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RESEARCH EVIDENCE ON

MATERNAL AND CHILD


HEALTH

SUBMITTED TO SUBMITTED BY
Mrs. Somibala Thokchom Mrs. Sneha Sehrawat
Tutor M.Sc Nursing
Rufaida College of Nursing Rufaida College of Nursing

INTRODUCTION

Maternal and Child Health


Maternal and child health is recognized as one of the significant components of Family
Welfare. Health of both mother and children is a matter of Public Health concern. It is also
being observed that the deaths of mothers and children are the major contributors to
mortality in any community in India. In India 125,000 (460 per 100,000 live births) women
die due to pregnancy and child birth related causes. About 1.8 million (74 per 1000 live
births) infants and 2.65 million (109 per 1000 live births) under five children die every year.
Health of mothers and children is very important for acceptance and practice of family norms
to stabilize population.Materal and Child Health care services are essential and specialized
services because mothers and children have special health needs which are not catered to by
general health care services.

Moreover, children are the asset for the family, community and nation. They are their future.
Whereas mothers have an important role in their growth and development. Mother’s health
status during pregnancy and after delivery determines health status of child. Therefore health
care of mothers and children occupies an important place in our health care delivery system
and is integrated part of Primary Health Care.

The problems of maternal and child mortality are complex, involving women’s status,
education, employment opportunities and the availability to women of basic rights and
freedom. The maternal health status differs tremendously from place to place and in the
same place. It is assessed in terms of maternal health problems (maternal morbidity) and
maternal mortality. The factors which are responsible for maternal health problems i.e.
maternal morbidity and maternal mortality include poverty, ignorance, illiteracy,
malnutrition, age at marriage and pregnancy, the number and frequency of child bearing and
the number of unwanted pregnancies and abortions, lower status and worth of women in
society, lack of access to quality maternal health/ reproductive health services, gender
discrimination.

- An assessment of maternal, newborn and child health implementation studies in


Nigeria: implications for evidence informed policymaking and practice: Chigozie Jesse
Unek
Abstract

Background: The introduction of implementation science


into maternal, newborn and child health (MNCH) research
has facilitated better methods to improve uptake of
research findings into practices. With increase in
implementation research related to MNCH world-wide,
stronger scientific evidence are now available and have
improved MNCH policies in many countries including
Nigeria. The purpose of this study was to review MNCH
implementation studies undertaken in Nigeria in order to
understand the extent the evidence generated informed
better policy.
Methods: This study was a systematic review. A MEDLINE Entrez PubMed search was performed in
August 2015 and implementation studies that investigated MNCH in Nigeria from 1966 to 2015 in relation
to health policy were sought. Search key words included Nigeria, health policy, maternal, newborn, and
child health. Only policy relevant studies that were implementation or intervention research which generated
evidence to improve MNCH in Nigeria were eligible and were selected.

Results: A total of 18 relevant studies that fulfilled the study inclusion criteria were identified out of 471
studies found. These studies generated high quality policy relevance evidence relating to task shifting,
breastfeeding practices, maternal nutrition, childhood immunization, kangaroo mother care (KMC),
prevention of maternal to child transmission of HIV, etc. These indicated significant improvements in
maternal health outcomes in localities and health facilities where the studies were undertaken.

