从全球视角看助产学的发展课件

从全球视角看助产学的发展从全球视角看助产学的发展1 1、舟遥遥以轻飏，风飘飘而吹衣。、舟遥遥以轻飏，风飘飘而吹衣。、舟遥遥以轻飏，风飘飘而吹衣。、舟遥遥以轻飏，风飘飘而吹衣。2 2、秋菊有佳色，裛露掇其英。、秋菊有佳色，裛露掇其英。、秋菊有佳色，裛露掇其英。、秋菊有佳色，裛露掇其英。3 3、日月掷人去，有志不获骋。、日月掷人去，有志不获骋。、日月掷人去，有志不获骋。、日月掷人去，有志不获骋。4 4、未言心相醉，不再接杯酒。、未言心相醉，不再接杯酒。、未言心相醉，不再接杯酒。、未言心相醉，不再接杯酒。5 5、黄发垂髫，并怡然自乐。、黄发垂髫，并怡然自乐。、黄发垂髫，并怡然自乐。、黄发垂髫，并怡然自乐。从全球视角看助产学的发展1、舟遥遥以轻飏，风飘飘而吹衣。从全1从全球视角看助产学的发展课件从全球视角看助产学的发展课件3从全球视角看助产学的发展课件4从全球视角看助产学的发展课件The Development of the Swedish midwifery system,cont.瑞典助产学的发展（续）瑞典助产学的发展（续）1711 Code of practice and ethics for midwives in Stockholm1711年，在斯德哥尔摩发布了助产士行为准则及道德规范1712 The first 18 midwives registrated by Collegium Medicum1712年，医学院首次录取了18位助产士学生1751 Audit(Collegium Medicum)&National statistics of number of births and deaths and the cause of death1751年，对出生人数、死亡人数及死因进行了全国性统计2024-05-17KyllikeChristenssonTheDevelopmentoftheSwedish62024-05-17KyllikeChristensson 100%50%20%deliveries assisted by a midwife 由助产士协助的分娩比例由助产士协助的分娩比例Midwives trained with“life saving skills”接受过专业训练的助产士接受过专业训练的助产士MMR 产妇死亡率产妇死亡率1890 1850100200300400500Therelationshipbetweenmaternalmortalityandtheassistanceofprofessionallytrainedmidwivesatbirth,Sweden185090产妇死亡率与专业助产士协助的分娩的关系，瑞典 185090Death per100 000live births每10万活产的死亡数2023-08-03KyllikeChristensson72024-05-17KyllikeChristenssonTheMidwifeslogisticsinacommonruralarea助产士在农村地区的出行方式2023-08-03KyllikeChristensson82024-05-17KyllikeChristenssonPrevalenceofhomedeliveriesinSweden瑞典的家庭分娩率189097%193076%194035%19505.9%Today今0.1%Home deliveries in Low income countries=5 60%在低收入国家，家庭分娩率可达5%至60%2023-08-03KyllikeChristensson92024-05-17KyllikeChristenssonTowards a Healthy Mother and Infant为了健康的母亲和婴儿As important the political will重要的政治意愿Recruitment 人才招聘Educational system教育系统Legislation立法Salary薪酬Safety 安全A professional trained midwife with the right to use obstetrical instruments since 1829自1829年起，受过专业训练的助产士可以使用产科器具2023-08-03KyllikeChristensson102024-05-17KyllikeChristenssonActions to be taken towards a Healthy Mother为了为了“健康母亲健康母亲”所采取的行动所采取的行动1987 The Safe Motherhood initiative TBA/Dai training1987年，“安全母亲”行动倡议1997 Lesson learnt(Siri Lanka)Skilled attendance at birth1997年，斯里兰卡的案例 专业助产士协助分娩2023-08-03KyllikeChristensson112024-05-17KyllikeChristenssonOnly 60%of births are assisted by a skilled attendant只有60%的分娩是由专业助产士协助进行的700.000 skilled attendants/health professionals with midwifery skills are needed仍然需要70万受训练的、具有助产技术的专业人士Towards a Healthy Mother and infant为了更健康的母亲和婴儿为了更健康的母亲和婴儿2023-08-03KyllikeChristensson12Each year more than 250 000 women die due to complications during pregnancy and/or childbirth每年有超过25万女性死于孕期及分娩过程中的并发症 Maternalmortalityrate(death/100000livebirths)每10万活产的死亡数：Sweden瑞典4USA 美国17China中国30India 印度190Afghanistan阿富汗400SierraLeone塞拉利昂1100Eachyearmorethan250000w“Women are not dying because of diseases we cannot treat.妇女并非死于那些无法治疗的疾病，They are dying because societies have yet to make the decision that their lives are worth saving”而是死于这个社会尚未下决心去承认她们生命的价值。