《中国的医疗卫生事业》白皮书(汉英对照版)
王冕者-生子祝福语
《中国的医疗卫生事业》白皮书
White Paper: Medical and
Health Services in China
中华人民共和国国务院新闻办公室26日发表《中国的医疗卫生事业》白皮书。
全文如下:
The State Council Information Office of the
People's Republic of China on
Wednesday
published a white paper on the medical and health
services in China.
Following is the full text
of the white paper:
中国的医疗卫生事业
(2012年12月)
中华人民共和国
国务院新闻办公室
Medical and
Health Services in China
(December 2012)
Information Office of the State Council
The People's Republic of China
目录
Contents
前言
Foreword
一、卫生基本状况
I. Basic Conditions
二、医药卫生体制改革
II.
Reform of Medical and Healthcare Systems
三、传染病防治与卫生应急
III. Infectious Disease
Prevention and Treatment, and Health
Management
四、慢性非传染性疾病防治
IV. Prevention
and Treatment of Chronic Non-communicable
Disorders
五、妇女儿童健康权益保护
V. Protecting Women
and Children's Right to Health
六、中医药发展
pment of Traditional Chinese Medicine
七、卫生国际合作
VII. International Medical and
Healthcare Cooperation
结束语
Conclusion
Emergency
前言Foreword
健康是促进人的全面发展的必然要求。提高人民健康水平,实现病有所医的理想,
是人类社会的共同追求
。在中国这个有着13亿多人口的发展中大国,医疗卫生
关系亿万人民健康,是一个重大民生问题。
Good health is a prerequisite for promoting
all-round development of the person. And
it is
a common pursuit of human societies to improve
people's health and ensure their
right to
medical care. For China, a large developing
country, medical and healthcare is
of vital
importance to its population of over 1.3 billion,
and is a major issue
concerning its people's
well being.
中国高度重视保护和增进人民健康。宪法规定,国家发展医疗卫生
事业,发展现
代医药和传统医药,保护人民健康。围绕宪法,中国逐步形成了相对完善的卫生
法
律法规体系。
China pays great attention to
protecting and improving its people's health. As
the
Constitution stipulates, state develops
medical and health services, promotes
modern
medicine and traditional Chinese medicine..., all
for the protection of the
people's on this
constitutional stipulation, China has put in place
a
complete system of laws and regulations
concerning medical and health services.
多
年来,中国坚持“以农村为重点,预防为主,中西医并重,依靠科技与教育,
动员全社会参与,为人民健
康服务,为社会主义现代化建设服务”的卫生工作方
针,努力发展具有中国特色的医疗卫生事业。经过不
懈努力,覆盖城乡的医疗卫
生服务体系基本形成,疾病防治能力不断增强,医疗保障覆盖人口逐步扩大,
卫
生科技水平日益提高,居民健康水平明显改善。
Over the years,
China has worked hard to develop its medical and
health services with
Chinese characteristics
in accordance with the policy of
of our work,
putting disease prevention first, supporting both
traditional Chinese
medicine and Western
medicine, relying on science, technology and
education, and
mobilizing the whole of society
to join the efforts, improving the people's health
and
serving socialist
modernization.
medical and healthcare systems
covering both urban and rural residents have taken
shape, the capabilities of disease prevention
and control have been enhanced, the
coverage
of medical insurance has expanded, continuous
progress has been made in
medical science and
technology, and the people's health has been
remarkably
improved.
为建立起覆盖城乡居民的基本医疗
卫生制度,保障每个居民都能享有安全、有
效、方便、价廉的基本医疗卫生服务,中国深入推进医药卫生
体制改革,取得了
重要阶段性成效。
To put into place basic
medical and healthcare systems covering both urban
and rural
residents, and ensure that every
resident has access to safe, effective, convenient
and
affordable basic medical and health
services, China has kept advancing the reform of
its medical and healthcare system, and made
important achievements in the current
stage.
一、卫生基本状况
I. Basic
Conditions
居民健康状况不断改善。从反映国民健康状况的重要指标看,中国居
民的健康水
平已处于发展中国家前列。2010年人均期望寿命达到74.8岁,其中男性72.4岁,
女性77.4岁。孕产妇死亡率从2002年的51.310万下降到2011年的26.110万。<
br>婴儿死亡率及5岁以下儿童死亡率持续下降,婴儿死亡率从2002年的29.2‰下
降到201
1年的12.1‰,5岁以下儿童死亡率从2002年的34.9‰下降到2011年
的15.6‰,提
前实现联合国千年发展目标。
The people's health has been
improved. Judging from important indicators that
give
expression to national health, the health
of the Chinese people is now among the top
in
developing countries. In 2010, the life expectancy
was 74.8 years - 72.4 years for
males and 77.4
years for females; the maternal mortality rate
went down from 51.3
per 100,000 in 2002 to
26.1 per 100,000 in 2011; the infant mortality
rate and the
mortality rate of children under
the age of five have kept dropping, with the
former
going down from 29.2 per thousand in
2002 to 12.1 per thousand in 2011, and the
latter, from 34.9 per thousand to 15.6 per
thousand, attaining ahead of schedule the
UN
Millennium Development Goal in this regard.
建立起覆盖城乡的医疗卫生体系。一是公共卫生服务体系。包括疾病预防控制、
健康教育、妇
幼保健、精神卫生、卫生应急、采供血、卫生监督和计划生育等专
业公共卫生服务网络,以及以基层医疗
卫生服务网络为基础、承担公共卫生服务
功能的医疗卫生服务体系。二是医疗服务体系。在农村建立起以
县级医院为龙头、
乡镇卫生院和村卫生室为基础的农村三级医疗卫生服务网络,在城市建立起各级
各类医院与社区卫生服务机构分工协作的新型城市医疗卫生服务体系。三是医疗
保障体系。这个体系以
基本医疗保障为主体、其他多种形式补充医疗保险和商业
健康保险为补充。基本医疗保障体系包括城镇职
工基本医疗保险、城镇居民基本
医疗保险、新型农村合作医疗和城乡医疗救助,分别覆盖城镇就业人口、
城镇非
就业人口、农村人口和城乡困难人群。四是药品供应保障体系。包括药品的生产、
流通、
价格管理、采购、配送、使用。近期重点是建立国家基本药物制度。
Medical and
healthcare systems covering both urban and rural
residents have been put
in place. Of these
systems, the first is the public health service
system, which covers
disease prevention and
control, health education, maternity and child
care, mental
health, health emergency
response, blood collection and supply, health
supervision,
family planning and some other
specialized public health services, and a medical
and
healthcare system based on community-level
healthcare networks that provides public
health services. The second is the medical
care system. In the rural areas, it refers to a
three-level medical service network that
comprises the county hospital, the township
hospitals and village clinics, with the county
hospital performing the leading role, and
township hospitals and village clinics service
at the base. And in the cities and towns,
it
refers to a new type of urban medical health
service system that features division of
responsibilities as well as cooperation among
various types of hospitals at all levels
and community healthcare centers. The
third is the medical security system. This
system comprises mainly the basic medical
security, supported by many forms of
supplementary medical insurance and commercial
health insurance. The basic medical
security
system covers basic medical insurance for working
urban residents, basic
medical insurance for
non-working urban residents, a new type of rural
cooperative
medical care and urban-rural
medical aid, which cover, respectively, the
employed
urban population, unemployed urban
population, rural population and people
suffering from economic difficulties. And the
fourth is the pharmaceutical supply
system,
which covers the production, circulation, price
control, procurement,
dispatching and use of
pharmaceuticals. The recent work is focused on
establishing a
national system for basic
drugs.
卫生筹资结构不断优化。卫生筹资来源包括政府一般税收、社会医疗保险、商
业
健康保险和居民自费等多种渠道。2011年,中国卫生总费用达24345.91亿元人
民
币,同期人均卫生总费用为1806.95元人民币,卫生总费用占国内生产总值的
比重为5.1%。按
可比价格计算,1978—2011年,中国卫生总费用年平均增长速
度为11.32%。个人现金卫生
支出由2002年的57.7%下降到2011年的34.8%,卫
生筹资系统的风险保护水平和再分配
作用不断提高。2011年,医院、门诊机构
费用为18089.4亿元人民币,公共卫生机构费用为2
040.67亿元人民币,分别占
卫生总费用的71.74%和8.09%。医院费用中,城市医院、县
医院、社区卫生服
务中心、乡镇卫生院费用分别占64.13%、21.28%、5.17%、9.3%
。
The health financing structure has been
constantly improved. China's health
expenditure comes from the government's
general tax revenue, social medical
insurance,
commercial health insurance, residents' out-of-
pocket spending, etc. In
2011, the total
health expenditure in China reached 2,434.591
billion yuan, 1,806.95
yuan per capita. The
total expenditure accounted for 5.1% of the
country's GDP. In
comparable prices, the
health expenditure grew by an average annual rate
of 11.32%
from 1978 to 2011. Individual
to
34.8% in 2011, showing that health financing is
working better in the areas of risk
protection
and re-distribution. In 2011, the spending on
hospitals and outpatient
establishments was
1,808.94 billion yuan, and that on public health
agencies, 204.067
billion yuan, comprising
71.74% and 8.09%, respectively, of the total
health
expenditure. Of the total spending on
hospitals, those on urban hospitals, county
hospitals, community health service centers
and township health service centers stood
at
64.13%, 21.28%, 5.17% and 9.3%, respectively.
卫生资源持续发展。截至2011年底,全国医疗卫生机构达95.4万个(所),与2003
年比较,医疗卫生机构增加14.8万个(所)。执业(助理)医师246.6万人,每千人
口执业(助
理)医师数由2002年的1.5人增加到1.8人。注册护士224.4万人,每
千人口注册护士数由
2002年的1人增加到1.7人。医疗卫生机构床位数516万
张,每千人口医疗卫生机构床位数由2
002年的2.5张提高到3.8张。
Health resources have been
developing in a sustained way. By the end of 2011,
medical and healthcare institutions around the
country totaled 954,000, an increase of
148,000 over 2003. Licensed doctors
(assistants) reached 2,466,000, or 1.8 per
thousand people, as compared with 1.5
per thousand people in 2002. Registered
nurses
totaled 2,244,000, or 1.7 per thousand people, as
compared with one per
thousand people in 2002.
The number of hospital beds reached 5160,000, or
3.8 per
thousand people, as compared with 2.5
per thou-sand people in 2002.
医疗卫生服务利用状况显
著改善。2011年,全国医疗机构诊疗人次由2002年的
21.5亿人次增加到62.7亿人次,住
院人数由2002年的5991万人增加到1.5亿人。
中国居民到医疗卫生机构年均就诊4.6次,每
百居民住院11.3人,医院病床使用
率为88.5%,医院出院者平均住院日为10.3天。居民看病
就医更加方便,可及性
显著提高。15分钟内可到达医疗机构住户比例,由2003年的80.7%提高
到2011
年的83.3%,其中农村地区为80.8%。医疗质量管理和控制体系不断完善。建立无偿献血制度,血液安全得到保障。
Marked improvement has been
seen in the utilization of medical and health
services.
In 2011, medical institutions
throughout the country hosted 6.27 billion
outpatients, as
compared with 2.15 billion in
2002; and admitted 150 million inpatients, as
compared
with 59.91 million in 2002. That
year, Chinese residents went to the medical
institutions for medical treatment 4.6 times
on average; 11.3 of every 100 people were
hospitalized; the utilization rate of hospital
beds reached 88.5%; and the hospital stay
of
the inpatients averaged 10.3 days. These figures
show that it has become
increasingly
convenient to see a doctor and more easily
accessible to get medical
services. In 2011,
83.3% of all households (80.8% in rural areas)
could reach medical
institutions within 15
minutes, as compared with 80.7% in 2002. Medical
service
quality management and control systems
have been constantly improved. A system of
blood donation without compensation has been
established, so as to ensure blood
supply and
safety.
二、医药卫生体制改革
II. Reform of
Medical and Healthcare Systems
经过多年努力,中国卫生事业取得
显著发展成就,但与公众健康需求和经济社会
协调发展不适应的矛盾还比较突出。特别是随着中国从计划
经济体制向市场经济
体制的转型,原有医疗保障体系发生很大变化,如何使广大公众享有更好、更健全的医疗卫生服务,成为中国政府面临的一个重大问题。从20世纪80年代开始,
中国启动医药卫
生体制改革,并在2003年抗击传染性非典型肺炎取得重大胜利
后加快推进。2009年3月,中国公
布《关于深化医药卫生体制改革的意见》,
全面启动新一轮医改。改革的基本理念,是把基本医疗卫生制
度作为公共产品向
全民提供,实现人人享有基本医疗卫生服务,从制度上保证每个居民不分地域、
民族、年龄、性别、职业、收入水平,都能公平获得基本医疗卫生服务。改革的
基本原则是保基本、强
基层、建机制。
With years of effort, China has made
remarkable achievements in the development of
its healthcare undertakings, which, however,
still fall far short of the public's demands
for healthcare as well as the requirements of
economic and social development.
Especially when China turned from a
planned economy to a market economy, the old
medical care system has undergone great
changes. So it became an issue of major
importance for the Chinese government to
provide better and more accessible medical
and
health services to the public. In the 1980s, the
Chinese government initiated
reform of the
medical and healthcare systems, and speeded up the
reform in 2003
after a success was won in the
fight against the SARS. In March 2009, the Chinese
government promulgated the on Deepening Reform
of the Medical and
Health Care Systems,
of
this reform was to provide the whole nation with
basic medical and health services
as a public
product, and ensure that everyone, regardless of
location, nationality, age,
gender, occupation
and income, enjoys equal access to basic medical
and health
services. And the basic principles
to be followed in the reform were to ensure basic
services, improving such services at the
grass-roots level and establishing the
effective mechanisms.
医改是一项涉及面广、难度大的社
会系统工程,在中国这样一个人口多、人均收
入水平低、城乡区域差距大的发展中国家,深化医改是一项
十分艰巨复杂的任务。
三年多来,中国政府大力推进医药卫生服务与经济社会协调发展,积极破解医改<
br>这一世界性难题。通过艰苦努力,中国的新一轮医改取得积极进展。
Medical
reform is a social program that covers a wide
range and involves difficult
tasks. And it is
a hard and complicated task to deepen this reform
in China, a
developing country with a large
population, low per-capita income and a wide gap
between urban and rural areas. For over three
years, the Chinese government has
worked hard
to strike a balance between improving medical and
health services on
one hand and economic and
social development on the other, trying to find a
solution
to this worldwide problem. Thanks to
the persistent efforts made, China has made
positive progress in this new round of medical
reform.
——基本医疗保障制度覆盖城乡居民。截至2011年,城镇职工基本医疗
保险、
城镇居民基本医疗保险、新型农村合作医疗参保人数超过13亿,覆盖面从2008
年的
87%提高到2011年的95%以上,中国已构建起世界上规模最大的基本医疗
保障网。筹资水平和报
销比例不断提高,新型农村合作医疗政府补助标准从最初
的人均20元人民币,提高到2011年的20
0元人民币,受益人次数从2008年的
5.85亿人次提高到2011年的13.15亿人次,政策范
围内住院费用报销比例提高
到70%左右,保障范围由住院延伸到门诊。推行医药费用即时结算报销,居
民就
医结算更为便捷。开展按人头付费、按病种付费和总额预付等支付方式改革,医
保对医疗机
构的约束、控费和促进作用逐步显现。实行新型农村合作医疗大病保
障,截至2011年,23万患有先
天性心脏病、终末期肾病、乳腺癌、宫颈癌、耐
多药肺结核、儿童白血病等疾病的患者享受到重大疾病补
偿,实际补偿水平约
65%。2012年,肺癌、食道癌、胃癌等12种大病也被纳入农村重大疾病保障
试
点范围,费用报销比例最高可达90%。实施城乡居民大病保险,从城镇居民医保
基金、新型
农村合作医疗基金中划出大病保险资金,采取向商业保险机构购买大
病保险的方式,以力
争避免城乡居民发生家庭灾难性医疗支出为目标,实施大病
保险补偿政策,对基本医疗保障补偿后需个人
负担的合规医疗费用给予保障,实
际支付比例不低于50%,有效减轻个人医疗费用负担。建立健全城乡
医疗救助制
度,救助对象覆盖城乡低保对象、五保对象,并逐步扩大到低收入重病患者、重
度残
疾人、低收入家庭老年人等特殊困难群体,2011年全国城乡医疗救助8090
万人次。
The basic medical care systems cover both
urban and rural residents. By 2011, more
than
1.3 billion people had joined the three basic
medical insurance schemes that
cover both
urban and rural residents, i.e., the basic medical
insurance for working
urban residents, the
basic medical insurance for non-working urban
residents, and the
new type of rural
cooperative medical care, with their total
coverage being extended
from 87% in 2008 to
95% in 2011. This signaled that China has built
the world's
largest network of basic medical
security. Medical care financing and the
reimbursable ratio of medical costs have been
raised, and the government subsidy
standards
for the new rural cooperative medical care system
were increased from 20
yuan at the beginning
to 200 yuan per person per year in 2011,
benefiting 1.315
persontimes in 2011 as
against 585 persontimes in 2008. The reimbursement
rate for
hospitalization expenses covered by
relevant policies has been raised to around 70%,
and the range of reimbursable expenses has
been expanded to include outpatient
expenses.
Real-time reimbursement has been adopted for
medical expenses, making it
more convenient
for people to have their medical costs settled.
Reform has been
carried out in respect of the
forms of payment to include payment by person,
payment
by disease and total amount pre-
payment, enabling medical insurance to play a
better
restrictive role over medical
institutions as well as to control expenses and
compel the
medical institutions to improve
their efficiency. Critical illness insurance has
been
included in the new type of rural
cooperative medical care system. By 2011, some
230,000 patients of congenital heart disease,
advanced rental diseases, breast cancer,
cervical cancer, multidrug-resistant
tuberculosis and childhood leukemia had been
granted subsidies for major and serious
diseases, with the actual subsidies accounting
for 65% of their total expenses. In 2012, lung
cancer, esophagus cancer, gastric cancer
and
eight other major diseases were included in the
rural pilot program of insurance
for the
treatment of major diseases, and the reimbursement
rate reached as high as
90%. Critical illness
insurance has been introduced for both urban and
rural residents,
in which certain amounts of
money are earmarked in the medical insurance fund
for
non-working urban residents and that of
the new type of rural cooperative medical
care
to buy critical illness insurance policies from
commercial insurance companies,
aiming to
relieve urban and rural families of the heavy
burden of catastrophic medical
spending. The
policy of subsidy for critical illness insurance,
which covers no less
than 50% of the actual
medical costs, provides a guarantee for the
compliance costs to
be shouldered by the
individual after reimbursement from the basic
medical insurance.
