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MATERNALAND CHILD HEALTH:
SAVING MOTHERS AND BABIES
Prepared by:
Prabita Shrestha
B.Sc. Nursing 4th year
MATERNAL AND CHILD HEALTH
Healthy children need healthy mothers
INTRODUCTION
• Maternal & child health (MCH) is one of the important elements of primary
health care.
• Maternal and child health services are the top priorities of community health
programs.
• MCH care is the health service provided to mothers (women in their child
bearing age) and children.
• Throughout the world, especially in the developing countries, there is an
increasing concern and interest in maternal and child health care. This
commitment towards MCH care gains further strength after the World
Summit for Children, 1991, which gave serious consideration and outlined
major areas to be addressed in the provision of Maternal and Child Health
Care services.
• Thus MCH service is an important and essential service related to mother and
child’s overall development.
INTRODUCTION
DEFINITION
• According to WHO, Maternal and child health services can be defined as
“promoting, preventing, therapeutic or rehabilitation facility or care for
the mother and child.”
• MCH refers to promotive, preventive, curative and rehabilitative health care
for mothers and children. It includes the sub-areas of maternal health, child
health, family planning, school health, handicapped children, adolescence,
and health aspects of care of children in special settings such as day care.
OBJECTIVES OF MCH
1. Reduction of maternal, perinatal, infant and childhood mortality and
morbidity
2. Promotion of reproductive health
3. Promotion of the physical and physiological development of child and
adolescent within the family
• The ultimate objective of MCH services is lifelong health.
OTHER OBJECTIVES OF MCH
• Promoting satisfying and safe sex life.
• Regulate fertility
• Child survival
• Promote and protect health of mothers.
• Ensure birth of healthy child
• Promote healthy growth & development
SCOPE OF MCH
• Safe motherhood
• Family planning
• Antenatal care
• Intranatal care
• Postnatal care
• Maternal and child nutrition
• Immunization
• Breast feeding
• Child feeding
• Reproductive health
• Basic essential obstetric care
(BEOC) and Comprehensive
essential obstetric care (CEOC)
CONCEPT OF MCH
1. Mothers and children from a special group
• Numbers- They comprise approximately 2/3rd of the total population in
developing countries.
• Mothers (15-45yrs): 20-23%
• Children (0-15yrs): 38-40%
• These groups are subjected to mark physical and physiological stress.
–Mothers: menstruation, pregnancy, childbirth, lactation, etc.
–Children: low immunity, infectious diseases, high nutritional requirement,
etc.
2. Mother and child as one unit
The mother and child are considered as one unit for providing health services
because of the following reasons:
• Foetus is a part of the mother. It obtains all the necessary nutrients and
oxygen from the mother’s blood.
• The health of the child is closely related with the health of the mother. . A
healthy mother brings forth a healthy baby. But if the mother is
malnourished, child may be malnourished.
CONCEPT OF MCH
• Certain diseases and conditions of the mothers during pregnancy can have
harmful effect on the health of the foetus. The examples of this is clarified in
the following table:
S.N. Mothers Effect
1. Severe anemia Low birth weight, still birth, asphyxia,
etc.
2. Uncleaned delivery Tetanus, sepsis, hemorrhage, etc.
3. Obstructed labour Still birth, asphyxia, etc.
CONCEPT OF MCH
• Child is dependent upon the mothers for feeding for the first few months of
life.
• The mental and social development of the child is also dependent on the
mother.
• The mother is also the 1st teacher of the child.
3. Maternal mortality
• It is a leading cause of death among women of reproductive age in most
developing countries. According to maternal mortality and morbidity survey,
pregnancy related complication accounts for ½ reproductive age morbidity
and mortality.
CONCEPT OF MCH
4. Maternal and child mortality bring crisis in the family
• A woman death affects her family’s wellbeing and that of society. Her death
increases the chances of her family to face poverty and malnutrition.
5. Almost entire maternal and child mortality is preventable
• Studies on the causes of maternal and child mortality shows that with prior
preparation and information, almost all the causes of maternal and child
mortality can be prevented.
