Maternal & Child Health
The term maternal and child health refers to promotive, preventive, curative and rehabilitative health care for mothers and children. It includes the sub-areas of maternal health, child health, family planning, school health and adolescent health. The specific objectives of MCH are:
Reduction of maternal, prenatal, infant and child mortality;
Promotion of reproductive health and;
Promotion of the physical and psychological development of the child and adolescent within the family.
Major Targets of MCH Services
• Women of reproductive age group (15-49 yr)
• Pregnant women
• Children < 15yr
• Children <5yr
• Children <1yr
Major component of MCH services
Provision of quality ANC, delivery care, PNC, and FP services
Prevention of STIs/HIV/AIDS
Immunization
Growth monitoring
Well baby clinic
Sick baby clinic
Nutrition Rehabilitation Clinic (NRC)
Philosophy
Pregnancy, labor and delivery and puerperium are part of the continuum of the total life cycle
Personal, cultural and religious attitudes and beliefs influence the meaning of pregnancy for individuals and make each experience unique
MCN is FAMILY CENTERED- the father is as important as the mother
Goals
To ensure that expectant mother and nursing mother maintain good health, learn the art of child care, has a normal delivery and bear healthy children
That every child lives and grows up in a family unit with love and security, in healthy surroundings, receives adequate nourishment, health supervision and efficient medical attention and is taught the elements of healthy living
Classification of pregnant women
Normal – healthy pregnancy
With mild complications- frequent home visits
With serious or potentially serious complication – referred to most skilled source of medical and hospital care
Home Based Mother’s Record (HBMR)
Tool used when rendering prenatal care containing risk factors and danger signs
Risk Factors
145 cm tall (4 ft & 9 inches)
Below 18 yrs old, above 35 yrs old
Have had 4 pregnancies
With TB, goiter, heart disease, DM, bronchial asthma, severe anemia
Last baby born was less than 2 years ago
Previous cesarian section delivery
History of 2 or more abortions, difficult delivery, given birth to twins, 2 or more babies born before EDD, stillbirth
Weighs less than 45 kgs. or more than 80 kgs.
Danger Signs
any type of vaginal bleeding
headache, dizziness, blurred vision
puffiness of face and hands
pallor
Prenatal Care
Schedule of Visits
1st – as early as pregnancy, 1st trimester
2nd – 2nd trimester
3rd & subsequent visits – 3rd trimester
More frequent visits for those at risk with complications
Tetanus Toxiod Immunization Schedule for Women
Vaccine
Minimum Age Interval
Percent Protected
Duration of Protection
TT1
As early as possible during pregnancy
0%
None
TT2
At least 4 weeks later
80%
Infants born to the mother will be protected from neonatal tetanus. Gives 3 years protection for the mother from the tetanus.
TT3
At least 6 months later
90%
Infants born to the mother will be protected from neonatal tetanus.
Gives 5 years protection for the mother.
TT4
At least 1 year later
99%
Gives 10 years protection for the mother
TT5
At least 1 year later
99%
Gives lifetime protection for the mothers. All Infants born to that mother will be protected.
Dose: 0.5ml
Route: Intramuscular
Site: Right or Left Deltoid/Buttocks
Components of Prenatal Visits
History – taking
Determination of obstetrical score- G, P, TPAL, AOG, EDD
U/A for Proteinuria, glycosuria and infxtn
Dental exam
Wt. Ht. BP taking
Exam of conjunctiva and palms for pallor
Abdominal exam – fundic ht, Leopold’s maneuver and FHT
Exam of breasts, face, hands and feet for edema and neck for thyroid enlargement
Health teachings- nutrition, personal hygiene, common complaints
Tetanus toxoid immunization
Iron supplementation – from 5th mo. Of pregnancy – 2 mos. Postpartum
In goiter endemic areas – iodized capsule once a year
In malaria infested areas- prophylactic Chloroquine (150 mg/tab ) 2 tabs/ wk for the whole duration of pregnancy
Reduction of maternal, prenatal, infant and child mortality;
Promotion of reproductive health and;
Promotion of the physical and psychological development of the child and adolescent within the family.
Major Targets of MCH Services
• Women of reproductive age group (15-49 yr)
• Pregnant women
• Children < 15yr
• Children <5yr
• Children <1yr
Major component of MCH services
Provision of quality ANC, delivery care, PNC, and FP services
Prevention of STIs/HIV/AIDS
Immunization
Growth monitoring
Well baby clinic
Sick baby clinic
Nutrition Rehabilitation Clinic (NRC)
Philosophy
Pregnancy, labor and delivery and puerperium are part of the continuum of the total life cycle
Personal, cultural and religious attitudes and beliefs influence the meaning of pregnancy for individuals and make each experience unique
MCN is FAMILY CENTERED- the father is as important as the mother
Goals
To ensure that expectant mother and nursing mother maintain good health, learn the art of child care, has a normal delivery and bear healthy children
That every child lives and grows up in a family unit with love and security, in healthy surroundings, receives adequate nourishment, health supervision and efficient medical attention and is taught the elements of healthy living
Classification of pregnant women
Normal – healthy pregnancy
With mild complications- frequent home visits
With serious or potentially serious complication – referred to most skilled source of medical and hospital care
Home Based Mother’s Record (HBMR)
Tool used when rendering prenatal care containing risk factors and danger signs
Risk Factors
145 cm tall (4 ft & 9 inches)
Below 18 yrs old, above 35 yrs old
Have had 4 pregnancies
With TB, goiter, heart disease, DM, bronchial asthma, severe anemia
Last baby born was less than 2 years ago
Previous cesarian section delivery
History of 2 or more abortions, difficult delivery, given birth to twins, 2 or more babies born before EDD, stillbirth
Weighs less than 45 kgs. or more than 80 kgs.
Danger Signs
any type of vaginal bleeding
headache, dizziness, blurred vision
puffiness of face and hands
pallor
Prenatal Care
Schedule of Visits
1st – as early as pregnancy, 1st trimester
2nd – 2nd trimester
3rd & subsequent visits – 3rd trimester
More frequent visits for those at risk with complications
Tetanus Toxiod Immunization Schedule for Women
Vaccine
Minimum Age Interval
Percent Protected
Duration of Protection
TT1
As early as possible during pregnancy
0%
None
TT2
At least 4 weeks later
80%
Infants born to the mother will be protected from neonatal tetanus. Gives 3 years protection for the mother from the tetanus.
TT3
At least 6 months later
90%
Infants born to the mother will be protected from neonatal tetanus.
Gives 5 years protection for the mother.
TT4
At least 1 year later
99%
Gives 10 years protection for the mother
TT5
At least 1 year later
99%
Gives lifetime protection for the mothers. All Infants born to that mother will be protected.
Dose: 0.5ml
Route: Intramuscular
Site: Right or Left Deltoid/Buttocks
Components of Prenatal Visits
History – taking
Determination of obstetrical score- G, P, TPAL, AOG, EDD
U/A for Proteinuria, glycosuria and infxtn
Dental exam
Wt. Ht. BP taking
Exam of conjunctiva and palms for pallor
Abdominal exam – fundic ht, Leopold’s maneuver and FHT
Exam of breasts, face, hands and feet for edema and neck for thyroid enlargement
Health teachings- nutrition, personal hygiene, common complaints
Tetanus toxoid immunization
Iron supplementation – from 5th mo. Of pregnancy – 2 mos. Postpartum
In goiter endemic areas – iodized capsule once a year
In malaria infested areas- prophylactic Chloroquine (150 mg/tab ) 2 tabs/ wk for the whole duration of pregnancy
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