I. Objectives
(a) the overall goal.
Raise people's awareness of preventing mother-to-child transmission of AIDS, prevent women of childbearing age from contracting AIDS, minimize children's infection of AIDS through mother-to-child transmission, reduce the impact of AIDS on women and children, and improve the quality of life and health of women and children.
(2) Specific objectives.
1. Establish and improve the management and service model for preventing mother-to-child transmission of AIDS, which is suitable for China's national conditions.
2 to undertake the prevention of mother-to-child transmission of AIDS service personnel training coverage rate reached more than 90%.
3. The awareness rate of prevention of mother-to-child transmission of AIDS among pregnant women is over 70%.
4 pregnant women and premarital health care groups to prevent mother-to-child transmission of AIDS counseling rate reached more than 85% respectively.
5. The HIV antibody detection rate of pregnant women and premarital health care population reached above 80% respectively.
6. The utilization rate of HIV-infected pregnant women and their babies' anti-HIV drugs reached over 90% respectively.
7. The artificial feeding rate of babies born to pregnant women infected with HIV is over 85%.
The HIV antibody detection rate of children born to HIV-infected pregnant women aged 8.65,438+02 months and 65,438+08 months reached above 80% respectively.
9. The HIV infection rate among children transmitted from mother to child has decreased by 50%.
II. Strategies and measures
(a) government-led, multi-sectoral cooperation, extensive social mobilization.
Prevention of mother-to-child transmission of AIDS is an important part of comprehensive prevention and treatment of AIDS. Governments at all levels and health administrative departments should strengthen the organization and leadership of the prevention of mother-to-child transmission of AIDS, establish a multi-sectoral cooperation mechanism, and widely mobilize the society to provide policy and social support for the smooth implementation of the prevention of mother-to-child transmission of AIDS.
1. Strengthen the leadership, organization and coordination of governments at all levels.
Governments at all levels and health administrative departments should incorporate the prevention of mother-to-child transmission of AIDS into the comprehensive prevention and control work plan of AIDS in various regions, and formulate the work objectives and implementation plans of the region. Establish a coordination mechanism for the prevention of mother-to-child transmission of AIDS, strengthen organization and coordination, clarify the responsibilities and tasks of various departments, increase policy and financial support, and ensure the smooth implementation of the work.
2. Strengthen multi-sectoral collaboration
Within the health system, it is necessary to establish a cooperative mechanism to prevent mother-to-child transmission of AIDS, which is mainly composed of maternity and child departments, disease control, medical administration, financial planning and other departments, with clear responsibilities and division of labor. Actively cooperate with the women's Federation, family planning, civil affairs, finance, education, the Communist Youth League, culture, radio and television, public security and other departments to carry out publicity and education on the prevention of mother-to-child transmission of AIDS, prevent women of childbearing age from being infected, reduce the unintended pregnancy of infected women, provide comprehensive intervention services and comprehensive care and support for the prevention of mother-to-child transmission of AIDS, and comprehensively promote the work.
3. Carry out extensive health education.
Make use of various media, school courses, lectures and consultation hotlines, extensively carry out health education activities, compile appropriate health education materials, and popularize AIDS prevention knowledge among women. Combined with maternal health care, premarital health care and family planning services, pregnant women, parents of children and their family members are given key guidance on preventing mother-to-child transmission of AIDS in maternity clinics, pregnant women schools, wards, delivery rooms, premarital health care clinics, community health service centers, village clinics and other places.
(two) in reproductive health care services, to carry out the prevention of mother-to-child transmission of AIDS services.
Medical and health institutions and their medical staff should pay attention to the possible ways and infection status of women's AIDS infection in reproductive health care services, and closely combine the prevention of AIDS infection among women of childbearing age and the reduction of unwanted pregnancy among women infected with AIDS with reproductive health care services.
