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PublicHealthPracticeandImprovementFrameworkPracticesandEssentialServices公共卫生实践,改善框架-实践和关键服务-,Page2,PublicHealthInfrastructureGoal公共卫生基础设施目标,Everyhealthdepartmentbetterprepared每一个卫生部门都应该准备好Everycommunitybetterprotected每一个社区都受很好的保护,Whatdoesittaketobefullyprepared?如何才能做好充分的准备？,丹麦留学,Page3,StepOne第一步,DevelopaCommunityHealthAssessmentPlan制定社区卫生评估计划GatherMostImportantData收集重要数据InterprettheData对数据进行分析Report撰写报告brief,简洁tothepoint,重点突出cleardata数据明晰specificrecommendations明确的建议,Page4,AssessmentEssentialServices评价关键服务,Page5,CausesofPrematureDeathintheU.S.19901990年美国过早死亡的原因,Cause原因%ofTotalDeaths总死亡Tobacco烟草38%Diet/activitypatterns饮食/运动模式28%Alcohol酒精10%Microbialagents微生物8%Toxicagents毒物6%Firearms枪支4%Sexualbehavior性行为2%Motorvehicles交通事故2%Illicitdrugs非法毒品1%,Source:McGinnis&Foege,JAMA1993,WhatwouldbetheleadingcausesinChina?在中国首要原因是什么?,Page6,WhatisMostImportanttoMonitor?Somepossiblecriteria监测的重点是什么？一些可能的标准,Contributemosttoyearsofproductivelifelost?是否导致生产年的丧失？Affectsotherregionsandcountries?是否影响其他的区域和国家？Couldbeimprovedgreatlywithgooddata是否可以通过好的数据显著改善健康状况？,0,Page7,TopThreeHealthProblems?,_Agingproblems老龄化_Cancers癌症_Childabuse/neglect,orphans虐待儿童_Diabetes糖尿病_DomesticViolence家庭暴力_Heartdisease/stroke心脏病/中风_bloodpressure高血压_HIV/AIDS艾滋病_Homicide他杀,_InfantDeath婴儿死亡_InfectiousDiseases传染病_Mentalhealthproblems精神病_Car/Bikeinjuries车祸_Rape性暴力_Lungdisease肺病_SexualDiseases性病_Suicide自杀_Other:_其他_,Page8,WhatWouldYouLiketoAchieveBy2010?到2010年想要达到什么目标不？,objectivesforchange目标DevelopAnObjective(Bywhen,whatwillbechanged,byhowmuchchange,forwhatgroup?)_制定目标（何时、取得何种变化、变化多少、目标人群是哪个？）,Page9,LeadingHealthIndicators主要的健康指标,Biologicalcausesofdeath,illness,injury导致死亡、疾病、伤害的生物学因素BehaviorandLifestyle行为与生活方式Environment:qualityofair,water,food,land环境因素：空气、水、食物、土地的质量Immunizations免疫接种Accesstohealthcare卫生保健的获得,Page10,ServicesNeedtoAddressAllDeterminantsofPublicHealth解决公共健康所有决定因素所需要的服务,Page11,SlideDetails:MultipleDeterminantsofHealth健康的影响因素,Biology生物学Behavior行为Social,Family&CommunityNetworks社会,家庭和社区网络Living&WorkingConditions工作生活环境Employment&occupation,Education,Socioeconomicstatus,Psychosocialfactors雇佣和职业,教育,社会经济状况,社会心理因素Naturalandbuiltenvironment自然和人为环境Public&healthcareservices卫生服务Social,economic,cultural&environmentalpolicies社会,经济,文化和环境政策,Page12,KeyComponentstoMonitorHealthStatus监测卫生现状的关键指标,deathcertificatesifdetailed&accurate死亡登记(详细,准确)immunizationregistries免疫接种登记largepopulationsurveys大人群调查healthinterview&examstudies健康访谈和体检研究requiredreportingofkeyinfectiousdiseases主要传染性疾病法定报告制度proxymeasures:infantmortality,averagelifespan替代指标:婴儿死亡率,平均寿命integrationacrossdistricts,providers,diseases地区,来源,疾病数据的整合electronicrecords:secure,simple,standardvariables,updatedregularly,wellstaffed电子记录:安全,简单,标准变量,经常更新,装备先进,Page13,AssessmentRecommendations评价建议,DevelopNationalHealthInformationInfrastructure建立国家卫生信息基础设施Regularlyassessthestateofthenationspublichealthsystemanditscapacitytoprovidetheessentialpublichealthservicestoeverycommunity常规评价全国公共卫生系统的现状和为社区提供基本公共卫生服务的能力Evaluatethestatusofthenationspublichealthlaboratorysystemperformance评价全国公共卫生实验室系统的运行状况,Page14,StepTwo第二步,DevelopaCommunityHealthImprovementPlan制定社区健康改善计划National,国家级Provincial省级Local地方DevelopCommunicationLinksBetweenAllPartners在各合作方间建立交流机制,0,Page15,PolicyDevelopment政策发展,Forproblemsthataffectlargepopulationsegments针对影响最大人群的问题Forproblemswithrootsinenvironmentorinstitutionsorbusinesses针对环境,体制或商业的根本Focusmoreonimprovingcommunitywideconditions,servicesandpractices.