Labor of LoveLabor of LoveBuilding the Foundations of Health Care in Taiwan

Maternal & Child Heath CareMaternal & Child Heath Care

Trend of Neonatal & I nf ant

Mortal i ty 1962- 2004

0

5

10

15

20

25

30

35

1962 1965 1968 1971 1974 1977 1980 1983 1986 1989 1992 1995 1998 2001 2004

MR(0

/00)

neonatal i nf ant

Trend of Neonatal & I nf ant

Mortal i ty 1962- 2004

0

5

10

15

20

25

30

35

1962 1965 1968 1971 1974 1977 1980 1983 1986 1989 1992 1995 1998 2001 2004

MR(0

/00)

neonatal i nf ant

1962 87.85 0.52

1963 81.79 0.50

1964 79.39 0.49

1965 74.52 0.46

1966 71.55 0.44

1967 62.26 0.34

1968 54.03 0.30

1969 48.88 0.28

1970 40.35 0.23

1971 39.69 0.22

1972 34.72 0.18

1973 40.33 0.20

1974 32.35 0.16

1975 24.75 0.12

1976 29.53 0.17

1977 29.56 0.15

1978 22.48 0.12

1979 17.28 0.09

1980 18.66 0.09

1981 19.38 0.09

1982 19.06 0.09

1983 17.01 0.07

1984 14.06 0.06

Trean of Maternal Mortal i ty(1962-2004)

-

20

40

60

80

100

MR(0

/000

0)

Main Health Projects for Maternal in Taiwan

Premarital stage

Genetic health services

Prenatal stage Postnatal stage

Mother-child friendly medical institutions

Breast-feeding promotion

10 free prenatal examinations of NHI

Family planning

Family planning

Main Health Projects for Infant and Young Children in Taiwannewborn

1day

Newborn screening

1month 6 month 1 year 4 years

infant Preschool children

Early Detection and Reporting of Children with Retarded Development

Children Vaccine preventive services

Injury prevention and Safety Promotion

Hearing Health

Visual Health

6years

Oral Health

Child health check-up of NHI preventive services

Management of Rare Diseases

3 years 5 years

Birth reporting system

& LaboratoriesBiochemical Genetics

Cytogenetics (26)

Molecular Genetics (14)

Delivery Hospitals

Clinics (180)

Newborn screen centers (3)

Prenatal Diagnosis (276)

GeneticExamination

Pre-marital Examination

Newborn Screening (698)

Referral Hospitals (18) / The Medical Centers for

Genetic Counseling Genetic Counseling (11)(11)

Government

Social Resources / NGOsPrimary Health Care

Genetic Health Services Network

The Genetic Health Law, 1985The Rare Disease and Orphan Drug Act, 2000

Newborn screening for congenital metabolic disorders

-

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

No. of birth

No. of exam

Screening rate 99.9%

Year No. of exam G-6-PD CHT PKU HCU GAL

1984 24,657 2 1 0 01985 38,792 9 3 0 01986 71,666 27 2 0 01987 117,739 413 38 3 1 01988 192,601 1,665 67 2 1 01989 214,477 2,605 65 6 0 01990 266,312 2,649 56 4 0 01991 282,453 4,430 55 11 3 01992 302,571 5,009 49 8 1 01993 314,781 5,965 69 9 1 01994 315,952 4,868 75 4 4 01995 320,456 5,967 56 15 0 11996 321,282 6,572 60 6 1 11997 322,835 6,427 103 10 2 01998 267,089 5,084 119 8 1 11999 282,395 5,879 199 7 1 12000 304,394 6,187 243 14 0 02001 255,643 3,808 175 8 2 02002 246,479 4,049 195 6 3 02003 226,825 3,320 141 4 0 32004 216,202 1,785 66 1 0 1

TOTAL 4,905,601 76,682 1,869 132 21 8 1 in 63 1 in 2601 1 in 35,797 1 in 223,305 1 in 669,914Incidence rate

The Service Flow Chart of Children with Retarded Development

• Early Screening:– Prenatal exam.– Newborn screen– Public health nurses– Developmental organization– Pediatric clinic/hospital– Nurseries and kindergartens

• Early identification:– Referred center

• Assessment:– 24 joint assessment centers in

Taiwan• Arrangement:

– Settle down for the retarded development children in related organizations

Assessment: joint assessment center

early identification: Reporting to Referred Center

Early Screen

Arrangement: Hospital, Special school, NGOs.

30,616 28,666 26,50913,904 17,156 23,239 27,746 30,8335.12

6.057.61

13.37 13.24 12.88

10.66

12.46

0

100000

200000

300000

400000

1998 1999 2000 2001 2002 2003 2004 20050

5

10

15

Total babies

babies born to spouses of foreign origins% of total babies

Children born to spouses of foreign origins (1998-2005)

Care for Spouses of Foreign Origins and their ChildrenCare for Spouses of Foreign Origins and their Children

ReproductiveHealth

Care

Enrolled into pregnantWomen Health Plan

Health-card Management system

Multi-languageEducation Materials

Subsidy for prenatal Care or birth control

Volunteers of foreign Origins facilitate Communication

past now future

2005 World Health DayMake Every Mother & Child Count

Respect Equality

•Humanized birth•Mother-child friendly medical institutions•Adolescent healthcare•…

•Universal NHI•Health care for foreign-born wives & their children •Health care for aboriginal•Prevention and care of rare disorders…

Our special experiences, resources, and achievementsthat it can share with the world

Retrospection

Innovation

prospect ion