Health Promotion for Women and Children and Genetic Health

1 Genetic Health
Congenital anomalies are the second leading cause of death of the newborns and infants. In accordance
with the Genetic Health Act, services such as premarital health examination, genetic counseling, prenatal genetic diagnosis, screening of the newborns and genetic counseling are promoted. In 2004, 99% of the newborns, or 216,317 of them, had been screened for congenital metabolic disorders, to detect in them 1,785 anomalous cases. In the same year, 20,936 pregnant women had been given prenatal genetic diagnosis; and 78% of those above the age of 34 years had accepted amniocentesis. 12,929 cases of individuals of suspected genetic diseases in themselves or in families had undergone further genetic examination. Eleven genetic-health counseling centers, twenty-six clinical cytogenesis laboratories and seven clinical genetic laboratories had been certified.

2. Care of Spouses of Foreign Origins and their Children
In 1998, 13,904 children were born to spouses of foreign origins (including those of mainland China, Hong Kong and Macau), accounting for 5.12% of the total number of births. In 2004, this figure went up to 30,142 children, accounting for 13.93% of the total. In other words, for every 7.5 children born, one is born to spouse of foreign origin (including those from mainland China, Hong Kong and Macau). To provide them with reproductive healthcare services, a health-card management system at the primary level has been established. In 2004, cards had been established for 97.37% of those spouses. The newborns born to spouses of foreign origins and the mainland China that were accepted for management were 5,426 (54.39% of those registered) and 2,969 (57.09% of those registered), respectively; they were included for follow-up management. Children are also screened for retarded development. In 2004, 44,003 children of 0-3 years born to spouses of foreign origins and the mainland China had been screened; of them, 294 were suspected abnormal, 288 were reported and referred, and 120 confirmed. A booklet, Child Care and Health Promotion
Manual, in Vietnamese, Thai, Indonesian, English and Cambodian languages has been developed for the use of spouses of foreign origins and health workers. In Yunlin and Hsinchu counties, a project to recruit and train volunteers of foreign origins tohelp staffs of the health stations is going on. They can communicate with their fellow country people in their own language and thus facilitate communication.

3. Health Promotion for Pregnant Women,
Infants and Young Children
To create a more mother-friendly environment for child delivery, a pilot project, Operational Standards on Humanitarian Child Delivery, was commissioned out. The project focused on delivery plan, development of health education materials on care during the process of child delivery (for medical- nursing personnel, and for the general public), and a manual on the practice of mother-friendly delivery. A recording system for epileptic pregnant women has been set up and health education given to them. The Health Manual for Pregnant Women has been revised to give women more information about pregnancy and also for keeping record of the process of pregnancy. An overall effort has been made to establish an obstacle-free breast-feeding environment, including subsidizing and encouraging private sector organizations, companies and business establishments to set up breastfeeding (collecting) rooms, promoting certification of baby-friendly medical care institutions, recruitment and training of breastfeeding community volunteers, establishing supporting groups, and building breastfeeding friendly environment at work sites. The use of stool identification card for the screening of infants with Cholestasis and the referral and follow-up of abnormal cases has been promoted. In 2004, through the screening, 27 cases of bile tract obstruction had been detected. To continue the care and follow-up of premature babies after discharge from hospital, databanks on premature babies and follow-up and referral procedures have been set up in four medical centers and 19 district hospitals. A working manual on the follow-up examination of premature babies, a manual on home visiting, and another manual for parents of premature babies have also been developed. To understand the growth curve of children, a study to measure physical structures of children 0-6 years has been conducted. Work will be done to amend the existing regulations concerning preventive healthcare for children to increase the number of free health examination from six to nine. The childrens health manual has been revised to include more information on healthcare, preventive healthcare services, and immunization. Training of professional workers in the screening of children of retarded development has been strengthened. In 2004, subsidies were made available to support eight such training courses for 604 participants.
Screening of children of retarded development in remote areas has been intensified. The Chinese Association of Early Untervention Program for Children with Developmental Disability was entrusted to conduct screening of infants and young children, and to train professional workers, four such training courses for 419 participants in 2004.

4. Prevention and Control of Rare Diseases
To strengthen medical care for patients of rare diseases, rare disease patients leading to physical and mental impairment are included in the Physically and Mentally Disabled Protection Act. They are also included in the serious illnesses and injuries in the National Health Insurance to waive their co-payment for medical care. On December 24, 2004, the Legislative Yuan passed the partial amendment of the Rare Disease Control and Orphan Drug Act. Some 128 rare diseases in 108 categories have been recognized through review and announced. A list of 71 orphan drugs for rare diseases and their indications has been announced. A list of 40 special dietary foods for rare disease patients and their indications has been announced. Subsidies have been made to support the establishment of a special dietary food supply center, a drug supply center for rare disease patients. Work has also been done to promote international laboratory testing through collaboration; and to establish a counseling window and databanks. In the period between August 9, 2000 and end of December 2004, a total of 1,674 cases had been reported.

5. The More Children Advocacy
Statistics shows that the total fertility rate of Taiwan was already as low as 1.2 in 2003. To promote willingness for more reproduction, the Department drafted a More Children Advocacy Plan to educate the public through various channels the concepts of reproduction and family value, sharing of responsibilities in a married life by both parties, and love life and value family line. A survey on attitudes toward marriage and reproduction, and a forum on building a high-quality and healthy reproductive environment have been conducted. Various channels of communication have been used to appeal to the younger generations with calls such as, children are hope of the future, give children companies, and have the first child before 30; have the second one before 35.