MCHMother and Child Health

CHP300:

Community Health Program-l

Mohamed M. B. Alnoor

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Lin, Yutang

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SPECIFIC OBJECTIVES

By the end of this presentation thestudent should be able to:

Appreciate the General Goals and Specific Objectives of MCH

Understand the common causes of Maternal Mortality

Be familiar with the Reproductive Health Policy Identify the different periods of maternal care, and recognize the important events in those periods:

I. Before pregnancyII. During pregnancyIII. During labour

V. Post lactationIV. Post-Natal Care

Appreciate the importance of reproductive health

Understand the objectives and phases of child care Understand the mortality in and around infancy

OBJECTIVES OF MCH SERVICES:

1.Reduction in maternal, perinatal, infant and childhood Mortality & Morbidity.

2.Promotion of reproductive health.

3.Promotion of physical and psychological

development of child and adolescent within the family.

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Females( 15 – 49): 19%

Each year > 200 million women become pregnant.

> 50 million women experience acute pregnancy related complications.

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Evidences:-

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Importance of reproductive health:

> 50 million women experience acute pregnancy related complications:

- Predictable- Manageable

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Evidences:-

15 million women develop long-term disabilities. 585,000 die annually. (UNICEF)

• Prevention• Diagnosis• Treatment

Importance of reproductive health:

Poor women health and nutritional status. Inappropriate management of labor is

responsible for about 75% of 7.5 million annual perinatal deaths.

Reproductive Health: - most neglected health problems. - interventions are available. - policies are inappropriate.

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Evidences:-

Importance of reproductive health:

Health of mothers greatly influences the healthy development and well-

being of their children.

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Childhood Diseases depend on

(Very closely linked with mothers)

Environment

Genetics

Evidences:-

Importance of reproductive health:

KAP of mother is beneficial

to their own health and the health of their children.

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Healthy daughter

Healthy mother

Evidences:-

Importance of reproductive health:

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(ICPD 1994)

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Reproductive Health Policy:

• Universal education

• Reduction of infant and child mortality

• Reduction of maternal mortality

• Access to reproductive and sexual health services including family planning

Facilitating:

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(ICPD 1994)

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by preventing & managing

pregnancy complications.

Promoting positive health practices e.g.

• safe motherhood

• early treatment of STDs

• safe delivery• safe pregnancy

Reproductive Health Policy:

• delayed marriages• birth spacing .

A) Nutrition:

PERIODS OF MATERNAL CARE:MCH

(> 15 yrs.) for physical and psychological preparation to bear responsibility.

The nutritional status strongly influences

Foetal growth

Birth weight (newborn)

Nutrition during infancy

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I. Before pregnancy:

•Maternal immunization against rubella

protects the outcome of pregnancy.

•Tuberculosis severely affects nutritional

status of mothers

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B) Infections:

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• Maternal Abs passive immunization

PERIODS OF MATERNAL CARE: I. Before pregnancy:

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II. During pregnancy:

Promote, protect and maintain health.

Detect high risk.

Relieve fear and anxiety.

Health Education: ( elements of child care, nutrition, hygiene …… etc)

(Antenatal Care)gy

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Aims:-

PERIODS OF MATERNAL CARE:

- Well nourished preg. good birth wt.

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- Common- Affects newborn infant

- Preventable

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A) Nutrition:

- Anaemia during pregnancy

II. During pregnancy:

PERIODS OF MATERNAL CARE:

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B) Infection:

- Rubella Congenital deformitiesAbortion

- Syphilis

IUFD

Stillbirth

- MalariaLow birth wt

Amnionitis- UTI

Placentitis Low birth wt

IUFD

IUFD

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II. During pregnancy:

PERIODS OF MATERNAL CARE:

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C) Chronic Diseases

StillbirthAbortionLow birth weight

High perinatal

mortality

D) Smoking

II. During pregnancy:

PERIODS OF MATERNAL CARE:

E) Heavy work and stress in late pregnancy

leads to low birth wt

F) Psychological stress

Good ANTENATAL care can provide for all of

this and more.

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II. During pregnancy:

PERIODS OF MATERNAL CARE:

First visit……… Beyond 16 weeks

Second visit….. Between 24 and 28 weeks

Third visit……...

Fourth visit……

Between 30 and 32 weeks

Between 36 and 40 weeks

(key family practices)

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(Intra-natal Care)

AIMS:Asepsis

(prolonged labor – ante partum hemorrhage – convulsions )

Care of baby at delivery.

Preparedness to deal with complications.

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Minimum injury to mother and newborn.

III. During labour :

PERIODS OF MATERNAL CARE:

b) Care during labour

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a) Antenatal Care (Risk assessment)

- Infection ophthalmia neonatorum

tetanus neonatorum- Bleeding

- Trauma MotherNewborn

- Asphyxia

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III. During labour :

PERIODS OF MATERNAL CARE:

V. Post lactation: spacing?

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IV. Post-Natal Care

Aims:

Restoration of health. Check adequacy of breast feeding. Provide basic health education. (Evaluate effect of antenatal Care)?!

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PERIODS OF MATERNAL CARE:

SAFE MOTHERHOOD

FP ANC SD EOC

E Q U I T Y F O R W O M E N

PRIMARY HEALTH CARE

BASIC MATERNITY CARE

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THE RIGHTS OF WOMEN !MCH

-Malnutrition- Anaemia- Infection

Pregnancy

- Bleeding- Infection

- Bleeding- Infection

-Lack of awareness- Lack of health services

-Lack of utilization of health services

Labour

Postpartum

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MCHMaternal Mortality

Infancy and Early Childhood:

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Rapid growthDevelopmentLearning

- Period of

- VulnerabilityInfectionMalnutritionEnvironmental hazards

- Infants: 4% of population: 25% of deaths

- “1- 4” years: 13% of pop: 20% of deaths

Child Welfare

Objectives of child care:Safe entry to life

Reduction in perinatal and neonatal deaths

Reaching a healthy adulthood

Promotion, protection and maintenance of health

(Overcome genetic factor)?

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MCHChild WelfareChild Care Program

Genetics

Family history

Feeding plans (Br. F)

Home preparation for baby care

Answering questions

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MCHChild WelfareChild Care Program

1. Prenatal Care ( Ideally before conception )

Parental guidance and discussion involving:

- Work of mothers

- Nutrition

- Smoking

- Drugs

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MCHChild WelfareChild Care Program

1. Prenatal Care ( Ideally before conception )

Parental guidance and discussion involving:Obstetric

- Early evaluation- Encourage breast feeding- Face parents’ concern

- Developmental problems- Anxiety- Sleep- Overfeeding

- Active immunization- Monitoring of growth and development

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MCHChild WelfareChild Care Program

2. Infant Care

Mortality in and around infancy

28th weekof gestation

Birth

7 Days

28 Days

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I N F A N T

FOETUS

N E O N A T E

PERINATALPERIOD

1 Year

Mortality in and around infancy

Infant Mortality

Post-neonatal death

Neonatal death

Lateneonatal

death

Early neo-natal deat

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Still birth

Birth

7 Days

28 Days 1 Year

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28th weekof gestation

Perinatal death

3. Second year of life- Rapid development- Increased parental concern

4. Pre-school years (< 5 years)- Accident prevention

5. School years

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MCHChild WelfareChild Care Program

6. Adolescent Care- Rapid physical growth- Marked emotional changes- Personality development

CONCLUSIONgy

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Addressing mortality in and around infancy

Integrated Management of Childhood Illness (IMCI)

Child care starts ideally before conception

Antenatal care is the key to modification of outcome to the mother and the newborn

Prevention and management of bleeding and infection during and after labour