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The Behavioral Risk Factor Surveillance System (BRFSS)

Thu, 11 Dec 2025 10:35:00 GMT

Background
To understand the general population's health conditions and risk behaviors and evaluate the effectiveness of projects on health promotion, the Health Promotion Administration (HPA) launched the first Behavioral Risk Factor Surveillance System (BRFSS) in 2007 by referencing to the U.S. BRFSS. This telephone interview survey targets people aged 18 and above in Taiwan, focusing on health issues and behavioral risk factors. Since 2007, BRFSS has been conducted annually to monitor the current status and trends of health conditions and relevant behavior risk factors among people in Taiwan. Due to the increase of mobile phone users in the population, HPA adapted the dual-frame design that combined landline and mobile phones survey in 2021. The HPA has redesigned its survey framework by integrating two previously independent annual telephone surveys—Adult Smoking Behavior Survey (ASBS) and the Behavioral Risk Factor Surveillance System (BRFSS). The redesigned system adopts a biennial cycle, in which tobacco-use surveys are conducted in odd-numbered years and health-promotion behavior surveys in even-numbered years.
To improve representativeness, the survey employs a dual-frame sampling design that combines landline and mobile phone samples. Data collection is conducted through telephone interviews across all four quarters of each year to ensure the timely provision of information needed for policy planning and evaluation.

Aim of the Survey

To monitor the health status of the population, major noncommunicable diseases (NCDs), related health behaviors, exposure to risk factors, health-related knowledge, and the utilization of health services, thereby providing essential evidence for the planning and evaluation of health promotion policies.

Survey Coverage and Target Population

Geographic Coverage
The survey covers all 22 counties and cities in Taiwan, including Kinmen and Lienchiang.
Survey Population
The target population consists of individuals aged 15 and above residing within the survey area. The inclusion and exclusion criteria are outlined as follows:
1.Landline Survey
Individuals are eligible if they reside in any of the 22 counties and cities—including Kinmen and Lienchiang—hold household registration, and live in a household with a landline telephone (including fixed-network numbers). One eligible household member is randomly selected for interview.
The sampling frame excludes telephone numbers belonging to government agencies, military units, hospitals, long-term care institutions, companies, schools, vocational training centers, dormitories, detention centers, and prisons.
2.Mobile Phone Survey
Individuals residing in the 22 counties and cities—including Kinmen and Lienchiang—who possess a personal mobile phone number are eligible for selection. Mobile numbers used exclusively for official or non-personal purposes (e.g., government-issued work phones) are excluded.

Sampling Design

The sampling frame in the landline survey is based on the Chunghwa Telecom residential telephone directory and the National Communications Commission's Code verification and allocation of local exchanges for Fixed Communication Network services as the sampling frame. It was applied the Probability Proportional to Size (PPS) as the sampling method in landline survey.
The sampling is conducted with the Random Digit Dialing (RDD) principle, which selects the prefix firstly, and then randomly selects the last four digits of the telephone numbers with those selected area codes. After phone calls are answered, within-household sampling is conducted to pick up the qualified respondent.
The sampling frame in the mobile phone survey is based on the National Communications Commission's Mobile communication network service user number allocation data. Mobile phone numbers are selected by Random Digit Dialing (RDD). The county's population size selected entries of the last five digits as the sample mobile numbers.

Reference Period for Data Collection

The survey is conducted quarterly each year, with fieldwork generally scheduled for January–March, April–June, July–September, and October–December. The reference period for the survey data is defined by the actual dates on which telephone interviews are completed.

Content of the Survey Questionnaire

This survey is conducted as an anonymous, randomly sampled telephone interview using a structured questionnaire as the data collection tool. Survey modules for each quarter are selected based on policy needs, and the questionnaire is designed accordingly. The survey topics encompass noncommunicable diseases, related health behaviors, exposure to risk factors, and the utilization of preventive and health-care services.

Implementing Agencies
Primary Agency: Health Promotion Administration, Ministry of Health and Welfare.
Supporting Agency: National Police Agency, Ministry of the Interior—165 Anti-Fraud Consultation Hotline, which provides necessary administrative assistance.
Commissioned Unit: A professional telephone survey firm contracted to conduct the interviews.

Data Process and Analysis

To safeguard the rights of respondents and ensure robust data protection, this survey is conducted as an anonymous, randomly sampled telephone interview. The implementation process follows all relevant provisions of the Personal Data Protection Act and the Human Subjects Research Act. All collected data are aggregated for statistical analysis and are not released individually. No respondent can be identified in any survey report, nor can any information be traced back to specific individuals.
The survey data are checked and cleaned before analysis. Post-stratification weighting is applied, and goodness of fit test is used to determine whether the distribution of the respondents in gender, age, and residence matched the target population's characteristics to ensure a good representative of the target population.

Survey Results
Results of the survey are published in the format of survey reports, press releases, and conference or journal papers. Descriptive statistics are accessible from the Statistical yearbook of Health Promotion.

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Healthy Hospitals

Wed, 10 Dec 2025 15:25:13 GMT

To better realize health promotion at hospitals, the HPA encourages nationwide hospitals to join the International Health Promoting Hospitals (HPH) network. Currently, 134 hospitals in Taiwan have become HPH members, making Taiwan the most represented country in the network.

Based on the HPA framework, the HPA further integrates elements such as age-friendliness and smoke-free environments to create its own “Healthy Hospitals” program, which encourages hospitals to provide more diverse health services to the public. Starting in 2024, participating hospitals are formally guided to establish mechanisms to assess the four major NCD risk factors (smoking, physical inactivity, unhealthy diet, and harmful use of alcohol) among their patients and provide preventive care or health education in accordance with the patient’s life stage. These efforts aim to turn hospitals into all-around healthcare providers that are conducive to preventing chronic diseases.

As of 2024, the coverage rate of Healthy Hospitals was 60% nationwide. To increase the participation rate, the HPA has replaced the previous certification requirement with a self-assessment system from 2023. Based on the hospital's level and available resources, we have devised standards for “Medical Centers and Regional Hospitals” and “District Hospitals,” respectively, to monitor the implementation of chronic disease prevention at different levels.

To encourage more hospitals to join the ranks of Healthy Hospitals, the HPA provides annual subsidies for participating institutions to implement chronic disease prevention, management, and health promotion-related tasks. We also offer counseling programs for Healthy Hospital members (such as co-learning groups, expert consultations, and others) to equip them with the capability for health promotion and chronic disease prevention. In addition, we also organize annual award selections to incentivize participation and ensure service quality.

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Asia Pacific liver health leaders and Ministry of Health officials unite in Taiwan to advance hepatocellular carcinoma surveillance and management

Thu, 30 Oct 2025 17:57:00 GMT

TAIPEI, Nov. 6, 2025 /PRNewswire/ -- Senior health officials, clinicians, and policy leaders from across the Asia Pacific region convened in Taipei for the hepatocellular carcinoma (HCC) Leadership & Policy Forum, hosted by the APAC Liver Disease Alliance, the Taiwan Health Promotion Administration and the Taiwan National Health Insurance Administration. The event marked a pivotal moment in regional efforts to combat HCC, the most common type of liver cancer and a major public health challenge across the Asia-Pacific.

During the Forum, the Alliance launched a peer-reviewed publication titled:
"Roadmap for Hepatocellular Carcinoma Surveillance and Management in Asia Pacific," published in Cancers (MDPI). The Roadmap offers concrete, territory-sensitive recommendations to improve early detection, access to care, and multi-stakeholder coordination in the fight against HCC. The publication reflects insights from the HCC APAC Policy Forum held in Bangkok in 2024 and months of collaboration among experts, civil society, and health authorities.

"Asia Pacific carries the highest burden of liver cancer globally, yet effective surveillance and treatment remain fragmented," said Roberta Sarno, Director of the APAC Liver Disease Alliance "This Roadmap provides Ministry of Health officials and practitioners with an actionable blueprint tailored to the region's specific challenges and strengths."

The Forum brought together representatives from Australia, Malaysia, Taiwan, and Thailand, fostering cross-territory learning and policy alignment. Discussions focused on scaling up screening programs, integrating HCC care into national cancer strategies, and leveraging real-world data to improve outcomes.

Building on the outcomes of the Taipei Forum, the Alliance is now collaborating with Ministries of Health across APAC to convene territory-specific HCC roundtables starting in November 2025. These discussions aim to translate the Roadmap's recommendations into national policies and implementation plans.

In parallel, the Alliance has initiated a new regional paper on MASH, MASLD, and liver fibrosis, collaborating with experts to shape evidence-based strategies for early diagnosis and management. The paper is expected to be launched in early 2026.

About APAC Liver Disease Alliance
The APAC Liver Disease Alliance is a multilateral group that unites all stakeholders on the mission to lower the growing burden of liver disease in the APAC region. Its strategic partners include the Coalition for Global Hepatitis Elimination, the Hepatitis Fund, the Harvard Medical School Program in Global Primary Care and Social Change, the Yellow Warriors Society Philippines, the International Liver Cancer Movement, and the Global Liver Institute. Supported by Abbott, AstraZeneca, and Roche, the Alliance is committed to its mission to reduce the growing burden of liver disease in APAC.

SOURCE APAC Liver Disease Alliance

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Three Steps to Prevent Falls in the Elderly

Tue, 01 Apr 2025 12:01:11 GMT

The risk of falls in the elderly is closely related to physical health, environmental factors, and lifestyle habits. To effectively prevent falls, the following "Three Steps to Prevent Falls" can be implemented:
Step 1: Adequate Nutrition and Regular Exercise
It is important to ensure sufficient intake of calories and protein. If necessary, seek advice from a community nutritionist. In addition, regular exercise and strength training help enhance muscle strength, improve the elderly's ability to perform daily activities independently, and increase self-defense ability in case of a fall.
Step 2: Chronic Disease Management and Regular Monitoring
According to the "National Health Interview Survey," 85% of seniors aged 65 and above have at least one chronic disease. High blood sugar and blood pressure can cause dizziness and imbalance. Therefore, it is essential to regularly monitor and track blood pressure, blood sugar, and blood lipid levels to prevent complications.
Step 3: Medication Safety and Self-Assessment
When visiting a doctor, ask for assistance in evaluating medications to avoid drug interactions that may increase the risk of falls. At the same time, use senior health assessment tools to regularly check your health status and detect potential risks early.

