Health Promotion in Taiwan

53 Pages·2012·7.68 MB·English

Overview of
Health Promotion
in Taiwan
Bureau of Health Promotion
Department of Health
1
National health is a key gauge of national competitiveness. To
increase physical, mental and social health in Taiwan, the BHP
has taken its lead from the Alma-Ata Declaration of 1978 and the
five action areas for health promotion identified in the Ottawa
Charter of 1986.
BHP has been striving to set health-friendly public policies,
bring about healthy communities, hospitals, schools and
workplaces, enhance public consciousness of health to usher in a
society where health always comes first, and develop citizens’
health skills and readjust health services.
The ultimate goal is to achieve “Health For All” enunciated by
the World Health Organization.
BHP also conducted public health surveillance, related research
and development to made evidence-based policy goals and
strategies that best meet present needs and future development.
2
Outline
Taiwan Health Profiles
Vision and Strategies of Health Promotion
Healthy Birth and Growth
Healthy Living
Healthy Environment
Healthy Ageing
Special Health Topics
Health Surveillance
3
Taiwan Health Profiles
4
Health Status in Taiwan
Taiwan
Total population 23,157,178
Population age 65 and above(%) 10.6
Crude birth rate (‰) 8.3
Crude death rate（ per 100,000 ） 618.7
Total fertility rate (‰) 1.02（2009）
Maternal mortality rate（ per 100,000 ） 6.5 (2008)
Neonatal mortality rate (‰) 2.7 (2008)
Infant mortality rate (‰) 4.5
Under 5 mortality rate (‰) 6.3
Life Expectancy 78.9
Male 75.9
Female 82.5
Source：1. Statistical Yearbook of Interior, R.O.C 5
2. National Vital Statistics Reports, U.S.A.
Life Expectancy at Birth, 2009
Data source：
1.World Health Statistics 2009, Table 1
2.Statics of Taiwan is from the website of Department of Health, 2009, Table 1 6
Population Statistics
U.S.A
Future Projected Proportion of Population
in Taiwan(Medium Projection )
25 actual estimate
11% 14%
20 7% 20%
m 65+
i
15
42%
l
l 68% 73% 74% 69%
10
i
15-64
o
5 49%
n
25%
16%
12% 11% 14 and under
0 9%
1993 2010 2017 2025 2060
ageing aged super-aged
7
Source：Council for Economic Planning and Development
Top 10 Leading causes of death inTaiwan
200 -. 0
Malignant neoplasms Heart disease
Cerebrovascular disease Pneumonia
Diabetes mellitus Accidents
Chronic lower respiratory tract disease Chronic liver disease and cirrhosis
Suicide Nephritis, nephritic syndrome and nephrosis
Age standardized mortality rate (1/100,000)
140
132.2
(Malignant neoplasms)
120
100
80
60 47.9 (Heart disease)
40 31.3 (Cerebrovascular)
26.9 (DM)
24.8 (Pneumonia)
20 24.1 (Accidents)
16.5 (Liver)
16.2 (Respiratory)
- 12.6 (Kidney)
12.3 (Suicide)
Year
5
Age standardization is based on the WHO’s world population age-structure in 2000.
million
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
1 9 8 6 1 9 9 3
2 0 0 0 2 0 0 7
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
Vision and Strategies of
Health Promotion
Cherish Life, Promote Health
Increasing healthy life expectancy
9
Vision and Strategies
Cherish Life, Promote Health
Prevention and Control of Noncommunicable Diseases Control of
Chronic Diseases Prevention; Safety Protection)
Health Promotion (3P: Prevention, Protection, Promotion)
Developing Create a Develop and Reorient
Invigorate
public policies supportive Enhance Hygiene
Communities
for health environment Health Skills Services
• Draft and • Strengthen • Build healthy • Health Literacy • Formulate a
amend laws and cross-sector families, • Health medical treatment
regulations cooperation communities, Communication and healthcare
• Devise health • Nurture a schools, • Health system conducive to
policies for system workplaces, Surveillance health promotion
different conducive to hospitals and R&D •
wBuelilrdo au n ded system
societal groups health • Have health • Healthy for preventing and
• Narrow gaps in promotion accepted as top Lifestyles caring for
citizen health • Make industry priority in society Noncommunicable
healthy and diseases
bring health to • Turn medical care
industry resources into
health resources 10
Healthy Birth and Growth
1. Maternal Health
Systematic Reproductive Health Services
Comprehensive Reproductive Health Regulations and Systems
11
Preventive Services - Maternal Health Promotion
Before Before the Due Date After the Due
Pregnancy Date
Antenatal care 10 Free Prenatal