This has effectively
reduced the financial burden of individuals. An
urban-rural
medical assistance system has been
established and improved, which at first covered
urban and rural subsistence allowance
recipients and childless and infirm rural
residents who receive the so-called
those who are severely ill and have low
comes, the severely disabled, senior citizens
from low-income families, and some other
groups with special difficulties. In 2011,
the
urban-rural medical assistance was granted to
80.90 million cases across the
country.
<
br>——基本药物制度从无到有。初步形成了基本药物遴选、生产供应、使用和医疗
保险报销的体系。
2011年,基本药物制度实现基层全覆盖,所有政府办基层医
疗卫生机构全部配备使用基本药物,并实
行零差率销售,取消了以药补医机制。
制定国家基本药物临床应用指南和处方集,规范基层用药行为,促
进合理用药。
建立基本药物采购新机制,基本药物实行以省为单位集中采购,基层医疗卫生机
构
基本药物销售价格比改革前平均下降了30%。基本药物全部纳入基本医疗保障
药品报销目录。有序推进
基本药物制度向村卫生室和非政府办基层医疗卫生机构
延伸。药品生产流通领域改革步伐加快,药品供应
保障水平进一步提高。
A basic system of drugs has been
developed from scratch. A system for the
selection,
production, supply and use of basic
drugs, and cover of them in medical insurance has
been put into place. In 2011, the coverage of
this system was extended to all
grass-roots
medical and health-care institutions run by the
government, where these
drugs were sold at
zero profit, practically eliminating the practice
of hospitals
subsidizing their medical
services with drug sales. A national guideline for
the clinical
application of basic drugs and a
formulary have been drawn up to ensure that basic
drugs are used according to due procedures at
grass-roots medical institutions. A new
mechanism has been established for the
procurement of basic drugs, under which the
basic drugs are to be purchased by provinces.
As a result, the prices of basic drugs at
grass-roots medical and healthcare
institutions have dropped by 30% on average, as
compared with those before the reform. The
basic drugs have all been included in the
list
of reimbursable drugs covered by basic medical
insurance. Also, efforts have been
made to
supply basic drugs in an orderly way to village
clinics and non-governmental
medical
institutions at the grass-roots level. The steps
of reform have been quickened
in drug
production and circulation, and the supply of
drugs has been better ensured.
——城乡基层医疗卫生
服务体系进一步健全。加大政府投入,完善基层医疗卫生
机构经费保障机制,2009—2011年,中
央财政投资471.5亿元人民币支持基层医
疗机构建设发展。采取多种形式加强基层卫生人才队伍建设
,制定优惠政策,为
农村和社区培养、培训、引进卫生人才。建立全科医生制度,开展全科医生规范化培养,安排基层医疗卫生机构人员参加全科医生转岗培训,组织实施中西部地
区农村订单定向医学
生免费培养等。实施万名医师支援农村卫生工程,
2009—2011年,1100余家城市三级医院支
援了955个县级医院,中西部地区城
市二级以上医疗卫生机构每年支援3600多所乡镇卫生院,提高
了县级医院和乡
镇卫生院医疗技术水平和管理能力。转变基层医疗服务模式,在乡镇卫生院开展
巡回医疗服务,在市辖区推行社区全科医生团队、家庭签约医生制度,实行防治
结合,保障居民看病就医
的基本需求,使常见病、多发病等绝大多数疾病的诊疗
在基层可以得到解决。经过努力,
基层医疗卫生服务体系不断强化,农村和偏远
地区医疗服务设施落后、服务能力薄弱的状况明显改变,基
层卫生人才队伍的数
量、学历、知识结构出现向好趋势。2011年,全国基层医疗卫生机构达到91.
8
万个,包括社区卫生服务机构2.6万个、乡镇卫生院3.8万所、村卫生室66.3万
个,
床位123.4万张。
Urban and rural grass-roots level
medical and health services have been further
improved. The government has invested more to
ensure the funding for grass-roots
medical and
healthcare institutions. From 2009 to 2011, the
central government
invested 47.15 billion yuan
to support the building and development of grass-
roots
level medical institutions. Diverse
forms have been adopted to strengthen the ranks of
healthcare workers at the grass-roots level,
and preferential policies have been made
to
train and introduce competent personnel for rural
and community healthcare. A
system of general
practitioners (medical workers with sufficient
knowledge in all
branches of medicine) has
been established, under which general
practitioners are
trained in the regular way;
grass-roots medical and healthcare workers are
enrolled in
training courses for upgrading
them to general practitioners; and medical
students are
specially trained for the needs
of central and western urban areas, for which they
do
not have to pay their tuition fees. A
project, known as thousand doctors
extending
support to rural medical care,
1,100 Grade-III
urban hospitals extended support to 955 rural
county-level hospitals
every year, and urban
medical institutions above Grade II in central and
western
China granted aid to over 3,600
township hospitals every year, thus helping
improve
the overall technological level and
management of the county and township hospitals.
Meanwhile, the mode of medical services has
been changed. Touring medical services
have
been provided in township hospitals; and in the
urban districts ranks of general
practitioners
have been formed and a system of family doctors
has been set up.
Prevention has been combined
with the treatment, measures have been taken to
ensure
basic needs of the residents to see
doctors and make it possible that the diagnosis
and
treatment of most commonly seen and
frequently occurring diseases are performed at
the community level. After years of effort,
community-level medical and healthcare
system
has been strengthened; marked changes have taken
place to the situation of
backward facilities
and poor services in rural and remote areas;
community-level
medical workers have increased
in number, and their educational background and
knowledge have improved. In 2011, the number
of grass-roots medical and healthcare
institutions across the country reached
918,000, including 26,000 urban community
service centers, 38,000 township hospitals and
663,000 village clinics, and the
number of
hospital beds reached 1,234,000.
——基本公共卫生
服务均等化水平明显提高。国家免费向全体居民提供国家基本
公共卫生服务包,包括建立居民健康档案、
健康教育、预防接种、0—6岁儿童
健康管理、孕产妇健康管理、老年人健康管理、高血压和II型糖尿
病患者健康
管理、重性精神疾病患者管理、传染病及突发公共卫生事件报告和处理、卫生监
督协管等10类41项服务。针对特殊疾病、重点人群和特殊地区,国家实施重大
公共卫生服
务项目,对农村孕产妇住院分娩补助、15岁以下人群补种乙肝疫苗、
消除燃煤型氟中毒危害、农村妇女
孕前和孕早期补服叶酸、无害化卫生厕所建设、
贫困白内障患者复明、农村适龄妇女宫颈癌和乳腺癌检查
、预防艾滋病母婴传播
等,由政府组织进行直接干预。2011年,国家免疫规划疫苗接种率总体达到9
0%
以上,全国住院分娩率达到98.7%,其中农村住院分娩率达到98.1%,农村孕产
妇
死亡率呈逐步下降趋势。农村自来水普及率和卫生厕所普及率分别达到72.1%
和69.2%。200
9年启动“百万贫困白内障患者复明工程”,截至2011年,由政府
提供补助为109万多名贫困白内
障患者实施了复明手术。
Access to basic public health
services has become more equitable. The state
provides
all residents with a free package of
41 basic public health services in ten categories,
including health record, health education,
preventive inoculation, healthcare for
children under six, healthcare for pregnant
and lying-in women, healthcare for elderly
people, treatment for hypertension and type II
diabetes patients, healthcare for severe
psychosis patients, reporting and handling of
infectious diseases and public health
emergencies, and healthcare supervision and
coordination. Targeting special diseases,
key
groups and special areas, the state has launched
key public health service
programs, including
subsidizing rural pregnant women for hospitalized
childbirth,
re-vaccinating people under 15
against hepatitis B, eliminating fluorosis caused
by
coal burning, supplementary taking of folic
acid by rural women before pregnancy
and in
the early stage of pregnancy, building sanitary
toilets, cataract removal for poor
patients,
cervical and breast cancer tests for rural women
within eligible age, and
preventing mother-to-
child transmission of AIDS. In 2011, the
inoculation rate of the
National Immunization
Program (NIP) exceeded 90%; the rate of
hospitalized
childbirth nationwide reached
98.7% (98.1% in rural areas); and the maternity
mortality rate in rural areas kept going down.
In the rural areas, 72.1% of the
population
had access to tap water and 69.2% had access to
sanitary toilets. In 2009,
the government
launched a program to provide cataract operations
for a million poor
patients, and by 2011 more
than 1.09 million such people had had such
operations
with government subsidies.
——公立医院改革有序推进。从2010年起,在17个国家联系试点城市和37个
省级试点
地区开展公立医院改革试点,在完善服务体系、创新体制机制、加强内
部管理、加快形成多元化办医格局
等方面取得积极进展。2012年,全面启动县
级公立医院综合改革试点工作,以县级医院为龙头,带动
农村医疗卫生服务体系
能力提升,力争使县域内就诊率提高到90%左右,目前已有18个省(自治区、
直
辖市)的600多个县参与试点。完善医疗服务体系,优化资源配置,加强薄弱区
域和薄弱领
域能力建设。区域医学中心临床重点专科和县级医院服务能力提升,
公立医院与基层医疗卫生机构之间的
分工协作机制正在探索形成。多元化办医格
局加快推进,鼓励和引导社会资本举办营利性和非营利医疗机
构。截至2011年,
全国社会资本共举办医疗机构16.5万个,其中民营医院8437个,占全国医
院总
数的38%。在全国普遍推行预约诊疗、分时段就诊、优质护理等便民惠民措施。
<
br>医药费用过快上涨的势头得到控制,按可比价格计算,在过去三年间,公立医院
门诊次均医药费用
和住院人均医药费用增长率逐年下降,2011年比2009年均下
降了8个百分点,公立医院费用控制
初见成效。
The reform of public hospitals has been
carried on in an orderly way. In 2010, the
Chinese government started pilot reforms of
public hospitals in 17 state-designated
cities
and 37 province-level districts; and positive
progress has been witnessed in
improving
services, innovating institutions and mechanisms,
strengthening internal
management and speeding
up the creation of a situation in which hospitals
are
established and run in diversified forms.
In 2012, the government launched a pilot
comprehensive reform of county-level public
hospitals, aiming to improve rural
system of
medical services with the county hospitals playing
the leading role, and
enabling 90% of the
population in a county to see doctors. So far,
over 600 counties in
18 provinces, autonomous
regions and municipalities directly under the
central
government have been included in this
reform. The government has worked hard to
improve medical services, optimize the
allocation of medical resources, and enhance
the medical capabilities of weak areas and
weak fields. The capabilities of key clinical
specialties in regional medical centers and
county-level hospitals to deliver medical
services have been enhanced, and the mechanism
of division of responsibilities and
cooperation between public hospitals and
community-level medical institutions is
being
studied and formed. The government has intensified
efforts in the creation of a
situation of
establishing and running hospitals in diversified
forms, encouraging and
guiding non-
governmental funds to establish both for-profit
and non-profit medical
institutions. By 2011,
there were 165,000 medical institutions
established with
non-governmental investment,
including 8,437 private hospitals, accounting for
38%
of the national total. Doctor-appointment
service, time-phased outpatient service and
high-quality nursing service that bring
benefits and convenience to the people have
been introduced nationwide. The fast price
growth of medicine has been contained. In
comparable prices, the growth rates of average
outpatient and inpatient costs in public
hospitals has decreased year by year in the
past three years, and that of 2011 went
down
by eight percentage points from that of 2009,
reaping initial results in expense
control for
public hospitals.
新一轮医改给中国城乡居民带来了很大实惠。基本公
共卫生服务的公平性显著提
高,城乡和地区间卫生发展差距逐步缩小,农村和偏远地区医疗服务设施落后
、
服务能力薄弱的状况明显改善,公众反映较为强烈的“看病难”、“看病贵”的问题
得到缓解
,“因病致贫”、“因病返贫”的现象逐步减少。
The new round of
medical reform has brought substantial benefits to
both urban and
rural residents. Access to
basic public health services has become much more
equitable; the gap between urban and rural
areas and between regions has been
narrowed in
medical development; medical services in rural and
remote areas with
backward facilities and weak
capabilities have been remarkably improved;
medical
services have become more
affordable and accessible; and fewer and fewer
people are
becoming poor or return to poverty
because of illness.
三、传染病防治与卫生应急
III.
Infectious Disease Prevention and Treatment, and
Health Emergency
Management
新中国成立以来,中
国政府坚持“预防为主,防治结合”方针,不断加大传染病防
治力度,通过开展预防接种和爱国卫生运动
等防控措施,降低了传染病发病率,
有效控制了传染病的流行和蔓延。自20世纪50年代起,基本控制
了鼠疫、霍乱、
黑热病、麻风病等疾病的流行。2011年甲类和乙类传染病发病率控制在241.41
0
万的较低水平,有力保障了广大居民的身体健康和生命安全。
Since the
founding of New China, the Chinese government has
persisted in the
principle of first and
integrating prevention with treatmentand
continuously intensified efforts in the
prevention and treatment of infectious diseases.
By preventive inoculation, patriotic health
campaigns and other prevention and
control
measures, China has succeeded in bringing down the
morbidity of infectious
diseases and brought
their spread under control. China has basically
brought under
control the epidemics of such
diseases as plague, cholera, kala-azar and leprosy
since
the 1950s. In 2011, the morbidity of
Class A and B infectious diseases was kept at a
low level - 241.4 per 100,000 people. All
these measures help to safeguard the
Chinese
people's health and life.
实施国家免疫规划。免疫规划工作
是中国卫生事业成效最为显著、影响最为广泛
的工作之一。20世纪60年代初,中国通过接种牛痘消灭
了天花,较世界卫生组
织1980年宣布全球根除天花早了十几年。2000年,中国实现了无脊髓灰质
炎目
标。2002年,中国决定将新生儿乙肝疫苗纳入国家免疫规划,国家免疫规划由
接种4种
疫苗预防6种传染病,扩大到接种5种疫苗预防7种传染病。2007年,
国家决定实施扩大国家免疫规
划,国家免疫规划疫苗增加到14种,预防15种传
染病,免疫规划人群也从儿童扩展到成人。新一轮医
改启动以来,国家免疫规划
内容不断扩大,对于减少传染病发生、保护公众身体健康起到了积极作用,目
前
多数疫苗可预防传染病的发病已降至历史最低水平。
National
immunization program has been implemented. The
national immunization
program represents one
of the most notable and influential undertakings
of China's
healthcare work. In the early
1960s, China eliminated smallpox through vaccine
inoculation, a dozen years ahead before the
World Health Organization (WHO)
announced the
eradication of the disease in 1980. China attained
the goal of
eliminating poliomyelitis in 2000.
In 2002, the Chinese government decided to
include hepatitis B vaccination for the
newborn in the national immunization program,
increasing the number of four vaccines against
six infectious diseases to five vaccines
against seven infectious diseases. In 2007,
China decided to further expand the scope
of
the program, increasing the number of vaccines to
14 to prevent 15 infectious
diseases and
extending the scope of vaccination from children
to including adults.
Since the launch of the
new round of medical reform, the scope of the
national
immunization program has kept
expanding, and it has played a positive role in
reducing the morbidity of infectious diseases
and improving the health of the public.
Already, the morbidity of most infectious
diseases that can be prevented by
vaccination
has fallen to the lowest level in history.
重点传染病地方病得到有效控制。艾滋病、结核病、血吸虫病、包虫病、麻风病、
疟疾等重大及重点
传染病患者获得免费药物治疗。截至2011年,中国存活艾滋
病病毒感染者和病人约为78万人,远低
于将艾滋病病毒感染人数控制在150万
以内的目标。传染性肺结核患病率降至6610万,提前实现了
联合国千年发展目
标确定的结核病控制指标。所有血吸虫病流行县实现疫情控制目标,血吸虫病病
人控制在32.6万。率先在全球83个丝虫病流行国家和地区中消除了丝虫病。提
升以监测为核心的
流感防控能力,2010年,中国疾病预防控制中心国家流感中
心被正式命名为全球第五个流感参比和研
究中心。稳步推进地方病防治工作,在
国家层面实现消除碘缺乏病目标,大骨节病、克山病和氟中毒等病
情得到有效控
制,发病患者显著减少。
Major infectious and
endemic diseases have been brought under effective
control.
Patients of many major infectious
diseases, such as AIDS, tuberculosis, snail fever,
hydatid disease, leprosy and malaria, are
provided medicines and treatment free of
charge. In 2011, China's living HIV-infected
persons and AIDS patients were
estimated at
780,000, far below China's goal of controlling the
HIV-infected
population within 1.5 million.
The morbidity of infectious tuberculosis has
fallen to
only 66 per 100,000 people,
attaining the goal defined in the UN Millennium
Development Goals ahead of time. All counties
where epidemics of snail fever used to
break
out have attained the goal of bringing under
control such epidemics, limiting the
number of
snail fever patients to 326,000. China took the
lead in eradicating filariasis
among the 83
countries where epidemics of filariasis hit. China
keeps improving its
capabilities of influenza
control and prevention, taking monitoring at the
major task.
In 2010, the National Influenza
Center of the Chinese Center for Disease Control
and
Prevention was officially nominated the
fifth WHO Collaboration Center for
Reference
and Research on Influenza. China steadily promotes
endemic disease
prevention and treatment. It
has eradicated the diseases caused by iodine
deficiency at
the national level, and brought
under effective control of Kashin-Beck disease,
Keshan disease and fluorine poisoning, notably
reducing the incidence of these
diseases.
