Issued by the National Health Commission: Maternal and Child Safety Action Improvement Plan (2021-2025)

（2021-2025）

 

〔2021〕30

 

、、：

 

《 》，，，，2018-2020，《（2021-2025）》（）
。，，
。

 

 

2021109

 

（：）

 

（2021-2025）

 

，，，，2021，
。

 

、

 

，，、，，，
。

 

、

 

　　Promote the safe and high-quality development of mothers and infants, and reduce the maternal and infant mortality rates.
By 2025, the national maternal mortality rate will drop to 14.
5 per 100,000, and the national infant mortality rate will drop to 5.
2‰.
This is a goal to achieve "Healthy China 2030" as scheduled.
"The main goal is to lay a solid foundation
.
Further improve the level of maternal and child health services, improve the treatment system for critically ill pregnant women and newborns, provide safe, effective, convenient and warm high-quality maternal and child health services for women and children, so that the people's sense of gain and happiness will be more satisfactory and the sense of happiness will be more sustainable , Safety and health are more guaranteed
.

 

　　3.
Scope of Action

 

　　Medical institutions that provide technical services for midwifery are focused on general hospitals at the second level and above, Chinese medicine hospitals, maternal and child health care centers, and obstetrics and gynecology hospitals
.
The treatment centers for critically ill pregnant women and newborns at all levels shall organize their implementation in an all-round way
.

 

　　4.
Action content

 

　　 (1) The level of pregnancy risk prevention has been improved
.

 

　　1.
Strengthen the awareness of risk prevention
.
For each link in the fertility service chain, formulate health education work plans, develop targeted health education materials, write popular science articles, make popular science pictures, and shoot popular science videos
.
Relying on maternity schools, fertility consultation clinics, WeChat public accounts, Weibo, short videos and other platforms, combine offline and online education to popularize pregnancy health knowledge, improve health literacy, and strengthen the "first responsible person for their own health" of pregnant women Awareness, the new media platform of the Tertiary Maternal and Child Health Hospital publishes no less than 50 popular science works every year, and the average reading volume of a single popular science work is striving to reach 10,000
.

 

　　2.
Implement pregnancy risk assessment
.
Strictly implement the requirements of the "Regulations on Pregnancy Risk Assessment and Management", standardize the development of pregnancy risk screening and assessment of pregnant women, pay attention to multidisciplinary joint dynamic assessment and management, and strengthen postpartum risk assessment
.
Standardize and orderly carry out prenatal screening and prenatal diagnosis, strictly implement comprehensive prevention and control measures for mother-to-child transmission of AIDS, syphilis and hepatitis B, timely discover and intervene risk factors affecting pregnancy, and prevent adverse pregnancy outcomes
.
For pregnant women who have diseases that may be life-threatening and are not suitable for continuing pregnancy, the evaluation and diagnosis shall be conducted by qualified physicians at or above the deputy director level
.
Encourage the use of information systems to classify and categorize pregnant women
.

 

　　 (2) The level of treatment for critical and critical illnesses has been improved
.

 

　　3.
Strictly manage high-risk pregnant and lying-in women
.
Standardize pregnancy risk factor screening, identify high-risk pregnant women, strictly implement project management for high-risk pregnant women classified as "orange", "red" and "purple" in pregnancy risk, and specify that senior obstetrician physicians are responsible for the management and guidance Order and centralized medical treatment to ensure special personnel, full management, dynamic supervision, centralized treatment, and timely referral to ensure that "one case is found, one case is registered, one case is reported, one case is managed, and one case is treated
.
"

 

　　4.
Improve the treatment of weak links
.
For common critical illnesses such as postpartum hemorrhage and neonatal asphyxia, special skills training and rapid response team emergency drills will be carried out at least once a quarter.
Emergency cesarean section will be controlled within 30 minutes from the operation to the delivery of the fetus (DDI) and gradually Shorten
.
Organize at least one multi-department joint meeting every six months to improve the rescue process and specifications, further clarify the responsibilities and tasks of relevant departments and personnel, and strengthen the guarantee mechanisms for emergency equipment, medicines , blood for pregnant women, and transportation
.
Standardize the evaluation of critical and severe cases of pregnant and lying-in women, conduct a full-process analysis from early pregnancy filing to postpartum follow-up, sort out the management and technical problems existing in each link, and continuously improve the diagnosis and treatment plan and management system
.

 

　　5.
Improve the treatment coordination mechanism
.
Clarify the special organization to implement the safety management responsibilities of the obstetrics department in the hospital, and the dean in charge will be specifically responsible for improving the consultation, referral system and coordination mechanism for critically ill pregnant and lying-in women and newborns in the hospital, establishing an in-hospital multidisciplinary treatment team for critically ill pregnant and lying-in women and newborns, and encouraging neonatology The doctor enters the delivery room
.
Establish and improve the doctor-patient communication mechanism for the treatment of critically ill pregnant and lying-in women.
During the treatment and rescue period, the medical team should designate an obstetrician to be responsible for communicating with the patient’s family
.
On the basis of continuous improvement of treatment capabilities, all levels of critically ill maternal and neonatal treatment centers must pay close attention to the implementation of scribing and zoning responsibilities, strengthen guidance to lower-level medical institutions, and establish a high-level linkage and efficient consultation and referral mechanism to further smooth The green channel for critically ill referrals will ensure the safety of pregnant women and newborns
.

