Annual goals of Xishui County’s 2006 new cycle consumption reduction project implementation plan

(County as a unit)

1. Overall goal

(1) Maternal mortality rate: reduce by 1/4 (80%) based on 2001 / less than 100,000)

(2) Neonatal tetanus incidence rate: controlled below 1‰

(3) Hospital delivery rate of pregnant women: more than 50%

(4) The hospital delivery rate of high-risk pregnant women: above 95%

(5) Do a good job in maternal death monitoring, monitoring of children under 5 years old, and monitoring of birth defects.

2. Supportive goals

(1) Maternal prenatal examination coverage: ≥90

(2) High-risk maternal screening management rate: Above 70

(3) Disinfection and delivery rate: ≥98

(4) County-level medical and health care institutions, township (district) health center obstetrics "three basics" examination passing rate: ≥ 98

(5) Awareness rate of health education for women of childbearing age: gt; 85

2. Project implementation scope and time

(1) Project work covers all areas in the county Townships (districts) and villages.

(2) Maternal deaths are monitored throughout the county. The monitoring points for deaths of children under 5 years old are: Sangmu Town, Wenshui Town, and Minhua Township. Birth defect monitoring points are: County People's Hospital, County Hospital of Traditional Chinese Medicine, and County Family Planning Maternal and Child Health Center.

(3) Project implementation time: December 2005 - December 2006

3. Project tasks

The overall project tasks are: personnel training; rural areas Hospitalized delivery assistance for pregnant and lying-in women; establishing and improving maternal first aid "green channels" and "critical disease rescue centers", carrying out health education, supervision and guidance; equipping township health centers with basic equipment for obstetrics, consolidating and creating the achievements of baby-friendly hospitals, and actively creating Aiying County.

IV. Project Measures

The project work at this stage will further increase the intensity of work based on the work in the previous cycle.

(1) Project Management

1. Adjust and enrich the "Reduction and Elimination" project coordination leading group, give full play to coordination, organization and management functions, and be responsible for the leadership of the entire project implementation process.

2. The County Health Bureau will adjust and enrich the project technical guidance group and supervision group to strengthen project management and business guidance.

3. Promote target management responsibility system. The county people's government signed a target responsibility letter with each member unit of the county's coordination and coordination leading group for the reduction of pollution and the township (district) people's government. Each township (district) based on the implementation plan of the county's "degradation reduction" project and combined with the actual situation of the township (district), Formulate specific implementation plans, sign responsibility letters step by step, and effectively implement project tasks at the grassroots level.

(2) Personnel training

1. Management training: (Each training must have notices, training records, sign-in books and other materials)

(1) Responsible departments: The county health bureau takes the lead, and the county women and children working committee cooperates.

(2) Training objects and content

① Administrative personnel training: The training objects are county, township (district) administrative leading cadres, and heads of departments responsible for organizing and implementing projects. The training contents include project purpose and significance, relevant department responsibilities, project implementation and fund management, project supervision and coordination.

②Medical care institution training: The training targets are leaders and staff of county medical care institutions. The training contents include the purpose and significance of the project, project implementation and execution unit responsibilities and management, and the establishment and operation of the maternal first aid system.

③Village cadre training: The training targets are village party secretaries, directors, and women directors. The training contents include the purpose and significance of the project, the responsibilities of village cadres, health education methods, and the establishment and operation of the village's maternal emergency first aid "green life channel" support system.

2. Business training: organized by the County Health Bureau. Each training includes training content and course arrangements, lecture notes, roster of participants and examination results.

(1) County-level teacher training.

The training content includes: the purpose and requirements of project training, training methods, and the formulation of training plans; maternal health care, and the treatment and referral of obstetric critical illness; relevant health technical service specifications, common obstetric technical operating procedures, and emergency equipment operating specifications and equipment Management and use, etc.

(2) Training of midwives in county-level medical care institutions and township (district) health centers: Midwifery personnel in county-level medical care institutions and central township (district) health centers focus on training on basic obstetric first aid knowledge, Skills and technical standards to improve obstetric first aid capabilities; midwives in general township (district) health centers focus on training basic first aid skills in normal delivery handling and common obstetric first aid skills in the referral process. The training materials are mainly county, township, and village-level textbooks and question banks for the "Reduction and Elimination" project.