爱国卫生运动卓有成效。爱国卫生运动是中国公众广泛参与、与公众健康密切
相关的社会公益
事业,迄今已开展60年。爱国卫生运动坚持预防为主的方针,
通过开展除害灭病、健康教育和健康促进
、农村改水改厕、国家卫生城镇创建、
城乡环境卫生整治等,降低了传染病危害,提高了居民健康水平,
形成了爱国卫
生人人参与、健康生活人人共享的良好局面。截至目前,中国累计命名153个国
家卫生城市、32个国家卫生区和456个国家卫生镇(县城),并在此基础上探索国
家健康城市(镇)
创建工作。
Patriotic health campaign has gained
fruitful results. Patriotic health campaign, an
invention of China that has been in existence
for 60 years so far, is a social welfare
undertaking featuring massive public
participation and a close relationship with the
public health. Following the principle of
taking prevention first, the campaign has
reduced the hazards of infectious diseases and
promoted the public health through a
series of
measures, such as exterminating pests, health
education and promotion,
improving rural water
supply and sanitation, building
improving the
environmental hygiene in both urban and rural
areas. A wholesome
atmosphere is taking shape,
with everyone participating in the campaign and
enjoying
a healthy lifestyle. Now, China is
exploring a better working mechanism for building
cities and towns,based on the 153 cities, 32
districts and 456 towns
(counties) that have
been nominated
卫生应急水平全面提高。颁布突发事件应对法、突发公共卫
生事件应急条例等法
律法规,修订传染病防治法,推动卫生应急工作走上法制化和规范化轨道。以疾病预防控制体系、卫生监督体系和医疗体系为基础,初步建成统一指挥、布局合
理、反应灵敏、运转
高效、保障有力的突发公共事件卫生应急体系。建立完善卫
生应急预案体系,覆盖突发急性传染病、不明
原因疾病、中毒事件等突发公共卫
生事件防控以及自然灾害、事故灾难、恐怖事件的医疗卫生救援和重大
活动医疗
卫生保障。建立国家、省(自治区、直辖市)、地(市)、县四级应急管理体制。建
立
卫生应急能力评估指标体系。国家组建了传染病控制、医疗救援、中毒处置、
核和放射处置等4类27支
国家级卫生应急队伍,地方也组建了各级突发公共事
件卫生应急专业队伍。国家医药储备制度日趋完善,
保障了应对突发公共卫生事
件所需的医药产品。近年来,中国有效处置了传染性非典型肺炎、甲型H1N
1流
感、鼠疫、人禽流感等突发公共卫生事件,及时开展四川汶川特大地震、青海玉
树地震、甘
肃舟曲特大山洪泥石流灾害的紧急医学救援,顺利完成北京奥运会、
上海世博会等大型活动的医疗卫生保
障任务。
Health emergency management capability
has been enhanced. China is striving to
make
its health emergency management more standard and
law-based by issuing the
Law on Emergency
Management and the Regulations on Preparedness for
and
Response to Public Health Emergencies, and
amending the Law on the Prevention
and
Treatment of Infectious Diseases. Based on the
disease prevention and control
system, the
public health monitoring system and the medical
service system, China
has basically set up a
response system for public health emergencies
featuring unified
leadership, reasonable
distribution, quick response, efficient operation
and powerful
logistics. China has established
and improved health emergency plans, which cover
the prevention and control of such public
health emergencies as acute infectious
disease
emergencies, diseases with unknown causes and
poisoning incidents, medical
rescue in case of
natural disasters, disastrous accidents and
terrorist attacks, and
medical services for
important events. A four-level emergency
management system
has been established that
covers the national, provincial, city and county
levels. Also
has been established is the
public health emergency response ability
assessment
system. The central government has
organized 27 teams for health emergencies to
respond to four categories of incidents,
namely, infectious disease control, medical
rescue, poisoning treatment, and nuclear and
radiation accident handling. Local
governments
have also set up professional teams to handle
health emergencies at their
respective
levels. China's medicine reserve system keeps
improving, ensuring
sufficient supply of
medicines for health emergencies. In the past few
years, China
has successfully dealt with many
public health emergencies, especially pandemic
threats of infectious diseases, including
SARS, H1N1, plague and avian influenza,
carried out urgent medical rescues for the
2008 Wenchuan earthquake in Sichuan
Province,
2010 Yushu earthquake in Qinghai Province and 2010
Zhouqu mudslide in
Gansu Province, and
provided medical services for the 2008 Beijing
Olympic Games
and 2010 Shanghai Expo.
法定传染病和突发公共卫生事件实现网络直报。2004年,中国启用传染病和突
发公共卫生事件网络
直报系统,实现对39种法定传染病病例个案信息和突发公
共卫生事件的实时、在线监测。截至2011
年,全国100%的疾病预防控制机构、
98%的县级及以上医疗机构和94%的乡镇卫生院实现了法定
传染病网络直报。
Online direct report system has been
enforced for notifiable infectious diseases and
public health emergencies. The online direct
report system, which puts the 39
infectious
diseases defined by law and public health
emergencies under real-time and
online
surveillance, was not available in China until
2004. By 2011, the online direct
reporting of
infectious diseases had been extended to all
disease prevention and
control institutes, 98%
of medical institutions at and above the county
level, and 94%
of township clinics in China.
四、慢性非传染性疾病防治
IV. Prevention and
Treatment of Chronic Non-communicable Disorders 伴随中国工业化、城镇化、老龄化进程的加快,居民慢性病患病、死亡呈现持续
快速增长趋势。中国
现有确诊慢性病患者2.6亿人,慢性病导致的死亡占中国总
死亡的85%,导致的疾病负担占总疾病负
担的70%。
Accelerated industrialization,
urbanization and ageing of the population have
brought
about a trend of a continuous and
rapid increase in the incidence of chronic
diseases
and mortality caused by such
diseases. At present, about 260 million Chinese
have
been diagnosed to have contracted chronic
diseases that have caused 85% of total
deaths
in China and incurred 70% of total medical costs.
中国政府把防治慢性病作为增进公众健康、改善民生的重要任务,逐步建立起覆
盖全
国的慢性病防治服务体系,对主要慢性病进行分级管理,实施综合防控策略,
全面提高慢性病综合防治能
力,努力降低人群慢性病危险因素水平,减少慢性病
发病率、致残率和死亡率。
The
Chinese government regards chronic disease
prevention and treatment as an
important task
in improving the people's health and well-being.
It has established step
by step a
nationwide prevention and treatment service for
chronic diseases, adopted
level-by-level
management over certain major chronic diseases,
implemented a
comprehensive control strategy,
enhanced the overall prevention and treatment
capacity over chronic diseases, made efforts
to reduce factors that cause chronic
diseases
and bring down the morbidity and mortality of
chronic diseases as well as
disability caused
by them.
促进慢性病防治结合。2002年以来,慢性病防控策略逐步实现由重治
疗向防治
结合方向的转变。国家级层面形成了以中国疾控中心、国家癌症中心和国家心血
管病中
心为主要技术支撑的慢性病防控格局。各地逐步形成了由疾控机构、基层
医疗卫生机构、医院和专业防治
机构共同构筑的慢性病防控工作网络。提出早诊
断、早治疗,降低发病率、病死率和病残率的慢性病防治
目标,面向一般人群、
高危人群和患病人群,对心脑血管病、恶性肿瘤、糖尿病和慢性阻塞性肺病等主<
br>要慢性病,血压升高、血糖升高、胆固醇升高和超重肥胖等主要生物危险因素,
以及烟草使用、不
健康饮食、缺少体力活动和过量饮酒等主要行为危险因素,实
施有效干预。
Integration has been promoted between
prevention and treatment of chronic diseases.
Since 2002, China's strategy for prevention
and control of chronic diseases has
gradually
shifted to placing equal emphasis on prevention
and treatment from laying
stress on treatment
alone. At the state level, a chronic disease
prevention and control
system, which takes as
its technical support the China Center for Disease
Control, the
National Cancer Center of China
and the National Center for Cardiovascular
Diseases
of China, has gradually taken shape.
In the localities, networks of chronic disease
prevention and control have gradually been
formed, comprising the local disease
control
institutions, grass-roots medical and healthcare
institutions, hospitals as well
as
professional prevention and treatment
organizations. The principle of early
diagnosis and early treatment was proposed, in
a bid to realize the targets of reducing
the
rate of morbidity, mortality and disability in the
prevention and treatment of
chronic diseases.
Primary attention has been directed at the general
public, the
high-risk population and people
with diseases. For major chronic diseases such as
cardiovascular diseases, malignant tumors,
diabetes and chronic obstructive lung
diseases, effective medical interventions
should be taken to reduce biological risk
factors, like high blood pressure,
hyperglycemia, high cholesterol in blood and
overweightobesity, and behavioral risk
factors, such as smoking, unhealthy diet, lack
of physical exercises and excessive drinking.
制定慢性病防控措施。出台《中国慢性病防治工作规划(2012—2015年)》等一系<
br>列慢性病防控政策性文件和慢性病防治指南。从2005年开始,实施癌症早诊早
治等慢性病防治
重大专项。2007年,在全国启动全民健康生活方式行动,多途
径、多形式、多角度推动健康生活方式
行为养成。2009年,将高血压、糖尿病、
老年人健康管理纳入医改基本公共卫生服务项目内容。20
10年启动国家级慢性
病综合防控示范区建设工作,提高慢性病综合防控能力。大力开展
儿童口腔疾病
综合干预,预防儿童龋齿。
Measures for chronic
disease control and prevention have been worked
out. China has
issued the Program for Chronic
Disease Control and Prevention
(2012-2015)policy documents and guidelines.
Starting in 2005,
such major special programs
as that for early diagnosis and early treatment of
cancer
have been put into implementation. In
2007, a nationwide movement of healthy
lifestyle was launched in the general public,
employing various measures and
channels to
encourage the people to cultivate a healthy
lifestyle. In 2009, the
government included
hypertension, diabetes and elders' health
management in the
basic public health services
amidst medical reform. In 2010, China set out to
build
state-level demonstration areas in
chronic disease prevention and control capacity,
aiming at enhancing the comprehensive
prevention and control capability against
chronic diseases. Comprehensive intervention
has been vigorously carried out for
early-
childhood oral disorders to prevent dental caries
among children.
建立慢性病信息管理系统。实施慢性病综合监测,开展慢
性病危险因素监测、慢
性病患病监测、死因监测、营养健康状态监测、恶性肿瘤随访登记,建立和逐步<
br>完善覆盖全生命周期的围绕慢性病及其危险因素流行情况的慢性病信息系统,为
国家开展慢性病防
控工作提供科学的基础数据。
Information management system of
chronic diseases has been established. China
enforces comprehensive surveillance of chronic
diseases, monitors the risk factors of
such
diseases, the incidence, the causes of death, and
nutrition and health conditions
of people
suffering from these diseases, and has established
cancer registries, thereby
establishing and
gradually improving an information system that
centers around
chronic diseases and the
prevalence of their risk factors, so as to provide
scientific
basic data for the state's chronic
disease prevention and control efforts.
开
展健康教育和健康促进活动。持续开展“全国亿万农民健康促进行动”、“相约
健康社区行”、“健康素
养促进行动”等。逐步建立健康教育体系,初步形成多部
门合作、全社会参与的健康教育格局。居民健康
素养基本知识和技能日益普及,
自我保健意识和能力不断提高。加大控烟宣传力度,提高公众对烟草危害
的认识,
逐步形成全社会支持控烟的氛围。世界卫生组织《烟草控制框架公约》2006年1
月
在中国生效以来,各地积极推动公共场所控烟立法,建设无烟环境。
Health
education and promotion movements have been
carried out. China will
continue to promote
the
community campaign,manners promotion
campaign,and other
health-promotion campaigns.
Efforts will be made to gradually build a health
education system featuring cooperation among
multiple departments and the
whole-
society participation. Knowledge of and skills
related to health will become
increasingly
widespread among the Chinese people, and their
awareness of good
health and ability to keep
healthy are being constantly enhanced. Publicity
has been
intensified for tobacco control to
enhance the public's awareness of the hazards of
smoking, and eventually creating the
atmosphere that the whole society support
tobacco control. Since China joined the WHO
Framework Convention of Tobacco
Control in
January 2006, the various localities in China have
made proactive efforts to
legalize control of
smoking in public places for a smoking-free
environment.
重视维护公众的精神健康。颁布精神卫生法,通过立法规范精神
卫生服务,保护
精神障碍患者的权益。完善重性精神疾病防治网络,加强精神卫生医疗机构救治
急重性精神疾病能力建设,建立医院与社区相互支持和配合的重性精神疾病防治
工作机制。把精神卫生专
业人员列入“十二五”时期急需紧缺的人才类别,加强人
才培养工作。规范患者服务管理,启用国家重性
精神疾病基本数据收集分析系统,
实现病人信息电子化管理。目前,在城市社区和农村居家接受规范管理
的重性精
神疾病患者有302.6万人。
Maintenance of people's
mental health has been valued. China issued the
Mental
Health Law to regulate the mental
health services and protect the rights and
interests
of people with mental disorders. The
Chinese government strives to improve the
prevention and treatment network of severe
mental illnesses, enhance the ability of
mental healthcare institutions to treat and
cure acute or severe mental illnesses, and
has
established a working mechanism for severe mental
illness prevention and
treatment in which
psychiatric hospitals and communities support and
cooperate with
each other. China has included
professionals in mental health services as the
urgently
needed task during the 12th Five-Year
Plan, and has intensified their training. It has
standardized patient services and management,
launched a basic data collection and
analysis
system for severe mental illnesses, and digitized
data on patients. At present,
there are 3.026
million people with serious mental disorders in
China's urban and
rural areas who are
receiving standard management at their homes.
五、妇女儿童健康权益保护
V. Protecting Women and
Children's Right to Health
中国现有8.6亿妇女儿童,约
占总人口的三分之二。中国政府将男女平等作为一
项基本国策,一贯高度重视妇女儿童的生存和健康状况
,完善妇幼卫生法制与政
策,签署多项保护妇女儿童的国际公约,健全妇幼卫生服务体系,实施妇幼公共
卫生服务项目,着力提高妇幼卫生服务的公平性和可及性,促使广大妇女儿童健
康权益得到有效
保护。
Currently, China has 860 million
women and children, accounting for two thirds of
the nation's total population. The Chinese
government has established gender equality
as
a basic national policy, and has always attached
great importance to the life and
health of
women and children. The state strives to improve
the legal regime and
related policies
regarding women and children's healthcare, and has
signed many
international conventions
committed to the protection of women and children.
China
has improved its health services for
women and children, and implemented public
health service programs for them, focusing on
making these services more equitable
and
accessible so as to effectively protect women and
children's right to health.
完善妇幼卫生法制和政策。1
994年10月全国人大常委会审议通过母婴保健法,
标志着妇幼卫生工作进入法制化管理阶段。20世
纪90年代以来,中国政府制定
实施《中国妇女发展纲要(1995—2000年)》、《中国妇女发展
纲要(2001—2010
年)》、《中国妇女发展纲要(2011—2020年)》和《九十年代中国
儿童发展规划
纲要》、《中国儿童发展纲要(2001—2010年)》、《中国儿童发展纲要(201
1—2020
年)》,把妇女儿童健康纳入国民经济和社会发展规划,作为优先发展的领域之
一
。
The legal regime and related policies
regarding women and children's healthcare have
been improved. In October 1994, the Standing
Committee of the National People's
Congress
reviewed and passed the Law on Healthcare for
Mothers and Infants, which
signaled that
China's management of women and children's affairs
had entered a
law-based stage. Since the
1990s, the Chinese government has enacted the
Program
for the Development of Chinese Women
(1995-2000), Program for the Development
of
Chinese Women (2001-2010), Program for the
Development of Chinese Women
(2011-2020),
Program for the Development of Chinese Children in
the 1990s,
Program for the Development of
Chinese Children (2001-2010) and Program for the
Development of Chinese Children (2011-2020),
giving priority to women and
children's health
in national programs of economic and social
development.
健全妇幼卫生服务体系。中国妇幼卫生体系以妇幼保健专业机构
为核心,以城乡
基层医疗卫生机构为基础,以大中型综合医疗机构和相关科研教学机构为技术支
持,为妇女儿童提供全方位的医疗保健服务。建立妇幼卫生年报系统和世界上规
模最大的妇幼卫生监测网
络,实施出生缺陷监测、孕产妇死亡监测、5岁以下儿
童死亡监测、危重孕产妇监测和儿童营养健康监测
。妇幼卫生信息为各级政府制
定卫生政策特别是妇幼卫生政策提供了科学依据。
The
health service system for women and children has
been improved. China's
healthcare system for
women and children takes professional women and
children's
health organizations as its core
and is based on community-level urban and rural
healthcare services. With technical support
from large and medium-sized general
hospitals
and relevant research and training institutions,
the state provides all-round
healthcare
services for women and children. The country
publishes annual reports on
women and
children's healthcare progress and has developed
the world's largest
monitoring network in this
regard, keeping track of cases of birth defects,
deaths of
pregnant and lying-in women, deaths
of children under five years of age, and
complicated cases of pregnant and lying-in
women, as well as children's nutrition and
health. The information collected on women and
children's health has provided a solid
statistical basis for governments at all
levels to formulate healthcare policies,
especially policies on women and children's
health.
开展妇女生殖保健服务。积极推广婚前和孕前保健,普及优生优育、生殖健
康科
学知识,深入开展孕产期保健,形成包括产前检查、产前筛查与诊断、高危孕产
妇筛查与管
理、住院分娩、新生儿保健和产后访视在内的一整套孕产期保健服务。
2011年全国孕产妇产前检查率
、产后访视率和系统管理率分别为93.7%、91.0%
和85.2%,比2000年分别提高4.8
1%、5.57%和10.36%,高危孕产妇管理率达到
了99.6%。开展“降低孕产妇死亡率、消
除新生儿破伤风”项目,消除了孕产妇及
新生儿破伤风。2011年,全国孕产妇死亡率为26.110
万,比1990年和2000年
下降了72.4%和50.8%。开展妇女病普查普治、青春期保健和更
老年期保健等,
为广大妇女提供全生命周期服务。
The reproductive
health services for women are provided. China has
proactively
promoted premarital and pre-
pregnancy healthcare, and has been publicizing
knowledge on prenatal and postnatal care, and
reproductive health. Intensive
healthcare
services for pregnant and lying-in women are
available, and a complete
array of services
for pregnant and lying-in women has been
developed, covering
prenatal examination,
prenatal defect screening and diagnosis, screening
and
management of high-risk pregnant and
lying-in women, hospitalized delivery, infant
healthcare and postnatal home visits. In 2011,
a total of 93.7%, 91.0% and 85.2% of
pregnant
and lying-in women, respectively, received
prenatal examinations, postnatal
home visits
and other medical management services in China,
4.81%, 5.57% and
10.36% higher than the
statistics of 2000. The percentage of high-risk
pregnant and
lying-in women included in the
medical management program has reached 99.6%.
China has carried out a program to the
maternal mortality and eliminate
neonatal
tetanus,
2011 was 26.1 per 100,000, dropping
72.4% and 50.8% as compared to 1990 and
2000,
respectively. The state also provides medical
services for the screening and
treatment of
gynecological diseases, adolescence health, and
climacteric and old-age
health, offering
services that cover the whole life cycle of
Chinese women.
