Maternal and child health work in our region will continue to implement the spirit of the 18th CPC National Congress and the Third and Fourth Plenary Sessions of the 18th CPC Central Committee, closely focus on the central task of maternal and child health work, and realize the resource integration of maternal and child health care and family planning technical services with the idea of reform and legal thinking. Focusing on protecting women's and children's health, we should innovate working ideas, expand service areas, improve service quality, and provide safe, effective, convenient and high-quality medical and health care services for women and children in the whole region. According to the requirements of the higher authorities and the work plan for women and children in our city, combined with the actual work in this area, the following plans are formulated:
First, standardize the management of women's health care and improve the capacity of maternal and child health care services.
Take measures to ensure the health and safety of pregnant women.
1, implement perinatal health care management. In accordance with national requirements, we will strengthen maternal health management services during pregnancy and move the threshold for controlling maternal mortality to pre-pregnancy and early pregnancy. In all aspects of maternal health management, such as early pregnancy registration, regular prenatal examination, high-risk pregnancy screening, high-risk monitoring during pregnancy, and postpartum visit, pregnant women are comprehensively, systematically and meticulously monitored and managed. At the same time, strengthen health education and expand the target of health education to the families of pregnant women. Advocate active medical treatment, reduce the occurrence of serious complications during pregnancy and delivery, and effectively reduce maternal and perinatal mortality.
2, improve the early pregnancy card rate, as soon as possible to provide scientific and standardized health guidance for pregnant women in the area, improve the quality of maternal health care, and ensure the safety of pregnant women. First, based on the "one-stop" service of free premarital examination-marriage registration, the "Instructions for expectant mothers" will be distributed to prospective couples for face-to-face health education and publicity; Second, the whole district 10 community health service center, 1 township, 1 1 midwifery institutions assist pregnant women to take folic acid, register folic acid in the register, and inform pregnant women to set up a maternal and child health care manual free of charge in the responsible unit of maternal health care for three months; Third, all medical institutions will report the registered flower names of pregnant women to Yuhua District Maternal and Child Health Center in time, and the Maternal and Child Health Center will promptly transfer them to the responsible units for maternal health care; Fourth, maternal health care doctors and maternal and child specialists regularly visit the jurisdiction to check pregnant women's information and urge pregnant women to build cards and books as soon as possible; Fifth, strengthen the horizontal cooperation between street and community departments, unite street family planning departments, take advantage of the work of family planning directors in various communities, keep abreast of pregnant women's trends, distribute publicity materials, and urge pregnant women to file and track health care as soon as possible. Fifth, the quality control of pregnant women's health manual in midwifery institutions should be carried out regularly and incorporated into obstetric quality management.
3. Smooth the "green channel" for high-risk pregnant women. First, pay close attention to high-risk screening, establish a ledger of high-risk cases, and establish a red warning and unsuitable pregnancy register for women and children in special areas. 1 1 township and street community health service centers should strengthen pregnancy care services, seriously carry out high-risk screening, conduct special management on screened high-risk pregnant women, and follow up regularly. High-risk pregnant women with a score of ≥20 must report to the District Maternal and Child Health Hospital within 48 hours, and timely fill in the information of high-risk pregnant women screened by midwifery medical institutions within their jurisdiction into the pregnancy risk early warning report card. The community health service center of the street under its jurisdiction shall summarize and submit it to the Maternal and Child Health Department of the District Maternal and Child Health Hospital every Friday. The second is to implement high-risk follow-up. The district women and children shall follow up the high-risk pregnant women with high-risk score ≥20 by telephone once a month, at least once during pregnancy, and give full guidance during pregnancy until their safe delivery. The women's health care team in each street should carry out monthly telephone follow-up or face-to-face visits to pregnant women under the project management. The third is to improve the emergency network for difficult and critical pregnant women, formulate the Emergency Plan for Emergency Relief for Critical Pregnant Women in Yuhua District, clarify the responsibilities and tasks of all levels, departments and units, set up a leading group and expert group for emergency relief for difficult and critical pregnant women, strictly implement the Notice of Changsha Municipal Health Bureau [2065438+02] No.94 on Printing and Distributing the Treatment and Referral Work Plan for Difficult and Critical Pregnant Women in Changsha, and uniformly use Hunan Province.
4. Improve the evaluation quality of critically ill pregnant women. Midwifery institutions at all levels should review critically ill pregnant women in strict accordance with the procedures of Chang [2013]19 and Changsha Municipal Health Bureau's Notice on Forwarding the Implementation Plan of Hunan Province's Critical Pregnant Women Assessment (for Trial Implementation), once every quarter, and report the assessment data to the District Maternal and Child Affairs Office in a timely manner, and conduct the district-level assessment once or twice.
