maternal and child health MCH

Maternal Health Care

Cont.

Specific objectives

At the end of this lecture, you will be able to:
Define child health care services
Enumerate main functions of MCH (child care)
Identify basic steps in the care of newborn baby
Define integrated management of childhood illnesses and specify its components

Child Health.

Child's health includes physical, mental and social well-being too.

Children under five years of age account for nearly 50% of the world's population.

Children under five bear 30% of the total burden of disease in poor countries.

Each year more than 10 million children under the age of five die mostly in developing countries.


At least 6.6 million child deaths can be prevented each year if affordable health interventions are made available to the mothers and children who need them.

Perinatal mortality accounted for more than 20% of deaths in children

under five years of age, in 2000 and includes birth asphyxia, trauma,
and low birth weight.

What can be done to improve child health?

Child Health Service (Program)
The MCH center provides child care that starts before birth and continues through out childhood.

Functions of MCH centers for child care:

Maternal care (prenatal and natal)
Neonatal care
Adequate nutrition of infants and children
Health appraisal (assessment)
Prevention and control of communicable diseases including immunization.
Clinical (curative services)
Social services.


NEONATAL CARE

OBJECTIVES:

• Establish and maintain of cardio-respiratory functions.
• Maintenance of body temperature.
• Avoidance of infection
• Establish a satisfactory feeding regimen (encouraging exclusive breast feeding)
• Early detection and management of any anomalies.
• Start immunization as early as possible

IMMEDIATE CARE

1.CLEARING THE AIRWAY: TO HELP TO ESTABILISH BREATHING,THE AIRWAYS SHOULD BE CLEARED MUCUS AND OTHER SECRETIONS
2.APGAR SCORE: IT IS TAKEN 1 MINUTE & AGAIN AT 5 MINUTES AFTER BIRTH.

Sign

Score 0
Score 1
Score 2
Heart Rate
Absent
Slow (below 100)
Over 100
Respiratory Effort
Absent
Slow irregular
Good crying
Muscle Tone
Flaccid
Some flexion of extremities
Active movements
Reflex Response
No response
Grimace
Cry
Color
Blue, pale
Blue, pink extremities blue
Completely pink
Total score=10
Severe depression 0-3
Mild depression 4-7
No depression
7-10


3. Care of the cord
4.Care of the eyes
5. Care of the skin
6.Maintainance of body temperature
7.Breast feeding

Neonatal care

Neonatal examinations
Measuring the baby; weight, height , head circumference
Identification of “ AT RISK” infants
Late neonatal care

Neonatal care

The Integrated Management of Childhood Illness (IMCI)
IMCI is a broad strategy to improve child health outcomes developed by WHO and UNICEF. IMCI encompasses interventions at home, in the community and in the health system.
The aims are to reduce childhood deaths, illnesses, and disability and to improve children's growth and development, with a particular focus on the poorest and most disadvantaged children.

IMCI has three main components:

Improve family and community practices related to child health and nutrition;
Improve the health system for effective management of childhood illness;
Improve health workers' skills.


Improve family and community practices related to child health and nutrition;
Counseling on child feeding including
exclusive breast feeding
Adequate amount of micronutrient or supplementation
Complete full course of immunization for children
Promote safe disposal of waste and hand washing before preparing meals and feeding children
Provide adequate care to sick children
Promote mental and social development by responding to children's needs for care,
Provide adequate prenatal care to every pregnant woman

Improve the health system for effective management of childhood illness;

Ensure drugs and supplies for treating major childhood illnesses are available in health facilities
Improve quality of care provided at health facilities and organization of work
Improve referral pathways
Identify and develop methods for sustainable financing and equity of access

Improve health workers' skills

Develop and adapt case management guidelines and standards for major childhood illnesses in the country
Train health providers at first level health facilities and referral level in standard case management
Improve and maintain health workers' performance through follow-up after training and periodic supervision


A combination of integrated curative and preventive interventions is required to address the immediate and underlying determinants of child health. Maternal determinants and risk factors associated with pregnancy and childbirth are especially important.

Simple, cost-effective interventions delivered at the community level can save most newborn and children lives in developing countries.

To summarize

Optimum child health is achieved through:
Adequate maternal care
Periodic follow up of the “healthy child”
Breast feeding and proper child nutrition
Immunization
Early detection and proper management
A sanitary and safe environment
Health education of parents.

THANK YOU