开展儿童保健服务。加强新生儿保健,规范新生儿访视服务
。开展婴幼儿及学龄
前儿童保健,实施7岁以下儿童保健管理和3岁以下儿童系统管理。2011年全<
br>国3岁以下儿童系统管理率和7岁以下儿童保健管理率分别达到84.6%和85.8%。
儿童生长发育水平不断提高,儿童营养不良状况持续减少。努力控制出生缺陷,
提高出生人口素
质,开展新生儿疾病筛查、0—3岁儿童早期综合发展、发育偏
离儿童的康复训练、高危儿早期干预、食
物过敏的早期干预、睡眠问题干预、环
境污染对儿童健康损害的早期干预以及青春期保健等。关注和重视
留守儿童、流
动儿童、伤残儿童等特殊儿童群体的身心健康。
The healthcare
services for children are provided. China has
strengthened healthcare
for newborns and
regularized home-visiting service for newborns.
The state offers
healthcare services for
infants, young children and pre-school children,
and exercises
health management of children
under seven years of age and comprehensive
management of children under three years of
age. In 2011, some 84.6% of children
under
three years of age and 85.8% of children under
seven years of age received
comprehensive
health management and medical management services.
Chinese
children are growing healthier and
faster physically, and cases of malnutrition keep
declining. The state strives to control birth
defects and improve the quality of
newborn
babies, and has conducted disease screenings for
newborns, early
development programs for
children under three years old, rehabilitation
training for
children with growth deviation,
early-stage intervention for high-risk children,
early-stage intervention in cases of food
allergy, assistance with sleep problems,
early-stage help in case of damage to
children's health caused by environmental
pollution, and adolescence healthcare, among
others. Children whose parents seek
employment
away from home, children who live with their
migrant-worker parents,
disabled children and
other special groups of children also receive
attention and help
from the state both
physically and mentally.
六、中医药发展
VI.
Development of Traditional Chinese Medicine
中医
药在中国有着悠久的历史,是中华民族在生产生活实践以及治疗疾病过程中
形成和发展的医学科学,是中
华民族智慧的结晶,为中华民族繁衍昌盛作出了重
要贡献。中医药在治疗常见病、多发病和疑难病等方面
独具特色和优势,在治疗
传染性疾病方面也有良好效果,并以其费用低、疗效好、副作用小等特点,深受
中国公众喜爱,在医疗卫生保健中发挥着不可替代的重要作用。中国政府一贯积
极扶持和促进中
医药事业的发展。
Traditional Chinese Medicine (TCM)
has a long history in China, and is a medical
science formed and developed by the Chinese
people in their daily work and life as
well as
attempts to treat diseases. TCM is the
crystallization of the wisdom of the
Chinese
people, and has made important contributions to
the continuance and thriving
of the Chinese
nation. Known for its unique characteristics and
advantages in curing
common diseases,
frequently occurring diseases and complicated
diseases, TCM has
also proved effective in
treating infectious diseases and is very popular
among the
Chinese public for its low cost,
satisfactory curative action and mild side
effects.
TCM plays an irreplaceable
role in China's medical and healthcare endeavors,
and the
Chinese government has always
supported and promoted its development.
建
立覆盖城乡的中医医疗服务体系。在城市,形成了以中医医院、民族医医院、
中西医结合医院、中医专科
医院、综合医院中医科、社区卫生服务机构及中医门
诊部和中医诊所为主的城市中医药服务网络。在农村
,形成了由县级中医医院、
乡镇卫生院中医科和村卫生室为主的农村中医药服务网络。目前,75.6%
的社区
卫生服务中心、51.6%的社区卫生服务站、66.5%的乡镇卫生院、57.5%的村卫生<
br>室能够提供中医药服务。
Networks of TCM medical
services have been established to cover both urban
and
rural areas. Networks of TCM medical
services now cover Chinese cities, providing
services for urban residents through TCM
hospitals, ethnic-medicine hospitals,
hospitals of integrated traditional Chinese
and Western medicine, specialized TCM
hospitals, TCM departments of general
hospitals, community health services, TCM
outpatient departments and TCM clinics. In the
rural areas, TCM service networks
have also
been developed to serve rural residents through
county-level TCM hospitals,
and TCM
departments or sections of township hospitals and
village clinics. Currently,
75.6% of community
health service centers, 51.6% of community health
service
stations, 66.5% of village and
township hospitals and 57.5% of village clinics
can
provide TCM services.
形成独具特色的中医药人
才培养体系。国家把人才培养作为中医药事业发展的根
本,加强名老中医药专家学术思想和经验继承工作
以及优秀中医临床人才培养,
加强社区、农村基层中医药人才的培养,基本形成了院校教育、师承教育、
继续
教育多形式、多层次、多途径的中医药教育体系,初步建立起社区、农村基层中
医药人才培
养机制。截至2011年,全国共有高等中医药、民族医药院校46所,
高等教育中医药类在校生人数5
5.3万人,卫生机构中医类别执业(助理)医师29.4
万人,中药师(士)9.7万人。
A unique training system for qualified TCM
professionals has been developed. The
state
takes the cultivation of qualified professionals
as the cornerstone for the
development of TCM.
China has enhanced its efforts to pass down the
academic
achievements and experience of
renowned and senior TCM experts as well as the
training of high-caliber professionals in
clinical practice. An education system for
TCM
personnel has been basically developed in the
forms of academic education,
master-apprentice
tutorials and continued education at different
levels and through
different channels. By
2011, China had a total of 46 institutions of
higher learning
specializing in TCM and ethnic
medicine, with 553,000 undergraduate students of
TCM on campus, as well as 294,000
practitioners and assistant doctors of TCM, in
addition to 97,000 licensed and assistant
pharmacists in TCM.
推进中医药现代化。积极利用现
代科学技术,推进中医药的理论和技术创新,在
中医基础理论、临床诊疗、中药技术等领域取得重要成果
。推进中药产业化和现
代化,中药产业规模、技术水平大幅提高。目前,全国中药生产企业近1500家
。
中药产品种类、数量、生产工艺水平有了很大提高。重视和保护中医药的文化价
值,41项中
医药项目列入国家非物质文化遗产名录。
A modernization drive for
TCM has been initiated. The state has proactively
promoted theoretical and technical innovations
in TCM through the application of
modern
science and technology, and has gained important
achievements in basic
TCM theory, clinical
diagnosis and treatment, TCM technology and other
related
areas. China promotes the
industrialization and modernization of TCM, and as
a result
the industrial scale and technical
level of TCM has increased markedly. Currently,
there are about 1,500 manufacturers of TCM
pharmaceuticals in China, and the
variety,
quantity and processing technique of TCM
pharmaceuticals have improved
by a wide
margin. The state attaches importance to the
protection of TCM's cultural
values, and 41
TCM programs have been included on the nation's
intangible heritage
list.
积极开展国际交流合作
。目前,已有70多个国家与中国签订了包含中医药内容
的政府协议或专门的中医药合作协议,中医药对
外医疗、教育、科技合作不断扩
大,已传播到世界上160多个国家和地区。“中医针灸”列入人类非物
质文化遗产
代表作名录,《黄帝内经》、《本草纲目》等中医药典籍列入《世界记忆遗产名
录》
。国际标准化组织(ISO)成立了中医药技术委员会,并将这一委员会的秘书
处设在中国。
International exchanges and cooperation have
been actively promoted. China has
signed
treaties with TCM contents or special TCM
cooperation agreements with over
70 countries,
and cooperation in TCM application in foreign
countries, and TCM
education and technical
cooperation has steadily expanded. Now, over 160
countries
and regions around the world have
access to TCM. TCM acupuncture and
moxibustion
has been recognized as a masterpiece of the
intangible heritage of
mankind, and the
Huangdi Neijing (Inner Canon of the Yellow
Emperor), Bencao
Gangmu (Compendium of Materia
Medica) and other TCM treatises have been
included in the UNESCO Memory of the World.
The International Standardization
Organization
(ISO) has set up a TCM technical committee and
located its secretariat
in China.
七、卫生国际合作
VII. International Medical and
Healthcare Cooperation
长期以来,中国积极参与全球卫生事
务,广泛开展卫生领域的政府间和民间的多
边、双边合作交流,积极参加国际社会、国际组织倡导的重大
卫生行动。高度重
视卫生国际援助,先后为许多发展中国家援建医院、培训卫生人才、开展疾病防
控等工作,为受援国医疗卫生事业发展发挥了巨大作用。
For a long period
of time, China has been actively participating in
international health
affairs, and has carried
out extensive inter-government and non-
governmental
multilateral and bilateral
cooperation and exchanges. China has also
proactively taken
part in major health
programs of the international community and
international
organizations. The state pays
great attention to international health assistance
programs, and has played a huge role in
improving the medical and health conditions
in
many developing countries by building hospitals,
training medical and healthcare
professionals
and carrying out disease control there.
支
持世界卫生组织等国际组织工作。积极参与全球卫生议题讨论,分享经验。20
世纪70年代,中国总结
和贡献卫生实践经验,为推动1978年《阿拉木图宣言》
实施初级卫生保健发挥了重要作用。近年来,
在《国际卫生条例(2005)》框架下,
与世界卫生组织及各国保持及时、密切、畅通联系,为全球疾
病防控作出贡献。
中国政府每年向世界卫生组织、联合国艾滋病规划署以及全球抗击艾滋病、结核
病和疟疾基金等国际组织提供捐款。大力支持国际社会在慢性病、人禽流感、控
烟、应急等技术领域的
工作。
Support has been rendered to the work of
the World Health Organization and other
international organizations. China has been
taking an active role in international
discussions on health issues and sharing
experiences in this regard. In the 1970s,
China summarized its practices in healthcare
and played an important part in the
signing of
the Declaration of Alma-Ata in 1978 on primary
healthcare by contributing
its medical
experience. In recent years, China has been
efficiently maintaining timely
and close
contact with the World Health Organization and
various countries under the
framework of the
International Health Regulations (2005), making
its due
contribution to disease control on a
global scale. The Chinese government makes
annual donations to the World Health
Organization, the Joint United Nations Program
on HIV and AIDS (UNAIDS), the Global Fund to
fight AIDS, tuberculosis and
malaria, and
other international efforts. China also vigorously
supports international
work to combat chronic
diseases and human avian influenza, as well as in
tobacco
control, emergency medical responses
and other related technical fields.
加强区域卫
生合作。2003年以来,以中国—东盟传染病防控领域的合作为开端,
加快推进区域卫生合作进程。目
前,中国已在大湄公河次区域、中亚区域经济合
作、中国—东盟、东盟与中日韩、中日韩、亚太经济合作
组织和上海合作组织等
7个区域性合作机制下,开展与周边国家和本区域的卫生合作和国际援助。从
p>
2005年起,中国与缅甸、越南、老挝合作,在边境地区开展疟疾、艾滋病联防
联
控项目,还开展了结核病、登革热防治等跨境合作项目。
Regional health
cooperation has been strengthened. In 2003, China
initiated
cooperation in the field of
infectious disease control with ASEAN, and has
quickened
its steps to promote regional health
cooperation since then. Currently, China is
carrying out health cooperation with
peripheral countries and regional international
aid programs within seven regional cooperation
mechanisms, namely, those of the
Greater
Mekong Sub-region, Central Asia Region, China-
ASEAN, ASEAN and
China, Japan and Korea,
Inter-China-Japan-Korea, Asia-Pacific, and
Shanghai
Cooperation Organization. Since 2005,
China has been cooperating with Myanmar,
Vietnam and Laos to carry out joint prevention
and control programs of malaria and
AIDS, as
well as cross-border cooperation programs on the
prevention and treatment
of tuberculosis and
dengue fever.
派遣援外医疗队。援外医疗队是中国履行国际义务,按政府双
边协议向受援国派
遣医务人员团队,在发展中国家开展医疗卫生服务的无偿援助项目。1963年,中国政府向阿尔及利亚派出第一支援外医疗队。截至2011年,中国政府已先后
向73个国家派遣
了医疗队。目前,有56支医疗队分布在阿尔及利亚、坦桑尼亚、
摩洛哥、津巴布韦等53个国家,为当
地特别是贫困地区人民提供免费医疗服务,
并为受援国引入大批先进医疗技术。50年来,中国援外医疗
队共诊疗患者约2.6
亿人次。医疗队的工作获得当地民众的高度赞扬,受到受援国政府的充分肯定,<
br>迄今约有900名中国医疗队员获得受援国颁发的勋章等各种荣誉。在此期间,有
50名中国援外
医疗队员牺牲在异国他乡。
Medical teams have been sent to
developing countries to improve medical conditions
there. The medical teams China dispatches to
developing countries to improve the
medical
and health conditions there are a regular aid
program between the Chinese
government and the
recipient countries in accordance with bilateral
agreements. In
1963, the Chinese government
sent its first medical team abroad, to Algeria,
and by
2011, China had sent medical teams to
73 countries. Currently, there are 56 Chinese
medical teams in Algeria, Tanzania, Morocco,
Zimbabwe and 49 other countries. The
medical
teams provide free medical services for local
people there, especially people
in poverty-
stricken areas, as well as introducing advanced
medical technology into the
recipient
countries. For 50 years, the Chinese medical teams
have diagnosed and
treated a total of 260
million cases, and their work has been much
appreciated by the
people and fully recognized
by the governments of the recipient countries. So
far,
about 900 Chinese medical team members
have been awarded honors by the recipient
countries, and 50 members died during their
service abroad.
援建医疗机构。从1970年开始,中国
支援非洲等地区的发展中国家建设医疗机
构,致力于改善受援国医疗设施条件。截至2011年底,中国
共帮助52个国家建
成100所医院和医疗中心,为解决当地民众看病就医困难作出了积极贡献。中国<
br>为援建医院提供大量成套医疗设备和药品,仅2011年中国就提供了34批医疗设
备和药品。截
至2011年11月,还有28个国家的31个援建项目在建。
Medical
institutions have been built in developing
countries with aid from China.
Since 1970,
China has been committed to helping developing
countries in Africa and
other areas to build
medical institutions and improve their medical
conditions. By the
end of 2011, China had
helped a total of 52 countries, and built 100
hospitals and
medical centers for them,
improving medical conditions and providing medical
services for local people. China equipped the
hospitals with a large number of
complete sets
of medical equipment and medicines, and in 2011
alone it shipped 34
batches of medical
equipment and medicines to the recipient
countries. By November
2011, 31 new projects
in this regard were still under construction in 28
countries.
培训卫生人力资源。中国援外医疗队通过带教、讲座、培训等方式,
将医疗技术
传授给当地医护人员,提高受援国卫生技术水平。中国政府支持卫生技术机构在
华为
发展中国家举办卫生技术研修和培训,截至2011年,共举办培训班400多
期,培训15000余人
,涉及卫生管理、紧急救援管理、食品卫生、传统医药、传
染病防控、实验室检测、卫生检疫和护理技术
等。为帮助发展中国家培养高层次
医学卫生人才,中国政府还向在华学习医学和中医药学的发展中国家学
生提供政
府奖学金。
Health professionals have been
trained by China for developing countries. The
Chinese medical teams pass their medical
knowledge and technology to local medics
through personal tutorials, lectures and
training courses, improving the medical
technology of the recipient countries. The
Chinese government supports health
technology
institutions to hold related study and training
programs for developing
countries in China. By
2011, China had held over 400 training courses for
15,000
persons on health management, emergency
management, food hygiene, traditional
medicine, infectious disease prevention and
control, laboratory testing, health
quarantine, nursing skills and other areas. To
help developing countries train medical
and
health professionals of high caliber, China also
offers government scholarships
for students
from developing countries studying medicine and
TCM in China.
开展国际紧急救援。2004年,印度洋地震和海啸在东南亚
和南亚地区造成重大
人员伤亡,中国及时派出卫生救援队赴泰国、斯里兰卡、印度尼西亚开展救援,并通过世界卫生组织向受灾国家捐助医疗仪器设备和美元现汇。近五年来,中国
政府累计开展卫生紧
急救援近200次,包括向发生疫情、自然灾害的几内亚比绍、
马达加斯加、巴基斯坦、印度尼西亚、海
地等国家派遣卫生救援队、提供物资或
现汇紧急援助等。中国还派出救援队赴黎巴嫩、刚果(金)等国际
维和任务区实施
人道主义医学援助,派遣“和平方舟号”医院船赴亚非五国、拉美四国开
展巡回医
疗服务。
International emergency rescue
has been undertaken. In 2004, Southeast Asia and
South Asia suffered great casualties due to an
earthquake in the Indian Ocean and the
following tsunami. China promptly responded to
the emergency by sending medical
rescue teams
to Thailand, Sri Lanka and Indonesia to help
relief efforts there, and
donated medical
equipment and cash in US dollar to the affected
countries through
the World Health
Organization. Over the past five years, the
Chinese government has
responded to about 200
health emergencies, sending medical rescue teams
to
Guinea-Bissau, Madagascar, Pakistan,
Indonesia, Haiti and other countries stricken by
epidemics or natural disasters, as well as
providing relief supplies and cash to those
countries. China has also dispatched rescue
teams to Lebanon, the Democratic
Republic of
the Congo and other international peacekeeping
mission areas to offer
humanitarian medical
aid there, and its Peace Ark hospital ship sailed
to five Asian
and African and four Latin-
American nations to provide medical services to
the
people there.
结束语
Conclusion
随着中国工业化、城市化进程和人口老龄化趋势的加快,居民健康面临着传染病
和慢性病的双重
威胁,公众对医疗卫生服务的需求日益提高。与此同时,中国卫
生资源特别是优质资源短缺、分布不均衡
的矛盾依然存在,医疗卫生事业改革与
发展的任务十分艰巨。
With the
quickened pace of the country's industrialization
and urbanization, as well as
its increasingly
aging population, the Chinese people are facing
the dual health threats
of infectious and
chronic diseases, and the public needs better
medical and health
services. In the meantime,
problems still exist regarding China's health
resources,
especially the shortage of high-
quality resources and the unbalanced distribution
of
those resources. China has arduous tasks
ahead for reforming and developing its
medical
and health services.
中国政府提出,到2020年建立健全覆盖城
乡居民的基本医疗卫生制度,实现人
人享有基本医疗卫生服务。为此,中国将继续深入推进改革,全面发
展医疗卫生
事业,更好地维护、保障和增进全体居民的健康。中国也将继续积极参与全球卫
生事
务,与各方共同携手,为改善全球健康作出更大努力。
The Chinese
government has announced that it will establish a
sound basic medical
and health system covering
both urban and rural residents by 2020, so as to
ensure
that everyone enjoys access to
basic medical and health services. For this goal,
China
will continue to reform and develop its
medical and health services, and better
maintain, ensure and enhance the health of its
people. China will also continue its
active
role in international health affairs and work
together with different parties to
make
greater effort to improve the health of mankind.