CONCEPT OF MCH
MATERNALAND CHILD HEALTH SERVICES
• Maternal and child health services are various facilities and programs
organized for the purpose of providing medical and social services for
mothers and children.
MCH Services
RATIONALE OF MCH SERVICES
1. Maternal mortality is an adverse outcome of many pregnancies.
Miscarriage, induced abortion, and other factors, are causes for over 40 %
of the pregnancies in developing countries to result in complications,
illnesses, or permanent disability for the mother or child.
About 80 % of maternal deaths are directed obstetric deaths which results
from obstetric complications of the pregnant state.
2. Most pregnant women in the developing world receive insufficient or no
prenatal care and deliver without help from appropriately trained health
care providers. More than 7 million newborn deaths are believed to result
from maternal health problems and their mismanagement.
3. Poorly timed unwanted pregnancies carry high risks of morbidity and
mortality, as well as social and economic costs, particularly to the
adolescent and many unwanted pregnancies end in unsafe abortion.
4. Large number of women suffers severe chronic illnesses that can be
worsened by pregnancy and the mother's weakened immune system and
levels of these illnesses are extremely high.
5. Infectious diseases like malaria are more prevalent in pregnant women than
in non-pregnant women (most common in the first pregnancy). In addition,
an increasing number of pregnant women are testing positive for the human
immunodeficiency virus.
RATIONALE OF MCH SERVICES
6. Many women suffer pregnancy-related disabilities like uterine prolapse
long after delivery due to early marriage and childbearing.
7. Nutritional problems are severe among pregnant mothers and 60 to 70 % of
pregnant women in developing countries are estimated to be anemic.
Women with poor nutritional status are more likely to deliver a LBW
infant.
8. Majority of perinatal deaths are associated with maternal complications,
poor management techniques during labor and delivery, and maternal health
and nutritional status before and during pregnancy.
RATIONALE OF MCH SERVICES
9. The large majority of pregnancies that end in a maternal death also result in
fetal or perinatal death. Among infants who survive the death of the mother,
fewer than 10 % live beyond their first birthday.
10.APH, eclampsia, and other complications are associated with large number
of perinatal deaths each year in developing countries plus considerable
suffering and poor growth and development for those infants who survive.
11.Development impairments among children due to poor management during
labor and delivery.
RATIONALE OF MCH SERVICES
12.Because many women are fed less, marry early, carry a heavy workload, and
spend a considerable portion of their lifespan in pregnancy and lactation, they
are exposed to persistent low nutritional status and high-energy expenditure.
This predisposes mothers to bear LBW infants.
13.Women often lack access to relevant information, trained providers and
supplies, emergency transport, and other essential services.
14.Cultural attitudes and practices hinder women's use of services that are
available.
RATIONALE OF MCH SERVICES
REASONS FOR ADVANCING MHC
SERVICES IN NEPAL
• mortality rates
• percent of population
• physical and physiological stress
• susceptibility of disease
• immunity
• gender discrimination
FACTORS CONTRIBUTING TO THE VULNERABLE
HEALTH STATUS OF WOMAN AND CHILDREN
1. Physical and physiological stress
2. Low socioeconomic status
3. Nutrition
4. Culture and taboos
5. Gender discrimination
6. Lack of education
23
Bibliography
Addisse, M. (2003). Maternal and child health care. Retrieved from
https://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_
notes/health_science_students/ln_maternal_care_final.pdf
Dr. Kailash, N. (2016). Maternal and child health care. Slideshare. Retrieved
from http://www.slideshare.net/krishnagar90/maternal-and-child-health-
care-services?qid=d2cf08e5-fdd0-4167-9474-
1e4b6146da71&v=&b=&from_search=2
International, R. (2015). Area of Focus: Maternal and Child Health. Slideshare.
Retrieved from http://www.slideshare.net/Rotary_International/mch-en
Park, K. (2005). Preventive medicine in obstetrics, paediatrics and geriatrics
(18th ed.). Jabalpur: M/s Banarsidas Bhanot.
Shrestha, S. C., & Shrestha, A. (2010). A Textbook of Primary Health Care and
Family Health (2nd ed.). Kathmandu, Nepal: Vidhyarthi Prakashan.
