MCH CARE

MOTHER AND CHILD HEALTH CARE is an important topic in community. They are two vulnerable group who need special care that's why government provides special care to them for preventing mortality rate of both. Mother is pillar of the family and child is future of nation.

1. WELCOME

2. HEALTHY CHILDREN NEED HEALTHY MOTHER

3. MATERNAL AND CHILD HEALTH CARE

4. INTRODUCTION Maternal and child health (MCH) refer to a package of comprehensive health care services which are developed to meet promotive, preventive, curative, rehabilitative needs of pregnant women before, during and after delivery and of infants and pre-school children from birth to five years.

5. DEFINITION Maternal and child health services can be defined as " promoting, preventing, therapeutic or rehabilitation facility or care for the mother and child”. -WHO

6. OBJECTIVES OF MCH CARE

7. To reduce maternal and child mortality and morbidity rate. To promote a satisfying and safe sex life. To promote and protect health of mothers by early diagnosis and treatment of health problems. To ensure birth of healthy child. To regulate fertility so as to have wanted and healthy children when desired. To prevent and malnutrition and communicable diseases.

8. To promote and protect physical growth and psychosocial development of children. To provide health education and family planning services

9. GOALS OF MCH CARE To identify health problems in mother and children. To promote the healthy Growth and Development of children. 01 03 02 To ensure the birth of a healthy infant to every expectant mother.

10. GOALS OF MCH CARE To prevent communicable and non-communicable diseases in mothers and children. To promote family planning services. 04 06 05 To prevent malnutrition in mothers and children. O7 To educate the mothers on the improvement of their own and their children's health.

11. Maternal mortality rate= 97/1 lakh live births Infant mortality rate= 27.7/ 1000 live birth The states who have most maternal mortality cases are- Rajasthan, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Bihar, Odisha and Assam (According Registrar General of India March 14, 2022) The state who has most infant mortality cases are- Andhra Pradesh

12. SCENARIO OF INDIA D eliveries are conducted by trained health personnel. Getting postnatal care Institutional deliveries BMI below than normal Familiar with AIDS Suffering with anemia 48.3% 36% 40% 33% 57% 57.9%

13. CAUSES OF MATERNAL MORTALITY RATE

14. MEDICAL CAUSES OBSTETRICAL Toxemias of pregnancy Haemorrhage Infection Obstructed labour Unsafe abortion Unregulated fertility Uterine prolapse NON-OBSTETRICAL Anaemia Associated disorder cardiac,renal,metabolic Accidents Cancer in cervix

15. SOCIAL FACTORS Too close pregnancies Big family size Malnutritions Poverty Illiteracy Ignorances Lack of maternal services Delivery by untrained dais Poor transportation and communication facilities Social customs

16. TRENDS IN MCH CARE

17. A. INTEGRATION OF CARE D. PRIMARY HEALTH CARE C. MANPOWER CHANGES B. RISK APPROACHES

18. SERVICES OF MCH CARE FAMILY CARE SERVICES MOTHER CARE SERVICES CHILD HEALTH CARE SERVICES

19. MOTHER CARE SERVICES

20. CAUSES OF MATERNAL HEALTH RISK B. ELDERLY PRIMI ( 30 Years and after ) YOUNG PRIMI ( Below 19 years ) E. OTHER CONDITIONS- Short height weight (>70Kg,<40Kg) Malnutrition, anemia Other medical conditions D. HAVING TOO CLOSE PREGNANCIES C. HAVING TOO MANY BABIES

21. COMPLICATIONS OF POSTPARTUM (Rise of temperature, pulse, foul smelling lochia and lower abdominal pain and tenderness) PUERPERAL SEPSIS (Infection of the leg veins more often linked with the varicose veins.) THROMBOPHLEBITIS Vaginal bleeding that occurs any time after 6 hours of delivery to the end of the puerperium (6 weeks) HEMORRHAGE UTI, MASTITIS OTHERS

22. ANTENATAL CARE AIM - To achieve at the end of a pregnancy a healthy mother and a healthy baby.

23. To promote protect and maintain the health of the mother during pregnancy To detect:" high risk" cases and special attention To foresee complications and prevent them To reduce maternal and infant mortality and morbidity To teach the mother elements of child care, nutrition personal hygiene and environmental sanitation,family planning. OBJECTIVES

24. SERVICES The mother must be registered within 12 weeks of pregnancy. A. REGISTRATION OF PREGNANT MOTHER Provide one tablet of iron and folic acid twice a day for at least 100 days to prevent anaemia . C. IRON AND FOLIC ACID Minimum 4 antenatal care including registration- 12 weeks(1st),14 and 26 weeks(2nd),28 and 34 weeks(3rd),between 36 and term(4th). B. ANTENATAL VISITS

25. Taking health history . Physical examination (height,weight) General medical examination (anaemia,bleeding) Obstetrical examination (FHR,PVE,Fundal grips) Laboratory examination (blood,Hb,urine sugar, albumin) Identifies high risks. D. CARE DURING FIRST CONTACT 1st dose at 16-20 weeks 2nd dose at 20-24 weeks of pregnancy. E. IMMUNIZATION

26. Diet Personal hygiene Smoking and drinking Drugs Radiation Sexual activites Travel Identified any abnormalities Follow up visits HEALTH EDUCATION PSYCHOLOGICAL PREPARATION The expectant mother, especially the primary Para mother has fear and anxiety about child birth, its outcome, complications etc. It is very important to discuss various aspects of pregnancy and delivery.

