MCH – Introduction

1. MCH – Introduction A.A.TRIVEDI

2. MCH (Maternal and Child Health) • MCH is a promotive, preventive curative and rehabilitative health care to mother and children. • Health care to a special and vulnerable group • Children of < 5yrs of age • Female of reproductive age group (15-45 yrs ) • MCH care includes all the activities which promotes health and prevent health problem of mother and child.

3. Why women and children • Forms priority group in any community • Forms 60-70% of population in developing countries • In India • Women (15-45) – 19% • Children (<5yrs) – 40% • Vulnerable to disease, disability and death • Women – Child bearing • Children – Growth Development Survival

4. Objectives of MCH care • Reduction of morbidity and mortality rates for mother and child • Promotion of reproductive health • Promotion of physical and psychological development of children.

5. Components of MCH care(Sub areas) • Maternal health • Family planning • Child health • School health • Handicapped children • Care of children in special settings like day Care centers

6. Why - Mother and child combined ? • Considered as one unit – • During ante-natal period child is a part of mother only and obtain all his building material and oxygen from mother. • Child health depends on health of mother • Healthy mother provides healthy child • Certain diseases of mother during pregnancy have effects on foetus • Even after birth child is dependant on mother for nutrition up to 6 – 9 months of life. • Mother and child un-seperable – post-natal care. • Mother is first teacher of child

7. Who provide MCH care • In past MCH services were fragmented • Current trend is to provide MCH services and Family planning services through Family Welfare services. • MCH services should be flexible based on local community needs which are based on • Social and economical status • Local customs and traditions • Status of women • Level of urbanization and migration • An Obstratisian and Pediatrician joins hands and link themselves with PSM

8. Common MCH problems • Malnutrition • Infection • Consequences of unregulated fertility • Malnutrition • Pregnant female • LBW, Anemia, PPH, • Nursing women • Children • Two most important period are intrauterine life and weaning period

9. Common MCH problems • Infection • Maternal infection can cause • Growth retardation • Abortion • LBW • Puerperal sepsis • Infection of children • Diarrhoea • RTI • Chronic infection like Malaria, Tb • Consequences of Uncotrolled Fertility • Increase prevalence of LBW • Anemia • Abortion • APH

10. Maternal Health • Each year in India, 30 million women experience pregnancy and 27 million have a live birth • Of these, over 100,000 maternal deaths and one million newborn deaths occur annually. • Despite a series of programmatic initiatives, there is little evidence that maternity has become significantly safer over the last 20 years. • Current MMR is 407/100000 live births

12. Child Health • Each year 27 million infants are born in India. • Around 10% of them do not even survive to 5 years of age. • Nearly half of the under 5 deaths occur in neonatal period. • Over the decades there has been a declining trend in infant mortality rate, neonatal mortality rate and still birth rate. • Prematurity is a major cause for both neonatal and infant deaths

14. COMMON CAUSES OF IMR

15. COMMON CAUSES OF NMR

16. Evolution of Maternal and Child health programmes in India

17. IMCI – IMNCI • Focus on the young infant: Since a significant proportion of child mortality is centered in the first few months of life; • Inclusion of essential newborn care in the programme. • Development of a protocol for Home Visits by field functionaries like ANMs and anganwari workers for all newborns in the first week of life.

18. What is IMNCI • Standardized case management of sick newborns and children • Focus on the most common causes of mortality • Nutrition assessment and counselling for all sick infants and children • Home care for newborns to • promote exclusive breastfeeding • prevent hypothermia • improve illness recognition & timely care seeking

19. · Ø Give first dose of intramuscular a mpicillin and C onvulsions or · gentamicin . Fast breathing (60 breaths per POSSIBLE minute or more) or Ø Treat to prevent low blood sugar. · Severe chest indrawing or SERIOUS · Nasal flaring or BACTERIAL Ø Warm the young infant by Ski n to Skin contact if · Grunting o r INFECTION o temperature less than 36.5 C (or feels cold to · Bulging fontanelle or touch) while arranging referral. · Many skin pustules or a big boil or o · If axillary temperature 37.5 C or Ø Advise mother ho w to keep the young infant warm above (or feels hot to touc h) or on the way to the hospital. o temperature less than 35.5 C or · Lethargic or unconscious or # Ø Refer URGENTLY to hospital · Yellow palms and soles or Ø Treat to prevent low blood sugar. · Age less than 24 hours or SEVERE Ø Warm the young infant by Skin to Skin contact if o · Age 14 days or more. temperature less than 35.5 C (or feels cold to JAUNDICE touch) while waiting for referral to be arranged. Ø Advise mother how to keep the young infant warm on the way to t he hospital. · Ø Follow up in 2 days Palms and soles not yellow JAUNDICE Ø Give home care . Ø Advise the mother when to return immediatel y . · LOCAL Ø Give oral co - trimoxazole or amoxycillin for 5 days. Umbilicus red or draining pus or BACTERIAL Ø Teach mother to treat local infections at home. · Pus discharge from ear or INFECTION Ø Follow up in 2 days. · Skin pustules. o · Temperature 35.5 - 36. 4 C or Ø Warm the baby using Skin to Skin contact for 1 hour · LOW BODY and REASSESS. Feels cold to touch. TEMPERATURE Ø Treat to prevent low blood sugar.

20. MAKE EVERY MOTHER AND CHILD COUNT THANK YOU