Maternal And Child Health (MCH) Lecture PDF

Maternal and Child Health (MCH) Dr. Mustafa M.A. Wahhudi Health Systems & Programs Section Public Health Department - Babylon Maternal and Child Health (MCH) Maternal health refers to the health of women during pregnancy, childbirth and the postnatal period. Child health refer...

Maternal and Child Health (MCH) Dr. Mustafa M.A. Wahhudi Health Systems & Programs Section Public Health Department - Babylon Maternal and Child Health (MCH) Maternal health refers to the health of women during pregnancy, childbirth and the postnatal period. Child health refers to the health of children from time of conception through infancy until the age of five years.  MCH Services Refers to a package of comprehensive health care services which are developed to protect and monitor the health of pregnant women before, during and after delivery; and of infants and pre-school children from time of conception to five years.  Objectives of MCH Services Reduce maternal morbidity and mortality Reduce perinatal and neonatal morbidity and mortality Promote reproductive health & regulate fertility Provide maternal and child health care to all mothers and children Promote and protect the health of mothers Promote and protect the physical, mental, and social growth and development of children  Components of MCH Services Maternal Health – Antenatal Care – Intra-natal care – Postnatal care Child Health Family Planning  Goal 3: Ensure healthy lives and promote well- being for all at all ages Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births" Indicator 3.1.1: Maternal mortality ratio Indicator 3.1.2: Proportion of births attended by skilled health personnel  Maternal Deaths Female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.* * World Health Organization  Direct Maternal Deaths Deaths resulting from obstetric complications of the pregnant state (pregnancy, labour and puerperium), Direct and from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the Maternal above. Deaths Indirect Maternal Deaths Deaths resulting from previous Indirect existing disease or disease that developed during pregnancy and not due to direct obstetric causes but were aggravated by the physiologic effects of pregnancy.  Postpartum Hemorrhage Obstetric Embolism Direct Maternal Hypertension Maternal Maternal Maternal Sepsis Deaths Deaths Cardiac Diseases Diabetes Mellitus Indirect Indirect COVID-19 Renal Diseases  Maternal Mortality Ratio Number of maternal deaths during a given time period per 100,000 live births. Number of maternal deaths MMR = ×100′ 000 Number of live births Maternal Mortality Ratio, 2015  Maternal deaths per 100'000 livebirths 0 20 40 60 80 100 140 160 180 200 120 2004 2005 2006 2007 2008 2009 2010 * MoH Iraq, World Health Organization, CSO Iraq. 2011 2012 2013 Years 2014 2015 2016 2017 2018 2019 70 2020 2021 2022 Maternal Mortality Ratio, IRAQ Maternal Mortality Ratio, IRAQ  MDSR Program Maternal Death Surveillance and Response (MDSR) is: The routine identification, notification, quantification, and determination of causes and avoidability of all maternal deaths. It also includes the use of this information to respond with actions that will prevent future deaths. Elimination of preventable maternal mortality is the goal of MDSR. It is a continuous-action cycle (a form of continuous surveillance).  Goal of MDSR Program Elimination of preventable maternal mortality through: Counting every maternal death, permitting an assessment of the true magnitude of maternal mortality and the impact of actions taken to reduce it. Providing information that effectively guides actions to eliminate preventable maternal mortality at health facilities and in the community. Most Common Causes of Maternal Mortality  Postpartum Hemorrhage Blood loss ≥ 500ml within 24 hours after birth.* * World Health Organization  Postpartum Hemorrhage Postpartum Hemorrhage is the leading cause of maternal mortality worldwide (approximately 35%). 35%  Postpartum Hemorrhage PPH is a PREVENTABLE condition. BUT It is potentially FATAL within a few hours.  3 Delays D1 D2 D3 Death from PPH  Impact of treatment delay for severe bleeding * The Lancet (2017)  Maternal Sepsis Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion, or postpartum period.* * World Health Organization  Maternal Sepsis Maternal sepsis is one of the leading causes of maternal mortality worldwide. Maternal sepsis causes more than 260,000 deaths every year.  Emergency Obstetric & Neonatal Care (EmONC) Antibiotics (i.v./i.m.) Oxytocin (i.v./i.m.) Anticonvulsants (i.v./i.m.) Comprehensive Basic Manual removal of placenta Manual vacuum aspiration of retained products of conception Vacuum extraction Newborn resuscitation Blood Transfusion Surgery (including C/S)