Reduced project implementation plan
Article 1: Implementation plan for the project
In order to implement the spirit of the province's “reduction” project and the maternal and child health management work conference, the objectives of the “China Women and Children Development Program” were earnestly implemented, and the “reduction and elimination” project was fully implemented. Now the county’s “reduction” project will be implemented in 20XX. The programme is organized as follows:
I. Project objectives
1. Maternal mortality rate: The maternal mortality rate in 20XX decreased by 1/4 on the basis of 85.95/100,000 in 20XX;
2. The incidence of neonatal tetanus falls below 1‰;
3. The maternal hospital delivery rate increased to over 80% on the basis of 75.02%.
4. The sterilization birth rate is ≥98%;
5, prenatal inspection coverage rate ≥ 90%;
6. The basic theory, basic knowledge and basic skills training rate of the obstetrics and maternal and child health care professionals in county and township health care institutions are ≥95%, and the passing rate of assessment is ≥90%.
Second, the project content
Strengthen the training and training of all types of personnel at all levels.
In order to improve the management level of managers and the technical level of business personnel, three training courses will be held during the year. One type of training course for administrative staff, one class of county and township pediatrician training classes, and one type of village-level maternal and child health personnel training class. The village-level training is organized by the women and children station to cooperate with the township health center to carry out training work.
The training personnel of the administrative management personnel are mainly the leaders of the townships and towns, the presidents of the health centers, and the women cadres. The main contents of the training are project objectives, management responsibilities at all levels, project implementation and funding management, establishment of referral emergency systems, project supervision and coordination, etc.
The training content of pediatric staff in county and central township health centers is basic knowledge, skills and technical specifications of obstetric first aid, and neonatal asphyxia resuscitation techniques, etc., to improve first aid ability. At the same time, three township midwifery personnel were selected to participate in the province's “reduction” training training for no less than four months; the training of normal midwifery staff in general township hospitals, the basic production of common obstetrics Skills and basic first aid skills during referral;
The training of village-level maternal and child health workers is mainly to improve the maternal system health care and management, prenatal examination and postpartum visit, screening and identification of high-risk maternal women, mobilization of hospital delivery, and health education.
The midwife health center's midwifery staff will be trained by the women and children station. Each township health center will hold four training courses for rural doctors and village maternal and child health workers.
Vigorously promote health education work.
The popularization of health education knowledge is an important measure for women to improve their self-care awareness and reduce maternal mortality.
1. The township and village maternal and child health workers should enter the village to carry out the health education model of “taking women as the core and the family as the best place” to publicize and educate pregnant women on maternity health care and safe delivery.
2. The maternal and child station set up a maternity school, established and improved health education equipment, and organized various training courses from time to time to address the low educational level and old customs of rural women.
3. Use radio and television news media to conduct a radio lecture once a month; write flyers and brochures with popular language and pictures, and use the gatherings and festivals to widely publicize the benefits of pregnancy care and hospital delivery, and “slow” The policies of the project, etc., enable the public to understand the knowledge about maternal health and improve the ability to use maternal and child health services.
4. At least in the intensive and eye-catching places of 18 townships and towns, at least one fixed slogan of “hospital delivery, maternal and child safety”, “good hospital delivery”, “free hospital delivery, and mother and child safety”, wall slogan Not less than 3, each village has at least one fixed publicity column.
5. Each medical unit conducts face-to-face communication and publicity when using the service target, and imparts health education knowledge by means of opening a health prescription.
Increase supervision and guidance.
Strengthening supervision and guidance is a key link in implementing good project work. To this end, this year's county project office shall conduct supervision and guidance for each township every two months, covering all townships and administrative villages throughout the year. Township hospitals should supervise once a month, cover all administrative villages, and hold regular meetings of township doctors and health workers on a monthly basis to arrange specific work for this month.
The main contents of supervision and guidance are:
(1) Progress of the project plan;
(2) Implementation of subsidy funds;
(3) The effect of “three basics” knowledge training and household survey health education;
(4) The use of equipment and equipment, as well as the use of equipment;
(5) The completion of project indicators and activities;
(6) Operation, referral, rescue records, and outpatient visits of the first aid “green channel”;
(7) On-site guidance and special lectures, as well as township medical meetings, maternal system management records;
(8) Check the various types of archives and materials for the work and operation of projects at all levels.
Each supervisor will make the task clear and focused, and ensure the supervision effect.
Seriously do a good job in maternal hospital delivery and poverty relief.
1. The county and township medical institutions shall implement the “prepaid” subsidy system for the “reduction” project. After the maternal hospital delivery, the medical unit that receives the maternal delivery will be prepaid at the time of discharge from the mother, and then the county project office will approve the application. Disbursement; the subsidy for childbirth in a medical institution outside the county shall be submitted to the project office for approval after the mother's household registration is in the township health center. The county and township medical units shall regularly collect and report the information of the women who have been hospitalized for delivery, timely cash the subsidy funds, and strengthen the standardized management of the hospital delivery allowance work.
2. The subsidy standard for rural maternity hospital delivery is 400 yuan per person, and will be implemented from May 20XX. Implement the basic service items and limit price standards for rural maternity hospital delivery subsidies in the county. The county hospitals and the Chinese medicine hospitals charge 650-800 yuan for flat production. The maternal and child stations and township health centers are free to give birth to hospitals. The cost of cesarean section continues to be controlled within 2,000 yuan. All units must strictly implement the maternal hospitalization limit price limit, intervene unreasonable medical behavior, reduce medical expenses, so that the hospitalized pregnant women can directly benefit, and each medical unit must publicly display the charging standards and accept public supervision.
3, rural maternity hospital delivery reimbursement methods. The rural maternity hospital in our county pays for hospitalization and gives a quarterly report. Rural maternity women with ID card, household registration to the county, township health care institutions hospitalized delivery, discharged at the hospital according to the standard immediately reduced the cost of hospitalization, and on the discharge statement, indicate the amount of the "reduction" project reduction, fill in the rural The maternity hospitalization subsidy triple list, determine the reduction of the free amount, signed by the mother or family members in the hospital invoice, "triple single" and "Gansu Province rural maternal hospital delivery subsidy summary table", medical institutions in the "triple single" Sealed, the first joint county project office saves, the second joint is saved by the health care institution, and the third joint is saved by the subsidized object. The medical units will finally approve the disbursement of funds in the county project office based on the maternity ID card, the household registration book, the copy of the hospitalization invoice, the “Sanlian Single” and the “Summary Form for the Subsidy for Rural Maternal Hospital Delivery in Gansu Province”.
4. Rational use of drugs. According to the actual situation of maternal hospital delivery, rational use of drugs, avoid abuse of antibiotics and a wide range of health care products, in order to reduce the economic burden of maternity hospitalization.
Strengthen the construction of obstetrics to ensure the smooth flow of maternal first aid “green channel”.
1. The county hospital should further strengthen and improve the “green channel” for maternal first aid and the construction of the maternal rescue center for critical and acute diseases, give full play to the first aid function, minimize the maternal death, and form a “green channel” for maternal first aid. Technical strength.
2. All township hospitals should combine the construction projects of rural health centers, actively strive for the production of pediatric equipment, strive to improve the hardware construction of obstetrics, and do a good job in the delivery of flat products. At the same time, it is necessary to strictly implement the indications for high-risk maternal referrals and timely Referral work.
3, the village level should be responsible for high-risk maternal screening and transfer work, banned family delivery.
Strengthen the collection and reporting of information on “reduction” projects.
Continue to implement the “reduction” project information data for direct network reporting. All medical units should fully understand the importance of project data work, and provide scientific, accurate and timely data statistics and analysis to the project office, and resolutely eliminate hidden reports. , reports, false reports and other phenomena. At the same time, the Women and Children Station should strengthen the training of information management for women and children at the township and village levels, improve their business level, and standardize the management of information data.
Organizational management of the project.
1. Formulate reasonable fund management methods, make special funds for funds, conduct independent accounting, adhere to the fair and transparent rescue funds, audit the use of project funds once a year, and report the audit to the provincial project office in a timely manner.
2. The county project office organizes and implements project activities, formulates personnel training plans, organizes social mobilization activities, and urges medical institutions to implement price limit fees for maternal hospital delivery, strengthen project equipment use and maintenance, and improve equipment use efficiency.
3. Accept the assessment and assessment of the national, provincial and municipal project leading groups and strengthen the management of all aspects of the project.
Part 2: Implementation plan for the project
In the past three years, the town has implemented the public health special fund of the central government to reduce the maternal and elimination of neonatal tetanus. In 20XX, the central government continued to arrange project funds to subsidize the implementation of the “reduction” project in our town. In order to implement the “20XX Central Subsidy Taihu County Public Health Special Fund to Reduce Maternal Mortality and Eliminate Neonatal Tetanus Project Implementation Plan”, this program was formulated in conjunction with the actual situation of our town.
I. Project objectives
20XX annual target
1. The number of maternal deaths in the whole year is no more than 1 case, and try to avoid maternal mortality;
2. The incidence of neonatal tetanus is controlled below 1‰;
3, maternal hospital delivery rate of 100%.
