MCH Mother and Child Health

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MCHMother and Child Health
CHP300 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 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

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• 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

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MCH
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.

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MCH
Importance of reproductive health
Evidences-

• Females( 15 49) 19
• Each year gt 200 million women become pregnant.
• gt 50 million women experience acute pregnancy
  related complications.

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MCH
Importance of reproductive health
Evidences-

• gt 50 million women experience acute pregnancy
  related complications
• - Predictable
• - Manageable

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• Prevention
• Diagnosis
• Treatment

• 15 million women develop long-term disabilities.
• 585,000 die annually. (UNICEF)

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MCH
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.

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MCH
Importance of reproductive health
Evidences-

• Health of mothers greatly influences
• the healthy development and well-being of their
  children.

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Childhood Diseases depend on
Environment
Genetics
(Very closely linked with mothers)
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MCH
Importance of reproductive health
Evidences-
Healthy mother
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Healthy daughter
KAP of mother is beneficial to their own health
and the health of their children.
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MCH
Reproductive Health Policy
(ICPD 1994)

• Universal education

• Reduction of infant and child mortality

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• Reduction of maternal mortality

• Access to reproductive and sexual health
• services including family planning

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MCH
Reproductive Health Policy
(ICPD 1994)

• Facilitating

• safe pregnancy

by preventing managing pregnancy
complications.

• safe delivery

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• safe motherhood

• Promoting positive health practices e.g.

• early treatment of STDs

• delayed marriages

• birth spacing .

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

• Maternal Abs passive immunization

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• Maternal immunization against rubella
• protects the outcome of pregnancy.
• Tuberculosis severely affects nutritional
• status of mothers

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

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MCH
PERIODS OF MATERNAL CARE
II. During pregnancy
A) Nutrition
- Well nourished preg. good birth wt.
- Anaemia during pregnancy
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- Common
- Affects newborn infant
- Preventable
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MCH
PERIODS OF MATERNAL CARE
II. During pregnancy
B) Infection
- Rubella
Congenital deformities
Abortion
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- Syphilis
Stillbirth
IUFD
- Malaria
IUFD
Low birth wt
- UTI
Amnionitis
IUFD
Placentitis
Low birth wt
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MCH
PERIODS OF MATERNAL CARE
II. During pregnancy
C) Chronic Diseases

• Stillbirth
• Abortion
• Low birth weight

• High perinatal
• mortality

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D) Smoking

• E) Heavy work and stress in late pregnancy
• leads to low birth wt
• F) Psychological stress

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MCH
PERIODS OF MATERNAL CARE
II. During pregnancy
Good ANTENATAL care can provide for all of this
and more.
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(key family practices)
First visit
Beyond 16 weeks
Second visit..
Between 24 and 28 weeks
Third visit...
Between 30 and 32 weeks
Fourth visit
Between 36 and 40 weeks
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MCH
PERIODS OF MATERNAL CARE
(Intra-natal Care)
III. During labour
AIMS

• Asepsis

• Minimum injury to mother and newborn.

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• Preparedness to deal with complications.

(prolonged labor ante partum hemorrhage
convulsions )

• Care of baby at delivery.

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

• Restoration of health.
• Check adequacy of breast feeding.
• Provide basic health education.
• (Evaluate effect of antenatal Care)?!

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V. Post lactation spacing?
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MCH
THE RIGHTS OF WOMEN !
SAFE MOTHERHOOD
SD
EOC
ANC
FP
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BASIC MATERNITY CARE
PRIMARY HEALTH CARE
E Q U I T Y F O R W O M E N
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MCH
Maternal Mortality

• Malnutrition
• Anaemia
• Infection

Pregnancy
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• Bleeding
• Infection

Labour

• Bleeding
• Infection

Postpartum

• Lack of awareness
• Lack of health services
• Lack of utilization of health services

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MCH
Child Welfare
Infancy and Early Childhood

Rapid growth
Development
- Period of
Learning
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Infection
- Vulnerability
Malnutrition
Environmental hazards
- Infants 4 of population 25 of deaths -
1- 4 years 13 of pop 20 of deaths
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MCH
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)?

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MCH
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
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MCH
Child Welfare
Child Care Program
1. Prenatal Care ( Ideally before conception )
Parental guidance and discussion involving
Obstetric
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- Work of mothers -
Nutrition - Smoking
- Drugs
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MCH
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
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Mortality in and around infancy
MCH
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I N F A N T
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N E O N A T E
FOETUS

• PERINATAL
• PERIOD

Birth
7 Days
28 Days
28th week of gestation
1 Year
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Mortality in and around infancy
MCH
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Infant Mortality
Post-neonatal death
Neonatal death
Lateneonatal death
Early neo-natal death
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Perinatal death
Still birth
Birth
7 Days
28 Days
28th week of gestation
1 Year
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MCH
Child Welfare
Child Care Program
3. Second year of life - Rapid development -
Increased parental concern 4. Pre-school years
(lt 5 years) - Accident prevention 5. School
years
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6. Adolescent Care - Rapid physical growth -
Marked emotional changes - Personality
development
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CONCLUSION
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• 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

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• Child care starts ideally before conception

• Integrated Management of Childhood Illness
  (IMCI)

• Addressing mortality in and around infancy