Conclusion: There is a dire need for more implementation research related to MNCH in low income settings
because the priority for improved MNCH outcome is not so much the development of new technologies but
solving implementation issues, such as how to scale up and evaluate interventions within complex health
system.
- Improving maternal and child health policymaking processes in Nigeria: an
assessment of policymakers' needs, barriers and facilitators of evidence-informed
policymaking.
Uneke CJ
Abstract
BACKGROUND:
In Nigeria, interest in the evidence-to-policy process is gaining momentum among
policymakers involved in maternal, newborn and child health (MNCH). However, numerous
gaps exist among policymakers on use of research evidence in policymaking. The objective
of this study was to assess the perception of MNCH policymakers regarding their needs and
the barriers and facilitators to use of research evidence in policymaking in Nigeria.
METHODS:
The study design was a cross-sectional assessment of perceptions undertaken during a
national MNCH stakeholders' engagement event convened in Abuja, Nigeria. A
questionnaire designed to assess participants' perceptions was administered in person. Group
consultations were also held, which centred on policymakers' evidence-to-policy needs to
enhance the use of evidence in policymaking.
RESULTS:
A total of 40 participants completed the questionnaire and participated in the group
consultations. According to the respondents, the main barriers to evidence use in MNCH
policymaking include inadequate capacity of organisations to conduct policy-relevant
research; inadequate budgetary allocation for policy-relevant research; policymakers'
indifference to research evidence; poor dissemination of research evidence to policymakers;
and lack of interaction fora between researchers and policymakers. The main facilitators of
use of research evidence for policymaking in MNCH, as perceived by the respondents,
include capacity building for policymakers on use of research evidence in policy
formulation; appropriate dissemination of research findings to relevant stakeholders;
involving policymakers in research design and execution; and allowing policymakers' needs
to drive research. The main ways identified to promote policymakers' use of evidence for
policymaking included improving policymakers' skills in information and communication
technology, data use, analysis, communication and advocacy.
CONCLUSION:
To improve the use of research evidence in policymaking in Nigeria, there is a need to
establish mechanisms that will facilitate the movement from evidence to policy and address
the needs identified by policymakers. It is also imperative to improve organisational
initiatives that facilitate use of research evidence for policymaking.

- An Assessment of National Maternal and Child Health Policy-Makers' Knowledge


and Capacity for Evidence- Informed Policy-Making in Nigeria.: Uneke CJ
Abstract
BACKGROUND:
There is increasing interest globally in the use of more rigorous processes to ensure that
maternal, newborn, and child health (MNCH) care recommendations are informed by the
best available research evidence use. The purpose of this study was to engage Nigerian
MNCH policy-makers and other stakeholders to consider issues around research to policy
and practice interface and to assess their existing knowledge and capacity on the use of
research evidence for policy-making and practice.
METHODS:
The study design is a cross-sectional evaluation of MNCH stakeholders' knowledge as it
pertains different dimensions of research to practice. This was undertaken during a national
MNCH stakeholders' engagement event convened under the auspices of the West African
Health Organization (WAHO) and the Federal Ministry of Health (FMoH) in Abuja, Nigeria.
A questionnaire was administered to participants, which was designed to assess participants'
knowledge, capacity and organizational process of generation, synthesis and utilization of
research evidence in policy-making regarding MNCH.
RESULTS:
A total of 40 participants signed the informed consent form and completed the questionnaire.
The mean ratings (MNRs) of participants' knowledge of electronic databases and capacity to
identify and obtain relevant research evidence from electronic databases ranged from 3.62-
3.68 on the scale of 5. The MNRs of participants' level of understanding of a policy brief, a
policy dialogue and the role of researchers in policy-making ranged from 3.50-3.86. The
MNRs of participants' level of understanding of evidence in policy-making context, types
and sources of evidence, capacity to identify, select, adapt, and transform relevant evidence
into policy ranged from 3.63-4.08. The MNRs of the participants' organization's capacity to
cover their geographical areas of operation were generally low ranging from 3.32-3.38 in
terms of manpower, logistics, facilities, and external support. The lowest MNR of 2.66 was
recorded in funding.
CONCLUSION:
The outcomes of this study suggest that a stakeholders' engagement event can serve as an
important platform to assess policy-makers' knowledge and capacity for evidence-informed
policy-making and for the promotion of evidence use in the policy process.

