Introduction of Women Health

Introduction of Women Health

Liqian Qiu Dept. Women’s Health

OB/GYN Hospital, School of Medicine, Zhejiang University

What women’s health is studying

• Definition: Maintaining and promoting women’s reproductive health. The target people are women population not individual.

• Purpose: To study the different health problem in women’s different life stage from childhood to ageing.

Importance of Women’s Health1.Half of Population2.Women’s health will influence next

generation; they have major responsibility of family planning in culture.

3.Women usually have lower social, economic status, less education, low employment rate, less health care.

4.Women have some special physiological periods: puberty, prenatal, labour, postpartum, breastfeeding, menopause.

Women’s Health Study Task

1. Decrease mobility and mortality( 降低发病、死亡率）

2. Control some genetic disease and STD spread

3. Promoting the women’s physical and

psychological health. （促进心身健康）

What progress we made so far

• NEJM 2011, (Are we making progress in MMR?)• Diminishing STD, Cervical cancer • Increasing expectancy life time.

Working method

• There are some specific methods to study women’s health which is difference from basic and clinic medicine. This is a edge subject.(between clinic and prevent medicine)

• Ternary net works, group people involving (administration, health work, medical specialist)

Main Work1 ． Health clinic for different reproductive stage

women.2 ． Investigation: the factors which influence

women’s health. 3 ． Common gynecological disease prevention.

(screening and treatment )4 ． Establishing all kinds of rules, regulations,

procedure to protect women’s health5 ． Education (all channels)6 ． Maternal and child health information

collection

Methodology

• Writing protocol, • Training (get training and training other health

worker),• Education,(pamphlets, lecture, board, hotline,

internet, broadcast….) • Either for population and individual. （人群和

个体健康）

MCH Administration Structure in China1 ． Government administration from central of

Health Ministry to county level Health Bureau 2 ． Professional institute ： Ternary MCH

hospitals, clinics and station.

Study Subjects

1. women’s physical characteristic in their stage of life.

2. Health care issue for different phase

Puberty Reproductive Health

1. WHO definition: 10-20 years

Characteristics during Puberty

1. Weight and height ： the 2nd fast growth period

2. Development of reproductive organs and the sexual characteristic appearing .

Psychological Development

1 ． Individual thinking

2 ． Changeable emotion 3 ． Sexual attractive

Health Guide ： 1. Balance nutrition

2. Personal hygiene habits 3. Psychological health and health behavior 4. Sexual education

Pre-married healthHealth care before and after getting marry 1. Health guide 2. Health consultation 3. Health examinationFor prevention medicine, it is given more attention from government

and professional. It became free service in whole province since 2009.

Prenatal Health CarePurpose ： Prevent the pregnant complicationContent ：

1. Identify the early pregnancy2. Regular prenatal checking3. Monitoring the fetal developing.4. Treatment of pregnant complication5. Health care, nutrition, genetic disease consulting, prenatal diagnosis

About DoHaD

• 1990’s Prof Barker (UK) gave hypothesis that most adult cardiovascular diseases developed from infant or fetus

• Fetal original disease theory• Developmental Origins of Health and

Disease(DoHaD) 健康与疾病发展起源学说

Health Care in labour

Five protections: (1.prolong of labour, 2.infection, 3.trauma, 4.hemorrhage, 5.asphyxia)

1. Decrease Complication2. Decrease abnormal delivery3.Doula accompany delivery

Postpartum health care

1 ． Body hygiene (vulva, skin, breast).

2 ． Nutrition ,rehibilitation ， exercise.

3 ． Family planning。4 ． Postpartum follow-up and postpartum check.

Breastfeeding Period

1. The central issue of health care in this period is promoting breast milk feeding.

2. WHO/UNICEF launched the ten steps of successful breastfeeding in 1990s.

3. National target of breastfeeding is 85% exclusive breastfeeding in 4 month in all province.

Ten steps of successful breastfeeding• Have a written breastfeeding policy that • Train all health-care staff• Inform all pregnant women about the benefits of breastfeeding• Help mothers initiate breastfeeding within a half-hour of birth.• Show mothers how to breastfeed and how to maintain lactation• Give newborn infants no food or drink other than breast milk• rooming-in 24 hours a day• Demand breastfeeding• Give no artificial teats or pacifiers• Establishment of breastfeeding support groups

WHO Health Care in Life Cycle for women

Multiple external factors influence outcomes of the MCH cycle

Main interventions during pregnancy and early life

Main interventions in childhood, adolescence and reproductive period

Nutrition interventions around the life-cycle – including just before pregnancy

Menopause and Ageing time

Characteristic

The function of ovary is getting weak. Gradually no ovulation.

Health Care Contents for old: 1 ． General health information ． 2 ． Nutrition 3 ． Exercise 4 ． Psychological problem adaption 5. Chronic disease, cancer screening

6 ． Health education 7 ． Hormone replacement therapy.

Aging People Health Care

1 ． Living and working: Try their best to do some house working and exercise. The bottom line is fitting their capability.

2. Eating: high protein, low fat, high fibrinous products.

3 ． Regular living time schedule.

Women common gynecologic disease screening Purpose early diagnosis 早发现 early treatment 早治疗

重大公共卫生项目（ priority public health project) 两癌筛查

Occupation health for women

1. Menstruation2 ． Pregnant3 ． Postpartum period4 ． Nursing period5 ． Menopause

Family Planning

consulting medical doctor 咨询Information giving 普及知识Acceptable method 推广有效措施

Surgery quality 提高计划生育手术质量。

Health Education

• Scientific way to educate the health care knowledge 宣传科学的保健健身方法，破除迷信，

• Different methods 宣传多样化 .• Acceptable for public 通俗易懂 .

Information collection

Basic data registering methods ( 簿、本、表、册等的登记管理工作 )

Common prenatal care indicator 孕产妇死亡率 MMR　早期新生儿死亡率 early neonatal mortality

　 围 产 儿 死 亡 率 Prenatal death rate

　产前检查率 maternal check 　产后访视率 Pastpartum follow up

妊高征发病率 PIH incidence　产后出血率 Hemorrhage incidence 　住院分娩率 hospital delivery rate

　妇女病普查率 women’s disease screening rate

人口出生率 = 出生人口 / 同年平均人口 birth rate

人口自然增长率 = 同年出生人口 – 同年死亡人口 / 某地某年平均人口数 nature population growth rate

Reference

流行病学： Dr. Daniel W. Cramer. Chapter 4, Sec 1,

Novak’s Gymecology, 13th Edition Pg 49-65妇女保健学：

丰有吉 沈铿 妇产科学 第 2 版 第 30 章妇女保健 , 人民卫生出版社 2010.7