 

　　 (3) Improve the quality and safety management level
.

 

　　6.
Improve the quality management system
.
Practice in strict accordance with laws and regulations, and medical institutions and medical staff should obtain corresponding qualifications in accordance with the law to implement midwifery technology
.
To implement the "Medical Quality Management Measures", obstetrics and pediatrics should set up medical quality management working groups in undergraduate rooms, and carry out no less than two medical quality and safety case warning educations every year
.
Strictly abide by the core system of medical quality and safety, and focus on strengthening the three-level rounds system, the preoperative discussion system, and the rescue system for critically ill patients
.

 

　　7.
Strict medical safety management
.
Strengthen the management of obstetric visits, and improve the management system and handover procedures for newborns' entry and exit
.
Strictly implement the infectious disease prevention and control management system and work requirements, strengthen the management of infection prevention and control in key departments, key locations and key links such as outpatient and emergency departments, obstetric wards, delivery rooms, neonatal and pediatric wards, inspections, imaging, etc.
, and strictly implement disinfection and isolation.
Regulations on hand hygiene and hospital infection monitoring
.

 

　　8.
Implement quality improvement measures
.
Strictly abide by the obstetric professional diagnosis and treatment guidelines and technical operating specifications, carry out monthly self-assessment and analysis around key links and weak links for key departments such as operating rooms, delivery rooms, and neonatal wards, and continue to implement quality improvement measures
.
Comprehensively carry out the delivery safety inspection in the delivery room, fill in the inspection form in a standardized manner, and incorporate it into the medical record management as a medical document, so as to reduce the incidence of medical errors and safety adverse events in the delivery room
.

 

　　9.
Strengthen the application of data analysis
.
Regularly submit data related to maternal and child safety, and report to the county-level maternal and child health care institution at the local level as soon as possible after a maternal death occurs
.
Improve the quality control index system and data collection of obstetrics in the hospital, find out existing problems through data analysis, and put forward suggestions for improvement
.
Strictly implement relevant systems for medical quality (safety) adverse event information collection, recording and reporting
.

 

　　 (4) The service capacity of women and children specialists has been improved
.

 

　　10.
Strengthen the construction of key specialties
.
Carry out pilot projects for multidisciplinary collaborative diagnosis and treatment of maternity and obstetrics and subspecialty construction of obstetrics, improve the level of clinical diagnosis and treatment of obstetrics, and encourage the establishment of three-level maternity and child specialist alliances in provinces, cities and counties
.
General hospitals focus on strengthening the treatment of pregnancy complications and multidisciplinary joint treatment of critically ill pregnant and lying-in women; maternal and child health hospitals and obstetrics and gynecology hospitals with large deliveries focus on strengthening the construction of obstetric subspecialties and neonatology, and gradually establish obstetric key specialized disease medical groups
.
Strengthen the construction of specialties for pregnancy and childbirth health care and newborn health care, and promote the integrated development of preventive health care and clinical medicine
.
Strengthen the capacity building of health care during pregnancy in township health centers and community health service centers, and improve the health management capabilities of pregnant and lying-in women
.

 

　　11.
Promote Chinese medicine services
.
Departments of Obstetrics and Gynecology and Pediatrics actively apply the appropriate technology of Chinese medicine to give full play to the unique role of Chinese medicine in women and children's preventive health care and disease diagnosis and treatment
.
Actively promote appropriate technologies and methods of Chinese medicine, and establish a system of collaborative diagnosis and treatment of Chinese and Western medicine
.
All levels of maternal and child health care institutions fully develop traditional Chinese medicine services, optimize and strengthen specialties such as traditional Chinese medicine gynecology and traditional Chinese medicine pediatrics, gradually increase the proportion of outpatient traditional Chinese medicine services, and encourage qualified maternal and child health hospitals to provide medicated meals, nutritious meals and other services.
90% and 70% of Chinese medicine specialist services are carried out in the first-level and second-level maternal and child health care hospitals
.

 

　　12.
Strengthen the construction of talent team and scientific research capacity
.
Ensure that obstetric and pediatric physicians, midwives and nurses participate in targeted continuing medical education at least once a year
.
Guided by clinical application, strengthen scientific research and clinical transformation, and accelerate the promotion and application of appropriate technologies
.
Maternal and child health institutions should steadily increase the proportion of supporting scientific research funds to the total institutional expenditures, and encourage qualified tertiary maternal and child health hospitals to strengthen the construction of scientific research platforms such as clinical medicine research centers
.

