ReportsPolicy interpretation of relevant documents on Healthy China Initiative
On June 25, 2019, the State Council issued the Opinions on the Implementation of Health China Action (Guo Fa [2019] No. 13, hereinafter referred to as the Opinions), an important document at the national level to guide disease prevention and health promotion for the next ten years or so. Based on the Opinions, the Healthy China Initiative Promotion Committee was established and the Healthy China Initiative (2019-2030) (hereinafter referred to as the Healthy China Initiative) was issued, and the General Office of the State Council issued the Evaluation Plan on Healthy China Initiative Organization and Implementation (Guo Ban Fa [2019] No. 32, hereinafter referred to as the Evaluation Plan). (The above three documents are hereafter collectively referred to as the relevant documents of the Healthy China Initiative).
The Party Central Committee and the State Council attach great importance to people's health, and General Secretary Xi Jinping has stressed the need on many occasions to implement the prevention-oriented policy, adhere to the combination of prevention and treatment, joint prevention and control, mass prevention and control, and strive to provide the people with health services throughout their life cycle. In accordance with the Party Central Committee and the State Council deployment, the National Health Commission took the lead in organizing the drafting of documents related to Healthy China Initiative.
Since the 18th Party Congress, China's health care has made remarkable achievements, and people's health has continued to improve. With industrialization, urbanization, population aging process accelerated, the production and lifestyle of our residents and the spectrum of diseases continue to change. At present, cardiovascular diseases, cancer, chronic respiratory diseases, diabetes and other chronic diseases have become the main cause of death of residents, resulting in a burden of more than 70% of the total disease; the prevention and control situation of hepatitis, tuberculosis, AIDS and other major infectious diseases is still serious, while occupational health, endemic diseases and other issues can not be ignored. In addition, some key groups of people have their own urgent health problems to be solved. Our residents' health knowledge is limited, and smoking, excessive alcohol consumption, lack of exercise, unreasonable diet and other unhealthy lifestyle are more common. In order to actively and effectively respond to the current outstanding health problems, the development and introduction of Healthy China Initiative related documents and the implementation of ten years of national disease prevention and health promotion action are to implement the spirit of the 19th CPC National Congress, the requirements of implementation of the health China strategy, the implementation of the prevention-oriented approach, and the overall solution to the current outstanding problems of people's health, which fully embody the people's strategic thinking of health priority development, and at the same time, is also a major initiative to comply with international trends and fulfill international commitments.
I. Drafting of documents related to Healthy China Initiative
In 2016, the Party Central Committee and the State Council held the National Conference on Health and Wellness and issued the "Healthy China 2030" Planning Outline, which put forward the goals and tasks for the construction of a healthy China. The 19th Party Congress made a major decision to implement the Healthy China strategy.Since June 2018, under the leadership of the State Council, a special team led by the National Health Commission, together with the Ministry of Education, the General Administration of Sports and other departments, has conducted thematic studies in various fields and drafted and prepared the Opinions, Evaluation Plan on the Immplementation of Healthy China Initiative Implementation. The preparation work adheres to the principles of prudence, science and rigor, and the team has organized more than 100 experts from more than 10 disciplines in clinical medicine, public health and health science, held nearly 20 discussion and demonstration sessions, and fully listened to the views and suggestions of local, relevant departments, professional institutions and other parties, and repeatedly revised and improved. On April 3, 2019, the State Council executive meeting reviewed the documents related to the Healthy China Initiative and the State Council agreed to issue documents related to the Healthy China Initiative on June 24.
Ⅱ. Features of documents related to the Healthy China Initiative
Documents related to the Healthy China Initiative focus on the main health problems and factors affecting the people, and from the levels of government, society, and individuals (family) promote the concerted efforts to achieve the goal of promoting the health of all people through the popularization of health knowledge, participation in health actions, health services, and with the following four characteristics.
First, in terms of positioning, it has changed the focus from "disease"-centered to "health"-centered. Focusing on the lifestyle, production and living environment and medical and health services that everyone is concerned about, the documents make systematic and detailed arrangements and recommendations for the outstanding health problems faced by each person in different life cycles.
Second, in terms of strategy, it has changed the focus from "treating the disease" to "preventive treatment of disease". The documents focus on targeted health promotion and education according to the characteristics of different groups of people, and strive to enable individuals to understand the necessary core health knowledge and information through documents, to master the channels and ways to obtain relevant knowledge and information, so that health knowledge, behavior and skills become the universal quality and ability of all people, to form a self-disciplined healthy lifestyle, and to promote the "everyone is the first person responsible for their own health". The concept of "everyone is the first person responsible for their own health" is put into practice, so that people can keep fit and improve the quality of life.
