1 Lec - FINAL LECTURE 1 Introduction to Maternal and Child Health .pdf

Lecture 1: Introduction to Maternal and Child Health Objectives 1. To understand the importance of Maternal and Child health (MCH). 2. To analyze the link between the health issues of mothers and children and unde rstand the consequences of ill health. 3. To list the application of the global stra...

Lecture 1: Introduction to Maternal and Child Health Objectives 1. To understand the importance of Maternal and Child health (MCH). 2. To analyze the link between the health issues of mothers and children and unde rstand the consequences of ill health. 3. To list the application of the global strategies in place for MCH care. 4. To list the strategies of MCH care in KSA Outline • • • • • • • • • • • Specific Objectives of MCH. Definition of MCH. Components of MCH. Facts about global Maternal health. Maternal Death. Global causes of maternal mortality. Why do women not get the care they need? Facts about Child health. Emerging Issues in child health. Global response. Mother and Child Health Passport Project. Specific Objectives of MCH • Reduction of maternal, perinatal, infant and childhood mortality and morbidity • Promotion of Reproductive health • Promotion of the physical and psychological developmen t of the child and adolescent within the family Definition of MCH “Maternal and Child health (MCH) refers to the promotive, preventive, curative, and rehabilitati ve health care for mothers and children. It includ es the sub areas of maternal health, child health, family planning, school health, handicapped chil dren, adolescence, and health aspects of care of c hildren in special settings such as day care.” Components of MCH • • • • • • Maternal health Family planning Child health School health Handicapped children Care of children in special setting such as Day care Facts about global Maternal health Fact 1: Nearly 830 women die every day due to complications during pr egnancy and childbirth .In developing countries, conditions related to pr egnancy and childbirth constitute the second leading causes (after HIV/ AIDS) of death among women of reproductive age. Fact 2: Women die in pregnancy and childbirth for 5 main reasons, These are severe bleeding, infections, unsafe abortion, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications like cardiac dise ase, diabetes, or HIV/AIDS complicating or complicated by pregnancy Cont.... Fact 3: More than 135 million women give birth per year, About 20 million of them are esti mated to experience pregnancy-related illness after childbirth. The list of morbidities is lon g and diverse, and includes fever, anemia, incontinence, infertility and depression. Fact 4: Complications from pregnancy and childbirth are the leading cause of death among girls 15-19. Fact 5: Maternal health mirrors the gap between the rich and the poor , Less than 1% of maternal deaths occur in high-income countries. The maternal mortality ratio in developing countries is 239 per 100 000 births versus 12 per 100 000 in developed countries. Also, ma ternal mortality is higher in rural areas and among poorer and less educated communities. Cont.….. • Every day, approximately 830 women die from preventable causes related to pr egnancy and childbirth. • 99% of all maternal deaths occur in developing countries. • Maternal mortality is higher in women living in rural areas and among poorer commu nities. • Young adolescents face a higher risk of complications and death as a result of pregnan cy than other women. • Skilled care before, during and after childbirth can save the lives of women and newbo rn babies. • Between 1990 and 2015, maternal mortality worldwide dropped by about 44%. • Between 2016 and 2030, as part of the Sustainable Development Agenda, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births. This pic shows you the maternal mortality ratio in different countries worldwide We conclude that its much higher in developing countries in comparison to developed (rich) countries (fact 5) KSA= 1-19 Maternal Death Cont…. Why women are dying ? Women die as a result of complications during and following pregnanc y and childbirth. The major complications that account for nearly 75% of all maternal de aths are: ● severe bleeding (mostly bleeding after childbirth) ● infections (usually after childbirth) ● high blood pressure during pregnancy (pre-eclampsia and ecla mpsia) ● complications from delivery ● unsafe abortion ● The remainder are caused by or associated with diseases such as malaria, and AIDS during Pregnancy. Global causes of maternal mortality Why do women not get the care they need? Three Delays Model (three main causes) 1. Delay in decision to seek care if the number of those seeking antenatal care (clinics) is very low this means there is a problem • Lack of understanding of complications • Acceptance of maternal death • Low status of women • Socio-cultural barriers to seeking care 2. Delay in reaching care • Mountains, islands, rivers — poor organization 3. Delay in receiving care • Supplies, personnel • Poorly trained personnel . • Finances Trends in maternal mortality 1990 - 2015 • Maternal mortality fell by almost half between 