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Maternal and child health programme


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Maternal and child health programme

  1. 1. Maternal and child health programme MR. INDRA MANI MISHRA (M.Sc. Nursing , B.Sc. Biotech, Diploma in Hospital Management) Nursing Tutor in RIMSCON Ranchi
  2. 2. 1. Mothers and children not only constitute a large group, but they are also” vulnerable “ or special group. They comprises 71.4 % of population of the developing countries. In India ,women of child bearing age (15-44 years) constitute 22.2% and children under 15 years of age about 35.3% of total population, together 57.5% of population consists of mothers and children. (current population of India as on 22 march 2015 is 1.28 billion. And of Jharkhand is 32,966,238 (32 Carores 9 lakh 66 thousand 2 hundred 38) INTRODUCTION:-
  3. 3. 2. Children are the foremost priorities of community health program. Their aim is to increase the nutrition level of mothers and children to ensure the birth of healthy child. 3. MCH services started due to different reasons in different countries. maternal and child health services were first organized in India in 1921 by a committee of “The lady Chelmsford league’’ which collected funds for child welfare and established demonstration services on an all India basis.
  4. 4. 4. Various facilities and programme organized for the purpose of providing medical and social services for mothers and children. 5. Medical services include prenatal and postnatal services, family planning care, and pediatric care in infancy.
  5. 5. DEFINITION According to WHO (1976) Maternal and child health services can be defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the mother and child”. Thus maternal and child health service is an important and essential service related to mother and child’s overall development.
  6. 6. AIMS AND OBJECTIVES OF MCH PROGRAMME • Reducing maternal (current status-2013: 190 per one lakh live births) ,Perinatal ("number of stillbirths and deaths in the first week of life per 1,000 live births) infant (current status-2013: 41 per one thousand live births) and child mortality and morbidity rates. • Child survival • Promoting reproductive health or safe motherhood • Ensure birth of healthy child
  7. 7. • Prevent malnutrition • Prevent communicable diseases • Early diagnosis and treatment of the health problems • Health education and family planning services
  8. 8. INFRASTRUCTURE:- • The MCH services are rendered through the infrastructure of primary health centres and sub- centres, whose number are 24,049 (september 2013) and 1,48,366 (september 2013) respectively. It is proposed to set up one primary health centres for every 30,0000 population, and one sub-centre for 3000 to 5000 population. • Each sub centres are foundation of national health system. Each sub-centres is manned by a team of one male and female health worker. In addition there is a team of one trained dai and one health guide in every village.
  9. 9. SUB AREAS:- • The components of MCH include the following sub areas. Maternal health Family planning Child health School health Handicapped children Care of the children in special setting such as day care centers.
  10. 10. ACTIVITIES OF MCH PROGRAMME:- Maternal and child health services are an important part of primary health care. Traditional activity areas of these programme:- • Complete health check -up and care of the child and mothers from conception to birth. • Studying health problems of mothers and children. • Providing health education to parents for taking care of children. • Training to professional and assistant workers.
  11. 11. NEED FOR MCH PROGRAMME:- • There are four main reasons why mother and child health must be given top priority in health programme 1. Mother and child below the age of 15 years make up the majority of the population in almost countries. 2. Mother and children constitute a “special risk’’ or vulnerable group in the case of illness, deaths, in the terms of pregnancy, childbirth of mothers, and growth and development in the case of children. 3. By improving the health of mother and children we can improve the health of the family and community. 4. Ensuring child survival is a future investment for the family and community.
  12. 12. INDICATOR OF MATERNAL AND CHILD HEALTH PROGRAMME Maternal and child health can be evaluated on the basis of the following indicators: 1. Maternal mortality rate-below 1(for every 1000 live births) 2. Infant mortality rate-below 30 (for every 1000 live births) 3. Death rate of 1-4 year old age group-below 10. 4. Size of family- 2-3 members. 5. Perinatal mortality rate-30-35 6. Weight of minimum 90% of total children- according to height/weight chart.