《中国的医疗卫生事业》白皮书
White Paper: Medical
and Health Services in China
中华人民共和国国务院新闻办公室26日发表《中国的医疗卫生事业》白皮书。
全文如下:
The State Council Information Office of the
People's Republic of China on
Wednesday
published a white paper on the medical and health
services in China.
Following is the full text
of the white paper:
中国的医疗卫生事业
(2012年12月)
中华人民共和国
国务院新闻办公室
Medical and
Health Services in China
(December 2012)
Information Office of the State Council
The People's Republic of China
目录
Contents
前言
Foreword
一、卫生基本状况
I. Basic Conditions
二、医药卫生体制改革
II.
Reform of Medical and Healthcare Systems
三、传染病防治与卫生应急
III. Infectious Disease
Prevention and Treatment, and Health
Management
四、慢性非传染性疾病防治
IV. Prevention
and Treatment of Chronic Non-communicable
Disorders
五、妇女儿童健康权益保护
V. Protecting Women
and Children's Right to Health
六、中医药发展
pment of Traditional Chinese Medicine
七、卫生国际合作
VII. International Medical and
Healthcare Cooperation
结束语
Conclusion
Emergency
前言Foreword
健康是促进人的全面发展的必然要求。提高人民健康水平,实现病有所医的理想,
是人类社会的共同追求
。在中国这个有着13亿多人口的发展中大国,医疗卫生
关系亿万人民健康,是一个重大民生问题。
Good health is a prerequisite for promoting
all-round development of the person. And
it is
a common pursuit of human societies to improve
people's health and ensure their
right to
medical care. For China, a large developing
country, medical and healthcare is
of vital
importance to its population of over 1.3 billion,
and is a major issue
concerning its people's
well being.
中国高度重视保护和增进人民健康。宪法规定,国家发展医疗卫生
事业,发展现
代医药和传统医药,保护人民健康。围绕宪法,中国逐步形成了相对完善的卫生
法
律法规体系。
China pays great attention to
protecting and improving its people's health. As
the
Constitution stipulates, state develops
medical and health services, promotes
modern
medicine and traditional Chinese medicine..., all
for the protection of the
people's on this
constitutional stipulation, China has put in place
a
complete system of laws and regulations
concerning medical and health services.
多
年来,中国坚持“以农村为重点,预防为主,中西医并重,依靠科技与教育,
动员全社会参与,为人民健
康服务,为社会主义现代化建设服务”的卫生工作方
针,努力发展具有中国特色的医疗卫生事业。经过不
懈努力,覆盖城乡的医疗卫
生服务体系基本形成,疾病防治能力不断增强,医疗保障覆盖人口逐步扩大,
卫
生科技水平日益提高,居民健康水平明显改善。
Over the years,
China has worked hard to develop its medical and
health services with
Chinese characteristics
in accordance with the policy of
of our work,
putting disease prevention first, supporting both
traditional Chinese
medicine and Western
medicine, relying on science, technology and
education, and
mobilizing the whole of society
to join the efforts, improving the people's health
and
serving socialist
modernization.
medical and healthcare systems
covering both urban and rural residents have taken
shape, the capabilities of disease prevention
and control have been enhanced, the
coverage
of medical insurance has expanded, continuous
progress has been made in
medical science and
technology, and the people's health has been
remarkably
improved.
为建立起覆盖城乡居民的基本医疗
卫生制度,保障每个居民都能享有安全、有
效、方便、价廉的基本医疗卫生服务,中国深入推进医药卫生
体制改革,取得了
重要阶段性成效。
To put into place basic
medical and healthcare systems covering both urban
and rural
residents, and ensure that every
resident has access to safe, effective, convenient
and
affordable basic medical and health
services, China has kept advancing the reform of
its medical and healthcare system, and made
important achievements in the current
stage.
一、卫生基本状况
I. Basic
Conditions
居民健康状况不断改善。从反映国民健康状况的重要指标看,中国居
民的健康水
平已处于发展中国家前列。2010年人均期望寿命达到74.8岁,其中男性72.4岁,
女性77.4岁。孕产妇死亡率从2002年的51.310万下降到2011年的26.110万。<
br>婴儿死亡率及5岁以下儿童死亡率持续下降,婴儿死亡率从2002年的29.2‰下
降到201
1年的12.1‰,5岁以下儿童死亡率从2002年的34.9‰下降到2011年
的15.6‰,提
前实现联合国千年发展目标。
The people's health has been
improved. Judging from important indicators that
give
expression to national health, the health
of the Chinese people is now among the top
in
developing countries. In 2010, the life expectancy
was 74.8 years - 72.4 years for
males and 77.4
years for females; the maternal mortality rate
went down from 51.3
per 100,000 in 2002 to
26.1 per 100,000 in 2011; the infant mortality
rate and the
mortality rate of children under
the age of five have kept dropping, with the
former
going down from 29.2 per thousand in
2002 to 12.1 per thousand in 2011, and the
latter, from 34.9 per thousand to 15.6 per
thousand, attaining ahead of schedule the
UN
Millennium Development Goal in this regard.
建立起覆盖城乡的医疗卫生体系。一是公共卫生服务体系。包括疾病预防控制、
健康教育、妇
幼保健、精神卫生、卫生应急、采供血、卫生监督和计划生育等专
业公共卫生服务网络,以及以基层医疗
卫生服务网络为基础、承担公共卫生服务
功能的医疗卫生服务体系。二是医疗服务体系。在农村建立起以
县级医院为龙头、
乡镇卫生院和村卫生室为基础的农村三级医疗卫生服务网络,在城市建立起各级
各类医院与社区卫生服务机构分工协作的新型城市医疗卫生服务体系。三是医疗
保障体系。这个体系以
基本医疗保障为主体、其他多种形式补充医疗保险和商业
健康保险为补充。基本医疗保障体系包括城镇职
工基本医疗保险、城镇居民基本
医疗保险、新型农村合作医疗和城乡医疗救助,分别覆盖城镇就业人口、
城镇非
就业人口、农村人口和城乡困难人群。四是药品供应保障体系。包括药品的生产、
流通、
价格管理、采购、配送、使用。近期重点是建立国家基本药物制度。
Medical and
healthcare systems covering both urban and rural
residents have been put
in place. Of these
systems, the first is the public health service
system, which covers
disease prevention and
control, health education, maternity and child
care, mental
health, health emergency
response, blood collection and supply, health
supervision,
family planning and some other
specialized public health services, and a medical
and
healthcare system based on community-level
healthcare networks that provides public
health services. The second is the medical
care system. In the rural areas, it refers to a
three-level medical service network that
comprises the county hospital, the township
hospitals and village clinics, with the county
hospital performing the leading role, and
township hospitals and village clinics service
at the base. And in the cities and towns,
it
refers to a new type of urban medical health
service system that features division of
responsibilities as well as cooperation among
various types of hospitals at all levels
and community healthcare centers. The
third is the medical security system. This
system comprises mainly the basic medical
security, supported by many forms of
supplementary medical insurance and commercial
health insurance. The basic medical
security
system covers basic medical insurance for working
urban residents, basic
medical insurance for
non-working urban residents, a new type of rural
cooperative
medical care and urban-rural
medical aid, which cover, respectively, the
employed
urban population, unemployed urban
population, rural population and people
suffering from economic difficulties. And the
fourth is the pharmaceutical supply
system,
which covers the production, circulation, price
control, procurement,
dispatching and use of
pharmaceuticals. The recent work is focused on
establishing a
national system for basic
drugs.
卫生筹资结构不断优化。卫生筹资来源包括政府一般税收、社会医疗保险、商
业
健康保险和居民自费等多种渠道。2011年,中国卫生总费用达24345.91亿元人
民
币,同期人均卫生总费用为1806.95元人民币,卫生总费用占国内生产总值的
比重为5.1%。按
可比价格计算,1978—2011年,中国卫生总费用年平均增长速
度为11.32%。个人现金卫生
支出由2002年的57.7%下降到2011年的34.8%,卫
生筹资系统的风险保护水平和再分配
作用不断提高。2011年,医院、门诊机构
费用为18089.4亿元人民币,公共卫生机构费用为2
040.67亿元人民币,分别占
卫生总费用的71.74%和8.09%。医院费用中,城市医院、县
医院、社区卫生服
务中心、乡镇卫生院费用分别占64.13%、21.28%、5.17%、9.3%
。
The health financing structure has been
constantly improved. China's health
expenditure comes from the government's
general tax revenue, social medical
insurance,
commercial health insurance, residents' out-of-
pocket spending, etc. In
2011, the total
health expenditure in China reached 2,434.591
billion yuan, 1,806.95
yuan per capita. The
total expenditure accounted for 5.1% of the
country's GDP. In
comparable prices, the
health expenditure grew by an average annual rate
of 11.32%
from 1978 to 2011. Individual
to
34.8% in 2011, showing that health financing is
working better in the areas of risk
protection
and re-distribution. In 2011, the spending on
hospitals and outpatient
establishments was
1,808.94 billion yuan, and that on public health
agencies, 204.067
billion yuan, comprising
71.74% and 8.09%, respectively, of the total
health
expenditure. Of the total spending on
hospitals, those on urban hospitals, county
hospitals, community health service centers
and township health service centers stood
at
64.13%, 21.28%, 5.17% and 9.3%, respectively.
卫生资源持续发展。截至2011年底,全国医疗卫生机构达95.4万个(所),与2003
年比较,医疗卫生机构增加14.8万个(所)。执业(助理)医师246.6万人,每千人
口执业(助
理)医师数由2002年的1.5人增加到1.8人。注册护士224.4万人,每
千人口注册护士数由
2002年的1人增加到1.7人。医疗卫生机构床位数516万
张,每千人口医疗卫生机构床位数由2
002年的2.5张提高到3.8张。
Health resources have been
developing in a sustained way. By the end of 2011,
medical and healthcare institutions around the
country totaled 954,000, an increase of
148,000 over 2003. Licensed doctors
(assistants) reached 2,466,000, or 1.8 per
thousand people, as compared with 1.5
per thousand people in 2002. Registered
nurses
totaled 2,244,000, or 1.7 per thousand people, as
compared with one per
thousand people in 2002.
The number of hospital beds reached 5160,000, or
3.8 per
thousand people, as compared with 2.5
per thou-sand people in 2002.
医疗卫生服务利用状况显
著改善。2011年,全国医疗机构诊疗人次由2002年的
21.5亿人次增加到62.7亿人次,住
院人数由2002年的5991万人增加到1.5亿人。
中国居民到医疗卫生机构年均就诊4.6次,每
百居民住院11.3人,医院病床使用
率为88.5%,医院出院者平均住院日为10.3天。居民看病
就医更加方便,可及性
显著提高。15分钟内可到达医疗机构住户比例,由2003年的80.7%提高
到2011
年的83.3%,其中农村地区为80.8%。医疗质量管理和控制体系不断完善。建立无偿献血制度,血液安全得到保障。
Marked improvement has been
seen in the utilization of medical and health
services.
In 2011, medical institutions
throughout the country hosted 6.27 billion
outpatients, as
compared with 2.15 billion in
2002; and admitted 150 million inpatients, as
compared
with 59.91 million in 2002. That
year, Chinese residents went to the medical
institutions for medical treatment 4.6 times
on average; 11.3 of every 100 people were
hospitalized; the utilization rate of hospital
beds reached 88.5%; and the hospital stay
of
the inpatients averaged 10.3 days. These figures
show that it has become
increasingly
convenient to see a doctor and more easily
accessible to get medical
services. In 2011,
83.3% of all households (80.8% in rural areas)
could reach medical
institutions within 15
minutes, as compared with 80.7% in 2002. Medical
service
quality management and control systems
have been constantly improved. A system of
blood donation without compensation has been
established, so as to ensure blood
supply and
safety.
二、医药卫生体制改革
II. Reform of
Medical and Healthcare Systems
经过多年努力,中国卫生事业取得
显著发展成就,但与公众健康需求和经济社会
协调发展不适应的矛盾还比较突出。特别是随着中国从计划
经济体制向市场经济
体制的转型,原有医疗保障体系发生很大变化,如何使广大公众享有更好、更健全的医疗卫生服务,成为中国政府面临的一个重大问题。从20世纪80年代开始,
中国启动医药卫
生体制改革,并在2003年抗击传染性非典型肺炎取得重大胜利
后加快推进。2009年3月,中国公
布《关于深化医药卫生体制改革的意见》,
全面启动新一轮医改。改革的基本理念,是把基本医疗卫生制
度作为公共产品向
全民提供,实现人人享有基本医疗卫生服务,从制度上保证每个居民不分地域、
民族、年龄、性别、职业、收入水平,都能公平获得基本医疗卫生服务。改革的
基本原则是保基本、强
基层、建机制。
With years of effort, China has made
remarkable achievements in the development of
its healthcare undertakings, which, however,
still fall far short of the public's demands
for healthcare as well as the requirements of
economic and social development.
Especially when China turned from a
planned economy to a market economy, the old
medical care system has undergone great
changes. So it became an issue of major
importance for the Chinese government to
provide better and more accessible medical
and
health services to the public. In the 1980s, the
Chinese government initiated
reform of the
medical and healthcare systems, and speeded up the
reform in 2003
after a success was won in the
fight against the SARS. In March 2009, the Chinese
government promulgated the on Deepening Reform
of the Medical and
Health Care Systems,
of
this reform was to provide the whole nation with
basic medical and health services
as a public
product, and ensure that everyone, regardless of
location, nationality, age,
gender, occupation
and income, enjoys equal access to basic medical
and health
services. And the basic principles
to be followed in the reform were to ensure basic
services, improving such services at the
grass-roots level and establishing the
effective mechanisms.
医改是一项涉及面广、难度大的社
会系统工程,在中国这样一个人口多、人均收
入水平低、城乡区域差距大的发展中国家,深化医改是一项
十分艰巨复杂的任务。
三年多来,中国政府大力推进医药卫生服务与经济社会协调发展,积极破解医改<
br>这一世界性难题。通过艰苦努力,中国的新一轮医改取得积极进展。
Medical
reform is a social program that covers a wide
range and involves difficult
tasks. And it is
a hard and complicated task to deepen this reform
in China, a
developing country with a large
population, low per-capita income and a wide gap
between urban and rural areas. For over three
years, the Chinese government has
worked hard
to strike a balance between improving medical and
health services on
one hand and economic and
social development on the other, trying to find a
solution
to this worldwide problem. Thanks to
the persistent efforts made, China has made
positive progress in this new round of medical
reform.
——基本医疗保障制度覆盖城乡居民。截至2011年,城镇职工基本医疗
保险、
城镇居民基本医疗保险、新型农村合作医疗参保人数超过13亿,覆盖面从2008
年的
87%提高到2011年的95%以上,中国已构建起世界上规模最大的基本医疗
保障网。筹资水平和报
销比例不断提高,新型农村合作医疗政府补助标准从最初
的人均20元人民币,提高到2011年的20
0元人民币,受益人次数从2008年的
5.85亿人次提高到2011年的13.15亿人次,政策范
围内住院费用报销比例提高
到70%左右,保障范围由住院延伸到门诊。推行医药费用即时结算报销,居
民就
医结算更为便捷。开展按人头付费、按病种付费和总额预付等支付方式改革,医
保对医疗机
构的约束、控费和促进作用逐步显现。实行新型农村合作医疗大病保
障,截至2011年,23万患有先
天性心脏病、终末期肾病、乳腺癌、宫颈癌、耐
多药肺结核、儿童白血病等疾病的患者享受到重大疾病补
偿,实际补偿水平约
65%。2012年,肺癌、食道癌、胃癌等12种大病也被纳入农村重大疾病保障
试
点范围,费用报销比例最高可达90%。实施城乡居民大病保险,从城镇居民医保
基金、新型
农村合作医疗基金中划出大病保险资金,采取向商业保险机构购买大
病保险的方式,以力
争避免城乡居民发生家庭灾难性医疗支出为目标,实施大病
保险补偿政策,对基本医疗保障补偿后需个人
负担的合规医疗费用给予保障,实
际支付比例不低于50%,有效减轻个人医疗费用负担。建立健全城乡
医疗救助制
度,救助对象覆盖城乡低保对象、五保对象,并逐步扩大到低收入重病患者、重
度残
疾人、低收入家庭老年人等特殊困难群体,2011年全国城乡医疗救助8090
万人次。
The basic medical care systems cover both
urban and rural residents. By 2011, more
than
1.3 billion people had joined the three basic
medical insurance schemes that
cover both
urban and rural residents, i.e., the basic medical
insurance for working
urban residents, the
basic medical insurance for non-working urban
residents, and the
new type of rural
cooperative medical care, with their total
coverage being extended
from 87% in 2008 to
95% in 2011. This signaled that China has built
the world's
largest network of basic medical
security. Medical care financing and the
reimbursable ratio of medical costs have been
raised, and the government subsidy
standards
for the new rural cooperative medical care system
were increased from 20
yuan at the beginning
to 200 yuan per person per year in 2011,
benefiting 1.315
persontimes in 2011 as
against 585 persontimes in 2008. The reimbursement
rate for
hospitalization expenses covered by
relevant policies has been raised to around 70%,
and the range of reimbursable expenses has
been expanded to include outpatient
expenses.
Real-time reimbursement has been adopted for
medical expenses, making it
more convenient
for people to have their medical costs settled.
Reform has been
carried out in respect of the
forms of payment to include payment by person,
payment
by disease and total amount pre-
payment, enabling medical insurance to play a
better
restrictive role over medical
institutions as well as to control expenses and
compel the
medical institutions to improve
their efficiency. Critical illness insurance has
been
included in the new type of rural
cooperative medical care system. By 2011, some
230,000 patients of congenital heart disease,
advanced rental diseases, breast cancer,
cervical cancer, multidrug-resistant
tuberculosis and childhood leukemia had been
granted subsidies for major and serious
diseases, with the actual subsidies accounting
for 65% of their total expenses. In 2012, lung
cancer, esophagus cancer, gastric cancer
and
eight other major diseases were included in the
rural pilot program of insurance
for the
treatment of major diseases, and the reimbursement
rate reached as high as
90%. Critical illness
insurance has been introduced for both urban and
rural residents,
in which certain amounts of
money are earmarked in the medical insurance fund
for
non-working urban residents and that of
the new type of rural cooperative medical
care
to buy critical illness insurance policies from
commercial insurance companies,
aiming to
relieve urban and rural families of the heavy
burden of catastrophic medical
spending. The
policy of subsidy for critical illness insurance,
which covers no less
than 50% of the actual
medical costs, provides a guarantee for the
compliance costs to
be shouldered by the
individual after reimbursement from the basic
medical insurance.
