疾病的预防策略和疾病监测PPT课件

1、第1页/共146页第2页/共146页第3页/共146页为什么要修订疾病防制策略？为什么要修订疾病防制策略？ 第4页/共146页第5页/共146页第6页/共146页第7页/共146页二、全球卫生策略和初级卫生保健二、全球卫生策略和初级卫生保健第8页/共146页“Health for all by the year 2000” vat least 5% of gross national product should be spent on health;vat least 90% of children should have a weight for age that corresponds

2、to the reference values;vsafe water should be available in the home or within 15 minutes walking distance, and adequate sanitary facilities should be available in the home or immediate vicinity;vpeople should have access to trained personnel for attending pregnancy and childbirth; andvchild care sho

3、uld be available up to at least one year of age.“Health for all by the year 2000” 第9页/共146页全球卫生策略确切的含义：全球卫生策略确切的含义：第10页/共146页第11页/共146页Declaration of Alma-AtavAn International Conference on Primary Health Care was held from 6-12 September 1978 in Alma-Ata, capital of the Kazahhistan.v134 governments

4、 and 67 UN organizations, specialized agencies and non-governmental organizations in official relation with WHO and UNICEF attended.vDeclaration of Alma-Ata.第12页/共146页第13页/共146页What is Primary Health Care (PHC)? PHC is essential health care made universally accessible to individuals and families in

5、the community by means acceptable to them, through their full participation and at a cost that the community and country can afford.第14页/共146页第15页/共146页第16页/共146页Case study: the GambiavIn the Gambia, in west Africa, a study by the United Kingdom Medical Research Council of 40 villages beginning in 1

6、981 over a 15-year period compared infant and child mortality between villages with and without primary health care (PHC).A routine primary health care activities at Thmor Bang Health Center, Koh Kong Province, Cambodia.第17页/共146页Case study: Extra services to the PHC villages included a paid Communi

7、ty Health Nurse for about every five villages, as well as a Village Health Worker and a trained Traditional Birth Attendant. Maternal and child health services with a vaccination program were accessible to residents in both PHC and non-PHC villages. There were marked improvements in infant and child

8、 (5 years) mortality in both PHC and non-PHC villages.第18页/共146页vAfter the establishment of PHC in 1983, infant mortality in the PHC villages dropped from 134/1000 in 19821983 to 69/1000 in 19921994, and from 155/1000 to 91/1000 in the non-PHC villages over the same period. The change in death rates

9、 for children aged 14 years between the two groups was not as marked.Case study:第19页/共146页Case study: Supervision of the PHC system weakened after 1994, and infant mortality rates in the PHC villages rose to 89/1000 in 19941996.The rates in non-PHC villages fell to 78/1000 for the same period. Morta

10、lity rates rose significantly when PHC services were weakened.第20页/共146页History of Chinas primary health service systemv1949 to 1980: 80% of urban residents covered by work units; 90% of rural residents were covered by cooperative health plans.v1985 to 2002: The health system was turned over to the

11、market and became dependent on fee-for-service. 第21页/共146页Current Policy of Chinas Primary Health Service Systemv2003 to now:Rural: The New Rural Health Cooperative began. 80% of farmers are covered now.Urban: Community Health System was started in 2006 in major cities and all cities should have the

12、 system in place by 2010. 第22页/共146页Urban community health services steadily improvedvBy the end of 2006, over 23,000 community health centers had been in place nationwide, an increase of 5,528 over 2005;v24 provinces nationwide have specified the average financial input per person in community-base

13、d public health services. 第23页/共146页第24页/共146页第25页/共146页第26页/共146页第27页/共146页第28页/共146页第29页/共146页第30页/共146页第31页/共146页第32页/共146页第33页/共146页。 第34页/共146页第35页/共146页第36页/共146页第37页/共146页第38页/共146页第39页/共146页第40页/共146页第41页/共146页 第42页/共146页第43页/共146页第44页/共146页 第45页/共146页第46页/共146页第47页/共146页第48页/共146页v19861986年