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Adult Health Checkups

Tue, 05 Nov 2024 16:33:00 GMT

For the early detection of major chronic diseases and their risk factors to enable early intervention and treatment, the HPA funds medical institutions to provide Adult Health Checkups. These services are available once every five years for people aged 30 to 39 years, once every three years for people aged 40 to under 65 years and annually for those aged 65 and above (with earlier eligibility for Indigenous people from 55 years old and polio patients from 35 years old).The checkup items include health behavior surveys, physical examinations, blood tests, urine tests, and health consultations. These measures effectively assess six essential indicators, including blood pressure, blood sugar, blood lipids, kidney function, liver function, and body weight. Regular checkups and continuous monitoring of the changes in health indicators are critical to health management and promotion. For those without clinical symptoms of three highs (hypertension, hyperglycemia, hyperlipidemia) and other cardiovascular diseases, the program can help them detect health problems early to enable early diagnosis, intervention, treatment, and disease management, thereby preventing the occurrence and worsening of the disease.On the other hand, in alignment with the World Health Organization’s goal of eliminating hepatitis B and C by 2030, the scope of hepatitis B and C screening has been expanded to include individuals born before 1986, up to the age of 79 for a one-time free screening for life.

According to HPA’s implementation data, the national Adult Health Checkups utilization is nearly two million people (about 30% of the eligible population). However, in recent years, due to rapid aging and the impact of the COVID-19 pandemic, the utilization rate has slightly declined but still remains near 30%. In 2021, among recipients of Adult Health Checkups over 40 years old who reported no history of three highs, heart disease, or stroke, 25.0%, 21.6%, and 8.3% were newly found to have abnormal blood .lipid, blood pressure, and blood sugar, respectively, through Adult Health Checkups. Aside from the public-funded Adult Health Checkups, people in Taiwan also have numerous other channels to check their health, including those designed employees, workplaces, and public servants. In June 2025, the hepatitis C screening and medical examination achieved a coverage ratio of 70%, corresponding to about 7.5 million people. According to HPA’s 2017 National Health Interview Survey, 60.2% of people over 40 years old had their health checked through either one of those programs.

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Preventing Heat-Related Illness

Mon, 08 Jul 2024 17:35:26 GMT

●6 High-Risk Groups

Although heat-related illness can affect everyone, some people are at greater risk than others. These include infant and young children, people 65 years of age or older, people with chronic illnesses, people on medicine, those who work outside (such as food delivery workers or athletes), and people who are overweight. Because of the high temperatures, these high-risk groups are more susceptible to heat-related illness.

●3 Tips to Prevent Heat-Related Injuries

To prevent heat-related injuries, please note the following:

1.Stay Cool:

(1) Choose lightweight, light-colored, loose-fitting, and breathable clothes.

(2) Never leave infant and young children alone in a closed, parked car, regardless of the duration.

(3) Stay indoors in cool, well-ventilated, or air-conditioned places whenever possible. If there is no air conditioning at home, consider going to public places with air conditioning during periods of high temperature.

(4) Install window shades and blackout curtains indoors to avoid direct sunlight and turn off unnecessary lights and electrical appliances to prevent generating more heat.

(5) Employers should enhance ventilation or use air conditioners to isolate high-temperature facilities at the workplace and provide cooling devices to reduce heat exposure in the work area.

2.Stay Hydrated:

(1) Maintain hydration at all times, regardless of your level of physical activity and do not wait until you feel thirsty. Develop the habit of drinking at least 2,000 cc of plain water daily. However, if a doctor advises limited fluid intake, consult them about the appropriate amount to drink in hot weather.

(2) Those who work outside or are athletes should drink 2 to 4 cups (240 cc per cup) of plain water per hour and avoid smoke and alcohol.

(3) Consume adequate fruits and vegetables. They are high in water, vitamins, minerals, and dietary fiber, all of which can help to improve your health.

(4) Avoid drinks with alcohol and high sugar content to prevent dehydration.

(5) Avoid drinking extremely cold water to prevent stomach discomfort.

3.Stay Vigilant:

(1) Monitor your own and colleagues' physical condition during outdoor activities, take proper breaks, and maintain hydration.

(2) Infants, young children, and elderly individuals should avoid outdoor activities between 10 AM and 2 PM. If necessary, stay in shaded areas, use sunscreen, and wear wide-brimmed hats and sunglasses.

(3) Keep an indoor thermometer to monitor the temperature, avoid excessive heat, and stay updated with weather forecasts to plan outdoor activities on cooler days.

(4) Ensure that air conditioning and related equipment at home and work are in good working condition.

(5) In work environments, employers should provide a suitable work environment and related protective measures, promote heat injury prevention, adjust work schedules, and arrange relevant courses to help employees recognize the symptoms of heat injuries and strengthen preventive actions.

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ICOPE: bring local partners together to promote and implement services of assessments

Fri, 15 Dec 2023 18:56:45 GMT

Taiwan is one of the fast aging countries, in order to prevent functional decline in the elderly, we followed the principles of Integrated Care for Older People (ICOPE), developed by the World Health Organization (WHO), to establish our own model and facilitate ICOPE assessments for older people in 2020.

There are six key intrinsic capacities in the ICOPE, covering cognitive functions, mobility, nutrition, hearing, vision, and depression status. We have a payment scheme to service providers, mainly medical institutes, through local health authorities, who are supposed to monitor the service quality. We designed a standardized form including questions assessing six perspectives, with our own modification according to native culture, for clinical staff to carry out.

Those who are assessed abnormal, will be taken care of by according to their level of capacity loss. Local health authorities were asked to inventory their community resources which are beneficial to restore the intrinsic capacities, and refer those who are in need, then may be followed up and reassessed based on their situations.

As of end of 2023, we have around 1,000 medical institutes, such as pharmacies, clinics, optometry clinics, physical therapy facilities, and hospitals etc., to provide ICOPE services, and the amount of elderly who have been assessed was more than above 222 thousands people. These numbers continue to rise.

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Introduction of Aging and Chronic Disease Control Division

Thu, 23 Nov 2023 14:18:37 GMT

Aging and Chronic Disease Control Division (ACDCD; called 慢性疾病防治組 in traditional Chinese) is an official and governmental unit in Health Promotion Administration (HPA) in Taiwan. We take charge of prevention and control of chronic diseases, such as cardiovascular diseases, hypertension, hyperlipidemia, diabetes, chronic kidney disease, metabolic syndrome, and so on.

There are three sections in the ACDCD. First section mainly promotes health policies through institutes and platforms, like local health bureau, health centers, clinics and hospitals; Second section is responsible for adult and elderly preventive health Care, reducing occurrence of chronic diseases by prevent and discover early; Third section focuses metabolic syndrome, diabetes and chronic kidney disease, and take actions and methods to teach patients to control their chronic diseases and avoid the worsening of the condition.

In order to prevent and early discover adults who have chronic diseases, we provided preventive healthcare service, as known as regular health check-up, including physical examinations, blood and urine tests, and health consultations. Besides that, we also introduced Integrated Care for Older People (ICOPE) to prevent and delayed from elders disability, and provided integrated evaluations covering cognitive functions, mobile abilities, nutrition, hearing abilities, vision, and depression status.

Due to the increasing prevalence of major chronic disease in Taiwan, we has set metabolic syndromes, diabetes, cardiovascular diseases, and chronic kidney diseases, amongst others, as the preventive foci of chronic diseases. Chronic diseases can negatively affect health in the long term, and also worsens gradually. Therefore, we has stipulated preventive goals for major chronic diseases, including:

Prevent, decrease, and delay the occurrence of chronic disease.
Improve and maintain the health of middle-aged and elderly people.
Create and enhance healthy environment in medical institutes.

Please refer our other articles to learn more about policies and services HPA conducted for major chronic diseases. Feel free to contact us by writing a letter if you have any questions and assistances. We also welcome any opportunities to communicate and interact with you in the future.

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Metabolic Syndrome Management Program

Mon, 12 Jun 2023 18:17:50 GMT

Metabolic Syndrome Management (MetS) Program

Key features

1.Focusing on Metabolic Syndrome and pre-disease patients

2.Introduce lifestyle changes as a viable alternative to medications and central to medical services.

3.Recruitment via existing outpatient and checkup practice.

4.Instructions with curated teaching materials and evidence-based risk assessment tools.

5.Assist patients in achieving self-imposed health targets.

Prevalence of metabolic syndrome

Taiwan’s adult health checkup reveals that 3.7 out of 10 adults aged above 40 have metabolic syndrome. Having this disorder means that people are metabolically abnormal but have yet been diagnosed with a particular disease. However, those people are already at a significantly higher risk of catching heart disease, diabetes, stroke, or other chronic illnesses and thus warrant great attention.

Lifestyle changes: Key to reversing course

Research shows that the occcurence of metabolic syndrome can be largely attributed to behavioral factors such as diet, activity level, or tobacco use. But with appropriate interventions, people are empowered to adopt a lifestyle by quitting smoking, changing their diet, and monitoring their health regularly, which will improve the underlying disorders and prevent them from contracting a disease.

Results of cross-departmental cooperation

Health Promotion Administration (HPA) rolled out the MetS program in 2022 in partnership with National Health Insurance Administration (NHIA) to incorporate lifestyle intervention as part of the existing outpatient medical and checkup services. Participating medical providers and personnel may claim payments for identifying and enrolling pre-disease patients to the program. Those whose patients show improvements in the respective metrics will receive additional performance rewards.

Latest progress

As of the end of 2024, around 4,600 physicians at 2,800 clinics nationwide had enrolled over 270,000 patients.

Potential outcome

With health instructions, proactive health management, and monitoring, we look forward to empowering patients to turn around their health. The outlook here is promising, as corroborated by experience from the US DPP (Diabetes Prevention Program). The patients at a pre-diabetes stage could reduce up to 58% of disease risk in three years following interventions in the form of weight loss, dietary change and increase in physical activity.