- Trends in maternal and neonatal mortality in South Africa: a systematic review


protocol.: Damian DJ
Abstract
BACKGROUND:
Measuring and monitoring progress towards Millennium Development Goals (MDG) 4 and 5
requires valid and reliable estimates of maternal and neonatal mortality. In South Africa,
there are conflicting reports on the estimates of maternal and neonatal mortality, derived
from both direct and indirect estimation techniques. This study aims to systematically review
the estimates made of maternal and neonatal mortality in the period from 1990 to 2015 in
South Africa and determine trends over this period.
METHODS:
For the purpose of this review, searches for eligible studies will be conducted in MEDLINE,
Africa-Wide Information, African Index Medicus, African Journals Online, Scopus, Web of
Science and CINAHL databases. Searches will be restricted to articles written in English and
presenting data covering the period between 1990 and 2015. Reference lists of retrieved
articles will also be screened for additional publications. Three independent reviewers will
be involved in the study selection, data extractions and achieving consensus. Study quality
and risk of bias will thereafter be assessed by two authors. The results will be presented as
rates/ratio with their corresponding 95% confidence/uncertainty intervals.
DISCUSSION:
Identifying trends in maternal and neonatal mortality will help to track progress in MDGs 4
and 5 and will serve in evaluating interventions focusing on
reducing maternal and child mortality in the country. This study will, in particular, provide
the context for understanding inconsistencies in reported estimates of maternal and neonatal
mortality by considering estimation methods, data sources and definitions used.

- A stepwise regression analysis on under-five diarrhoael morbidity prevalence in


Nekemte town, western Ethiopia: maternal care giving and hygiene behavioral
determinants: Eshete W
Abstract
OBJECTIVE:
Various studies have addressed the relationship between maternal care giving behaviours
including hygiene behaviours and the occurrence of diarrhoea in children. However, very
few studies have done in Ethiopia in general and none exist in Nekemte town, western
Ethiopia. Therefore, the present study aimed to estimate the prevalence of under-five
diarrhoea morbidity in relation to mothers/care takers behaviours including hygiene
behavioural determinants.
METHODS:
Community-based cross-sectional study was conducted in Nekemte town, western Ethiopia
from October 15- November 26, 2007. 477 mothers/ care takers of index under-five children
living in the households selected randomly from sub cities in the town formed the study
population. Structured and pre-tested questionnaire was used to collect data. The data were
entered into a computer, edited and analyzed using SPSS for windows version 12.01.
Stepwise logistic regression model was used to calculate the Odds ratios and 95% confidence
interval for the different risk factors was considered.
RESULTS:
From 477, 461 were participated in the study giving a response rate of 96.6%. The mean
ages of the respondents and the index children were about 32.4 (+/- 8.8 SD) years and 25.27
(+/- 15.16 SD) months respectively. Diarrhoea morbidity prevalence over a period of two
weeks preceding the study was about 28.9%. Although several maternal cares giving and
hygiene-related risk factors showed significant association with diarrhoea morbidity on
bivariate analysis, the use of cover material during drinking water transportation, faeces seen
around the pit-hole and bottle feeding were the only significant variables on multivariate
analysis.
CONCLUSION:
As diarrhoea morbidity was major problem among under-five children in Nekemte town,
appropriate intervention programmes should be formulated focused on identified risk factors.

- Risk factors for anemia among pregnant women attending antenatal clinic at Jimma
University Hospital, southwest Ethiopia.
Belachew
Abstract
OBJECTIVE:
to determine anemia and its risk factors among pregnant women
METHODS:
A cross-sectional analytic study was carried out among pregnant women who came for
antenatal care follow up for the first time to Jimma University hospital, Jimma town,
southwestern Ethiopia from May-June 2005.
RESULTS:
A total of 168 pregnant women who came for their first antenatal care visit to Jimma
University hospital were enrolled in the study. A structured and interviewer administered
questionnaire was used to collect data on the socio-demographic variables, dietary habit and
other gynecologic and obstetric history. Dietary data were collected using food frequency
questionnaire prepared for assessing nutritional factors for anemia. Sahli hemoglobinometer
and a microscope were used for assessing hemoglobin level and stool for hookworm
infection, respectively. Data were cleaned, edited and entered in to a computer and analyzed
using SPSS for windows, version 11.0. Statistical tests were performed at the level of
significance of 5%. The prevalence of anemia was 64/168 (38.2%) and the mean hemoglobin
level was 11.3 mg/dl. Anemic cases were 4 times likely to have history of excess menstrual
bleeding prior to the index pregnancy 2 times likely to have hook worm infection and 3
times likely not to have shoe wearing habit, 3 times likely to have birth intervals less than 24
moths between the previous pregnancy and index pregnancy (p < 0.05).