14、经国务院批准，确年经国务院批准，确定定4 4月月2525日为日为“全国儿童预全国儿童预防接种日防接种日”。v党和国家领导人多次在党和国家领导人多次在“全国儿童预防接种日全国儿童预防接种日”现场为儿童喂服糖丸，为现场为儿童喂服糖丸，为计划免疫题词，体现了党计划免疫题词，体现了党和政府对计划免疫工作的和政府对计划免疫工作的重视和关怀，也推动了计重视和关怀，也推动了计划免疫的广泛宣传。划免疫的广泛宣传。第49页/共146页v常规免疫滑坡趋势没有得到遏制，贫困地区和流动人常规免疫滑坡趋势没有得到遏制，贫困地区和流动人口聚集地免疫覆盖率低口聚集地免疫覆盖率低v仍然维持无脊灰状态，但疫苗可预防疾病发病有反

15、弹仍然维持无脊灰状态，但疫苗可预防疾病发病有反弹（如麻疹）（如麻疹）v中央重视程度提高（领导人出席中央重视程度提高（领导人出席4.254.25活动和增加投入）活动和增加投入）v承诺承诺20122012年消除麻疹，乙肝疫苗纳入计划免疫取得较年消除麻疹，乙肝疫苗纳入计划免疫取得较大进展大进展v免疫规划国际合作项目减少免疫规划国际合作项目减少第50页/共146页第51页/共146页发病率（/10万）第52页/共146页第53页/共146页第54页/共146页%100%对照组发病率接种组发病率对照组发病率）疫苗保护率（接种组发病率对照组发病率疫苗效果指数 第55页/共146页%100%某疫苗应接种人数

16、数按免疫程序完成接种人）某疫苗接种率（第56页/共146页%100%调查的适龄儿童接种人数四苗均符合免疫程序的）四苗覆盖率（%100%某设备装备数某设备正常运转数）冷链设备完好率（第57页/共146页第58页/共146页第59页/共146页第60页/共146页第61页/共146页第62页/共146页急性出血性结膜炎，除霍乱、痢疾、伤寒以急性出血性结膜炎，除霍乱、痢疾、伤寒以外的感染性腹泻病。外的感染性腹泻病。第63页/共146页第64页/共146页第65页/共146页构指导下治疗或隔离治疗。对疑似病人应尽构指导下治疗或隔离治疗。对疑似病人应尽快明确诊断。快明确诊断。第66页/共146页 第67

17、页/共146页 第68页/共146页第69页/共146页第70页/共146页第71页/共146页第72页/共146页第73页/共146页 第74页/共146页第75页/共146页第76页/共146页第77页/共146页第78页/共146页第79页/共146页第80页/共146页第81页/共146页第82页/共146页第83页/共146页第84页/共146页第85页/共146页第86页/共146页 第87页/共146页 第88页/共146页 第89页/共146页 第90页/共146页第91页/共146页第92页/共146页不关心生化恐怖的可能因素不关心生化恐怖的可能因素 第93页/共146页第9

18、4页/共146页第95页/共146页 第96页/共146页第97页/共146页第98页/共146页第99页/共146页第100页/共146页这些事件也可能发生在这些事件也可能发生在我们身边我们身边! !这些事件就是这些事件就是 生化恐怖事件！生化恐怖事件！第101页/共146页第102页/共146页第103页/共146页There are three levels of prevention：Q Primary preventionQ Secondary preventionQ Tertiary preventionPrevention Cube 第104页/共146页 第105页/共146页

19、 第106页/共146页健康促进健康促进第107页/共146页第108页/共146页第109页/共146页第110页/共146页 第111页/共146页第112页/共146页第113页/共146页 Screening is a strategy used in a population to detect a disease in individuals without signs or symptoms of that disease. Unlike most medicine, in screening, tests are performed on those without any c

20、linical indication of disease.Breast cancer screening第114页/共146页 Breast cancerAll women aged 50-64 invited once every three years; women older than 65 on request Cervical cancerAll women aged 20-64 invited once every three or five years Bladder cancerOccupational exposure HIV antibodyAll women receiving antenatal care