Introduction to Maternal and Child Health

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Introduction to Maternal and Child Health

  • 1. MATERNALAND CHILD HEALTH: SAVING MOTHERS AND BABIES Prepared by: Prabita Shrestha B.Sc. Nursing 4th year
  • 2. MATERNAL AND CHILD HEALTH Healthy children need healthy mothers
  • 3. INTRODUCTION • Maternal & child health (MCH) is one of the important elements of primary health care. • Maternal and child health services are the top priorities of community health programs. • MCH care is the health service provided to mothers (women in their child bearing age) and children.
  • 4. • Throughout the world, especially in the developing countries, there is an increasing concern and interest in maternal and child health care. This commitment towards MCH care gains further strength after the World Summit for Children, 1991, which gave serious consideration and outlined major areas to be addressed in the provision of Maternal and Child Health Care services. • Thus MCH service is an important and essential service related to mother and child’s overall development. INTRODUCTION
  • 5. DEFINITION • According to WHO, Maternal and child health services can be defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the mother and child.” • MCH refers to promotive, preventive, curative and rehabilitative health care for mothers and children. It includes the sub-areas of maternal health, child health, family planning, school health, handicapped children, adolescence, and health aspects of care of children in special settings such as day care.
  • 6. OBJECTIVES OF MCH 1. Reduction of maternal, perinatal, infant and childhood mortality and morbidity 2. Promotion of reproductive health 3. Promotion of the physical and physiological development of child and adolescent within the family • The ultimate objective of MCH services is lifelong health.
  • 7. OTHER OBJECTIVES OF MCH • Promoting satisfying and safe sex life. • Regulate fertility • Child survival • Promote and protect health of mothers. • Ensure birth of healthy child • Promote healthy growth & development
  • 8. SCOPE OF MCH • Safe motherhood • Family planning • Antenatal care • Intranatal care • Postnatal care • Maternal and child nutrition • Immunization • Breast feeding • Child feeding • Reproductive health • Basic essential obstetric care (BEOC) and Comprehensive essential obstetric care (CEOC)
  • 9. CONCEPT OF MCH 1. Mothers and children from a special group • Numbers- They comprise approximately 2/3rd of the total population in developing countries. • Mothers (15-45yrs): 20-23% • Children (0-15yrs): 38-40% • These groups are subjected to mark physical and physiological stress. –Mothers: menstruation, pregnancy, childbirth, lactation, etc. –Children: low immunity, infectious diseases, high nutritional requirement, etc.
  • 10. 2. Mother and child as one unit The mother and child are considered as one unit for providing health services because of the following reasons: • Foetus is a part of the mother. It obtains all the necessary nutrients and oxygen from the mother’s blood. • The health of the child is closely related with the health of the mother. . A healthy mother brings forth a healthy baby. But if the mother is malnourished, child may be malnourished. CONCEPT OF MCH
  • 11. • Certain diseases and conditions of the mothers during pregnancy can have harmful effect on the health of the foetus. The examples of this is clarified in the following table: S.N. Mothers Effect 1. Severe anemia Low birth weight, still birth, asphyxia, etc. 2. Uncleaned delivery Tetanus, sepsis, hemorrhage, etc. 3. Obstructed labour Still birth, asphyxia, etc. CONCEPT OF MCH
  • 12. • Child is dependent upon the mothers for feeding for the first few months of life. • The mental and social development of the child is also dependent on the mother. • The mother is also the 1st teacher of the child. 3. Maternal mortality • It is a leading cause of death among women of reproductive age in most developing countries. According to maternal mortality and morbidity survey, pregnancy related complication accounts for ½ reproductive age morbidity and mortality. CONCEPT OF MCH
  • 13. 4. Maternal and child mortality bring crisis in the family • A woman death affects her family’s wellbeing and that of society. Her death increases the chances of her family to face poverty and malnutrition. 5. Almost entire maternal and child mortality is preventable • Studies on the causes of maternal and child mortality shows that with prior preparation and information, almost all the causes of maternal and child mortality can be prevented. CONCEPT OF MCH
  • 14. MATERNALAND CHILD HEALTH SERVICES • Maternal and child health services are various facilities and programs organized for the purpose of providing medical and social services for mothers and children.