20XX annual support target
1. Disinfection birth rate >98%;
2. The prenatal inspection coverage rate is >90%;
3. The pass rate of the “three basics” in the obstetrics of the hospital is >85%.
Second, the project content and organization and implementation
Personnel training: Select the obstetric technicians to go to the obstetrics and gynaecology department of the hospital at or above the county level. The training content focuses on the basic knowledge of basic obstetrics, basic skills, technical operation rules and neonatal asphyxia technology to improve the first aid ability and technology of obstetric medical staff. Level.
Train rural doctors and maternal and child health workers.
Social mobilization: Extensive publicity, implementation of social mobilization, and through various forms, increase the promotion of “reduction” projects, so that the town's people and society can know, care, and support project implementation.
Maternal hospitalization, childbirth, poverty relief
1. Scope: Maternal women who belong to the county's rural hukou and some urban households with difficulties in hukou may enjoy hospital delivery during the hospitalization of medical care institutions in the county from January 20 to December 31, 20XX.
2. Standards: Each case of poor maternal hospital delivery is subsidized by 150 yuan per standard. The maternal delivery of special maternal families is subsidized by 450 yuan per case. The number of maternal destitute places in our town is 40 in rural areas and 4 in urban areas.
3, hospital delivery assistance implementation of the account system, township hospitals should strictly control the cost of poor maternal hospital delivery, the implementation of limited-price hospital delivery, control within 600 yuan, that is, the implementation of free hospital delivery, the limit price is borne by the hospital.
4. Operational program: Pregnant women or their families who meet the conditions for assistance apply for the “Application Form for Rescue Funds for Poor Maternal Hospital Delivery”, and the villagers’ committee will review the scope, targets and subsidy standards determined according to this plan, and the special assistance targets and towns The list of household assistance targets shall be publicized and accepted by the public. After the review, the official seal shall be affixed to the town health center. After the review, the list of special hardship relief and the list of maternal poverty relief for the local urban household registration shall be submitted to the electronic document together with the application form for the rescue fund. County “reduction” project office. The approved list of objects and rescue cards will be distributed to the town health center and the village committee, and will be issued to the maternal family. The maternity card will be given to the county health care institution to receive the corresponding subsidy for hospital delivery, and the health care institution will fill in the assistance. The funds triple list together with the rescue card and the maternal hospital delivery assistance registration form will be reported to the county reduction project office, and the project office will remit the funds to the medical institution after review.
Third, the project execution time
The project was launched in January 20XX and completed on December 31.
Fourth, supervision and evaluation
The county “reduction” project office will randomly check the health care institutions from time to time to understand whether the burden reduction meets the requirements and standards, and at any time to take the rescued women to conduct household surveys to understand the implementation of funds.
Part 3: Implementation plan for the project
To implement the "Mother and Child Health Care Law of the People's Republic of China", to achieve the goals of the "China Children's Development Program" and the "China Women's Development Program", to reduce maternal mortality, under-five mortality and elimination of neonatal tetanus, to implement provincial health The Department of Finance, the Ministry of Finance, and the Women and Children's Working Committee's Implementation Plan for the Maternal and Child Health Project of the Public Welfare Fund for Public Health in Anhui Province in 20XX, combined with the actual situation of the district, formulated this implementation plan.
I. Project objectives
1. Maternal mortality: By the end of 2019, the maternal mortality rate in the jurisdiction is below the city average.
2. The incidence of neonatal tetanus: the incidence of neonatal tetanus fell below 1‰, and strive to avoid neonatal tetanus cases.
3. The sterilization delivery rate is ≥98%.
4. Prenatal check coverage is ≥90%.
5. The pass rate of the “three basics” in the obstetrics of the medical and health care institutions in the municipal and municipal districts is ≥80%.
Second, the scope and content of the project
Project scope
This project covers the Ganyu District and Zhangzhou Economic and Technological Development Zone.
Project Description
1. staff training
The Municipal Health Bureau and the Municipal Health Center are responsible for project management training, and the obstetric staff of the municipal health care institutions in the municipal and municipal districts participate in the training.
2. health education
The municipal and district-level health care units actively promoted the health education model of “taking women as the core and the family as the best place”, publicizing and educating pregnant women on maternity care and safe delivery; using community medical institutions to organize “ "Pregnant women's school", "parent school" to spread health knowledge; write a popular language education, illustrated health education books, distributed to pregnant women and family members, widely publicize the benefits of hospital delivery.
Health care institutions and community health service agencies at all levels post maternal health knowledge and safe childbirth knowledge posters to educate the public about maternal health knowledge and improve the utilization rate of maternal and child health services.
3. Establish a maternal emergency “green channel” and emergency rescue center
As the maternal rescue center, the city's second hospital and the city's integrated Chinese and western medicine hospital serve as the maternal rescue center, responsible for critical maternal first aid, the city's first hospital as a newborn emergency center, the district's midwifery institutions to strengthen obstetric construction, do Good birth delivery and high-risk maternal screening, strict implementation of high-risk maternal referral indications. The urban community neighborhood committee is responsible for the critical maternal transport by the municipal 120 emergency center; the agriculture-related street community health service center has set up a transfer group to organize 2 motor vehicles, responsible for transferring high-risk pregnant women.
4. Project launch and promotion
In April, the project kick-off meeting was held. At the same time, the news media and lectures were used to make the general public understand the contents of the “reduction project”, enhance the awareness of maternal and child health care, and improve the utilization rate of health care services.
Third, the project organization and implementation
Organizational form
In accordance with the requirements of the Provincial Women's and Children's Working Committee, the Provincial Health Department, and the Provincial Department of Finance's "Notice on Seriously Doing the Work of "Reducing Projects", the Leading Group for the "Reduction" Project in the Reclamation Area was established. The bureau and the municipal health center are responsible for the supervision and management of the project implementation activities and technical guidance. The District Women and Children Working Committee and the Health Bureau are responsible for the organization and implementation of the project in the region. The Municipal Maternal and Child Health Center is responsible for the specific implementation of supervision and management and technical guidance.
Training training
The Municipal Women and Children's Working Committee, the Health Bureau and the Municipal Health Center personnel participate in administrative training, and the Provincial Maternal and Child Health Center is responsible. The Municipal Health Bureau and the Municipal Maternal and Child Health Center are responsible for the training of street and village administrative staff and obstetric staff.
Funding arrangement
The central government allocated special funds for personnel training, rural maternity hospital delivery subsidies, social propaganda and health education.
Rural maternal hospital delivery allowance
Any rural pregnant woman who is holding an “agricultural hukou” and is planning to give birth in a medical institution with midwifery qualifications can enjoy a subsidy of 400 yuan per mother and a rural health care institution in the district. In the case of hospital delivery, fill out the "Eastern Rural Maternal Hospital Delivery Grant Card" in Anhui Province, directly deducting the cost of hospital delivery, and then the medical institution will report to the district's new rural cooperative management center on a monthly basis; in the outpatient health care institution, the hospital will give birth. The maternity holding discharge summary, hospitalization invoice, household registration book, family planning certificate, and subsidy card will be reported to the district new rural cooperative management center.
Strict control of cesarean section rate
The cesarean section rate of the municipal health care institution shall not exceed 50%; the cesarean section rate of the community health service center shall not exceed 20%, and the municipal and district health bureaus shall regularly supervise the cesarean section of the midwifery institution for cesarean section. A midwifery agency with a rate exceeding 5% of the prescribed standard is given a notice of criticism.
Fourth, project execution time
The project work began on January 1, 20XX and was completed on December 31, 20XX.
V. Project supervision and evaluation
1. Supervision and guidance
The municipal, district health bureaus, and municipal health clinics supervise and guide once every quarter. Supervisory content: organization management, equipment use, personnel training, health education, completion of project indicators, public reflection and evaluation.
2. Capital use and equipment management
All medical institutions must pay special funds for the project, and have detailed accounts, which should not be used for other purposes. The equipment equipped with the project must be staffed and kept in good condition.
Part 4: Implementation plan for the project
In order to consolidate the previous cycle to reduce maternal mortality and eliminate the results of the neonatal tetanus project, efforts will be made to achieve the health goals of the Women and Children in the 20XX-20XX period, according to the arrangements of the State Council, the provincial and municipal departments, according to the 20XX Zunyi City The implementation plan of the project is reduced, and the implementation plan is formulated in combination with the actual situation of our county.
I. Project objectives
Long-term goals
By 20XX, the maternal mortality rate will drop by 1/3 on the basis of 20XX years. The county's maternal and child health monitoring system will be established and the obstetrics construction will be improved. The 24 township health centers in the county will set up obstetrics and assist the medical staff. To provide a reliable basis for the implementation of the evaluation of “reduction” projects, and provide a scientific basis for the government to formulate maternal and child health policies.
annual target
1. The overall goal
Maternal mortality rate: 1/4 decline based on 20XX years
Neonatal tetanus incidence: controlled below 1‰
Maternal hospital delivery rate: 50% or more
High-risk maternal hospital delivery rate: 95% or more
Monitor maternal mortality, monitor children under 5 years of age, and monitor birth defects.
2, supportive goals
Maternal prenatal check coverage: ≥90%
High-risk maternal screening management rate: 70% or more
Disinfection birth rate: ≥98%
County-level health care institutions, township health centers, obstetrics, "three basic" examination pass rate: ≥ 98%
Awareness rate of health education for women of childbearing age: >85%
Second, the scope and time of implementation
The project work covers all towns and villages in the county.
Maternal deaths are monitored throughout the county. The monitoring points for children under 5 years of age are: Sangmu Town, Wenshui Town, and Minhua Township. The birth defect monitoring points are: County People's Hospital, County Chinese Medicine Hospital, and County Family Planning Health Care Center.
