mch mother and child health chp310: community health program-l mohamed m. b. alnoor
TRANSCRIPT
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MCHMother and Child Health
CHP310:
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 lactation
IV. Post-Natal Care
Appreciate the importance of reproductive health
Understand the objectives and phases of child care Understand the mortality in and around infancy
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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.
MCHgy
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Females( 15 – 49): 19%
Each year > 200 million women become pregnant.
> 50 million women experience acute pregnancy related complications.
MCH
Evidences:-
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Importance of reproductive health:
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> 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:
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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:
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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:
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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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MCH
(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
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Facilitating:
MCH
(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 .
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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:
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• Maternal immunization against rubella
protects the outcome of pregnancy.
• Tuberculosis severely affects nutritional
status of mothers
MCH
B) Infections:
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• Maternal Abs passive immunization
PERIODS OF MATERNAL CARE: I. Before pregnancy:
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MCH
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:
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- Well nourished preg. good birth wt.
MCH
- 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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MCH
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
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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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MCH
(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:
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b) Care during labour
MCH
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:
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V. Post lactation: spacing?
MCH
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:
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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
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-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
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Infancy and Early Childhood:
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MCH
Rapid growthDevelopmentLearning
- Period of
- VulnerabilityInfectionMalnutritionEnvironmental hazards
- Infants: 4% of population: 25% of deaths
- “1- 4” years: 13% of pop: 20% of deaths
Child Welfare
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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
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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:
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- 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
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- 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
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Periods in and around infancy
28th weekof gestation
Birth
7 Days
28 Days
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MCH
I N F A N T
FOETUS
N E O N A T E
PERINATALPERIOD
1 Year
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Mortality in and around infancy
Infant Mortality
Perinatal death
Post-neonatal death
Neonatal death
Lateneonatal
death
Early neo-natal deat
h
Still birth
Birth
7 Days
28 Days 1 Year
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MCH
28th weekof gestation
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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
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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