CONCLUSION:
This finding suggests the need for strengthening of interventions related to child spacing and
raising awareness about family planning methods. All ANC attendants should be screened
for anemia and hookworm infection at first visit and those anemic mothers and infected with
hookworm should be treated appropriately. Health education should be given to pregnant
mothers on family planning, and the need to gynecologic evaluation before pregnancy and
the importance of wearing shoes to decrease hook worm infection and subsequent anemia.

The prevalence and causes of anemia during pregnancy in Maharaj Nakorn Chiang
Mai Hospital: Sukrat

Abstract

OBJECTIVE:
To determine the prevalence and causes of anemia during pregnancy in Maharaj Nakorn
Chiang Mai Hospital.
MATERIAL AND METHOD:
The pregnant women were screened with hemoglobin, hematocrit, osmotic fragility test,
hemoglobin E test and serology for hepatitis B, syphilis and HIV at first antenatal visit. In
anemic cases, serum ferritin, serum iron/total iron binding capacity, or therapeutic trial with
iron supplementation were performed to assess the iron status. The cases of abnormal
thalassemia screening were followed by hemoglobin A2 level, PCR for alpha-1 (SEA type)
and hemoglobin electrophoresis. Additional tests were stool exam, stool occult blood and red
blood cell indices. Anemia was defined as a hemoglobin level less than 11.0 g/dl in the first
and third trimester or less than 10.5 g/dl in the second trimester of pregnancy. The data was
presented as mean, standard deviation and percentage.

RESULTS:
Six hundred and forty eight pregnant women were recruited. The prevalence of anemia was
20.1 percent (128 cases). Classified in each trimester the prevalence was 17.3%, 23.8% and
50.0% in the first, second and third trimester, respectively. Thalassemia carriers and diseases
were detected in 56 from 102 anemic pregnant women (54.9%). Iron status was assessed in
58 cases and iron deficiency anemia was found in 25 cases (43.1%). Other causes of anemia
were parasitic infection (8.7%) and anemia of chronic disease (2.7%). In 37 anemic pregnant
women (33.0%), the causes of anemia were not found.
CONCLUSION:
The prevalence of anemia in pregnant women who first attended at the antenatal clinic was
20.1%. The main causes of anemia were thalassemia carriers/diseases and iron deficiency
anemia.

- Maternal Iron Status in Pregnancy and Long-Term Health Outcomes in the


Offspring.
Abstract
Iron is an essential micronutrient and is important not only in carrying oxygen but also to the
catalytic activity of a variety of enzymes. In the fetus, it is vital to the synthesis of
hemoglobin and in brain development. Iron deficiency (ID) anemia in pregnancy is a
common problem, even in high-income country settings. Around 50% of pregnant women
worldwide are anemic, with at least half of this burden due to ID. Iron supplements are
widely recommended and used during pregnancy globally. However, the evidence on the
extent of benefit they contribute to the offspring's health is not well established, and their
routine use has its side effects and drawbacks. Dietary iron intake is difficult to assess
accurately and it is unlikely to be sufficient to meet the demands of pregnancy if women start
with inadequate body iron stores at conception. Evidence from experimental animal models
suggests that maternal ID during pregnancy is associated with fetal growth restriction, as
well as offspring obesity and high blood pressure later in life. The possible biological
mechanisms for this observed association may be due to ID-induced changes in placental
structure and function, enzyme expression, nutrient absorption, and fetal organ development.
However, such evidence is limited in human studies. Prenatal ID in experimental animal
models also adversely affected the developing brain structures, neurotransmitter systems, and
myelination resulting in acute brain dysfunction during the period of deficiency and
persistence of various postnatal neurobehavioral abnormalities as well as persistent
dysregulation of some genes into adult life after iron repletion pointing to the possibility of
gene expression changes. The evidence from human population studies is limited and
heterogeneous and more research is needed in the future, investigating the effects of ID in
pregnancy on future offspring health outcomes.
DEFINITION AND MEANING OF MATERNAL AND CHILD HEALTH

Maternal and Child Health (MCH) refers to a package of comprehensive health care services
which are developed to meet promotive, preventive, curative, rehabilitative health care of
mothers and children. It includes the sub areas of maternal health, child health, family
planning, school health and health aspects of the adolescents, handicapped children and care
for children in special settings.

