1. MCH Mother and Child Health
CHP200:
Community Health Program-l
Mohamed M. B. Alnoor

2. gy

3. SPECIFIC OBJECTIVES By the end of this presentation thegy
By the end of this presentation the
student should be able to:
Appreciate the General Goals and
Specific Objectives of MCH
Appreciate the importance of reproductive health
Be familiar with the Reproductive Health Policy gy
Identify the different periods of maternal care, and recognize the important events in those periods:
I. Before pregnancy
II. During pregnancy
III. During labour
IV. Post-Natal Care
V. Post lactation
Understand the common causes of Maternal Mortality
Understand the objectives and phases of child care
Understand the mortality in and around infancy

4. MCH OBJECTIVES OF MCH SERVICES:gy
1.Reduction in maternal, perinatal, infant and childhood Mortality & Morbidity.
2.Promotion of reproductive health.
3.Promotion of physical and psychological
development of child and adolescent within the family. gy
'Reproductive health' is defined as:“a state of complete physical, mental and social well-being and...not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed [about] and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of birth control which are not against RELIGION, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.

5. MCH Importance of reproductive health: Evidences:-gy
Evidences:-
Females( 15 – 49): 19%
Each year > 200 million women become pregnant.
> 50 million women experience acute pregnancy related complications. gy

6. MCH Importance of reproductive health: Evidences:-gy
Evidences:-
> 50 million women experience acute pregnancy related complications:
- Predictable
- Manageable gy
Prevention
Diagnosis
Treatment
15 million women develop long-term disabilities.
585,000 die annually. (UNICEF)

7. MCH Importance of reproductive health: Evidences:-gy
Evidences:-
Poor women health and nutritional status.
Inappropriate management of labor is responsible for about 75% of 7.5 million annual perinatal deaths.
Reproductive Health:
- most neglected health problems.
- interventions are available.
- policies are inappropriate. gy

8. MCH Importance of reproductive health:gy
Evidences:-
Health of mothers greatly influences
the healthy development and well-being of their children. gy
Childhood Diseases depend on
Genetics
Environment
(Very closely linked with mothers)

9. KAP of mother is beneficial
MCH
Importance of reproductive health: gy
Evidences:-
Healthy mother gy
Healthy daughter
KAP: Knowledge, Attitude and Practice.
KAP of mother is beneficial
to their own health and
the health of their children.

10. MCH Reproductive Health Policy: (ICPD 1994)gy
(ICPD 1994)
Linking reproductive health policies to:
girls’ education
status of women
overall poverty reduction.
Preventing unwanted pregnancies. gy
ICPD: International Conference on Population and Development

11. pregnancy complications.
MCH
Reproductive Health Policy: gy
(ICPD 1994)
Facilitating:
safe pregnancy
by preventing
& managing
pregnancy complications.
safe delivery gy
safe motherhood
ICPD: International Conference on Population and Development
Promoting positive health practices e.g.
early treatment of STDs
delayed marriages
birth spacing .

12. MCH PERIODS OF MATERNAL CARE: I. Before pregnancy:gy
I. Before pregnancy:
(> 15 yrs.) for physical and psychological preparation to bear responsibility.
A) Nutrition:
The nutritional status
strongly influences gy
Foetal growth
Birth weight (newborn)
Nutrition during infancy

13. MCH PERIODS OF MATERNAL CARE: Maternal Abs passive immunizationgy
I. Before pregnancy:
B) Infections:
Maternal Abs passive immunization gy
Maternal immunization against rubella
protects the outcome of pregnancy.
Tuberculosis severely affects nutritional
status of mothers

14. MCH PERIODS OF MATERNAL CARE: (Antenatal Care) II. During pregnancy:gy
Aims:- gy
Promote, protect and maintain health.
Detect high risk.
Relieve fear and anxiety.
Health Education: ( elements of
child care, nutrition, hygiene …… etc)

15. MCH PERIODS OF MATERNAL CARE: A) Nutrition:gy
II. During pregnancy:
A) Nutrition:
- Well nourished preg good birth wt.
- Anaemia during pregnancy gy
- Common
- Affects newborn infant
- Preventable

16. MCH PERIODS OF MATERNAL CARE: B) Infection: II. During pregnancy:gy
II. During pregnancy:
B) Infection:
- Rubella
Congenital deformities
Abortion gy
- Syphilis
IUFD
Stillbirth
- Malaria
IUFD
Low birth wt
- UTI
Amnionitis
IUFD
Placentitis
Low birth wt

