Maternal and Child Health Overview
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Questions and Answers

Which factors are considered proximal determinants of disease?

  • Symptoms, treatment, and prevention
  • Host, agent, and environment (correct)
  • Infectious agents and disease manifestations
  • Demographic characteristics and transmission modes

    • What is the main reason that the presence of an infectious agent does not always lead to disease?

  • The host's immune system may inhibit the agent. (correct)
  • Agents require specific environmental conditions to cause disease.
  • Effective vaccination can prevent disease.
  • All agents are equally pathogenic.

    • Which type of environment is NOT considered a component of the determinants affecting infectious diseases?

  • Biological environment
  • Physical environment
  • Social environment
  • Nutritional environment (correct)

    • Which transmission mode is associated with the transfer of infectious agents via insects or ticks?

    <p>Vector-borne</p> Signup and view all the answers

    What percentage of malaria deaths in Africa occurs in children?

    <p>80%</p> Signup and view all the answers

    What is the primary benefit of kangaroo mother care for preterm or low birth weight infants?

    <p>It helps regulate temperature and promotes breastfeeding.</p> Signup and view all the answers

    What was one key outcome of the enhanced emergency obstetric care program in Western Kenya?

    <p>Better trained community health workers.</p> Signup and view all the answers

    What is one of the components of the TUBAraMURE program in Burundi?

    <p>Promotion of the use of preventative and curative health services.</p> Signup and view all the answers

    What significant impact did the universal maternal care program in India have on maternal mortality rates?

    <p>Decreased maternal mortality ratio from 130 to 97 deaths per 100,000 live births.</p> Signup and view all the answers

    What is the definition of maternal mortality ratio?

    <p>The number of maternal deaths per 100,000 live births per year.</p> Signup and view all the answers

    What is a major factor contributing to the high maternal mortality rate in Sub-Saharan Africa?

    <p>Socioeconomic disparities</p> Signup and view all the answers

    Which of the following is considered a communicable disease?

    <p>Tuberculosis.</p> Signup and view all the answers

    Which of the following contributes to maternal mortality as an indirect cause?

    <p>Iron folate supplements</p> Signup and view all the answers

    Which factor is NOT part of the epidemiological triad?

    <p>Vaccination.</p> Signup and view all the answers

    What does prevalence measure in a population?

    <p>The current number of cases at a specific moment in time.</p> Signup and view all the answers

    What is the largest contributor to preventable maternal deaths?

    <p>Complications from unsafe abortion</p> Signup and view all the answers

    How are communicable diseases primarily transmitted?

    <p>Via infectious microorganisms.</p> Signup and view all the answers

    What percentage of maternal deaths are caused by sepsis and other maternal infections?

    <p>9%</p> Signup and view all the answers

    Which statement about maternal health programs is true?

    <p>They often encompass a continuum of care including post-natal support.</p> Signup and view all the answers

    Which of the following is NOT a direct intervention to improve maternal and child health?

    <p>Enhancing public sanitation infrastructure</p> Signup and view all the answers

    Which age group experiences the highest number of preventable child deaths?

    <p>Children aged 1-5 years old</p> Signup and view all the answers

    In which region is stunting in children most prevalent?

    <p>Sub-Saharan Africa</p> Signup and view all the answers

    What is one of the indirect societal risk factors for child mortality?

    <p>Mother's education level</p> Signup and view all the answers

    What is the relationship between maternal mortality and wealth?

    <p>Higher wealth correlates with lower maternal mortality</p> Signup and view all the answers

    What is a common misconception about child malnutrition?

    <p>Malnutrition is only a problem in low-income countries</p> Signup and view all the answers

    Study Notes

    Maternal and Child Health

    • Maternal health encompasses the well-being of women during pregnancy, childbirth, and the postpartum period.
    • Early childhood (first 5 years) significantly impacts long-term development.
    • Maternal health outcomes are influenced by both external (social determinants, behaviors, policies, gender, environment) and internal (biological, genetic, molecular, physiological sex influences) factors.
    • Maternal mortality violates human rights principles: accountability, equality, non-discrimination, and participation.
    • Global maternal mortality is decreasing in most continents except Africa.
    • 2017 maternal mortality rate (MMR): 211 deaths per 100,000 live births.
    • Sub-Saharan Africa bears the largest MMR burden (⅔ of maternal deaths).
    • Maternal mortality is inversely associated with wealth.
    • Maternal deaths are largely preventable.

