MCH PROGRAMME

1.  Mothers and children not only constitute a large group, but they are also” vulnerable “ or
special group. They comprises 71.4 % of population of the developing countries. In
India ,women of child bearing age (15-44 years) constitute 22.2% and children under 15
years of age about 35.3% of total population, together 57.5% of population consists of
mothers and children. (current population of India as on 22 march 2015 is 1.28 billion.
And of Jharkhand is 32,966,238 (32 Carores 9 lakh 66 thousand 2 hundred 38)
INTRODUCTION:-
2. 3. 2. Children are the foremost priorities of community health program. Their aim is to
increase the nutrition level of mothers and children to ensure the birth of healthy child. 3.
MCH services started due to different reasons in different countries. maternal and child
health services were first organized in India in 1921 by a committee of “The lady
Chelmsford league’’ which collected funds for child welfare and established
demonstration services on an all India basis.
3. 4. 4. Various facilities and programme organized for the purpose of providing medical
and social services for mothers and children. 5. Medical services include prenatal and
postnatal services, family planning care, and pediatric care in infancy.
4. 5. DEFINITION According to WHO (1976) Maternal and child health services can be
defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the
mother and child”. Thus maternal and child health service is an important and essential
service related to mother and child’s overall development.
5. 6. AIMS AND OBJECTIVES OF MCH PROGRAMME • Reducing maternal (current
status-2013: 190 per one lakh live births) ,Perinatal ("number of stillbirths and deaths in
the first week of life per 1,000 live births) infant (current status-2013: 41 per one
thousand live births) and child mortality and morbidity rates. • Child survival • Promoting
reproductive health or safe motherhood • Ensure birth of healthy child
6. 7. • Prevent malnutrition • Prevent communicable diseases • Early diagnosis and
treatment of the health problems • Health education and family planning services
7. 8. INFRASTRUCTURE:- • The MCH services are rendered through the infrastructure of
primary health centres and sub- centres, whose number are 24,049 (september 2013)
and 1,48,366 (september 2013) respectively. It is proposed to set up one primary health
centres for every 30,0000 population, and one sub-centre for 3000 to 5000 population. •
Each sub centres are foundation of national health system. Each sub-centres is manned
by a team of one male and female health worker. In addition there is a team of one
trained dai and one health guide in every village.
8. 9. Care of the children in special setting such as day care centers.Handicapped
children School health Child health Family planning Maternal health SUB
AREAS:- • The components of MCH include the following sub areas.
9. 10. ACTIVITIES OF MCH PROGRAMME:- Maternal and child health services are an
important part of primary health care. Traditional activity areas of these programme:- •
Complete health check -up and care of the child and mothers from conception to birth. •
Studying health problems of mothers and children. • Providing health education to
parents for taking care of children. • Training to professional and assistant workers.
10. 11. NEED FOR MCH PROGRAMME:- • There are four main reasons why mother and
child health must be given top priority in health programme 1. Mother and child below the
age of 15 years make up the majority of the population in almost countries. 2. Mother and
children constitute a “special risk’’ or vulnerable group in the case of illness, deaths, in
the terms of pregnancy, childbirth of mothers, and growth and development in the case of
children. 3. By improving the health of mother and children we can improve the health of
the family and community. 4. Ensuring child survival is a future investment for the family
and community.
11. 12. INDICATOR OF MATERNAL AND CHILD HEALTH PROGRAMME Maternal and
child health can be evaluated on the basis of the following indicators: 1. Maternal
mortality rate-below 1(for every 1000 live births) 2. Infant mortality rate-below 30 (for
every 1000 live births) 3. Death rate of 1-4 year old age group-below 10. 4. Size of
 family- 2-3 members. 5. Perinatal mortality rate-30-35 6. Weight of minimum 90% of total
children- according to height/weight chart.
12. 13. RECENT TRENDS IN MCH SERVICE PROGRAMME a. Integration of care:- Earlier
maternal and child health care services were divided into antenatal, child care and family
planning. Naturally it is helpful in increasing the capability and effectiveness of service b.