  13. 13. RECENT TRENDS IN MCH SERVICE PROGRAMME a. Integration of care:- Earlier maternal and child health care services were divided into antenatal, child care and family planning. Naturally it is helpful in increasing the capability and effectiveness of service b. Risk approach :- This new thought was born from the lack of resources and their availability. As per this the risk group among mother and infant is identified special care is given to them. c. Man power changes :- According to new concept, maternal and child health services should be left to traditional health workers(ANMs, health visitors) rather than specialist of field and child volunteers and workers of NGOs.
  14. 14. Cont... d. Primary health care:- It makes available information about protection and protection and resources for mother and child health care. e. Reproductive and child health :- As per the decision taken in world women’ conferences, Beijing(1995), maternal and child health services have been included in reproductive and child health services.
  15. 15. PRINCIPLES:- The guiding principle for the maternal and child health program me are:- a) Consultation and participation:- consultation with, and participation by, families is integral to the services. Services will be informed by, and seek to meet, the young needs of young children and their families. b) Access and availability:- All families with young children should be able to readily access the information, services and resources that are appropriate for, and useful to, them. c) Primacy of prevention:- Prevention of harm or damage is preferable to repairing it later. Early detection of risk factors is required, and intervention, where appropriate. d) Capacity building:- Promotion of resilience and capacity is preferable to allowing problems to undermine health or autonomy. e) Equity:- All children should be able to grow up actively learning,healthy,sociaable and safe-irrespective of their family circumstances and background.
  16. 16. Cont….. f) Family cantered- The identification and management of child and family needs requires a family- centered approach that focuses on strength. g) Inclusion:- Inclusive practices are essential for all children to get the best start, irrespective of their family circumstances, differing abilities and background. h) Partnership:- Quality services are archived through integrated services delivery and partnership with other early childhood and specialist services, and with family. i) Quality:- All families with young children must be confident of the quality of information , services and resources provided to them.
  17. 17. MATERNAL AND CHILD HEALTH SERVICE PROGRAMME STANDARDS 1.The maternal and child health services provides universal access to its services for children from birth to school age and their families. 2.The maternal and child health services promotes optimal health and development outcomes for children from birth to school age through a focus on the child, mother and family. 3.The maternal and child health services builds partnership with families and communities and collaborates and integrates with other services and organizations. 4.The maternal and child health services is delivered by a competent and professional workforce. 5.The maternal and child health service ,supported by local government or the governing authority, provides a responsive and accountable se CONT……
  18. 18. Cont… • Service for the child, mother and family through effective governance and management. • The maternal and child health services delivers a quality and safe services.
  19. 19. ORGANIZATIONAL ACTIVITIES OF MCH SERVICES • Complete health check up and care of the child and mother from conception to birth • Studying the health problems of mothers and child • Providing health education to parents for taking care of children • Training to professionals and assistant workers
  20. 20. Responsibilities of community health nurse in MCH services Direct care Managerial functions Educational functions
  21. 21. The function of community health nurse are:- 1.Direct care provider: A. Antenatal care:- i. Contact: Contacting every pre-gnant mother in the primary Stage of pregnancy. ii. History:- taking history of general health, previous child birth and pres-ent pregnancy. iii. Antenatal examination:- Conducting physical birth and present pregnancy. .
  22. 22. Cont.... iv. Antenatal Examination:- a. Calculate obstetric examination etc. b. Calculating the expected date of delivery c. Identifying high risk of mothers d. Providing counselling and health education. e. Helping mother and other family members in planning the delivery. B. Intranatal care:- • Preparing the place for delivery. • Arranging necessary equipment. • Giving mental support to mothers. • Preparing mother for delivery.