DEFINITION AND CONCEPTS OF MATERNAL HEALTH/ REPRODUCTIVE


HEALTH

Maternal Health is now referred as “Reproductive Health” (RH). According to WHO it is


defined as a state of complete physical, mental and social wellbeing and not merely the
absence of disease or infirmity in all matters relating to the reproductive system and its
functions and processes. It implies that people are able to have a satisfying and safe sex life,
are informed about to have access to safe, effective, affordable and acceptable methods of
family planning as well as other methods of their choice for regulation of fertility which are
not against the law, are able to have access to appropriate health care services that will
enable women to go safely through pregnancy and child birth and provide couples with the
best chance of having healthy babies.

Reproductive Health is defined as “People have the ability to reproduce and regulate their
fertility, women are able to go through pregnancy and child birth safely, the outcome of
pregnancies is successful in terms of maternal and infant survival and well being and couples
are able to have sexual relations free of fear of pregnancy and of contracting diseases.”
OBJECTIVES OF MATERNAL AND CHILD HEALTH

 To reduce maternal, infant and childhood mortality and morbidity.


 To reduce perinatal and neonatal mortality and morbidity.
 Promoting satisfying and safe sex life.
 Regulate fertility so as to have wanted and healthy children when desired.
 Provide basic maternal and child Health Care to all mothers and children.
 Promote and protect health of mothers.
 To promote reproductive health.
 To promote physical and psychological development of children and adolescents with in
the family.

GOALS OF MATERNAL AND CHILD HEALTH SERVICES

The main goal of maternal and child health services is the birth of a healthy infant into the
family and prevention of diseases in mothers and children. The goals which are included are
as follows:-
 To ensure the birth of a healthy infant to every expectant mother.
 To provide services to promote the healthy growth and development of children up to the
age of under- five- years.
 To identify health problems in mother and children at an early stage and initiate proper
treatment.
 To prevent malnutrition in mothers and children.
 To promote family planning services to improve the health of mothers and children.
 To prevent communicable and non- communicable diseases in mothers and children.
 To educate the mothers on improvement of their own and their children’s health.
FACTORS INFLUENCING MATERNAL AND CHILD HEALTH

 Maternal Age
As maternal age advances, so does the rate of aneuploidy. The result is increased rates of
pregnancy loss and birth of infants with chromosomal anomalies. Most women and men are
aware that advanced maternal age (older than 35 years) may affect a pregnancy adversely.
This awareness is the direct outcome of the adoption of practice standards that obligate
obstetricicians, gynecologists, and women’s health nurses to appropriately disseminate this
information and the considerable media exposure about this issue through public service
campaigns, news programs, and storylines in popular entertainment.
Conversely, the general public health care providers are less aware that advanced paternal
age (older than 45 years at conception) unfavourably affects fetal growth and development.
People of advanced reproductive age require information about the possible outcomes for a
child conceived with their genetic gametes. The nurse should offer education and counseling
using incidence tables for chromosomes anomalies associated with advanced maternal age
and review characteristics of disorders that may occur through paternal transmission of
spontaneous new mutation as a result of advanced paternal age.

 Sexuality Factor
Both the client and her partner may express concerns about sexuality and intercourse during
pregnancy. Although there is no reason why the healthy woman need abstain from
intercourse or orgasm during pregnancy, some sources suggest that women should avoid
coitus and orgasm in the last 4 weeks of pregnancy. Regardless of suggestions studies have
found that the frequency of coitus decreases as pregnancy progresses.
Intercourse or orgasm is contraindicated in cases of known placenta previa, or ruptured
membranes.
Nipple stimulation, vaginal penetration, or orgasm may cause uterine contractions secondary
to the release of prostaglanins and oxytocin. Therefore women who are predisposed to
preterm labour or threatened abortion may choose to avoid intercourse.
Development of sexuality is an important part of each person’s psychosocial identity,
integrated sense of self, reproductive capacity and ability to fulfill role functions in society.
 Nutrition
During pregnancy changes must occur to ensure that gestation progresses and both mother
and fetus remain healthy. These changes involve synthesis of new tissues and hormonal
variations to regulate essential processes. Nutrition has critical role in pregnancy outcomes
maternal nutritional status at conception and throughout gestation greatly influences not only
the mother’s health but also that of the fetus. Although solid nutrition cannot guarantee a
healthy pregnancy, it can certainly minimize problems.
Adequate folate status, which helps prevent neural tube defects, and control of blood glucose
level, which improves the abilities to conceive and to give birth to a healthy newborn.
Women require proper nutrition and normal endocrine function for normal fetal
development. Women specially require additional vitamins and minerals to support fetal
growth and development. Especially important is additional folic acid to reduce the risk for
neural tube defects.