Project implementation time: December 20XX - December 20XX
Third, the project task
The overall tasks of the project are: personnel training; rural maternal hospital delivery assistance; establishment and improvement of maternal emergency “green channel” and “critical emergency rescue center”, health education, supervision and guidance; basic equipment of maternity health department equipment, consolidation And the creation of the baby-friendly hospital, and actively create the baby-friendly county.
Fourth, the project measures
At this stage, the project work will be further strengthened on the basis of the previous cycle work.
Project management
1. Adjust and enrich the “reduction” project coordination leading group, give full play to the coordination, organization and management functions, and be responsible for the whole process of project implementation leadership.
2. The County Health Bureau adjusted and enriched the project technical guidance group and supervision team to strengthen project management and business guidance.
3. Implement the target management responsibility system. The county people's government and the member units of the county resettlement project transfer association and the township people's government sign the target responsibility letter, and each township and town shall formulate specific implementation plans according to the implementation plan of the county “reduction” project, combined with the actual situation of the township, step by step. Sign the responsibility letter and implement the project work tasks to the grassroots level.
staff training
1. Management training:
Responsible department: The county health bureau is the main, and the county women and children work committee cooperates.
Training objects and content
1 Administrative staff training: The training targets are county and township administrative leading cadres, and organize the implementation of the relevant project department responsible persons. The training content is the purpose and significance of the project, related department responsibilities, project implementation and fund management, project supervision and coordination.
2 Health care institution training: The training target is the county health care institution leader and staff. The training content is the purpose and significance of the project, the project implementation and execution unit responsibility and management, and the establishment and operation of the maternal emergency system.
3 village cadre training: the training target is the village party secretary, director, and women director. The training content is the establishment and operation of the project's purpose and significance, the responsibility of the village cadre, the health education method, and the “green life channel” support system for the village pregnant women.
2, business training: County Health Bureau, each training has training content and curriculum arrangements, lectures and participants in the roster and test results.
County-level teacher training. The training includes: the purpose requirements of the project training, the training methods, the formulation of the training plan; the maternal health care, the treatment and referral of the critically ill obstetrics; the relevant technical specifications for health services, the common technical procedures for obstetrics and the operation specifications and equipment for emergency equipment. Management and use, etc.
Training for midwifery health care institutions and township health centers: mid-level health care institutions and central township health center midwifery personnel focus on training basic knowledge, skills and technical specifications of obstetrics first aid to improve obstetric first aid; general township hospitals The production personnel focus on training the basic first aid skills in the normal production and treatment, and common obstetric first aid basic skills referral process. The training materials are mainly based on the “reduction” project county, township and village level textbooks and question banks.
Village doctors, village birth attendants, health workers training: key training maternal system health management, maternal risk identification and management, postpartum visits, breastfeeding and infant nutrition guidance, health education methods. Transform the function of the birth attendant, do a good job of mobilizing and escorting maternal hospital delivery.
3. Time schedule
The county and township trainings were completed in two phases. The business training was completed in early April 20XX, and the administrative training was completed before June 30, 20XX. During the implementation of the project, intensive training was carried out in a timely manner in response to problems and shortcomings in management and obstetric clinical and maternal and child health services.
Project supervision
1. Special experts will supervise
Expert candidates: The county health bureau coordinates the provincial and municipal health departments to select women and children health care and obstetric clinical business backbones with intermediate and senior professional titles and certain clinical and management experience as experts in the county.
2, hierarchical supervision
The County Leading Group Office is responsible for project management and business supervision. According to the principle of hierarchical supervision, during the project implementation period, the county-level supervision is carried out irregularly. The county maternal and child health station implements the project fragmentation responsibility system, covering all townships and administrative villages. The township hospitals should also slash and pack, and the villages should guide the work, and the guidance work should cover all administrative villages.
Supervised content
1 organization management of the project. Organizational leadership, coordination and project planning of township governments and relevant departments, implementation of supporting funds, collection and collation of project materials;
2 personnel training, health education publicity;
3 county-level maternal emergency center operation, township health center midwifery technical service and high-risk maternal referral system operation, standardized management of obstetrics at all levels of health care institutions;
4 Maternal hospital delivery and rescue fund management and use, county, township level of flat birth hospital delivery limit price charges.
Supervisory requirements
1 Supervise and guide the whole process of project implementation, and master the operation of the project execution unit;
2 to help grassroots units improve their ability to execute projects and the quality of their work;
3 Help the grassroots to solve the difficulties and problems encountered in the implementation of the project;
4 Go deep into the village and farmers to understand the situation.
5 Supervise the record, each time the supervisor fills in the project supervision record, in duplicate, after the signature of the person in charge of the supervised unit, one is left to be supervised by the supervisory unit, and one is reported to the project office for future reference.
Baby-friendly hospital
On the basis of the work of the “reduction” project, we will continue to consolidate the results of the baby-friendly hospital and launch the “Ai-Yi County” campaign. County People's Hospital and County Chinese Medicine Hospital should do a good job in perinatal care, Tucheng, Liangcun, Wenshui, Sangmu, Erlang, Malin, Dapo, Chengzhai, Tongmin, Yong'an Health Center should strengthen the construction of obstetrics and At the same time of service quality, it actively promoted the development of rural maternal and child health care. The three township township hospitals of Xijiu, Guandian and Zhaiba and other conditional township hospitals actively created baby-friendly hospitals.
Maternal hospital delivery
Promoting maternal hospital delivery is the top priority of this phase of the project.
1, the implementation of hospital delivery limit
In order to enable rural pregnant women to receive hospital delivery, county-level health care institutions and township health centers must implement hospitalization delivery limits, and flat production costs. The limit price is: pregnant women in rural households in the county.
The county-level medical institution has a flat product limit of 300 yuan for hospitalization and 200 yuan for township and town health centers;
The cesarean section of the county-level medical institution is priced at 1,500 yuan, and the township hospital is 1,000 yuan.
Each project implementation unit shall announce the price limit situation or publicize the limit price standard through the media.
2, carry out hospital delivery assistance
Maternal hospital delivery and delivery assistance: All the hospitals and county-level health care institutions that hold the “Mother and Child Health Care Technical Service License” and the “Medical Organization Practice License” issued by the Municipal and County Health Bureau There are rural maternity peasants, urban poor households, and laid-off workers who are planning maternity documents. If the child care certificate is not delivered to the medical service institution, the medical service institution must promptly respond to the local plan and birth department and handle it accordingly.
Rescue criteria: hospitalization and childbirth relief funds are 150 yuan for each maternal parity, 250 yuan for each dystocia, and 500 yuan for each case of cesarean section and obstetric complications.
The poverty relief program is in accordance with the requirements of the “Ministry of Women’s Department of the Ministry of Health on the “Down” project for the operation of the poor maternal hospital delivery and rescue funds, combined with the actual operation of the “Shuishui County Project” "Handle.
Townships and towns should review the target of poor maternal help, and after the announcement of 7 days of non-response, do a good job in mobilizing and mobilizing hospital delivery, and submit a “Application Form for Rescue Maternal Hospital Delivery Assistance Fund” to the County Project Office every quarter. After the examination and approval, the implementation of maternal hospital delivery and poverty relief measures.
3, the implementation of high-risk maternal hospital delivery transfer subsidy
Village doctors, health workers, and birth attendants escorted a high-risk maternity woman to the hospital and county-level health care institutions for hospitalization and childbirth, and subsidized 30 yuan, which was paid by the receiving unit and reported to the county project office every quarter.
4. County-level health care institutions and township health centers should strengthen the quality management of obstetrics, rationally use drugs, avoid abuse of antibiotics, do everything possible to reduce medical costs, improve the quality of medical services, and reduce the economic burden of maternal hospital delivery.
Life green channel
1. Strengthen the construction of county-level maternal emergency centers. Improve the rules and regulations, improve first-aid facilities, strengthen skills training, improve the level of treatment, and do a good job in critically ill maternal and newborn emergency work and maternal delivery and treatment. Township hospitals should also strengthen obstetric construction, standardize operational skills, and strictly implement high-risk maternal referral indications. Rural doctors and birth attendants should do a good job in maternal health care, improve the ability of high-risk maternal identification, timely transfer and escort high-risk maternal women, and form a “green life channel” for maternal first aid.
2. Establish and improve the maternal transport support system. The township government and the village committee should attach great importance to the maternal transshipment work, give full play to the skills of the township and village maternal transfer group, organize and coordinate relevant departments, and establish a “maternal hospital delivery transfer” organization at the township and village levels to timely deliver the pregnancy. Maternal women go to hospital or hospital for hospital delivery and treatment.
3. Improve hospital delivery conditions, 80% of township hospitals meet the “Evaluation Standards for Obstetrics in Guizhou Township Health Centers”, and health care institutions and health centers should standardize maternal and child room and delivery areas, and provide convenience for pregnant women and their families. The delivery room and the maternal and child room have heating facilities to create a safe, hygienic, warm and comfortable hospital delivery environment for pregnant women.
health education
The County Women and Children Working Committee and the health department work closely together to carry out health education publicity in an in-depth manner and vigorously create a social atmosphere of “care for the health of mothers and children”.
1. Free broadcast of maternal and child health science knowledge in county cable TV stations, township towns, and radio stations.
