Presentation on theme: "Maternal and Newborn Health Training Package"— Presentation transcript:
1 Maternal and Newborn Health Training Package Session 7: Postnatal Care for the Mother and Essential Newborn Care
2 How many women die in the postpartum period and why? In 2013, 289,000 women died during pregnancy or childbirthPostpartum causes of maternal mortality include hemorrhage (bleeding), sepsis (infection of the genital tract) and infectionHIV-positive mothers are at greater risk of postpartum maternal death than HIV-negative womenWHO WHO Recommendations on Postnatal Care of the Mother and Newborn. Geneva: WHO and PMNCH Opportunities for Africa’s Newborns: Practical data, policy and programme support for newborn care in Africa. Geneva: WHO.PMNCH Opportunities for Africa’s Newborns: Practical data, policy and programme support for newborn care in Africa. Geneva: WHOPhoto credit: https://isetfiretotherain.files.wordpress.com/2011/09/mother-holding-sleeping-baby-bw.jpg
3 How many newborns die? Each year, 3 million newborn babies die About two-thirds of infant deaths occur in the first month of lifeOf those who die in the first month, about two-thirds die in the first week of lifeOf those who die in the first week of life, two-thirds die in the first 24 hours of lifeBeck, D., F. Ganges, S. Goldman, P. Long Care of the Newborn Reference Manual: Washington, DC: Save the Children
4 Why do newborns die?4 out of 5 newborn deaths result from three preventable and treatable causes:complications from preterm birth (including prematurity and low birth weight)complications during childbirth (including birth asphyxia – deprivation of oxygen to a newborn infant)newborn infections
5 Premature & Low Birth Weight (LBW) Babies Each year, 15 million babies are born preterm and 32.4 million babies are born too small for gestational age: may be preterm or fulltermPreterm birth and being small for gestational age are the reasons for LBWLBW contributes to 60% to 80% of all neonatal deathsPreterm birth occurs due to multiple pregnancies, infections, and chronic conditions such as diabetes and high blood pressureLBW stems primarily from poor maternal health & nutritionWHO Every Newborn Action Plan (Draft). Geneva: WHO
6 Quiz answersQ ,000 womenQ 2. hemorrhage (bleeding), sepsis (infection of the genital tract) or infectionQ million newbornsQ 4. prematurity, low birthweight, birth asphyxia or other complications, infectionsQ 5. Multiple pregnancies, infections and chronic conditions such as diabetes and high blood pressureQ 6. Poor maternal health, poor maternal nutrition
7 Post AdaptationBriefly review country statistics on postnatal maternal deaths, newborn deaths and premature and LBW babies as appropriate
8 Postpartum care and services Identifying danger signs indicating the need to seek careNutrition counseling and servicesHealthy behaviorsBirth spacing and postpartum family planning (PPFP) counselingSupport for early and exclusive breastfeeding and counseling for breastfeeding problemsPMTCT; special attention should be given to mothers who are HIV+Emotional and psycho-social support to reduce stress and prevent depressionUNICEF State of the World’s Children. New York: UNICEFPMNCH 2006 Op. cit. andPhoto credit:
9 Essential Newborn Care Essential newborn care includes:Immediate care at birthCare during the first day (24 hours)Care up to 28 daysPhoto credit: Save the children (http://www.healthynewbornnetwork.org/sites/default/files/images/REV%20MICHAEL_TSEGAYE_DESSIE_REFERRAL_HOSPITAL_IN_AFAR_REGION__ETHIOPIA_ jpg)
10 Reading Task: Essential Newborn Care Handout Take 5 minutes to read this handout. As you read:Circle any points needing further explanation and clarification.Name 3 ways that you could use this information on essential newborn care in your work with counterparts; for example, community health workers.
11 Postnatal Visits and Home Visits for the Newborn: Where and When Where: facility, outreach services, home care visits by trained health worker or combinationWhen: If home birth, visit to a health facility for postnatal care as soon as possible after birth. If not feasible, home visit schedule by a skilled attendantFirst home visit ASAP, not later than 24 hours after birthSecond home visit on day 3Third home visit on day 7Extra contacts for babies needing special care (low-birth weight, etc.)WHO WHO/UNICEF Joint Statement: Home Visits for the newborn child: a strategy to improve survival. Geneva: WHOPhoto credit:
12 Post AdaptationShare country-specific policies, guidelines and protocols for postnatal visits and who performs these.If Volunteers support postnatal visits, share information.
13 Post Adaptation: Postnatal Care Programs and Volunteer Work Describe relevant country-specific programs on:Postnatal care, including postnatal visitsCounseling and education of mothers and family members on danger signsPost-partum family planningReferral systems pertinent to post-natal care; how a newborn or mother with danger signs are referredWhat postnatal care is provided at what levelCommunication efforts and campaigns regarding postnatal careShare information on current or potential role of Volunteers in postnatal care at different levels of the continuum of care – household, community and outreach, health facilities
14 Volunteers and support for postnatal care Volunteers can support postnatal care at all levelsFamilies play an important role; health outcomes determined by household decisionsCHWs often tasked to conduct postnatal visits; play crucial role to bridge health facility services and families; must be supported by a strong referral systemCommunity-based activities help address postnatal care of mothers and newbornsWHO Op. cit.Gogia, S., HS Schdev “Home visits by community health workers to prevent neonatal deaths in developing countries: a systematic review.” Bulletin World Health Organization. Sep ; 88(9): ; and Kirkwood, B.R., A. Manu, AH ten Asbroek, et al “Effect of the Newhints home-visits intervention on neonatal mortality rate and care practices in Ghana: a cluster randomized controlled trial”. Lancet. Jun ; 381(9884)