政府报告：《平等发展共享新中国70年妇女事业的发展》

　　六、妇女健康状况极大改善

　　VI. Women’s Health Condition Has Improved Dramatically

　　妇女儿童健康是全民健康的基石。中国高度重视发展妇幼保健事业，将保障妇女儿童健康纳入国家战略，不断完善妇幼健康法规政策体系。建立覆盖城乡的三级妇幼健康服务网络，大力实施妇幼卫生项目，为妇女提供全生命周期的健康服务，不断提高妇幼卫生服务的公平性、均等化，妇女健康状况显著改善。

　　Health of women and children is the cornerstone of the health of all people. China attaches great importance to the development of maternal and child health care, incorporates the protection of women’s and children’s health into the national strategy, and constantly improves the system of laws and policies on maternal and child health. China has established a three-tier network of maternal and child health services, covering urban and rural areas. China vigorously implements maternal and child health projects, providing full life-cycle health services for women and constantly improving the fairness and equalization of maternal and child health services. As a result, women’s health has significantly improved.

　　妇幼健康法律法规和政策体系不断完善。新中国成立之初，把妇幼健康作为卫生健康事业重要内容，积极推进妇幼保健工作。改革开放40多年来，中国颁布实施母婴保健法等法律法规，将妇幼健康事业纳入经济社会发展总体规划。国家“十三五”规划纲要、“健康中国2030”规划纲要、中国妇女发展纲要和中国儿童发展纲要等，都提出明确的妇幼健康目标措施，将妇幼健康核心指标纳入各级政府目标考核，强化政府主体责任。

　　The system of laws, regulations and policies on maternal and child health has been continuously improved. At the beginning of the founding of the People’s Republic of China, maternal and child health was actively promoted as an important part of health care. Over the past four decades since the reform and opening up, China has promulgated and implemented laws and regulations on maternal and child health, including the Law of the People’s Republic of China on Maternal and Infant Health Care. China has incorporated maternal and child health into its overall economic and social development plan. Many national plans, including the Outline of the 13th Five-Year Plan, the Outline of the Healthy China 2030, the Program for the Development of Chinese Women and the Program for the Development of Chinese Children, all set out specific targets and measures for maternal and child health, incorporate core indicators of maternal and child health into the target assessment of governments at all levels, and strengthen the primary responsibilities of the government.

　　中国特色妇幼健康服务网络不断加强。中国致力于加强妇幼卫生机构建设。自1950年起，在城乡逐步建立以妇幼保健机构为核心、以基层医疗卫生机构为基础、以大中型综合医院专科医院和相关科研教学机构为支撑，具有中国特色的妇幼健康服务网络。改革开放40多年来，中国持续加大基层妇幼保健网络投入，不断完善妇幼保健服务体系，建立了妇幼卫生年报系统和世界上规模最大的妇幼卫生监测网络。党的十八大以来，妇幼保健网络逐步嵌入覆盖14亿人口的医疗保障网和覆盖城乡的三级医疗保健网，妇幼健康信息化建设不断加强。2018年，全国共有妇幼保健机构3080家、妇产医院807家、妇幼保健工作者近64万人，被世界卫生组织列为妇幼健康高绩效的10个国家之一。

　　A network of maternal and child health services with Chinese characteristics has been improved. China is committed to strengthening the construction of maternal and child health institutions. Since 1950, a network of maternal and child health services with Chinese characteristics has been gradually established in urban and rural areas, with maternity and child care institutions as the core, community-level health care institutions as the foundation, and large and medium-sized medical institutions and relevant research and teaching institutions as the support. Over the past four decades since the reform and opening up, China has continued to increase input in the community-level network of maternal and child health care and improve the service system. China has built an annual reporting system as well as the largest monitoring network in the world on maternal and child health. Since the 18th CPC National Congress, the network of maternal and child health care has been gradually embedded into the medical security network covering 1.4 billion people and the three-tier medical care network covering urban and rural areas. The IT construction of maternal and child health has been strengthened. In 2018, there were 3,080 maternal and childcare institutions, 807 maternity hospitals and nearly 640,000 maternal and childcare workers throughout the country. The World Health Organization lists China as one of the 10 countries with high performance in maternal and child health.

　　妇幼健康服务公平性、可及性逐步提升。新中国重视保障母婴安全，积极推广新法接生，防治危害妇女身心健康的严重疾病。改革开放40多年来，中国积极推广婚前医学检查，提供全方位孕期保健服务，全面推广普及住院分娩，积极推进产后保健服务，加强孕产妇系统管理，逐步建立起系统规范的孕产妇管理制度和服务模式，有效保障了孕产妇健康。从2000年起，相继实施降低孕产妇死亡率和消除新生儿破伤风、农村孕产妇住院分娩补助、预防艾滋病梅毒乙肝母婴传播、农村妇女“两癌”检查、免费孕前优生健康检查等妇幼重大公共卫生服务项目。2009年起，实施国家基本公共卫生服务项目，人均补助经费由最初的15元提高到2018年的55元，免费提供包括孕产妇健康管理在内的14类基本公共卫生服务。2018年，全国孕产妇住院分娩率为99.9%。截至2018年底，农村妇女“两癌”检查项目为超过8500万名妇女免费提供宫颈癌检查，为2000万名妇女免费提供乳腺癌检查，仅妇联系统救助贫困患病妇女10.22万人。