(3) Training of village doctors, village midwives, and health workers: focusing on maternal system health care management, maternal risk identification and management, postpartum visits, breastfeeding and infant nutrition guidance, and health Educational methods, etc. Transform the functions of midwives and do a good job in publicity, mobilization and escorting pregnant women (especially high-risk pregnant women) to give birth in hospitals.

3. Time arrangement

Various trainings at the county and township levels will be completed in two stages. The business training will be completed in early April 2006, and the administrative training will be completed in June 2006. Completed before 30. During the project implementation process, timely intensive training will be conducted to address existing problems and deficiencies in management, obstetric clinical, and maternal and child health services.

(3) Project Supervision

1. Special experts assigned to supervise on site

Expert candidates: The county health bureau coordinates with the provincial and municipal health departments (bureaus) to select and dispatch qualified experts Backbones of maternal and child health care and obstetrics clinical services with intermediate and senior professional titles and certain clinical and management experience serve as experts stationed in the county.

2. Hierarchical supervision

(1) The office of the county-level abatement project leading group is responsible for project management and business supervision. According to the principle of hierarchical supervision, during the project implementation period, county-level supervision shall not It is carried out on a regular basis. The county maternal and child health care station implements a project responsibility system that covers all townships (towns, districts) and administrative villages. Township (district) health centers also need to carry out project responsibilities and go to the villages to provide guidance. The guidance work must cover all administrative villages. .

(2) Supervision content

①Project organization and management. Organizational leadership, coordination and project plan formulation of township (district) governments (management committees) and relevant departments, implementation of supporting funds, and collection of project data;

②Personnel training, health education and publicity;

③The operation of county-level maternal emergency centers, the operation of midwifery technical services in township health centers and the operation of referral systems for high-risk pregnant women, and the standardized management of obstetrics departments in medical and health care institutions at all levels;

④Hospital delivery of pregnant women Management and use of relief funds, and price-limited charges for hospital delivery at the county and township levels.

(3) Supervision requirements

① Supervise and guide the entire project implementation process, and understand the operation status of the project execution units;

② Help grassroots units improve their ability to implement projects ability and work quality;

③Help the grassroots solve the difficulties and problems encountered during project implementation;

④Go deep into the villages and farmers to understand the situation.

⑤ Supervision records. Fill in the project supervision record for each supervision, in duplicate, signed by the person in charge of the unit being supervised, one copy is retained by the unit being supervised, and the other is reported to the Project Office for Reduction and Elimination (Health Bureau) )for future reference.

(4) Baby-friendly hospitals (health centers)

Based on the work of the "reduction and elimination" project (continuation period), continue to consolidate the achievements of baby-friendly hospitals (health centers) and carry out Create a “Baby Friendly County” activity. The County People's Hospital and the County Hospital of Traditional Chinese Medicine should do a good job in perinatal care. Tucheng, Liangcun, Wenshui, Sangmu, Erlang, Malin, Dapo, Chengzhai, Tongmin, and Yongan Health Hospitals should strengthen obstetrics construction and services. While improving quality, we actively promoted the development of maternal and child health care in rural areas, and actively established baby-friendly health centers in the three central township health centers of Xijiu, Guandian and Zhaiba and other qualified township health centers.

(5) Hospitalized delivery of pregnant women

Promoting hospitalized delivery of pregnant women is the top priority of this phase of the project.

1. Implement a price limit for hospital delivery

In order to enable rural pregnant women to accept hospital delivery, county-level medical care institutions and township (district) health centers must implement a price limit for hospital delivery. , flat production costs are lump sum. The price limit targets: pregnant women with rural household registration in the county (laid-off urban workers and extremely poor households can enter project management with relevant certificates and certificates issued by relevant departments).

(1) The price limit for inpatient delivery in county-level medical institutions is 300 yuan, and the price limit for township and town health centers is 200 yuan;

(2) The price limit for cesarean section in county-level medical institutions 1,500 yuan, and 1,000 yuan for township health centers;

(3) Each project implementation unit must publish the price limit information on a list or announce the price limit charging standards through the media.

2. Carry out hospital delivery assistance

(1) Target recipients of hospital delivery assistance for pregnant and lying-in women: Anyone who holds the "Maternal and Infant Health Technical Service Practice License" issued by the city or county health bureau Pregnant women with rural household registration in the county, pregnant women from extremely poor urban households, and laid-off workers who hold family planning certificates who are hospitalized for delivery in medical and health care institutions at the county and township levels and hold a "Practice License for Medical Institutions". For those who go to a medical service institution to give birth without a family planning certificate, the medical service institution must promptly report back to the local family planning department and handle it accordingly in accordance with the law.