Risk approach :- This new thought was born from the lack of resources and their
availability. As per this the risk group among mother and infant is identified special care is
given to them. c. Man power changes :- According to new concept, maternal and child
health services should be left to traditional health workers(ANMs, health visitors) rather
than specialist of field and child volunteers and workers of NGOs.
13. 14. Cont... d. Primary health care:- It makes available information about protection and
protection and resources for mother and child health care. e. Reproductive and child
health :- As per the decision taken in world women’ conferences, Beijing(1995), maternal
and child health services have been included in reproductive and child health services.
14. 15. PRINCIPLES:- The guiding principle for the maternal and child health program me
are:- a) Consultation and participation:- consultation with, and participation by, families is
integral to the services. Services will be informed by, and seek to meet, the young needs
of young children and their families. b) Access and availability:- All families with young
children should be able to readily access the information, services and resources that are
appropriate for, and useful to, them. c) Primacy of prevention:- Prevention of harm or
damage is preferable to repairing it later. Early detection of risk factors is required, and
intervention, where appropriate. d) Capacity building:- Promotion of resilience and
capacity is preferable to allowing problems to undermine health or autonomy. e) Equity:-
All children should be able to grow up actively learning,healthy,sociaable and safe-
irrespective of their family circumstances and background.
15. 16. Cont….. f) Family cantered- The identification and management of child and family
needs requires a family- centered approach that focuses on strength. g) Inclusion:-
Inclusive practices are essential for all children to get the best start, irrespective of their
family circumstances, differing abilities and background. h) Partnership:- Quality services
are archived through integrated services delivery and partnership with other early
childhood and specialist services, and with family. i) Quality:- All families with young
children must be confident of the quality of information , services and resources provided
to them.
16. 17. MATERNAL AND CHILD HEALTH SERVICE PROGRAMME STANDARDS 1.The
maternal and child health services provides universal access to its services for children
from birth to school age and their families. 2.The maternal and child health services
promotes optimal health and development outcomes for children from birth to school age
through a focus on the child, mother and family. 3.The maternal and child health services
builds partnership with families and communities and collaborates and integrates with
other services and organizations. 4.The maternal and child health services is delivered
by a competent and professional workforce. 5.The maternal and child health service
,supported by local government or the governing authority, provides a responsive and
accountable se CONT……
17. 18. Cont… • Service for the child, mother and family through effective governance and
management. • The maternal and child health services delivers a quality and safe
services.
18. 19. ORGANIZATIONAL ACTIVITIES OF MCH SERVICES • Complete health check up
and care of the child and mother from conception to birth • Studying the health problems
of mothers and child • Providing health education to parents for taking care of children •
Training to professionals and assistant workers
19. 20. Responsibilities of community health nurse in MCH services Direct care Managerial
functions Educational functions
20. 21. The function of community health nurse are:- 1.Direct care provider: A. Antenatal
care:- i. Contact: Contacting every pre-gnant mother in the primary Stage of pregnancy.
ii. History:- taking history of general health, previous child birth and pres-ent pregnancy.
iii. Antenatal examination:- Conducting physical birth and present pregnancy. .
21. 22. Cont.... iv. Antenatal Examination:- a. Calculate obstetric examination etc. b.
Calculating the expected date of delivery c. Identifying high risk of mothers d. Providing
counselling and health education. e. Helping mother and other family members in
planning the delivery. B. Intranatal care:- • Preparing the place for delivery. • Arranging
necessary equipment. • Giving mental support to mothers. • Preparing mother for
delivery.
22. 23. Cont... • Examine position of foetus, dilatation of cervix, and heart of foetus,
observing the position of bladder and uterine contraction. • Noting general condition of
the pregnant mother, process of pain and time of membrane rupture. • Ensuring safe
delivery, examining umbilical cord and noting abnormalities. • If necessary, taking help of
doctor or referring patient to a specialist. • Maintaining through asepsis during delivery. •
Should be ready to handle complications like bleeding, malpresentation, cord prolaps etc.
