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    Maternal, Child Health Prog-Part 2

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    Ann Justine Orbeta
    This document outlines the core package of services for a Maternal, Newborn, and Child Health and Nutrition Program. It describes the services provided at each stage of care: pre-pregnancy, prenatal, childbirth, postpartum, newborn (first week), and child care. For each stage, it lists the specific services and interventions provided, such as nutrition counseling, supplementation, health promotion, family planning services, and immunizations. It provides details on prenatal visits, assessments, and the tetanus toxoid immunization schedule. It also describes practices for childbirth, including facility-based delivery, management of complications, and access to emergency obstetric and newborn care.

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    Maternal, Child Health Prog-Part 2

    Uploaded by

    Ann Justine Orbeta
    32 views23 pages
    This document outlines the core package of services for a Maternal, Newborn, and Child Health and Nutrition Program. It describes the services provided at each stage of care: pre-pregnancy, prenatal, childbirth, postpartum, newborn (first week), and child care. For each stage, it lists the specific services and interventions provided, such as nutrition counseling, supplementation, health promotion, family planning services, and immunizations. It provides details on prenatal visits, assessments, and the tetanus toxoid immunization schedule. It also describes practices for childbirth, including facility-based delivery, management of complications, and access to emergency obstetric and newborn care.

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    Maternal , Child Health Prog-part 2

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    This document outlines the core package of services for a Maternal, Newborn, and Child Health and Nutrition Program. It describes the services provided at each stage of care: pre-pregnancy, prenatal, childbirth, postpartum, newborn (first week), and child care. For each stage, it lists the specific services and interventions provided, such as nutrition counseling, supplementation, health promotion, family planning services, and immunizations. It provides details on prenatal visits, assessments, and the tetanus toxoid immunization schedule. It also describes practices for childbirth, including facility-based delivery, management of complications, and access to emergency obstetric and newborn care.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    32 views23 pages

    Maternal, Child Health Prog-Part 2

    Uploaded by

    Ann Justine Orbeta
    This document outlines the core package of services for a Maternal, Newborn, and Child Health and Nutrition Program. It describes the services provided at each stage of care: pre-pregnancy, prenatal, childbirth, postpartum, newborn (first week), and child care. For each stage, it lists the specific services and interventions provided, such as nutrition counseling, supplementation, health promotion, family planning services, and immunizations. It provides details on prenatal visits, assessments, and the tetanus toxoid immunization schedule. It also describes practices for childbirth, including facility-based delivery, management of complications, and access to emergency obstetric and newborn care.

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    MATERNAL, NEWBORN, and

    CHILD HEALTH and


    NUTRITION PROGRAM
    Part 2

    By:
    ROWENA MISSION TURTAL, MAN, RN
    MNCHN Program Core Package of
    Services
    a. Pre-pregnancy
    b. Pre-natal
    c. Childbirth
    d. Postpartum
    e. Newborn (first week of life) care
    f. Child care
    A. Pre-pregnancy service package
    - Delivered to adolescents and adults
    1.Nutrition-
    -counselling
    -use of iodized salt
    -supplementation of iron and folate
    and vitamin A (5000 IU every
    week) or a multivitamin
    2. Healthy lifestyle promotion
    3. Family planning counselling
    and services
    4. Prevention and management
    of NCDs like DM and HPN
    5. Prevention and management
    of infection- deworming, etc.
    6. Counselling on STDs,
    nutrition, hygiene, and
    consequences of abortion
    7. Oral health services
    B. Prenatal service package
    1. Prenatal visits- Pregnant mothers should
    have quality prenatal visits which
    means having 4 or more visits
    throughout the pregnancy.
    Prenatal Visits Period of Pregnancy

    1st visit As early in pregnancy as possible before 4


    months or during the 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. Prenatal Assessment includes:
    -weight and BP monitoring
    -fundal height
    -fetal heart beat and movement
    -diagnostic exams like CBC, blood
    typing, urinalysis, blood sugar,
    pregnancy test, cervical CA and STI
    screening
    3. Micro nutrient supplementation
    -iron and folate (60 mg/40 µg) one
    tablet a day for 3-6 months
    - elemental iodine 200 mg once during
    pregnancy
    - promotion of iodized salt use
    4. Tetanus toxoid immunization- 0.5 ml IM to
    deltoid muscle
    Tetanus Toxoid Immunization Schedule

