Maternal and Child Health

Maternal and Child Health Program

GOALS

To ensure that every expectant and nursing mother maintains good health, learns that art of child care, has a normal delivery and bears healthy child.

 That every child,

wherever possible, lives and grows up in a family unit with love and security in healthy surroundings, receives adequate nourishment, health supervision and efficient medical attention, and is taught the elements of health living.

PHILOSOPHY
Pregnancy, labor and delivery

and puerperium are part of the continuum of the total life cycle. They are meaningful only in the context of the total life.

 Personal, cultural and religious

attitudes and beliefs influence the meaning of pregnancy for individuals and make each experience unique.

Maternal-child nursing is family

centered. The father of the child is as important as the mother.

MATERNAL CARE
1. Pre-natal Care
There should be at least 3

prenatal visits during pregnancy following the prescribed timing:

 1st Visit- As early in pregnancy as possible during 1st trimester 2nd visit- During the 2nd trimester 3rd visit- During the 3rd trimester

Every 2 weeks after 8th month of pregnancy till delivery

2. Nursing care During Childhood

Home deliveries for normal

pregnancies attended by licensed health personnel shall be encouraged. Trained hilots or traditional birth attendants may be allowed to attend home deliveries only in the following circumstances:

In areas where there are no

licensed health personnel on maternal care.

When at the time of home

delivery, such personnel is not available.

3. Nursing Care After Delivery

The following should be checked :

MOTHER
Uterus is contracted and hard Blood pressure and pulse rate must be normal Placenta must be completely expelled Lacerations along the birth canal

BABY
Vital signs/reflexes with the use of APGAR

scoring Congenital defects Each baby must be registered in the civil registry. Birth certificate must be filled up by the attendant at birth.

For home deliveries: 1st Postpartum visit- within 24 hours after delivery 2nd visit- 1 week after delivery 3rd Visit- 2-4 weeks thereafter

NOTE:
Visit to the health facility shall be within 4 to 6 weeks after delivery.

4. Breastfeeding
Exclusive BF of infants recommended for the first 6 months of their lives and BF with Supplementary food thereafter.

5. Hilot Training
The purpose is to train traditional

birth attendants or hilots to extend

various health services to the community levels.

6. Expanded Program on Immunization

Legal basis: PD 996 (September 16, 1976) Providing for compulsory basic immunization for infants and children below 8 years old.

National Health Situation (MCH)

Crude Birth rate(1997)= 28.4/1000 p0p. Birth Sex Ratio= 109 male babies for every 100 female babies born There is a higher proportion of males born

Crude Death Rate(1997)= 6.1/1000 pop.

Death rates by age tend to be very high

at infancy and early childhood, declining sharply by the age of 10. Death Sex Ratio= 147 males per 100 females Total Fertility Rate (between 19951998)=3.7 children per woman

Total Fertility Rate (TFR)- average number

of births that a woman would have at the end of her reproductive life. TFR varies with location and education - higher TFR in rural areas than urban areas - higher TFR among women without education - lower TFR among women with college education

Reproductive age for women

(childbearing age)= 15-49 years old

Infant Mortality

Rate (2003)= 29/1000 livebirths

There is a declined trend of IMR in the Philippines; however, IMR is very high compared to that in neighboring countries

Malaysia= 3.2 Indonesia= 2.3

Thailand= 2.0
Singapore= 1.7

IMR varies with socioeconomic and demographic factors.

Regions With Lowest IMR 1. NCR= 23.7 2. Central Luzon= 23.6 3. Western Visayas= 26.0 Regions With Highest IMR 1. Eastern Visayas= 60.8 2. ARMM= 55.1 3. CARAGA= 53.2

Maternal Mortality Rate

1995= 180/100,000 live births 1997= 172/100,000 live births
Maternal Mortality- deaths among

women during pregnancy, at childbirth or in period after childbirth.

The Philippines Ranks Second to Indonesia in MMR

Indonesia= 312/100,000 livebirths Malaysia= 20/100,000 livebirths Thailand= 10.7/100,000 livebirths Japan =

7.6/100,000 livebirths Singapore= 4.1/ 100,000 livebirths

 Among Filipino women, the lifetime risk of dying from maternal causes is one in 100. Maternal deaths made up less than one percent of the total deaths in the country, but contributed 14% of all deaths in women aged 15-49. Maternal deaths are due to postpartum hemorrhage, hypertension and its complications, sepsis, obstructed labor and complications from abortions. Most of these can be prevented through quality maternal care.

A father may turn his back on his child; brothers and sisters may become inveterate enemies; husbands may desert their wives and wives their husbands. But a mother's love endures through all; in good repute, in bad repute, in the face of the world's condemnation, a mother still loves on, and still hopes that her child may turn from his evil ways, and repent; still she remembers the infant smiles that once filled her bosom with rapture, the merry laugh, the joyful shout of his childhood, the opening promise of his youth; and she can never be brought to think him all unworthy.

END OF PART 1