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Quality Antenatal Care

SBA - Presentation 2 (a). Quality Antenatal Care. Maternal Health Division Ministry of Health & Family Welfare Government of India. Session Objective. To understand Importance of antenatal check-up Components of quality ANC Need for early registration of pregnancy

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Quality Antenatal Care

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  1. SBA - Presentation 2 (a) Quality Antenatal Care Maternal Health Division Ministry of Health & Family Welfare Government of India

  2. Session Objective To understand • Importance of antenatal check-up • Components of quality ANC • Need for early registration of pregnancy • How to use pregnancy detection kit (Nischay kit) • Number and timing of antenatal check-ups • How to calculate number of pregnancies in a year • How to track all pregnant women Quality Antenatal Care

  3. “Every Pregnancy is at Risk” Every pregnancy needs special care All pregnant women should be registered and encouraged for institutional delivery Quality Antenatal Care

  4. What do you understand by the term - Antenatal Care? Antenatal care is systemic supervision of a woman during pregnancy at regular intervals to monitor : • Maternal wellbeing • Fetal wellbeing • Progress of fetal growth Quality Antenatal Care

  5. What is the importance of Antenatal Care? • Preparation of birth plan and identification of facility for delivery • Providing quality of care for well being of pregnant women and the foetus • Early identification of maternal and fetal complications and timely referral • Identification of a facility for referral Quality Antenatal Care

  6. Quality Antenatal Care:Should ensure • Registration and first check up within first trimester (12 wks) • Minimum 4 antenatal check ups; at least one ANC by M.O. (Preferably 3rd ANC) • Two doses of Injection tetanus toxoid • Intake of at least 100 tablets of IFA Quality Antenatal Care

  7. Number and Timing of Antenatal visits No. of visit Timing of visit 1st Visit With in 12 weeks preferably as soon as pregnancy is suspected 2nd Visit Between 14 – 26 weeks 3rd Visit Between 28 – 34 weeks 4th Visit Between 36 weeks and term Quality Antenatal Care

  8. Quality Antenatal Care: Essential Components • History taking • Physical examination (Weight, BP, pallor, respiratory rate, edema) • Abdominal palpation • Laboratory investigations (Hb, urine for sugar and proteins) Quality Antenatal Care

  9. Quality Antenatal Care: Desirable Components • Blood group and Rh type • VDRL / RPR (Rapid Plasma Reagin) • Offering rapid testing for HIV screening Tie up with nearest ICTC / PPTCT centre for: • Rapid testing kits for HIV screening • Referral and management of +ve cases • HBsAg testing • Blood sugar testing Quality Antenatal Care

  10. Quality Antenatal Care: Counseling What are the important points? • Promotion of institutional delivery & stay for 48 hrs. • Birth preparedness • Recognizing danger signs & symptoms during pregnancy, labor & post natal period • Plan for complication management • Diet, Rest, Family planning • Care of new born • Initiation of breast feeding • Exclusive and complimentary breastfeeding • Janani Suraksha Yojana (JSY) • Emphasising importance of seeking ANC & PNC Quality Antenatal Care

  11. Estimation of total no. of expected pregnancies in your area • The expected no. of pregnancies to be registered annually can be estimated • Information required : Crude Birth rate (CBR) and Population size of the area under consideration • Expected no. of Live Births Formula : CBR per 1000 population X (Population in the given area / 1000) • Expected no. of pregnancies = Expected no. of Live Births +10% of figure obtained above (being correction for abortions, still births) Quality Antenatal Care

  12. Tracking missed and lost pregnant women Rule of Thumb • In any given month approximately half the number of pregnancies estimated should be in the records • If less, community workers such as AWWs and ASHAs should identify pregnant women • Home visits should be conducted by ANMs to pregnant women who have not returned for ANC Quality Antenatal Care

  13. Supportive activities by ANM during antenatal period • Filling of MCP card • Giving safe motherhood booklet to every pregnant woman • Tracking of every pregnant women for antenatal care, institutional delivery and post natal care • Tracking of every child for immunisation

  14. To summarize All pregnant women should be: • Encouraged for institutional delivery • Be provided quality antenatal care • Ensured at least 4 antenatal check-ups • In case of referral, should be given referral slip • Given discharge slip at the time of discharge Quality Antenatal Care

  15. Thank you

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