Dr.Awatif Alam
Content:-
Rationale
Background *EMRO & WHO
Objectives
Components
Principles for developing MCH services
Information system
Periods of Maternal Health Care
Child Care Programme
Childhood Health Problems.
Health Profile in Saudi Arabia:
I.Population Growth:
*Estimated population was 12.574, and 19million (1990) and 1995, with a growth rate of3.8%. Why?
II.Health Indicators:
*Life expectancy at birth > 70 yrs.
*Infant mortality rate= 21/1,000 live births.
*Under-5 mortality rate= 31/1,000 live births.
*Adult mortality rate = 165/1,000 adults
(age 15 – 60 yrs)
HEALTH POLICY AND STRATEGY:-
Saudi Arabia is committed to the goal of
“Health For All” by yr. 2000.
Principles of PHC adopted in S.A. in 1980.
A Ministerial Decree called for comprehensiveapproach to h. services and integration ofservices with MCH Centers.
Main strategy of PHC is to ensure providingoptimum health care to vulnerable groups e.g.pregnant woman, and preschool children.
PATTERN OF MCH:-
A .The culture pattern.
B .Genetic consideration.
C .Level of development of community.
OBJECTIVES OF MCH SERVICES:
1.Reduction in maternal, perinatal,
infant and childhood Mortality & Morbidity.
2.Promotion of reproductive health.
3.Promotion of physical and psychological
development of child and adolescent within
the family.
METHODOLOGY FOR APPLICATION:
Detection.
High risk management.
Equity in coverage.
Follow up.
Rationale for reproductive health:
Evidences:-
Each year > 200 million women becomepregnant.
> 50 million experience acute pregnancyrelated complications.
15 million develop long-term disabilities.
585,000 die annually. (UNICEF)
Poor maternal health and nutritionalstatus.
Inappropriate management of labor isresponsible for about 75% of 7.5million annual perinatal deaths.
[Reproductive Health is one of the mostneglected health problems in the world.Interventions are available, but policiesare inappropriate.]
(ICPD 1994)Reproductive Health Policy:
Linking rep. health policies to girls’education, status of women and overallpoverty reduction.
Preventing unwanted pregnancies.
Facilitating safe pregnancy, delivery andmotherhood by preventing and managingpregnancy complications.
Promoting positive health practices e.g.early treatment of STDs., delayedmarriages, birth spacing and education.
COMPONENTS OF MCH SERVICES:-
A.Promotive.
B.Preventive.
C.Curative.
For Developing Appropriate MCHServices:
1. Adaptation to ecology and needs.
2. Real community participation.
3.Within economic constraints*
4.Integration within general h. services.
5.“At – risk” in focus.
6.Education.
7.Trained staff.
8.Guided evaluation.
9.Acceptable within national development
planning activities.
*Re-assess priorities
** Consider cost-effectiveness
INFORMATION SYSTEMS ANDMCH SERVICES:-
(Monitor events, report them, complete records).
Useful data for building MCH information systeminclude:
1. Births. 2. Marriages.
3. Divorce. 4. Deaths.
5 . Mortality. 6 . Morbidity.
7 . Use of services.
To be categorized by Age and sex.
SPECIFIC DATA ON UTILIZATION OFHEALTH SERVICES INCLUDE:
Prenatal Care
Mechanisms for referral of ill mothers tohigh risk centers and rate of return andfollow-up.
Data on availability and use of non-medicalprenatal services i.e. nutrition, educationand other programs.
Data on screening tests done.
PERIODS OF MATERNAL CARE:
I. Before Pregnancy:-
(> 15 yrs.) for physical and psychological preparation to bearresponsibility.
II.Antenatal Care:
Aims:-
Promote, protect and maintain health.
Detect high risk.
Foresee complications to apply prevention.
Relieve fear and anxiety. Teach elements of child care,nutrition, hygiene and environmental sanitation.
Infant and Maternal “Morbidity + Mortality”
To attend the < 5 yrs. accompanying the mother.
To promote mutual trust.
III. Intra-natal Care:-
AIMS:
Asepsis
Minimum injury to motherand newborn.
Preparedness to deal withcomplications.
(prolonged labor – ante partumhemorrhage convulsions malpr.)
Care of baby at delivery.
Place of delivery soundscientific judgment.*
IV.Post-Natal Care:
Aims:
Health restoration.
Check adequacy of breast feeding.
Provide basic health education.
(Evaluate effect of antenatal Care)?!
