MATERNAL & CHILD HEALTH PROGRAMME IN COMMUNITY HEALTH NURSING According to W.H.O. (1976)  Maternal & child health services can be defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the mother & child.”  Thus maternal & child health services is an important & essential services related to mother & child’s overall development. 6.  Reduce maternal, perinatal, infant & child mortality & morbidity rates.  Child survival.  Promoting reproductive health or safe motherhood.  Ensure birth of healthy child. 7.  Prevent malnutrition.  Prevent communicable disease.  Early diagnosis & treatment of the health problems.  Health education & family planning services. 8.  The MCH service are rendered through the infrastructure of P.H.C. & sub centers. It is proposed to set up one P.H.C. & sub-centers.  It is proposed to set up one P.H.C. for every 30,0000 population, & one sub-centers for every 3000 to 5000 population.  Each sub-centers are foundation of national health system. Each sub-sub-center is manned by a team of one male & female health worker. In addition there is a team of one trained Dai & one health guidein every village.

1. Presented by-
Harsh Rastogi
M.Sc. Nursing 1st year
King George’s Medical University,
Institute of Nursing,
Lucknow.

3.  Mother & 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% & children under 15 years of
age about 35.3% of total population, together 57.5% of
population consists of mother & children.
 Current population of India as on 1.324 billion (2016)

4.  Children are the foremost priorities of Community
Health Program. Their aim is to increase the nutrition
level of mother & children to ensure the birth of
healthy child.
 MCH services started due to different reasons in
different countries. Maternal & child health services
were first organized in India in 1921 by a committee of
“The Lady Chelmsford League” which collected funds
for child welfare & established demonstration services
on an all India basis.

5.  4. Various & s facilities & programme organized for the
purpose of providing medical & social services for
mother & children.
 5. medical services includes prenatal & postnatal
services, family planning care, & pediatric care in
infancy.

7.  According to W.H.O. (1976)
 Maternal & child health services can be defined as
“promoting, preventing, therapeutic or
rehabilitation facility or care for the mother &
child.”
 Thus maternal & child health services is an important
& essential services related to mother & child’s overall
development.

9.  Reduce maternal, perinatal, infant & child mortality &
morbidity rates.
 Child survival.
 Promoting reproductive health or safe motherhood.
 Ensure birth of healthy child.

10.  Prevent malnutrition.
 Prevent communicable disease.
 Early diagnosis & treatment of the health problems.
 Health education & family planning services.

12.  The MCH service are rendered through the
infrastructure of P.H.C. & sub centers. It is proposed to
set up one P.H.C. & sub-centers.
 It is proposed to set up one P.H.C. for every 30,0000
population, & one sub-centers for every 3000 to 5000
population.
 Each sub-centers are foundation of national health
system. Each sub-sub-center is manned by a team of
one male & female health worker. In addition there is a
team of one trained Dai & one health guidein every
village.

13. • 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.

14.  Maternal & child health services are an important part
of primary health care.
 Traditional activity areas of these programme-
1. Complete health check-up & care of the child &
mother from conception to birth.
2. Studying health problems of mothers & children.
3. Providing health education to parents for taking care
of children.
4. Training to professional & assistant workers.

15.  There are 4 main reasons why mother & children health
must be given top priorities in health programme-
1. Mother & child below the age of 15 years makeup the
majority of the population in almost countries.
2. Mother & children constitutes a ‘special risk’ or
vulnerable group in the case of illness, death, in the
terms of pregnancy, childbirth of mothers, & growth 7
development in the case of children.
3. by improving the health of mother & children we can
improve the health o the family & community.
4. Ensuring child survival is a future investment for the
family & community.

16.  Maternal & 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 o f family: 2-3 members.
5. Perinatal mortality rate: 30-35.
6. Weight of minimum 90% of total children: according
to height/weight charts.

17. 1. Integration of care: Earlier MCH care services were
divide into antenatal, child care & family planning.
Naturally it is helpful in increase the capability &
effectiveness of services.
2. Risk approach: This new thought was born from the
lack of resources & their availability. As per this the
risk group among mother & infant is identified
special care is given to them.
3. Man power changes: According to new concept,
maternal & child health services should be left to
traditional health workers (ANMs, health visitors)
rather than specialist of field & child volunteers &
workers of NGOs.

18. 4. Primary health care: It makes available information
about protection & resources for mother & child
health care.
5. Reproductive & child health: As per the decision
taken in world women’s conferences, Beijing (1995),
maternal & child health services have been included
in reproductive & child health services.

19.  The guiding principles for the M.C.H. programme are:
a. Consultation & participation: Consultation with , &
participation by, families id integral to the services. Services
will be informed by, & seek to meet, the young needs of young
children & their families.
b. Access & availability: all families with young children should
be able to readily access the information, services & resources
that are appropriate for, & useful to them.
c. Primary prevention: Prevention of harm or damage is
preferable to repairing it later. Early detection of risk factors is
required, & intervention, where appropriate .
d. Capacity building: Promotion of resilience & capacity is
preferable to allowing problems to undermine health or
autonomy.

20. a. Equity: All children should be able to grow up actively
learning, healthy, sociable & safe-irrespective of their family
circumstances & background.
b. Family centered: The identification & management of child &
family needs requires a family centered approach that focuses
on strength..
c. Inclusion: Inclusive practices are essential for all children to
get the best start, irrespective of their family circumstances,
differing abilities 7 background.
d. Partnership: Quality services are achieved through integrated
services delivered & partnership with other early childhood &
specialist services, & with family.
e. Quality: All families with young children must be confident of
the quality of information, services & resources provided to
them.

