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Session 2.4 emergencies and rh


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from Dr Archana

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Session 2.4 emergencies and rh

  1. 1.  Gender based and sexual violence As the situation stabilizes, pressure on women increases to replenish lost population Fertility rates increases, this may increase the obstetric risk – may have pregnancies at close intervals No access to FP services Increase in traditional practices ex. deliveries at home Risk of spread of RTI/STDs increases immediately
  2. 2.  RH needs of men, adolescents and minority groups are neglected The overwhelming trauma of loss, no hope for future may affect the mental health status and can lead to risk taking behaviour Young, single, widowed or disabled women are at higher risks of GBSV Women who are singled may be forced to offer sex in exchange of food, shelter and security Control of reproductive rights are lost with the social disruption There is often a lack of RH care facilities
  3. 3. 1. In decision to seek care “The three delays”2. In reaching health facility3. In receiving appropriate treatment
  4. 4. At health centers (1 per 30,000 people)Provided by midwives and nurses1. Parenteral antibiotics Kit 62. Parenteral uterotonic drugs (oxytocin)3. Parenteral anticonvulsants for pre-eclampsia and eclampsia (magnesium sulfate – MgSO4)4. Perform manual removal of placenta Kit 85. Perform removal of retained products of conception(MVA - manual vacuum aspiration, D&C dilatation &curetage)6. Perform assisted vaginal delivery, e.g. VacuumKit 9 Kit 10
  5. 5. At hospital with operating theatre (1 per 150,000 – 200,000 people)Provided by team of doctors, anaesthetists,midwives and nurses Kit 11BEmONC (steps 1-6), plus7.Perform surgery(Cesarean section, laparotomy for ectopic pregnancy, anaesthesia)8. Perform safe blood transfusion Kit 12
  6. 6.  Establish referral system Supply referral level (CEmONC) Midwife delivery kits (health facility, BEmONC) Clean delivery kits (home deliveries in case access to health facility not possible) Plan for antenatal care (ANC) and postnatal care (PNC) integrated into primary health care (PHC) services as soon as possible
  7. 7.  Globally, 9 to 33 babies out of every 1000 born die in the perinatal period 25% birth asphyxia ADVOCACY 25% birth injuries prematurity, low-birth weight hypothermia infections (sepsis, tetanus, syphilis)Neonatal and perinatal mortality : country, regional and global estimates, WHO 2006