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   Introduction
   Maternal and child health care including family
    planning
•   Antenatal care
•   Intra-natal care
•   Post natal care
•   New born care
•   Care of the child
•   Family planning
 Each  year, lakhs of women, newborns, and children
  die from preventable causes.
 While the interventions that could save their lives
  are widely known, they are often not available to
  those most in need.
 With the intention of avoiding these preventable
  deaths the government of Karnataka set up the
  Primary Health Care Centre in rural villages.
A look at the statistics worldwide shows that
each year:
 • More than 60 million women deliver at home
   without skilled care.
 • About 530,000 women die from pregnancy related
   complications, with some 68,000 of those deaths
   resulting from unsafe abortion.
• About 4 million babies die within the first
month of life (the newborn period), and more
than 3 million die as stillbirths.
•   Over 10 million children under the age of 5 die.
•   Moreover, nearly all (99 percent) maternal,
    newborn, and child deaths occur in low- and
    middle-income countries.
MATERNAL AND CHILD HEALTH CARE
INCLUDING FAMILY PLANNING
 Antenatal care:
  Early registration of all pregnancies ideally in the
   first trimester (before 12th week of pregnancy).
   However, even if a woman comes late in her
   pregnancy for registration she should be registered
   and care given to her according to gestational age.
•    Minimum 3 antenatal checkups and provision of
    complete package of services. First visit as soon as
    pregnancy is suspected/between 4th and 6th month
    (before 26 weeks), second visit at 8th month (around
    32weeks) and third visit at 9th month (around 36
    weeks).
•   Associated services like providing iron and folic acid
    tablets, injection Tetanus toxoid etc (as per the
    “guidelines for ante-natal care and skilled
    attendance at birth by ANMs and LHVs)
•    Minimum laboratory investigations like
    haemoglobin, urine albumin, and sugar, RPR test
    for syphilis
•    Nutrition and health counseling
•    Identification of high-risk pregnancies/ appropriate
    management
•    Chemoprophylaxis for Malaria in high malaria
    endemic areas as per NVBDCP (National Vector
    Borne Disease Control Programme) guidelines.
•    Referral to First Referral Units (FRUs)/other
    hospitals of high risk pregnancy beyond the
    capability of Medical Officer, PHC to manage.
Intra-natal care:
(24-hour delivery services both normal and assisted)
i) Promotion of institutional deliveries
ii) Conducting normal deliveries
iii) Assisted vaginal deliveries including forceps /
vacuum delivery whenever required
iv) Manual removal of placenta
v) Appropriate and prompt referral for cases needing
specialist care.
vi) Management of Pregnancy Induced hypertension
including referral
vii) Pre-referral management (Obstetric first-aid) in
Obstetric emergencies that need expert assistance
(Training of staff for emergency management to be
ensured)
LABOUR WARD
Postnatal Care:
• A minimum of 2 postpartum home visits, first
  within 48 hours of delivery, 2nd within 7 days
  through Sub-centre staff.
• Initiation of early breast-feeding within half-hour
  of birth
• Education on nutrition, hygiene, contraception,
  essential new born care (As per Guidelines of GOI
  on Essential new-born care)
• Others: Provision of facilities under Janani
  Suraksha Yojana (JSY)
New Born care:
 Facilities and care for neonatal resuscitation
 Management of neonatal hypothermia / jaundice
Care of the child:
 Emergency care of sick children including
  Integrated Management of Neonatal and Childhood
  Illness (IMNCI)
•    Care of routine childhood illness
•    Essential Newborn Care
•    Promotion of exclusive breast-feeding for 6 months.
•    Full Immunization of all infants and children
    against vaccine preventable diseases as per
    guidelines of GOI.
•   Vitamin A prophylaxis to the children as per
    guidelines.
•    Prevention and control of childhood diseases,
    infections, etc.
Family Planning:
• Education, Motivation and counseling to adopt
  appropriate Family planning methods.
• Provision of contraceptives such as condoms, oral
  pills, emergency contraceptives, IUD insertions.
• Permanent methods like Tubal ligation and
  vasectomy / NSV.
• Follow up services to the eligible couples adopting
  permanent methods (Tubectomy/Vasectomy).
• Counseling and appropriate referral for safe
  abortion services (MTP) for those in need.
•  Counseling and appropriate referral for couples
  having infertility.
 Medical Termination of Pregnancies using Manual
  Vacuum Aspiration (MVA) technique. (wherever
  trained personnel and facility exists)
 Management of Reproductive Tract Infections /
  Sexually Transmitted Infections:
 Health education for prevention of RTI/ STIs
 Treatment of RTI/ STIs
 Nutrition Services (coordinated with ICDS)
 Diagnosis of and nutrition advice to malnourished
  children, pregnant women and others.
 Diagnosis and management of anaemia, and
  vitamin A deficiency.
 Coordination with ICDS.
 School Health: Regular check ups, appropriate
  treatment including deworming, referral and
  follow-ups.