This has effectively
reduced the financial burden of individuals. An
urban-rural
medical assistance system has been
established and improved, which at first covered
urban and rural subsistence allowance
recipients and childless and infirm rural
residents who receive the so-called
those who are severely ill and have low
comes, the severely disabled, senior citizens
from low-income families, and some other
groups with special difficulties. In 2011,
the
urban-rural medical assistance was granted to
80.90 million cases across the
country.
<
br>——基本药物制度从无到有。初步形成了基本药物遴选、生产供应、使用和医疗
保险报销的体系。
2011年,基本药物制度实现基层全覆盖,所有政府办基层医
疗卫生机构全部配备使用基本药物,并实
行零差率销售,取消了以药补医机制。
制定国家基本药物临床应用指南和处方集,规范基层用药行为,促
进合理用药。
建立基本药物采购新机制,基本药物实行以省为单位集中采购,基层医疗卫生机
构
基本药物销售价格比改革前平均下降了30%。基本药物全部纳入基本医疗保障
药品报销目录。有序推进
基本药物制度向村卫生室和非政府办基层医疗卫生机构
延伸。药品生产流通领域改革步伐加快,药品供应
保障水平进一步提高。
A basic system of drugs has been
developed from scratch. A system for the
selection,
production, supply and use of basic
drugs, and cover of them in medical insurance has
been put into place. In 2011, the coverage of
this system was extended to all
grass-roots
medical and health-care institutions run by the
government, where these
drugs were sold at
zero profit, practically eliminating the practice
of hospitals
subsidizing their medical
services with drug sales. A national guideline for
the clinical
application of basic drugs and a
formulary have been drawn up to ensure that basic
drugs are used according to due procedures at
grass-roots medical institutions. A new
mechanism has been established for the
procurement of basic drugs, under which the
basic drugs are to be purchased by provinces.
As a result, the prices of basic drugs at
grass-roots medical and healthcare
institutions have dropped by 30% on average, as
compared with those before the reform. The
basic drugs have all been included in the
list
of reimbursable drugs covered by basic medical
insurance. Also, efforts have been
made to
supply basic drugs in an orderly way to village
clinics and non-governmental
medical
institutions at the grass-roots level. The steps
of reform have been quickened
in drug
production and circulation, and the supply of
drugs has been better ensured.
——城乡基层医疗卫生
服务体系进一步健全。加大政府投入,完善基层医疗卫生
机构经费保障机制,2009—2011年,中
央财政投资471.5亿元人民币支持基层医
疗机构建设发展。采取多种形式加强基层卫生人才队伍建设
,制定优惠政策,为
农村和社区培养、培训、引进卫生人才。建立全科医生制度,开展全科医生规范化培养,安排基层医疗卫生机构人员参加全科医生转岗培训,组织实施中西部地
区农村订单定向医学
生免费培养等。实施万名医师支援农村卫生工程,
2009—2011年,1100余家城市三级医院支
援了955个县级医院,中西部地区城
市二级以上医疗卫生机构每年支援3600多所乡镇卫生院,提高
了县级医院和乡
镇卫生院医疗技术水平和管理能力。转变基层医疗服务模式,在乡镇卫生院开展
巡回医疗服务,在市辖区推行社区全科医生团队、家庭签约医生制度,实行防治
结合,保障居民看病就医
的基本需求,使常见病、多发病等绝大多数疾病的诊疗
在基层可以得到解决。经过努力,
基层医疗卫生服务体系不断强化,农村和偏远
地区医疗服务设施落后、服务能力薄弱的状况明显改变,基
层卫生人才队伍的数
量、学历、知识结构出现向好趋势。2011年,全国基层医疗卫生机构达到91.
8
万个,包括社区卫生服务机构2.6万个、乡镇卫生院3.8万所、村卫生室66.3万
个,
床位123.4万张。
Urban and rural grass-roots level
medical and health services have been further
improved. The government has invested more to
ensure the funding for grass-roots
medical and
healthcare institutions. From 2009 to 2011, the
central government
invested 47.15 billion yuan
to support the building and development of grass-
roots
level medical institutions. Diverse
forms have been adopted to strengthen the ranks of
healthcare workers at the grass-roots level,
and preferential policies have been made
to
train and introduce competent personnel for rural
and community healthcare. A
system of general
practitioners (medical workers with sufficient
knowledge in all
branches of medicine) has
been established, under which general
practitioners are
trained in the regular way;
grass-roots medical and healthcare workers are
enrolled in
training courses for upgrading
them to general practitioners; and medical
students are
specially trained for the needs
of central and western urban areas, for which they
do
not have to pay their tuition fees. A
project, known as thousand doctors
extending
support to rural medical care,
1,100 Grade-III
urban hospitals extended support to 955 rural
county-level hospitals
every year, and urban
medical institutions above Grade II in central and
western
China granted aid to over 3,600
township hospitals every year, thus helping
improve
the overall technological level and
management of the county and township hospitals.
Meanwhile, the mode of medical services has
been changed. Touring medical services
have
been provided in township hospitals; and in the
urban districts ranks of general
practitioners
have been formed and a system of family doctors
has been set up.
Prevention has been combined
with the treatment, measures have been taken to
ensure
basic needs of the residents to see
doctors and make it possible that the diagnosis
and
treatment of most commonly seen and
frequently occurring diseases are performed at
the community level. After years of effort,
community-level medical and healthcare
system
has been strengthened; marked changes have taken
place to the situation of
backward facilities
and poor services in rural and remote areas;
community-level
medical workers have increased
in number, and their educational background and
knowledge have improved. In 2011, the number
of grass-roots medical and healthcare
institutions across the country reached
918,000, including 26,000 urban community
service centers, 38,000 township hospitals and
663,000 village clinics, and the
number of
hospital beds reached 1,234,000.
——基本公共卫生
服务均等化水平明显提高。国家免费向全体居民提供国家基本
公共卫生服务包,包括建立居民健康档案、
健康教育、预防接种、0—6岁儿童
健康管理、孕产妇健康管理、老年人健康管理、高血压和II型糖尿
病患者健康
管理、重性精神疾病患者管理、传染病及突发公共卫生事件报告和处理、卫生监
督协管等10类41项服务。针对特殊疾病、重点人群和特殊地区,国家实施重大
公共卫生服
务项目,对农村孕产妇住院分娩补助、15岁以下人群补种乙肝疫苗、
消除燃煤型氟中毒危害、农村妇女
孕前和孕早期补服叶酸、无害化卫生厕所建设、
贫困白内障患者复明、农村适龄妇女宫颈癌和乳腺癌检查
、预防艾滋病母婴传播
等,由政府组织进行直接干预。2011年,国家免疫规划疫苗接种率总体达到9
0%
以上,全国住院分娩率达到98.7%,其中农村住院分娩率达到98.1%,农村孕产
妇
死亡率呈逐步下降趋势。农村自来水普及率和卫生厕所普及率分别达到72.1%
和69.2%。200
9年启动“百万贫困白内障患者复明工程”,截至2011年,由政府
提供补助为109万多名贫困白内
障患者实施了复明手术。
Access to basic public health
services has become more equitable. The state
provides
all residents with a free package of
41 basic public health services in ten categories,
including health record, health education,
preventive inoculation, healthcare for
children under six, healthcare for pregnant
and lying-in women, healthcare for elderly
people, treatment for hypertension and type II
diabetes patients, healthcare for severe
psychosis patients, reporting and handling of
infectious diseases and public health
emergencies, and healthcare supervision and
coordination. Targeting special diseases,
key
groups and special areas, the state has launched
key public health service
programs, including
subsidizing rural pregnant women for hospitalized
childbirth,
re-vaccinating people under 15
against hepatitis B, eliminating fluorosis caused
by
coal burning, supplementary taking of folic
acid by rural women before pregnancy
and in
the early stage of pregnancy, building sanitary
toilets, cataract removal for poor
patients,
cervical and breast cancer tests for rural women
within eligible age, and
preventing mother-to-
child transmission of AIDS. In 2011, the
inoculation rate of the
National Immunization
Program (NIP) exceeded 90%; the rate of
hospitalized
childbirth nationwide reached
98.7% (98.1% in rural areas); and the maternity
mortality rate in rural areas kept going down.
In the rural areas, 72.1% of the
population
had access to tap water and 69.2% had access to
sanitary toilets. In 2009,
the government
launched a program to provide cataract operations
for a million poor
patients, and by 2011 more
than 1.09 million such people had had such
operations
with government subsidies.
——公立医院改革有序推进。从2010年起,在17个国家联系试点城市和37个
省级试点
地区开展公立医院改革试点,在完善服务体系、创新体制机制、加强内
部管理、加快形成多元化办医格局
等方面取得积极进展。2012年,全面启动县
级公立医院综合改革试点工作,以县级医院为龙头,带动
农村医疗卫生服务体系
能力提升,力争使县域内就诊率提高到90%左右,目前已有18个省(自治区、
直
辖市)的600多个县参与试点。完善医疗服务体系,优化资源配置,加强薄弱区
域和薄弱领
域能力建设。区域医学中心临床重点专科和县级医院服务能力提升,
公立医院与基层医疗卫生机构之间的
分工协作机制正在探索形成。多元化办医格
局加快推进,鼓励和引导社会资本举办营利性和非营利医疗机
构。截至2011年,
全国社会资本共举办医疗机构16.5万个,其中民营医院8437个,占全国医
院总
数的38%。在全国普遍推行预约诊疗、分时段就诊、优质护理等便民惠民措施。
<
br>医药费用过快上涨的势头得到控制,按可比价格计算,在过去三年间,公立医院
门诊次均医药费用
和住院人均医药费用增长率逐年下降,2011年比2009年均下
降了8个百分点,公立医院费用控制
初见成效。
The reform of public hospitals has been
carried on in an orderly way. In 2010, the
Chinese government started pilot reforms of
public hospitals in 17 state-designated
cities
and 37 province-level districts; and positive
progress has been witnessed in
improving
services, innovating institutions and mechanisms,
strengthening internal
management and speeding
up the creation of a situation in which hospitals
are
established and run in diversified forms.
In 2012, the government launched a pilot
comprehensive reform of county-level public
hospitals, aiming to improve rural
system of
medical services with the county hospitals playing
the leading role, and
enabling 90% of the
population in a county to see doctors. So far,
over 600 counties in
18 provinces, autonomous
regions and municipalities directly under the
central
government have been included in this
reform. The government has worked hard to
improve medical services, optimize the
allocation of medical resources, and enhance
the medical capabilities of weak areas and
weak fields. The capabilities of key clinical
specialties in regional medical centers and
county-level hospitals to deliver medical
services have been enhanced, and the mechanism
of division of responsibilities and
cooperation between public hospitals and
community-level medical institutions is
being
studied and formed. The government has intensified
efforts in the creation of a
situation of
establishing and running hospitals in diversified
forms, encouraging and
guiding non-
governmental funds to establish both for-profit
and non-profit medical
institutions. By 2011,
there were 165,000 medical institutions
established with
non-governmental investment,
including 8,437 private hospitals, accounting for
38%
of the national total. Doctor-appointment
service, time-phased outpatient service and
high-quality nursing service that bring
benefits and convenience to the people have
been introduced nationwide. The fast price
growth of medicine has been contained. In
comparable prices, the growth rates of average
outpatient and inpatient costs in public
hospitals has decreased year by year in the
past three years, and that of 2011 went
down
by eight percentage points from that of 2009,
reaping initial results in expense
control for
public hospitals.
新一轮医改给中国城乡居民带来了很大实惠。基本公
共卫生服务的公平性显著提
高,城乡和地区间卫生发展差距逐步缩小,农村和偏远地区医疗服务设施落后
、
服务能力薄弱的状况明显改善,公众反映较为强烈的“看病难”、“看病贵”的问题
得到缓解
,“因病致贫”、“因病返贫”的现象逐步减少。
The new round of
medical reform has brought substantial benefits to
both urban and
rural residents. Access to
basic public health services has become much more
equitable; the gap between urban and rural
areas and between regions has been
narrowed in
medical development; medical services in rural and
remote areas with
backward facilities and weak
capabilities have been remarkably improved;
medical
services have become more
affordable and accessible; and fewer and fewer
people are
becoming poor or return to poverty
because of illness.
三、传染病防治与卫生应急
III.
Infectious Disease Prevention and Treatment, and
Health Emergency
Management
新中国成立以来,中
国政府坚持“预防为主,防治结合”方针,不断加大传染病防
治力度,通过开展预防接种和爱国卫生运动
等防控措施,降低了传染病发病率,
有效控制了传染病的流行和蔓延。自20世纪50年代起,基本控制
了鼠疫、霍乱、
黑热病、麻风病等疾病的流行。2011年甲类和乙类传染病发病率控制在241.41
0
万的较低水平,有力保障了广大居民的身体健康和生命安全。
Since the
founding of New China, the Chinese government has
persisted in the
principle of first and
integrating prevention with treatmentand
continuously intensified efforts in the
prevention and treatment of infectious diseases.
By preventive inoculation, patriotic health
campaigns and other prevention and
control
measures, China has succeeded in bringing down the
morbidity of infectious
diseases and brought
their spread under control. China has basically
brought under
control the epidemics of such
diseases as plague, cholera, kala-azar and leprosy
since
the 1950s. In 2011, the morbidity of
Class A and B infectious diseases was kept at a
low level - 241.4 per 100,000 people. All
these measures help to safeguard the
Chinese
people's health and life.
实施国家免疫规划。免疫规划工作
是中国卫生事业成效最为显著、影响最为广泛
的工作之一。20世纪60年代初,中国通过接种牛痘消灭
了天花,较世界卫生组
织1980年宣布全球根除天花早了十几年。2000年,中国实现了无脊髓灰质
炎目
标。2002年,中国决定将新生儿乙肝疫苗纳入国家免疫规划,国家免疫规划由
接种4种
疫苗预防6种传染病,扩大到接种5种疫苗预防7种传染病。2007年,
国家决定实施扩大国家免疫规
划,国家免疫规划疫苗增加到14种,预防15种传
染病,免疫规划人群也从儿童扩展到成人。新一轮医
改启动以来,国家免疫规划
内容不断扩大,对于减少传染病发生、保护公众身体健康起到了积极作用,目
前
多数疫苗可预防传染病的发病已降至历史最低水平。
National
immunization program has been implemented. The
national immunization
program represents one
of the most notable and influential undertakings
of China's
healthcare work. In the early
1960s, China eliminated smallpox through vaccine
inoculation, a dozen years ahead before the
World Health Organization (WHO)
announced the
eradication of the disease in 1980. China attained
the goal of
eliminating poliomyelitis in 2000.
In 2002, the Chinese government decided to
include hepatitis B vaccination for the
newborn in the national immunization program,
increasing the number of four vaccines against
six infectious diseases to five vaccines
against seven infectious diseases. In 2007,
China decided to further expand the scope
of
the program, increasing the number of vaccines to
14 to prevent 15 infectious
diseases and
extending the scope of vaccination from children
to including adults.
Since the launch of the
new round of medical reform, the scope of the
national
immunization program has kept
expanding, and it has played a positive role in
reducing the morbidity of infectious diseases
and improving the health of the public.
Already, the morbidity of most infectious
diseases that can be prevented by
vaccination
has fallen to the lowest level in history.
重点传染病地方病得到有效控制。艾滋病、结核病、血吸虫病、包虫病、麻风病、
疟疾等重大及重点
传染病患者获得免费药物治疗。截至2011年,中国存活艾滋
病病毒感染者和病人约为78万人,远低
于将艾滋病病毒感染人数控制在150万
以内的目标。传染性肺结核患病率降至6610万,提前实现了
联合国千年发展目
标确定的结核病控制指标。所有血吸虫病流行县实现疫情控制目标,血吸虫病病
人控制在32.6万。率先在全球83个丝虫病流行国家和地区中消除了丝虫病。提
升以监测为核心的
流感防控能力,2010年,中国疾病预防控制中心国家流感中
心被正式命名为全球第五个流感参比和研
究中心。稳步推进地方病防治工作,在
国家层面实现消除碘缺乏病目标,大骨节病、克山病和氟中毒等病
情得到有效控
制,发病患者显著减少。
Major infectious and
endemic diseases have been brought under effective
control.
Patients of many major infectious
diseases, such as AIDS, tuberculosis, snail fever,
hydatid disease, leprosy and malaria, are
provided medicines and treatment free of
charge. In 2011, China's living HIV-infected
persons and AIDS patients were
estimated at
780,000, far below China's goal of controlling the
HIV-infected
population within 1.5 million.
The morbidity of infectious tuberculosis has
fallen to
only 66 per 100,000 people,
attaining the goal defined in the UN Millennium
Development Goals ahead of time. All counties
where epidemics of snail fever used to
break
out have attained the goal of bringing under
control such epidemics, limiting the
number of
snail fever patients to 326,000. China took the
lead in eradicating filariasis
among the 83
countries where epidemics of filariasis hit. China
keeps improving its
capabilities of influenza
control and prevention, taking monitoring at the
major task.
In 2010, the National Influenza
Center of the Chinese Center for Disease Control
and
Prevention was officially nominated the
fifth WHO Collaboration Center for
Reference
and Research on Influenza. China steadily promotes
endemic disease
prevention and treatment. It
has eradicated the diseases caused by iodine
deficiency at
the national level, and brought
under effective control of Kashin-Beck disease,
Keshan disease and fluorine poisoning, notably
reducing the incidence of these
diseases.