  23. 23. Cont... • Examine position of foetus, dilatation of cervix, and heart of foetus, observing the position of bladder and uterine contraction. • Noting general condition of the pregnant mother, process of pain and time of membrane rupture. • Ensuring safe delivery, examining umbilical cord and noting abnormalities. • If necessary, taking help of doctor or referring patient to a specialist. • Maintaining through asepsis during delivery. • Should be ready to handle complications like bleeding, malpresentation, cord prolaps etc.
  24. 24. Cont.... • Noting the correct time of birth. C. Postnatal care:- • The week immediately after the child birth is called postnatal period. The responsibilities of community health nurse are.- • Observing the blood pressure, temperature and pulse of mother immediately after the delivery and then during the following period. • Collecting information about the general condition of mother, food, sleep, pain and elimination etc. and, accordingly the nursing care.
  25. 25. Cont...... • Observing fundus, perineum, lochia, bladder etc. • Observing breast and nipples. • Protecting the mother from complications like puerperal sepsis, breast inflammation, postpartum hemorrhage,urinary incontinence, urinary retention and thrombophlebitis and providing required treatment. D. Neonatal care • Observing the respiration of newborn, immediately after birth and if necessary providing resuscitation. • Taking care of the umbilical cord and cutting the
  26. 26. Cont..... • Cord and tying it using proper techniques. • Taking notice of abnormalities or congenital defects and informing the relatives. • Assessing the physical condition of the newborn by his apgar score ( 9 or 10 is ideal score ) • Cleaning the newborn child ( giving bath to the newborn has become less popular. • Taking care of the newborn skin and eyes. • Keeping the newborn child on safe bed and providing breast feeding to baby at the earliest. • Maintaining normal body temperature of the new • born. Give kangaroo care.
  27. 27. Cont.... • Function related to maternal clinics :- • Home visits:- During home visit, community health nurse should try to focus the attention of mother of mother on the following points:- • Antenatal check up and its importance. • Anatomy, physiology, and psychology of pregnancy. • Diet during pregnancy • Plans of delivery • Neonatal care • Family planning
  28. 28. Cont... 2. Managerial functions:- • Organizing and managing the nursing homes. • Playing the role of liaison officer under referral system, for sending the mother to hospital for safe delivery. • Taking part in community activities. • Explaining the importance of reproductive and child health in community. • Supervising the work of midwives and female health workers and giving them appropriate suggestions. • Organizing and managing maternal clinics.
  29. 29. Cont.... • Coordinating between the doctor, family and patients. • Storing and maintaining the records of maternal and child health services. • Assisting the research work in the field of maternal and child health services. 3. Educational functions:- • Providing health education to mother and family either individually or in the group. • Educating (using demonstration) pregnant mothers and relatives about maternal nursing.
  30. 30. Cont.... • Community health nurse should discuss following topics with pregnant mothers : • Importance of regular antenatal check up. • Personal hygiene and proper diet. • Clean environment ( including mental environment) • Importance of hospital delivery or delivered or delivery by trained worker. • Taking care of infant. • Thus, community health nurse has a multifaceted role in maternal services. It is only through proper discharge maternal and infant mortality can be reduced to targeted rate.
  31. 31. SUMMARY • Introduction of maternal and child health programme. • Aims of maternal and child health programmes. • Sub areas of MCH. • Activities of MCH programme. • Need for NCH programme. • Principles of MCH programme. • Indicators of MCH programme. • Recent trends in MCH • Role of nurse in MCH.
  32. 32. Bibliography • Park.k,Preventive and social medicine, 22rd edition 2013,published by premnagar,Jabalpur, pg no.-481,514. • Park. K, Essential of community health nursing,4th edition2014, published by premnagar,Jabalpur,pg,no,- 278- 280. • Rao sundar kasthuri Mrs.Dr.,An introduction to community health nursing,4th edition(reprint) 2005,published byB.I.publication, chennai, • Swarnkar Keshav,Community health nursing, 2nd edition 2007, published byN.R.Brothers,indore, •
  33. 33. THANK YOU