NCM 107 – Care of Mother, Child and Adolescent

S.Y. 2021-2022 | 1st Semester | Preliminary Term

Module 1: FRAMEWORK OF MATERNAL AND CHILD HEALTH NURSING

Description
The module provides an overview of the area of childbearing and childrearing families
as a major focus of nursing practice in promoting health for the next generation.
Comprehensive preconception and prenatal care are essential in ensuring healthy a outcome
for mother and child.
This module will focus on the primary goal of both maternal and child health nursing
which is the promotion and maintenance of optimal family health. Maternal and child health
nursing extends from preconception to menopause with an expansive array of health issues
and health care and health care providers.

Learning Outcomes
LO1 Integrate the concepts of maternal and child health nursing: framework for maternal
and child health nursing care; universal health goals; sustainable development goals of 2030
and common statistical terms in the formulation and application of appropriate nursing care to
the mother and child during childbearing and childrearing years:
Module Outline
I. The Philosophy of Maternal and Child Health Nursing
II. A Framework for Maternal and Child Nursing Care
III. Universal Health Care (UHC)
IV. Measuring Maternal and Child Health

Module Pre-Test
True/False
1. To avoid duplication of care sites, communities are establishing centralized maternal
and pediatric health services.
2. Today, many patients view physical health more important than quality of health.
3. The most meaningful and important measure of maternal health is infant mortality.

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 4. The primary goal of maternal health nursing is to maintain optimal family health.
5. Universal Health Care (Kalusugan Pangkalahatan) was launched through Administrative
Order 2010-0036.

Fill in the Blank

1. __________ is the conscientious, explicit, and judicious use of current best evidence in
making decisions about all patients.
2. It has been noted that __________ between the mother and baby immediately after
birth provides numerous benefits.
3. A(n) _____ approach enables the nurse to provide more holistic care.
4. ____________ is a scientific form of problem solving, serves as the basis for assessing,
making a nursing diagnosis, planning, implementing and evaluating care.
5. An objective view of maternal and child health can be provided by using ________to
describe the degrees of illness.
Module
The primary goal of maternal and child health nursing care can be stated simply as the
promotion and maintenance of optimal family health to ensure cycles of optimal child bearing
and childrearing (Fig. 1). The health of each stage of the individual impacts the next stage and
the health of the family to which the individual belongs. Healthy pregnancy will lead to healthy
newborn who will grow up to become healthy children who will comprise the healthy family.

Figure 1. The Cycle of Optimal Childbearing and Childrearing

Module 1: Framework of Maternal and Child Nursing 2

 The range of practice throughout the childbearing and childrearing includes:
1. Provision of preconception health care
2. Provision of nursing care of women throughout pregnancy, birth, and postpartum
period
3. Provision of nursing care of children from birth through adolescence
4. Provision of nursing care to families in all settings

I. The Philosophy of Maternal and Child Health Nursing includes:

1. Family-centered; assessment should always include the family as well as an individual.
2. Community-centered; the health of families is both affected by and influences the
health of communities.
3. Evidenced-based; this is the means whereby critical knowledge increases
A challenging role for nurses and a major factor is to keep families well and optimally
functioning.
A maternal and child health nurse:
1. Considers the family as a whole an as partner care when planning or implementing or
evaluating the effectiveness of care.
2. Serves as an advocate to protect the rights of all family members, including the fetus.
3. Demonstrates a high degree of independent nursing functions because teaching and
counseling are major interventions.
4. Promotes health and disease prevention because these protect the health of the next
generation.

5. Serves as an important resource for families during childbearing and childrearing as

these can be extremely stressful times in a life cycle.

6. Respects personal, cultural and spiritual attitudes and beliefs as these so strongly
influence the meaning and impact of childbearing and childrearing.

7. Encourages developmental stimulation during both health and illness so children can
reach their ultimate capacity in adult life.

8. Assesses families for strengths as well as specific needs or challenges.

Module 1: Framework of Maternal and Child Nursing 3

 9. Encourages family bonding through rooming-in and family visiting in maternal and child
health care settings.

10. Encourages early hospital discharge options to reunite families as soon as possible in
order to create a seamless, helpful transition process.

11. Encourages families to reach out to their community so the family can develop a wealth
of support people they can call on in time of family crisis.

II. A Framework for Maternal and Child Nursing Care

Maternal and child nursing care can be visualized within a framework in which nurses use
nursing process, nursing theory, and Quality and Safety Education for Nurses competencies to
care for families during childbearing and childrearing years and through the four phases of
health care:
• Health promotion – health education, immunization
• Health maintenance – maintain health when risk of illness is present
• Health restoration – caring during complications
• Health rehabilitation – helping a patient with residual effects achieve an optimal state of
wellness and independence
1. Nursing process – a scientific form of problem solving, serves as the basis for assessing,
making a nursing diagnosis, planning, implementing and evaluating care.
2. Nursing theory – is a discipline’s knowledge flows from a base of established theory. It
designed to offer helpful ways to view patients so nursing activities can be created to
best meet patient needs.
3. Quality and Safety Education for Nurses (QSEN) enumerated six competencies deemed
necessary for quality care. The overall goal is to address the challenge of preparing
future nurses with the abilities necessary to continuously improve the quality and safety
of the healthcare systems which they work.
a. Patient-centered care; The patient as the source of control and full partner in the
provision of compassionate and coordinated care based on respect for the
patient’s preferences, values, and needs