 

　　 (5) The satisfaction of the masses in attending a doctor and giving birth has been improved
.

 

　　13.
Optimize the allocation of diagnosis and treatment resources
.
Scientifically assess the capacity of institutions to accurately measure the medical needs of the people, and in accordance with the open beds and allocation standards, fully equip medical staff and facilities to ensure that the service resources match the service volume
.
During the epidemic, it is encouraged to appropriately adjust and extend the outpatient time of obstetrics, ultrasound and other departments.
Institutions with conditions can explore to open weekend outpatient clinics, holiday outpatient clinics, and night outpatient clinics to reduce the pressure of centralized admissions
.
Reasonably set up outpatient waiting areas, make full use of various medical treatment systems, number calling systems, and examination appointment systems to divert patients, and strictly implement "one person, one consultation and one room" to ensure orderly treatment
.

 

　　14.
Improve convenience and benefit services
.
Optimize the layout and service process of obstetric clinics, concentrate on obstetric outpatient clinics, ultrasound examinations, fetal heart rate monitoring, blood collection, urine examinations, payment and other links, and strive to provide "one-stop" convenient services
.
Make full use of information technology to promote comprehensive appointments.
The obstetric appointment diagnosis and treatment rate in tertiary maternal and child health hospitals is ≥70%, and the prenatal check-up appointment rate in tertiary general hospitals and tertiary maternal and child health hospitals is ≥90%
.
On the premise of guaranteeing the treatment of critically ill pregnant women, promote appointments for hospital delivery
.
Promote appointments for diagnosis and treatment during pregnancy and delivery, guide pregnant women to determine the responsible physician when building midwifery machines, and encourage an obstetrician or an obstetric medical team to provide full-course systematic health services for pregnant women who have not been transferred
.

 

　　15.
Promote safe and comfortable childbirth
.
Create a warm and comfortable delivery room environment and provide humanized delivery services centered on women
.
Standardize the development of non-pharmaceutical analgesia services such as professional accompanying childbirth, encourage the development of drug analgesic childbirth services, and medical institutions with conditions can carry out family accompany childbirth
.
Strengthen the establishment of high-quality, inclusive obstetrics beds, encourage qualified medical institutions to provide obstetric wards with single rooms and double rooms, and effectively improve the conditions of obstetric hospitalization, and increase the happiness and satisfaction of the people
.

 

　　Five, work requirements

 

　　 (1) Detailed implementation of action measures
.
Local health administrative departments at all levels should formulate specific implementation plans, clarify timetables and roadmaps, and consolidate work responsibilities based on local conditions
.
The National Health Commission will focus on commissioned hospitals and provincial-level maternal and child care institutions, determine some key contact hospitals, strengthen supervision and guidance, and regularly understand the progress of the work
.
Provincial health administrative departments should also establish a key contact unit system to urge medical institutions to earnestly implement safety measures for mothers and babies
.

 

　　 (2) Strengthen regional organization and coordination
.
Local health and health administrative departments at all levels must establish and improve the coordination mechanism for maternal and infant safety guarantees, refine work tasks, establish a linkage mechanism for midwifery agencies, emergency centers, and blood stations, and strengthen the protection of key links such as transportation, treatment, and blood use
.
In accordance with the "Guidelines for the Construction and Management of Critical Maternal Care Centers" and "Guidelines for the Construction and Management of Critical Newborn Care Centers", strengthen the standardized construction and standardized management of the critically ill pregnant and lying-in women and newborn care system, carry out critical care network evaluation, and improve the level of responsibility, upper and lower levels Linkage, orderly response, and efficient operation of first aid, consultation, and referral network
.
Establish a regional expert group for the treatment of critically ill pregnant and lying-in women and newborns composed of multidisciplinary experts to guide and participate in the medical treatment work in the jurisdiction
.
The National Health Commission will organize timely assessments of the construction and operation of critically ill pregnant women and newborn care networks in various regions
.

 

　　 (3) Increase support and guidance
.
The National Health Commission will select a group of qualified medical institutions to carry out regional treatment and guidance for critically ill pregnant and lying-in women, support provincial maternal and child health institutions to implement the provincial-level maternal and child health "hand in hand" action, and accelerate the construction of the "Cloud on Women and Children" platform.
Carry out extensive business training and guidance and consultation and referral
.
Speed ​​up the establishment of a midwifery technology assessment and training system, and carry out random inspections of midwifery technology
.
Provide targeted guidance to provinces with severe maternal and child safety, and conduct interviews and notifications for provinces where mission measures are not implemented and where work is seriously declining
.
Provincial-level health administrative departments should strengthen support and guidance to municipal and county-level health administrative departments and medical institutions, and promote the improvement plan to achieve practical results
.