2. Organize women cadres and medical personnel to enter the village to carry out health education publicity activities of “taking women as the core and family as the best place” to publicize and educate pregnant women on health care such as maternal health care and safe delivery.
3. The county health care institutions, township 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. Distribute and post the provincial and municipal “reduction” projects and eugenics and publicity posters in a timely manner. The folding pictures should be distributed to the pregnant women’s home. All towns and villages should also produce leaflets and propaganda slogans according to local conditions. All medical institutions should issue open letters to pregnant women, use inpatient health education guidance forms, and vigorously promote the knowledge of maternal and child health sciences in hospitalization, maternal and child safety, and promote the implementation of the county. The “reduction of the project”, the implementation of hospital admissions limit fees and medical assistance related policies.
Data management
The county reduction project office, the township project working group and the county-level project implementation unit shall pay attention to the management of the relevant data of the project in the area under their jurisdiction, and clarify the responsibility of the person in charge, and reflect the information of the project work, such as the project responsibility book, implementation plan, The original materials such as meeting minutes, supervision forms, training files and rosters, health education, publicity and consultation activities, typical cases, voucher documents for expenditures, etc. should be carefully collected, organized, archived and reported and reported.
V. Project fund use and arrangement
Use of funds
1. Central funds
In the 20XX year, the central government's financial transfer payment funds totaled RMB 106.85 million, which was mainly used for maternal hospitalization assistance, personnel training, equipment and health education, supervision and maternal and child health monitoring.
Health Education: 10,000 yuan, managed by the County Women and Children Working Committee.
Personnel training: 10,000 yuan, managed by the project office. County-level training: 2928, township-level training: According to the number of administrative villages, each village subsidizes 32 yuan for township health centers, and 24 townships total 7072 yuan.
Equipment: 30,000 yuan, the county reduction project office according to the higher-level designated equipment name reporting equipment plan, the provincial finance, provincial health department unified bidding procurement.
Hospital delivery assistance: 956,850 yuan, managed by the project office. According to the number of live births per child × 150 yuan budget for the township and town rescue funds.
2. Project matching funds
Mainly used for project information management and project supervision.
Funding and equipment management
1. Strictly follow the regulations of the State and Provincial Health Department and the Ministry of Finance on the management of special funds, strengthen the management of project funds, and improve the efficiency of fund use.
2. The project funds are closedly operated, and the poverty relief and free work and the subsidy for the work are paid to the project office by the health care institutions to collect the relevant evidence of the hospitalized delivery or signing of the hospitalized delivery or signing of the poverty relief.
3. Implement the project fund management reporting system, report the financial statements once every two months, and report the financial year reports at the end of the year. In accordance with the “Guizhou Province Measures to Reduce Maternal Mortality and Eliminate the Financial Management of Neonatal Tetanus Projects”.
4. The township health centers shall establish a project maintenance registration system. The project funds must be earmarked for special purposes. The county health bureau and the finance bureau shall verify the use of the project funds and the maintenance and use of the equipment according to relevant regulations, and strictly use them for other purposes.
5. The equipment provided by the project shall be distributed by the county health bureau according to the actual needs of the township health center. The health center shall be responsible for the person and keep it in good condition.
Project supervision and evaluation
Supervision and guidance
1. Accept the supervisory guidance of the superiors 2-3 times a year. The county level conducts daily work supervision and supervises 4 times a year, covering all township and county-level project units.
2. The supervision and guidance contents mainly include: the project plan and the use of project funds; the situation of hospitalization and delivery assistance, the focus is on the benefit of the people; the effect of personnel training and health education; the purchase and use of equipment; the completion of project indicators; On-site guidance and special lectures, as well as public evaluation of the project.
Evaluation
During the project period, the county carried out two assessments, which were divided into half-term and final-term assessments. The self-inspection assessment of each township and project unit and the evaluation of the health assessment bureau organized by the health bureau were evaluated to cover all township and county-level project units.
7. Project organization and departmental duties
County level
1. County Responsibility Project Leading Group Office Responsibilities
Formulate and implement the project implementation plan of the county, incorporate the project work into the government work agenda, and implement the target responsibility system management;
Manage the whole process of the project, organize supervision and training, and report the progress of the project to the county government;
Sign the responsibility letter with the project execution unit to implement the project work tasks;
Responsible for the arrangement of project funds.
The County Women and Children's Working Committee is responsible for coordinating the relevant departments of the project, and organizing health education publicity and mobilization, escorting maternal hospital delivery, etc. The county finance bureau is responsible for the allocation of funds, and with the cooperation of the Health Bureau to strengthen the supervision and management of the use of funds.
2. Responsibilities of county-level health care institutions
County Family Planning Maternal and Child Health Center
1 Comprehensively and timely grasp the progress of various township project activities, collect, statistics, analyze and report project work data;
2 to organize case investigations and reviews of maternal deaths and neonatal tetanus cases;
3 Responsible for the training of township level personnel, and assist in guiding township hospitals to carry out village-level training;
④分片包乾負責鄉、村婦幼保健管理與服務技術指導，在降消項目辦的安排下，協助項目技術指導組開展基層項目督導工作；
每月書面向縣衛生局匯報項目工作進展情況。
縣急救中心
①根據衛生局的安排，健全孕產婦急救組織，做好孕產婦急救中心的工作；
②協助降消項目辦做好鄉級人員培訓工作；
③在降消項目辦的安排下，協助項目技術指導組開展基層項目督導工作；
④負責指導鄉鎮衛生院產科建設和助產技術服務，指導全縣孕產婦和嬰兒死亡原因分析、評審，提高干預措施，協助計生婦幼保健中心指導基層婦幼保健技術服務。
鄉級：鄉鎮項目工作組職責
1、制訂項目工作計畫，納入政府工作日程，並組織實施；
2、負責村級衛生人員培訓；
3、健全例會工作制度，鄉級召開村醫會議每月一次，通過每月例會收集上月工作數據信息，布置工作，進行針對性的管理與技術培訓，作好例會記錄；
4、劃片包乾，縣婦幼保健站和鄉鎮衛生院劃片包乾，深入鄉、村指導工作；
5、加強本院產科建設與質量管理，提高助產技術服務能力，促進住院分娩，及時組織危重孕產婦的應急救治和轉運；
6、加強婦幼保健資料管理，掌握各村育齡婦女數、孕產婦數、高危孕產婦數、活產數、住院分娩及消毒接生數，孕產婦死亡和五歲以下兒童死亡，新生兒破傷風發病及孕產期保健服務基本數據，按時收集統計，上報縣計生婦幼保健中心。
村級
1、“村級孕產婦住院分娩轉運小組”由村長、婦女主任、村醫、村長助理及村裡有影響的人組成，負責動員本村孕產婦住院分娩和高危孕產婦的轉運；
2、村衛生室負責本村婦幼保健工作和相關數據的記錄、收集、統計、上報；
3、村醫應做好孕產婦建卡、產檢、產訪、高危識別篩查和健康教育及動員孕產婦住院分娩，發現高危孕產婦要及時向村委會報告並協助轉診；
4、對確需家庭接生的孕產婦，要嚴格按消毒接生操作規範進行；
5、及時掌握孕產婦和5歲以下兒童死亡、新生兒破傷風病例，做好登記，立即報告鄉鎮衛生院防保組。
八、相關工作要求
進一步加強《出生醫學證明》管理工作，積極推動住院分娩率的提高。在醫療保健機構外出生的嬰兒《出生醫學證明》的發放，必須有家庭接生員出具的接生情況證明，家庭接生員必須持有《助產技術考核合格證書》，並且村委會必須出具證明。縣衛生局、各鄉鎮人民政府務必做好《出生醫學證明》的監督、管理工作。縣公安局要進一步加強戶籍管理，新出生嬰兒必須出具《出生醫學證明》方可辦理戶籍上戶。
延續期項目實施至本方案行文之日止。延續期各項目實施單位要認真做好項目實施工作小結，制定項目工作計畫和切實有效的措施，保證項目工作正常運行。
篇五： 降消項目實施方案
為了更加真實地了解“降低孕產婦死亡率和消除新生兒破傷風”項目實施情況，確保“降消項目”目標的基本實現和各項指標的真實性，十堰市衛生局組織、市婦幼保健院有關領導及專業技術人員參與組成十堰市“降消”項目監督指導小組，於20XX年5 月25日—6月1日對竹山、房縣、鄖縣、丹江口四個縣項目工作進行監督指導和評估，。
一、督導目的：
了解項目實施進展情況；了解項目取得的成功經驗和存在的問題；評價項目實施的效果及項目指標的完成情況；對發現的問題提出改進意見和建議；提供技術指導。
二、督導內容有：
1、 項目管理，組織與實施，如項目方案和有關配套檔案，項目相關活動，項目領導小組及技術指導組開展工作情況；2、項目的經費和設備管理，即項目經費使用及管理情況，配套經費落實情況，貧困孕產婦住院分娩救助資金使用及運轉情況，設備管理及使用等。3、人員培訓：培訓計畫、方案，培訓實施情況，培訓效果考核。 4、縣產科急救中心建設及“綠色通道”運轉及高危孕產婦轉診，制度建設、技術水平等情況。5、健康教育：查看健康教育方式、方法，鄉村婦聯參與健康活動情況，民眾對“降消”項目內容知曉率。6、婦幼衛生年報監測、孕產婦死亡評審情況等。
In order to implement the spirit of the province's “reduction” project and the maternal and child health management work conference, the objectives of the “China Women and Children Development Program” were earnestly implemented, and the “reduction and elimination” project was fully implemented. Now the county’s “reduction” project will be implemented in 20XX. The programme is organized as follows:
I. Project objectives
1. Maternal mortality rate: The maternal mortality rate in 20XX decreased by 1/4 on the basis of 85.95/100,000 in 20XX;
2. The incidence of neonatal tetanus falls below 1‰;
3. The maternal hospital delivery rate increased to over 80% on the basis of 75.02%.
4. The sterilization birth rate is ≥98%;
5, prenatal inspection coverage rate ≥ 90%;
6. The basic theory, basic knowledge and basic skills training rate of the obstetrics and maternal and child health care professionals in county and township health care institutions are ≥95%, and the passing rate of assessment is ≥90%.