Third, in the main body, it has changed from relying on the health system to the overall social linkage. The documents adhere to the "big health " concept, and urged efforts from the supply side and demand side. Each action in the "Healthy China Initiative" is developed in the order of preamble, action objectives, individual and family, society, and government responsibilities, focusing on the issues of "why, what, how, and especially how to do it together". Each task and initiative is specific and clear, requires sectoral collaboration, mobilizes the enthusiasm and creativity of society as a whole, to achieve the goal of the government's leading responsibility, active participation of society, personal embodiment of health responsibility, put the basic path of "building and sharing" health China into practice, and serve as the concrete practice of "health in all policies".
Fourth, in terms of style, it strives to change from a document to a social initiative. The "Healthy China Initiative" to the public as the main reading target, in the full absorption of existing special documents, norms, guidelines, etc. turns the terminology into easy-to-understand language, combine the science and popularization, and strive to do a good job in popularizing health knowledge, so as to make it easier for people to read, remember, and carry out.
Ⅲ. The main content of the documents relevant to Healthy China Initiative
The "Opinions" outline and put forward 15 special actions; "Healthy China Initiative" refines the implementation of 15 special actions, sets the goals, indicators and specific tasks and responsibilities of each action; "The Evaluation Plan" enures the implementation of the "Opinions" and "Healthy China Initiative".
(1) The "Opinions". The Opinions" are divided into four parts: the first part is the action background. It puts forward the importance and necessity of the implementation of health China action. The second part is the general requirements. It puts forward the guiding ideology and basic principles of the implementation of Healthy China Initiative, and sets milestones to 2022 and 2030. The third part is the main tasks, from three aspects, including the organization and implementation of 15 major actions. The first is to intervene in all aspects of health factors, for the impact of health behavior and lifestyle, the environment and other factors, and to implement health knowledge dissemination, reasonable diet, national fitness, tobacco control, psychological, environmental 6 health promotion actions. The second is to maintain the whole life cycle of health, for women and children, primary and secondary school students, workers, the elderly and other key population characteristics, and to implement four health promotion actions. The third is to prevent and control of major diseases with 5 preventive measures, including four types of major chronic diseases which are cerebrovascular diseases, cancer, chronic respiratory diseases and diabetes, , as well as the prevention and control of infectious and endemic diseases. The fourth is to do a good job of organization and implementation, including strengthening organizational leadership, mobilizing a wide range of parties to participate, improving the support system, and focusing on publicity and guidance. It clarifies the national level to set up the Healthy China Initiative Promotion Committee (hereinafter referred to as the Promotion Committee) led by the State Council leaders, which is responsible for the development and issuance of "Healthy China Initiative", refines the goals, targets, tasks and division of responsibilities of the 15 actions, and organizes the implementation.
(2) "Healthy China Initiative". Healthy China Initiative is divided into four parts: the first part is the general requirements, including a comprehensive analysis of the importance and necessity of implementing a number of major actions, the guiding ideology and basic path of work to promote, and the milestones to 2022 and 2030. The second part is the main indicators, including outcome indicators, personal and social advocacy indicators, government work indicators with a total of 124, most of which are expected indicators, advocacy indicators, the scientific nature of the indicators, and feasibility has been fully studied and demonstrated. The third part is the major actions which are divided into three sections: First, for the pre-existing factors affecting health. Personal behavior and lifestyle, environmental factors on health accounted for 60% and 17% respectively. Actions 1-6 are mainly focused on early intervention of the pre-influencing health factors, respectively, health knowledge dissemination, reasonable diet, national fitness, tobacco control, mental health and healthy environment promotion. Second, for key populations. Actions 7-10 mainly focus on some special problems faced by key populations such as women and children, primary and secondary school students, workers and the elderly, and carry out comprehensive interventions. Third, for current major diseases. Currently, chronic non-communicable diseases such as cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes cause 88% of all deaths in China, and major infectious diseases and endemic diseases are still serious in some places. Action 11-15 is mainly focused on the outstanding problems of major diseases prevention and control intervention. At the same time, relevant measures are proposed in each relevant special action for disability prevention and rehabilitation services, and health promotion for residents in poor areas. Each action from the individual, society, the government, in accordance with the idea of "why to do, what to do, how to do" t, highlights the concept of personal responsibility for their own health. Fourth, for the security measures, including strengthening organizational leadership, monitoring and evaluation, the establishment of performance assessment and evaluation mechanism, improving the support system, and strengthening the publicity and guidance.
