By Students

110201442-110201452

Introduction

Maternal and child health care including family

planning

• Antenatal care

• Intra-natal care

• Post natal care

• New born care

• Care of the child

• Family planning

Each year, lakhs of women, newborns, and children

die from preventable causes.

While the interventions that could save their lives

are widely known, they are often not available to

those most in need.

With the intention of avoiding these preventable

deaths the government of Karnataka set up the

Primary Health Care Centre in rural villages.

A look at the statistics worldwide shows that

each year:

• More than 60 million women deliver at home

without skilled care.

• About 530,000 women die from pregnancy related

complications, with some 68,000 of those deaths

resulting from unsafe abortion.

• Over 10 million children under the age of 5 die.

• Moreover, nearly all (99 percent) maternal,

newborn, and child deaths occur in low- and

middle-income countries.

• About 4 million babies die within the first

month of life (the newborn period), and more

than 3 million die as stillbirths.

MATERNAL AND CHILD HEALTH CARE INCLUDING FAMILY PLANNING

Antenatal care:

Early registration of all pregnancies ideally in the

first trimester (before 12th week of pregnancy).

However, even if a woman comes late in her

pregnancy for registration she should be registered

and care given to her according to gestational age.

• Minimum 3 antenatal checkups and provision of

complete package of services. First visit as soon as

pregnancy is suspected/between 4th and 6th month

(before 26 weeks), second visit at 8th month (around

32weeks) and third visit at 9th month (around 36

weeks).

• Associated services like providing iron and folic acid

tablets, injection Tetanus toxoid etc (as per the

“guidelines for ante-natal care and skilled

attendance at birth by ANMs and LHVs)

• Minimum laboratory investigations like

haemoglobin, urine albumin, and sugar, RPR test

for syphilis

• Nutrition and health counseling

• Identification of high-risk pregnancies/ appropriate

management

• Chemoprophylaxis for Malaria in high malaria

endemic areas as per NVBDCP (National Vector Borne Disease Control Programme) guidelines.

• Referral to First Referral Units (FRUs)/other

hospitals of high risk pregnancy beyond the

capability of Medical Officer, PHC to manage.

Intra-natal care:

(24-hour delivery services both normal and assisted)

i) Promotion of institutional deliveries

ii) Conducting normal deliveries

iii) Assisted vaginal deliveries including forceps /

vacuum delivery whenever required

iv) Manual removal of placenta

v) Appropriate and prompt referral for cases needing

specialist care.

vi) Management of Pregnancy Induced hypertension

including referral

vii) Pre-referral management (Obstetric first-aid) in

Obstetric emergencies that need expert assistance

(Training of staff for emergency management to be

ensured)

LABOUR WARD

Postnatal Care:

• A minimum of 2 postpartum home visits, first

within 48 hours of delivery, 2nd within 7 days

through Sub-centre staff.

• Initiation of early breast-feeding within half-hour

of birth

• Education on nutrition, hygiene, contraception,

essential new born care (As per Guidelines of GOI

on Essential new-born care)

• Others: Provision of facilities under Janani

Suraksha Yojana (JSY)

New Born care:

Facilities and care for neonatal resuscitation

Management of neonatal hypothermia / jaundice

Care of the child:

Emergency care of sick children including

Integrated Management of Neonatal and Childhood

Illness (IMNCI)

• Care of routine childhood illness

• Essential Newborn Care

• Promotion of exclusive breast-feeding for 6 months.

• Full Immunization of all infants and children

against vaccine preventable diseases as per

guidelines of GOI.

• Vitamin A prophylaxis to the children as per

guidelines.

• Prevention and control of childhood diseases,

infections, etc.

Family Planning:

• Education, Motivation and counseling to adopt

appropriate Family planning methods.

• Provision of contraceptives such as condoms, oral

pills, emergency contraceptives, IUD insertions.

• Permanent methods like Tubal ligation and

vasectomy / NSV.

• Follow up services to the eligible couples adopting

permanent methods (Tubectomy/Vasectomy).

• Counseling and appropriate referral for safe

abortion services (MTP) for those in need.

• Counseling and appropriate referral for couples

having infertility.

Medical Termination of Pregnancies using Manual

Vacuum Aspiration (MVA) technique. (wherever

trained personnel and facility exists)

Management of Reproductive Tract Infections /

Sexually Transmitted Infections:

Health education for prevention of RTI/ STIs

Treatment of RTI/ STIs

Nutrition Services (coordinated with ICDS)

Diagnosis of and nutrition advice to malnourished

children, pregnant women and others.

Diagnosis and management of anaemia, and

vitamin A deficiency.

Coordination with ICDS.

School Health: Regular check ups, appropriate

treatment including deworming, referral and

follow-ups.

Adolescent Health Care: Life style education,

counseling, appropriate treatment.

THANK YOU