MCH Lecture
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Transcript of MCH Lecture
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Maternal and Child
Health
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Maternal and Child Health Program
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GOALS
To ensure that every expectant andnursing mother maintains good
health, learns that art of child care,has a normal delivery and bears
healthy child.
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That every child,wherever possible, livesand grows up in afamily unit with love
and security in healthysurroundings, receivesadequate nourishment,health supervision and
efficient medicalattention, and is taughtthe elements of healthliving.
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PHILOSOPHYPregnancy, labor and deliveryand puerperium are part of thecontinuum of the total lifecycle. They are meaningful
only in the context of the totallife.
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Personal, cultural and religious
attitudes and beliefs influence the
meaning of pregnancy for
individuals and make each
experience unique.
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Maternal-child nursing is family
centered. The father of the child is as
important as the mother.
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MATERNAL CARE
1. Pre-natal Care
There should be at least 3
prenatal visits during pregnancyfollowing the prescribed timing:
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1st Visit- As early in pregnancy as possible during1st trimester
2nd
visit- During the 2nd
trimester
3rd visit- During the 3rd trimester
Every 2 weeks after 8th month of pregnancy tilldelivery
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2. Nursing care During ChildhoodHome deliveries for normal
pregnancies attended by licensed
health personnel shall be encouraged.
Trained hilots or traditional birth
attendants may be allowed to attend
home deliveries only in the following
circumstances:
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In areas where there are nolicensed health personnel onmaternal care.
When at the time of home
delivery, such personnel is notavailable.
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3. Nursing Care After Delivery
The following should be checked :
MOTHER
Uterus is contracted and hard
Blood pressure and pulse rate must be normalPlacenta must be completely expelled
Lacerations along the birth canal
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BABYVital signs/reflexes with the use of APGAR
scoring
Congenital defects
Each baby must be registered in the
civil registry. Birth certificate must
be filled up by the attendant at birth.
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For home deliveries:
1st Postpartum visit- within 24 hours
after delivery
2nd visit- 1 week after delivery
3rd Visit- 2-4 weeks thereafter
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NOTE:
Visit to the health facilityshall be within 4 to 6
weeks after delivery.
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4. BreastfeedingExclusive BF of
infants
recommended for the
first 6 months of their
lives and BF with
Supplementary food
thereafter.
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5. Hilot Training
The purpose is to train traditional
birth attendants or hilots to extend
various health services to the
community levels.
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6. Expanded Program on Immunization
Legal basis:
PD 996 (September 16, 1976)
Providing for compulsory basicimmunization for infants and childrenbelow 8 years old.
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National Health Situation (MCH)Crude Birth
rate(1997)= 28.4/1000
p0p.Birth Sex Ratio= 109
male babies for every100 female babies born
There is a higherproportion of malesborn
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Crude Death Rate(1997)= 6.1/1000 pop.
Death rates by age tend to be very high
at infancy and early childhood,declining sharply by the age of 10.
Death Sex Ratio= 147 males per 100
females
Total Fertility Rate (between 1995-
1998)=3.7 children per woman
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Total Fertility Rate (TFR)- average numberof births that a woman would have at theend of her reproductive life.
TFR varies with location and education
- higher TFR in rural areas than urbanareas
- higher TFR among women withouteducation
- lower TFR among women with collegeeducation
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Reproductiveage for women(childbearingage)= 15-49
years old
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Infant Mortality
Rate (2003)=29/1000
livebirths
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There is a declined trend of IMR in the
Philippines; however, IMR is very highcompared to that in neighboring countries
Malaysia= 3.2
Indonesia= 2.3
Thailand= 2.0
Singapore= 1.7
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IMR varies with socioeconomic and
demographic factors.
Regions With Lowest IMR
1. NCR= 23.7
2. Central Luzon= 23.63. Western Visayas= 26.0
Regions With Highest IMR
1. Eastern Visayas= 60.8
2. ARMM= 55.1
3. CARAGA= 53.2
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Maternal Mortality Rate1995= 180/100,000 live births
1997= 172/100,000 live births
Maternal Mortality- deaths among
women during pregnancy, atchildbirth or in period afterchildbirth.
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The Philippines Ranks Second to
Indonesia in MMR
Indonesia= 312/100,000 livebirths
Malaysia= 20/100,000 livebirths
Thailand= 10.7/100,000 livebirths
Japan = 7.6/100,000 livebirthsSingapore= 4.1/ 100,000 livebirths
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Among Filipino women, the lifetime risk of dyingfrom maternal causes is one in 100.
Maternal deaths made up less than one percent ofthe total deaths in the country, but contributed14% of all deaths in women aged 15-49.
Maternal deaths are due to postpartumhemorrhage, hypertension and its complications,sepsis, obstructed labor and complications fromabortions. Most of these can be prevented throughquality maternal care.
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A father may turn his back on his child; brothersand sisters may become inveterate enemies;husbands may desert their wives and wives theirhusbands. But a mother's love endures through all;
in good repute, in bad repute, in the face of theworld's condemnation, a mother still loves on, andstill hopes that her child may turn from his evilways, and repent; still she remembers the infantsmiles that once filled her bosom with rapture, the
merry laugh, the joyful shout of his childhood, theopening promise of his youth; and she can neverbe brought to think him all unworthy.
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END OF PART 1