(3) The Evaluation Plan. To ensure the effective implementation of the "Opinions" and "Health China Action", the General Office of the State Council issued the Evaluation Plan, which is divided into three parts, one is to establish a sound organizational structure. Relying on the National Public Health Campaign Committee the Healthy China Initiative Promotion Committee will be established to clarify the organizational structure and working mechanism of the Promotion Committee. Second, to strengthen the monitoring and evaluation. Monitoring and assessment work is coordinated and led by the Promotion Committee, and each special action working group is responsible for the specific organization and implementation, based on existing statistical data, the Internet and big data, to monitor the implementation progress of the main indicators and key tasks. The Office of the Promotion Committee produces the overall monitoring and evaluation report, which will be approved by the Promotion Committee and submitted to the State Council, and releases the monitoring and evaluation report. Third, the evaluation. The evaluation is led and coordinated by the Promotion Committee, the Office of the Promotion Committee is responsible for the organization and implementation, and the Expert Advisory Committee provides technical support. Around the main objectives and tasks required for the construction of a healthy China, a relatively stable framework of assessment indicators should be established. The main health indicators will be included into the performance appraisal indicators of the party committees and governments at all levels. The comprehensive evaluation results will be released after validated by the Promotion Committee, and be used as an important reference for the assessment of the leadership team and leading cadres of provinces (autonomous regions and municipalities) and the relevant departments of the party and government.
Opinions of the State Council on the implementation of Healthy China Initiative
To Provinces, autonomous regions, municipalities directly under the Central People's Government, the State Council ministries and commissions:
People's health is an important symbol of national prosperity and national wealth and strength, and prevention is the most economical and effective health strategy. The Party Central Committee and the State Council issued the "Healthy China 2030" plan outline, which puts forward the goals and tasks of the construction of a healthy China. The 19th Party Congress made a major decision to implement the Healthy China strategy, emphasizing the importance of prevention, advocating a healthy and civilized lifestyle, and preventing and controlling major diseases. In order to accelerate the transformation from the treatment of diseases as the center to the people's health as the center, mobilize the whole society to implement the prevention-oriented approach, the implementation of health China action to improve the health of the whole population, the following views are put forward.
I. The action background
After the founding of New China, especially since the reform and opening up, China's health care has achieved significant development, and the main health indicators of the residents are better than the average level of middle and high-income countries. With industrialization, urbanization, population aging process accelerated, the production and life style of Chinese residents and the spectrum of diseases continue to change. Chronic non-communicable diseases such as cardiovascular diseases, cancer, chronic respiratory diseases and diabetes cause 88% of the total number of deaths, resulting in more than 70% of the total disease burden. Residents' health knowledge is limited, and unhealthy lifestyles such as smoking, excessive alcohol consumption, lack of exercise and unreasonable diet are common, and the resulting disease problems are becoming increasingly prominent. Hepatitis, tuberculosis, AIDS and other major infectious diseases prevention and control situation is still serious, and mental health, occupational health, endemic diseases and other aspects of the problem can not be ignored.
In order to adhere to the prevention-oriented, put prevention in a more prominent position, and actively and effectively respond to the current outstanding health problems, we must move forward, take effective intervention measures, refine the implementation of the "Healthy China 2030" plan outline of the popularization of healthy living, optimize health services, build a healthy environment, focus on the major diseases and outstanding problems affecting people's health in the current and future period, implement disease prevention and health promotion in the medium and long term actions, keep improving the implementation of prevention-oriented system for the whole society, and strive to make people keep fit and improve the quality of life.
II. General requirements
(1) Guiding ideology.
Guided by Xi Jinping’s socialism with Chinese characteristics in new era, the documents fully implement the spirit of the 19th CPC National Congress and the second and third plenary sessions of the 19th CPC Central Committee, adhere to the people-centered development thinking, adhere to reform and innovation, implement health work policy in the new era, strengthen government, social and personal responsibility, transform the health work philosophy, and service mode from the treatment of disease as the center to the people's health as the center, establish a sound health education system, popularize health knowledge, guide the public to establish a correct view of health, strengthen early intervention, form a healthy lifestyle, ecological environment and social environment, extend the healthy life expectancy, and lay a solid foundation for all-round and full-cycle protection of people's health and building a healthy China.
(2) Basic principles.
Popularize knowledge and improve literacy. To enhance health literacy is a prerequisite for promoting the health of all people. According to the characteristics of different groups of people targeted, the documents stress to strengthen health education and promotion, so that health knowledge, behavior and skills will become the general quality and ability of all people, in order to achieve health literacy for all.
Self-discipline and healthy living. The documents advocate the concept that everyone is the first person responsible for his or her own health, and inspire residents to love health, pursue health, develop a healthy lifestyle in line with their own and family characteristics, have a reasonable diet, do scientific exercise, quit smoking and limit alcohol, and keep psychological balance, thus to achieve a healthy life.
