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Maternal Health indicators
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  1. Maternal Health indicators

  2. Maternal Health indicators *RAMOS: Reproductive Age Mortality Survey *DHS: Demographic and Health Survey

  3. COMMUNITY (RURAL MIDWIVES) JOB DISCRIPTION Taking history during ANP, Labor & postpartum Antenatal & postnatal care Identification of high risk pregnancy & referall Calculation of EDD Identification of danger signs of pregnancy& labor & puerperium Measurement of vital sign Controlling weight & height Intramuscular injection Examination of breast

  4. continued • Distribution of iron, folic acid & multivitamin Information regarding breast feeding • Initial management of antepurtom ,post purtom hemorrhage,eclampsia & refer • Control blood presser and refer if needed • Diagnoses of intera utraine death & refer • Diagnoses of abortion & refer • Vaginal examination • Management first, second & third stage of labor

  5. continued • Cutting & tieing umbilical cord • Examination of placenta & membrane • Diagnosis mal presentation • Diagnosis of prolonged & obstructed labor & refer • Diagnosis of premature rupture membrane & refer • Counseling of postpartum women (FP & BF) • Diagnosis of problems after delivery & refer • Newborn care • External bimanual compression

  6. continued • Diagnosis of puerperal sepsis & refer • Family planning services & distribution pill & condom • Sterile instrument for delivery • Record keeping & reporting • Follow up cases & paying home visit

  7. She isn’t allowed to Deliver : • primipara & grand multipara • Pregnancy before 18 & after 35 years of old • height less than 145 Cm • Women with history of C.S, vacuum extraction, forceps delivery, any complication during their previous pregnancy & delivery • Women RH negative & husband RH posetive

  8. The following diagnostic tree has been drawn by using the information gathered from 2.5 years (2001 to 2003) working of the surveillance system all over the country and case investigation of more than 680 maternal deaths. It is clear that improving the quality of EOC (emergency obstetric care) services is a priority compared with improving the coverage of services. In order to cover the MDG goal the following policies/strategies has been translated into action plans. Improving hospital services for safe delivery

  9. Diagnostic tree for cause analysis of maternal death in Iran (Based on the data adopted from national maternal mortality surveillance system (2001-2003)

  10. IN1990 MMR (maternal mortality ratio) was estimated around 75 to 90, so based on the MDGs commitment in 2015 it should be reduced to 18-20

  11. Strategies for 4th 5 Year Development Plan: • Establishing mother friendly hospitals to provide comprehensive EOC services and painless delivery and encouraging families to understand the advantages of normal delivery and painless delivery in order to reduce the rate of caesarean section. • Providing high quality of care and standardized routine antenatal & post partum care for outpatient mothers. • Improving the quality of academic education of Ob/Gyns and other related staffs. (Linking the medical education with maternal care services and related research)

  12. continued • Mass awareness of families regarding danger signs and symptoms of pregnancy and childbirth and importance of safe delivery. • Improving the implementation of maternal mortality surveillance system to monitor and evaluate the trend of maternal death in the country. • Pilot study the management information system (MIS) on all over the country in order to monitor the quality and measure the effectiveness of the program. (MIS was designed and published in 3 books during 2001 – 2003, including 1- new monitoring system of reproductive health system, 2- new evaluation system of reproductive health program, 3- new monitoring system of the logistic process of reproductive health program)