(2) Assistance standards: Hospitalized childbirth assistance funds are 150 yuan for each pregnant woman, 250 yuan for each case of dystocia, cesarean section (those with medical indications that require special rescue) and obstetrics Assistance for each case of serious complications is 500 yuan (the so-called dystocia here is: ① forceps assisted delivery; ② transverse breech delivery; ③ prolonged labor requiring treatment; ④ intrapartum hemorrhage; ⑤ intrauterine distress; ⑥ birth canal injury requiring treatment; ⑦ Placental adhesion; ⑧ Uterine contraction weakness, etc.).

(3) The poverty relief and reduction procedures are in accordance with the requirements of the "Operation Plan for Hospitalized Childbirth Assistance Funds for Poor Pregnant Women in the "Reduction and Elimination" Project of the Ministry of Health and Women's Department" and combined with the actual "Xishui County Reduction and Elimination" program formulated by the county. "Processing Fund Operation Plan for Maternal Hospitalization and Childbirth Assistance for Consumer Projects".

(4) Townships (districts) should identify the recipients of assistance for poor pregnant women and publish a list of them. After 7 days of no response, they should do a good job in publicity and mobilization for hospital delivery, and report to the county consumption reduction project office (Health Bureau) every quarter. ) Submit once the "Application Form for Assistance Funds for Hospitalized Pregnant Women and Pregnant Women", and implement measures to assist poor pregnant women in hospitalized delivery after review and approval.

3. Implement transfer subsidy for high-risk pregnant women to be hospitalized for delivery

Village doctors, health workers, and midwives will escort a high-risk pregnant woman to a health center or county-level medical care institution for hospitalization and give birth, and provide her with missed work time The subsidy is 30 yuan, which is advanced by the delivery unit and reported to the county consumption reduction project office (health bureau) every quarter.

4. County-level medical care institutions and township (district) health centers should strengthen obstetric quality management, use drugs rationally, avoid abuse of antibiotics, do everything possible to reduce medical costs, improve the quality of medical services, and reduce the risk of hospital delivery for pregnant women. financial burden.

(6) Green channel for life

1. Strengthen the construction of county-level maternal emergency centers. Improve rules and regulations, improve first aid facilities, strengthen skills training, improve treatment levels, and conscientiously carry out first aid work for critically ill pregnant women and newborns, as well as transport and treatment of pregnant women. Township (district) health centers should also strengthen the construction of obstetrics departments, standardize operating skills, and strictly implement the referral indications for high-risk pregnant women. Rural doctors and midwives must provide maternal and childbirth health care services, improve their ability to identify high-risk pregnant women, transport and escort high-risk pregnant women in a timely manner, and form a "green life channel" for maternal emergency care that connects up and down.

2. Establish and improve the maternal transport support system. Township (district) governments (management committees) and village committees should attach great importance to maternal transport, give full play to the skills of township and village maternal transport teams, organize and coordinate relevant departments (personnel), and establish "pregnant women transport" at the township and village levels. Maternal Hospital Delivery Transport" organization, which promptly transports pregnant women to hospitals or health centers for inpatient delivery and treatment.

3. Improve hospital delivery conditions. 80 township health centers have reached the "Guizhou Province Township Health Center Obstetrics Evaluation Standards". Medical care institutions and health centers should standardize the setting up of mother-infant rooming-in and delivery areas, and provide facilities for pregnant and postpartum women. It is convenient for you and your family members to have meals. The delivery room and maternal and child room have heating facilities to create a safe, hygienic, warm and comfortable hospital delivery environment for pregnant women.

(7) Health Education

The County Women and Children's Working Committee and the health department work closely together to carry out comprehensive and in-depth health education and publicity, and vigorously create a social atmosphere of "caring for the health of mothers and children".

1. Broadcast popular science knowledge on maternal and child health for free on county cable TV stations, township (district) relay stations, and radio stations.

2. Organize women cadres and medical personnel to go into villages and households to carry out health education and publicity activities that "focus on women and the family as the best place", and provide maternal health care and safe delivery to pregnant women. Propaganda and education of health care knowledge.

3. County medical and health care institutions, township (district) health centers and village clinics should set up health education and health columns, and cooperate with the Women and Children’s Working Committee to carry out various forms of maternal and child health publicity and consultation activities.