 Environmental Factor
Environmental factor also influence on maternal and child health. So we have to know about
the environment in which the woman and partner reside and work.
Men exposed to toxic substances such as heat, radiation, viruses, bacteria, alcohol, and
prescription and recreational drugs are more likely to have decreased morphologically and
genetically normal sperm in a single ejaculate. This results in reproductive failure
preconception and post fertilization.
Women exposed to similar toxic agents experience diminished ovarian reserver, poor
endometrial lining development, and abnormal fetal development. Likewise, chronic and
acute diseses decrease fecundity and increase fetal wastage.

 Psychological Factor
Virtually all culture emphasizes the importance of maintaining a psychological and agreeable
environment for a pregnant woman. An absence of stress is important in ensuring a
successful outcome for the mother and baby. Harmony with other people must be fostered,
and visits from extended family members may be required to demonstrate pleasant and no
controversial relationships. If discord exists in a relationship, it is usually dealt with in
culturally prescribed ways.
Certain environmental factors such as emotional stress, anxiety, fears, frustrations, broken
homes, poverty and many others can lead to mental illness. The psychosocial environment at
home or school is an essential factor for health. Children exposed to happy and healthy
homes make them physically and mentally healthy. Other factors affecting the health status
of children include community and social support measures etc.
Pregnancy is the gestational process. Comprising the growth and development with a woman
of a new individual from conception through the embryonic and fetal periods to birthing
environment. However, an increasing amount of social science and midwifery research has
explored the issue of social support for child bearing women and the role that the maternity
services might play in offering or facilitating rather than undetermining such support to
women.
Support must be individualized and tailored to the woman’s changing needs during labour.
Emotional support includes physical presence and words of affirmation reassurance,
encouragement and praise. Comfort measures are any hands on activity aim at decreasing the
physical discomfort (pain, hunger and thirst) of labour. Information and advice ensure that
the woman is aware of what is happening and of techniques that may help her to cope.

 Ethnic and Socio Cultural Factor


Culture and family must be viewed simultaneously for, regardless of the family type, it
remains the basic unit of society and influences human development over the life span. The
older adults in these families often have significant roles in health and child care, household
maintenance, and decision making. Multiple care takers are available to help with
childrearing and discipline.
Socialization is an early family function. Socialization includes all the learning experiences
of early life. Home remedies and folk care practices for prevention of illness, maintenance of
health, and curative purposes remain primary sources for most families, regardless of ethnic
and cultural backgrounds.
Communication patterns are influenced by a family’s culture. Religious beliefs and practices
are part of cultural and familial heritage and influence health care behaviours.Within the
neighborhood and community, health families tend to associate freely with community
groups and institutions to identify resources and receive services as needed by them. The
ability of the healthy family to seek help through contact with others appears related in part
to the family’s perception of itself as a part of a whole and to their successful dealings with
the larger community in meeting physical, psychologic, and social requirements.
The value of the children varies greatly, depending on the meaning each society attaches to
children. Health values and beliefs are also important in understanding reactions and
behaviour. If a culture views pregnancy as a sickness, certain behaviours can be expected,
whereas if pregnancy is viewed as a natural occurrence, other behaviours may be expected.
Prenatal care may not be a priority for women who view pregnancy as a natural
phenomenon.
Many cultural variations in prenatal care exist. Even if the prenatal care describes is familiar
to a woman, some practices may conflict with the beliefs and practices of a subculture group
to which she belongs. Because of these and other factors, such as lack of transportation, and
poor communication on the part of health care providers, women from many such groups do
not participate in the prenatal care system. Such behaviour may be misinterpreted by nurses
as uncaring, lazy or ignorant.
A concern for modesty is also a deterrent to the seeking of prenatal care for many women.
For some women exposing body parts, especially to a man is considered a major violation of
their modesty. For many women, invasive procedures, such as vaginal examination, may be
so threatening that they cannot be discussed, even with their own husbands. Thus many
women prefer a female to a male health care provider.
Although pregnancy is considered normal by many, certain practices are expected of women
of all culture to ensure a good outcome. Cultural prescriptions tell women what to do, and
prescriptions establish taboos. The purposes of these practices are to prevent maternal illness
resulting from a pregnancy – induced imbalanced state and to protect the vulnerable fetus.
Prescriptions regulate the women’s emotional response, clothing, activity and rest, sexual
activity, and dietary practices.