1. Provide AIDS prevention information and services to prevent women of childbearing age from being infected.
In the process of reproductive health care services, combined with pre-marital health care, diagnosis and treatment of women's diseases, prevention and treatment of sexually transmitted diseases/reproductive tract infections, family planning and other medical services, actively provide health education and consultation on AIDS prevention for women receiving medical services and their spouses/sexual partners, improve women's familiarity with AIDS prevention knowledge, avoid dangerous behaviors of AIDS infection, and enhance their awareness of protection; Conduct risk behavior assessment, mobilize high-risk actors to receive AIDS testing and further counseling, prevent spouse/sexual partner infection, and minimize the infection and spread of AIDS among women of childbearing age.
2. Provide contraceptive advice and guidance to reduce unintended pregnancy.
Women of childbearing age infected with HIV and their families should be provided with information on the harm and prevention of mother-to-child transmission of AIDS, corresponding contraceptive counseling and services, medical care and referral services. To help them choose safe sex, make appropriate family planning, provide safe pregnancy termination services for women with unintended pregnancy, and reduce unintended pregnancy among women infected with HIV.
(three) the prevention of mother-to-child transmission of AIDS into the routine work of maternal and child health care, to provide comprehensive services to prevent mother-to-child transmission of AIDS.
Based on the maternal and child health care network, we will establish a routine working mechanism to prevent mother-to-child transmission of AIDS, and integrate the prevention of mother-to-child transmission of AIDS into the process of maternal and child health care and reproductive health services, forming a comprehensive care and support system for the prevention of mother-to-child transmission of AIDS with women, children and families as the core.
1. Provide consulting and testing services.
While providing maternal health care, medical and health institutions should actively provide information on preventing mother-to-child transmission of AIDS and counseling before HIV antibody testing, and suggest and mobilize pregnant women to receive AIDS testing; Provide information about the risk behaviors of HIV infection and conduct risk behavior assessment.
In accordance with the requirements of the national AIDS testing technical specification, provide AIDS antibody testing services for pregnant women. Emphasis should be placed on early detection during pregnancy, and the infection status should be clarified as soon as possible. See annex 1 for HIV testing and service flow of maternal health care.
Provide post-test counseling services according to the results of HIV antibody testing. Explain the test results; Provide information on preventing AIDS infection and changing risky behaviors; Provide contraceptive guidance, maternal health care, intervention measures to prevent mother-to-child transmission of AIDS and referral services.
2. Health care for pregnant women infected with HIV
Provide routine health care and follow-up for pregnant women infected with HIV during pregnancy, delivery and postpartum, and strengthen services such as pregnancy health care, safe sex guidance, nutritional support, monitoring of AIDS-related symptoms and signs, hospital delivery, feeding guidance, postpartum contraception, psychological support and family protection guidance. For pregnant women who choose to terminate pregnancy, provide artificial termination service and give effective contraceptive guidance. Follow-up management of women infected with HIV after delivery into the local comprehensive AIDS prevention and control system.
3. Application of anti-HIV drugs
Provide free antiviral drugs for pregnant women infected with HIV and their babies. Closely monitor AIDS-related symptoms and signs, and carry out CD4 cell detection in areas where conditions permit. According to the disease development degree, immune status and antiviral treatment of infected pregnant women, taking into account the needs of pregnant women's own health and prevention of mother-to-child transmission, choose the appropriate antiviral drug scheme (see Annex 2).
Provide consultation and guidance on the application of antiviral drugs and related monitoring to ensure that infected pregnant women and their babies use drugs in a timely, full-course and standardized manner. Before starting to use antiviral drugs, pregnant women infected with HIV and their families should be fully informed of the importance of adhering to the standard use of antiviral drugs and related information to improve drug compliance; During medication, maternal blood routine, liver, renal function and immune status should be monitored regularly, drug resistance and side effects should be paid close attention to, follow-up after antiviral drugs are used should be strengthened, and treatment or referral services should be provided if necessary.