4. Promptly distribute and post provincial and municipal “consumption reduction” projects and eugenics and eugenics propaganda posters. The folded pictures should be distributed to the homes of pregnant women. All towns and villages should also produce leaflets and slogans according to local conditions, and all medical institutions should issue open letters to pregnant women, use inpatient health education guidance forms, vigorously promote the popular science knowledge of maternal and child health on "hospital delivery, maternal and infant safety", and publicize the county's implementation of " "Reduction and elimination" project, implement relevant policies on price limits for hospital delivery and medical assistance.

(8) Data management

The county pollution reduction project office (health bureau), township project working group (health center) and county-level project implementation units must pay attention to their respective jurisdictions, local For information management related to unit projects, a designated person shall be clearly responsible for information reflecting project work, such as project responsibility letters, implementation plans, meeting (regular meeting) records, supervision forms, training files and rosters, health education, publicity and consultation activities, typical cases , Original materials such as vouchers and documents for expenditures must be carefully collected, organized, archived and managed, and reported in accordance with regulations.

V. Use and Arrangement of Project Funds

(1) Fund Usage

1. Central Funds

2006 Central Government The fiscal transfer payment fund totals 1.00685 million yuan, which is mainly used for maternal hospitalization assistance, personnel training, equipment and health education, supervision and maternal and child health monitoring.

(1) Health education: 10,000 yuan, managed by the County Women and Children’s Working Committee.

(2) Personnel training: 10,000 yuan, managed by the consumption reduction project office. County-level training: 2928, township-level training: based on the number of administrative villages, each village subsidizes the township health center 32 yuan, and 24 towns and villages total 7072 yuan.

(3) Equipment allocation: 30,000 yuan. The county project office for reducing consumption will submit an equipment plan based on the equipment items designated by superiors, and the provincial finance and provincial health departments will conduct unified bidding and procurement.

(4) Hospitalized childbirth assistance: 956,850 yuan, managed by the Project Office for Reduction and Discharge. The rescue funds for each township are budgeted based on the number of live births per case (end of 2004) x 150 yuan.

2. Project supporting funds

Mainly used for project information management and project supervision.

(2) Fund and equipment management

1. Strictly follow the regulations of the national and provincial health departments and finance departments on special fund management, strengthen project fund management, and improve the efficiency of fund use. .

2. The project funds are operated in a closed manner (operated on the account), and the poverty relief and exemption fees and lost work allowance fees are collected by the medical and health care institutions. The hospitalized parturients or escorts who have received the poverty relief and exemption will have their fingerprints and signatures Relevant basis shall be reported to the project office.

3. Implement a project fund management reporting system, reporting financial statements every two months and annual financial statements at the end of the year. It is specifically implemented in accordance with the "Guizhou Province Provincial Measures for the Financial Management of Projects to Reduce Maternal Mortality and Eliminate Neonatal Tetanus".

4. Each township health center has established a project maintenance registration system. Project funds must be earmarked for specific purposes. The county health bureau and the finance bureau will verify the use of project funds and equipment maintenance in accordance with relevant regulations, and seriously misappropriate them for other purposes. use.

5. The equipment equipped for the project will be distributed to township health centers by the county health bureau according to actual needs. The health centers will have dedicated personnel in charge and keep them in good condition.

6. Project Supervision and Evaluation

(1) Supervision and Guidance

1. Accept supervision and guidance from superiors 2-3 times a year. Daily work supervision is carried out at the county level, and supervision is carried out 4 times a year, covering all townships (districts) and county-level project units.

2. The supervision and guidance content mainly includes: project plan and use of project funds; hospital delivery assistance, focusing on the benefits of the masses; the effectiveness of personnel training and health education; the purchase and use of equipment; Completion of project indicators; on-site guidance and special lectures as well as public evaluation of the project.

(2) Assessment

During the project period, the county conducted 2 assessments, divided into half-term and final (July and December) assessments, using assessment methods from each township and town. Self-examination and evaluation by project units and re-evaluation by an evaluation team organized by the Health Bureau cover all township and county-level project units.

7. Project Organization and Implementation and Department Responsibilities

(1) County Level

1. Responsibilities of the County “Reduction and Elimination” Project Leading Group Office

(1) Formulate the county's project implementation plan and organize its implementation, incorporate the project work into the government work agenda, and implement target responsibility management;

(2) Manage the entire project work process, organize supervision, and Training, and reporting project progress to the county government;

(3) Signing a letter of responsibility with the project implementation unit to implement project tasks;

(4) Responsible for the arrangement and use of project funds.

