ACTIVITY SHEETS FOR EXERCISE A

EXERCISE A: Causes of MATERNAL death and priority health interventions

EXERCISE A1

EXERCISE A2

EXERCISE A3

What are mothers dying Which interventions will save them from At which level of the health
from?
these causes? List in order from most to least system is this delivered?
impact. Top 5 interventions for each cause
of death only

EXERCISE A. Causes of maternal deaths

Source. World Health Organization, Global Burden of Disease, MDG East Asia Region, 2008

Haemorrhage

43%

Hypertensive disorder

3%

Infection/Puerperal sepsis

12%

Abortion

12%

Obstructed labour

3%

Anaemia
HIV/AIDS
Ectopic pregnancy
Embolism
Other

27%

0%

20%

40%

60%

80%

100%

EXERCISE A. Efficacy of interventions for maternal health

CAUSE OF DEATH

EFFECTIVENESS

Haemorrhage (antepartum)
Basic emergency obstetric care (BEmOC)

90.0%

Comprehensive emergency obstetric care (CEmOC)

95.0%

Haemorrhage (postpartum)
Active management of the third stage of labor

27.0%

Basic emergency obstetric care (BEmOC)

65.0%

Comprehensive emergency obstetric care (CEmOC)

95.0%

Hypertensive disorders (Ecclampsia)

Case Management During Pregnancy (antenatal care)

20.0%

Calcium supplementation in pregnancy

23.0%

Detection and management of (pre) ecclampsia (Mg Sulphate)

46.0%

Sepsis/infections (puerperal infection)

Antibiotics for Preterm/Prelabor Rupture of Membrane (P/PROM)

26.0%

Basic emergency obstetric care (BEmOC)

50.0%

Comprehensive emergency obstetric care (CEmOC)

90.0%

Detection and treatment of asymptomatic bacteriuria

10.0%

Normal delivery by skilled attendant

10.0%

Safe home delivery (clean delivery and cord care)

10.0%

Abortion
Management of complications of abortion

99.0%

Obstructed labor
Case Management During Pregnancy (antenatal care)

10.0%

Basic emergency obstetric care (BEmOC)

8.0%

Comprehensive emergency obstetric care (CEmOC)

99.0%

Anaemia
Basic emergency obstetric care (B-EOC)

20.0%

Comprehensive emergency obstetric care (C-EOC)

80.0%

Intermittent preventive treatment (IPTp) for malaria in pregnancy

12.0%

Management of severe malaria in pregnancy

84.0%

Prevention and treatment of iron deficiency anemia in pregnancy

12.0%

Supplementation in pregnancy with multi-micronutrients

39.0%

HIV/AIDS
First line ART for pregnant women with HIV/AIDS

84.5%

Ectopic pregnancy
Basic emergency obstetric care (BEmOC)

30.0%

Comprehensive emergency obstetric care (CEmOC)

90.0%

Other
Case Management During Pregnancy (antenatal care)

10.0%

Tetanus toxoid

0.5%

ACTIVITY SHEETS FOR EXERCISE B

EXERCISE B: Causes of NEWBORN death and priority health interventions

EXERCISE B1

EXERCISE B2

EXERCISE B3

What are newborns (0-1 Which interventions will save them from these At which level of the health
month) dying from?
causes? List in order from most to least impact. system is this delivered?
Top 5 interventions for each cause of death only

EXERCISE B. Causes of neonatal deaths

Source. World Health Organization Database, Philippines, 2008

Congenital abnormalities

14%

Neonatal sepsis

4%

Birth asphyxia

14%

Preterm birth complications

41%

Pneumonia

12%

Tetanus

2%

Other neonatal deaths

14%

0%

20%

40%

60%

80%

100%

EXERCISE B. Efficacy of interventions for neonatal health

CAUSE OF DEATH

EFFECTIVENESS

Tetanus
Basic emergency obstetric care (BEmOC)

36.0%

Comprehensive emergency obstetric care (CEmOC)

36.0%

Normal delivery by skilled attendant

36.0%

Safe home delivery (clean delivery and cord care)

30.0%

Tetanus toxoid vaccination

94.0%

Severe infection
Antibiotics for Preterm/Prelabor Rupture of Membrane (P/PROM)

8.0%

Basic emergency obstetric care (BEmOC)

25.0%

Comprehensive emergency obstetric care (CEmOC)

25.0%

Community based management of neonatal sepsis

42.0%

Early Breastfeeding (within 1st hour) and Temperature Management

19.0%

Management of neonatal infections

83.0%

Normal delivery by skilled attendant

25.0%

Safe home delivery (clean delivery and cord care)

20.0%

Treatment of syphilis in pregnancy

2.5%

Emergency neonatal care: management of serious illness (infections,

50.0%
asphyxia, prematurity, jaundice)
Universal extra community-based care of LBW infants

5.5%

Birth asphyxia
Basic emergency obstetric care (BEmOC)

40.0%

Case Management During Pregnancy (antenatal care)

15.0%

Comprehensive emergency obstetric care (CEmOC)

80.0%

Management of neonatal infections

5.0%

Normal delivery by skilled attendant

25.0%

Emergency neonatal care: management of serious illness (infections,

2.5%
asphyxia, prematurity, jaundice)
Resuscitation of asphyctic newborns at birth

