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REPRODUCTIVE HEALTH & MATERNAL AND INFANT HEALTH CARE SERVICES– THE SEYCHELLES EXPERIENCE

REPRODUCTIVE HEALTH & MATERNAL AND INFANT HEALTH CARE SERVICES– THE SEYCHELLES EXPERIENCE. Ms. Julianna Labrosse Ms. Cecile Bacco Dr. Zia Rizvi. THE SEYCHELLES. Officially – REPUBLIC OF SEYCHELLES Current Head of State – H.E. JAMES A. MICHEL

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REPRODUCTIVE HEALTH & MATERNAL AND INFANT HEALTH CARE SERVICES– THE SEYCHELLES EXPERIENCE

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  1. REPRODUCTIVE HEALTH & MATERNAL AND INFANT HEALTH CARE SERVICES–THE SEYCHELLES EXPERIENCE Ms. Julianna Labrosse Ms. Cecile Bacco Dr. Zia Rizvi Ministry of Health, Seychelles

  2. Ministry of Health, Seychelles

  3. THE SEYCHELLES • Officially – REPUBLIC OF SEYCHELLES • Current Head of State – H.E. JAMES A. MICHEL • Over 116 Islands scattered over 1 million km2 of the Western Indian Ocean • Stretches from 4°to 55°south of Equator • Mahe, the most important island, is 27 kms wide and 11 kms wide & rises abruptly to 905 metres from sea level Ministry of Health, Seychelles

  4. ! • Health services at all levels 100% state-funded for citizens and expatriate government employees. Health sector enjoys the largest allocation of national budget (about 10%), followed by education. Ministry of Health, Seychelles

  5. SOME FACTS • Total population of 87,298! (end of 2009) • Small population - difficulties in estimating statistics and deceptive fluctuations • Life Expectancy 72.89 years in 2009 (up from 69.48 in 1980) 67.7 for males, 78.9 for females • Literacy rate of 96% for males and females • MMR about 32 per 100,000 LB’(approx 51,300 deliveries from 1978 to 2009) • IMR about 11 per 1000 live births (down from 33 per 1000 in 1971) Ministry of Health, Seychelles

  6. FERTILITY RATESTREND Ministry of Health, Seychelles

  7. AGE DISTRIBUTION OF POPULATION Ministry of Health, Seychelles

  8. POPULATION, BIRTHS & DEATHS (‘71 TO ‘09) Ministry of Health, Seychelles

  9. BIRTHS, DEATHS, MIGRATIONS(‘75 TO ’09) Ministry of Health, Seychelles

  10. INFANT MORTALITY Ministry of Health, Seychelles

  11. REPRODUCTIVE HEALTH IN THE SEYCHELLES MATERNITY SERVICES GYNAECOLOGY FAMILY PLANNING COMMUNICABLE DISEASES CONTROL UNIT Ministry of Health, Seychelles

  12. MATERNITY SERVICES Midwife-managed Consultant-guided services • Antenatalcare • Intrapartum services • Postnatal care All low-risk cases are managed by qualified midwives at community level High-risk cases referred to Obstetrician Three routine ultrasounds for all clients Ministry of Health, Seychelles

  13. Maternity Services (contd) • Majority of labours managed at the main Victoria Hospital • Less than 5 % of labours take place at 3 other health centres • No c-sections on request (so far!) • Two obstetricians on call 24-hours for complicated labours • C-section rate of 20 – 22% • 99% of labours conducted by skilled attendants • All high-risk and induced labours monitoredwith EFM • Misoprostol in standard use for induction for last 8 years Ministry of Health, Seychelles

  14. GYNAECOLOGY SERVICES • Specialist general gynaecology outpatient clinics Monday to Friday • Menopause clinic once a week • Colposcopy clinic once a week • Sexual Abuse clinic once a week • Gynaecological Oncology clinic once a week • Infertility clinic once a week • Gynaecological ultrasound clinics everyday • All major gynaecological operations including cancer surgery Ministry of Health, Seychelles

  15. Postnatal and Infant Care • Home visit by community midwife within one week for all postpartum clients after discharge • Six-week assessment for mother and child at primary health centre • All infants and children up to 6 years of age covered by EPI • Early Childhood Intervention Clinic (ECIC)for suspected problems Ministry of Health, Seychelles

  16. FAMILY PLANNING SERVICES • Family planning counselling at all primary health centres • Cervical cytology and breast disease screening part of FP services (76% coverage) • Hormonal contraception main modality • Female sterilisation about 400 per year (laparoscopic predominantly) • Male sterilisation rare and performed by general surgeon or urologist Ministry of Health, Seychelles

  17. ABORTION SERVICES • TOP act governs granting of safe abortion • TOP Board • Allowed up to 12 weeks in case of: - risk to maternal or fetal physical or mental health - pregnancy after rape or incest • Special consideration for cases above 12 weeks in which case CMO takes responsibility Ministry of Health, Seychelles

  18. CDCU • Controls the HIV/AIDS prevention programme • Independent of OBGYN services • All STI’s and recurrent RTI’s reported / referred • Liaises with midwife and obstetrician for MTCT prophylaxis Ministry of Health, Seychelles

  19. CONSTRAINTS • Lack of full-fledged laparoscopic surgical equipment • Lack of genetics diagnostic facility • Disparity between age of consent for sex and for use of contraception Ministry of Health, Seychelles

  20. FUTURE • To strive to achieve the Millenium Goals • Advanced Laparoscopic surgery • Pre-conceptional counselling (…premarital counseling) Ministry of Health, Seychelles

  21. Our HEARTFUL THANKS to: China Training Centre MOFCOM AIBO THANK YOU CHINA!! Ministry of Health, Seychelles

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