爱国卫生运动卓有成效。爱国卫生运动是中国公众广泛参与、与公众健康密切
相关的社会公益
事业,迄今已开展60年。爱国卫生运动坚持预防为主的方针,
通过开展除害灭病、健康教育和健康促进
、农村改水改厕、国家卫生城镇创建、
城乡环境卫生整治等,降低了传染病危害,提高了居民健康水平,
形成了爱国卫
生人人参与、健康生活人人共享的良好局面。截至目前,中国累计命名153个国
家卫生城市、32个国家卫生区和456个国家卫生镇(县城),并在此基础上探索国
家健康城市(镇)
创建工作。
Patriotic health campaign has gained
fruitful results. Patriotic health campaign, an
invention of China that has been in existence
for 60 years so far, is a social welfare
undertaking featuring massive public
participation and a close relationship with the
public health. Following the principle of
taking prevention first, the campaign has
reduced the hazards of infectious diseases and
promoted the public health through a
series of
measures, such as exterminating pests, health
education and promotion,
improving rural water
supply and sanitation, building
improving the
environmental hygiene in both urban and rural
areas. A wholesome
atmosphere is taking shape,
with everyone participating in the campaign and
enjoying
a healthy lifestyle. Now, China is
exploring a better working mechanism for building
cities and towns,based on the 153 cities, 32
districts and 456 towns
(counties) that have
been nominated
卫生应急水平全面提高。颁布突发事件应对法、突发公共卫
生事件应急条例等法
律法规,修订传染病防治法,推动卫生应急工作走上法制化和规范化轨道。以疾病预防控制体系、卫生监督体系和医疗体系为基础,初步建成统一指挥、布局合
理、反应灵敏、运转
高效、保障有力的突发公共事件卫生应急体系。建立完善卫
生应急预案体系,覆盖突发急性传染病、不明
原因疾病、中毒事件等突发公共卫
生事件防控以及自然灾害、事故灾难、恐怖事件的医疗卫生救援和重大
活动医疗
卫生保障。建立国家、省(自治区、直辖市)、地(市)、县四级应急管理体制。建
立
卫生应急能力评估指标体系。国家组建了传染病控制、医疗救援、中毒处置、
核和放射处置等4类27支
国家级卫生应急队伍,地方也组建了各级突发公共事
件卫生应急专业队伍。国家医药储备制度日趋完善,
保障了应对突发公共卫生事
件所需的医药产品。近年来,中国有效处置了传染性非典型肺炎、甲型H1N
1流
感、鼠疫、人禽流感等突发公共卫生事件,及时开展四川汶川特大地震、青海玉
树地震、甘
肃舟曲特大山洪泥石流灾害的紧急医学救援,顺利完成北京奥运会、
上海世博会等大型活动的医疗卫生保
障任务。
Health emergency management capability
has been enhanced. China is striving to
make
its health emergency management more standard and
law-based by issuing the
Law on Emergency
Management and the Regulations on Preparedness for
and
Response to Public Health Emergencies, and
amending the Law on the Prevention
and
Treatment of Infectious Diseases. Based on the
disease prevention and control
system, the
public health monitoring system and the medical
service system, China
has basically set up a
response system for public health emergencies
featuring unified
leadership, reasonable
distribution, quick response, efficient operation
and powerful
logistics. China has established
and improved health emergency plans, which cover
the prevention and control of such public
health emergencies as acute infectious
disease
emergencies, diseases with unknown causes and
poisoning incidents, medical
rescue in case of
natural disasters, disastrous accidents and
terrorist attacks, and
medical services for
important events. A four-level emergency
management system
has been established that
covers the national, provincial, city and county
levels. Also
has been established is the
public health emergency response ability
assessment
system. The central government has
organized 27 teams for health emergencies to
respond to four categories of incidents,
namely, infectious disease control, medical
rescue, poisoning treatment, and nuclear and
radiation accident handling. Local
governments
have also set up professional teams to handle
health emergencies at their
respective
levels. China's medicine reserve system keeps
improving, ensuring
sufficient supply of
medicines for health emergencies. In the past few
years, China
has successfully dealt with many
public health emergencies, especially pandemic
threats of infectious diseases, including
SARS, H1N1, plague and avian influenza,
carried out urgent medical rescues for the
2008 Wenchuan earthquake in Sichuan
Province,
2010 Yushu earthquake in Qinghai Province and 2010
Zhouqu mudslide in
Gansu Province, and
provided medical services for the 2008 Beijing
Olympic Games
and 2010 Shanghai Expo.
法定传染病和突发公共卫生事件实现网络直报。2004年,中国启用传染病和突
发公共卫生事件网络
直报系统,实现对39种法定传染病病例个案信息和突发公
共卫生事件的实时、在线监测。截至2011
年,全国100%的疾病预防控制机构、
98%的县级及以上医疗机构和94%的乡镇卫生院实现了法定
传染病网络直报。
Online direct report system has been
enforced for notifiable infectious diseases and
public health emergencies. The online direct
report system, which puts the 39
infectious
diseases defined by law and public health
emergencies under real-time and
online
surveillance, was not available in China until
2004. By 2011, the online direct
reporting of
infectious diseases had been extended to all
disease prevention and
control institutes, 98%
of medical institutions at and above the county
level, and 94%
of township clinics in China.
四、慢性非传染性疾病防治
IV. Prevention and
Treatment of Chronic Non-communicable Disorders 伴随中国工业化、城镇化、老龄化进程的加快,居民慢性病患病、死亡呈现持续
快速增长趋势。中国
现有确诊慢性病患者2.6亿人,慢性病导致的死亡占中国总
死亡的85%,导致的疾病负担占总疾病负
担的70%。
Accelerated industrialization,
urbanization and ageing of the population have
brought
about a trend of a continuous and
rapid increase in the incidence of chronic
diseases
and mortality caused by such
diseases. At present, about 260 million Chinese
have
been diagnosed to have contracted chronic
diseases that have caused 85% of total
deaths
in China and incurred 70% of total medical costs.
中国政府把防治慢性病作为增进公众健康、改善民生的重要任务,逐步建立起覆
盖全
国的慢性病防治服务体系,对主要慢性病进行分级管理,实施综合防控策略,
全面提高慢性病综合防治能
力,努力降低人群慢性病危险因素水平,减少慢性病
发病率、致残率和死亡率。
The
Chinese government regards chronic disease
prevention and treatment as an
important task
in improving the people's health and well-being.
It has established step
by step a
nationwide prevention and treatment service for
chronic diseases, adopted
level-by-level
management over certain major chronic diseases,
implemented a
comprehensive control strategy,
enhanced the overall prevention and treatment
capacity over chronic diseases, made efforts
to reduce factors that cause chronic
diseases
and bring down the morbidity and mortality of
chronic diseases as well as
disability caused
by them.
促进慢性病防治结合。2002年以来,慢性病防控策略逐步实现由重治
疗向防治
结合方向的转变。国家级层面形成了以中国疾控中心、国家癌症中心和国家心血
管病中
心为主要技术支撑的慢性病防控格局。各地逐步形成了由疾控机构、基层
医疗卫生机构、医院和专业防治
机构共同构筑的慢性病防控工作网络。提出早诊
断、早治疗,降低发病率、病死率和病残率的慢性病防治
目标,面向一般人群、
高危人群和患病人群,对心脑血管病、恶性肿瘤、糖尿病和慢性阻塞性肺病等主<
br>要慢性病,血压升高、血糖升高、胆固醇升高和超重肥胖等主要生物危险因素,
以及烟草使用、不
健康饮食、缺少体力活动和过量饮酒等主要行为危险因素,实
施有效干预。
Integration has been promoted between
prevention and treatment of chronic diseases.
Since 2002, China's strategy for prevention
and control of chronic diseases has
gradually
shifted to placing equal emphasis on prevention
and treatment from laying
stress on treatment
alone. At the state level, a chronic disease
prevention and control
system, which takes as
its technical support the China Center for Disease
Control, the
National Cancer Center of China
and the National Center for Cardiovascular
Diseases
of China, has gradually taken shape.
In the localities, networks of chronic disease
prevention and control have gradually been
formed, comprising the local disease
control
institutions, grass-roots medical and healthcare
institutions, hospitals as well
as
professional prevention and treatment
organizations. The principle of early
diagnosis and early treatment was proposed, in
a bid to realize the targets of reducing
the
rate of morbidity, mortality and disability in the
prevention and treatment of
chronic diseases.
Primary attention has been directed at the general
public, the
high-risk population and people
with diseases. For major chronic diseases such as
cardiovascular diseases, malignant tumors,
diabetes and chronic obstructive lung
diseases, effective medical interventions
should be taken to reduce biological risk
factors, like high blood pressure,
hyperglycemia, high cholesterol in blood and
overweightobesity, and behavioral risk
factors, such as smoking, unhealthy diet, lack
of physical exercises and excessive drinking.
制定慢性病防控措施。出台《中国慢性病防治工作规划(2012—2015年)》等一系<
br>列慢性病防控政策性文件和慢性病防治指南。从2005年开始,实施癌症早诊早
治等慢性病防治
重大专项。2007年,在全国启动全民健康生活方式行动,多途
径、多形式、多角度推动健康生活方式
行为养成。2009年,将高血压、糖尿病、
老年人健康管理纳入医改基本公共卫生服务项目内容。20
10年启动国家级慢性
病综合防控示范区建设工作,提高慢性病综合防控能力。大力开展
儿童口腔疾病
综合干预,预防儿童龋齿。
Measures for chronic
disease control and prevention have been worked
out. China has
issued the Program for Chronic
Disease Control and Prevention
(2012-2015)policy documents and guidelines.
Starting in 2005,
such major special programs
as that for early diagnosis and early treatment of
cancer
have been put into implementation. In
2007, a nationwide movement of healthy
lifestyle was launched in the general public,
employing various measures and
channels to
encourage the people to cultivate a healthy
lifestyle. In 2009, the
government included
hypertension, diabetes and elders' health
management in the
basic public health services
amidst medical reform. In 2010, China set out to
build
state-level demonstration areas in
chronic disease prevention and control capacity,
aiming at enhancing the comprehensive
prevention and control capability against
chronic diseases. Comprehensive intervention
has been vigorously carried out for
early-
childhood oral disorders to prevent dental caries
among children.
建立慢性病信息管理系统。实施慢性病综合监测,开展慢
性病危险因素监测、慢
性病患病监测、死因监测、营养健康状态监测、恶性肿瘤随访登记,建立和逐步<
br>完善覆盖全生命周期的围绕慢性病及其危险因素流行情况的慢性病信息系统,为
国家开展慢性病防
控工作提供科学的基础数据。
Information management system of
chronic diseases has been established. China
enforces comprehensive surveillance of chronic
diseases, monitors the risk factors of
such
diseases, the incidence, the causes of death, and
nutrition and health conditions
of people
suffering from these diseases, and has established
cancer registries, thereby
establishing and
gradually improving an information system that
centers around
chronic diseases and the
prevalence of their risk factors, so as to provide
scientific
basic data for the state's chronic
disease prevention and control efforts.
开
展健康教育和健康促进活动。持续开展“全国亿万农民健康促进行动”、“相约
健康社区行”、“健康素
养促进行动”等。逐步建立健康教育体系,初步形成多部
门合作、全社会参与的健康教育格局。居民健康
素养基本知识和技能日益普及,
自我保健意识和能力不断提高。加大控烟宣传力度,提高公众对烟草危害
的认识,
逐步形成全社会支持控烟的氛围。世界卫生组织《烟草控制框架公约》2006年1
月
在中国生效以来,各地积极推动公共场所控烟立法,建设无烟环境。
Health
education and promotion movements have been
carried out. China will
continue to promote
the
community campaign,manners promotion
campaign,and other
health-promotion campaigns.
Efforts will be made to gradually build a health
education system featuring cooperation among
multiple departments and the
whole-
society participation. Knowledge of and skills
related to health will become
increasingly
widespread among the Chinese people, and their
awareness of good
health and ability to keep
healthy are being constantly enhanced. Publicity
has been
intensified for tobacco control to
enhance the public's awareness of the hazards of
smoking, and eventually creating the
atmosphere that the whole society support
tobacco control. Since China joined the WHO
Framework Convention of Tobacco
Control in
January 2006, the various localities in China have
made proactive efforts to
legalize control of
smoking in public places for a smoking-free
environment.
重视维护公众的精神健康。颁布精神卫生法,通过立法规范精神
卫生服务,保护
精神障碍患者的权益。完善重性精神疾病防治网络,加强精神卫生医疗机构救治
急重性精神疾病能力建设,建立医院与社区相互支持和配合的重性精神疾病防治
工作机制。把精神卫生专
业人员列入“十二五”时期急需紧缺的人才类别,加强人
才培养工作。规范患者服务管理,启用国家重性
精神疾病基本数据收集分析系统,
实现病人信息电子化管理。目前,在城市社区和农村居家接受规范管理
的重性精
神疾病患者有302.6万人。
Maintenance of people's
mental health has been valued. China issued the
Mental
Health Law to regulate the mental
health services and protect the rights and
interests
of people with mental disorders. The
Chinese government strives to improve the
prevention and treatment network of severe
mental illnesses, enhance the ability of
mental healthcare institutions to treat and
cure acute or severe mental illnesses, and
has
established a working mechanism for severe mental
illness prevention and
treatment in which
psychiatric hospitals and communities support and
cooperate with
each other. China has included
professionals in mental health services as the
urgently
needed task during the 12th Five-Year
Plan, and has intensified their training. It has
standardized patient services and management,
launched a basic data collection and
analysis
system for severe mental illnesses, and digitized
data on patients. At present,
there are 3.026
million people with serious mental disorders in
China's urban and
rural areas who are
receiving standard management at their homes.
五、妇女儿童健康权益保护
V. Protecting Women and
Children's Right to Health
中国现有8.6亿妇女儿童,约
占总人口的三分之二。中国政府将男女平等作为一
项基本国策,一贯高度重视妇女儿童的生存和健康状况
,完善妇幼卫生法制与政
策,签署多项保护妇女儿童的国际公约,健全妇幼卫生服务体系,实施妇幼公共
卫生服务项目,着力提高妇幼卫生服务的公平性和可及性,促使广大妇女儿童健
康权益得到有效
保护。
Currently, China has 860 million
women and children, accounting for two thirds of
the nation's total population. The Chinese
government has established gender equality
as
a basic national policy, and has always attached
great importance to the life and
health of
women and children. The state strives to improve
the legal regime and
related policies
regarding women and children's healthcare, and has
signed many
international conventions
committed to the protection of women and children.
China
has improved its health services for
women and children, and implemented public
health service programs for them, focusing on
making these services more equitable
and
accessible so as to effectively protect women and
children's right to health.
完善妇幼卫生法制和政策。1
994年10月全国人大常委会审议通过母婴保健法,
标志着妇幼卫生工作进入法制化管理阶段。20世
纪90年代以来,中国政府制定
实施《中国妇女发展纲要(1995—2000年)》、《中国妇女发展
纲要(2001—2010
年)》、《中国妇女发展纲要(2011—2020年)》和《九十年代中国
儿童发展规划
纲要》、《中国儿童发展纲要(2001—2010年)》、《中国儿童发展纲要(201
1—2020
年)》,把妇女儿童健康纳入国民经济和社会发展规划,作为优先发展的领域之
一
。
The legal regime and related policies
regarding women and children's healthcare have
been improved. In October 1994, the Standing
Committee of the National People's
Congress
reviewed and passed the Law on Healthcare for
Mothers and Infants, which
signaled that
China's management of women and children's affairs
had entered a
law-based stage. Since the
1990s, the Chinese government has enacted the
Program
for the Development of Chinese Women
(1995-2000), Program for the Development
of
Chinese Women (2001-2010), Program for the
Development of Chinese Women
(2011-2020),
Program for the Development of Chinese Children in
the 1990s,
Program for the Development of
Chinese Children (2001-2010) and Program for the
Development of Chinese Children (2011-2020),
giving priority to women and
children's health
in national programs of economic and social
development.
健全妇幼卫生服务体系。中国妇幼卫生体系以妇幼保健专业机构
为核心,以城乡
基层医疗卫生机构为基础,以大中型综合医疗机构和相关科研教学机构为技术支
持,为妇女儿童提供全方位的医疗保健服务。建立妇幼卫生年报系统和世界上规
模最大的妇幼卫生监测网
络,实施出生缺陷监测、孕产妇死亡监测、5岁以下儿
童死亡监测、危重孕产妇监测和儿童营养健康监测
。妇幼卫生信息为各级政府制
定卫生政策特别是妇幼卫生政策提供了科学依据。
The
health service system for women and children has
been improved. China's
healthcare system for
women and children takes professional women and
children's
health organizations as its core
and is based on community-level urban and rural
healthcare services. With technical support
from large and medium-sized general
hospitals
and relevant research and training institutions,
the state provides all-round
healthcare
services for women and children. The country
publishes annual reports on
women and
children's healthcare progress and has developed
the world's largest
monitoring network in this
regard, keeping track of cases of birth defects,
deaths of
pregnant and lying-in women, deaths
of children under five years of age, and
complicated cases of pregnant and lying-in
women, as well as children's nutrition and
health. The information collected on women and
children's health has provided a solid
statistical basis for governments at all
levels to formulate healthcare policies,
especially policies on women and children's
health.
开展妇女生殖保健服务。积极推广婚前和孕前保健,普及优生优育、生殖健
康科
学知识,深入开展孕产期保健,形成包括产前检查、产前筛查与诊断、高危孕产
妇筛查与管
理、住院分娩、新生儿保健和产后访视在内的一整套孕产期保健服务。
2011年全国孕产妇产前检查率
、产后访视率和系统管理率分别为93.7%、91.0%
和85.2%,比2000年分别提高4.8
1%、5.57%和10.36%,高危孕产妇管理率达到
了99.6%。开展“降低孕产妇死亡率、消
除新生儿破伤风”项目,消除了孕产妇及
新生儿破伤风。2011年,全国孕产妇死亡率为26.110
万,比1990年和2000年
下降了72.4%和50.8%。开展妇女病普查普治、青春期保健和更
老年期保健等,
为广大妇女提供全生命周期服务。
The reproductive
health services for women are provided. China has
proactively
promoted premarital and pre-
pregnancy healthcare, and has been publicizing
knowledge on prenatal and postnatal care, and
reproductive health. Intensive
healthcare
services for pregnant and lying-in women are
available, and a complete
array of services
for pregnant and lying-in women has been
developed, covering
prenatal examination,
prenatal defect screening and diagnosis, screening
and
management of high-risk pregnant and
lying-in women, hospitalized delivery, infant
healthcare and postnatal home visits. In 2011,
a total of 93.7%, 91.0% and 85.2% of
pregnant
and lying-in women, respectively, received
prenatal examinations, postnatal
home visits
and other medical management services in China,
4.81%, 5.57% and
10.36% higher than the
statistics of 2000. The percentage of high-risk
pregnant and
lying-in women included in the
medical management program has reached 99.6%.
China has carried out a program to the
maternal mortality and eliminate
neonatal
tetanus,
2011 was 26.1 per 100,000, dropping
72.4% and 50.8% as compared to 1990 and
2000,
respectively. The state also provides medical
services for the screening and
treatment of
gynecological diseases, adolescence health, and
climacteric and old-age
health, offering
services that cover the whole life cycle of
Chinese women.