Ultimately, the goal is to create a new social dynamic where people start viewing lifestyle interventions as the go-to means for addressing chronic conditions and proactively seek help from cessation providers, dieticians, or exercise specialists, which will be the key to eliminate the current over-relience on medications and excessive use of the health system.

Design & implementation of the MetS program

Providers’ eligiblity:

1.Clinics: A certified provider of Adult Health Checkup

2.Physicians:

Meeting either 1 of the 2 requirements:
I. Being a family physician, internist, or engaging in Adult Health Checkup or Diabetes Shared-care Program;
II. Having completed a 4-hour introductory traning.

Targeted risk factors and corresponding interventions:

Behavioral:

1.Smoking

I. Instructions on smoking cessation.
II. Referral to a certified smoking cessation provider for more care (provided in-house when available).

2.Betel quid use

I. Instructions on betel quid cessation.
II. Referral to oral mucosa examination (provided in-house when available)

Health measurements:

1.Waist circumfence and BMI
Instructions on diet, exercise, and waist circumfence control.

2.Blood pressure
Instructions on diet, exercise, and blood pressure measurement.

3.Blood sugar
Instructions on diet, exercise, and blood sugar management.

4.Blood fat
Instructions on diet, exercise, and blood fat management.

Work and payment schedule

Base payments:

1.Case enrollment (900 NTD):
Eligibility confirmation, profile creation, risk factor profiling, risk assessment, insturction provision, and assist patients in determining health targets.

2.Follow-up (200 NTD):
Contact the patients via phone call, outreach visit, or clinic appointment, each at least 12 weeks apart, to monitor the progress and provide additional instructions and resources.

3.Yearly evaluation (500 NTD):
Thoroughly evaluate the patient’s progress in the 5 metabolic indicators, following at least 3 follow-ups and at least 12 weeks apart from the previous follow-up.

Reward payments:

1.Yearly clinic performance (5,000 to 10,000 NTD, varied by relative performance):
Based on a clinic’s cummulative outcome of all cases it enroll within the calendar year.

2.Discovery of an undiagnosed patient (150 NTD):
For enrollment of a chronic disease patient under 40 that had not been previously diagnosed to the MetS program.

3.On target or improvement (500 NTD)
Patients have any 3 of the metabolic indicators meeting the self-imposed targets or showing significant improvement.

4.Full completion (1,000 NTD):
Patients have any 3 of the metabolic indicators within the reference range, stopped relevant medications, and been discarged from the program.

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Foreword

Thu, 03 Jun 2021 11:00:00 GMT

Achieving a 30% reduction in tobacco use in advance of the WHO’s 2025 NCD target date, Taiwan saw the smoking rate among adults above the age of 18 fall from 21.9% in 2008 to 12.8% in 2024. Thanks to gradual expansion of nonsmoking areas, the nation also posted a significant decline in the secondhand smoke exposure rate for adults above the age of 18 in indoor public areas from 27.8% in 2008 to 2.9% in 2022. Meanwhile, the secondhand smoke exposure rate in both indoor and outdoor public nonsmoking areas also decreased considerably, from 23.7% in 2008 to 4.0% in 2022. Bans on smoking have achieved a protective efficacy of 96% in preventing exposure to secondhand smoke through the designation of nonsmoking areas. Furthermore, the e-cigarette use rate among people over 18 was 1.4% in 2022, down from 1.7% in 2020 (for more statistics from the Health Promotion and Behavioral Risk Factor Surveillance for people over the age of 18, please refer to the HPA’s Statistics of Health Promotion).

Fifteen years after the 2009 amendment to the Tobacco Hazards Prevention Act, it was recognized that there was a regulatory deficiency in addressing e-cigarettes and other new varieties of tobacco products that were increasingly harming public health, especially among adolescents. Consequently, the Ministry of Health and Welfare initiated another amendment to the Tobacco Hazards Prevention Act. Its third and final reading by the Legislative Yuan on January 12, 2023 was followed by presidential promulgation on February 15, 2023 and the Executive Yuan announcement of its implementation from March 22, 2023. Key points of the amendment include a comprehensive ban on the manufacture, import, sale, supply, display, advertisement, and use of all types of imitation tobacco products, including e-cigarettes. Meanwhile, before manufacturing or importing designated tobacco products announced by the Ministry of Health and Welfare (MOHW), manufacturers and importers shall apply to MOHW for the health risk assessment review. The essential components needed to be used in conjunction with the designated tobacco products will also be reviewed. Other key revisions include expanding smoking-free public places, both indoor and outdoor, to include universities, kindergartens, childcare centers, and home-based childcare facilities; banning smoking in bars and nightclubs except in indoor smoking rooms with independent air conditioning systems and separate compartment; raising the minimum smoking age to 20; expanding the area of health warning texts and images on tobacco packages shall not be less than 50% of each labeling surface; prohibiting the use of additives banned by the central competent authority; and with stiffened penalties for violations. The HPA collaborates with local governments to strengthen inspections of the market and the internet, imposing severe penalties on violators according to the law. At the same time, we continue to promote smoking-free workplaces and support corporate efforts in introducing smoking cessation services to the workplace.]]>

Continued enforcement of the “Tobacco Hazards Prevention Act”

Thu, 03 Jun 2021 00:00:00 GMT

We have continued to enforce the Tobacco Hazards Prevention Act by conducting inspections, providing educational programs on tobacco hazards prevention for specific groups, bolstering advocacy efforts, expanding the network of smoking cessation services, and promoting tobacco hazards prevention initiatives in communities. These methods encourage people to comply with the Tobacco Hazards Prevention Act to achieve a more comprehensive smoke-free environment.

(1) Procactive enforcement, inspection and guidance
County and city health bureaus have taken the initiative in enforcing the act and in conducting inspections and offering guidance reflecting inspection results. In 2024, more than 610,000 entities were inspected nationwide, totaling over 7.77 million inspections. A total of 8,318 penalties were imposed, resulting in fines amounting to over NT$338 million. Fines imposed for 3,374 cases violating the provisions of Imitation tobacco products and designated tobacco products set forth in Article 15 of the Tobacco Hazards Prevention Act exceeded NT$307 million.
(2) Training for raising professionalism in tobacco hazards prevention
The HPA has improved the quality of tobacco prevention work by organizing workshops, seminars, and training sessions, as well as compiling guidelines for law enforcement. Additionally, education and training is provided for tobacco hazards prevention volunteers.
(3) Tobacco Hazards Complaints Hotline: Working together to protect all
The HPA operates a “Tobacco Hazards Complaints Hotline” at 0800-531-531 to address public inquiries and reports related to the Tobacco Hazards Prevention Act. Cases involving illegal activities were referred to county and city health bureaus for investigation and carry out enforcement in accordance with the law and regulations.
(4) Active promotion of the amendment of related laws to build a tobacco-free environment
The amendment of Tobacco Hazards Prevention Act passed the third reading in the Legislative Yuan on January 12, 2023, promulgated by President on February 15, 2023 and the effective date was March 22, 2023. The amendment consists of the following key points:
i. Banning all kinds of imitation tobacco products, including electronic cigarettes.
ii. Designated tobacco products shall be applied to the central competent authority for the health risk assessment review (e.g. heated tobacco products).
iii. The health warning graphic and text labels on tobacco packaging increase from 35% to 50%.
iv. Tobacco products shall not contain prohibited additives announced by the central competent authority.
v. Raising the legal smoking age from 18 to 20.
vi. Expanding non-smoking places: Universities, kindergartens, childcare centers and family childcare facilities are completely non-smoking; bars and nightclubs are also prohibited for smoking, except in separate smoking rooms.
vii. Increased penalties.

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Multiple Smoking-cessation Counseling Service

Thu, 03 Jun 2021 00:00:00 GMT

Provision of comprehensive and accessible smoke cessation services to assist smokers to change their habit and reduce obstacles: Smokers receive assistance in their efforts to quit smoking through outpatient smoking cessation treatment, toll-free phone counseling, and smoking cessation courses.

1.Second Generation Smoking Cessation Service:
(1)In 2012, second generation smoking cessation services were introduced. Smoking cessation medication is subsidized through the Tobacco Health and Welfare Surcharge.
(2)As of 2024, a total of 2,733 medical institutions provide smoking cessation services.
(3)From May 15th 2022, co-payment for drugs exempted.
(4) In 2024, 116,996 were served with 430,518 visits and the six-month cessation success rate was 29.9%, helping about 35 thousand people to quit smoking. In the short term, it is estimated that more than NT$192 million will be saved in medical health insurance expenditure and in the long term, more than NT$14.7 billion in social and economic benefits.
2.Smoker’s Helpline: From 2003-2024, telephone counseling received 1,704 ,606 calls and a total of 487,107 individuals were helped to set cessation plans. The success rate for cases that received multiple counseling sessions exceeded 47.5% in 2024.
3.Smoking Cessation Classes: In 2024, local governments held a total of 361 classes, with approximately 4,202 participants.

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Improvement of staff training

Thu, 03 Jun 2021 00:00:00 GMT

The HPA enhanced the problem analysis capability of colleagues involved in tobacco hazards prevention work to increase related knowledge for practice and plan formulation. Through city-county exchange and learning platform, it also increased the depth and breadth of smoking cessation services provided by medical professionals. In accordance with the different needs of people who want to stop smoking, the HPA also provides various smoking cessation services, and develops a smoking cessation collective care model to enhance the understanding of laws of inspection personnel and enforcement skills.

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Application process for inclusion as a rare disease

Tue, 29 Dec 2020 16:40:50 GMT

Applicant Institution
（一）罕見疾病及藥物審議會之委員或所屬醫療機構（若非醫療背景委員，須有專科醫師協助專業評估後提出申請）。
Members of The Review Committee for Rare Diseases and Orphan Drugs or affiliated medical care institutions (for members with no medical background, specialists physicians must assist in professional evaluation prior to the application submission).
（二）中央衛生主管機關得請收治病人之醫療機構提出申請。
The medical care institution where the patient has been admitted for treatment, shall submit their application to the Central Health Authority (MOHW).
（三）相關專科醫師或所屬醫療機構、醫學會。
Relevant specialist physicians or affiliated medical care institutions, medical associations.
（四）病友團體及藥事團體（兩類團體須有專科醫師專業評估，始可提出申請）。
Patient support groups and pharmaceutical affairs group (both types of group must have a professional evaluation by a specialist physician before application submission).