4. Provide appropriate and safe midwifery services.
Mobilize pregnant women infected with HIV to give birth in hospital, provide appropriate midwifery services, prevent mother-to-child transmission of AIDS, try to avoid destructive operations that may increase the risk of mother-to-child transmission of AIDS, and reduce the probability of child infection during delivery.
5. Infant feeding
For babies born to HIV-infected mothers, artificial feeding is advocated, breastfeeding is avoided, and mixed feeding is put an end to. To evaluate the acceptability, suitability, affordability, sustainability and safety of artificial feeding, provide scientific guidance and follow-up for infant feeding, minimize the mother-to-child transmission caused by feeding, and ensure the normal growth and development of children.
6. Health care for children born to HIV-infected mothers
Provide targeted care for newborns born to HIV-infected mothers, provide infant feeding guidance, carry out routine child care, strengthen growth and development monitoring and prevent malnutrition. According to the national immunization requirements, children born to mothers infected with HIV are immunized. When the immunization program is not completed, attention should be paid to avoiding contact with patients with tuberculosis, measles and polio, and avoiding going to crowded places.
Strengthen the follow-up service for children born to HIV-infected mothers, so that they can receive HIV antibody testing at the age of 12 months and 18 months, and make clear the HIV infection status. See annex 1 for the service flow of infant follow-up and testing. In conditional areas, infants can be diagnosed and tested at the same time, so as to provide corresponding services as soon as possible.
7. Provide care and support
Medical and health institutions, communities and other relevant institutions and organizations shall, according to the characteristics and contents of their services, provide consultation, psychological support, comprehensive care and referral services for pregnant women and their families infected with HIV, reduce the impact of AIDS on women, children and their families, reduce discrimination and improve the quality of life of women and children infected with HIV.
(four) to strengthen organizational management and service capacity building, to ensure the smooth implementation of the prevention of mother-to-child transmission of AIDS.
Clear division of labor, strengthen institutional construction, carry out personnel training, standardize laboratory testing, improve the service capacity of medical and health institutions and personnel at all levels, and ensure the implementation of various measures to prevent mother-to-child transmission of AIDS.
1. Organization and division of labor
The Department of Maternal and Child Health and Community Health of the Ministry of Health is responsible for the specific organization and coordination of the prevention of mother-to-child transmission of AIDS under the overall organization and coordination of the Office of the the State Council AIDS Prevention Working Committee.
The Maternal and Child Health Center of China Center for Disease Control and Prevention undertakes the technical guidance for the prevention of mother-to-child transmission of AIDS, organizes the national expert technical guidance group, and formulates the work plan and implementation plan; Prepare training materials for teacher training; To supervise, inspect and evaluate the development of local work; Responsible for information collection and analysis; Organize experience exchange and promotion; Carry out scientific research related to the prevention of mother-to-child transmission of AIDS.
Provincial, city and county maternal and child health administrative departments are responsible for the organization and coordination of the prevention of mother-to-child transmission of AIDS in their respective jurisdictions, and do a good job in the implementation of related work.
Provincial, municipal and county-level maternal and child health care institutions undertake technical guidance on the prevention of mother-to-child transmission of AIDS in their respective jurisdictions, form an expert technical guidance group, supervise and inspect the progress of work, and train personnel; Responsible for the collection, collation, reporting, analysis and feedback of relevant information in the region.
Medical and health institutions at all levels that provide maternal health care and midwifery technical services are responsible for implementing technical services to prevent mother-to-child transmission of AIDS, participating in and receiving relevant technical guidance and training, and collecting and reporting relevant information.
2. Strengthening institutional capacity building
Medical and health institutions at all levels that provide maternal health care and midwifery technical services shall provide services in accordance with the requirements and service processes for preventing mother-to-child transmission of AIDS. Strengthen the management, technology and infrastructure construction to prevent mother-to-child transmission of AIDS, and improve the comprehensive service capacity to prevent mother-to-child transmission of AIDS.