5, continue to consolidate the achievements of obstetric construction. First, medical and health institutions at all levels should conscientiously implement the Ministry of Health's Measures for the Administration of Maternal Health Care, the Norms for Maternal Health Care and Changsha's management system for high-risk pregnant women, strictly control the graded hospital delivery system for high-risk pregnant women, and prohibit the interception of high-risk pregnant women. The second is to actively promote natural delivery, strictly grasp the indications of cesarean section, and reduce the rate of first cesarean section. Carry out health education during pregnancy, promote the training of professional technology and management personnel for natural delivery, strictly implement the spirit of the notice of Hunan Provincial Health Department on strengthening the management of cesarean section, control the cesarean section rate below 40% in the whole region, and establish a regular notification system for cesarean section rate in midwifery service institutions. Third, medical and health care units at all levels continue to do a good job in the issuance and management of birth medical certificates. In strict accordance with the spirit of Chang Wei [20 13] 14 1, it is required to be kept by a special person and stored in the counter. Seals and blank vouchers should be kept separately. The registration form issued for the first time should be filled in completely, and the stub should be filed in time. Strive to achieve an average issuance rate of "Birth Medical Certificate" for babies born in that year above 90%, and the invalid certificate rate does not exceed 1%. Submit the annual statistical data on the management and use of the Birth Medical Certificate before 1 month 10 every year. District Maternal and Child Health Hospital organizes obstetric quality supervision every quarter, and in March and July, District Maternal and Child Health Hospital organizes baby-friendly hospital supervision.
(b) Improve the quality and promote the construction of women's health care norms.
1, establish and improve the working system. Adhere to the grass-roots guidance and responsibility system for maternal and child health care, the system of "evaluation instead of training", the system of supervision and inspection, the system of regular meetings and the system of notification.
2. Strengthen training. The first is to hold special business training courses. In March, a training meeting on critical pregnant and lying-in women in the whole region was organized, and in April, a training course for maternal and child health care practitioners was organized. In May, all women and children cadres in the region were trained, and 1 1 midwifery institutions in the region were organized to carry out neonatal asphyxia resuscitation training; The second is to "promote reform through investigation", carry out cross-examination of institutions, exchange experiences and promote each other; The third is "evaluation instead of training", and the district women and children organize a review meeting for critically ill pregnant women every six months. First, the director of obstetrics and gynecology of the hospital with critically ill pregnant women introduces the case rescue process, analyzes the reasons, summarizes the experience and lessons, and then comments by experts in the urban area to find the gap, so that the evaluation meeting can truly become a suitable technical training meeting.
(three) the implementation of policies, the implementation of major maternal and child health projects
1, carry out general survey and treatment of rural women's diseases. Do a good job in the general survey and treatment of gynecological diseases in Dongshan and Rio Tinto streets from May to June, and promptly refer and diagnose suspected positive patients. The positive cases found should be managed and followed up by special personnel, and effective treatment measures should be implemented.
2, the implementation of prevention of mother-to-child transmission of AIDS, syphilis, hepatitis B project. Incorporate the prevention of mother-to-child transmission of AIDS, syphilis and hepatitis B into the routine work of maternal and child health care, formulate and improve the implementation plan and fund use management plan for blocking mother-to-child transmission of AIDS, syphilis and hepatitis B, speed up financial subsidies for recipients, and fully implement the "one-stop" direct subsidy for medical institutions. Strengthen the special training of relevant professional and technical personnel, and the coverage rate of trainers should reach more than 90% of the personnel in midwifery institutions. Improve the detection rate during pregnancy, set up multi-point blood collection and centralized screening in the whole region, expand the free screening area, do a good job in the follow-up management of pregnant women and babies with positive screening (newborns are transferred to pediatrics in time), and implement free mother-to-child blocking for pregnant women with three positive results and their newborns. Notify the units that failed to meet the standards before 28 weeks of pregnancy and failed to implement relevant intervention measures.
3. Improve the quality of pre-marital medical examination. Continue to implement free pre-marital medical examination and marriage registration through-train service, and effectively improve the quality and efficiency of pre-marital examination. Strengthen publicity, guide the masses to consciously conduct premarital examinations, distribute folic acid free of charge, and form a joint effort. The rate of pre-marital medical examination is over 90%. We will implement the system of case discussion, referral consultation and follow-up of premarital medical examination, strengthen the quality control of premarital health care, conduct comprehensive quality control once every quarter, and improve the items of premarital medical examination, with the completion rate reaching over 90%. Establish and improve the referral network of diseases found in pre-marital medical examination.
4. Standardize folic acid supplementation. Continue to implement the "Changsha folic acid supplement to prevent neural tube defects project implementation plan", standardize the folic acid distribution process, and keep abreast of the actual progress of the work. Expand distribution channels and implement two lines of maternal and child health care and medical institutions at the same time. Improve the county, township and village ledger (including free family planning), timely register the collection, distribution and taking of folic acid, and report it step by step. Folic acid supplementation will be included in the assessment of this year's work objectives.
