mch lecture

7/27/2019 MCH Lecture

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Maternal and Child

Health


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Maternal and Child Health Program


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GOALS

To ensure that every expectant andnursing mother maintains good

health, learns that art of child care,has a normal delivery and bears

healthy child.


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That every child,wherever possible, livesand grows up in afamily unit with love

and security in healthysurroundings, receivesadequate nourishment,health supervision and

efficient medicalattention, and is taughtthe elements of healthliving.


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PHILOSOPHYPregnancy, labor and deliveryand puerperium are part of thecontinuum of the total lifecycle. They are meaningful

only in the context of the totallife.


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Personal, cultural and religious

attitudes and beliefs influence the

meaning of pregnancy for

individuals and make each

experience unique.


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Maternal-child nursing is family

centered. The father of the child is as

important as the mother.


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MATERNAL CARE

1. Pre-natal Care

There should be at least 3

prenatal visits during pregnancyfollowing the prescribed timing:


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1st Visit- As early in pregnancy as possible during1st trimester

2nd

visit- During the 2nd

trimester

3rd visit- During the 3rd trimester

Every 2 weeks after 8th month of pregnancy tilldelivery


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2. Nursing care During ChildhoodHome deliveries for normal

pregnancies attended by licensed

health personnel shall be encouraged.

Trained hilots or traditional birth

attendants may be allowed to attend

home deliveries only in the following

circumstances:


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In areas where there are nolicensed health personnel onmaternal care.

When at the time of home

delivery, such personnel is notavailable.


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3. Nursing Care After Delivery

The following should be checked :

MOTHER

Uterus is contracted and hard

Blood pressure and pulse rate must be normalPlacenta must be completely expelled

Lacerations along the birth canal


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BABYVital signs/reflexes with the use of APGAR

scoring

Congenital defects

Each baby must be registered in the

civil registry. Birth certificate must

be filled up by the attendant at birth.


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For home deliveries:

1st Postpartum visit- within 24 hours

after delivery

2nd visit- 1 week after delivery

3rd Visit- 2-4 weeks thereafter


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NOTE:

Visit to the health facilityshall be within 4 to 6

weeks after delivery.


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4. BreastfeedingExclusive BF of

infants

recommended for the

first 6 months of their

lives and BF with

Supplementary food

thereafter.


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5. Hilot Training

The purpose is to train traditional

birth attendants or hilots to extend

various health services to the

community levels.


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6. Expanded Program on Immunization

Legal basis:

PD 996 (September 16, 1976)

Providing for compulsory basicimmunization for infants and childrenbelow 8 years old.


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National Health Situation (MCH)Crude Birth

rate(1997)= 28.4/1000

p0p.Birth Sex Ratio= 109

male babies for every100 female babies born

There is a higherproportion of malesborn


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Crude Death Rate(1997)= 6.1/1000 pop.

Death rates by age tend to be very high

at infancy and early childhood,declining sharply by the age of 10.

Death Sex Ratio= 147 males per 100

females

Total Fertility Rate (between 1995-

1998)=3.7 children per woman


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Total Fertility Rate (TFR)- average numberof births that a woman would have at theend of her reproductive life.

TFR varies with location and education

- higher TFR in rural areas than urbanareas

- higher TFR among women withouteducation

- lower TFR among women with collegeeducation


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Reproductiveage for women(childbearingage)= 15-49

years old


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Infant Mortality

Rate (2003)=29/1000

livebirths


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There is a declined trend of IMR in the

Philippines; however, IMR is very highcompared to that in neighboring countries

Malaysia= 3.2

Indonesia= 2.3

Thailand= 2.0

Singapore= 1.7


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IMR varies with socioeconomic and

demographic factors.

Regions With Lowest IMR

1. NCR= 23.7

2. Central Luzon= 23.63. Western Visayas= 26.0

Regions With Highest IMR

1. Eastern Visayas= 60.8

2. ARMM= 55.1

3. CARAGA= 53.2


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Maternal Mortality Rate1995= 180/100,000 live births

1997= 172/100,000 live births

Maternal Mortality- deaths among

women during pregnancy, atchildbirth or in period afterchildbirth.


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The Philippines Ranks Second to

Indonesia in MMR

Indonesia= 312/100,000 livebirths

Malaysia= 20/100,000 livebirths

Thailand= 10.7/100,000 livebirths

Japan = 7.6/100,000 livebirthsSingapore= 4.1/ 100,000 livebirths


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Among Filipino women, the lifetime risk of dyingfrom maternal causes is one in 100.

Maternal deaths made up less than one percent ofthe total deaths in the country, but contributed14% of all deaths in women aged 15-49.

Maternal deaths are due to postpartumhemorrhage, hypertension and its complications,sepsis, obstructed labor and complications fromabortions. Most of these can be prevented throughquality maternal care.


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A father may turn his back on his child; brothersand sisters may become inveterate enemies;husbands may desert their wives and wives theirhusbands. But a mother's love endures through all;

in good repute, in bad repute, in the face of theworld's condemnation, a mother still loves on, andstill hopes that her child may turn from his evilways, and repent; still she remembers the infantsmiles that once filled her bosom with rapture, the

merry laugh, the joyful shout of his childhood, theopening promise of his youth; and she can neverbe brought to think him all unworthy.


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END OF PART 1

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