Second, the project content
Strengthen the training and training of all types of personnel at all levels.
In order to improve the management level of managers and the technical level of business personnel, three training courses will be held during the year. One type of training course for administrative staff, one class of county and township pediatrician training classes, and one type of village-level maternal and child health personnel training class. The village-level training is organized by the women and children station to cooperate with the township health center to carry out training work.
The training personnel of the administrative management personnel are mainly the leaders of the townships and towns, the presidents of the health centers, and the women cadres. The main contents of the training are project objectives, management responsibilities at all levels, project implementation and funding management, establishment of referral emergency systems, project supervision and coordination, etc.
The training content of pediatric staff in county and central township health centers is basic knowledge, skills and technical specifications of obstetric first aid, and neonatal asphyxia resuscitation techniques, etc., to improve first aid ability. At the same time, three township midwifery personnel were selected to participate in the province's “reduction” training training for no less than four months; the training of normal midwifery staff in general township hospitals, the basic production of common obstetrics Skills and basic first aid skills during referral;
The training of village-level maternal and child health workers is mainly to improve the maternal system health care and management, prenatal examination and postpartum visit, screening and identification of high-risk maternal women, mobilization of hospital delivery, and health education.
The midwife health center's midwifery staff will be trained by the women and children station. Each township health center will hold four training courses for rural doctors and village maternal and child health workers.
Vigorously promote health education work.
The popularization of health education knowledge is an important measure for women to improve their self-care awareness and reduce maternal mortality.
1. The township and village maternal and child health workers should enter the village to carry out the health education model of “taking women as the core and the family as the best place” to publicize and educate pregnant women on maternity health care and safe delivery.
2. The maternal and child station set up a maternity school, established and improved health education equipment, and organized various training courses from time to time to address the low educational level and old customs of rural women.
3. Use radio and television news media to conduct a radio lecture once a month; write flyers and brochures with popular language and pictures, and use the gatherings and festivals to widely publicize the benefits of pregnancy care and hospital delivery, and “slow” The policies of the project, etc., enable the public to understand the knowledge about maternal health and improve the ability to use maternal and child health services.
4. At least in the intensive and eye-catching places of 18 townships and towns, at least one fixed slogan of “hospital delivery, maternal and child safety”, “good hospital delivery”, “free hospital delivery, and mother and child safety”, wall slogan Not less than 3, each village has at least one fixed publicity column.
5. Each medical unit conducts face-to-face communication and publicity when using the service target, and imparts health education knowledge by means of opening a health prescription.
Increase supervision and guidance.
Strengthening supervision and guidance is a key link in implementing good project work. To this end, this year's county project office shall conduct supervision and guidance for each township every two months, covering all townships and administrative villages throughout the year. Township hospitals should supervise once a month, cover all administrative villages, and hold regular meetings of township doctors and health workers on a monthly basis to arrange specific work for this month.
The main contents of supervision and guidance are:
(1) Progress of the project plan;
(2) Implementation of subsidy funds;
(3) The effect of “three basics” knowledge training and household survey health education;
(4) The use of equipment and equipment, as well as the use of equipment;
(5) The completion of project indicators and activities;
(6) Operation, referral, rescue records, and outpatient visits of the first aid “green channel”;
(7) On-site guidance and special lectures, as well as township medical meetings, maternal system management records;
(8) Check the various types of archives and materials for the work and operation of projects at all levels.
Each supervisor will make the task clear and focused, and ensure the supervision effect.
Seriously do a good job in maternal hospital delivery and poverty relief.
1. The county and township medical institutions shall implement the “prepaid” subsidy system for the “reduction” project. After the maternal hospital delivery, the medical unit that receives the maternal delivery will be prepaid at the time of discharge from the mother, and then the county project office will approve the application. Disbursement; the subsidy for childbirth in a medical institution outside the county shall be submitted to the project office for approval after the mother's household registration is in the township health center. The county and township medical units shall regularly collect and report the information of the women who have been hospitalized for delivery, timely cash the subsidy funds, and strengthen the standardized management of the hospital delivery allowance work.
2. The subsidy standard for rural maternity hospital delivery is 400 yuan per person, and will be implemented from May 20XX. Implement the basic service items and limit price standards for rural maternity hospital delivery subsidies in the county. The county hospitals and the Chinese medicine hospitals charge 650-800 yuan for flat production. The maternal and child stations and township health centers are free to give birth to hospitals. The cost of cesarean section continues to be controlled within 2,000 yuan. All units must strictly implement the maternal hospitalization limit price limit, intervene unreasonable medical behavior, reduce medical expenses, so that the hospitalized pregnant women can directly benefit, and each medical unit must publicly display the charging standards and accept public supervision.
3, rural maternity hospital delivery reimbursement methods. The rural maternity hospital in our county pays for hospitalization and gives a quarterly report. Rural maternity women with ID card, household registration to the county, township health care institutions hospitalized delivery, discharged at the hospital according to the standard immediately reduced the cost of hospitalization, and on the discharge statement, indicate the amount of the "reduction" project reduction, fill in the rural The maternity hospitalization subsidy triple list, determine the reduction of the free amount, signed by the mother or family members in the hospital invoice, "triple single" and "Gansu Province rural maternal hospital delivery subsidy summary table", medical institutions in the "triple single" Sealed, the first joint county project office saves, the second joint is saved by the health care institution, and the third joint is saved by the subsidized object. The medical units will finally approve the disbursement of funds in the county project office based on the maternity ID card, the household registration book, the copy of the hospitalization invoice, the “Sanlian Single” and the “Summary Form for the Subsidy for Rural Maternal Hospital Delivery in Gansu Province”.
4. Rational use of drugs. According to the actual situation of maternal hospital delivery, rational use of drugs, avoid abuse of antibiotics and a wide range of health care products, in order to reduce the economic burden of maternity hospitalization.
Strengthen the construction of obstetrics to ensure the smooth flow of maternal first aid “green channel”.
1. The county hospital should further strengthen and improve the “green channel” for maternal first aid and the construction of the maternal rescue center for critical and acute diseases, give full play to the first aid function, minimize the maternal death, and form a “green channel” for maternal first aid. Technical strength.
2. All township hospitals should combine the construction projects of rural health centers, actively strive for the production of pediatric equipment, strive to improve the hardware construction of obstetrics, and do a good job in the delivery of flat products. At the same time, it is necessary to strictly implement the indications for high-risk maternal referrals and timely Referral work.
3, the village level should be responsible for high-risk maternal screening and transfer work, banned family delivery.
Strengthen the collection and reporting of information on “reduction” projects.
Continue to implement the “reduction” project information data for direct network reporting. All medical units should fully understand the importance of project data work, and provide scientific, accurate and timely data statistics and analysis to the project office, and resolutely eliminate hidden reports. , reports, false reports and other phenomena. At the same time, the Women and Children Station should strengthen the training of information management for women and children at the township and village levels, improve their business level, and standardize the management of information data.
Organizational management of the project.
1. Formulate reasonable fund management methods, make special funds for funds, conduct independent accounting, adhere to the fair and transparent rescue funds, audit the use of project funds once a year, and report the audit to the provincial project office in a timely manner.
2. The county project office organizes and implements project activities, formulates personnel training plans, organizes social mobilization activities, and urges medical institutions to implement price limit fees for maternal hospital delivery, strengthen project equipment use and maintenance, and improve equipment use efficiency.
3. Accept the assessment and assessment of the national, provincial and municipal project leading groups and strengthen the management of all aspects of the project.
Part 2: Implementation plan for the project
In the past three years, the town has implemented the public health special fund of the central government to reduce the maternal and elimination of neonatal tetanus. In 20XX, the central government continued to arrange project funds to subsidize the implementation of the “reduction” project in our town. In order to implement the “20XX Central Subsidy Taihu County Public Health Special Fund to Reduce Maternal Mortality and Eliminate Neonatal Tetanus Project Implementation Plan”, this program was formulated in conjunction with the actual situation of our town.
I. Project objectives
20XX annual target
1. The number of maternal deaths in the whole year is no more than 1 case, and try to avoid maternal mortality;
2. The incidence of neonatal tetanus is controlled below 1‰;
3, maternal hospital delivery rate of 100%.
20XX annual support target
1. Disinfection birth rate >98%;
2. The prenatal inspection coverage rate is >90%;
3. The pass rate of the “three basics” in the obstetrics of the hospital is >85%.
Second, the project content and organization and implementation
Personnel training: Select the obstetric technicians to go to the obstetrics and gynaecology department of the hospital at or above the county level. The training content focuses on the basic knowledge of basic obstetrics, basic skills, technical operation rules and neonatal asphyxia technology to improve the first aid ability and technology of obstetric medical staff. Level.