17. MCH PERIODS OF MATERNAL CARE: II. During pregnancy:gy
II. During pregnancy:
C) Chronic Diseases gy
Stillbirth
Abortion
Low birth weight
High perinatal
mortality
D) Smoking

18. MCH PERIODS OF MATERNAL CARE:gy
II. During pregnancy:
E) Heavy work and stress in late pregnancy
leads to low birth wt
F) Psychological stress
Good ANTENATAL care can provide for all of this and more. gy

19. MCH PERIODS OF MATERNAL CARE: (Intra-natal Care) III. During labour :gy
AIMS:
Asepsis
Minimum injury to mother and newborn. gy
Preparedness to deal with complications.
(prolonged labor – ante partum hemorrhage – convulsions )
Care of baby at delivery.

20. MCH PERIODS OF MATERNAL CARE: b) Care during labourgy
III. During labour :
a) Antenatal Care(Risk assessment)
b) Care during labour
- Infection
ophthalmia neonatorum gy
tetanus neonatorum
- Bleeding
Perinatal asphyxia or neonatal asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. It results most commonly from a drop in maternal blood pressure or some other substantial interference with blood flow to the infant's brain during delivery.
- Trauma
Mother
Newborn
- Asphyxia

21. MCH PERIODS OF MATERNAL CARE: IV. Post-Natal Care Aims:gy
Aims:
Restoration of health.
Check adequacy of breast feeding.
Provide basic health education.
(Evaluate effect of antenatal Care)?! gy
V. Post lactation: spacing?

22. MCH THE RIGHTS OF WOMEN ! PRIMARY HEALTH CAREgy
SAFE MOTHERHOOD FP
ANC SD
EOC gy
BASIC MATERNITY CARE
FP: Family planning, ANC: Antenatal care, SD : Safe delivery, EOC: Emergency obstetrics care
PRIMARY HEALTH CARE
E Q U I T Y F O R W O M E N

23. MCH Maternal Mortality Malnutrition Anaemia Pregnancy Infectiongy
Malnutrition
Anaemia
Infection
Pregnancy gy
Bleeding
Infection
Labour
Bleeding
Infection
Postpartum
Lack of awareness
Lack of health services
Lack of utilization of health services

24. MCH Child Welfare Infancy and Early Childhood: Rapid growthgy
Infancy and Early Childhood:
Rapid growth
- Period of
Development
Learning gy
Infection
- Vulnerability
Malnutrition
Environmental hazards
- Infants: 4% of population: 25% of deaths
- “1- 4” years: 13% of pop: 20% of deaths

25. MCH Child Welfare Child Care Program Objectives of child care:gy
Child Care Program
Objectives of child care:
Safe entry to life
Reduction in perinatal and neonatal deaths
Reaching a healthy adulthood
Promotion, protection and maintenance of health
(Overcome genetic factor)? gy

26. MCH Child Welfare Child Care Programgy
Child Care Program
1. Prenatal Care( Ideally before conception )
Parental guidance and discussion involving:
Genetics
Family history
Feeding plans (Br. F)
Home preparation for baby care
Answering questions gy

27. MCH Child Welfare Child Care Programgy
Child Care Program
1. Prenatal Care( Ideally before conception )
Parental guidance and discussion involving:
Obstetric gy
- Work of mothers
- Nutrition
- Smoking
- Drugs

28. MCH Child Welfare Child Care Program 2. Infant Care - Early evaluationgy
Child Care Program
2. Infant Care
- Early evaluation
- Encourage breast feeding
- Face parents’ concern
- Developmental problems
- Anxiety
- Sleep
- Overfeeding
- Active immunization
- Monitoring of growth and development gy

30. Mortality in and around infancy
MCH
Mortality in and around infancy gy
I N F A N T gy
N E O N A T E
FOETUS
PERINATAL PERIOD
28th week
of gestation
Birth
7 Days
28 Days
1 Year

31. Mortality in and around infancy
MCH
Mortality in and around infancy gy
Infant Mortality
Post-neonatal death
Neonatal death
Early neo-natal death
Late neonatal death gy
Perinatal death
Still birth
28th week
of gestation
Birth
7 Days
28 Days
1 Year

32. MCH Child Welfare Child Care Program 3. Second year of lifegy
Child Care Program
3. Second year of life
- Rapid development
- Increased parental concern
4. Pre-school years (< 5 years)
- Accident prevention
5. School years gy
6. Adolescent Care
- Rapid physical growth
- Marked emotional changes
- Personality development

33. THANK YOU