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Working Strategies of Chinese Newborn Healthcare Chinese Center for Disease Control and Prevention National Center for Women and Children's Health Wang Huishan 1 Why to focus on healthcare for newborns? – Neonatal mortality accounts for more than half of deaths of children aged under 5; – Two-thirds of newborn deaths occur within 3 days after birth; – A large number of causes of neonatal death are avoidable; – Technologies to reduce neonatal mortality are simple and economic; – Reducing neonatal mortality is the goal of Women Transition from MDG to SDG Millennium Development Goals MDG4: From 2000 to 2015, reducing neonatal mortality SDG3: From 2016 to 2020, eliminating preventable neonatal mortality WHO Action Plan for Newborn Infants in the Western Pacific Region • WHO launched the campaign First Embrace in December 2015 • Introducing the latest Early Essential Newborn Care (EENC) Measures beneficial to newborns Skin-to-skin contact Immediate wipe dry, Delayed clamping and cutting of umbilical cord Measures beneficial to newborns Early initiating of breastfeeding, Breast-feeding Kangaroo Mother Care for premature infants Strategies coping with newborn death Strengthening development & management of Obstetrics & Neonatology Improving service network for pregnant/prenatal women and newborns Management mode of Neonatal Resuscitation program National Healthand Family Planning Commission Department of Maternal and Child Health National Center for Women and Children's Health Johnson & Johnson Pediatric Institute American Academy of Pediatrics Implementation Strategies Policy Support Organizational Management Specific implementations Policy and Financial Support Provincial Medical Institutions Provincial Health and Family Planning Departments Chinese Society of Perinatal Medicine Chinese Nursing Association Newborn Healthcare Services Providing 1. Newborn disease screening (two diseases, hearing, etc.) 2. Newborn family visits 3. Newborn disease treatment Maternal and Child Health Care System, China Basic Health Institutions Providing Services Name of Organization Number of Organizations (10,000) Community Health Service 0.8 Center Community Health Service 2.5 Station Township Hospital 3.8 Village Clinic 66.3 11 One children‘s hospital in every prefecture-level city One pediatrics department in a general hospitalin every county Every one thousand children under 5 years old shall be equipped with 2.5 healthcare providers Obj ecti Every one thousand newborns shall be equipped with 2.5 maternal and child healthcare providers. Providing free medical insurance for newborns National variation trend of mortality rates of newborn and children aged under 5 from 2000 to 2014 Constituent Ratio of Causes of National Newborn Deaths in 2014 (%) Premature Birth 18.0% 29.1% 17.4% Perinatal Complication Pneumonia 11.3% 24.2% Congenital Malformation Other Diseases Types of birth defects Congenital heart disease has been the No. 1 malformation for perinatal infants Birth Defect Countermeasures Strengthening responsibilitis of the government Government leadership, departmental collaboration and social participation Enhancing establishment of integrated prevention and treatment system of birth defects Prenatal screening, prenatal diagnosis, newborn disease screening Implementing integrated prevention and treatment measures for birth defects Primary prevention, secondary prevention, tertiary prevention Status Quo of Children Disease Acute respiratory infection and diarrhea: 8.62% and 0.58% Infectious disease MTCT of HIV lowering from 34.8% to 6.1% in 2014 Rate of Newborns with Congenital Syphilis is 61.6 per 100,000 Live Birth in 2014, dropping by 22% as of 2011 Prevalence Rate of Disabled Children is 1.69% Strategies Coping with Child Diseases National Essential Public Health Services Policies Free Regular Antenatal Examination for Pregnant Women Free Regular Health Examination for Children Free Folic acid supplementation before and during pregnancy Blockage of perinatal transmission diseases such as ADIS, syphilis and HBV Free nutrition supplementation for infants of 624 months old in rural areas Promotion of prevention of child common diseases and harms Ultimate Objective Reducing child mortality Improving population quality at birth