Early intervention and improvement of services. The documents suggest to take early and effective intervention measures for major health problems and influencing factors, improve prevention and treatment strategies, promote structural reform on the supply side of health services, provide systematic and continuous integrated services for prevention, treatment, rehabilitation and health promotion, strengthen the interface between medical security policies and health services, and realize early diagnosis and treatment as well as early rehabilitation.
Universal participation and sharing. The documents propose to strengthen cross-sectoral collaboration, encourage and guide units, communities (villages), families and individuals to take action, so as to form a good situation where the government actively leads, the community is widely mobilized, and everyone does their best to all participate in Healthy China Initiative.
(3) The overall goal.
By 2022, the health promotion policy system is basically established, the level of national health literacy is steadily improved, the promotion of a healthy lifestyle is accelerated, the rising trend of major chronic diseases is curbed, key infectious diseases, serious mental disorders, endemic diseases, occupational diseases are effectively prevented and controlled, the risk of disability and death is gradually reduced, and the health status of key populations is significantly improved.
By 2030, the level of national health literacy is significantly raised, a healthy lifestyle is widely adopted, the main health factors of the residents are effectively controlled, the premature death rate due to major chronic diseases is significantly reduced, the average life expectancy has been greatly improved, the main health indicators of the residents reach the level of high-income countries, and health equity is basically achieved.
III. The main tasks
(1) A full range of intervention health factors.
1. Actions on health knowledge popularization. Maintain healthy requires health knowledge. The knowledge and skills to maintain health, such as disease prevention, early detection, emergency rescue, timely medical care, rational use of drugs are popularized to families and individuals. The library of health science experts and resources will be established and improved, and a mechanism for publishing and disseminating health science knowledge will be built. Actions also include strengthening the incentive constraints for medical and health institutions and medical personnel to carry out health promotion and education, and encouraging radio and television stations and other media at all levels to run quality health science popularization programs. By 2022 and 2030, the national health literacy level will be no less than 22% and 30% respectively.
2. Actions on reasonable diet. A reasonable diet is the foundation of health. For the general population, specific groups and families, focus on canteens, restaurants and other places, nutrition and dietary guidance is strengthened. The whole society is encouraged to participate in reducing salt, oil and sugar, and the packaging standards for salt, oil and sugar should be improved. The general rules for nutrition labeling of prepackaged foods should be revised, and a food nutrition standard system should be set up. Nutrition intervention for key populations in poor areas will be implemented. By 2022 and 2030, the growth rate of adult obesity will continue to slow down, and the growth retardation rate of children under 5 years old will be less than 7% and 5% respectively.
3. Actions on national fitness. Life is exercise, and exercise requires science. Targeted exercise and fitness programs or exercise guidance services are provided for different groups of people. Efforts are made to set up fitness organizations around the people and "15-minute fitness circle". Free or low-charge opening of public sports facilities are promoted. Disease management and health service models that integrate physical medicine are set up. The physical health status of college students is incorporated into the assessment and evaluation of colleges and universities. By 2022 and 2030, the proportion of urban and rural residents who meet the National Physical Fitness Standards will reach at least 90.86% and 92.17%, respectively, and the proportion of people who regularly participate in physical exercise will reach 37% and above and 40% and above.
4. Actions on tobacco control. Smoking seriously endangers people's health. Individuals and families have access to the serious hazards of smoking and secondhand smoke exposure. Leading cadres, medical personnel and teachers are encouraged to play a leading role in tobacco control. Party and government offices at all levels are build into smoke-free organs. The use of taxation, price regulation, and other comprehensive means are studied to improve the effectiveness of tobacco control. The content and form of tobacco hazard warnings on cigarette packages are further improved. By 2022 and 2030, the proportion of the population protected by comprehensive smoke-free regulations will reach 30% and above and 80% and above, respectively.
5. Actions on mental health promotion. Mental health is an important part of health. Through mental health education, counseling, treatment, crisis intervention, etc., the public is guided to scientifically relieve stress, correctly understand and cope with common mental disorders and psychological behavior problems. The social psychological service network is improved and the training of mental health personnel is strengthened. Actions also include the establishmeng of an integrated mental health management mechanism and improvement on community rehabilitation services for mental disorders. By 2022 and 2030, the level of mental health literacy of residents will be raised to 20% and 30%, and the rising trend of occurrence of mental-related diseases will be slowed down.
6. Implement healthy environment promotion actions. A good environment is a guarantee of health. Popularize environmental and health-related protection and response knowledge to the public, families and units (enterprises). Promote the prevention and control of air, water and soil pollution. Promote the construction of healthy cities, healthy villages and towns. Establish a system of investigation, monitoring and risk assessment of the environment and health. Take effective measures to prevent and control environmental pollution-related diseases, road traffic injuries, and consumer product quality and safety accidents. By 2022 and 2030, the population's drinking water quality standards are significantly improved and continue to improve.
