疾病的預(yù)防策略和疾病監(jiān)測(cè)PPT課件

1、第1頁/共146頁第2頁/共146頁第3頁/共146頁為什么要修訂疾病防制策略？為什么要修訂疾病防制策略？ 第4頁/共146頁第5頁/共146頁第6頁/共146頁第7頁/共146頁二、全球衛(wèi)生策略和初級(jí)衛(wèi)生保健二、全球衛(wèi)生策略和初級(jí)衛(wèi)生保健第8頁/共146頁“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頁/共146頁全球衛(wèi)生策略確切的含義：全球衛(wèi)生策略確切的含義：第10頁/共146頁第11頁/共146頁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頁/共146頁第13頁/共146頁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頁/共146頁第15頁/共146頁第16頁/共146頁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頁/共146頁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頁/共146頁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頁/共146頁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頁/共146頁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頁/共146頁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頁/共146頁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頁/共146頁第24頁/共146頁第25頁/共146頁第26頁/共146頁第27頁/共146頁第28頁/共146頁第29頁/共146頁第30頁/共146頁第31頁/共146頁第32頁/共146頁第33頁/共146頁。 第34頁/共146頁第35頁/共146頁第36頁/共146頁第37頁/共146頁第38頁/共146頁第39頁/共146頁第40頁/共146頁第41頁/共146頁 第42頁/共146頁第43頁/共146頁第44頁/共146頁 第45頁/共146頁第46頁/共146頁第47頁/共146頁第48頁/共146頁v19861986年

14、經(jīng)國務(wù)院批準(zhǔn)，確年經(jīng)國務(wù)院批準(zhǔn)，確定定4 4月月2525日為日為“全國兒童預(yù)全國兒童預(yù)防接種日防接種日”。v黨和國家領(lǐng)導(dǎo)人多次在黨和國家領(lǐng)導(dǎo)人多次在“全國兒童預(yù)防接種日全國兒童預(yù)防接種日”現(xiàn)場(chǎng)為兒童喂服糖丸，為現(xiàn)場(chǎng)為兒童喂服糖丸，為計(jì)劃免疫題詞，體現(xiàn)了黨計(jì)劃免疫題詞，體現(xiàn)了黨和政府對(duì)計(jì)劃免疫工作的和政府對(duì)計(jì)劃免疫工作的重視和關(guān)懷，也推動(dòng)了計(jì)重視和關(guān)懷，也推動(dòng)了計(jì)劃免疫的廣泛宣傳。劃免疫的廣泛宣傳。第49頁/共146頁v常規(guī)免疫滑坡趨勢(shì)沒有得到遏制，貧困地區(qū)和流動(dòng)人常規(guī)免疫滑坡趨勢(shì)沒有得到遏制，貧困地區(qū)和流動(dòng)人口聚集地免疫覆蓋率低口聚集地免疫覆蓋率低v仍然維持無脊灰狀態(tài)，但疫苗可預(yù)防疾病發(fā)病有反

15、彈仍然維持無脊灰狀態(tài)，但疫苗可預(yù)防疾病發(fā)病有反彈（如麻疹）（如麻疹）v中央重視程度提高（領(lǐng)導(dǎo)人出席中央重視程度提高（領(lǐng)導(dǎo)人出席4.254.25活動(dòng)和增加投入）活動(dòng)和增加投入）v承諾承諾20122012年消除麻疹，乙肝疫苗納入計(jì)劃免疫取得較年消除麻疹，乙肝疫苗納入計(jì)劃免疫取得較大進(jìn)展大進(jìn)展v免疫規(guī)劃國際合作項(xiàng)目減少免疫規(guī)劃國際合作項(xiàng)目減少第50頁/共146頁第51頁/共146頁發(fā)病率（/10萬）第52頁/共146頁第53頁/共146頁第54頁/共146頁%100%對(duì)照組發(fā)病率接種組發(fā)病率對(duì)照組發(fā)病率）疫苗保護(hù)率（接種組發(fā)病率對(duì)照組發(fā)病率疫苗效果指數(shù) 第55頁/共146頁%100%某疫苗應(yīng)接種人數(shù)

16、數(shù)按免疫程序完成接種人）某疫苗接種率（第56頁/共146頁%100%調(diào)查的適齡兒童接種人數(shù)四苗均符合免疫程序的）四苗覆蓋率（%100%某設(shè)備裝備數(shù)某設(shè)備正常運(yùn)轉(zhuǎn)數(shù)）冷鏈設(shè)備完好率（第57頁/共146頁第58頁/共146頁第59頁/共146頁第60頁/共146頁第61頁/共146頁第62頁/共146頁急性出血性結(jié)膜炎，除霍亂、痢疾、傷寒以急性出血性結(jié)膜炎，除霍亂、痢疾、傷寒以外的感染性腹瀉病。外的感染性腹瀉病。第63頁/共146頁第64頁/共146頁第65頁/共146頁構(gòu)指導(dǎo)下治療或隔離治療。對(duì)疑似病人應(yīng)盡構(gòu)指導(dǎo)下治療或隔離治療。對(duì)疑似病人應(yīng)盡快明確診斷。快明確診斷。第66頁/共146頁 第67

17、頁/共146頁 第68頁/共146頁第69頁/共146頁第70頁/共146頁第71頁/共146頁第72頁/共146頁第73頁/共146頁 第74頁/共146頁第75頁/共146頁第76頁/共146頁第77頁/共146頁第78頁/共146頁第79頁/共146頁第80頁/共146頁第81頁/共146頁第82頁/共146頁第83頁/共146頁第84頁/共146頁第85頁/共146頁第86頁/共146頁 第87頁/共146頁 第88頁/共146頁 第89頁/共146頁 第90頁/共146頁第91頁/共146頁第92頁/共146頁不關(guān)心生化恐怖的可能因素不關(guān)心生化恐怖的可能因素 第93頁/共146頁第9

18、4頁/共146頁第95頁/共146頁 第96頁/共146頁第97頁/共146頁第98頁/共146頁第99頁/共146頁第100頁/共146頁這些事件也可能發(fā)生在這些事件也可能發(fā)生在我們身邊我們身邊! !這些事件就是這些事件就是 生化恐怖事件！生化恐怖事件！第101頁/共146頁第102頁/共146頁第103頁/共146頁There are three levels of prevention：Q Primary preventionQ Secondary preventionQ Tertiary preventionPrevention Cube 第104頁/共146頁 第105頁/共146頁

19、 第106頁/共146頁健康促進(jìn)健康促進(jìn)第107頁/共146頁第108頁/共146頁第109頁/共146頁第110頁/共146頁 第111頁/共146頁第112頁/共146頁第113頁/共146頁 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頁/共146頁 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