 Lifestyle Factors

The health of an individual has direct relationship to the lifestyle. It is nothing but just a way
of living. A person who has healthy practices of day to day living will remain healthy. Those
people who follow the healthy life styles are much healthier than those who follow injurious
life styles. The way of life of people in a community and their individual life style also has a
significant impact on health.

Health is related deeply to life- style which includes ways of living, personal hygiene, habits
and behaviour. A healthy lifestyle helps to promote health and poor lifestyle has ill effects on
health. Lifestyles are the most critical modifiable factor influencing the health today. Life
style refers to a person’s general way of living, including living conditions and individual
patterns of behaviour that are influenced by sociocultural factors and personal characteristics.

Life styles choices may have positive or negative effects on health. Practices that have
potentially negative effects on health are often referred to as risk factors.
E.g. over eating
Getting insufficient exercise

Being over viewing are closely related to the incidence of heart disease, diabetes and
hypertension. Excessive use of tobacco is clearly implicated in lung cancer, emphysema and
cardiovascular diseases. These lifestyle risk factors have gained increased attention because
it is known that many of the leading causes of death. This also represents a huge impact on
the economics of the health care system. Therefore it is important to understand the impact
of lifestyle behaviours on health status. Nurses can educate their clients and the public on
wellness- promoting lifestyle behaviours.

Factors Influencing Maternal and Child Health Lifestyles

 Proper nutrition and exercise.


 Healthy sleep patterns.
 Adequate rest.
 Healthy coping with stress.
 Ability to use family and community support and resources.
 Health promotion progress in community
 Educating school children about the food guide.
 Encouraging the provision of healthy snacks.
 Well – balanced meals in the home.
 Fitness program for all ages.
 Promotion of community play grounds in the community.
 Establishing networks of support in the community.

 Life enhancing activities

 Meaningful work
 Creative outlet
 Interpersonal Relationship
 Recreational activities
 Opportunity for spiritual and intellectual growth

 Mental Health Promotion interventions


 Arts and crafts classes
 Encourage creative expression
 Community event sports events.
 Volunteer programs encourage community participants.
 Personal hygiene
 Washing hands with soap and water before eating.
 Avoidance of excess salt, fats, sweets and cholesterol containing items.
 Consumptions of fiber- rich foods.
 Avoiding of having tobacco, alcohol, drugs of addiction.
 Indulgence in safe sex practices
 Practicing relaxation techniques.
E.g. yoga, Mediation
 Health education is an important aspect to change life style and practicing the healthy
ways of living.
 Daily routine work
 Bathing
 Washing of hair and clothes
 Care of teeth, ear, and eyes.
 Eating habits
 Exercise
 Sleep
 Rest
 Avoid smoking and drinking
 Care of posture

 The school children must be taught good health habits and include health topic in
curriculum.
 Health education is a basic element of all health activity.

 Changing views of people


 Changing behaviour of people
 Changing habits of people

Examples of Healthy Lifestyles Choices of Maternal and Child Health

 Regular exercise
 Weight control
 Avoidance of saturated fats
 Alcohol and tobacco avoidance
 Seat belt use
 Immunization updates
 Regular dental check up
 Regular health maintenance
 Regular exercise

Regular routine exercise is very important in human life. Regular exercise makes the body
healthy. Regular exercise helps in maintaining the muscle tone, preventing from diseases.
During the antenatal period the pregnant mother can do light exercise daily.