21. 1. The MCH services provide universal access to its
services for children from birth to school age & their
families.
2. The MCH services promotes optimal health &
development outcomes for children from birth to
school age through a focus on the child, mother &
family.
3. The MCH services builds partnership with families &
communities & collaborates & integrated with other
services & organizations.

22. 1. The MCH services are delivered by competent &
professional workplace.
2. The MCH services are supported local government or
the governing authority, provides a responsive &
accountable services.
3. Services for children mothers & families through
effective governance & managements.
4. The MCH services deliver a quality & safe services.

23.  Complete health check up & care of the child &
mother from conception to birth.
 Studying the health problems of mother & child.
 Providing health education to parents for taking care
to children.
 Training to professional & assistant workers.

24. 1. • DIRECT CARE
2. • MANAGERIAL FUNCTIONS
3. • EDUCATIONAL FUNCTIONS

26.  The function of Community Health Nurse are:
a. Direct care provider:
1. Antenatal care:
i. Contact: Contacting every pregnant mother in the
primary stage of pregnancy.
ii. History : Taking history of general health,
previous child birth & present pregnancy.
iii. Antenatal examination: Conducting physical
birth & present pregnancy.

28. iv. Antenatal examination:
 Calculate obstetrics examination etc.
 Calculating the expected date of delivery.
 Identifying high risk of mother.
 Providing counseling & health education.
 Helping mother & other family members in planning
the delivery.

29. 2. Intranatal care:
i. Preparing the place for delivery.
ii. Arranging necessary equipments.
iii. Giving mental support to mothers.
iv. Preparing mother for delivery.
v. Examine position of fetus, dilatation of
cervix, & heart of fetus, observing the
position of bladder & uterine
contraction.

31. i. Noting general condition of the pregnant
mother, process of pain & time of membrane
rupture.
ii. Ensuring safe delivery, examining umbilical cord
& noting abnormalities.
iii. If necessary, taking help of doctor or referring
patient to a specialist.
iv. Maintaining through asepsis during delivery.
v. Should be ready to handle complications like
bleeding, malpresentation, cord prolepses etc.
vi. Noting the correct time of birth.

32. 3. Postnatal care:
 The week immediately after the child birth is called
postnatal period. Responsibilities of Community
Health nurse are-
 Observing the blood pressure, temperature and pulse
of mother immediately after the delivery & then
during the following period.
 Collecting information about the general condition of
mother, sleep pain and elimination acceptor and
accordingly the nursing care.

34.  Observing fundus, perineum, lochia, bladder etc.
 Observing breast and nipples.
 Protecting the mother from complication like
puerperal sepsis, breast inflammation, postpartum
hemorrhage, urinary incontinence, urinary
retention and thrombophlebitis and providing
required treatment.

35. 4. Neonatal care:
 Observing the respiration of newborn, immediately
after birth and if necessary provide resuscitation.
 Taking care of umbilical cord and cutting the cord &
tying it using proper techniques.
 Taking notice of abnormalities or congenital defects
and informing the relatives.
 Assessing the physical condition of newborn by his
APGAR score (9 or 10 is ideal score).

37.  Cleaning the new born child (giving bath to newborn
has become less popular).
 Taking care of newborn skin and eyes.
 Keeping the new born child on save bed and providing
breastfeeding to baby at earliest.
 Maintaining normal body temperature of the
newborn (give kangaroo care).


38.  Home visit: During home visit, community health
nurse should try to focus the attention of mother on
the following-
 Antenatal check up and its importance.
 Anatomy, physiology and psychology of pregnancy.
 Diet during pregnancy.
 Plans of delivery.
 Neonatal care .
 Family planning.

39.  Organizing and managing the nursing home.
 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 and community.

41.  Supervising the work of midwives and female health
workers and give them appropriate suggestions.
 Organizing and managing maternal clinics.
 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.

42.  Providing health education to mother and family
either individually or in the groups.
 Educating using demonstration pregnant mother and
relatives about maternal nursing.
 Community health nurse can discuss following topics
with pregnant mothers:
 Importance of regular antenatal check up.

44.  Personal hygiene and proper diet.
 Clean environment including mental environment.
 Importance of hospital delivery or delivery by trained
workers.
 Taking care of infants.
 The 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.

45.  Introduction of maternal and child health program.
 Aims of maternal and child health program.
 Sub areas of MCH.
 Activities of MCH program
 Need for MCH program
 Principles of MCH program
 Indicators of MCH program
 Recent trends in MCH.
 Role of nurse in MCH.

47.  Park K, Preventive And Social Medicine, 22nd Edition
2013, Published by Prem Nagar, Jabalpur, Page Number 481-514.
 Park K, Essentials Of Community Health Nursing, 4th Edition
2014, Published by Prem Nagar, Jabalpur ,Page Number 278-
280.
 Dr Mrs. Rao Sundari Kasturi, An Introduction To Community
Health Nursing 4th Edition 2005, Published by B. I. Publication
Private Limited, Chennai, Page Number 446.
 Swarnkar Keshav, Community Health Nursing 2nd Edition
2007, Published By N.R. Brothers Indore , Page Number 83-87
 www.google.com