Maternal and child health programme

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 1 st year King George’s Medical University, Institute of Nursing, Lucknow . MATERNAL & CHILD HEALTH PROGRAMME

2. 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) INTRODUCTION

3. 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.

4. 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.

5. 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. DEFINITION

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

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. INFRASTRUCTURE

9. 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. SUB AREA

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

11. There are 4 main reasons why mother & children health must be given top priorities in health programme - Mother & child below the age of 15 years makeup the majority of the population in almost countries. 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. by improving the health of mother & children we can improve the health o the family & community. Ensuring child survival is a future investment for the family & community. Need for MCH programme

12. Maternal & child health can be evaluated on the basis of the following indicators: Maternal mortality rate: below 1 (for every 1000 live births) Infant mortality rate: below 30 (for every 1000 live births) Death rate of 1-4 year old age group: below 10. Size o f family: 2-3 members. Perinatal mortality rate: 30-35. Weight of minimum 90% of total children: according to height/weight charts. I ndicators of MCH programme

13. 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. 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. 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. R ecent trends in MCH service programme

14. Primary health care: It makes available information about protection & resources for mother & child health care. 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. C ont …

15. The guiding principles for the M.C.H. programme are: 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. Access & availability: all families with young children should be able to readily access the information, services & resources that are appropriate for, & useful to them. Primary prevention: Prevention of harm or damage is preferable to repairing it later. Early detection of risk factors is required, & intervention, where appropriate . Capacity building: Promotion of resilience & capacity is preferable to allowing problems to undermine health or autonomy. Principles

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

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

18. The MCH services are delivered by competent & professional workplace. The MCH services are supported local government or the governing authority, provides a responsive & accountable services. Services for children mothers & families through effective governance & managements. The MCH services deliver a quality & safe services. C ont …

19. 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. O rganizational activies of MCH services

20. R esponsibilities of Community Health Nurse in MCH services

21. The function of Community Health Nurse are: 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. Role of Nurse in MCH

22. 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. C ont …

23. 2. Intranatal care: Preparing the place for delivery. Arranging necessary equipments. Giving mental support to mothers. Preparing mother for delivery. Examine position of fetus, dilatation of cervix, & heart of fetus, observing the position of bladder & uterine contraction. C ont …

24. Noting general condition of the pregnant mother, process of pain & time of membrane rupture. Ensuring safe delivery, examining umbilical cord & 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 prolepses etc. Noting the correct time of birth. C ont …

25. 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. C ont …

26. 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. C ont …

27. 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). C ont …

28. 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).   C ont …

29. 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. Functions related to maternal clinics:

30. 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. Managerial functions:

31. 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. C ont …

32. 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. Educational functions:

33. 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. C ont …

34. 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. Summary:

35. 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 Bibliography