    • Both mother and


    newborn are protected
    against
    tetanus/neonatal
    tetanus
    • Creates passive
    immunity in the
    newborn
    Vaccine Schedule Percent Duration of protection
    Dose Protected

    TT1 As early as
    possible
    during
    pregnancy

    TT2 At least 4 80%  infants born to the


    weeks later mother will be protected
    from neonatal tetanus

    TT3 At least 6 95%  infants born to the


    months mother will be protected
    later from neonatal tetanus
     gives 5 years protection
    for the mother
    Vaccine Schedule Percent Duration of protection
    Dose Protected

    TT4 At least one 99%  infants born to the mother will


    year later be protected from neonatal
    tetanus
     gives the mother 10 years
    protection

    TT5 At least one 99%  gives lifetime protection for


    year later the mother
     all infants born to that mother
    will be protected
    Pre-natal service package, cont….

    5. Promotion of exclusive breastfeeding


    (BF), newborn screening (NSB),
    and immunization
    6. Counselling on healthy lifestyle and
    disease prevention
    7. Early detection and management of
    complications of pregnancy and other
    conditions like TB, malaria, etc…
    8. Birth planning and promotion of facility-
    based delivery
    Note: Every pregnant woman should have a
    facility-based record and a home-based
    record to facilitate continuity of care, early
    recognition of complications, and for more
    efficient care.
    C. Childbirth package
    1. Facility-based childbirth attended
    by a skilled health professional
    2. Proper management of
    pregnancy and delivery
    complications and newborn
    complications through
    implementation of essential
    intrapartum and newborn care
    (EINC) practices
    Essential practices include:
    a. Assess to determine status and labor
    stage. Done by taking the history of the
    following:
     LMP (last menstrual period)
     number of pregnancy
     Start of labor pains
     Age / Height
    Danger signs of pregnancy
    b. continuous maternal support by
    allowing a companion of choice
    c. freedom of movement during labor
    d. monitoring of progress of labor using a
    partograph. A partograph ensures
    recording of the labor progress and
    significant conditions of mother and
    fetus
    e. Give a supportive care throughout labor
     encourage to take a bath at the onset of
    labor
     encourage to drink but not to eat as this
    may interfere surgery in case needed
     encourage to empty bladder and bowels to
    facilitate delivery of the baby. (remind to
    empty bladder every 2 hours)
     encourage to do breathing technique
    f. Non-drug pain relief before offering
    labor anesthesia
    g. position of choice during labor and
    delivery
    h. spontaneous pushing in a semi-
    upright position
    i. hand hygiene
    j. non-routine episiotomy
    k. active management of third stage of
    labor
    It is important for a skilled
    health professional to handle a
    woman on labor and delivery
    to:
     ensure hygiene
     provide safe and none
    traumatic care
     recognize complications
     check for vaginal tears and bleeding
     Clean the woman and make her comfortable
     encourage her to drink high – energy foods
    that are easily digested
     Check every 15 minutes for emergency signs
    and uterine contraction
    • manage referrals when necessary

    Note: Please also read Intrapartal Services found in the


    book of Nies, 2020, pp. 277-282.
    3. Access to basic emergency obstetric and
    newborn care (BEmONC) or comprehensive
    emergency obstetric and newborn care
    (CEmONC) services
    References
    • Cuevas, F. (Ed.). (2007) Public Health Nursing in the
    Philippine Setting. Philippines: League of Government
    Nurses in the Philippines.

    • Famorca, Z., Nies, MA, McEwen, M. (2017 or 2018).


    Nursing Care of the Community. Singapore: Elsevier
    Mosby.

    • Nies, M., McEwen, M. Sumile, E. F. (Ed.). (2020).


    Community and Public Health Nursing. 2nd ed. Singapore:
    Elsevier.
    THANK YOU!

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