 Adolescent Health Care: Life style education,
  counseling, appropriate treatment.
THANK YOU

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Maternal and Child Healthcare at Primary Health Centres

  • 2. Introduction  Maternal and child health care including family planning • Antenatal care • Intra-natal care • Post natal care • New born care • Care of the child • Family planning
  • 3.  Each year, lakhs of women, newborns, and children die from preventable causes.  While the interventions that could save their lives are widely known, they are often not available to those most in need.  With the intention of avoiding these preventable deaths the government of Karnataka set up the Primary Health Care Centre in rural villages.
  • 4. A look at the statistics worldwide shows that each year: • More than 60 million women deliver at home without skilled care. • About 530,000 women die from pregnancy related complications, with some 68,000 of those deaths resulting from unsafe abortion.
  • 5. • About 4 million babies die within the first month of life (the newborn period), and more than 3 million die as stillbirths. • Over 10 million children under the age of 5 die. • Moreover, nearly all (99 percent) maternal, newborn, and child deaths occur in low- and middle-income countries.
  • 6. MATERNAL AND CHILD HEALTH CARE INCLUDING FAMILY PLANNING Antenatal care:  Early registration of all pregnancies ideally in the first trimester (before 12th week of pregnancy). However, even if a woman comes late in her pregnancy for registration she should be registered and care given to her according to gestational age.
  • 7. Minimum 3 antenatal checkups and provision of complete package of services. First visit as soon as pregnancy is suspected/between 4th and 6th month (before 26 weeks), second visit at 8th month (around 32weeks) and third visit at 9th month (around 36 weeks). • Associated services like providing iron and folic acid tablets, injection Tetanus toxoid etc (as per the “guidelines for ante-natal care and skilled attendance at birth by ANMs and LHVs)
  • 8. Minimum laboratory investigations like haemoglobin, urine albumin, and sugar, RPR test for syphilis • Nutrition and health counseling • Identification of high-risk pregnancies/ appropriate management • Chemoprophylaxis for Malaria in high malaria endemic areas as per NVBDCP (National Vector Borne Disease Control Programme) guidelines.
  • 9. Referral to First Referral Units (FRUs)/other hospitals of high risk pregnancy beyond the capability of Medical Officer, PHC to manage.
  • 10. Intra-natal care: (24-hour delivery services both normal and assisted) i) Promotion of institutional deliveries ii) Conducting normal deliveries iii) Assisted vaginal deliveries including forceps / vacuum delivery whenever required
  • 11. iv) Manual removal of placenta v) Appropriate and prompt referral for cases needing specialist care. vi) Management of Pregnancy Induced hypertension including referral vii) Pre-referral management (Obstetric first-aid) in Obstetric emergencies that need expert assistance (Training of staff for emergency management to be ensured)
  • 13.
  • 14. Postnatal Care: • A minimum of 2 postpartum home visits, first within 48 hours of delivery, 2nd within 7 days through Sub-centre staff. • Initiation of early breast-feeding within half-hour of birth • Education on nutrition, hygiene, contraception, essential new born care (As per Guidelines of GOI on Essential new-born care) • Others: Provision of facilities under Janani Suraksha Yojana (JSY)
  • 15. New Born care:  Facilities and care for neonatal resuscitation  Management of neonatal hypothermia / jaundice Care of the child:  Emergency care of sick children including Integrated Management of Neonatal and Childhood Illness (IMNCI)
  • 16. Care of routine childhood illness • Essential Newborn Care • Promotion of exclusive breast-feeding for 6 months. • Full Immunization of all infants and children against vaccine preventable diseases as per guidelines of GOI. • Vitamin A prophylaxis to the children as per guidelines. • Prevention and control of childhood diseases, infections, etc.
  • 17. Family Planning: • Education, Motivation and counseling to adopt appropriate Family planning methods. • Provision of contraceptives such as condoms, oral pills, emergency contraceptives, IUD insertions. • Permanent methods like Tubal ligation and vasectomy / NSV. • Follow up services to the eligible couples adopting permanent methods (Tubectomy/Vasectomy). • Counseling and appropriate referral for safe abortion services (MTP) for those in need.
  • 18. • Counseling and appropriate referral for couples having infertility.  Medical Termination of Pregnancies using Manual Vacuum Aspiration (MVA) technique. (wherever trained personnel and facility exists)  Management of Reproductive Tract Infections / Sexually Transmitted Infections:  Health education for prevention of RTI/ STIs  Treatment of RTI/ STIs
  • 19.  Nutrition Services (coordinated with ICDS)  Diagnosis of and nutrition advice to malnourished children, pregnant women and others.  Diagnosis and management of anaemia, and vitamin A deficiency.  Coordination with ICDS.  School Health: Regular check ups, appropriate treatment including deworming, referral and follow-ups.  Adolescent Health Care: Life style education, counseling, appropriate treatment.
  • 20.