3. Personnel training
Provide knowledge and service skills training to all relevant personnel who undertake the service of preventing mother-to-child transmission of AIDS. The training targets include local maternal and child health care and prevention of mother-to-child transmission of AIDS authorities, health administrative departments and managers of relevant institutions and related professional and technical personnel. According to the actual needs, the training content can be determined, or the national unified training materials can be compiled by the central expert technical guidance group. Take various forms to carry out national-provincial-city (prefecture)-county (district)-township-village level-by-level training.
4. Standardized laboratory testing
Medical and health institutions that undertake the work of preventing mother-to-child transmission of AIDS shall carry out HIV antibody testing in accordance with the requirements of the national technical specification for AIDS testing. Equipped with necessary equipment and qualified testing personnel, establish laboratories or AIDS testing points that meet the requirements, improve the testing system, standardize testing operations, integrate resources of relevant departments, and jointly establish an effective and feasible testing process for preventing mother-to-child transmission of AIDS.
5. Prevention of iatrogenic infection and occupational exposure
Medical and health institutions that undertake the work of preventing mother-to-child transmission of AIDS should follow the standard prevention principle and strictly implement the relevant disinfection and isolation system to avoid iatrogenic infection and occupational exposure of medical staff.
According to the requirements of the Ministry of Health's "Guiding Principles for the Protection of Occupational Exposure to HIV for Medical Staff", establish and improve the protection and emergency mechanism for occupational exposure to HIV. In case of occupational exposure, emergency measures should be taken, the competent leaders should be informed, local disease prevention and control institutions should be contacted, exposure levels and exposure sources should be assessed and determined, registration should be made, preventive drugs should be used correctly, and epidemiological monitoring should be accepted.
Third, information management.
Establish and improve the management information system for preventing mother-to-child transmission of AIDS, and gradually improve the information management and reporting system. Designate a person to be responsible, strengthen the collection, reporting, review and management of information, improve the timeliness, completeness and accuracy of information reporting, and improve the analysis, utilization and feedback of information.
Information related to the prevention of mother-to-child transmission of AIDS includes relevant reports and various registrations. The report includes the monthly report on the prevention of mother-to-child transmission of AIDS, the basic information registration card of HIV-infected pregnant women/women undergoing premarital examination, the registration card of HIV-infected pregnant women and their babies, and the follow-up registration card of HIV-infected pregnant women and their children. All kinds of registration include premarital health care outpatient registration, pregnancy health care outpatient registration, delivery registration and HIV antibody positive pregnant women's test results report, health care manual, medical records, follow-up records and so on.
For pregnant women infected with HIV and women undergoing premarital examination, report the epidemic situation of infectious diseases in accordance with the requirements of the Law of People's Republic of China (PRC) on the Prevention and Control of Infectious Diseases and the Management Specification for AIDS Epidemic Information Reporting, and fill in the relevant reports on the prevention of mother-to-child transmission of AIDS and a series of case registration cards. See Annex 3 for reporting procedures and requirements.
Four. Monitoring, guidance and evaluation
Establish a national, provincial, city (prefecture) and county-level supervision, guidance and evaluation system for the prevention of mother-to-child transmission of AIDS. The Ministry of Health and the national technical guidance department are responsible for formulating the supervision plan for the prevention of mother-to-child transmission of AIDS, and conducting regular spot checks and supervision. Local health administrative departments at all levels should formulate local supervision plans according to the annual work plan and the national supervision plan, regularly organize self-examination, supervision and guidance, evaluate the work of preventing mother-to-child transmission of AIDS within their respective jurisdictions, and continuously improve the quality of the work of preventing mother-to-child transmission of AIDS.
Attachment: 1. Service process of preventing mother-to-child transmission of AIDS
2. Application scheme of antiviral drugs to prevent mother-to-child transmission of AIDS
3. Reporting process and requirements of related reports on prevention of mother-to-child transmission of AIDS
Reference content: http://202.96.155.163/wsj/fs/ygzl/doc5296.doc.