 

　　 (4) Play a typical demonstration role
.
Hospitals under the management of the National Health Commission should play the role of the "national team", and provincial general hospitals and maternity and child care hospitals should play the role of regional "leading"
.
Health administrative departments at all levels must dig deeper, establish advanced models, and carry out the construction of mother-child friendly hospitals
.
It is necessary to strengthen the publicity of the maternal and child safety action promotion plan, report the progress of the work in a timely manner, publicize typical institutions, personnel and examples, and create a good range of public opinion
.
Actively promote first-line medical staff who have roots in the grassroots and care for the masses, and enhance the sense of professional honor of medical staff
.

 

　　All localities should put the protection of mother and child safety in a more prominent position in health work, and carefully organize and implement them to ensure that all measures are fully implemented
.
All provinces (autonomous regions and municipalities) are requested to report the progress of work and practice experience to our committee in a timely manner
.

 

　　Interpretation of the "Maternal and Child Safety Action Improvement Plan (2021-2025)" document

 

　　1.
Drafting background

 

　　The health of women and children is the cornerstone of the health of the whole people.
The maternal mortality rate and infant mortality rate are internationally recognized comprehensive indicators that reflect the national health level and social civilization of a country and region
.
The "Healthy China 2030" Planning Outline and the 2021-2030 China Women's and Children's Development Program have made clear requirements for ensuring the safety of mothers and infants, requiring that by 2030 the national maternal mortality rate be reduced to 12 per 100,000 and infant deaths nationwide The rate has dropped to 5‰, and hard work is still needed to achieve the mission objectives set out in the outline on schedule
.
Faced with the new expectations of women and children for a better life during the "14th Five-Year Plan" period, the implementation of the three-child policy and the new situation of ensuring the safety of mothers and infants are the ardent expectations of hundreds of millions of families.
The important measures of the State Council’s Decision on Optimizing the Fertility Policy and Promoting the Long-term Balanced Development of the Population are of great significance to enhancing the people’s sense of happiness, sense of gain, and security
.

 

　　On the basis of summarizing the implementation of the 2018-2020 Maternal and Child Safety Action Plan and the effective local experience and practices, our committee organized and formulated the "Maternal and Child Safety Action Enhancement Plan (2021-2025)" (hereinafter referred to as the "Enhancement Plan").
Instruct local governments to further strengthen the work of ensuring the safety of mothers and babies, and earnestly guarantee the life safety and health of pregnant women and newborns
.

 

　　2.
Main content

 

　　The "Enhancement Plan" includes 5 parts: First, the overall requirements
.
With the theme of high-quality development, with the in-depth implementation of the five systems of maternal and child safety as the main line, focusing on the improvement of service quality, the improvement of specialized skills and the improvement of public satisfaction, we will continue to strengthen quality and safety management, improve the service capacity of medical institutions, and prevent the reduction of pregnant women and women.
The baby died
.
The second is the action goal
.
Promote the safe and high-quality development of mothers and babies, further improve the level of maternal and child health services, and reduce maternal and infant mortality rates.
By 2025, the national maternal mortality rate will drop to 14.
5 per 100,000, and the national infant mortality rate will drop to 5.
2 per thousand.
Lay a solid foundation for realizing the main goals of "Healthy China 2030" as scheduled
.
Further improve the level of maternal and child health services, improve the treatment system for critically ill pregnant women and newborns, provide safe, effective, convenient and warm high-quality maternal and child health services for women and children, so that the people's sense of gain and happiness will be more satisfactory and the sense of happiness will be more sustainable , Safety and health are more guaranteed
.
The third is the scope of action
.
For medical institutions that provide technical services for midwifery, the focus is on general hospitals, Chinese medicine hospitals, maternity and child care hospitals, and maternity hospitals at secondary level and above, and treatment centers for critically ill pregnant women and newborns at all levels should be fully organized and implemented
.
The fourth is action content
.
Including the improvement of pregnancy risk prevention level, the improvement of emergency treatment level, the improvement of quality and safety management level, the improvement of maternal and child specialist service capabilities, and the improvement of the satisfaction of mass visits and delivery, medical institutions are urged to fully implement the five systems of maternal and child safety
.
The fifth is work requirements
.
Clear requirements have been put forward for detailed implementation of action measures, strengthening of regional organization and coordination, increasing support and guidance, and playing a typical exemplary role
.

　　Notice of the National Health Commission on Issuing the Maternal and Child Safety Action Plan (2021-2025)

 

　　National Health Women's and Children's Hair (2021) No.
30

 

　　The health committees of all provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps:

 

　　In order to implement the "Decision of the Central Committee of the Communist Party of China and the State Council on Optimizing the Fertility Policy to Promote the Long-term Balanced Development of the Population", further improve the level of prenatal and postnatal care services, consolidate and strengthen the five systems of maternal and child safety, and safeguard the health rights of women and children, our committee is summarizing the 2018-2020 period of maternal and child health.
On the basis of the implementation of the infant safety action plan and effective experience and practices, the "Mother and Child Safety Action Improvement Plan (2021-2025)" (available for download from the National Health Commission's website) was formulated
.
Now it is issued to you.
Please organize and implement it carefully to ensure that the work is effective
.