The County Women and Children’s Working Committee Office is responsible for coordinating relevant departments of the project, organizing health education and publicity and mobilization, escorting pregnant women to hospital for delivery, etc. The County Finance Bureau is responsible for the allocation of funds, and with the cooperation of the Health Bureau Strengthen supervision and management of the use of funds.

2. Responsibilities of county-level medical and health care institutions

(1) County Family Planning Maternal and Child Health Center

① Comprehensively and timely grasp the progress of project activities in each township (district) , collect, count, analyze and report project work data;

② Organize case investigation and review of maternal deaths and neonatal tetanus cases;

③ Responsible for the training of township-level personnel and assist Guide township (district) health centers to carry out village-level training;

④ Responsible for the technical guidance of township and village maternal and child health care management and service, and assist the project under the arrangement of the consumption reduction project office (Health Bureau) The technical guidance group carries out grassroots project supervision work;

Reports the progress of the project work to the county health bureau in writing every month.

(2) County Emergency Center (County People’s Hospital)

① According to the arrangements of the Health Bureau, improve the maternal emergency organization and do a good job as a maternal emergency center;

② Assist the project office (Health Bureau) to provide training for township-level personnel;

③ Under the arrangement of the project office (Health Bureau), assist the project technical guidance group to carry out grassroots Project supervision work;

④ Responsible for guiding the construction of obstetrics departments and midwifery technical services in township (district) health centers, guiding the analysis and review of causes of maternal and infant deaths in the county, improving intervention measures, and assisting family planning maternal and child health centers Provide guidance on grassroots maternal and child health care technical services.

(2) Township level: Township (district) project working group (health center) responsibilities

1. Formulate the project work plan, incorporate it into the government work schedule, and organize its implementation;

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2. Responsible for the training of village-level health personnel;

3. Improve the regular meeting work system. Village doctors’ meetings are held at the township level once a month. Through monthly meetings, work data and information of the previous month are collected and arranged. Work, carry out targeted management and technical training, and keep records of regular meetings;

4. Demarcate and assign responsibility, county maternal and child health stations and township health centers assign responsibility for assignments, and go deep into townships and villages to guide work;

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5. Strengthen the construction and quality management of the hospital's obstetrics department, improve midwifery technical service capabilities, promote hospital delivery, and promptly organize emergency treatment and transport of critically ill pregnant women;

6. Strengthen maternal and child health care Data management, including the number of women of childbearing age, number of pregnant women, number of high-risk pregnant women, number of live births, number of hospital deliveries and sterilized deliveries, maternal deaths and deaths of children under five years old, neonatal tetanus incidence and maternal health care in each village Basic service data is collected on time and reported to the county family planning maternal and child health center.

(3) Village level

1. The "Village-level maternal hospital delivery transfer team" consists of the village chief, women's director, village doctor, assistant to the village chief and influential people in the village It is responsible for mobilizing pregnant women in the village for hospital delivery and transporting high-risk pregnant women;

2. The village clinic is responsible for the recording, collection, statistics and reporting of maternal and child health care work and related data in the village;

3. Village doctors should do a good job in maternal registration, prenatal examination, prenatal visits, high-risk identification screening and health education, and mobilize pregnant women to be hospitalized for delivery. If high-risk pregnant women are found, they should report to the village committee in a timely manner and assist in referral;

4. For pregnant women who really need home delivery, they must strictly follow the disinfection and delivery operating procedures;

5. Timely grasp the deaths of pregnant women and children under 5 years old, and neonatal tetanus. Cases should be registered and reported immediately to the prevention and protection team of the township (district) health center.

8. Relevant work requirements

(1) Further strengthen the management of "Medical Birth Certificate" and actively promote the increase in hospital delivery rate. The issuance of a "Medical Birth Certificate" for babies born outside medical care institutions must be accompanied by a certificate of delivery issued by a home midwife. The home midwife must hold a "Midwifery Technology Assessment Certificate" and the village committee must issue a certificate. The county health bureau and the people's governments (management committees) of all townships (districts) must do a good job in the supervision and management of the "Medical Birth Certificate". The County Public Security Bureau should further strengthen household registration management. New-born babies must issue a "Birth Medical Certificate" before they can apply for household registration.

(2) The extension period project shall be implemented until the date of drafting of this plan. During the extension period, each project implementation unit must carefully summarize the project implementation work, formulate project work plans and practical and effective measures to ensure the normal operation of the project.