二、所需文件：
Documents required:
（一）申請列入罕見疾病之說明（附件一）。
Description of application for inclusion as a rare diseases (Annex 1).
1、申請列入罕病之動機及必要性。
Motivation and necessity of application for inclusion as a rare diseases.
2、疾病盛行率。
Disease prevalence rate.
（1）優先舉證本國盛行率資料。
Preferential proof of the country’s (Taiwan’s) prevalence data.
（2）如無本國盛行率，則優先舉證亞洲人種（如：日本、韓國、東南亞）之疾病盛行率資料。
In case there is no prevalence rate of such disease in the country, priority will be given to evidence of the prevalence rate of such disease in Asian races (such as Japan, Korea and Southeast Asia).
（3）若前述國家並無該疾病盛行率之發表文獻時，則檢附德國、美國、英國、法國、日本、瑞士、加拿大、澳洲、比利時及瑞典等十大醫藥先進國家中之兩個國家之疾病盛行率，以供委員審查之參據。
If there is no published literature on the prevalence rate of such disease in the aforementioned countries, the prevalence rate of two of the top ten advanced medical countries including Germany, United States, United Kingdom, France, Japan, Switzerland, Canada, Australia, Belgium and Sweden must be attached to serve as a reference for the Committee to review.
（4）請檢附國內外相關文獻資料。
Please attach relevant domestic and foreign literature.
3、是否需要遺傳諮詢或有利於疾病防治。
Whether genetic counseling or benefit from disease control is needed.
請檢附國內外相關文獻資料。
Please attach relevant domestic and foreign literature.
4、診斷標準
Diagnostic criteria.
（1）確認診斷標準，例如臨床症狀、檢驗或檢查結果報告、家族史.…等個案資料。
Confirmation of diagnostic criteria, such as case data of clinical symptoms, test or examination result reports, family history...etc.
（2）基因檢測內容，例如基因檢測名稱、基因序列變異情形.…等，需檢附基因檢測結果報告。
Basic genetic test information, such as the name of the genetic test, the variation of the gene sequence, etc., are required to be submitted with the genetic test result report.
（3）現行國內、外採用之鑑別診斷及治療方式。
Differential diagnosis and treatment methods currently used at home country (Taiwan) and abroad.
5、診療困難性
Difficulty in diagnosis and treatment.
（1）診斷資源困難：運用相關醫療之測試或檢查、檢驗、診斷等資源困難。
Difficulties in diagnostic resources: Difficulties in using relevant medical tests or resources for examination, inspection, and diagnosis.
（2）治療資源之取得困難：治療之資源（係指非藥物方面之治療，例：手術方法或儀器設備等）取得有困難。
Difficulties in obtaining treatment resources: Difficulties in obtaining treatment resources (referring to non-medicinal treatment, such as surgical methods or equipment, etc.).
（3）藥物使用資源之取得困難：指醫師在處方藥品（按藥事法第6條規定）或專案進口，供病人治療之資源取得有困難。
Difficulties in obtaining resources for the use of medications: Refers to physicians having difficulties in obtaining resources for prescribing drugs (as stipulated in Article 6 of the Pharmaceutical Affairs Act) or projects of drug importation for patient treatment.
（4）上述之鑑別診斷及治療方式，全民健康保險有無提供給付、已提供給付項目及尚未提供給付項目。
Whether the National Health Insurance provides subsidy (already has/does not have provision for subsidy items) for the above-mentioned differential diagnosis and treatment methods.
6、診斷治療費用
Cost of diagnosis and treatment.
一年所需診斷治療費用。
The cost of diagnosis and treatment required for one year.
7、其他補充說明資料。
Other supplementary information.
(二) 個案資料表（附件二）
Case information sheet (Annex 2).
1、個案基本資料
Basic information of the case.
2、家族史
Family history.
3、主訴及症狀
Chief complaint and symptoms.
4、檢驗結果
Test results.
5、診斷名稱
Diagnostic name.
6、治療情形
Treatment situation.
7、診療醫院及醫師資料
Information on medical hospital and physician.
8、檢附個案與罕見疾病病程相關之原始病歷紀錄、檢驗及影像學等報告
Attach original medical records, examinations and radiographic imaging reports of the patient taken during the course of rare disease.
(三）罕見疾病個案通報審查標準
Notification and review standards of rare disease cases.]]>

Newborn Screening for Inherited Metabolic Disorders (Newborn screening)

Fri, 17 Jul 2020 10:12:27 GMT

Newborn Screening for Inherited Metabolic Disorders (Newborn screening)
    It can help your baby by detecting inherited metabolic abnormalities early, so your baby can have early treatment to reduce physical or cognitive impairment caused by the disease.