开展儿童保健服务。加强新生儿保健,规范新生儿访视服务
。开展婴幼儿及学龄
前儿童保健,实施7岁以下儿童保健管理和3岁以下儿童系统管理。2011年全<
br>国3岁以下儿童系统管理率和7岁以下儿童保健管理率分别达到84.6%和85.8%。
儿童生长发育水平不断提高,儿童营养不良状况持续减少。努力控制出生缺陷,
提高出生人口素
质,开展新生儿疾病筛查、0—3岁儿童早期综合发展、发育偏
离儿童的康复训练、高危儿早期干预、食
物过敏的早期干预、睡眠问题干预、环
境污染对儿童健康损害的早期干预以及青春期保健等。关注和重视
留守儿童、流
动儿童、伤残儿童等特殊儿童群体的身心健康。
The healthcare
services for children are provided. China has
strengthened healthcare
for newborns and
regularized home-visiting service for newborns.
The state offers
healthcare services for
infants, young children and pre-school children,
and exercises
health management of children
under seven years of age and comprehensive
management of children under three years of
age. In 2011, some 84.6% of children
under
three years of age and 85.8% of children under
seven years of age received
comprehensive
health management and medical management services.
Chinese
children are growing healthier and
faster physically, and cases of malnutrition keep
declining. The state strives to control birth
defects and improve the quality of
newborn
babies, and has conducted disease screenings for
newborns, early
development programs for
children under three years old, rehabilitation
training for
children with growth deviation,
early-stage intervention for high-risk children,
early-stage intervention in cases of food
allergy, assistance with sleep problems,
early-stage help in case of damage to
children's health caused by environmental
pollution, and adolescence healthcare, among
others. Children whose parents seek
employment
away from home, children who live with their
migrant-worker parents,
disabled children and
other special groups of children also receive
attention and help
from the state both
physically and mentally.
六、中医药发展
VI.
Development of Traditional Chinese Medicine
中医
药在中国有着悠久的历史,是中华民族在生产生活实践以及治疗疾病过程中
形成和发展的医学科学,是中
华民族智慧的结晶,为中华民族繁衍昌盛作出了重
要贡献。中医药在治疗常见病、多发病和疑难病等方面
独具特色和优势,在治疗
传染性疾病方面也有良好效果,并以其费用低、疗效好、副作用小等特点,深受
中国公众喜爱,在医疗卫生保健中发挥着不可替代的重要作用。中国政府一贯积
极扶持和促进中
医药事业的发展。
Traditional Chinese Medicine (TCM)
has a long history in China, and is a medical
science formed and developed by the Chinese
people in their daily work and life as
well as
attempts to treat diseases. TCM is the
crystallization of the wisdom of the
Chinese
people, and has made important contributions to
the continuance and thriving
of the Chinese
nation. Known for its unique characteristics and
advantages in curing
common diseases,
frequently occurring diseases and complicated
diseases, TCM has
also proved effective in
treating infectious diseases and is very popular
among the
Chinese public for its low cost,
satisfactory curative action and mild side
effects.
TCM plays an irreplaceable
role in China's medical and healthcare endeavors,
and the
Chinese government has always
supported and promoted its development.
建
立覆盖城乡的中医医疗服务体系。在城市,形成了以中医医院、民族医医院、
中西医结合医院、中医专科
医院、综合医院中医科、社区卫生服务机构及中医门
诊部和中医诊所为主的城市中医药服务网络。在农村
,形成了由县级中医医院、
乡镇卫生院中医科和村卫生室为主的农村中医药服务网络。目前,75.6%
的社区
卫生服务中心、51.6%的社区卫生服务站、66.5%的乡镇卫生院、57.5%的村卫生<
br>室能够提供中医药服务。
Networks of TCM medical
services have been established to cover both urban
and
rural areas. Networks of TCM medical
services now cover Chinese cities, providing
services for urban residents through TCM
hospitals, ethnic-medicine hospitals,
hospitals of integrated traditional Chinese
and Western medicine, specialized TCM
hospitals, TCM departments of general
hospitals, community health services, TCM
outpatient departments and TCM clinics. In the
rural areas, TCM service networks
have also
been developed to serve rural residents through
county-level TCM hospitals,
and TCM
departments or sections of township hospitals and
village clinics. Currently,
75.6% of community
health service centers, 51.6% of community health
service
stations, 66.5% of village and
township hospitals and 57.5% of village clinics
can
provide TCM services.
形成独具特色的中医药人
才培养体系。国家把人才培养作为中医药事业发展的根
本,加强名老中医药专家学术思想和经验继承工作
以及优秀中医临床人才培养,
加强社区、农村基层中医药人才的培养,基本形成了院校教育、师承教育、
继续
教育多形式、多层次、多途径的中医药教育体系,初步建立起社区、农村基层中
医药人才培
养机制。截至2011年,全国共有高等中医药、民族医药院校46所,
高等教育中医药类在校生人数5
5.3万人,卫生机构中医类别执业(助理)医师29.4
万人,中药师(士)9.7万人。
A unique training system for qualified TCM
professionals has been developed. The
state
takes the cultivation of qualified professionals
as the cornerstone for the
development of TCM.
China has enhanced its efforts to pass down the
academic
achievements and experience of
renowned and senior TCM experts as well as the
training of high-caliber professionals in
clinical practice. An education system for
TCM
personnel has been basically developed in the
forms of academic education,
master-apprentice
tutorials and continued education at different
levels and through
different channels. By
2011, China had a total of 46 institutions of
higher learning
specializing in TCM and ethnic
medicine, with 553,000 undergraduate students of
TCM on campus, as well as 294,000
practitioners and assistant doctors of TCM, in
addition to 97,000 licensed and assistant
pharmacists in TCM.
推进中医药现代化。积极利用现
代科学技术,推进中医药的理论和技术创新,在
中医基础理论、临床诊疗、中药技术等领域取得重要成果
。推进中药产业化和现
代化,中药产业规模、技术水平大幅提高。目前,全国中药生产企业近1500家
。
中药产品种类、数量、生产工艺水平有了很大提高。重视和保护中医药的文化价
值,41项中
医药项目列入国家非物质文化遗产名录。
A modernization drive for
TCM has been initiated. The state has proactively
promoted theoretical and technical innovations
in TCM through the application of
modern
science and technology, and has gained important
achievements in basic
TCM theory, clinical
diagnosis and treatment, TCM technology and other
related
areas. China promotes the
industrialization and modernization of TCM, and as
a result
the industrial scale and technical
level of TCM has increased markedly. Currently,
there are about 1,500 manufacturers of TCM
pharmaceuticals in China, and the
variety,
quantity and processing technique of TCM
pharmaceuticals have improved
by a wide
margin. The state attaches importance to the
protection of TCM's cultural
values, and 41
TCM programs have been included on the nation's
intangible heritage
list.
积极开展国际交流合作
。目前,已有70多个国家与中国签订了包含中医药内容
的政府协议或专门的中医药合作协议,中医药对
外医疗、教育、科技合作不断扩
大,已传播到世界上160多个国家和地区。“中医针灸”列入人类非物
质文化遗产
代表作名录,《黄帝内经》、《本草纲目》等中医药典籍列入《世界记忆遗产名
录》
。国际标准化组织(ISO)成立了中医药技术委员会,并将这一委员会的秘书
处设在中国。
International exchanges and cooperation have
been actively promoted. China has
signed
treaties with TCM contents or special TCM
cooperation agreements with over
70 countries,
and cooperation in TCM application in foreign
countries, and TCM
education and technical
cooperation has steadily expanded. Now, over 160
countries
and regions around the world have
access to TCM. TCM acupuncture and
moxibustion
has been recognized as a masterpiece of the
intangible heritage of
mankind, and the
Huangdi Neijing (Inner Canon of the Yellow
Emperor), Bencao
Gangmu (Compendium of Materia
Medica) and other TCM treatises have been
included in the UNESCO Memory of the World.
The International Standardization
Organization
(ISO) has set up a TCM technical committee and
located its secretariat
in China.
七、卫生国际合作
VII. International Medical and
Healthcare Cooperation
长期以来,中国积极参与全球卫生事
务,广泛开展卫生领域的政府间和民间的多
边、双边合作交流,积极参加国际社会、国际组织倡导的重大
卫生行动。高度重
视卫生国际援助,先后为许多发展中国家援建医院、培训卫生人才、开展疾病防
控等工作,为受援国医疗卫生事业发展发挥了巨大作用。
For a long period
of time, China has been actively participating in
international health
affairs, and has carried
out extensive inter-government and non-
governmental
multilateral and bilateral
cooperation and exchanges. China has also
proactively taken
part in major health
programs of the international community and
international
organizations. The state pays
great attention to international health assistance
programs, and has played a huge role in
improving the medical and health conditions
in
many developing countries by building hospitals,
training medical and healthcare
professionals
and carrying out disease control there.
支
持世界卫生组织等国际组织工作。积极参与全球卫生议题讨论,分享经验。20
世纪70年代,中国总结
和贡献卫生实践经验,为推动1978年《阿拉木图宣言》
实施初级卫生保健发挥了重要作用。近年来,
在《国际卫生条例(2005)》框架下,
与世界卫生组织及各国保持及时、密切、畅通联系,为全球疾
病防控作出贡献。
中国政府每年向世界卫生组织、联合国艾滋病规划署以及全球抗击艾滋病、结核
病和疟疾基金等国际组织提供捐款。大力支持国际社会在慢性病、人禽流感、控
烟、应急等技术领域的
工作。
Support has been rendered to the work of
the World Health Organization and other
international organizations. China has been
taking an active role in international
discussions on health issues and sharing
experiences in this regard. In the 1970s,
China summarized its practices in healthcare
and played an important part in the
signing of
the Declaration of Alma-Ata in 1978 on primary
healthcare by contributing
its medical
experience. In recent years, China has been
efficiently maintaining timely
and close
contact with the World Health Organization and
various countries under the
framework of the
International Health Regulations (2005), making
its due
contribution to disease control on a
global scale. The Chinese government makes
annual donations to the World Health
Organization, the Joint United Nations Program
on HIV and AIDS (UNAIDS), the Global Fund to
fight AIDS, tuberculosis and
malaria, and
other international efforts. China also vigorously
supports international
work to combat chronic
diseases and human avian influenza, as well as in
tobacco
control, emergency medical responses
and other related technical fields.
加强区域卫
生合作。2003年以来,以中国—东盟传染病防控领域的合作为开端,
加快推进区域卫生合作进程。目
前,中国已在大湄公河次区域、中亚区域经济合
作、中国—东盟、东盟与中日韩、中日韩、亚太经济合作
组织和上海合作组织等
7个区域性合作机制下,开展与周边国家和本区域的卫生合作和国际援助。从
p>
2005年起,中国与缅甸、越南、老挝合作,在边境地区开展疟疾、艾滋病联防
联
控项目,还开展了结核病、登革热防治等跨境合作项目。
Regional health
cooperation has been strengthened. In 2003, China
initiated
cooperation in the field of
infectious disease control with ASEAN, and has
quickened
its steps to promote regional health
cooperation since then. Currently, China is
carrying out health cooperation with
peripheral countries and regional international
aid programs within seven regional cooperation
mechanisms, namely, those of the
Greater
Mekong Sub-region, Central Asia Region, China-
ASEAN, ASEAN and
China, Japan and Korea,
Inter-China-Japan-Korea, Asia-Pacific, and
Shanghai
Cooperation Organization. Since 2005,
China has been cooperating with Myanmar,
Vietnam and Laos to carry out joint prevention
and control programs of malaria and
AIDS, as
well as cross-border cooperation programs on the
prevention and treatment
of tuberculosis and
dengue fever.
派遣援外医疗队。援外医疗队是中国履行国际义务,按政府双
边协议向受援国派
遣医务人员团队,在发展中国家开展医疗卫生服务的无偿援助项目。1963年,中国政府向阿尔及利亚派出第一支援外医疗队。截至2011年,中国政府已先后
向73个国家派遣
了医疗队。目前,有56支医疗队分布在阿尔及利亚、坦桑尼亚、
摩洛哥、津巴布韦等53个国家,为当
地特别是贫困地区人民提供免费医疗服务,
并为受援国引入大批先进医疗技术。50年来,中国援外医疗
队共诊疗患者约2.6
亿人次。医疗队的工作获得当地民众的高度赞扬,受到受援国政府的充分肯定,<
br>迄今约有900名中国医疗队员获得受援国颁发的勋章等各种荣誉。在此期间,有
50名中国援外
医疗队员牺牲在异国他乡。
Medical teams have been sent to
developing countries to improve medical conditions
there. The medical teams China dispatches to
developing countries to improve the
medical
and health conditions there are a regular aid
program between the Chinese
government and the
recipient countries in accordance with bilateral
agreements. In
1963, the Chinese government
sent its first medical team abroad, to Algeria,
and by
2011, China had sent medical teams to
73 countries. Currently, there are 56 Chinese
medical teams in Algeria, Tanzania, Morocco,
Zimbabwe and 49 other countries. The
medical
teams provide free medical services for local
people there, especially people
in poverty-
stricken areas, as well as introducing advanced
medical technology into the
recipient
countries. For 50 years, the Chinese medical teams
have diagnosed and
treated a total of 260
million cases, and their work has been much
appreciated by the
people and fully recognized
by the governments of the recipient countries. So
far,
about 900 Chinese medical team members
have been awarded honors by the recipient
countries, and 50 members died during their
service abroad.
援建医疗机构。从1970年开始,中国
支援非洲等地区的发展中国家建设医疗机
构,致力于改善受援国医疗设施条件。截至2011年底,中国
共帮助52个国家建
成100所医院和医疗中心,为解决当地民众看病就医困难作出了积极贡献。中国<
br>为援建医院提供大量成套医疗设备和药品,仅2011年中国就提供了34批医疗设
备和药品。截
至2011年11月,还有28个国家的31个援建项目在建。
Medical
institutions have been built in developing
countries with aid from China.
Since 1970,
China has been committed to helping developing
countries in Africa and
other areas to build
medical institutions and improve their medical
conditions. By the
end of 2011, China had
helped a total of 52 countries, and built 100
hospitals and
medical centers for them,
improving medical conditions and providing medical
services for local people. China equipped the
hospitals with a large number of
complete sets
of medical equipment and medicines, and in 2011
alone it shipped 34
batches of medical
equipment and medicines to the recipient
countries. By November
2011, 31 new projects
in this regard were still under construction in 28
countries.
培训卫生人力资源。中国援外医疗队通过带教、讲座、培训等方式,
将医疗技术
传授给当地医护人员,提高受援国卫生技术水平。中国政府支持卫生技术机构在
华为
发展中国家举办卫生技术研修和培训,截至2011年,共举办培训班400多
期,培训15000余人
,涉及卫生管理、紧急救援管理、食品卫生、传统医药、传
染病防控、实验室检测、卫生检疫和护理技术
等。为帮助发展中国家培养高层次
医学卫生人才,中国政府还向在华学习医学和中医药学的发展中国家学
生提供政
府奖学金。
Health professionals have been
trained by China for developing countries. The
Chinese medical teams pass their medical
knowledge and technology to local medics
through personal tutorials, lectures and
training courses, improving the medical
technology of the recipient countries. The
Chinese government supports health
technology
institutions to hold related study and training
programs for developing
countries in China. By
2011, China had held over 400 training courses for
15,000
persons on health management, emergency
management, food hygiene, traditional
medicine, infectious disease prevention and
control, laboratory testing, health
quarantine, nursing skills and other areas. To
help developing countries train medical
and
health professionals of high caliber, China also
offers government scholarships
for students
from developing countries studying medicine and
TCM in China.
开展国际紧急救援。2004年,印度洋地震和海啸在东南亚
和南亚地区造成重大
人员伤亡,中国及时派出卫生救援队赴泰国、斯里兰卡、印度尼西亚开展救援,并通过世界卫生组织向受灾国家捐助医疗仪器设备和美元现汇。近五年来,中国
政府累计开展卫生紧
急救援近200次,包括向发生疫情、自然灾害的几内亚比绍、
马达加斯加、巴基斯坦、印度尼西亚、海
地等国家派遣卫生救援队、提供物资或
现汇紧急援助等。中国还派出救援队赴黎巴嫩、刚果(金)等国际
维和任务区实施
人道主义医学援助,派遣“和平方舟号”医院船赴亚非五国、拉美四国开
展巡回医
疗服务。
International emergency rescue
has been undertaken. In 2004, Southeast Asia and
South Asia suffered great casualties due to an
earthquake in the Indian Ocean and the
following tsunami. China promptly responded to
the emergency by sending medical
rescue teams
to Thailand, Sri Lanka and Indonesia to help
relief efforts there, and
donated medical
equipment and cash in US dollar to the affected
countries through
the World Health
Organization. Over the past five years, the
Chinese government has
responded to about 200
health emergencies, sending medical rescue teams
to
Guinea-Bissau, Madagascar, Pakistan,
Indonesia, Haiti and other countries stricken by
epidemics or natural disasters, as well as
providing relief supplies and cash to those
countries. China has also dispatched rescue
teams to Lebanon, the Democratic
Republic of
the Congo and other international peacekeeping
mission areas to offer
humanitarian medical
aid there, and its Peace Ark hospital ship sailed
to five Asian
and African and four Latin-
American nations to provide medical services to
the
people there.
结束语
Conclusion
随着中国工业化、城市化进程和人口老龄化趋势的加快,居民健康面临着传染病
和慢性病的双重
威胁,公众对医疗卫生服务的需求日益提高。与此同时,中国卫
生资源特别是优质资源短缺、分布不均衡
的矛盾依然存在,医疗卫生事业改革与
发展的任务十分艰巨。
With the
quickened pace of the country's industrialization
and urbanization, as well as
its increasingly
aging population, the Chinese people are facing
the dual health threats
of infectious and
chronic diseases, and the public needs better
medical and health
services. In the meantime,
problems still exist regarding China's health
resources,
especially the shortage of high-
quality resources and the unbalanced distribution
of
those resources. China has arduous tasks
ahead for reforming and developing its
medical
and health services.
中国政府提出,到2020年建立健全覆盖城
乡居民的基本医疗卫生制度,实现人
人享有基本医疗卫生服务。为此,中国将继续深入推进改革,全面发
展医疗卫生
事业,更好地维护、保障和增进全体居民的健康。中国也将继续积极参与全球卫
生事
务,与各方共同携手,为改善全球健康作出更大努力。
The Chinese
government has announced that it will establish a
sound basic medical
and health system covering
both urban and rural residents by 2020, so as to
ensure
that everyone enjoys access to
basic medical and health services. For this goal,
China
will continue to reform and develop its
medical and health services, and better
maintain, ensure and enhance the health of its
people. China will also continue its
active
role in international health affairs and work
together with different parties to
make
greater effort to improve the health of mankind.