 

　　National Health Commission

 

October 9 , 　　2021

 

　　 (Information Disclosure Form: Active Disclosure)

 

　　Maternal and Child Safety Action Improvement Plan (2021-2025 )

 

　　In order to improve the quality and level of maternal and child health services, consolidate and strengthen maternal and child safety, ensure the implementation of optimized childbirth policies, and safeguard the health rights of women and children, starting from 2021, we will organize and implement maternal and child safety action plans across the country
.

 

　　1.
General requirements

 

　　With the theme of high-quality development, with the in-depth implementation of the five systems of maternal and child safety as the main line, focusing on the improvement of service quality, the improvement of specialized skills and the improvement of public satisfaction, we will continue to strengthen quality and safety management, improve the service capacity of medical institutions, and prevent the reduction of pregnant women and women.
The baby died
.

 

　　2.
Action goals

 

　　Promote the safe and high-quality development of mothers and infants, and reduce the maternal and infant mortality rates.
By 2025, the national maternal mortality rate will drop to 14.
5 per 100,000, and the national infant mortality rate will drop to 5.
2‰.
This is a goal to achieve "Healthy China 2030" as scheduled.
"The main goal is to lay a solid foundation
.
Further improve the level of maternal and child health services, improve the treatment system for critically ill pregnant women and newborns, provide safe, effective, convenient and warm high-quality maternal and child health services for women and children, so that the people's sense of gain and happiness will be more satisfactory and the sense of happiness will be more sustainable , Safety and health are more guaranteed
.

 

　　3.
Scope of Action

 

　　Medical institutions that provide technical services for midwifery are focused on general hospitals at the second level and above, Chinese medicine hospitals, maternal and child health care centers, and obstetrics and gynecology hospitals
.
The treatment centers for critically ill pregnant women and newborns at all levels shall organize their implementation in an all-round way
.

 

　　4.
Action content

 

　　 (1) The level of pregnancy risk prevention has been improved
.

 

　　1.
Strengthen the awareness of risk prevention
.
For each link in the fertility service chain, formulate health education work plans, develop targeted health education materials, write popular science articles, make popular science pictures, and shoot popular science videos
.
Relying on maternity schools, fertility consultation clinics, WeChat public accounts, Weibo, short videos and other platforms, combine offline and online education to popularize pregnancy health knowledge, improve health literacy, and strengthen the "first responsible person for their own health" of pregnant women Awareness, the new media platform of the Tertiary Maternal and Child Health Hospital publishes no less than 50 popular science works every year, and the average reading volume of a single popular science work is striving to reach 10,000
.

 

　　2.
Implement pregnancy risk assessment
.
Strictly implement the requirements of the "Regulations on Pregnancy Risk Assessment and Management", standardize the development of pregnancy risk screening and assessment of pregnant women, pay attention to multidisciplinary joint dynamic assessment and management, and strengthen postpartum risk assessment
.
Standardize and orderly carry out prenatal screening and prenatal diagnosis, strictly implement comprehensive prevention and control measures for mother-to-child transmission of AIDS, syphilis and hepatitis B, timely discover and intervene risk factors affecting pregnancy, and prevent adverse pregnancy outcomes
.
For pregnant women who have diseases that may be life-threatening and are not suitable for continuing pregnancy, the evaluation and diagnosis shall be conducted by qualified physicians at or above the deputy director level
.
Encourage the use of information systems to classify and categorize pregnant women
.

 

　　 (2) The level of treatment for critical and critical illnesses has been improved
.

 

　　3.
Strictly manage high-risk pregnant and lying-in women
.
Standardize pregnancy risk factor screening, identify high-risk pregnant women, strictly implement project management for high-risk pregnant women classified as "orange", "red" and "purple" in pregnancy risk, and specify that senior obstetrician physicians are responsible for the management and guidance Order and centralized medical treatment to ensure special personnel, full management, dynamic supervision, centralized treatment, and timely referral to ensure that "one case is found, one case is registered, one case is reported, one case is managed, and one case is treated
.
"

 

　　4.
Improve the treatment of weak links
.
For common critical illnesses such as postpartum hemorrhage and neonatal asphyxia, special skills training and rapid response team emergency drills will be carried out at least once a quarter.
Emergency cesarean section will be controlled within 30 minutes from the operation to the delivery of the fetus (DDI) and gradually Shorten
.
Organize at least one multi-department joint meeting every six months to improve the rescue process and specifications, further clarify the responsibilities and tasks of relevant departments and personnel, and strengthen the guarantee mechanisms for emergency equipment, medicines , blood for pregnant women, and transportation
.
Standardize the evaluation of critical and severe cases of pregnant and lying-in women, conduct a full-process analysis from early pregnancy filing to postpartum follow-up, sort out the management and technical problems existing in each link, and continuously improve the diagnosis and treatment plan and management system
.