23. 24. Cont.... • Noting the correct time of birth. C. Postnatal care:- • The week immediately
after the child birth is called postnatal period. The responsibilities of community health
nurse are.- • Observing the blood pressure, temperature and pulse of mother immediately
after the delivery and then during the following period. • Collecting information about the
general condition of mother, food, sleep, pain and elimination etc. and, accordingly the
nursing care.
24. 25. Cont...... • Observing fundus, perineum, lochia, bladder etc. • Observing breast and
nipples. • Protecting the mother from complications like puerperal sepsis, breast
inflammation, postpartum hemorrhage,urinary incontinence, urinary retention and
thrombophlebitis and providing required treatment. D. Neonatal care • Observing the
respiration of newborn, immediately after birth and if necessary providing resuscitation. •
Taking care of the umbilical cord and cutting the
25. 26. Cont..... • Cord and tying it using proper techniques. • Taking notice of abnormalities
or congenital defects and informing the relatives. • Assessing the physical condition of
the newborn by his apgar score ( 9 or 10 is ideal score ) • Cleaning the newborn child
( giving bath to the newborn has become less popular. • Taking care of the newborn skin
and eyes. • Keeping the newborn child on safe bed and providing breast feeding to baby
at the earliest. • Maintaining normal body temperature of the new • born. Give kangaroo
care.
26. 27. Cont.... • Function related to maternal clinics :- • Home visits:- During home visit,
community health nurse should try to focus the attention of mother of mother on the
following points:- • Antenatal check up and its importance. • Anatomy, physiology, and
psychology of pregnancy. • Diet during pregnancy • Plans of delivery • Neonatal care •
Family planning
27. 28. Cont... 2. Managerial functions:- • Organizing and managing the nursing homes. •
Playing the role of liaison officer under referral system, for sending the mother to hospital
for safe delivery. • Taking part in community activities. • Explaining the importance of
reproductive and child health in community. • Supervising the work of midwives and
female health workers and giving them appropriate suggestions. • Organizing and
managing maternal clinics.
28. 29. Cont.... • Coordinating between the doctor, family and patients. • Storing and
maintaining the records of maternal and child health services. • Assisting the research
work in the field of maternal and child health services. 3. Educational functions:- •
Providing health education to mother and family either individually or in the group. •
Educating (using demonstration) pregnant mothers and relatives about maternal nursing.
29. 30. Cont.... • Community health nurse should discuss following topics with pregnant
mothers : • Importance of regular antenatal check up. • Personal hygiene and proper diet.
• Clean environment ( including mental environment) • Importance of hospital delivery or
delivered or delivery by trained worker. • Taking care of infant. • Thus, community health
nurse has a multifaceted role in maternal services. It is only through proper discharge
maternal and infant mortality can be reduced to targeted rate.
30. 31. SUMMARY • Introduction of maternal and child health programme. • Aims of
maternal and child health programmes. • Sub areas of MCH. • Activities of MCH
 programme. • Need for NCH programme. • Principles of MCH programme. • Indicators of
MCH programme. • Recent trends in MCH • Role of nurse in MCH.
31. 32. Bibliography • Park.k,Preventive and social medicine, 22rd edition 2013,published by
premnagar,Jabalpur, pg no.-481,514. • Park. K, Essential of community health
nursing,4th edition2014, published by premnagar,Jabalpur,pg,no,- 278- 280. • Rao
sundar kasthuri Mrs.Dr.,An introduction to community health nursing,4th edition(reprint)
2005,published byB.I.publication pvt.ltd, chennai, pg.no.-446 • Swarnkar
Keshav,Community health nursing, 2nd edition 2007, published
byN.R.Brothers,indore,pg.no-83-87 • www.google.com
32. 33. THANK YOU
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