Prof.M.F.FathallaAssiet University,Egypt从全球视角看助产学的发展课件142024-05-17KyllikeChristenssonMaternal mortality and morbidity产妇死亡率及发病率产妇死亡率及发病率 low-income countries vs.Sweden 低收入国家低收入国家 vs.vs.瑞典瑞典Haemorrhage大出血Sepsis败血症Eclampsia子痫Obstructedlabour难产Unsafeabortion不安全的终止妊娠Indirectcauses(e.g.malaria)间接原因（如疟疾）Cardiovascular心血管疾病Stroke脑卒中Haemorrhage大出血Heartdiseases心脏病Sepsis败血症Mentaldistress精神损害2023-08-03KyllikeChristensson152024-05-17KyllikeChristenssonThe Swedish context-The overall aim of Midwifery/Maternity and Newborn Health Care瑞典的情况助产学及母婴健康的总体目标 A healthy mother健康的母亲 A healthy infant健康的婴儿 A pleasant experience 愉快的体验 with as few intervention as possible尽可能少的干预2023-08-03KyllikeChristensson16Present distribution of various types of interventions当前多种类型干预的分布当前多种类型干预的分布 Of unknown effect,but in good qualityresearch programDomoreharmthangood伤害多于获益Do more good than harm获益多余伤害Of unknowneffect not inresearch settingor in poor quality research效果未知来源于非研究环境或不佳的研究环境效果未知来源于良好的研究项目Presentdistributionofvariou17Midwifery research as a tool to evaluate current practices and improve maternity and new-born care助产学研究是评估当前实践的工具，可以改善妇幼卫生服务质量Up-rightposition竖位分娩Alloweating允许进食Non-pharmacologicalpain-relif不用药物的疼痛缓解Allowingbirthcompanion允许分娩陪伴2024-05-17KyllikeChristenssonMidwiferyresearchasatoolt182024-05-17KyllikeChristenssonFrom home delivery towards institutional deliveries-risks to be considered从在家分娩到医院分娩从在家分娩到医院分娩同样存在诸多风险同样存在诸多风险Toomanyunnecessaryinterventions有许多非必要的干预措施oxytocinargumentation关于催产素的争论episiotomy外阴侧切术caesareansection剖腹产separationofthemotherandinfant妇婴分离formula婴儿配方食品2023-08-03KyllikeChristensson19Lancet,March 20054 million neonatal deaths/year,4 million stillbirths/year每年四百万新生儿死亡、四百万死胎Infections 36%,Preterm births 27%and Asphyxia 23%36%感染，27%早产，23%窒息Interventions with proven efficacy(universal)could avert 41-72%of neonatal deaths worldwide有效的干预措施可以减少世界41%-72%的新生儿死亡Lancet,March20054millionne202024-05-17KyllikeChristenssonThe newborn infants needs 新生儿的需求新生儿的需求Skin-to-skin care vs.mother/infant separation 紧密关怀紧密关怀 vs.母婴分离母婴分离Temperature 体温Blood-glucosesandMetabolic Adaptation血葡萄糖和新陈代谢适应Crying behaviour哭泣行为2023-08-03KyllikeChristensson21The Swedish Midwives Scope of activities Reproductive Health(at womens all stages of life)瑞士助产士活动范围瑞士助产士活动范围-女性生命全程的生殖健康女性生命全程的生殖健康Antenatal-Intrapartum-Postpartum Care产前产前-分娩时分娩时-产后护理产后护理sexuality counselling 性咨询性咨询contraceptive counselling 避孕咨询避孕咨询pre-conceptual counselling 孕前咨询孕前咨询STI-prevention 性病预防性病预防 PAP smear 子宫颈抹片检查子宫颈抹片检查 Menopausal counselling 更年期咨询更年期咨询 New-born infants-11-12yrs -Adolescens -Childbearing Women -Menopause -Elderly women 新生儿新生儿-11-12岁岁 青春期青春期 孕妇孕妇-更年期更年期 老年妇女老年妇女Sexuality education 性教育性教育17/05/2024KyllikeChristensson22Gynaecological Care 妇科护理妇科护理sexualitycounselling性咨询22Reproductive Health includes Sexual Health and Rights生殖健康包括性健康和性权利生殖健康包括性健康和性权利in Sweden 85%of contraceptives