(2) Maintain the health of the whole life cycle.
7. Actions on promoting maternal and child health. Maternity and infancy are the beginning of life. In response to the characteristics of premarital, preconception, pregnancy and childhood stages, families are actively guided to scientifically conceive and raise a healthy new life, and the birth defect prevention and control system is also improved. Early childhood development service, infant and child care services and the rehabilitation and assistance system for children with disabilities are improved. Actions also include promotion of reproductive health and cervical cancer and breast cancer screening for rural women. By 2022 and 2030, the infant mortality rate will be controlled at 7.5‰ and below and 5‰ and below, respectively, and the maternal mortality rate will drop to 18/100,000 and below and 12/100,000 and below, respectively.
8. Actions on health promotion in primary and secondary schools. Primary and secondary school students are at a critical stage of growth and development. Families, schools and society are encouraged to maintain the physical and mental health of primary and secondary school students. Students are guided from an early age to develop healthy habits, exercise a healthy body, and prevent myopia, obesity and other diseases. Primary and secondary schools will open a full physical education and health curriculum as required. The physical health status of students is incorporated into the performance assessment of schools. Based on the age characteristics of students, students' health knowledge is tested in various ways, and is included in physical education in the high school academic level test. By 2022 and 2030, the national student physical health standard will attain a good rate of 50% and above and 60% and above, respectively, the overall myopia rate of children and adolescents nationwide will reduce 0.5 percentage or more per year, and the rate of new myopia will decrease significantly.
9. Actions on occupational health protection. Workers enjoy the right to occupational health protection in accordance with the law. For different occupational groups, healthy work style should be advocated, and the main responsibility of the employer and government supervision should be implemented to prevent and control occupational disease hazards. The system of occupational disease prevention and control regulations and standards is improved, and employers are encouraged to carry out employee health management. Actions also include the protection of pneumoconiosis and other occupational diseases rescue and treatment. By 2022 and 2030, the proportion of the number of new cases of pneumoconiosis reported by workers with less than 5 years of dust catching experience in the total number of reported cases will achieve a significant and sustained decline.
10. Actions on health promotion for the elderly. The health and happiness of the elderly is an important sign of social civilization and progress. Actions include popularizing the knowledge of diet and nutrition, physical exercise, regular medical checkups, health management, mental health and rational use of drugs for the elderly, improving the health service system for the elderly, improving the policy of home and community care, promoting the integration of medical care, exploring the long-term care insurance system, creating a livable environment for the elderly, and realizing healthy aging. By 2022 and 2030, the incidence of disability among the elderly aged 65 to 74 will decrease, and the prevalence of senile dementia among people aged 65 and above will decrease in growth rate.
(3) prevention and control of major diseases.
11. Actions on cardiovascular and cerebrovascular disease prevention and control. Cardiovascular disease is the first cause of death in China. Actions include guiding residents to learn to master cardiopulmonary resuscitation and other self-help knowledge and skills, conducting lifestyle guidance for high-risk groups and patients, implementing the system of blood pressure measurement at the first consultation for people over 35 years old, strengthening the standardized management of hypertension, hyperglycemia and dyslipidemia and improving pre-hospital emergency care, intravenous thrombolysis, arterial clot retrieval and other emergency treatment capabilities. By 2022 and 2030, the mortality rate of cardiovascular and cerebrovascular diseases will drop to 209.7/100,000 and below and 190.7/100,000 and below respectively.
12. Actions on cancer prevention and treatment. Cancer seriously affects people's health. Actions include advocating active cancer prevention, promoting early screening, early diagnosis, early treatment, reduce cancer incidence and mortality, improving the quality of survival of patients, expanding the scope of cancer screening in an orderly manner, promoting the application of common cancer diagnosis and treatment standards, improving cancer treatment capacity in the central and western regions and at the grassroots level, strengthening scientific and technological research and development for cancer prevention and treatment, and accelerating the review and approval of drugs in urgent clinical need. By 2022 and 2030, the overall cancer 5-year survival rate will be no less than 43.3% and 46.6% respectively.
13. Actions on prevention and treatment of chronic respiratory diseases. Chronic respiratory diseases seriously affect the quality of life of patients. Actions include guiding key populations to detect diseases early, controlling risk factors and preventing disease development, exploring the measurement of pulmonary function in the first consultation of high-risk groups and the detection of pulmonary function in physical examinations of people aged 40 and above, strengthening the health management of patients with chronic obstructive pulmonary disease and improving the capacity of lung function tests in primary health care institutions. By 2022 and 2030, the mortality rate of chronic respiratory diseases for people aged 70 and below will drop to 9/100,000 and below and 8.1/100,000 and below.
