2a_Quality-Antenatal-Care.ppt

ANC care

1. Quality Antenatal Care
SBA -Presentation 2 (a)
Maternal Health Division
Ministry of Health & Family Welfare
Government of India

2. Quality Antenatal Care 2
Session Objective
To understand
–Importance of antenatal check-up
–Components of quality ANC
–Need for early registration of pregnancy
–How to use pregnancy detection kit (Nischay kit)
–Number and timing of antenatal check-ups
–How to calculate number of pregnancies in a year
–How to track all pregnant women

3. Quality Antenatal Care 3
“Every Pregnancy is at Risk”
Every pregnancy needs special care
All pregnant women should be registered
and encouraged for institutional delivery

4. Quality Antenatal Care 4
What do you understand by the term -
Antenatal Care?
Antenatal care is systemic supervision of
a woman during pregnancy at regular
intervals to monitor :
–Maternal wellbeing
–Fetal wellbeing
–Progress of fetal growth

5. Quality Antenatal Care 5
What is the importance of Antenatal Care?
•Preparation of birth plan and identification of
facility for delivery
•Providing quality of care for well being of
pregnant women and the foetus
•Early identification of maternal and fetal
complications and timely referral
•Identification of a facility for referral

6. Quality Antenatal Care 6
Quality Antenatal Care:
Should ensure
•Registration and first check up within first trimester
(12 wks)
•Minimum 4 antenatal check ups; at least one ANC by
M.O. (Preferably 3
rd
ANC)
•Two doses of Injection tetanus toxoid
•Intake of at least 100 tablets of IFA

7. Quality Antenatal Care 7
Number and Timing of Antenatal visits
No. of visit Timing of visit
1
st
Visit With in 12 weeks preferably as soon as
pregnancy is suspected
2
nd
Visit Between 14 –26 weeks
3
rd
Visit Between 28 –34 weeks
4
th
Visit Between 36 weeks and term

8. Quality Antenatal Care 8
Quality Antenatal Care:
Essential Components
•History taking
•Physical examination (Weight, BP, pallor,
respiratory rate, edema)
•Abdominal palpation
•Laboratory investigations (Hb, urine for
sugar and proteins)

9. Quality Antenatal Care 9
Quality Antenatal Care:
Desirable Components
•Blood group and Rh type
•VDRL / RPR (Rapid Plasma Reagin)
•Offering rapid testing for HIV screening
Tie up with nearest ICTC / PPTCT centrefor:
–Rapid testing kits for HIV screening
–Referral and management of +vecases
•HBsAgtesting
•Blood sugar testing

10. Quality Antenatal Care 10
Quality Antenatal Care: Counseling
What are the important points?
•Promotion of institutional delivery & stay for 48 hrs.
•Birth preparedness
•Recognizing danger signs & symptoms during pregnancy,
labor & post natal period
•Plan for complication management
•Diet, Rest, Family planning
•Care of new born
•Initiation of breast feeding
•Exclusive and complimentary breastfeeding
•Janani Suraksha Yojana (JSY)
•Emphasising importance of seeking ANC & PNC

11. Quality Antenatal Care 11
Estimation of total no. of
expected pregnancies in your area
•The expected no. of pregnancies to be registered annually
can be estimated
•Information required :
Crude Birth rate (CBR) and Population size of the area under
consideration
•Expected no. of Live Births
Formula : CBR per 1000 population X (Population in the
given area / 1000)
•Expected no. of pregnancies = Expected no. of Live Births
+10% of figure obtained above (being correction for abortions,
still births)

12. Quality Antenatal Care 12
Tracking missed and lost pregnant women
Rule of Thumb
•In any given month approximately half the
number of pregnancies estimated should be in
the records
•If less, community workers such as AWWs and
ASHAs should identify pregnant women
•Home visits should be conducted by ANMs to
pregnant women who have not returned for ANC

13. Supportive activities by ANM during
antenatal period
•Filling of MCP card
•Giving safe motherhood booklet to every
pregnant woman
•Tracking of every pregnant women for antenatal
care, institutional delivery and post natal care
•Tracking of every child for immunisation

14. Quality Antenatal Care 14
To summarize
All pregnant women should be:
–Encouraged for institutional delivery
–Be provided quality antenatal care
–Ensured at least 4 antenatal check-ups
–In case of referral, should be given referral
slip
–Given discharge slip at the time of
discharge

15. Thank you