coverage (%)
Examinations
At least 1 visit: 98.16%
At least 4 visits:
Reproductive Health Services for
95.88%
Foreign Spouses
Assisted Promotion of
Reproduction
Breastfeeding
Genetic Testing and Counseling Services
(including Prenatal Diagnosis )
12
Preventive Services - Maternal Health Promotion
Item Target Interval Content
Prenatal pregnant 2 times Physical check-up,
examinations women (<17 weeks) Blood and urine tests ,
for pregnant Ultrasound examination,
2 times
women Health education
(17-29 weeks)
6 times
(>29 weeks)
low once
Group B
income Group B streptococcus
streptococcus
pregnant culturing and screening
screening
women
13
Utilization Rate of Prenatal Examinations
100.0
95.0 92.8
90.9
90.0 89.1 87.0 87.5 86.9 87.2 88.0 88.6 87.5 88.4
85.0
83.5
80.7 80.7 81.8
80.0
78.1
75.0 74.5
70.0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Year
Source：Data for 2002-2005 is taken from the Bureau of National Health Insurance 、data for 2006-2010 is based on BHP calculations
Average utilization rate:the number of prenatal examinations/ the number of births multiplied by 10 prenatal tests
14
Utilization rate (%)
Amniocentesis Rates for Pregnant
Women over Age 34, 2000-2009
100%
89.5%
90% 86.1% 87.3%
88.9% 88.0%
80% 77.5% 83.3%
75.5%
76.1%
70% 70.4%
60%
50%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
15
Healthy Birth and Growth
2. Infant and Child Health
Provision of Comprehensive Healthcare Services
Preventive Healthcare Services for Children
Newborn Screening
Upgrading the Competence of Health Professionals
Creating a Friendly Environment Conducive to Breastfeeding
Promoting Legislation on "Public Breastfeeding Act“
Countermeasures to Rectify Sex Ratio at Birth Imbalances
16
Utilization rate (%)
Preventive Services - Child Health Promotion
Newborns Infants Pre-school children Elementary school children
1 day m1on 6 mons 1 yr 2 yrs 3 yrs 4 yrs 5 yrs 6 yrs 7 yrs 8 yrs 9 yrs 10 yrs 11 yrs 12 yrs
New born
screening for
congenital
metabolic
disorders
Infant
stool color
card
Preventive Health Examination for Children
(vaccines, development screening, vision,
hearing, oral health screening)
Infants Strabismus/ Student Student
chiladnrde n’s Asmcrbeelynoinpgia Cphheycski-cuapl s physical
Check-ups
Hearing Vaccinatio
screening n
Elementary school students fluoride
17
Fluoride application of teeth mouth rinse to prevent caries
Preventive Services - Newborns and Children
Item Target Interval Content
Newborn newborns once G-6-PD, CHT, CAH, PKU, HCU, Isovaleric
screening acidemia, MSUD, GAL, MMA, GA1, MCAD
services
Hearing check newborns in low once Hearing check
income families
Preventive child children under 7 7 times Physical check-up: Medical history of
health care years old individual and family, height, weight, hearing
services ability, eyes, mouth and dental, growth and
development appraisal
Examination of development: children hearing,
language and Autism screening
Health counseling: Breast feeding, nutrition,
childhood development, oral health care, eye
care, injury prevention
Professionally children under 5 semiannually Professional fluoride application by dentists,
applied fluoride years old general oral examination, oral health education
treatment
Pit-and-Fissure elementary first and second once Pit-and-Fissure Sealant of first molar
grade students in
Sealant Program mountainous area and first
for Children grade elementary school
children of low-income 18 18
families
Completion rate of Taiwan newborn screening
452 hospitals/
clinics nationwide 97.8% 98.7% 98.4% 99.7% 99.6% 100.0% 100.0% 98.7%
o
tafkfeinrign gs esravmicpele 100.0% 94.1% 96.7% 97.2% 99.0% 99.6% 98.2% 99.9% 100.0% 99.5% 99.9%
90.0% 87.7%
99% of newborn 80.0% 79.4%
babies receiving
screening 70.0% 68.0%
60.0%
3 screening 56.3%
laboratories 50.0%
31 hospitals
offering 40.0%
37.5%
confirmation tests
30.0%
1.88% abnormality rate 23.2%
(96.76% of abnormality 20.0%
found are G6PD. The 11.2%
second highest 10.0% 6.7%
abnormality found is
0.0%
CHT(2.87%)
19
1984 1988 1992 1996 2000 2004 2008
Maternal, Neonatal and Infant Mortality Rates
Neaonatal and Infant mortality Maternal mortality rate
rate(per 1,000 live births) (per 100,000 live births)
20 60
18
50
16
1995: Birth Reporting
14 System Initiated
40
12
Neonatal
10 30 Infant
8 Maternal
20
6
4 4.2
10
2.7
2 5.0
0 0
20
197119731975197719791981198319851987198919911993199519971999200120032005200720092011
Year