Train rural doctors and maternal and child health workers.
Social mobilization: Extensive publicity, implementation of social mobilization, and through various forms, increase the promotion of “reduction” projects, so that the town's people and society can know, care, and support project implementation.
Maternal hospitalization, childbirth, poverty relief
1. Scope: Maternal women who belong to the county's rural hukou and some urban households with difficulties in hukou may enjoy hospital delivery during the hospitalization of medical care institutions in the county from January 20 to December 31, 20XX.
2. Standards: Each case of poor maternal hospital delivery is subsidized by 150 yuan per standard. The maternal delivery of special maternal families is subsidized by 450 yuan per case. The number of maternal destitute places in our town is 40 in rural areas and 4 in urban areas.
3, hospital delivery assistance implementation of the account system, township hospitals should strictly control the cost of poor maternal hospital delivery, the implementation of limited-price hospital delivery, control within 600 yuan, that is, the implementation of free hospital delivery, the limit price is borne by the hospital.
4. Operational program: Pregnant women or their families who meet the conditions for assistance apply for the “Application Form for Rescue Funds for Poor Maternal Hospital Delivery”, and the villagers’ committee will review the scope, targets and subsidy standards determined according to this plan, and the special assistance targets and towns The list of household assistance targets shall be publicized and accepted by the public. After the review, the official seal shall be affixed to the town health center. After the review, the list of special hardship relief and the list of maternal poverty relief for the local urban household registration shall be submitted to the electronic document together with the application form for the rescue fund. County “reduction” project office. The approved list of objects and rescue cards will be distributed to the town health center and the village committee, and will be issued to the maternal family. The maternity card will be given to the county health care institution to receive the corresponding subsidy for hospital delivery, and the health care institution will fill in the assistance. The funds triple list together with the rescue card and the maternal hospital delivery assistance registration form will be reported to the county reduction project office, and the project office will remit the funds to the medical institution after review.
Third, the project execution time
The project was launched in January 20XX and completed on December 31.
Fourth, supervision and evaluation
The county “reduction” project office will randomly check the health care institutions from time to time to understand whether the burden reduction meets the requirements and standards, and at any time to take the rescued women to conduct household surveys to understand the implementation of funds.
Part 3: Implementation plan for the project
To implement the "Mother and Child Health Care Law of the People's Republic of China", to achieve the goals of the "China Children's Development Program" and the "China Women's Development Program", to reduce maternal mortality, under-five mortality and elimination of neonatal tetanus, to implement provincial health The Department of Finance, the Ministry of Finance, and the Women and Children's Working Committee's Implementation Plan for the Maternal and Child Health Project of the Public Welfare Fund for Public Health in Anhui Province in 20XX, combined with the actual situation of the district, formulated this implementation plan.
I. Project objectives
1. Maternal mortality: By the end of 2019, the maternal mortality rate in the jurisdiction is below the city average.
2. The incidence of neonatal tetanus: the incidence of neonatal tetanus fell below 1‰, and strive to avoid neonatal tetanus cases.
3. The sterilization delivery rate is ≥98%.
4. Prenatal check coverage is ≥90%.
5. The pass rate of the “three basics” in the obstetrics of the medical and health care institutions in the municipal and municipal districts is ≥80%.
Second, the scope and content of the project
Project scope
This project covers the Ganyu District and Zhangzhou Economic and Technological Development Zone.
Project Description
1. staff training
The Municipal Health Bureau and the Municipal Health Center are responsible for project management training, and the obstetric staff of the municipal health care institutions in the municipal and municipal districts participate in the training.
2. health education
The municipal and district-level health care units actively promoted the health education model of “taking women as the core and the family as the best place”, publicizing and educating pregnant women on maternity care and safe delivery; using community medical institutions to organize “ "Pregnant women's school", "parent school" to spread health knowledge; write a popular language education, illustrated health education books, distributed to pregnant women and family members, widely publicize the benefits of hospital delivery.
Health care institutions and community health service agencies at all levels post maternal health knowledge and safe childbirth knowledge posters to educate the public about maternal health knowledge and improve the utilization rate of maternal and child health services.
3. Establish a maternal emergency “green channel” and emergency rescue center
As the maternal rescue center, the city's second hospital and the city's integrated Chinese and western medicine hospital serve as the maternal rescue center, responsible for critical maternal first aid, the city's first hospital as a newborn emergency center, the district's midwifery institutions to strengthen obstetric construction, do Good birth delivery and high-risk maternal screening, strict implementation of high-risk maternal referral indications. The urban community neighborhood committee is responsible for the critical maternal transport by the municipal 120 emergency center; the agriculture-related street community health service center has set up a transfer group to organize 2 motor vehicles, responsible for transferring high-risk pregnant women.
4. Project launch and promotion
In April, the project kick-off meeting was held. At the same time, the news media and lectures were used to make the general public understand the contents of the “reduction project”, enhance the awareness of maternal and child health care, and improve the utilization rate of health care services.
Third, the project organization and implementation
Organizational form
In accordance with the requirements of the Provincial Women's and Children's Working Committee, the Provincial Health Department, and the Provincial Department of Finance's "Notice on Seriously Doing the Work of "Reducing Projects", the Leading Group for the "Reduction" Project in the Reclamation Area was established. The bureau and the municipal health center are responsible for the supervision and management of the project implementation activities and technical guidance. The District Women and Children Working Committee and the Health Bureau are responsible for the organization and implementation of the project in the region. The Municipal Maternal and Child Health Center is responsible for the specific implementation of supervision and management and technical guidance.
Training training
The Municipal Women and Children's Working Committee, the Health Bureau and the Municipal Health Center personnel participate in administrative training, and the Provincial Maternal and Child Health Center is responsible. The Municipal Health Bureau and the Municipal Maternal and Child Health Center are responsible for the training of street and village administrative staff and obstetric staff.
Funding arrangement
The central government allocated special funds for personnel training, rural maternity hospital delivery subsidies, social propaganda and health education.
Rural maternal hospital delivery allowance
Any rural pregnant woman who is holding an “agricultural hukou” and is planning to give birth in a medical institution with midwifery qualifications can enjoy a subsidy of 400 yuan per mother and a rural health care institution in the district. In the case of hospital delivery, fill out the "Eastern Rural Maternal Hospital Delivery Grant Card" in Anhui Province, directly deducting the cost of hospital delivery, and then the medical institution will report to the district's new rural cooperative management center on a monthly basis; in the outpatient health care institution, the hospital will give birth. The maternity holding discharge summary, hospitalization invoice, household registration book, family planning certificate, and subsidy card will be reported to the district new rural cooperative management center.
Strict control of cesarean section rate
The cesarean section rate of the municipal health care institution shall not exceed 50%; the cesarean section rate of the community health service center shall not exceed 20%, and the municipal and district health bureaus shall regularly supervise the cesarean section of the midwifery institution for cesarean section. A midwifery agency with a rate exceeding 5% of the prescribed standard is given a notice of criticism.
Fourth, project execution time
The project work began on January 1, 20XX and was completed on December 31, 20XX.
V. Project supervision and evaluation
1. Supervision and guidance
The municipal, district health bureaus, and municipal health clinics supervise and guide once every quarter. Supervisory content: organization management, equipment use, personnel training, health education, completion of project indicators, public reflection and evaluation.
2. Capital use and equipment management
All medical institutions must pay special funds for the project, and have detailed accounts, which should not be used for other purposes. The equipment equipped with the project must be staffed and kept in good condition.
Part 4: Implementation plan for the project
In order to consolidate the previous cycle to reduce maternal mortality and eliminate the results of the neonatal tetanus project, efforts will be made to achieve the health goals of the Women and Children in the 20XX-20XX period, according to the arrangements of the State Council, the provincial and municipal departments, according to the 20XX Zunyi City The implementation plan of the project is reduced, and the implementation plan is formulated in combination with the actual situation of our county.
I. Project objectives
Long-term goals
By 20XX, the maternal mortality rate will drop by 1/3 on the basis of 20XX years. The county's maternal and child health monitoring system will be established and the obstetrics construction will be improved. The 24 township health centers in the county will set up obstetrics and assist the medical staff. To provide a reliable basis for the implementation of the evaluation of “reduction” projects, and provide a scientific basis for the government to formulate maternal and child health policies.
annual target
1. The overall goal
Maternal mortality rate: 1/4 decline based on 20XX years
Neonatal tetanus incidence: controlled below 1‰
Maternal hospital delivery rate: 50% or more
High-risk maternal hospital delivery rate: 95% or more
Monitor maternal mortality, monitor children under 5 years of age, and monitor birth defects.
2, supportive goals
Maternal prenatal check coverage: ≥90%
High-risk maternal screening management rate: 70% or more
Disinfection birth rate: ≥98%
County-level health care institutions, township health centers, obstetrics, "three basic" examination pass rate: ≥ 98%
Awareness rate of health education for women of childbearing age: >85%
Second, the scope and time of implementation
The project work covers all towns and villages in the county.
Maternal deaths are monitored throughout the county. The monitoring points for children under 5 years of age are: Sangmu Town, Wenshui Town, and Minhua Township. The birth defect monitoring points are: County People's Hospital, County Chinese Medicine Hospital, and County Family Planning Health Care Center.