 

　　5.
Improve the treatment coordination mechanism
.
Clarify the special organization to implement the safety management responsibilities of the obstetrics department in the hospital, and the dean in charge will be specifically responsible for improving the consultation, referral system and coordination mechanism for critically ill pregnant and lying-in women and newborns in the hospital, establishing an in-hospital multidisciplinary treatment team for critically ill pregnant and lying-in women and newborns, and encouraging neonatology The doctor enters the delivery room
.
Establish and improve the doctor-patient communication mechanism for the treatment of critically ill pregnant and lying-in women.
During the treatment and rescue period, the medical team should designate an obstetrician to be responsible for communicating with the patient’s family
.
On the basis of continuous improvement of treatment capabilities, all levels of critically ill maternal and neonatal treatment centers must pay close attention to the implementation of scribing and zoning responsibilities, strengthen guidance to lower-level medical institutions, and establish a high-level linkage and efficient consultation and referral mechanism to further smooth The green channel for critically ill referrals will ensure the safety of pregnant women and newborns
.

 

　　 (3) Improve the quality and safety management level
.

 

　　6.
Improve the quality management system
.
Practice in strict accordance with laws and regulations, and medical institutions and medical staff should obtain corresponding qualifications in accordance with the law to implement midwifery technology
.
To implement the "Medical Quality Management Measures", obstetrics and pediatrics should set up medical quality management working groups in undergraduate rooms, and carry out no less than two medical quality and safety case warning educations every year
.
Strictly abide by the core system of medical quality and safety, and focus on strengthening the three-level rounds system, the preoperative discussion system, and the rescue system for critically ill patients
.

 

　　7.
Strict medical safety management
.
Strengthen the management of obstetric visits, and improve the management system and handover procedures for newborns' entry and exit
.
Strictly implement the infectious disease prevention and control management system and work requirements, strengthen the management of infection prevention and control in key departments, key locations and key links such as outpatient and emergency departments, obstetric wards, delivery rooms, neonatal and pediatric wards, inspections, imaging, etc.
, and strictly implement disinfection and isolation.
Regulations on hand hygiene and hospital infection monitoring
.

 

　　8.
Implement quality improvement measures
.
Strictly abide by the obstetric professional diagnosis and treatment guidelines and technical operating specifications, carry out monthly self-assessment and analysis around key links and weak links for key departments such as operating rooms, delivery rooms, and neonatal wards, and continue to implement quality improvement measures
.
Comprehensively carry out the delivery safety inspection in the delivery room, fill in the inspection form in a standardized manner, and incorporate it into the medical record management as a medical document, so as to reduce the incidence of medical errors and safety adverse events in the delivery room
.

 

　　9.
Strengthen the application of data analysis
.
Regularly submit data related to maternal and child safety, and report to the county-level maternal and child health care institution at the local level as soon as possible after a maternal death occurs
.
Improve the quality control index system and data collection of obstetrics in the hospital, find out existing problems through data analysis, and put forward suggestions for improvement
.
Strictly implement relevant systems for medical quality (safety) adverse event information collection, recording and reporting
.

 

　　 (4) The service capacity of women and children specialists has been improved
.

 

　　10.
Strengthen the construction of key specialties
.
Carry out pilot projects for multidisciplinary collaborative diagnosis and treatment of maternity and obstetrics and subspecialty construction of obstetrics, improve the level of clinical diagnosis and treatment of obstetrics, and encourage the establishment of three-level maternity and child specialist alliances in provinces, cities and counties
.
General hospitals focus on strengthening the treatment of pregnancy complications and multidisciplinary joint treatment of critically ill pregnant and lying-in women; maternal and child health hospitals and obstetrics and gynecology hospitals with large deliveries focus on strengthening the construction of obstetric subspecialties and neonatology, and gradually establish obstetric key specialized disease medical groups
.
Strengthen the construction of specialties for pregnancy and childbirth health care and newborn health care, and promote the integrated development of preventive health care and clinical medicine
.
Strengthen the capacity building of health care during pregnancy in township health centers and community health service centers, and improve the health management capabilities of pregnant and lying-in women
.

 

　　11.
Promote Chinese medicine services
.
Departments of Obstetrics and Gynecology and Pediatrics actively apply the appropriate technology of Chinese medicine to give full play to the unique role of Chinese medicine in women and children's preventive health care and disease diagnosis and treatment
.
Actively promote appropriate technologies and methods of Chinese medicine, and establish a system of collaborative diagnosis and treatment of Chinese and Western medicine
.
All levels of maternal and child health care institutions fully develop traditional Chinese medicine services, optimize and strengthen specialties such as traditional Chinese medicine gynecology and traditional Chinese medicine pediatrics, gradually increase the proportion of outpatient traditional Chinese medicine services, and encourage qualified maternal and child health hospitals to provide medicated meals, nutritious meals and other services.
90% and 70% of Chinese medicine specialist services are carried out in the first-level and second-level maternal and child health care hospitals
.