Dear parents,
    Healthy children are the source of joy for a family. If a child becomes ill during the growth phase, it will often bring about different degrees of influence on the family and society. Therefore, we would like to remind you that it is essential for your child to receive newborn screening and related health screening services as soon as possible.
Through newborn screening, it can help children by detecting congenital metabolic abnormalities with inconspicuous symptoms and provide proper care in time to minimize damage to the body or cognition.
    To determine if your baby is suffering from one of the selective metabolic disorders, the hospital will take a small amount of blood from your baby’s heel when the baby is 48 hours after birth. The sample will then send to the Newborn Screening Center designated by the Health Promotion Administration, Ministry of Health and Welfare for tests. Currently, the government provides subsidize on the following newborn screening conditions:
1.Congenital hypothyroidism:
    Around one in every 3,000 newborns is diagnosed with this disorder. Newborns with hypothyroidism are almost asymptomatic and usually start developing symptoms at two to three months after birth. Hypothyroidism is the lack of thyroid hormones in the infant, thus affecting the brain and the development of the body. If left untreated 6 months after birth, most likely, the baby has severe intellectual disability, growth delay, and small body size. If detecting early and providing synthetic thyroid hormone within one to two months after birth, the baby can have a normal intellectual and physical development.
2.Phenylketonuria:
    About one in every 35,000 newborns has is diagnosed with this disorder. Symptoms such as growth delay or the mold smell of the urine and body odor usually appear at three to four months after birth. Phenylketonuria can lead to severe intellectual deficiency. Phenylketonuria is a deficiency of the enzyme that metabolizes dietary protein. If detected early (within two weeks after birth), physicians can provide special diet and regular check-ups; most infants can have normal intellectual development.
3.Homocystinuria:
    About one in every 100,000 to 200,000 newborns is diagnosed with this disorder. Infants with the disease are unable to metabolize dietary protein effectively. If left untreated, the baby may have complications such as skeletal deformity, learning, and intellectual disabilities, and thrombosis. With early detection and introduction of special diet and vitamin treatment, we can prevent that baby from the intellectual disability.
4.Galactosemia:
    Around one in a million infants is diagnosed with classical galactosemia. Infants with the disease cannot metabolize galactose, and present vomit and drowsy after feeding, and damage to the eyes, liver, and brain. With early detection, dairy products that are free from lactose and galactose will replace breastfeeding or normal infant formula, to decrease the damage made from the disease. Mothers who have given birth to such a baby should avoid foods containing dairy or lactose such as milk/dairy products/offal during her next and following pregnancy. By doing so may eliminate the possibility of harming a fetus with such condition.
5.Glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency, favism):
    Out of every 100 infants, 3 are diagnosed with the disorder. It is the most common hereditary disease in Taiwan. This disease is mainly the abnormal metabolism of glucose in red blood cells. When an infant with this condition is exposed to certain substances (such as broad beans, naphthalene (mothballs), gentian violet, sulfa drugs, antipyretic, analgesic, etc.), he/she is susceptible to acute hemolytic anemia. Failure to receive timely treatment could lead to jaundice and subsequently, intellectual disabilities or death. Early detection and avoiding the substances mentioned above can reduce the damage to your baby.
    To provide a more comprehensive screening service for newborns, since July 2006, in addition to the five conditions mentioned above, the government has prioritized the addition of six screening tests for congenital metabolic abnormalities as follows:
6.Congenital Adrenal Hyperplasia (CAH):
    Around one in every 15,000 newborn infants is diagnosed with the disorder. The most common defect of this condition is due to adrenal 21-hydroxylase deficiency. Clinical presentation is based on the degree of missing "21-hydroxylase" quality and quantity, and is defined as (1) Salt-wasting type – most newborns of this type will lose too much sodium and result in an emergency. If left undiagnosed, it could lead to death. (2) Simple virilizing type – female newborns of this type have ambiguous genitalia, may experience failure to menstruate, over masculine, difficulties getting pregnant, and abnormal growth. Male newborns of this type would also experience abnormalities in growth. Without early detection, it can be difficult to treat physical and psychological conditions. (3) Nonclassic CAH – most symptoms of this type will start to show after infancy. Apart from the nonclassic congenital adrenal hyperplasia, the other types can be detected early via the screening and receive treatment to avoid fatality. When treated appropriately with supplements, the child can have normal development and growth.
7.Maple syrup urine disease:
    About one in every 100,000 newborns is diagnosed with the disorder locally. It is named maple syrup urine disease because the patient’s body fluids and urine have the sweetness of maple syrup. Infants with this type of disease usually develop symptoms several days after starting feeding. The symptoms include vomiting, lethargy, loss of appetite, shortness of breath, jaundice, seizures, etc. In severe cases, the affected can experience unconsciousness and even death. This disease is due to the abnormal metabolism of certain branched-chain amino acids. The patient is unable to process branch-chain amino acids such as valine, leucine, and isoleucine. Early detection and treatment are vital for the newborn as it will allow a better chance of normal physical and intellectual growth for the child.
8.Medium-chain acyl-CoA dehydrogenase deficiency:
    Less than one in every 300,000 newborns is diagnosed with the disorder locally. However, there is about one in every 15,000 newborns diagnosed in Europe, and it is one of the most common fatty acids metabolic disorders. Clinical symptoms usually appear in the first two years after birth. The baby is unable to metabolize a group of fats due to the lack of medium-chain acyl-coenzyme A dehydrogenase. The buildup of fats accumulates in the body and becomes toxic, causing damage to the brain and nervous system, triggers vomiting, liver enlargement, hypoglycemia, loss of consciousness, coma, seizures, etc. Although some patients show no symptoms, 25% of the cases may die in the first episode and are often misdiagnosed as sudden infant death. Early screening can prevent the onset of the disease. Combined with rapid treatment of hypoglycemia in the acute phase, and long-term treatment of providing carbohydrate snacks before bedtime, avoid fasting and actively treat unexpected situations such as an infection or gastroenteritis, the disease can be properly managed with good prognosis.
9.Glutaric acidemia type 1:
    About one in every 100,000 newborns is diagnosed with the disorder locally. It is a rare disease related to the abnormalities of certain organic acids. Due to the lack of glutaryl-CoA dehydrogenase, the infant is unable to breakdown lysine and tryptophan normally. The buildup of toxins, such as glutaric acid in the bloodstream and tissues can cause progressive neurological symptoms and acute metabolic abnormalities. Usually the affected newborn may have no abnormalities or only asymptomatic enlarged head within a few months of birth. But in late infancy, the baby gradually shows symptoms of difficulties in movements, progressive athetosis, hypotonic, muscle stiffness, numbness, opisthotonos (backward arching of the limbs), etc. There may also be an acute episode of epilepsy or slumbering coma. Early detection and treatment are vital for the newborn. It allows the affected to have more normal physical and intellectual development.
10.Isovaleric acidemia:
    About one in every 80,000 newborns is diagnosed with this disease locally. This is a rare disease that is related to the abnormalities of metabolizing a certain organic acid. The affected cannot normally breakdown leucine due to the lack of isovaleryl-CoA dehydrogenase. The buildup of isovaleric acid accumulates and damages the nervous system and hematopoietic system. According to the severity of the symptoms and the onset of the disease, they are divided into typical and atypical. The typical patient may be asymptomatic at birth but will gradually show symptoms of nausea, vomiting, lethargy, poor appetite and cramps. With a large amount of isovaleric acid accumulates in the body, the infant will have a distinctive odor of sweaty feet from the body or urine. If there is no correct diagnosis and treatment at this time, the patient will gradually become unconscious. The atypical patients have a late-onset and mild symptoms that are not obvious. It is often diagnosed one year after birth and sometimes misdiagnosed as other similar diseases. With early screening, the use of diet control and regular monitoring, the treatment has effective results.
11.Methylmalonic acidemia:
    About one in every 100,000 newborns is diagnosed with this disease locally. It is a rare disease that is related to the abnormalities of metabolizing certain organic acids. The affected infant has abnormal function of methylmalonyl-CoA mutase or abnormal cobalamin metabolism that leads to a buildup of organic acids like methylmalonic acid and propionic acid etc. Such buildup can damage the nervous system, and in severe cases, it could cause ketoacidosis, hypoglycemia, hyperammonemia, and hyperglycemia. There is high mortality among newborns and infants. Early screening could detect and prevent the acute onset, replenish fluids at the right time, and avoid acidosis. For patients with abnormal cobalamin metabolism, vitamin B12 should be administered as treatment. For those not responding to vitamin B12, special infant formula and high-calorie diet are given to control the level of methylmalonic acid in the blood and urine at an acceptable range.
12.Citrullinemia type I
    Citrullinemia type I is one of the urea cycle disorders. The patient often cannot metabolize ammonia and presents hyperammonemia. During infancy, the early symptoms are poor appetite, vomiting, drowsiness, restlessness, shortness of breath, etc. The condition usually changes rapidly, showing more serious neurological and autonomic nervous system problems. If not treated appropriately, most patients will die or have complications. In the long-term treatment, patients need to limit protein intake, use special infant formula to supplement growth and development, use medication to remove excess ammonia from the blood, and regularly monitor blood ammonia and others.
13.Citrullinemia type II:
    Citrullinemia type II is caused by citrin deficiency. The neonatal onset of type II citrullinemia will experience cholestatic jaundice, abnormal liver function, elevation of several amino acid levels in the blood, galactosemia and hepatic steatosis, etc. Severe cases could present with delayed growth, abnormal bleeding or anemia, hypoglycemia, hepatomegaly, and even liver failure. Treatment includes taking fat-soluble vitamins, maintaining a high protein, and high-fat diet.
14.3-Hydroxy-3-Methylglutaric Aciduria (HMG CoA lyase deficiency):
    It is a congenital disorder in which the body is unable to metabolize leucine normally. It is one of the organic acidemias. The affected is unable to produce the enzyme to process leucine, The accumulation of such organic acid in the body leads to a high blood ammonia level, causing acidosis and hyperammonemia that may kill or intellectually disable an infant. Apart from being unable to metabolize leucine, the affected is also unable to make ketones. This causes the patient is not able to cope with long-duration of fasting. If detected early, babies can have less dietary protein, have supplement with special infant formula, and avoid long duration of fasting. Therefore patient’s physical and intellectual development can still be normal.
15.Holocarboxylase synthetase deficiency:
    It is a carboxylase deficiency due to inborn error of biotin metabolism. The affected infants often have symptoms such as difficulties in feeding, tachypnea, exfoliative dermatitis, loss of hair, lethargy, etc. In terms of metabolism, the patient can experience ketolactic acidosis, organic acidemia, organic aciduria, and hyperammonemia. Timely supplementation with biotin can prevent many complications. If left untreated, this condition can cause delayed development, seizures, coma, and may even become life-threatening.
16.Very Long Chain Acyl CoA Dehydrogenase Deficiency (LCAD):
    This is a condition in which the body is unable to properly breakdown certain fats and transforms into energy, particularly during periods without food (fasting). Signs and symptoms can occur during infancy or childhood and include hypoglycemia, drowsiness, and muscle weakness. The affected babies are also at risk of serious complications such as liver abnormalities and life-threatening heart problems. Signs and symptoms during puberty or adulthood often include intermittent rhabdomyolysis (breakdown of muscle), muscle cramps, and pain. When the muscle is breakdown, a protein called myoglobin is released. Myoglobin passes through the kidney and excretes into the urine, thus making the urine red or brown. In terms of diet, frequent meals with smaller portions are recommended to avoid hunger. The main treatment principles include limiting the intake of long-chain fatty acids and carnitine supplementation.
17.Primary carnitine deficiency:
    This disease is also known as carnitine transporter deficiency. About one in every 30,000 babies is diagnosed with the disease. Carnitine is responsible for bringing fatty acids into mitochondria to produce energy. Patients with primary carnitine deficiency may experience hyperammonemic encephalopathy before the age of one, and cardiomyopathy after the age of one. As long as the disease is diagnosed early, taking carnitine regularly can avoid the onset of those unwanted symptoms.
18.Carnitine Palmitoyltransferase I deficiency:
    Carnitine Palmitoyltransferase I (CPT I) deficiency is a condition that prevents the body from using certain fats for energy, particularly during periods without food (fasting). The severity of this condition varies among affected individuals. Signs and symptoms of CPT I deficiency often appear during early childhood. The affected cannot effectively produce energy from fatty acids and leads to hypoketotic hypoglycemia. Patients with CPT I deficiency can also have an enlarged liver (hepatomegaly), liver malfunction, etc. Individuals with CPT I deficiency are at risk for nervous system damage, liver failure, seizures, coma, and sudden death. The prevention of hypoglycemia reduces the risk of nervous system damage. In order to prevent hypoglycemia, infants need to increase the feeding frequency during the day, and then add corn starch during the night. Patients should not go on for more than 12 hours fasting especially when they are sick or undergoing specific medical treatment such as surgery. Adult patients need to be on high sugar and low-fat diet to ensure that the body uses sugar as the main source of energy.
19.Carnitine Palmitoyltransferase II deficiency:
    Carnitine Palmitoyltransferase II (CPT II) deficiency is a condition that prevents the body from using certain fats for energy, particularly during periods without food (fasting). The lethal neonatal form of CPT II deficiency becomes ill soon after birth. Infants with this form develop respiratory failure, seizures, liver failure, a weakened heart muscle (cardiomyopathy), an irregular heartbeat (arrhythmia), and hypoketotic hypoglycemia. The other forms can appear later during childhood. Treatment is mainly based on restricted intake of long-chain fatty acids, avoidance of hunger, preventing hypoglycemia, as well as adding more sugar to the diet to produce energy when needed. 20.Glutaric Acidemia type II:
    This disorder is due to the lack of multiple acyl CoA dehydrogenase and causes metabolic problems with fatty acids and branched-chain amino acids. The affected newborns may have symptoms of low blood sugar (hypoglycemia), acidemia, muscle weakness, enlarged liver (hepatomegaly), etc. In addition, glutaric acidemia type II may also present with an odor resembling that of sweaty feet. Some affected individuals have less severe symptoms that begin later in childhood or adulthood. Treatment includes riboflavin and carnitine supplement, using a high carbohydrate, low fat and low protein diet, avoiding hunger, preventing hypoglycemia, as well as adding more sugar to the diet for energy when needed.
21.Propionic Acidemia:
    Babies with the most severe form of propionic acidemia become apparent ill within a few weeks after birth. The signs and symptoms include poor feeding, vomiting, seizures, weak muscle tone (hypotonia), dehydration, lethargy, sluggishness, and brain damage, etc. The late-onset form of this condition is less common. The affected patients need to restrict protein intake, especially the amino acids that produce propionic acid. Therefore, in addition to a small amount of normal diet, special formulas are supplied to provide a sufficient supply of protein and calories for growth.
    Before you receive the screening results, please do not let your baby get in contact with naphthalene (mothballs), and do not medicate the baby at will. If the baby has a health problem, be sure to consult your pediatrician. If the screening result of your baby comes back as a positive, it does not mean that the baby has the disease. The original blood collection hospitals or the confirmational referred hospital will assist your baby to undergo further testing within the shortest time. The screening results of the initial (re-) examination can be obtained in about 2 weeks after the blood collection. Please contact the original blood collection hospitals or search online(https://www.ntuh.gov.tw/gene-lab-nbsc/Index.action、https://www.cfoh.org.tw/、https://www.tipn.org.tw/). For disease-related information, please call the Hotline:+886-2-23123456#71930; +886-2-87681020#15; +886-2-85962050#408.]]>

Examples of the reproductive cells donor information provided by the assisted reproduction institution carrying out the reproductive cells donation

Fri, 05 Jun 2020 11:31:18 GMT

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Consent forms for assisted reproductive technology

Tue, 24 Mar 2020 14:03:59 GMT

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Prevention and Healthcare of Rare Diseases

Mon, 25 Mar 2019 10:20:00 GMT

1.Establishing a Comprehensive Medical Network for Rare Diseases
(1) Review and Designate notifiable rare diseases, and establish a case reporting system:
The Ministry of Health and Welfare designates and publicly announces notifiable rare diseases in accordance with the “Rare Diseases and Orphan Drug Act”. The Ministry also developed a web-based reporting system for rare diseases and, to ensure the accurate reporting of rare diseases, all cases reported by medical personnel are reviewed by experts before being included into the database.