14. Actions on diabetes prevention and control. China is one of the countries with the fastest growing prevalence of diabetes. Actions include prompting residents to pay attention to blood sugar levels, guiding pre-diabetic people to reduce the risk of morbidity scientifically and diabetic patients to strengthen health management to delay or prevent the development of diabetes, strengthening the health management of diabetic patients and high-risk groups, and promoting the standardization of screening and treatment of diabetes and complications at the grassroots level. By 2022 and 2030, the rate of standardized management of diabetes patients will reach 60% and above and 70% and above, respectively.
15. Actions on infectious diseases and endemic diseases prevention and control. Infectious diseases and endemic diseases are major public health problems. Actions include guiding residents to raise awareness of self-prevention, personal hygiene and disease prevention and understand the important role of vaccines in disease prevention, advocating for high-risk groups to receive influenza vaccination before the influenza epidemic season, strengthening the prevention and control of major infectious diseases such as AIDS, viral hepatitis and tuberculosis, striving to control and reduce the epidemic level of infectious diseases, strengthening the prevention and control of endemic diseases such as parasitic diseases, drinking water-based coal-fired fluorine and arsenic poisoning, large bone disease, and fluorosis, and control and eliminating key endemic diseases. By 2022 and 2030, take the township (town, street) as a unit, the vaccination rate of school-age children immunization program in the towns will maintain at least 90%.
IV. Organization and implementation
(1) Strengthen organizational leadership. The Healthy China Initiative Promotion Committee is established at the national level, to develop and issue the " Healthy China Initiative (2019-2030)", refine the above 15 special action goals, targets, tasks and division of responsibilities, coordinate and guide all relevant departments in all regions to strengthen collaboration, study the integrated prevention and control strategies for diseases, and do a good job of monitoring and assessment. Based on medical progress and related technological developments, etc., the Committee should revise and improve the " Healthy China Initiative(2019-2030)" timely. All regions should combine the actual sound leadership to promote the work mechanism, research and development of implementation plans, and carry out the task. All relevant departments in accordance with the division of responsibilities, incorporate the prevention-oriented, disease prevention in the first into various policy initiatives, conduct research on specific policy measures to promote the implementation of key tasks.
(2) Mobilize a wide range of parties to participate. The Committee should gather the strength of the whole society to form a strong synergy of health promotion, encourage individuals and families to actively participate in the Healthy China Initiative, implement personal health responsibilities and develop a healthy lifestyle. All units, especially schools and communities (villages) should fully explore and use their own resources to actively carry out health cell project construction and create a healthy supportive environment. Enterprises should be encouraged to develop and produce products that meet health needs and increase the supply of health products, and state-owned enterprises, especially central enterprises, should set an example. Social donations are encouraged, relying on social forces to establish the Healthy China Initiative Foundation in accordance with the law, forming a guarantee mechanism with diversified sources of funding. Financial institutions should be encouraged to innovate health products and services. Health and health-related industry associations, associations and groups and other social organizations should play a full role in guiding and organizing health promotion and health science and technology work.
(3) Improve the support system. The Committee should strengthen public health system construction and talent training, improve disease prevention and treatment and emergency response capabilities, strengthen financial support and the coordination of funds, optimize the allocation of resources, improve the efficiency of basic public health service project funds and major public health service project funds, strengthen scientific and technological support, carry out a number of major special projects affecting health and difficult and serious diseases diagnosis and treatment research on major topics supported by the national key research and development programs, improve the system of relevant laws and regulations, carry out health policy reviews, guarantee the implementation of tasks and goals, strengthen the information support, and promote the sharing of health-related information between departments and regions.
(4) Focus on publicity and guidance. The Committee should take a variety of forms, promote public opinion publication, timely release policy interpretation, respond to social concerns; set up a special website on health China action, vigorously publicize the implementation of Healthy China Initiative, promote the health of all the major significance, goals and tasks and major initiatives; prepare popular interpretation materials and artworks to guide the public to understand and master the necessary health knowledge and practice a healthy lifestyle in an effective way; strengthen scientific guidance and typical reports to enhance the general awareness of society and create a good social atmosphere.
