Taiwan is facing a strict low birthrate challenge. Every birth is precious and valuable to both the family and society. Children health equals to future development and competitiveness. It is also the most important thing to all parents. Improving children health and survival rate should not only be part of national strategies but something that each parent would need to care.

Optimizing Genetic Health Services and Subsidies Can Make Pregnancy Comfortable and Relaxed

To decline two major causes of infant mortality (congenital malformation and premature birth), National Health Insurance Administration (NHI) provides all kinds of quality reproductive health services and caring environments to support parents to be. National Health Insurance program covers 10 sessions of prenatal examination: 2 sessions for the first trimester (less than 17 weeks), 2 sessions for the second trimester (weeks 17 through weeks 28) and 6 sessions for the third trimester (weeks 29 to 40). Average utilization rate reaches 94.3%.　

NHI also establishes maternity registration mechanism to conduct risks classification and management. Full subsidy on Group B Streptococus screening and 2 sessions of prenatal healthcare education and instruction services are also conducted by NHI. Besides, to reinforce preventive antibiotic treatment for those screening are positive, and to lower infection in early onset babies, on November 3rd, 2014, NHI increased subsidies for prenatal genetic diagnosis (amniocentesis) of high age or high-risk pregnant women from NT$2,000 to NT$5,000. It is estimated that there would be 46,000 pregnant women beneficiaries of this service. To better answer all kinds of questions that may occur during pregnancy, the government provides national free hotline and pregnancy care website, which consist of providing health information in response to queries about parent-children health, breastfeeding, pregnancy nutrition and weight management, physical and mental adjustment, and necessary referrals for health counseling services.

規劃救濟條例 強化關懷降低醫病溝通

生產事故救濟條例是臺灣首部醫療事故相關的救濟法案，也是世界首創涵蓋所有生產事故的不責難救濟條例。希望藉由國家提供的保障，讓所有婦女能安心生產，同時，透過生產事故救濟制度的實施，能使產科醫療爭議大幅下降，促進醫病和諧，並且累積更多本土數據，持續改善與提升生產品質。在統計案件中，將發生於101 年至105 年6 月29 日的生育事故，截至107 年6 月29 日試辦計畫結束前，受理494 件申請案，其中孕產婦死亡佔整體比例的47.2%；另外，在孕婦死亡事故原因分析統計顯示，羊水栓塞為最大宗，有63 件，占63.6%。目前羊水栓塞無確切預防機制，但醫院可加強專科醫師對臨床症狀的判斷，以利降低孕婦死亡事故。

生產事故救濟制度之推動，有助於減緩醫療爭議之訴訟，成功關鍵則在於事故發生後之及時關懷與溝通，長期運作下，有望降低減少醫療糾紛濫訟情形，有利改善產科執業環境，讓醫學生願意選擇婦產科。借鏡其成功經驗，已積極推動「醫療事故預防及爭議處理法」立法，建立全面性醫療事故之處理機制，引導醫病雙方以溝通取代訴訟解決爭議。

Plans for Children Health and Child Obesity Prevention

United Nations Children’s Fund (UNICEF) noted that the simplest way of evaluating a nation is by measuring children’s health. The Health Promotion Administration (HPA) was established in 2001. This government organization has been devoted to safeguarding children health and care, providing maternity healthcare and continuously improving our regulations and services.

We cannot continue to gamble with our children’s health. To ensure children health, HPA has planned a series of healthcare policies covering infants and children in school age. These policies include newborns biliary atresia screening, screenings for metabolic disorders in newborns, preventive healthcare for children under age of 7, referrals for children of potential slow development, country-wide subsidy for newborn and children under age of 3 hearing screening launched in 2012, screening and referral services to preschool children aged 4-5 for detection of myopia, strabismus and amblyopia, dental fluoride treatment for children under age of 5, and fluoride mouth rinsing for elementary school children to prevent tooth decay. Child obesity is of equally important. To prevent child obesity, the government launched a campaign committed to “smart eating, joyful moving, and daily weighing”.

Taiwan Breastfeeding Rate Near 50%, both Maternal and Infant Mortality Rate Drop

Breast milk contains irreplaceable precious nutrition. It’s the best present for the babies. The international communities have been promoting breastfeeding. In 2014, the breastfeeding rate in Taiwan for babies aged under 6 months has reached 45.8%, which was higher than the global average of 38% and closer to WHO 2025 target of increasing to 50%.

In responding to the latest maternal healthcare needs, a representative from HPA has mentioned: maternal and infant health is a vital topic to public health, and promoting holistic healthcare for them is regarded as highly important tasks. After years of efforts, the maternal mortality rate has dropped from 40 per 100,000 in early 1970 to 9.2 per 100,000 in 2013. Infant death rate has also dropped from 15-16 per 1000 live births to 3.9 in 2013. Health of pregnant women and children are greatly improved.

HPA works hard to improve and safeguard health for mothers, infants and children. We want to make mothers feel comfortable in pregnancy; moreover, we want to ensure healthy lives for our children.

Photo by Nikki Ganze from Pexels