(2) Include rare diseases in the National Health Insurance program and in the categories of major illnesses and injuries:
Since 1994, Taiwan has had National Health Insurance which reimburses an insured person who has a disease (including rare diseases) during a valid insurance period in accordance with the “National Health Insurance Act”. Although the Act has stipulated that the object of insurance for medical treatment shall bear part of the cost of medical care, rare disease patients are free from such burden.

(3) Subsidy for medical costs non-reimbursable by the National Health Insurance program:
To enhance medical care of those affected by rare diseases, according to Article 33 of the “ Rare Diseases and Orphan Drug Act” and the “Regulations Governing Subsidies for Medical and Healthcare Expenses for Rare Diseases”, the Health Promotion Administration, Ministry of Health and Welfare allocates a budget to subsidize the costs of diagnosis, treatments, and pharmaceuticals for rare diseases that are not included in the National Health Insurance. Items covered by the subsidy include domestic and international diagnostic tests, household medical facilities rental, nutritional counseling, emergency orphan drugs, treatments, etc. The maximum subsidy amount is limited to 80% of the expenses. However, expenses of patients from low-income or middle-low-income households, and expenses of emergency medicine and special nutrient foods essential for the maintenance of life are fully subsidized.

(4) Subsidy and supply for special nutrient foods as well as emergency orphan drugs for rare diseases:
The government has established a logistics center to reserve and supply special nutrient foods essential for the maintenance of life for rare disease patients with congenital metabolic abnormalities, and emergency orphan drugs.

(5) The HPA provides services and subsidies of prenatal diagnosis for high-risk pregnancies (with family history of genetic disorders), as well as congenital metabolic disorders screening for all newborns.

(6) Genetic counseling centers have been established in 14 medical centers to provide counseling, diagnosis and treatment services for hereditary diseases and rare diseases.

(7) In accordance with the provisions of the “Rare Diseases and Orphan Drug Act” and “Regulations Governing Healthcare Services for Rare Diseases and Rare Genetic Defects”, the entrusted professional institutions or groups will, upon receiving rare disease notifications and obtaining the consent of patients or their legal representative, dispatch professionals to visit and inform regarding the related impact of diseases, as well as to provide psychological support, childbirth care, care consultation and other services for patients and their families.

2. Implementing Research, Education and Publicity Programs to Prevent Rare Diseases
(1) Programs related to domestic rare disease prevention and treatment can apply for subsidies in accordance with the “Regulations Governing the Incentives and Subsidies for Rare Disease Prevention and Treatment”. Programs eligible for subsidies include: (a) Fostering the necessary professional manpower for the research, diagnosis, testing and treatment of rare diseases. (b) Conducting academic research and clinical research related to prevention and treatment of rare diseases. (c) Purchasing special equipment for the research, diagnosis, testing and treatment of rare disease prevention and treatment. (d) Conducting academic exchange and advocacy related to prevention and treatment of rare diseases

(2) The HPA uses media resources to raise public awareness about rare diseases.

(3) The HPA subsidizes patient groups in holding disease prevention and patient support activities.

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Cancer Prevention and Control in Taiwan

Mon, 11 Mar 2019 11:34:00 GMT

To fight cancer, Taiwan Cancer Control Act was promulgated in 2003. In accordance with the law, the government periodically convenes the Central Committee Meeting and the Policy Commission for cancer control, facilitating the coordination and communication between horizontal and vertical officials. Echoing the Act, three phases (2005-09, 2010-13, 2014-18) of National Cancer Control Programs have been implemented. The fourth phase of the national cancer prevention program (2019-23) has formulated 6 strategies to address the trend of austerity measures in international health expenditures and emphasize what data analysis and evidence can do for cancer prevention.

● Cancer has been the No. 1 leading cause of death in Taiwan since 1982, accounting for 29% of total death in 2020.
● The age-standardized cancer incidence was 309.8/105 in 2018; and the age-standardized cancer mortality was 117.3/105 in 2020.
● The 5-year relative survival rate of all cancers increased from 48.3% during 2003-2007 to 59.7% during 2014-2018.

§ Prevention §

Notes: 1. Behavioral Risk Factor Surveillance System (BRFSS) Survey, Adult Smoking Behavior Survey (ASBS).
2. Betal Quid Chewing Rate: Refer to those who have chewed within the past 6 months.

● Encourage physical activities and healthy diet
● Impose tobacco tax and surcharge
● Control areca/betel quid chewing. The chewing rate has decreased from 17.2% to 6.2% by the efforts in the past decade.
● Established the national database for cancer registries and cancer screening
● HBV mass vaccination program for infants since 1984. The incidence of acute Hepatitis B has a remarkable drop.

§ Screening §
● Four cancer screenings recommended by WHO are included in the National Cancer Screening Pro-gram.Besides, the lung cancer screening program was launched since July first, 2022.

§ Treatment §
● National Health Insurance pays for most of the cancer treatment.
● Accreditation of cancer care quality
● P4P (pay-for-performance) Program
● Oncology Nurse Navigator Program
● Cancer diagnosis disclosure in hospitals since 2014

§ Hospice and Palliative Care §
● Ranked 6/80 in the world and first in Asia in Quality of Death Index by the Economist Intelligence Unit in 2015
● 64.1% of palliative care utilization in the last year of life among cancer patients in 2020
● Promulgated Hospice Palliative Care Act in 2000
● Enacted Patient Right to Autonomy Act in 2016 for promoting Advance Care Planning (ACP)
●Launched Patient Self-Determination Act (PDSA) in 2019

Taiwan quality of death report, 2015

This Propaganda is funded by
Tobacco Health and Welfare Surcharge

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Health Literacy

Fri, 22 Feb 2019 10:50:00 GMT

Health literacy is an important factor affecting healthy behaviors and health outcomes. It is also an effective way to improve people's health and reduce health inequities. According to the relative surveys, approximately 51.6% of adults have insufficient and limited health literacy; 30% to 50% of adults have difficulty in mastering health information.
Given the importance of health literacy, the Health Promotion Administration, Ministry of Health and Welfare has put the promotion of health literacy in people as an important national policy, established a health literacy integration resource center, planned to accomplish the national action plan in the end of this year, and built a supportive environment to strengthen the skills of health service providers as well as develop guidelines of friendliness health literacy materials.]]>

Healthy workplace

Fri, 22 Feb 2019 10:35:00 GMT

A majority of people in Taiwan spend over one-third of their day at work, making the workplace a crucial setting for promoting public health. Since 2003, the Health Promotion Administration (HPA) has been implementing the Healthy Workplace initiative. In 2007, it established the Northern, Central, and Southern Regional Healthy Workplace Promotion Centers to provide consultation and coaching services, assisting enterprises in building quality work environments and enhancing employees’health. Starting in 2025, the initiative has been transformed into the "Self-Assessment Workplace Health Promotion", which encourages enterprises to take the lead in promoting employee health through a three-stage process: self-assessment, recognition of excellence, and awards for outstanding performance.

To further encourage participation, the HPA also organizes the “Outstanding Healthy Workplaces and Promoters Awards”, introducing newly added award categories and incentives. Through the recognition of diverse model practices and innovative approaches, the initiative aims to inspire nationwide corporate engagement in health promotion, enhance overall workplace health capacity, and ultimately strengthen the healthy workforce.

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Community Nutrition Promotion Center

Fri, 22 Feb 2019 10:15:00 GMT

Since 2018, HPA has been fully subsidizing and assisting local governments to establishing 43 "Community Nutrition Promotion Centers" and subsidiary centers in various counties and cities to provide the community nutrition services which are targeted specifically at the elderly. The services provided include individual and group nutrition education, the program of developing nutrition in communities, training courses for community medical personnel and volunteers, coaching and counseling restaurants to provide age-friendly and healthy diet for the elderly.

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National Health Interview Survey (NHIS)

Wed, 01 Nov 2017 00:00:00 GMT

Background
The National Health Interview Survey (NHIS) has been one of the principal sources of information that enables public health sectors to monitor the health status of the population. The first National Health Interview Survey in Taiwan was conducted in 2001 through a collaboration between the National Health Research Institutes (NHRI) and the Taiwan Health Promotion Administration (HPA). Since then, the survey has been conducted every four years to collect policy-relevant information for policy-making and program evaluation.