Healthy China Initiative (2019-2030)
People's health is an important symbol of national prosperity and national wealth and strength. Since the 18th Party Congress, China's health care has made new and remarkable achievements, the level of medical and health services has improved significantly, and the main health indicators of the population are generally better than the average level of middle and high-income countries. With the development of industrialization, urbanization, population aging and changes in ecological environment and lifestyle behavior, chronic non-communicable diseases (hereinafter referred to as chronic diseases) have become the main cause of death and disease burden for residents. The burden caused by chronic diseases such as cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes accounts for more than 70% of the total disease burden and has become an important factor limiting the improvement of healthy life expectancy. At the same time, the situation of prevention and control of major infectious diseases such as hepatitis, tuberculosis and AIDS is still serious, mental health, occupational health and endemic diseases cannot be ignored, and major safety accidents and traffic accidents occur from time to time. The 19th Party Congress made a major decision to implement the healthy China strategy, fully reflecting the firm determination to maintain the health of the people. In order to respond to the current outstanding health problems, it is necessary to move the gate forward and take effective interventions to strive to make people keep fit, improve the quality of life and extend the healthy life span. This is an effective strategy to achieve higher health performance at a lower cost, a realistic way to solve current health problems, and an important initiative to implement the Healthy China strategy. To this end, the Healthy China Initiative (2019-2030) has been developed.
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Evaluation Plan on Healthy China Initiative Organization and Implementation
In order to implement the "Healthy China 2030" plan outline and the "Opnions of the State Council on the implementation of health China action", to improve the coordination mechanism of Healthy China, and to ensure the effective implementation of health China actions, this Evaluation Plan is developed.
I. Establish a sound organizational structure
(1) Establish Healthy China Initiative Promotion Committee. Relying on the National Public Health Campaign Committee, the Healthy China Initiative Promotion Committee (hereinafter referred to as the Promotion Committee) is established at the national level, to develop and issue " Healthy China Initiative (2019-2030)" (hereinafter referred to as "Healthy China Initiative"), and to coordinate and promote the organization and implementation, monitoring and assessment of related work.
The director of the Promotion Committee is a leader in charge of the State Council, the deputy director is the official in charge of the National Health Commission, the deputy secretary-general of the State Council and the official in charge of education, sports and other relevant departments, the secretary-general is the deputy secretary-general of the State Council, the official in charge of the National Health Commission, and the members are officials in charge of relevant departments, experts, representatives of the National People's Congress, members of the National Committee of the Chinese People's Political Consultative Conference and public figures, etc. as. Office of the Promotion Committee is located in National Health Commission.
The Promotion Committee sets up an expert advisory committee, and hire experts in related fields, who provide technical support for Healthy China Initiative.
The Promotion Committee sets up special action working groups, responsible for the specific implementation and monitoring of special actions.
Provinces (autonomous regions and municipalities) can refer to the national organizational structure, form the deliberations and coordination agencies for the implementation of Healthy China Initiative, and make action plans according to the requirements of the Healthy China Initiative and the actual local situation.
(2) Working mechanism. The Promotion Committee organizes meetings regularly or irregularly according to the needs of the work, including plenary meetings, the director's office meeting and office meetings.
The Promotion Committee is responsible for studying and determining annual work priorities and coordinating to promote the implementation of the work of various regions and departments, and handling issues that require cross-sectoral coordination and resolution; establishing indicator systems and organizing monitoring and assessment; conducting in-depth research and studies, and providing guidance on health education and major disease prevention, treatment, rehabilitation, and health promotion; making adjustments according to changes in disease spectrum and medical advances, etc. indicators, action content; promoting the establishment of a foundation to form a diversified funding mechanism for the construction of a healthy China; using health channels, websites, WeChat, micro-blogs, mobile clients and short videos and other media methods to strengthen the dissemination of health science and information.
All relevant departments should actively study the major issues of implementing the Healthy China Initiative, develop and implement specific policies and measures of the Healthy China Initiative; put forward annual task proposals and implement the work according to the deployment; do a good job of publicizing and interpreting the Healthy China Initiative; implement the work tasks and agreed matters determined by the plenary session and the director's office meeting; exchange information, support each other, work closely together and form a synergy to jointly promote the work of the construction of a healthy China.
II. Strengthen the monitoring and evaluation
(1) monitoring body. Monitoring and evaluation work is led and coordinated by the Promotion Committee, the special action working groups are responsible for the specific organization and implementation, and the Advisory Committee of Experts is to provide technical support. Provinces (autonomous regions and municipalities) should develop their own monitoring and assessment methods as required.
(2) monitoring content. Based on existing statistical data, the statistical monitoring system should be improved. Relying on the Internet and big data, the Promotion Committee monitors the main indicators, key tasks of the implementation progress annually. The main content of monitoring includes: the main indicators of special actions (including outcome indicators, personal and social advocacy indicators, government work indicators) of the annual completion of special actions to achieve the goals, and the implementation of individuals, society, and government tasks.
(3) the application of results. Each special action working group based on the monitoring forms a special action implementation progress report annually. Office of the Promotion Committee produces an overall monitoring and evaluation report, approved by the Promotion Committee and reported to the State Council and informed the provincial (autonomous regions and municipalities) party committees, governments and relevant departments, and releases monitoring and evaluation reports.