 Weight control

There is need to control the weight to maintain healthy life style .In obese people the excess
weight leads to happen different diseases like cardiac disease, hypertension, diabetes etc.

 Avoidance of saturated fats

These saturated fats are not good for health. These fats will lead to accumulation in our body
which affects the healthy life. The mother and the children should be avoided of taking
saturated food.
Example of saturated food like burger, oil junk foods, noodles, deep fried food etc

 Alcohol and tobacco avoidance

Excessive use of alcohol and tobacco is clearly implicated in lung cancer, emphysema,
cardiovascular disease, pulmonary diseases, gastrointestinal disease, cirrhosis of liver,
hepatitis, reproductive disorders (infertility). Tobacco smoke contains different chemical
substances of which it produces cancer. Tobacco is the second major cause of death in the
world. Smoking produces peptic ulcer by increasing acid secretion. The role of the nurse in
avoidance of alcohol and tobacco through education, giving information and cessation efforts
etc.

 Seat belt use


Seat belt safety should be maintained to prevent from accident while driving car, bus
etc.Especially during pregnancy the mother should have seat belt.
 Immunization updates

Immunization is very necessary to protect from the six major killer diseases like
tuberculosis, tetanus, diphtheria, whooping cough, measles and poliomyelitis in the children.
After having immunization the update should be done appropriately. The detail of
immunization should be updated for not to miss any dose which may help to maintain
healthy life style.

 Regular dental check up

Regular dental check up should be done to know the condition of the teeth and to prevent
from dental carries. Regular dental check up should be done every interval of 6 months.

 Regular health maintenance

Regular health check up which includes monitoring of Blood Pressure, blood sugar, closterol
level and follow up for the pre- existing problems.

 Gender

In some society there may be the discrimination between the male and female baby. If the
mother having a male baby the family will provide more care and attention towards the
mother and baby. And if the mother having a female babies the family members will provide
her less care and attention towards the mother and baby. So gender also influences the
maternal and child health.
CONCLUSION

Maternal and child health is recognized as one of the significant components of Family
Welfare. Health of both mother and children is a matter of Public Health concern. It is also
being observed that the deaths of mothers and children are the major contributors to
mortality in any community in India.

The maternal health status differs tremendously from place to place and in the same place. It
is assessed in terms of maternal health problems (maternal morbidity) and maternal
mortality. The factors which are responsible for maternal health problems i.e. maternal
morbidity and maternal mortality include poverty, ignorance, illiteracy, malnutrition, age at
marriage and pregnancy, the number and frequency of child bearing and the number of
unwanted pregnancies and abortions, lower status and worth of women in society, lack of
access to quality maternal health/ reproductive health services, gender discrimination.

The different factors which influence the maternal and child health are age, gender, sexuality,
sociocultural factor, environment, nutrition etc.

JOURNAL RESEARCH ABSTRACT

“Assessment and Utilization of Maternal and Child Health and Family Welfare Services
among Rural Women.”
This study was conducted in selected primary health centers and its health sub centres areas
of Pondicherry health unit district. Out of 250 mothers selected, 208 mothers were delivered
and given birth to a baby and 42 mothers who were pregnant. A structured interview
schedule was used for data collection and analysis was done, the collected data were
analyzed and found out the main out come, Association of demographic variables, awareness
of MCH and family welfare services and the extent of utilization of services during perinatal
period. The conceptual frame work adopted for the study was based on systems model that
influences the factors that intervene in the utilization of maternal and child health services.
The infant mortality was found to be 33.5/1000 live births which was low, when compared to
National average (62/1000 live births) and it was statistically significant (P< 0.000). The
most causes of infant mortality identified were prematurity, asphyxia, and low birth weight.
The mother had poor knowledge in purpose of immunization, Vaccine Preventable diseases,
high risk factors, antenatal diet, family welfare methods and warning signs of pregnancy.
Though the government has given top priority in implementation of MCH Programmes, the
women were not aware of many health programmes related to mother and child health and
had poor knowledge in existing programmes.
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JOURNALS

Prof.Mrs.S.Kamalam, Principal, Kasturba Gandhi Nursing College, M.G.M.C and R.I,


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