The document discusses the significance of maternal and child health (MCH) services in India, highlighting that mothers and children constitute a significant portion (57.5%) of the population, making them a vulnerable group. It outlines the establishment and evolution of MCH services in India since 1921, their key components, goals, and the importance of improving health indicators to reduce mortality rates. The document emphasizes the integral role of community health nurses in providing maternal care and education, as well as in supporting health promotion and disease prevention for mothers and children.

1. Presented by-
Harsh Rastogi
M.Sc. Nursing 1st year
King George’s Medical University,
Institute of Nursing,
Lucknow.

3.  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)

4.  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.

5.  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.

7.  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.

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

10.  Prevent malnutrition.
 Prevent communicable disease.
 Early diagnosis & treatment of the health problems.
 Health education & family planning services.

12.  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.

13. • 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.

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

15.  There are 4 main reasons why mother & children health
must be given top priorities in health programme-
1. Mother & child below the age of 15 years makeup the
majority of the population in almost countries.
2. 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.
3. by improving the health of mother & children we can
improve the health o the family & community.
4. Ensuring child survival is a future investment for the
family & community.

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

17. 1. 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.
2. 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.
3. 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.

18. 4. Primary health care: It makes available information
about protection & resources for mother & child
health care.
5. 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.

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

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

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

22. 1. The MCH services are delivered by competent &
professional workplace.
2. The MCH services are supported local government or
the governing authority, provides a responsive &
accountable services.
3. Services for children mothers & families through
effective governance & managements.
4. The MCH services deliver a quality & safe services.

23.  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.

24. 1. • DIRECT CARE
2. • MANAGERIAL FUNCTIONS
3. • EDUCATIONAL FUNCTIONS

26.  The function of Community Health Nurse are:
a. 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.

28. 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.

29. 2. Intranatal care:
i. Preparing the place for delivery.
ii. Arranging necessary equipments.
iii. Giving mental support to mothers.
iv. Preparing mother for delivery.
v. Examine position of fetus, dilatation of
cervix, & heart of fetus, observing the
position of bladder & uterine
contraction.

31. i. Noting general condition of the pregnant
mother, process of pain & time of membrane
rupture.
ii. Ensuring safe delivery, examining umbilical cord
& noting abnormalities.
iii. If necessary, taking help of doctor or referring
patient to a specialist.
iv. Maintaining through asepsis during delivery.
v. Should be ready to handle complications like
bleeding, malpresentation, cord prolepses etc.
vi. Noting the correct time of birth.

32. 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.

34.  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.

35. 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).

37.  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).


38.  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.

39.  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.

41.  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.

42.  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.

44.  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.

45.  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.

47.  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
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