5. Implement the implementation plan of free basic medical care for rural pregnant women in Yuhua District. Strive to achieve a subsidy rate of over 95%. For rural pregnant women in special circumstances such as unplanned birth and delivery in different places, the payment procedures will be simplified and the subsidy policy will be implemented. Dongjing, Dongshan Street Community Health Service Center and Tiaoma Town Health Center provide hospital delivery subsidies for rural pregnant women on a monthly basis, and timely report financial subsidy information.
Two, improve the management of children's health care, and create a child health care service demonstration site.
(a) to increase the popularization of children's health service technology, improve service capacity.
1, standardize the health management of children aged 0-6. Strengthen the health follow-up of children aged 0-6, do a good job in systematic management of children aged 0-3 and health management of children aged 0-6, and strengthen the monitoring and management of children's health information files. The filing rate of children under 7 years old is 90%, and the detection rate of hemoglobin is over 70%.
2, around the eight technical specifications of children's health care services, to carry out theoretical training and skill operation training for children's health care professionals at the county and township levels, and improve the service level of grassroots personnel. Based on the Children's Health Center of Changsha Maternal and Child Health Hospital, children's health professionals at county and township levels were trained in children's health operation skills, focusing on further study and practice to improve the training effectiveness.
3. Strengthen work supervision and use the network platform to carry out real-time supervision of children's health information. Do a good job in standardizing and standardizing the service system; Standardize the service process and implement the referral mechanism; Implement hierarchical management of nutritional diseases of high-risk infants, and establish norms and mechanisms for identification and referral of nutritional diseases of high-risk infants.
4. Standardize the health care management of kindergartens, establish a network system of health care workers in kindergartens, improve the quality control system of health care work in kindergartens, and do a good job in information management and reporting of health care work in kindergartens.
5. Strengthen children's eye, ear, hearing and oral health care, and do a good job in early identification of common diseases and referral and reception of abnormal children.
(2) Effectively control child mortality.
1, strengthen the promotion of appropriate technologies for neonatal resuscitation in midwifery institutions, and carry out neonatal asphyxia resuscitation training step by step. Standardized training of neonatal resuscitation technology was carried out for new professionals in midwifery institutions. Implement the evaluation system of neonatal asphyxia cases.
2, to carry out the quality control of special information on the death of children under 5 years old, reduce the omission of child deaths, and put an end to concealment. Improve the evaluation system of neonatal death.
3. Improve the children's first aid network, and establish and improve the long-term working mechanism of neonatal intensive care. Carry out publicity and education on the prevention of accidental injuries of children and training on pre-hospital first aid knowledge of children.
(3) Create qualified children's health care areas to promote management and development.
After the completion of the new site in our district, we will further promote the creation of qualified areas for children's health care services and carry out activities to create demonstration units for children's health care quality services. Take the qualified child care area as a demonstration site, promote the all-round development of child care clinics at county and township levels in the whole region, intensify work, strive for strong support from policies and governments, improve service conditions and environment, implement staffing, and complete the establishment work as planned.
(4) Improve the health level of children and the quality of the birth population.
1, continue to do a good job in comprehensive prevention and treatment of birth defects and standardize newborn hearing screening. Establish a quality control management system for newborn hearing screening services, and gradually implement the quality control standards for hearing screening and diagnosis and treatment institutions to ensure the standardized and orderly work. The neonatal hearing screening rate is over 95%.
2, gradually expand the screening of neonatal diseases, neonatal disease screening rate reached more than 96%. Do a good job in screening quality control and information management, and standardize the referral, registration and management of positive children.
3, do a good job in monitoring, referral and management of children with developmental deviation, do a good job in the management of high-risk children's health care and nutritional diseases, carry out early childhood development and promote children's rehabilitation, and use the technological advantages of cities, counties and children's health clinics to improve the management, promotion and intervention of high-risk children and children with developmental deviation.
Third, strengthen maternal and child health education and realize information networking.
(1) Improve the health education team. Innovate the work mode, make full use of maternity and child care work positions such as pregnant women's schools, parents' schools, maternal and child care clinics and community health service centers, vigorously publicize health care knowledge and policies such as maternal and child care, prenatal and postnatal care, and major public health projects, and raise people's awareness of self-care and active participation in public health services.
(2) Establish an information management network. Promote the information construction of maternal and child health and implement the information management of maternal and child health. Strengthen the training of information teams, do a good job in the management of information files, gradually start the "Hunan Maternal and Child Health Information Management System" (new version), and carry out the collection, collation and reporting of maternal and child health information according to laws and regulations.