Project implementation time: December 20XX - December 20XX
Third, the project task
The overall tasks of the project are: personnel training; rural maternal hospital delivery assistance; establishment and improvement of maternal emergency “green channel” and “critical emergency rescue center”, health education, supervision and guidance; basic equipment of maternity health department equipment, consolidation And the creation of the baby-friendly hospital, and actively create the baby-friendly county.
Fourth, the project measures
At this stage, the project work will be further strengthened on the basis of the previous cycle work.
Project management
1. Adjust and enrich the “reduction” project coordination leading group, give full play to the coordination, organization and management functions, and be responsible for the whole process of project implementation leadership.
2. The County Health Bureau adjusted and enriched the project technical guidance group and supervision team to strengthen project management and business guidance.
3. Implement the target management responsibility system. The county people's government and the member units of the county resettlement project transfer association and the township people's government sign the target responsibility letter, and each township and town shall formulate specific implementation plans according to the implementation plan of the county “reduction” project, combined with the actual situation of the township, step by step. Sign the responsibility letter and implement the project work tasks to the grassroots level.
staff training
1. Management training:
Responsible department: The county health bureau is the main, and the county women and children work committee cooperates.
Training objects and content
1 Administrative staff training: The training targets are county and township administrative leading cadres, and organize the implementation of the relevant project department responsible persons. The training content is the purpose and significance of the project, related department responsibilities, project implementation and fund management, project supervision and coordination.
2 Health care institution training: The training target is the county health care institution leader and staff. The training content is the purpose and significance of the project, the project implementation and execution unit responsibility and management, and the establishment and operation of the maternal emergency system.
3 village cadre training: the training target is the village party secretary, director, and women director. The training content is the establishment and operation of the project's purpose and significance, the responsibility of the village cadre, the health education method, and the “green life channel” support system for the village pregnant women.
2, business training: County Health Bureau, each training has training content and curriculum arrangements, lectures and participants in the roster and test results.
County-level teacher training. The training includes: the purpose requirements of the project training, the training methods, the formulation of the training plan; the maternal health care, the treatment and referral of the critically ill obstetrics; the relevant technical specifications for health services, the common technical procedures for obstetrics and the operation specifications and equipment for emergency equipment. Management and use, etc.
Training for midwifery health care institutions and township health centers: mid-level health care institutions and central township health center midwifery personnel focus on training basic knowledge, skills and technical specifications of obstetrics first aid to improve obstetric first aid; general township hospitals The production personnel focus on training the basic first aid skills in the normal production and treatment, and common obstetric first aid basic skills referral process. The training materials are mainly based on the “reduction” project county, township and village level textbooks and question banks.
Village doctors, village birth attendants, health workers training: key training maternal system health management, maternal risk identification and management, postpartum visits, breastfeeding and infant nutrition guidance, health education methods. Transform the function of the birth attendant, do a good job of mobilizing and escorting maternal hospital delivery.
3. Time schedule
The county and township trainings were completed in two phases. The business training was completed in early April 20XX, and the administrative training was completed before June 30, 20XX. During the implementation of the project, intensive training was carried out in a timely manner in response to problems and shortcomings in management and obstetric clinical and maternal and child health services.
Project supervision
1. Special experts will supervise
Expert candidates: The county health bureau coordinates the provincial and municipal health departments to select women and children health care and obstetric clinical business backbones with intermediate and senior professional titles and certain clinical and management experience as experts in the county.
2, hierarchical supervision
The County Leading Group Office is responsible for project management and business supervision. According to the principle of hierarchical supervision, during the project implementation period, the county-level supervision is carried out irregularly. The county maternal and child health station implements the project fragmentation responsibility system, covering all townships and administrative villages. The township hospitals should also slash and pack, and the villages should guide the work, and the guidance work should cover all administrative villages.
Supervised content
1 organization management of the project. Organizational leadership, coordination and project planning of township governments and relevant departments, implementation of supporting funds, collection and collation of project materials;
2 personnel training, health education publicity;
3 county-level maternal emergency center operation, township health center midwifery technical service and high-risk maternal referral system operation, standardized management of obstetrics at all levels of health care institutions;
4 Maternal hospital delivery and rescue fund management and use, county, township level of flat birth hospital delivery limit price charges.
Supervisory requirements
1 Supervise and guide the whole process of project implementation, and master the operation of the project execution unit;
2 to help grassroots units improve their ability to execute projects and the quality of their work;
3 Help the grassroots to solve the difficulties and problems encountered in the implementation of the project;
4 Go deep into the village and farmers to understand the situation.
5 Supervise the record, each time the supervisor fills in the project supervision record, in duplicate, after the signature of the person in charge of the supervised unit, one is left to be supervised by the supervisory unit, and one is reported to the project office for future reference.
Baby-friendly hospital
On the basis of the work of the “reduction” project, we will continue to consolidate the results of the baby-friendly hospital and launch the “Ai-Yi County” campaign. County People's Hospital and County Chinese Medicine Hospital should do a good job in perinatal care, Tucheng, Liangcun, Wenshui, Sangmu, Erlang, Malin, Dapo, Chengzhai, Tongmin, Yong'an Health Center should strengthen the construction of obstetrics and At the same time of service quality, it actively promoted the development of rural maternal and child health care. The three township township hospitals of Xijiu, Guandian and Zhaiba and other conditional township hospitals actively created baby-friendly hospitals.
Maternal hospital delivery
Promoting maternal hospital delivery is the top priority of this phase of the project.
1, the implementation of hospital delivery limit
In order to enable rural pregnant women to receive hospital delivery, county-level health care institutions and township health centers must implement hospitalization delivery limits, and flat production costs. The limit price is: pregnant women in rural households in the county.
The county-level medical institution has a flat product limit of 300 yuan for hospitalization and 200 yuan for township and town health centers;
The cesarean section of the county-level medical institution is priced at 1,500 yuan, and the township hospital is 1,000 yuan.
Each project implementation unit shall announce the price limit situation or publicize the limit price standard through the media.
2, carry out hospital delivery assistance
Maternal hospital delivery and delivery assistance: All the hospitals and county-level health care institutions that hold the “Mother and Child Health Care Technical Service License” and the “Medical Organization Practice License” issued by the Municipal and County Health Bureau There are rural maternity peasants, urban poor households, and laid-off workers who are planning maternity documents. If the child care certificate is not delivered to the medical service institution, the medical service institution must promptly respond to the local plan and birth department and handle it accordingly.
Rescue criteria: hospitalization and childbirth relief funds are 150 yuan for each maternal parity, 250 yuan for each dystocia, and 500 yuan for each case of cesarean section and obstetric complications.
The poverty relief program is in accordance with the requirements of the “Ministry of Women’s Department of the Ministry of Health on the “Down” project for the operation of the poor maternal hospital delivery and rescue funds, combined with the actual operation of the “Shuishui County Project” "Handle.
Townships and towns should review the target of poor maternal help, and after the announcement of 7 days of non-response, do a good job in mobilizing and mobilizing hospital delivery, and submit a “Application Form for Rescue Maternal Hospital Delivery Assistance Fund” to the County Project Office every quarter. After the examination and approval, the implementation of maternal hospital delivery and poverty relief measures.
3, the implementation of high-risk maternal hospital delivery transfer subsidy
Village doctors, health workers, and birth attendants escorted a high-risk maternity woman to the hospital and county-level health care institutions for hospitalization and childbirth, and subsidized 30 yuan, which was paid by the receiving unit and reported to the county project office every quarter.
4. County-level health care institutions and township health centers should strengthen the quality management of obstetrics, rationally use drugs, avoid abuse of antibiotics, do everything possible to reduce medical costs, improve the quality of medical services, and reduce the economic burden of maternal hospital delivery.
Life green channel
1. Strengthen the construction of county-level maternal emergency centers. Improve the rules and regulations, improve first-aid facilities, strengthen skills training, improve the level of treatment, and do a good job in critically ill maternal and newborn emergency work and maternal delivery and treatment. Township hospitals should also strengthen obstetric construction, standardize operational skills, and strictly implement high-risk maternal referral indications. Rural doctors and birth attendants should do a good job in maternal health care, improve the ability of high-risk maternal identification, timely transfer and escort high-risk maternal women, and form a “green life channel” for maternal first aid.
2. Establish and improve the maternal transport support system. The township government and the village committee should attach great importance to the maternal transshipment work, give full play to the skills of the township and village maternal transfer group, organize and coordinate relevant departments, and establish a “maternal hospital delivery transfer” organization at the township and village levels to timely deliver the pregnancy. Maternal women go to hospital or hospital for hospital delivery and treatment.
3. Improve hospital delivery conditions, 80% of township hospitals meet the “Evaluation Standards for Obstetrics in Guizhou Township Health Centers”, and health care institutions and health centers should standardize maternal and child room and delivery areas, and provide convenience for pregnant women and their families. The delivery room and the maternal and child room have heating facilities to create a safe, hygienic, warm and comfortable hospital delivery environment for pregnant women.
health education
The County Women and Children Working Committee and the health department work closely together to carry out health education publicity in an in-depth manner and vigorously create a social atmosphere of “care for the health of mothers and children”.
1. Free broadcast of maternal and child health science knowledge in county cable TV stations, township towns, and radio stations.
