MCH Mother and Child Health

1. MCHMother and Child Health CHP300: Community Health Program-l Mohamed M. B. Alnoor

2. gy Lin, Yutang

3. gy SPECIFIC OBJECTIVES By the end of this presentation the student should be able to: • Appreciate the General Goals and • Specific Objectives of MCH • Appreciate the importance of reproductive health • Be familiar with the Reproductive Health Policy gy • Identify the different periods of maternal care, and recognize the important events in those periods: I. Before pregnancy II. During pregnancy III. During labour IV. Post-Natal Care V. Post lactation • Understand the common causes of Maternal Mortality • Understand the objectives and phases of child care • Understand the mortality in and around infancy

4. MCH gy 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. gy

5. MCH gy Importance of reproductive health: Evidences:- • Females( 15 – 49): 19% • Each year > 200 million women become pregnant. • > 50 million women experience acute pregnancy related complications. gy

6. MCH gy Importance of reproductive health: Evidences:- • > 50 million women experience acute pregnancy related complications: - Predictable - Manageable gy • 15 million women develop long-term disabilities. • 585,000 die annually. (UNICEF) • Prevention • Diagnosis • Treatment

7. MCH gy Importance of reproductive health: Evidences:- • 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. gy

8. MCH gy Importance of reproductive health: Evidences:- • Health of mothers greatly influences the healthy development and well-being of their children. gy Childhood Diseases depend on Genetics Environment (Very closely linked with mothers)

9. MCH gy Importance of reproductive health: Evidences:- Healthy mother gy Healthy daughter KAPof mother is beneficial to their own health and the health of their children.

10. MCH gy Reproductive Health Policy: (ICPD 1994) • Universal education • Reduction of infant and child mortality gy • Reduction of maternal mortality • Access to reproductive and sexual health • services including family planning

11. MCH gy Reproductive Health Policy: (ICPD 1994) • Facilitating: • safe pregnancy by preventing & managing pregnancy complications. • safe delivery gy • safe motherhood • Promoting positive health practices e.g. • early treatment of STDs • delayed marriages • birth spacing .

12. MCH gy PERIODS OF MATERNAL CARE: I. Before pregnancy: (> 15 yrs.) for physical and psychological preparation to bear responsibility. A) Nutrition: The nutritional status strongly influences gy Foetal growth Birth weight (newborn) Nutrition during infancy

13. MCH gy PERIODS OF MATERNAL CARE: I. Before pregnancy: B) Infections: • Maternal Abs passive immunization gy • Maternal immunization against rubella • protects the outcome of pregnancy. • Tuberculosis severely affects nutritional • status of mothers

14. MCH gy PERIODS OF MATERNAL CARE: (Antenatal Care) II. During pregnancy: Aims:- gy • Promote, protect and maintain health. • Detect high risk. • Relieve fear and anxiety. • Health Education: ( elements of • child care, nutrition, hygiene …… etc)

15. MCH gy PERIODS OF MATERNAL CARE: II. During pregnancy: A) Nutrition: - Well nourished preg. good birth wt. - Anaemia during pregnancy gy - Common - Affects newborn infant - Preventable

16. MCH gy PERIODS OF MATERNAL CARE: II. During pregnancy: B) Infection: - Rubella Congenital deformities Abortion gy - Syphilis Stillbirth IUFD - Malaria IUFD Low birth wt - UTI Amnionitis IUFD Placentitis Low birth wt

17. MCH gy PERIODS OF MATERNAL CARE: II. During pregnancy: C) Chronic Diseases Stillbirth Abortion Low birth weight High perinatal mortality gy D) Smoking E) Heavy work and stress in late pregnancy leads to low birth wt F) Psychological stress

18. MCH gy PERIODS OF MATERNAL CARE: II. During pregnancy: Good ANTENATAL care can provide for all of this and more. gy (key family practices) First visit……… Beyond 16 weeks Second visit….. Between 24 and 28 weeks Third visit……... Between 30 and 32 weeks Between 36 and 40 weeks Fourth visit……

19. MCH gy PERIODS OF MATERNAL CARE: (Intra-natal Care) III. During labour : AIMS: • Asepsis • Minimum injury to mother and newborn. gy • Preparedness to deal with complications. (prolonged labor – ante partum hemorrhage – convulsions ) • Care of baby at delivery.

20. MCH gy PERIODS OF MATERNAL CARE: III. During labour : a) Antenatal Care (Risk assessment) b) Care during labour ophthalmia neonatorum - Infection gy tetanus neonatorum - Bleeding - Trauma Mother Newborn - Asphyxia

21. MCH IV. Post-Natal Care PERIODS OF MATERNAL CARE: gy Aims: • Restoration of health. • Check adequacy of breast feeding. • Provide basic health education. • (Evaluate effect of antenatal Care)?! gy V. Post lactation: spacing?

22. MCH gy THE RIGHTS OF WOMEN ! SAFE MOTHERHOOD SD EOC ANC FP gy BASIC MATERNITY CARE PRIMARY HEALTH CARE E Q U I T Y F O R W O M E N

23. MCH gy Maternal Mortality • Malnutrition • Anaemia • Infection Pregnancy gy • Bleeding • Infection Labour • Bleeding • Infection Postpartum • Lack of awareness • Lack of health services • Lack of utilization of health services

24. MCH gy Child Welfare Infancy and Early Childhood: Rapid growth Development - Period of Learning gy Infection - Vulnerability Malnutrition Environmental hazards - Infants: 4% of population: 25% of deaths - “1- 4” years: 13% of pop: 20% of deaths

25. MCH gy Child Welfare Child Care Program • 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)? gy

26. MCH gy Child Welfare Child Care Program 1. Prenatal Care ( Ideally before conception ) Parental guidance and discussion involving: Genetics Family history Feeding plans (Br. F) Home preparation for baby care Answering questions gy

27. MCH gy Child Welfare Child Care Program 1. Prenatal Care ( Ideally before conception ) Parental guidance and discussion involving: Obstetric gy - Work of mothers - Nutrition - Smoking - Drugs

28. MCH gy Child Welfare Child Care Program 2. Infant Care - Early evaluation - Encourage breast feeding - Face parents’ concern - Developmental problems - Anxiety - Sleep - Overfeeding - Active immunization - Monitoring of growth and development gy

30. MCH Mortality in and around infancy gy I N F A N T gy N E O N A T E FOETUS PERINATAL PERIOD Birth 7 Days 28 Days 28th week of gestation 1 Year

31. MCH Mortality in and around infancy gy Infant Mortality Post-neonatal death Neonatal death Early neo-natal death Lateneonatal death gy Perinatal death Still birth Birth 7 Days 28 Days 28th week of gestation 1 Year

32. MCH gy Child Welfare Child Care Program 3. Second year of life - Rapid development - Increased parental concern 4. Pre-school years (< 5 years) - Accident prevention 5. School years gy 6. Adolescent Care - Rapid physical growth - Marked emotional changes - Personality development

33. CONCLUSION gy • 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 gy • Child care starts ideally before conception • Integrated Management of Childhood Illness (IMCI) • Addressing mortality in and around infancy