服务 ，以促进儿童健康和福祉的过程 。