　　Maternal and child health services have become more equitable and accessible. New China attaches great importance to the safety of mothers and infants, actively popularizing new methods of delivering babies, and preventing and controlling serious diseases that endanger women’s physical and mental health. Over the past four decades since the launch of reform and opening up, China has actively promoted pre-marital medical examination, provided comprehensive pregnancy health care services and popularized hospital childbirths. China has also improved postpartum health care services, strengthened the systematic management of pregnant and lying-in women, and gradually established systematic and standardized management systems and service models for pregnant and lying-in women, effectively protecting their health. Since 2000, major public health services for women and children have been implemented to reduce maternal mortality and eliminate neonatal tetanus. The state has subsidized hospital childbirths for rural pregnant women and carried out major projects on preventing mother-to-child transmission of HIV/AIDS, syphilis and hepatitis B. China has also launched the program of free cervical and breast cancer screening for rural women, providing free pre-pregnancy health check-ups. Since 2009, China has implemented the national program for basic public health services, increasing the per capita subsidy from 15 yuan in 2009 to 55 yuan in 2018, and providing 14 types of free basic public health services, including maternal health management. In 2018, the national hospital birth rate increased to 99.9%. By the end of 2018, the program of free cervical and breast cancer screening for rural women has provided free cervical cancer screening for more than 85 million women and free breast cancer screening for 20 million women. The system of women’s federations alone has helped 102,200 women having financial difficulties.

　　妇女生殖保健服务不断加强。制定出台法规政策和规划，实施生殖健康项目，不断提高妇女生殖健康水平。20世纪90年代，积极开展以人为本的计划生育优质服务，推进避孕方法知情选择，尊重和保护妇女生殖健康权益。党的十八大以来，中国调整完善生育政策，强化计划生育优质服务。2016年发布《“十三五”卫生与健康规划》，实施免费计划生育技术服务基本项目，普及避孕节育、优生优育和生殖健康知识，提高药具服务的可及性和便捷性，做好再生育技术指导服务，提高生殖健康水平。2018年印发《母婴安全行动计划》《人工流产后避孕服务规范》，开展妊娠风险防范、危急重症救治、质量安全提升、专科能力建设、便民优质服务五大行动，特别是为农村计划怀孕夫妇免费提供健康教育、健康检查等孕前优生服务。开展流动人口计划生育基本公共服务均等化试点，为流动妇女提供孕产妇保健服务。

　　Reproductive health services for women have been further strengthened. China has enacted relevant laws, policies, and plans to improve women’s reproductive health. In the 1990s, China launched people-oriented services for family planning, promoted informed choice of contraceptive methods and protected women’s rights and interests of reproductive health. Since the 18th National Congress of the CPC, China has adjusted and improved its family planning policy and strengthened the quality of family planning services. In 2016, the 13th Five-Year Plan on Health Development was released to implement basic programs of free technical services for family planning, popularize the knowledge of contraception, healthy childbirth and child rearing, and reproductive health, improve the accessibility and convenience of pharmaceutical services, enhance reproductive technical guidance services, and lift the level of reproductive health. In 2018, China issued the Maternal and Child Safety Action Plan and the Codes of Contraceptive Services after Induced Abortion to implement five major actions consisting of lowering pregnancy risk, treating severe diseases, improving quality and safety, empowering specialist capacity, and providing convenient and high-quality services for women. The country offers free pre-pregnancy health services including health education and health examination to rural couples who plan for pregnancy. China has launched pilot programs to ensure equal access to family planning and other basic public services by women in the migrant population, and has provided maternal health services for women in the migrant population.

　　妇女健康水平持续提高。2015年，妇女平均预期寿命为79.4岁，比1981年提高了10.1岁，比新中国成立时提高了42.7岁。孕产妇死亡率持续降低，提前实现联合国千年发展目标。2018年，全国孕产妇死亡率为18.3/10万，比1990年的88.8/10万大幅下降了79.4%(图5)。城乡差距不断缩小，城市与农村孕产妇死亡率之比从1990年的1∶2.2下降到2018年的1∶1.3。

　　Women’s health has further improved. Women’s average life expectancy grew to 79.4 years in 2015, an increase of 10.1 years over 1981 and 42.7 years over 1949 when New China was founded. The maternal mortality rate has fallen 79.4% from 88.8 per 100,000 in 1990 to 18.3 per 100,000 in 2018 (see Chart 5), meaning that China has achieved the United Nations Millennium Development Goals ahead of time. The gap between urban and rural areas has been further narrowed: the ratio of urban to rural maternal mortality decreased from 1:2.2 in 1990 to 1:1.3 in 2018.