2. Organize women cadres and medical personnel to enter the village to carry out health education publicity activities of “taking women as the core and family as the best place” to publicize and educate pregnant women on health care such as maternal health care and safe delivery.
3. The county health care institutions, township 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. Distribute and post the provincial and municipal “reduction” projects and eugenics and publicity posters in a timely manner. The folding pictures should be distributed to the pregnant women’s home. All towns and villages should also produce leaflets and propaganda slogans according to local conditions. All medical institutions should issue open letters to pregnant women, use inpatient health education guidance forms, and vigorously promote the knowledge of maternal and child health sciences in hospitalization, maternal and child safety, and promote the implementation of the county. The “reduction of the project”, the implementation of hospital admissions limit fees and medical assistance related policies.
Data management
The county reduction project office, the township project working group and the county-level project implementation unit shall pay attention to the management of the relevant data of the project in the area under their jurisdiction, and clarify the responsibility of the person in charge, and reflect the information of the project work, such as the project responsibility book, implementation plan, The original materials such as meeting minutes, supervision forms, training files and rosters, health education, publicity and consultation activities, typical cases, voucher documents for expenditures, etc. should be carefully collected, organized, archived and reported and reported.
V. Project fund use and arrangement
Use of funds
1. Central funds
In the 20XX year, the central government's financial transfer payment funds totaled RMB 106.85 million, which was mainly used for maternal hospitalization assistance, personnel training, equipment and health education, supervision and maternal and child health monitoring.
Health Education: 10,000 yuan, managed by the County Women and Children Working Committee.
Personnel training: 10,000 yuan, managed by the project office. County-level training: 2928, township-level training: According to the number of administrative villages, each village subsidizes 32 yuan for township health centers, and 24 townships total 7072 yuan.
Equipment: 30,000 yuan, the county reduction project office according to the higher-level designated equipment name reporting equipment plan, the provincial finance, provincial health department unified bidding procurement.
Hospital delivery assistance: 956,850 yuan, managed by the project office. According to the number of live births per child × 150 yuan budget for the township and town rescue funds.
2. Project matching funds
Mainly used for project information management and project supervision.
Funding and equipment management
1. Strictly follow the regulations of the State and Provincial Health Department and the Ministry of Finance on the management of special funds, strengthen the management of project funds, and improve the efficiency of fund use.
2. The project funds are closedly operated, and the poverty relief and free work and the subsidy for the work are paid to the project office by the health care institutions to collect the relevant evidence of the hospitalized delivery or signing of the hospitalized delivery or signing of the poverty relief.
3. Implement the project fund management reporting system, report the financial statements once every two months, and report the financial year reports at the end of the year. In accordance with the “Guizhou Province Measures to Reduce Maternal Mortality and Eliminate the Financial Management of Neonatal Tetanus Projects”.
4. The township health centers shall establish a project maintenance registration system. The project funds must be earmarked for special purposes. The county health bureau and the finance bureau shall verify the use of the project funds and the maintenance and use of the equipment according to relevant regulations, and strictly use them for other purposes.
5. The equipment provided by the project shall be distributed by the county health bureau according to the actual needs of the township health center. The health center shall be responsible for the person and keep it in good condition.
Project supervision and evaluation
Supervision and guidance
1. Accept the supervisory guidance of the superiors 2-3 times a year. The county level conducts daily work supervision and supervises 4 times a year, covering all township and county-level project units.
2. The supervision and guidance contents mainly include: the project plan and the use of project funds; the situation of hospitalization and delivery assistance, the focus is on the benefit of the people; the effect of personnel training and health education; the purchase and use of equipment; the completion of project indicators; On-site guidance and special lectures, as well as public evaluation of the project.
Evaluation
During the project period, the county carried out two assessments, which were divided into half-term and final-term assessments. The self-inspection assessment of each township and project unit and the evaluation of the health assessment bureau organized by the health bureau were evaluated to cover all township and county-level project units.
7. Project organization and departmental duties
County level
1. County Responsibility Project Leading Group Office Responsibilities
Formulate and implement the project implementation plan of the county, incorporate the project work into the government work agenda, and implement the target responsibility system management;
Manage the whole process of the project, organize supervision and training, and report the progress of the project to the county government;
Sign the responsibility letter with the project execution unit to implement the project work tasks;
Responsible for the arrangement of project funds.
The County Women and Children's Working Committee is responsible for coordinating the relevant departments of the project, and organizing health education publicity and mobilization, escorting maternal hospital delivery, etc. The county finance bureau is responsible for the allocation of funds, and with the cooperation of the Health Bureau to strengthen the supervision and management of the use of funds.
2. Responsibilities of county-level health care institutions
County Family Planning Maternal and Child Health Center
1 Comprehensively and timely grasp the progress of various township project activities, collect, statistics, analyze and report project work data;
2 to organize case investigations and reviews of maternal deaths and neonatal tetanus cases;
3 Responsible for the training of township level personnel, and assist in guiding township hospitals to carry out village-level training;
④分片包乾負責鄉、村婦幼保健管理與服務技術指導，在降消項目辦的安排下，協助項目技術指導組開展基層項目督導工作；
每月書面向縣衛生局匯報項目工作進展情況。
縣急救中心
①根據衛生局的安排，健全孕產婦急救組織，做好孕產婦急救中心的工作；
②協助降消項目辦做好鄉級人員培訓工作；
③在降消項目辦的安排下，協助項目技術指導組開展基層項目督導工作；
④負責指導鄉鎮衛生院產科建設和助產技術服務，指導全縣孕產婦和嬰兒死亡原因分析、評審，提高干預措施，協助計生婦幼保健中心指導基層婦幼保健技術服務。
鄉級：鄉鎮項目工作組職責
1、制訂項目工作計畫，納入政府工作日程，並組織實施；
2、負責村級衛生人員培訓；
3、健全例會工作制度，鄉級召開村醫會議每月一次，通過每月例會收集上月工作數據信息，布置工作，進行針對性的管理與技術培訓，作好例會記錄；
4、劃片包乾，縣婦幼保健站和鄉鎮衛生院劃片包乾，深入鄉、村指導工作；
5、加強本院產科建設與質量管理，提高助產技術服務能力，促進住院分娩，及時組織危重孕產婦的應急救治和轉運；
6、加強婦幼保健資料管理，掌握各村育齡婦女數、孕產婦數、高危孕產婦數、活產數、住院分娩及消毒接生數，孕產婦死亡和五歲以下兒童死亡，新生兒破傷風發病及孕產期保健服務基本數據，按時收集統計，上報縣計生婦幼保健中心。
村級
1、“村級孕產婦住院分娩轉運小組”由村長、婦女主任、村醫、村長助理及村裡有影響的人組成，負責動員本村孕產婦住院分娩和高危孕產婦的轉運；
2、村衛生室負責本村婦幼保健工作和相關數據的記錄、收集、統計、上報；
3、村醫應做好孕產婦建卡、產檢、產訪、高危識別篩查和健康教育及動員孕產婦住院分娩，發現高危孕產婦要及時向村委會報告並協助轉診；
4、對確需家庭接生的孕產婦，要嚴格按消毒接生操作規範進行；
5、及時掌握孕產婦和5歲以下兒童死亡、新生兒破傷風病例，做好登記，立即報告鄉鎮衛生院防保組。
八、相關工作要求
進一步加強《出生醫學證明》管理工作，積極推動住院分娩率的提高。在醫療保健機構外出生的嬰兒《出生醫學證明》的發放，必須有家庭接生員出具的接生情況證明，家庭接生員必須持有《助產技術考核合格證書》，並且村委會必須出具證明。縣衛生局、各鄉鎮人民政府務必做好《出生醫學證明》的監督、管理工作。縣公安局要進一步加強戶籍管理，新出生嬰兒必須出具《出生醫學證明》方可辦理戶籍上戶。
延續期項目實施至本方案行文之日止。延續期各項目實施單位要認真做好項目實施工作小結，制定項目工作計畫和切實有效的措施，保證項目工作正常運行。
篇五： 降消項目實施方案
為了更加真實地了解“降低孕產婦死亡率和消除新生兒破傷風”項目實施情況，確保“降消項目”目標的基本實現和各項指標的真實性，十堰市衛生局組織、市婦幼保健院有關領導及專業技術人員參與組成十堰市“降消”項目監督指導小組，於20XX年5 月25日—6月1日對竹山、房縣、鄖縣、丹江口四個縣項目工作進行監督指導和評估，。
一、督導目的：
了解項目實施進展情況；了解項目取得的成功經驗和存在的問題；評價項目實施的效果及項目指標的完成情況；對發現的問題提出改進意見和建議；提供技術指導。
二、督導內容有：
1、 項目管理，組織與實施，如項目方案和有關配套檔案，項目相關活動，項目領導小組及技術指導組開展工作情況；2、項目的經費和設備管理，即項目經費使用及管理情況，配套經費落實情況，貧困孕產婦住院分娩救助資金使用及運轉情況，設備管理及使用等。3、人員培訓：培訓計畫、方案，培訓實施情況，培訓效果考核。 4、縣產科急救中心建設及“綠色通道”運轉及高危孕產婦轉診，制度建設、技術水平等情況。5、健康教育：查看健康教育方式、方法，鄉村婦聯參與健康活動情況，民眾對“降消”項目內容知曉率。6、婦幼衛生年報監測、孕產婦死亡評審情況等。
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