1990 and 2015 Maternal mortality ratio (maternal deaths per 100,000 live births in women aged 15 to 49), by region, 1990, 2010 and 2015). • The global MMR in 2020 was 223 per 100 000 live births; achieving a global MMR below 70 by the year 2030. Where do Maternal Mortality data come from? • Vital registration data - MM Rate and MM Ratio • Health service data – maternity registers - MM Rati o • Special studies • Hospital studies – tracing deaths, interviews • Research, longitudinal studies. • Surveys & censuses • Direct estimation - Rate and Ratio • Sisterhood method (indirect):is a household survey t o estimate maternal deaths recommended by the World He alth Organization (WHO). – Rate and Ratio Maternal Mortality Indicators • Maternal mortality ratio look at the pics below • Maternal mortality rate look at the pics below • Life-time risk of maternal morality Cont.…… Saudi Arabia - Maternal mortality ratio 16.0(deaths per 100,000 live births)in 2020 In 2020, maternal mortality ratio for Saudi Arabia was 16 deaths per 100,000 live births. Maternal mortality ratio of Saudi Arabia fe ll gradually from 21 deaths per 100,000 live births in 2001 to 16 deaths per 100,000 live births in 2020. Saudi Arabia Maternal Mortality Rate 2000-2023 https://www.macrotrends.net/countries/SAU/saudi-arabia/maternal-mortality-rate Facts about Child health • 5.9 million children under the age of 5 died in 2015. • More than half of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions. • Leading causes of death in under-5 children are preterm birth complications, pneu monia, birth asphyxia, diarrhoea and malaria. About 45% of all child deaths are linke d to malnutrition. • Children in sub-Saharan Africa are more than 14 times more likely to die before the age of 5 than children in developed regions. Cont.….. The leading cause in neonatal is prematurity While in postne onatal its pneumonia -Malnutrition: e.g. protein energy malnutrition, iron deficiency anemia, rickets and vitamin s deficiencies. -Injuries: Of several categories including:• Wounds and fractures • Chemical poisoning • Swallowing of objects • Road Traffic Accidents • Burns • Drowning Cont…. Remember this number 43 which represent the mortality worldwide Emerging Issues in child health • Congenital anomalies • Injuries • Non-communicable diseases (chronic respiratory diseases, acquired heart diseases, childhood cancers, diabetes, and obesity) Indicators of Child Health • Mortality in infancy and childhood • Perinatal mortality rate • Neonatal mortality rate • Infant mortality rate • Under 5 mortality rate Global response • Sustainable Development Goal 3 • 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births. • 3.2 By 2030, end preventable deaths of newborn s and children under 5 years of age, with all coun tries aiming to reduce neonatal mortality to at lea st as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live bir ths Other Interventions for Maternal Care Antenatal care • Nutrition support (anemia) • Personal hygiene, dental care, rest and sleep • Immunization (mother and the newborn) • Education on delivery and care of the newborn • Identifying high risk pregnancies • Emphasizing on ANC visits and maintenance of AN card • Importance and management of lactation • Advise on birth spacing (not giving birth each year (taking time bet ween each birth)) Ref: WHO recommendations on maternal helath, guidelines to improve maternal health. 2017. Available at: http://apps.who.int/iris/bitstream/10665/259268/1/WHO-MCA-17.10-eng.pdf?ua=1 MCH In KSA Under-five mortality • The under-five mortality rate refers to the probability a newborn would die b efore reaching exactly 5 years of age, expressed per 1,000 live births. In 202 1, 5.0 million children under 5 years of age died. Globally, infectious disease s, including pneumonia, diarrhea and malaria, remain a leading cause of un der-five deaths, along with preterm birth and intrapartum-related complicati ons. • The global under-five mortality rate declined by 59 per cent, from 93 deaths per 1,000 live births in 1990 to 38 in 2021. https://data.unicef.org/topic/child-survival/under-five-mortality/ Trends in under-five mortality rate in Saudi Arabia https://data.unicef.org/country/sau/ Mother and Child Health Passport Project • Launched : 14 March 2011 • MOH has devised the Mother and Child Health Passport System, which is concerned with th e health of mother and child. It keeps record of their illness history, monitors and follows u p on their health status, and requires necessary examinations and analyses. All of this is the n documented in the passport to be used in health centers, becoming the first reference for the health of the mothers and children. The passport aims to provide integrated health care , safe pregnancy, a healthy childhood and a happy family. Summary Maternal and child health encompasses a range of strategies a nd practices aimed at ensuring the well-being of both mother s and children during pregnancy, childbirth, and the early yea rs of life. This field of healthcare focuses on promoting safe pr egnancies, healthy childbirth experiences, and optimal growt h and development for infants and children. THANK YOU