    Causes of Maternal Mortality and Prevention

    • Sepsis/Infections (9%): Tetanus toxoid, clean delivery, antibiotics, WASH facilities are crucial.
    • Unsafe Abortion (18%): Family planning, safe abortion services, post-abortion care promote safety.
    • Hemorrhage (18%): Uterotonics, blood transfusions, balloon tamponade, surgery, and NASG (Nasogastric tube) are essential interventions.
    • Indirect Causes (13%): Iron/folate supplements, intermittent malaria treatment, insecticide-treated nets, antiretrovirals are preventative.
    • Hypertensive Disorders (12%): Early identification, timely delivery, magnesium sulfate, calcium, aspirin, antihypertensives, and Cesarean section are needed.
    • Obstructed Labor (8%): Cesarean section may be necessary.
    • Other Maternal Disorders (22%): Cesarean section and other emergency obstetric care interventions are critical.

    Maternal Mortality in the US

    • Maternal mortality in the US is increasing, unlike the global trend.
    • Racial disparities exist, with Black women facing significantly higher risk (3x).
    • US has the highest infant mortality rate among high-income countries.

    Global Child Mortality

    • Approximately 15,000 children die daily.
    • Child deaths are disproportionately high.
    • Most child deaths are preventable.
    • Causes include issues with pregnancy, delivery, neonatal period, infectious and chronic diseases, and accidents.

    Societal Risk Factors

    • Food security, maternal education, and health, income, sanitation, access to health services, and political stability are significant societal risk factors.

    Global Undernutrition

    • Stunting (low height for age) is more prevalent than wasting (low weight for height) globally.
    • 2018: 149 million stunted and 49.5 million wasted children.
    • Burden of stunting and wasting is highest in Sub-Saharan Africa and South Asia.
    • Global stunting and wasting are declining, but childhood obesity is rising in both low- and high-income countries.
    • Child malnutrition (overweight and underweight) increases non-communicable disease risk in adulthood.

    Interventions for Maternal and Child Health

    • Direct: Mother education, high-quality healthcare, caregiver training, nutritional interventions, and supportive policies.
    • Indirect: Improved resources, environment, reduced poverty, addressing bias, and promoting gender equality.

    Example Programs

    • Western Kenya: Kangaroo mother care and emergency obstetric care, community health worker training, and maternal health care center improvements have reduced neonatal deaths and enhanced worker skills.
    • Burundi (TUBAraMURE): Multisectoral program with supplementary food, health-strengthening activities, education on hygiene and nutrition, improved maternal health, and nutrition knowledge, plus child weight-for-height and hemoglobin improvements.
    • India: Universal maternal care program (2016) with skilled birth attendants, free antenatal care, deliveries, and newborn care, a continuum of care approach, and improved emergency referral systems, decreasing maternal mortality from 130 to 97 per 100,000 live births.

    Other Examples

    • Data-driven healthcare approaches in California.
    • WIC (Special Supplemental Nutrition Program for Women, Infants, and Children).

    Definitions

    • Maternal mortality ratio: Maternal deaths per 100,000 live births (per year).
    • Maternal deaths: Pregnancy-related deaths during pregnancy or within 42 days of pregnancy termination.
    • Child mortality: Percentage of newborns dying by a specific age (per year).
    • Infant: Under one year of age.
    • Stunting: Low height-for-age.
    • Wasting: Low weight-for-height.

    Communicable Diseases

    • Communicable diseases are infectious, transmitted between humans or animals.
    • Caused by microorganisms (viruses, bacteria, parasites, fungi). Includes macroparasites (worms).
    • Major cause of death/disability in low-income countries and marginalized populations.
    • Communicable diseases are a leading cause of death in children under 5.
    • Many deaths (HIV/AIDS, malaria, TB) occur in low-income countries of Africa and South Asia.

    Epidemiology

    • Study of health-event distribution and determinants in populations, used to control issues.
    • Epidemiological triad (agent, host, environment): Disease from agent-host interaction in a supportive environment.
    • Incidence: New cases over time.
    • Prevalence: Existing cases at a time.

    Proximal Determinants

    • Host, environment, and etiologic agent.
    • Biological parasites/pathogens (bacteria, viruses, parasites), non-biological (physical, chemical, nutrient, mechanical, social)
    • Presence of agent not always sufficient for a disease.

    Morbidity

    • Disease manifestations of infectious diseases

    Host, Agent, and Environment

    • Host: Person/animal harboring or supporting an agent.
      • Demographics (sex, age), biology (immune status, genetic susceptibility), socioeconomic factors (poverty, education, geography).
    • Agent: Biological or non-biological (physical, chemical, nutrient, mechanical, social)
    • Environment: Physical, biological, and social.

    Transmission Modes

    • Contact, sex/blood-borne, inhalation/airborne, food-borne, water-borne, vector-borne.

    Malaria

    • 2022: 249 million cases and 608,000 estimated deaths globally.
    • Case incidence: 58 per 1,000 population at risk.
    • 80% of malaria deaths in Africa are in children.

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    Description

    Explore the critical aspects of maternal health, including the factors influencing maternal and child mortality rates. This quiz covers the global state of maternal health, the impact of social determinants, and strategies for prevention. Understand the significance of maternal health outcomes in ensuring the well-being of mothers and their children.

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