III. The evaluation work
(1) Main body of the evaluation. Evaluation work is led by the Promotion Committee, and is organized and implemented by the Office of the Promotion Committee, with the Expert Advisory Committee providing technical support. The provincial (regional and municipal) party committees and governments based on its actual situation in the region, develop the evaluation methods for the party committees and governments of the next level of assessment methods, and provide detailed implementation to specific places and units.
(2) Evaluation content. Around the main objectives and tasks required for the construction of a healthy China, while taking into account the availability of data, a relatively stable framework of assessment indicators (see annex) is established. Provinces (autonomous regions and municipalities) when evaluating the next level, can adjust and improve assessment indicators according to the actual local situation.
Trial evaluation will be made in 2019 and 2020, and after two years of exploration and practice, assessment indicators should be gradually fixed. Evaluation should be conducted scientifically with proper ways and means. Formalism and bureaucracy should be avoided without increasing the burden on the grassroots.
(3) Application of results. The main health indicators will be included into the performance appraisal indicators of party committees and government at all levels. The comprehensive evaluation results validated by the Promotion Committee will be released as important reference for the comprehensive assessment and evaluation of the party and government leadership team and leading cadres of the provinces (autonomous regions and municipalities).
Annex
Healthy China Initiative Evaluation Index Framework
Appraisal basis | No. | Indicator | Base period level | 2022 national target value |
Healthy China Initiative 2030 | 1 | Average life expectancy (years) | 76.7 | 77.7 |
2 | Infant mortality rate（‰） | 6.8 | ≤7.5 | |
3 | Mortality rate of kids under-five（‰） | 9.1 | ≤9.5 | |
4 | Maternal mortality rate（1/100,000） | 19.6 | ≤18 | |
5 | Proportion of urban and rural residents who have reached the National Physical Fitness Standard or above（%） | 89.6 in 2014 | ≥90.86 | |
6 | level of health literacy among residents（%） | 14.18 | ≥22 | |
7 | proportion of people who regularly do physical exercise（%） | 33.9 in 2014 | ≥37 | |
8 | Premature mortality rate of major chronic diseases（%） | 18.5 in 2015 | ≤15.9 | |
9 | Number of practicing (assistant) physicians per 1,000 resident population (person) | 2.44 | 2.6 | |
10 | Proportion of personal health expenditure in a total health expenditure（%） | 28.8 | 27.5 | |
Healthy China Initiative and related planning documents | 11 | Establish and improve health experts and resource base, and build a mechanism for publishing and disseminating health science knowledge | —— | Achieved |
12 | Establish a performance assessment mechanism for medical institutions and medical personnel to carry out health education and health promotion | —— | Achieved | |
13 | Prenatal screening rate（%） | 61.1 | ≥70 | |
14 | Newborn screening rate for genetic metabolic diseases（%） | 97.5 | ≥98 | |
15 | Coverage rate of cervical and breast cancer screening for rural women of appropriate age（%） | 52.6 | ≥80 | |
16 | Proportion of national student who meet the excellent standards of physical health（%） | 31.8 | ≥50 | |
17 | Commencement rate of physical education and health courses in primary and secondary schools that meet the requirements（%） | —— | 100 | |
18 | Daily physical activity time in school for primary and secondary school students（hours） | —— | ≥1 | |
19 | Percentage of boarding primary and secondary schools or non-boarding primary and secondary schools with more than 600 students equipped with full-time health professionals and technicians, and non-boarding primary and secondary schools with less than 600 students equipped with full-time and part-time health teachers or health professionals and technicians（%） | —— | ≥70 | |
20 | Proportion of primary and secondary schools with full-time and part-time mental health staff（%） | —— | ≥80 | |
21 | Proportion of new cases of pneumoconiosis reported by workers with less than 5 years of dust exposure to the total number of cases in the annual report（%） | —— | decreasing | |
22 | Proportion of geriatrics departments in general hospitals above the second level（%） | —— | ≥50 | |
23 | Standardized management rate of hypertensive patients（%） | 50 in 2015 | ≥60 | |
24 | Standardized management rate of patients with diabetes（%） | 50 in 2015 | ≥60 | |
25 | Proportion of township health centers and community health service centers providing TCM non-pharmacological therapy (%), proportion of village health offices providing TCM non-pharmacological therapy（%） | —— | 100，70 | |
26 | Vaccination rate of school-age children by township (town, street) for immunization planning（%） | 90 | ＞90 |
Healthy China Initiative Evaluation Index Framework
Note: Base period level values for years not specified are 2017 values.
Source: official website of the National Health Commission
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