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Health Promotion in Taiwan PDF

53 Pages·2012·7.68 MB·English
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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

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