重点在提高广泛社区的状况,服务和实践Canbeusedtocreateamorecomprehensiveandlinkedpublichealthcaresystem.可以用于创造一个更综合,紧密连接的公共卫生系统,Page16,EssentialPolicyComponentsThatMustBePutinPlaceforSuccess成功的基本要素,Enactment颁布,Enforcement实施,Planforcommunicationbetweendecisionmakers,andmobilizingsupport决策者和支持者之间的交流计划,Planforcommunicationbetweenauthorities,andenoughresources当局者和足够资源之间的交流计划,Planforeducationtoincreaseawareness,andmotivation提高意识和动员水平的教育计划,Compliance执行,Page17,ImportantPolicyComponents重要的政策要素,Isthereasystemforidentifyingandtrackingallpoliciesinplace?是否有确认和跟踪政策实施的系统?Ispolicycompliancemonitoredandenforced?Ifnot,thentheremaybenomotivationtocomply是否有政策监测系统?Isitclearwhohasresponsibilityforeachlawandhowtogetthemtotakeaction?每项法律的负责人是否清楚,如何使他们行动起来?Ispublicinformed?公众是否知情?Doespublicbelieveitwillbeenforced?公众是否相信政策可行?,Page18,PolicyRecommendations政策建议,Appointanationalcommissiontodevelopaframeworkforstatepublichealthlawreform.任命一个全国委员会建立国家公共卫生法律改革的框架Supportbold,large-scaledemonstrationstotestnewapproachestoincreasetheefficiencyandeffectivenessofhealthcaredeliverysystems支持大规模演示,以检验新方法提高卫生服务系统的有效性,Page19,AssuranceEssentialServices基本服务保证,Enforcepublichealthlawsandpolicies加强公共卫生法律和政策Assureacompetentpublichealthandpersonalhealthcareworkforce保证一支有力的公共卫生和个人医疗服务的队伍Linkpeopletoneededpersonalhealthservicesandassuretheprovisionofhealthcarewhenotherwiseunavailable将个人和个人所需的健康服务连接起来Evaluatecompliance,servicedelivery,healthoutcomesandneedforchange评价依从性,服务,健康产出和改善要求,Page20,OverviewofHealthPromotionStrategies健康促进策略回顾,Education:changeknowledge,attitudes,beliefs,readiness,intentionsandbehaviors教育：改变知识、态度、信仰、愿望、目的和行为Policy:discourageunhealthypractices,improveinfrastructureandenvironment政策：不鼓励那些不健康的作法，促进基层单位和环境的改善Environment:maketheenvironmentsafertoprovidehealthyconditions环境：使之更加安全，以提供健康的环境条件,Page21,Self-AssessmentforSelectedHealthIssue卫生问题的自我评价,Astronggovernmentalpublichealthinfrastructureforleadershipandservices?强大的政府公共卫生基础设施Up-to-dateandlinkedsystemsforunderstandinghealthstatusandtrends?理解健康状况和趋势的实时监测系统Clearsystemofhealthpoliciesthatassureadequateandsustainedcommunityhealth?确保适当和持续的社区健康的卫生政策系统Systemsinplacetoprotectandenhancethepublicshealth?保护和加强公众健康的合适系统,Page22,Mobilizecommunitypartnershipstoidentifyandsolvehealthproblems动员社区,确认和解决卫生问题,Governmentscannotworkalonetotacklebigandcomplexproblems政府不能在解决大的复杂问题上单枪匹马Poverty,poorfood,inadequatewagesandlackofphysicalexerciserequirecommunitypartnerships贫穷,差的食物,不适当的工资以及缺少体育锻炼方面需要社区配合Example:sextrade例如:性交易,Page23,ThePublicHealthWorkforce:IsitReadytoProvidetheCoreFunctionsandEssentialServicesatALLLevels?公共卫生队伍:能否在各个层次上提供核心功能和关键服务,Isthereawelldevelopedplantoprovideeachservice?是否有提供各种服务的成熟计划?Arethereenoughpeopleandresources?是否有足够的人员和资源?Arepeoplesufficientlytrained?人员是否经过充分培训?Isitintegratedwithotheressentialservices?是否与其它基本服务相整合?Istheregoodworkingrelationshipbetweenthelocal,regionalandnationalpublichealthsystems?在地方,地区和全国的公共卫生系统之间是否存在良好的工作关系?Istheregoodcommunicationwithothersectorsthataffecthealthsuchasstoresandschools?与影响健康的其它部门,例如商店和学校,之间是否存在良好的沟通与交流?,
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