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 b. Teamwork and Collaboration; Nurses function effectively within nursing and
inter professional teams, fostering open communication, mutual respect, and
shared decision making as they achieve quality patient care
c. Evidenced-based practice; Nurses integrate the best evidence with clinical
expertise and patient/family preferences and values for delivery of optimal
health care.
d. Quality improvement; Nurses use data to monitor the outcomes of care and use
improvement methods to design and test changes to continuously improve the
quality and safety of health care systems.
e. Safety; Nurses minimize the risk of harm to patients and providers through both
system effectiveness and individual performance.
f. Informatics; Nurses use information and technology to communicate, manage
knowledge, mitigate error, and support decision making.
III. Universal Health Care (UHC)

Universal Health Care (Kalusugan Pangkalahatan) was launched through Administrative

Order 2010-0036 (DOH 2010). It is directed towards ensuring the achievement of the health
system goals of (1) better health outcomes, (2) sustained health financing, (3) a responsive
health system by ensuring that all Filipinos, especially the disadvantaged group, have equitable
access to affordable health care.
The attainment of the goal of UHC is through the pursuit of three strategic thrusts:
A. Financial risk protection through expansion in National Health Insurance Program
(NHIP) enrollment and benefit delivery
B. Improved access to quality hospitals and health care facilities
C. Attainment of the health-related Millennium Development Goals (MDGs)

The Millennium Development Goals 2015 via UN Millennium Declaration includes:

1. Eradicate extreme poverty and hunger
2. Achieve universal primary education

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 3. Promote gender equality and empower women
4. Reduced child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop global partnership

The eight Millennium Development Goals of 2015 was replaced by the 17 Sustainable
Development Goals to be achieved in 2030. These include:
1. No Poverty
2. Zero Hunger
3. Good Health and Well-being
4. Quality Education
5. Gender Equality
6. Clean Water and Sanitation
7. Affordable and Clean Energy
8. Descent work and Economic growth
9. Industry, Innovation and Infrastructure
10. Reduced Inequalities
11. Sustainable Cities and Communities
12. Responsible Consumption and Production
13. Climate Action
14. Lie below Water
15. Life on Land
16. Peace, Justice and Strong Institution
17. Partnership for the Goals

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 IV. Measuring Maternal and Child Health

An objective view of maternal and child health can be provided by using national health
statistics to describe the degrees of illness.
1. Crude Birth Rate (CBR) – measures how fast people are added to the population through
births. It is useful measure of population. It is affected by the fertility, marriage pattern,
and practices of the place, sex, and age composition of a population, and birth
registration. A CBR greater than or equal to 45/1,000 live births implies high fertility,
while a level less than or equal to 20/1,000 live implies low fertility.
CBR = number of registered life births in a year x 1,000
Midyear population

2. General Fertility Rate (GFR) – is a more specific rate than CBR since births are related to
the segment of the population deemed to be capable of giving birth, that is, the women
in the reproductive age groups (15-44 years). High fertility rate is GFR of 200/1,000
women while 60/1,000 is low fertility rate.
GFR = Number of registered live births in a year x 1,000
Midyear population of women 15-44 years of age

3. Maternal Mortality Rate (MMR) – number of deaths of a female from any cause related
to or aggravated by pregnancy and childbirth or within 42 days of termination of
pregnancy, irrespective of the duration and the site of the pregnancy. The denominator
is the number of live births. It is a measure of obstetric risk and is affected by maternal
health practices, diagnostic ascertainment, and completeness of registration of births.

MMR = Number of deaths due to pregnancy, delivery, puerperium in a calendar year x 100
Number of life births in the same year

4. Infant Mortality Rate (IMR) – number of deaths of infants under one year of age in a
calendar year per one thousand live births in the same period. It is used as an
approximation of the risk of dying within the first year of life. It is a good index of the

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 level of health in a community because infants are very sensitive to adverse
environmental conditions. Thus, a high IMR means low levels of health standards that
may be secondary to poor maternal health and child health care. IMR levels of 60-
150/1,000 live births are commonly seen in poor population; ≥200/1,000 live births is
indicative of very severe environmental conditions.
IMR = Deaths under 1 year of age in a calendar year x 1,000
Number of live births in the same year

5. Neonatal Mortality Rate (NMR) – deaths of infants less than 28 days old are due mainly
to prenatal or genetic factors.

NMR = Number of deaths among those under 28 days of age in a calendar year x 1,000
Number of live births in the same year

6. Postneonatal Mortality Rate (PMR) – deaths among infants 28 days to less than 1 year of
age in a calendar year. This is influenced by environmental and nutritional factors as
well as infection.

PNR = Number of deaths among those 28 days to less than 1 year of age in a calendar year x 1,000
Number of live births in the same year

References
Flagg, J. (2018). Maternal and child health nursing: Care of the childbearing and childbearing
family (8thed.). Philadelphia, PA: WoltersKluwer.
Famorca, Z.U., M.A.Nies and M. McEwen. Nursing Care of the Community: A comprehensive text
on community and public health nursing in the Philippines (6th ed.). Singapore, Elsevier.

Credits and Quality Assurance

Prepared by:

MELANIE C. TAPNIO, MAN, RN

Assistant Professor

Recommending Approval:

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Noriel P. Calaguas, MSHSA, RN
Assistant Professor & Chairperson, Nursing Program

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Reviewed by:

Louie Roy E. Catu, PhD, RN

Assistant Professor & OBE Facilitator

Approved by:

Al D. Biag, EdD, RN, RM

Professor & Dean

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