27. The mother should be educated and motivated for small family norm and spacing of children. FAMILY PLANNING Makes appropriate and timely referral when higher level care or opinion needed on further management. REFERRAL

28. INTRANATAL CARE

29. SERVICES Preparation of place and surroundings of confinement. Preparation of equipment and supplies required during delivery. Physical and psychological preparation of the mother. Examination of mother's physical condition, abdominal palpation, monitoring foetal heart sound, observation of vital signs, labour pain and uterine extraction etc.

30. CONT…….. Conducting delivery, watchful about any problem and helping mother in taking pains. Referral of mother immediately in case of any such problem. Giving immediate care to mother and baby after delivery. Giving instruction to the mother and family members. Maintaining record and reporting of birth to authority

31. POST NATAL CARE

32. OBJECTIVES To restore, promote and maintain the health of mother and baby. To promote breastfeeding. To prevent complications that may occur during the postnatal period. To establish good nutrition for the baby. To prevent infection and identify any health problem/disorder in the baby. To support and strengthen the parents confidence and their role within their family and the cultural environment.

33. SERVICES IMMEDIATE CARE 1. After the baby is born and placenta is delivery, it is very important that mother is made comfortable and watched for any complication. 2. The fundus is palpated, clots are expressed, and fundal height is measured.The perineum is inspected for any laceration or tear, perineal care is given. Mother is made comfortable by removing the soiled linen, thorough cleaning and by keeping her warmth etc. 3.The vital signs are recorded. POST OP CARE 1. Perform home visit on 3rd day,7th day,42 day following delivery. 2.General observation of the mother and the surrounding to assess overall health status of mother, cleanliness etc. 3.Observation temperature, pulse and respiration. 4.Examination of breasts for any engorgements or other problems that interfere with breastfeeding .

34. POST-OP CARE Assess for involutions of uterus, lochia, perineum for any kind of abnormality,measures fundus. Observation of any abnormality in the abdomen likes painful and hard. Advice on suitable contraceptives measures. Advises to take an adequate nutritious diet, sufficient rest and sleep. Keeps herself clean and protects from infections .

35. CHILD HEALTH CARE SERVICES

36. OBJECTIVE 1.To provide adequate care and proper nourishment to every child. 2.To give immunisation to every child upto 5 year. 3.To monitor growth and development time to time. 4.To identify ailments and treated without delay. 5.To educate the mother and family members to give proper care to their children.

37. IMMEDIATE CARE Clearing of airway Apgar scoring Care of the eye Physical examination Maintaining body temperature Care of skin Care of umbilical Breast feeding

38. APGAR SCORE= 10-0 THIS TEST WILL BE DONE 10 MINUTES AFTER BIRTH.

39. AT VISIT CARE General observations of the baby and how he/she is. Observation of temperature, heart rate and respiration. Observation of eyes for any kind of abnormality such as watering of eyes or any discharge etc. Observation of skin . Observation of cord stump. The weight is checked and recorded. Observation of any sign of abnormality of abdomen such as distension, tenderness etc. It should be seen that the baby is. 1.Adequately clothed, kept clean. 2. Breast fed on demand. 3. Allowed to sleep and rest most of the time and handled only when necessary. 4.Not given bottle feeds. Mother should be enquired about any problem regarding babies.

40. FAMILY WELFARE SERVICE OBJECTIVE People should adopt the "small family norm" to stabilise the country's population . Helps individuals and couples to achieve their desired number of children as well to give intervals between their births.

41. SERVICES Provides advice on sterilisation for married men and women. Assists in spacing and limitation of births. Refers those mothers who need genetic counselling and premarital consultation and examination. Assesses for any illnesses related to reproductive systems and refers to the hospital. Provides pre parenthood education .

42. PROGRAMMES AND SCHEMES ARE SUPPORTED TO MCH National Rural Health Mission (NRHM) Vande Mataram Scheme Janani Suraksha Yojana (JSY) RMNCH+A National Urban Health Mission (NUHM) Integrated Management of Neonatal and Childhood Illness (IMNCI)

43. CONCLUSIO N The MCH or maternal and child health is not a new entity to health care professionals. However, it is definitely a significant area of importance since this package include two vulnerable groups the mother and children, whose health has major contribution in determining the health status of a country. The women of reproductive age group (15-44 years) and under five children constitute major (32.4%) portion of our India's population. MCH services concentrate on preventive, curatives and social aspects of mother and child care .

44. Thanks!