Aim of the Survey
● To investigate people’s health status and health behavior
● To understand people’s health care utilization
● To collect policy-relevant information for decision making and program evaluation

Sampling Design and Survey Method

The most recent survey was conducted in 2021 to 2022. The interviewees in this survey comprised a national and city/county representative sample of the whole population of the country. A multistage stratified systematic sampling design was applied for the cities and counties in Taiwan (including Penghu County). The townships were stratified by urbanization and location before sampling. Village/Lin in sampled townships and then the individual in sampled village/Lin were selected step by step following the principle of probability proportional to size (PPS). Because of
inconsistencies between the registered address and the actual address of the residents in the counties, area sampling was applied for Kinmen County and Lienchiang County, where competent member aged 12 years and above in the selected household were interviewed.

Data were collected using face to face interview. Since 2009, a computer-assisted personal interview tool was implemented to improve efficiency and data quality of the survey.

Content of the Survey
There were three sets of questionnaires designated for interviewees aged under 12, 12 to 64,

and 65 or above respectively. The contents of the questionnaire include:

●Personal characteristics

●Health status

●Knowledge of disease prevention

●Health care utilization

●Health behaviors

●Occupation and economic status

For international comparison, the NHIS also includes health measurements, such as:

●Euro Qol-5 Dimension (EQ-5D)

●Global Activity Limitation Indicator (GALI)

●Center for Epidemiologic Studies Depression Scale (CES-D)

●WHO Collaborating Center for Mental Health (WHO-5)

●Washington Group Disability Questions

●Global Physical Activity Questionnaire (GPAQ)

●The European Health Literacy Survey (HLS-EU-Q16)

●Mandarin Multidimensional Health Literacy Questionnaire (MMHLQ)

Survey Result
Part of the survey results were included in the Statistics of Health Promotion.
(Please visit the website at
https://www.hpa.gov.tw/EngPages/List.aspx?nodeid=3850 ).

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Key Tasks in the Promotion of Breastfeeding

Fri, 30 Jan 2015 00:00:00 GMT

Key points in the promotion of breastfeeding in Taiwan include continuing implementation of stage one of the Breastfeeding Promotion Plan and the National Health Promotion Three-Year Plan. Through the gentle promotion of breastfeeding, it is hoped that, by the year 2030, the goal of increasing the birth-to-one-month breastfeeding rate to 64% or higher can be achieved. The major tasks to be undertaken are detailed as follows:

1.Creating a breastfeeding-friendly environment in medical care institutions:
(1)Prohibiting the promotion of baby formula products, feeding bottles and nipples, and the display and giving away of baby formula product samples and baby bottles to expecting and new mothers at hospitals and clinics;
(2)Providing educational activities on breastfeeding for expecting and new mothers at prenatal outpatient clinics and wards in hospitals and clinics;
(3)Using the Ten Steps to Successful Breastfeeding established by the WHO and the United Nations Childrens Fund as a reference in devising certification standards for mother and infant friendly hospitals that are suited to local conditions; encouraging hospitals and clinics to attain mother and infant friendly hospital certification.

2.Enhancing the breastfeeding knowledge and skills of medical personnel:
(1)Cooperating with health bureaus, medical care institutions, academic institutions and civic groups to provide on-job training for breastfeeding personnel, thus improving the ability of specialized personnel to handle breastfeeding-related problems;
(2)Issuing a breastfeeding e-newsletter every three months to provide specialized personnel at medical care institutions with the latest breastfeeding information.

3.Promoting breastfeeding awareness of the public:
(1)Using the mass media (Internet, television, radio, print media) to promote breastfeeding;
(2)Pooling the resources of health bureaus, medical care institutions and civic groups to hold seminars and workshops in the interests of promoting breastfeeding education;
(3)Distributing breastfeeding educational materials at locations frequented by women;
(4)Producing health education materials such as booklets, leaflets and posters.

4.Providing a community environment conducive to breastfeeding:
(1)Using the WHO Breastfeeding Counseling: A Training Course teaching materials to train breastfeeding counselors and seed instructors in Taiwan;
(2)Establishing breastfeeding support groups so that mothers who have successfully breastfed can share their experience; recruiting and training volunteers to promote breastfeeding by making home visits;
(3)Establishing a toll-free breastfeeding information hotline (0800-870870), and providing referrals to local medical care institutions and support groups for follow-up support and assistance;
(4)Establishing a breastfeeding website to provide specialized personnel and the general public with information and consulting;
(5)Encouraging medical care institutions and health stations to establish breastfeeding information hotlines.

5.Creating a breastfeeding-friendly work environment, establishing workplace support systems, and encouraging working women to continue breastfeeding.

6.Coordinating with relevant government departments to bring them in line with related regulations, establishing a barrier-free breastfeeding environment, and implementing policies that encourage breastfeeding.

7.Coordinating with the Bureau of Food Safety in requiring that powdered milk companies self-restrict their promotional and advertising activities.

8.Conducting research and surveys related to breastfeeding.
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Kidney disease prevention and care

Thu, 29 Jan 2015 00:00:00 GMT

2. Promote the medical professional training on kidney disease
prevention.

3. Published the kidney care educational materials
(1) Kidney Care booklets, fact sheets, posters, videos, etc
(2) Kidney Disease Care Booklet (Excluding individuals on dialysis)

4. Set up Chronic Kidney Disease Health Promotion Institutes at 196 medical care institutions to increase public awareness on kidney care, and decrease the prevalence of End-Stage Renal Disease.

5.Establish the research on kidney disease
(1) Establish a renal care model within medical organizations which provides integrated and multidisciplinary treatment regimen and education program for patients with chronic kidney diseases. (2003)
(2) Taiwan renal registry of End-Stage Renal Disease patients and establishment of clinical performance measures. (2003)
(3) Epidemiological study of End-Stage Renal Disease patients in Taiwan: ten years survey. (2003)
(4) Establish the Hemodialysis Clinical Practice Guideline and Hemodialysis Procedure Guideline in Taiwan.(2003)
(5) The study was to explore the knowledge, attitude and behavior for renal health care in general population.(2004)
(6). Develop an experimental plan for the prevention and treatment of kidney diseases as well as the management for kidney care in the community: With the community as a unit, early signs of the disease are to be detected and follow-up management implemented.(2006)
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Health Care during Menopause

Wed, 28 Jan 2015 00:00:00 GMT

Complete menopause care plan to provide menopause information and consultation services, actively promote healthy lifestyles, and establish a friendly environment for people going through menopause.

Gather medical experts to discuss the issue on Hormone Replacement Treatment (HRT). Develop and publish the Hormone Replacement Treatment (HRT) Guide.

Train dedicated volunteers and establish support groups and community service projects.

Develop a continuing education plan for healthcare professionals including doctors, nurses etc. Hold seminars on menopause care for medical staffs to increase their knowledge and skills in the subject.

Published the “Menopausal Care Instruction” Booklet, and “Osteoporosis Prevention teaching materials”

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Nutrition and Health Survey in Taiwan (NAHSIT)

Tue, 27 Jan 2015 00:00:00 GMT

Background

Diet and nutrition are major determinants of health. The nutritional status of the population is an important indicator of the nation’s health. The Nutrition and Health Survey is essential to monitor nutrition and health status of the population and to inform policy making and program evaluation.

Taiwan launched the planning for national nutrition surveys since 1980. In 1980-81 and 1986-88, household surveys for dietary intake and children's physical development, as well as actual measuring and weighing of the food were conducted. Since 1993, the government has conducted a series of Nutrition and Health Survey in Taiwan. The protocol of the survey in 1993-1996 included 24-hour dietary recall of participants aged 13 to 64 and dietary habits of children aged 4-12. Target population of the surveys in the following years were senior citizens in 1990-2000, elementary school students in 2001-2002, children aged 0-6 and adults aged over 19 in 2005-2008, junior and senior high school students in 2010-2011, and elementary school students in 2012.

The Nutrition and Health Survey in Taiwan (NAHSIT) was initially managed and funded by the former Bureau of Food and Drug, Department of Health. The Health Promotion and Administration (HPA) took over the responsibility in 2013. A major redesign of the survey was undertaken in that year (2013) aiming to establish a stable and continuous monitoring system for health and nutritional status of the citizen. The current sampling design is featured with its national representative sampling design of the whole population for every single year. The most recent wave of NAHSIT after the redesign was conducted during 2013-2016 and 2017-2020.
2021-2024 is the third wave of investigations. Due to the COVID-19 pandemic, the NAHSIT operations were suspended in May 2021 to abide by the Central Epidemic Command Center (CECC) issued pandemic prevention and measures. And the development of a digital investigation model was carried out. The survey was relaunched in 2022, utilizing a dual-track approach combining in-person interviews and video conferencing.The survey was interrupted in 2021 due to the COVID-19 pandemic. In 2022, the sampling design was revised, and the third wave was scheduled for 2022–2025.

Aim of the Survey

The primary aim of NAHSIT is to establish a long-term, stable and regular monitoring system, which can monitor the national health and nutrition status. The data can be applied as a reference for nutrition and health policymaking.

Sampling Design

NAHSIT uses a multistage, stratified, clustered, probability sampling design to select participants represent for the civilian, non-institutionalized Taiwan population of all ages.

Survey method

Face to face interview is conducted in respondents’ homes. Health measurements are performed at an appropriate site in each township, some measurements are implemented in specially-designed and equipped mobile stations, which travel to locations throughout Taiwan.

Content of the Survey

Risk factors, those aspects of a person’s lifestyle, constitution, heredity that may increase the chances of developing a certain disease or condition, will be examined.
The diseases, medical conditions, and health indicators to be studied include:
1. Behavior indicators
● Diet behavior (nutrients, salt and ssbs intake)
● Diet belief(not included since 2021)
● Physical activity
● Weight control
● Using behavior of tobacco, alcohol, and betel nuts
2. Health outcome indicators
● Nutrition (vitamins and minerals)
● Obesity
● Body composition (muscle, body fat )(the bone density not included since 2021)
● Metabolic syndrome

●Cardiovascular disease (hypertension, Hyperlipidemia, ECG (not included since 2021) ,heart disease)

● Anemia

● Diabetes

● Kidney disease

● Physical functioning
● Medical and Reproductive history
● Respiratory disease (asthma, chronic bronchitis, emphysema)

Survey Result

Reports of survey results are published in four-year waves, with the findings for 2013–2016 and 2017–2020 already released. Some of the statistical indicators are collected and can be accessed from the Statistical Yearbook of Health Promotion.