 

　　12.
Strengthen the construction of talent team and scientific research capacity
.
Ensure that obstetric and pediatric physicians, midwives and nurses participate in targeted continuing medical education at least once a year
.
Guided by clinical application, strengthen scientific research and clinical transformation, and accelerate the promotion and application of appropriate technologies
.
Maternal and child health institutions should steadily increase the proportion of supporting scientific research funds to the total institutional expenditures, and encourage qualified tertiary maternal and child health hospitals to strengthen the construction of scientific research platforms such as clinical medicine research centers
.

 

　　 (5) The satisfaction of the masses in attending a doctor and giving birth has been improved
.

 

　　13.
Optimize the allocation of diagnosis and treatment resources
.
Scientifically assess the capacity of institutions to accurately measure the medical needs of the people, and in accordance with the open beds and allocation standards, fully equip medical staff and facilities to ensure that the service resources match the service volume
.
During the epidemic, it is encouraged to appropriately adjust and extend the outpatient time of obstetrics, ultrasound and other departments.
Institutions with conditions can explore to open weekend outpatient clinics, holiday outpatient clinics, and night outpatient clinics to reduce the pressure of centralized admissions
.
Reasonably set up outpatient waiting areas, make full use of various medical treatment systems, number calling systems, and examination appointment systems to divert patients, and strictly implement "one person, one consultation and one room" to ensure orderly treatment
.

 

　　14.
Improve convenience and benefit services
.
Optimize the layout and service process of obstetric clinics, concentrate on obstetric outpatient clinics, ultrasound examinations, fetal heart rate monitoring, blood collection, urine examinations, payment and other links, and strive to provide "one-stop" convenient services
.
Make full use of information technology to promote comprehensive appointments.
The obstetric appointment diagnosis and treatment rate in tertiary maternal and child health hospitals is ≥70%, and the prenatal check-up appointment rate in tertiary general hospitals and tertiary maternal and child health hospitals is ≥90%
.
On the premise of guaranteeing the treatment of critically ill pregnant women, promote appointments for hospital delivery
.
Promote appointments for diagnosis and treatment during pregnancy and delivery, guide pregnant women to determine the responsible physician when building midwifery machines, and encourage an obstetrician or an obstetric medical team to provide full-course systematic health services for pregnant women who have not been transferred
.

 

　　15.
Promote safe and comfortable childbirth
.
Create a warm and comfortable delivery room environment and provide humanized delivery services centered on women
.
Standardize the development of non-pharmaceutical analgesia services such as professional accompanying childbirth, encourage the development of drug analgesic childbirth services, and medical institutions with conditions can carry out family accompany childbirth
.
Strengthen the establishment of high-quality, inclusive obstetrics beds, encourage qualified medical institutions to provide obstetric wards with single rooms and double rooms, and effectively improve the conditions of obstetric hospitalization, and increase the happiness and satisfaction of the people
.

 

　　Five, work requirements

 

　　 (1) Detailed implementation of action measures
.
Local health administrative departments at all levels should formulate specific implementation plans, clarify timetables and roadmaps, and consolidate work responsibilities based on local conditions
.
The National Health Commission will focus on commissioned hospitals and provincial-level maternal and child care institutions, determine some key contact hospitals, strengthen supervision and guidance, and regularly understand the progress of the work
.
Provincial health administrative departments should also establish a key contact unit system to urge medical institutions to earnestly implement safety measures for mothers and babies
.

 

　　 (2) Strengthen regional organization and coordination
.
Local health and health administrative departments at all levels must establish and improve the coordination mechanism for maternal and infant safety guarantees, refine work tasks, establish a linkage mechanism for midwifery agencies, emergency centers, and blood stations, and strengthen the protection of key links such as transportation, treatment, and blood use
.
In accordance with the "Guidelines for the Construction and Management of Critical Maternal Care Centers" and "Guidelines for the Construction and Management of Critical Newborn Care Centers", strengthen the standardized construction and standardized management of the critically ill pregnant and lying-in women and newborn care system, carry out critical care network evaluation, and improve the level of responsibility, upper and lower levels Linkage, orderly response, and efficient operation of first aid, consultation, and referral network
.
Establish a regional expert group for the treatment of critically ill pregnant and lying-in women and newborns composed of multidisciplinary experts to guide and participate in the medical treatment work in the jurisdiction
.
The National Health Commission will organize timely assessments of the construction and operation of critically ill pregnant women and newborn care networks in various regions
.