20.0%

Diarrhoea
Early Breastfeeding (within 1st hour) and Temperature Management

42.5%

Oral Rehydration Therapy

93.0%

Congenital anomolies
Prevention and treatment of iron deficiency anemia in pregnancy

5.0%

Folic acid fortification of flour

13.0%

Preterm birth
Antenatal steroids for preterm labor

53.0%

Antibiotics for Preterm/Prelabor Rupture of Membrane (P/PROM)

4.0%

Balanced protein energy supplements for pregnant women

32.0%

Basic emergency obstetric care (BEmOC)

10.0%

Comprehensive emergency obstetric care (CEmOC)

10.0%

Detection and treatment of asymptomatic bacteriuria

9.5%

Management of neonatal infections

28.0%

Normal delivery by skilled attendant

10.0%

Resuscitation of asphyctic newborns at birth

5.0%

Supplementation in pregnancy with multi-micronutrients

14.0%

Emergency neonatal care: management of serious illness (infections,

27.5%
asphyxia, prematurity, jaundice)
Kangaroo care for LBW infants

51.0%

Universal extra community-based care of LBW infants

35.0%

Detection and management of (pre) ecclampsia (Mg Sulphate)

0.0%

ACTIVITY SHEETS FOR EXERCISE C

EXERCISE C: Causes of CHILD deaths (1-59 mo) and priority interventions

EXERCISE C1

EXERCISE C2

EXERCISE C3

What are children 1-59 Which interventions will save them from these At which level of the health
months dying from?
causes? List in order from most to least impact. system is this delivered?
Top 5 interventions for each cause of death only

EXERCISE C. Causes of child deaths (1-59 months)

Source. World Health Organization Database, Philippines, 2008

Pertussis

0%

Malaria

0%

Measles

1%

Meningitis

6%

Other infections

23%

Diarrhoeal diseases

12%

Pneumonia

34%

Injuries

8%

Other

16%

0%

20%

40%

60%

80%

100%

EXERCISE C. Efficacy of interventions for child health

CAUSE OF DEATH

EFFECTIVENESS

HIV/AIDS
Cotrimoxazole prophylaxis for children of HIV+ mothers

33.0%

First line ART for pregnant women with HIV/AIDS

33.0%

First line ART for children with HIV/AIDS

62.0%

Second-line ART for children with HIV/AIDS

9.0%

PMTCT (testing and counseling, ART and infant feeding counseling)

73.0%

Diarrhoea
Supply of safe drinking water

17.0%

Antibiotics for dysentery and enteric fevers

49.5%

Exclusive breastfeeding for children 0-5 months

30.9%

Breastfeeding for children 6-11 months

8.4%

Complementary feeding for children 6-23 months

21.6%

Handwashing with soap

48.0%

Management of Severe Acute Malnutrition (therapeutic feeding)

22.6%

Oral Rehydration Therapy

88.4%

Rotavirus immunization

15.0%

Safe disposal of child feces

15.0%

Use of sanitary latrine

36.0%

Use of good quality water source

63.0%

Zinc for diarrhea management

23.0%

Zinc preventive

6.6%

Vitamin A preventive

14.0%

Measles
Complementary feeding for children 6-23 months

13.8%

Management of Severe Acute Malnutrition (therapeutic feeding)

15.3%

Measles immunization

85.0%

Vitamin A - Treatment for measles

62.0%

Vitamin A preventive

41.7%

Malaria
Chloroquine for malaria (P.vivax)

41.7%

Complementary feeding for children 6-23 months

19.2%

Indoor Residual Spraying (IRS)

34.0%

Insecticide Treated Bed Nets (ITNs)

55.0%

Management of complicated malaria at referral level (2nd line drug)

67.0%

Management of Severe Acute Malnutrition (therapeutic feeding)

20.4%

Anti malarial combination treatment for children

90.0%

Intermittent Presumptive Treatment (IPT) for children

48.0%

Vitamin A preventive

32.4%

Pneumonia
Antibiotics for U5 pneumonia

70.0%

Exclusive breastfeeding for children 0-5 months

45.4%

Breastfeeding for children 6-11 months

10.8%

Complementary feeding for children 6-23 months

17.7%

DTP immunization

10.0%

Hib immunization

18.0%

Pentavalent (DTP+HepB+Hib) immunization

18.0%

Pneumococcal immunization

26.0%

Management of Severe Acute Malnutrition (therapeutic feeding)

19.1%

Zinc preventive

14.0%

Other
Hib immunization

1.0%

Pentavalent (DTP+HepB+Hib) immunization

1.0%

Pneumococcal immunization

1.0%

Meningococcal immunization

1.0%

BCG immunization

1.0%

Hepatitis B immunization

1.0%

Yellow Fever immunization

1.0%

DTP immunization

1.0%

Polio immunization

1.0%

ACTIVITY SHEET FOR EXERCISES D, E

Print multiple copies of blank coverage graphs for assessing morbidity, inequity and program performance.

100%
80%
60%
40%
20%
0%

ACTIVITY SHEET FOR EXERCISE H

EXERCISE H. Create your own bottleneck chart

SUPPLY

COMMODITIES

HUMAN RESOURCES

ACCESS

QUALITY

DEMAND

FIRST USE

CONTINUITY

QUALITY