影片一：國民營養狀況變遷調查調查沿革	影片二：調查簡介與抽樣設計 NAHSIT 2013-2016	影片三：SUDAA簡介


影片四：24小時飲食資料之蒐集、處理，與分析實例	影片五：問卷資料說明及分析實例	影片六：政策應用實例說明及資料使用申請

Related Links
Survey Content
Apply for NAHSIT 2013-2016 data

Survey Results and Products
NAHSIT Report 2013-2016
NAHSIT Report 2017-2020

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Diabetes prevention and control

Tue, 27 Jan 2015 00:00:00 GMT

Development of “Diabetes and Me” handbook, diabetes health education poster, shared decision making materials, etc.

A variety of promotional activities have been conducted in order to raise public awareness on diabetes and subsequently lead a healthy lifestyle.

Improve the health of high risk groups by developing early detection and monitoring of blood sugar and take action to prevent diabetes.

Raise the quality of diabetic care across all levels of organizations. The “Diabetes and Me” handbook shared information on diabetes care. It has been published to assist the 22 cities and counties in developing a shared care system for diabetes and medical staff certification.

Set up diabetic training to enhance medical staffs on diabetes education trainings, clinical consultations and professional services.

Set up Diabetic Health Promotion Institution (DPHI) to promote quality diabetic care and enhance health promotion on high risk groups of diabetes.

Set up diabetic patient self-help groups to share self-care behaviors in effectively controlling diabetes, and to support psychological adaptation for diabetes patients.

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Be Aware of Cervical Cancer

Tue, 27 Jan 2015 00:00:00 GMT

While busy with family and work, don’t forget to take care of yourself. Everyone deserves time to look after their well-being. Regular cervical cancer screening is an important step to protect your health. Taking care of yourself starts with regular screening.

Cervical cancer is preventable.

Research shows that most cervical cancer cases are caused by infection with human papillomavirus (HPV), which is transmitted primarily through sexual contact. Most people can recover completely after infection, but a small portion experience persistent infection, which long-term cellular stimulation, combined with other carcinogenic factors, can easily lead to cervical cancer. Therefore, preventing HPV infection and early detection effectively prevent cervical cancer.

Government provides free cervical cancer screening.

Cervical cancer is mostly related to HPV infection. Although most infected individuals clear the virus, while a minority develop persistent infection that can progress to precancerous lesions and eventually cervical cancer, usually over 10-20 years. Regular screening is thus very important. International studies show that having a Pap smear once every three years can reduce cervical cancer incidence by 60-90%!

Women with sexual experience are advised to have at least one Pap smear every three years, especially those who marry young, have had multiple childbirths or have multiple sexual partners. It is a misconception that screening becomes unnecessary after menopause or reduced sexual activity. According to the Ministry of Health and Welfare’s “LGBT+ Medical Care Reference Guidelines,” Pap smear screening is equally important for lesbian and bisexual women because HPV can be transmitted between female sexual partners. Moreover, lesbian women who have had male sexual partners should continue regular screening.

Since 2025, the government has offered free Pap smears every three years for women aged 25 to 29 and annually for women aged 30 and above, along with HPV testing at ages 35, 45, and 65.

Six minutes for lifetime protection: cervical cancer screening is easy.

A Pap smear involves a healthcare professional gently collecting cells from the cervix and upper vagina using a spatula and brush. The collected specimen is then stained and examined in the laboratory. It's a simple, reliable, and painless test. HPV testing is done similarly by collecting a small sample of exfoliated epithelial cells from the cervix for laboratory analysis.

Before screening, individuals should avoid vaginal douching, tub bathing, vaginal suppositories, sexual intercourse the night before, and menstruation. Bring your National Health Insurance(NHI) card and ID card when visiting an NHI-contracted medical facility.

Effective cervical cancer treatment.

Pap smear results help physicians determine whether further diagnostic procedures are necessary. If abnormal cellular changes are suspected, a biopsy is recommended. Most precancerous conditions require only minor outpatient surgery for cure. If cervical cancer is diagnosed early, especially carcinoma in situ (with nearly 100% cure rate), timely treatment yields very favorable outcomes.

Do not ignore abnormal symptoms.

The development of cervical cancer is a long-term process and in its early often stage lacks obvious symptoms, so it is easily overlooked. If you experience abnormal vaginal bleeding (including post-coital bleeding, bleeding between menstrual periods, or post-menopausal bleeding) or abnormal vaginal discharge (especially discharge with odor or blood), please immediately consult a physician for further evaluation.

Prevention is easy!

Currently, there is no medication that can treat human papillomavirus (HPV) infection; however, an effective vaccine is available to prevent infection. Since December 2018, the Health Promotion Administration has provided free HPV vaccination for junior high school girls. Starting from September 2025, public funding has been expanded to include junior high school boys as well.

In addition, practicing safe sex is an important method to protect yourself from infection. It is recommended to use condoms correctly and consistently to reduce the risk of HPV infection. At the same time, regular cervical cancer screening through Pap smears remains a crucial measure in safeguarding women's health.

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Taiwan Global School-Based Student Health Survey (GSHS)

Mon, 26 Jan 2015 00:00:00 GMT

Legal Basis

This survey is carried out pursuant to Article 4 of the Statistics Act.

Background

Health-related behaviors developed in adolescence influence health later in life. In order to understand the prevalence of adolescent health behavior, relating factors, and to develop effective prevention strategies, the Taiwan Youth Health Survey (TYHS) was initiated in 2006. The survey was designed by referring to the Youth Risk Behavior Survey (YRBS), which was conducted every two years since 1990 by the US Centers for Disease Control and Prevention (US CDC), and Global School-Based Student Health Survey (GSHS), which was developed by the World Health Organization (WHO) in collaboration with United Nations’ UNICEF, UNESCO, and UNAIDS; and with technical assistance from CDC.
The GSHS is a school-based cross-sectional survey and targets junior or senior high school student populations in Taiwan. The Health Promotion Administration collaborated with US CDC and launched Taiwan GSHS in 2012. The survey can establish trends in the prevalence of health behaviors and protective factors for use in evaluation of school health and youth health promotion.

Since 2012, the survey was conducted annually on a national representative sample of students selected from the 22 counties/ cities in Taiwan. The survey is conducted every year for the biennium, for one year in junior high schools students and the other year for the senior high schools students.
The survey results applied to policy prioritizing, program evaluation, and as the reference of the advocate. To better reflect the change in health behavior prevalence, the annual survey was changed to once in two years since 2019. In 2021, the survey was conducted with country representative samples of junior and senior high school students. However, the completion rate was lower than previous years in 2021 due to the COVID-19 pandemic, the completion rate be taken into consideration for data comparison limitation. In keeping with the WHO’s NCD Global monitoring framework aims international trends in public health surveillance, the GYTS and GSHS were integrated as the Adolescent Smoking and Health Behavior Survey in 2023. This integration aims to provide a better understanding of the current status and changing trends of youth smoking and health behaviors, thereby providing valuable insights for relevant agencies in formulating and advancing school-based tobacco control and youth health promotion policies.

Aim of the Survey

To understand the smoking behaviors, perceptions, and attitudes of adolescents in Taiwan, as well as the prevalence of related health behaviors and the status of school tobacco-control policies and their implementation, in order to provide evidence-based references for the government in formulating youth health promotion policies.

Main Organizer and Co-organizers

This survey was organized by the Health Promotion Administration (HPA), Ministry of Health and Welfare, and implemented with the assistance of local government health bureaus. The compilation of survey data, statistical analyses, and preparation of the report were carried out by the HPA. The Ministry of Education served as the supervising authority, while local education bureaus, the K–12 Education Administration of the Ministry of Education, and the participating schools provided the essential administrative collaboration during the implementation of the survey.

Survey Area and Participants

Survey Participants:
The participants were junior high school students and senior high school/vocational high school students, as well as students in five-year junior colleges (years 1–3) in Taiwan.
In the 2025 survey, around 22,000 junior high school students and around 25,000 senior high/vocational school students were included in the sample.
Geographical Scope:
The survey covered Taiwan, including Kinmen County and Lienchiang County (Matsu).

Sampling Design

The sampling was designed by the CDC of the United States, following the protocol of the GSHS to draw a national representative sample. The sampling method was a 2-step “probability proportional to size (PPS)” method, the sample schools was drawn first, and then sample classes in that school was drawn next. All students in the sample classes were invited to join the survey.

Survey Methods

The GSHS survey uses a self-administered, anonymous questionnaire to collect data. To ensure the protection of participants’ rights and the integrity of data protection practices, all procedures related to the collection, processing, and use of personal data in this survey were conducted in strict accordance with the Personal Data Protection Act and the Human Subjects Research Act. These measures were implemented to ensure full compliance with relevant ethical standards and regulatory requirements.

Contents of the Survey

The contents of the questionnaire are:
● Demographic information
● Body weight
● Dietary behaviors
● Physical activity
● Health behaviors: Tobacco use, Betel quid chewing and Alcohol use
● Sexual behaviors
● Knowledge of the cervical cancer vaccine
● Hygiene

Survey Period and Implementation Schedule

1. Survey Period
The survey is conducted biennially. In 2025, the survey was carried out from March to June, depending on the actual fieldwork schedule.
2. Implementation Schedule
● January – February 2025: Preparation of the implementation plan and questionnaires, followed by submission to the Directorate-General of Budget, Accounting and Statistics, Executive Yuan, for approval.
● March – June 2025: Field survey implementation.
● August – December 2025: Review and verification of survey data; data processing and quality check.
● January – March 2026: Compilation of statistical analysis and tables.
● June 2026: Announcement of the survey report, depending on the actual timeline.

Survey Result and Data

The survey results are published in the format of survey reports, press releases, and conferences, or journal papers. Some of the statistical indicators are collected and can be accessed from the Statistical Yearbook of Health Promotion. After compilation, the survey data and related documentation are converted into de-identified secondary data, and submit to the Health and Welfare Data Science Center for external release, exclusively for academic research purposes.

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