prescriptions and sexual counselling is given by the midwives在瑞典，在瑞典，85%的避孕药处方和性咨询服务是由助产士提供的的避孕药处方和性咨询服务是由助产士提供的Compulsorysexualityeducationinschoolssince1955自1955年起在学校强制开展性教育Youthcentres青年中心/以年轻人为中心AbortionLaw1975终止妊娠法17/05/2024KyllikeChristensson23ReproductiveHealthincludesS23Abortion care current“task shifting”projects from the physician/obstetrician to the midwife终止妊娠的实施者正从内科医生、产科医生转变为助产士终止妊娠的实施者正从内科医生、产科医生转变为助产士Firsttrimestermedicalabortionmedical头三个月的医学终止妊娠药物Secondtrimesterabortionmedical第二个三个月的终止妊娠药物2024-05-17KyllikeChristenssonAbortioncarecurrent“task24Global Perspective 全球视角全球视角Midwives recognized as primary care providers for normal childbirth 助产士已是主要分娩服务的提供者助产士已是主要分娩服务的提供者Practice by midwives 助产士的工作助产士的工作Higherpsychologicalsupporttowomen更多的心理支持Lessmedicalinterventions更少的医疗干预Midwifery situtation across countries 几个世纪以来的助产学情况几个世纪以来的助产学情况Thecompetence,title,scopeofpracticeofmidwivesdiffers助产士的能力、名字、工作内容不尽相同Recognizedasautonomousinmanycountries在许多国家被是独立的学科3 pathways to midwifery 成为助产士的成为助产士的3条途径条途径3yearsdirectentryeducation3年直接入职教育18monthseducationpostnursing18个月的后护士教育Integratednursingandmidwifery(notrecognizedbyICM)护士和助产士合一（并不被ICM认可）BharatiSharma25GlobalPerspective全球视角Midwive25International confederation of Midwives ICM meeting the global demands国际助产士联合会国际助产士联合会 面对全球需求面对全球需求The Philosophy and Model of Midwifery Care 助产学护理的哲学和模范International Definition of the Midwife助产士的国际定义International code of ethics for midwives助产士的国际道德规范Essential Competencies for Basic Midwifery Practice 基础助产学的必要能力Global Standards for Midwifery Regulation全球助产学规范标准Global Standards for Midwifery Education全球助产学教育标准2024-05-17KyllikeChritenssonInternationalconfederationof26Scaling up the capacities of midwives requires a combination of增强助产士的能力，需要结合以下几方面增强助产士的能力，需要结合以下几方面Politicaladvocacy政治宣传Toconvincethosewhomakethepolices,thosewhoallocatebudgetsandthosewhoregulatethecivilservice说服那些政策制定者、计划预算者和行政机构的领导Scientificadvocacy科学宣传Todemonstrateeffectivenessancosteffectivenessofvariousoptions论证各种选项的成本效益Ethicaladvocacy道德宣传Toapplycodesofconduct,rightsandgender遵守行为准侧、保障权利和性别Scalingupthecapacitiesofm27Scaling up the capacities of midwives requires a combination of,cont.增强助产士的能力，需要结合以下几方面增强助产士的能力，需要结合以下几方面Technicaladvocacy技术支持Toreviewnormsandprotocolsandrulesfordelegation审查标准、协议和规范Supportandpartnershipwith支持与合作Professionalassociationsandtraininginstitutions专业团体和培训机构Workwith共同努力Civilsocietyandcommunitytoincreasedemand民间团体和社区以增加需求Scalingupthecapacitiesofm28Midwives4all the actual Swedish Government launch to promote global midwifery care Midwives4all瑞典政府促进全球助产学护理瑞典政府促进全球助产学护理midwives4all.org/The right to midwifery care a means to end poverty利用助产士服务是一种消除贫困的方法利用助产士服务是一种消除贫困的方法Midwives4alltheactualSwed29谢谢你的阅读v知识就是财富v丰富你的人生71、既然我已经踏上这条道路，那么，任何东西都不应妨碍我沿着这条路走下去。康德72、家庭成为快乐的种子在外也不致成为障碍物但在旅行之际却是夜间的伴侣。西塞罗73、坚持意志伟大的事业需要始终不渝的精神。伏尔泰74、路漫漫其修道远，吾将上下而求索。屈原75、内外相应，言行相称。韩非谢谢你的阅读知识就是财富71、既然我已经踏上这条道路，那么，30