  • 16.
  • 17. RATIONALE OF MCH SERVICES 1. Maternal mortality is an adverse outcome of many pregnancies. Miscarriage, induced abortion, and other factors, are causes for over 40 % of the pregnancies in developing countries to result in complications, illnesses, or permanent disability for the mother or child. About 80 % of maternal deaths are directed obstetric deaths which results from obstetric complications of the pregnant state. 2. Most pregnant women in the developing world receive insufficient or no prenatal care and deliver without help from appropriately trained health care providers. More than 7 million newborn deaths are believed to result from maternal health problems and their mismanagement.
  • 18. 3. Poorly timed unwanted pregnancies carry high risks of morbidity and mortality, as well as social and economic costs, particularly to the adolescent and many unwanted pregnancies end in unsafe abortion. 4. Large number of women suffers severe chronic illnesses that can be worsened by pregnancy and the mother's weakened immune system and levels of these illnesses are extremely high. 5. Infectious diseases like malaria are more prevalent in pregnant women than in non-pregnant women (most common in the first pregnancy). In addition, an increasing number of pregnant women are testing positive for the human immunodeficiency virus. RATIONALE OF MCH SERVICES
  • 19. 6. Many women suffer pregnancy-related disabilities like uterine prolapse long after delivery due to early marriage and childbearing. 7. Nutritional problems are severe among pregnant mothers and 60 to 70 % of pregnant women in developing countries are estimated to be anemic. Women with poor nutritional status are more likely to deliver a LBW infant. 8. Majority of perinatal deaths are associated with maternal complications, poor management techniques during labor and delivery, and maternal health and nutritional status before and during pregnancy. RATIONALE OF MCH SERVICES
  • 20. 9. The large majority of pregnancies that end in a maternal death also result in fetal or perinatal death. Among infants who survive the death of the mother, fewer than 10 % live beyond their first birthday. 10.APH, eclampsia, and other complications are associated with large number of perinatal deaths each year in developing countries plus considerable suffering and poor growth and development for those infants who survive. 11.Development impairments among children due to poor management during labor and delivery. RATIONALE OF MCH SERVICES
  • 21. 12.Because many women are fed less, marry early, carry a heavy workload, and spend a considerable portion of their lifespan in pregnancy and lactation, they are exposed to persistent low nutritional status and high-energy expenditure. This predisposes mothers to bear LBW infants. 13.Women often lack access to relevant information, trained providers and supplies, emergency transport, and other essential services. 14.Cultural attitudes and practices hinder women's use of services that are available. RATIONALE OF MCH SERVICES
  • 22. REASONS FOR ADVANCING MHC SERVICES IN NEPAL • mortality rates • percent of population • physical and physiological stress • susceptibility of disease • immunity • gender discrimination
  • 23. FACTORS CONTRIBUTING TO THE VULNERABLE HEALTH STATUS OF WOMAN AND CHILDREN 1. Physical and physiological stress 2. Low socioeconomic status 3. Nutrition 4. Culture and taboos 5. Gender discrimination 6. Lack of education 23
  • 24.
  • 25.
  • 26.
  • 27. Bibliography Addisse, M. (2003). Maternal and child health care. Retrieved from https://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_ notes/health_science_students/ln_maternal_care_final.pdf Dr. Kailash, N. (2016). Maternal and child health care. Slideshare. Retrieved from http://www.slideshare.net/krishnagar90/maternal-and-child-health- care-services?qid=d2cf08e5-fdd0-4167-9474- 1e4b6146da71&v=&b=&from_search=2 International, R. (2015). Area of Focus: Maternal and Child Health. Slideshare. Retrieved from http://www.slideshare.net/Rotary_International/mch-en Park, K. (2005). Preventive medicine in obstetrics, paediatrics and geriatrics (18th ed.). Jabalpur: M/s Banarsidas Bhanot. Shrestha, S. C., & Shrestha, A. (2010). A Textbook of Primary Health Care and Family Health (2nd ed.). Kathmandu, Nepal: Vidhyarthi Prakashan.