 

　　 (3) Increase support and guidance
.
The National Health Commission will select a group of qualified medical institutions to carry out regional treatment and guidance for critically ill pregnant and lying-in women, support provincial maternal and child health institutions to implement the provincial-level maternal and child health "hand in hand" action, and accelerate the construction of the "Cloud on Women and Children" platform.
Carry out extensive business training and guidance and consultation and referral
.
Speed ​​up the establishment of a midwifery technology assessment and training system, and carry out random inspections of midwifery technology
.
Provide targeted guidance to provinces with severe maternal and child safety, and conduct interviews and notifications for provinces where mission measures are not implemented and where work is seriously declining
.
Provincial-level health administrative departments should strengthen support and guidance to municipal and county-level health administrative departments and medical institutions, and promote the improvement plan to achieve practical results
.

 

　　 (4) Play a typical demonstration role
.
Hospitals under the management of the National Health Commission should play the role of the "national team", and provincial general hospitals and maternity and child care hospitals should play the role of regional "leading"
.
Health administrative departments at all levels must dig deeper, establish advanced models, and carry out the construction of mother-child friendly hospitals
.
It is necessary to strengthen the publicity of the maternal and child safety action promotion plan, report the progress of the work in a timely manner, publicize typical institutions, personnel and examples, and create a good range of public opinion
.
Actively promote first-line medical staff who have roots in the grassroots and care for the masses, and enhance the sense of professional honor of medical staff
.

 

　　All localities should put the protection of mother and child safety in a more prominent position in health work, and carefully organize and implement them to ensure that all measures are fully implemented
.
All provinces (autonomous regions and municipalities) are requested to report the progress of work and practice experience to our committee in a timely manner
.

 

　　Interpretation of the "Maternal and Child Safety Action Improvement Plan (2021-2025)" document

 

　　1.
Drafting background

 

　　The health of women and children is the cornerstone of the health of the whole people.
The maternal mortality rate and infant mortality rate are internationally recognized comprehensive indicators that reflect the national health level and social civilization of a country and region
.
The "Healthy China 2030" Planning Outline and the 2021-2030 China Women's and Children's Development Program have made clear requirements for ensuring the safety of mothers and infants, requiring that by 2030 the national maternal mortality rate be reduced to 12 per 100,000 and infant deaths nationwide The rate has dropped to 5‰, and hard work is still needed to achieve the mission objectives set out in the outline on schedule
.
Faced with the new expectations of women and children for a better life during the "14th Five-Year Plan" period, the implementation of the three-child policy and the new situation of ensuring the safety of mothers and infants are the ardent expectations of hundreds of millions of families.
The important measures of the State Council’s Decision on Optimizing the Fertility Policy and Promoting the Long-term Balanced Development of the Population are of great significance to enhancing the people’s sense of happiness, sense of gain, and security
.

 

　　On the basis of summarizing the implementation of the 2018-2020 Maternal and Child Safety Action Plan and the effective local experience and practices, our committee organized and formulated the "Maternal and Child Safety Action Enhancement Plan (2021-2025)" (hereinafter referred to as the "Enhancement Plan").
Instruct local governments to further strengthen the work of ensuring the safety of mothers and babies, and earnestly guarantee the life safety and health of pregnant women and newborns
.

 

　　2.
Main content

 

　　The "Enhancement Plan" includes 5 parts: First, the overall requirements
.
With the theme of high-quality development, with the in-depth implementation of the five systems of maternal and child safety as the main line, focusing on the improvement of service quality, the improvement of specialized skills and the improvement of public satisfaction, we will continue to strengthen quality and safety management, improve the service capacity of medical institutions, and prevent the reduction of pregnant women and women.
The baby died
.
The second is the action goal
.
Promote the safe and high-quality development of mothers and babies, further improve the level of maternal and child health services, and reduce maternal and infant mortality rates.
By 2025, the national maternal mortality rate will drop to 14.
5 per 100,000, and the national infant mortality rate will drop to 5.
2 per thousand.
Lay a solid foundation for realizing the main goals of "Healthy China 2030" as scheduled
.
Further improve the level of maternal and child health services, improve the treatment system for critically ill pregnant women and newborns, provide safe, effective, convenient and warm high-quality maternal and child health services for women and children, so that the people's sense of gain and happiness will be more satisfactory and the sense of happiness will be more sustainable , Safety and health are more guaranteed
.
The third is the scope of action
.
For medical institutions that provide technical services for midwifery, the focus is on general hospitals, Chinese medicine hospitals, maternity and child care hospitals, and maternity hospitals at secondary level and above, and treatment centers for critically ill pregnant women and newborns at all levels should be fully organized and implemented
.
The fourth is action content
.
Including the improvement of pregnancy risk prevention level, the improvement of emergency treatment level, the improvement of quality and safety management level, the improvement of maternal and child specialist service capabilities, and the improvement of the satisfaction of mass visits and delivery, medical institutions are urged to fully implement the five systems of maternal and child safety
.
The fifth is work requirements
.
Clear requirements have been put forward for detailed implementation of action measures, strengthening of regional organization and coordination, increasing support and guidance, and playing a typical exemplary role
.