MATERNAL AND CHILD HEALTH
NURSING
PRIMARY GOAL OF MCHN:
Promotion and maintenance of optimal
family health to ensure cycles of optimal
childbearing and childrearing.
PHILOSOPHY OF MCHN:
● Maternal and child health nursing is
family centered.
● Maternal and child health nursing is
community centered.
● Maternal and child health nursing is
research oriented.
● Nursing Theory provides a ● Increase Industry, Innovation, and
foundation for nursing practice.
● A maternal and child health nurse
serves as an advocate of life.
● Maternal and child health nursing
uses a high degree of independent
nursing functions.
● Promoting health is an important
nursing role.
● Pregnancy or childhood illness can
be stressful.
● Personal, cultural, and religious
attitudes and beliefs influence the
meaning of illness and its impact on
the family.
● Maternal and child health nursing is
a challenging role for the nurse and
is a major factor in promoting
high-level wellness in families.
SUSTAINABLE DEVELOPMENT GOALS
(SDG)
● In 2015, 195 nations agreed with the
United Nation that they can change
the world for the better.
● This will be accomplished by
bringing together their respective
governments, businesses, media,
institutions of higher education, and
FINEZA, GAOR, GARZON (2NU04)
local NGOs to improve the lives of
the people in their country by the
year 2030.
GOALS:
● Eliminate Poverty
● Erase Hunger
● Establish Good Health and
Well-Being
● Provide Quality Education
● Enforce Gender Equality
● Improve Clean Water and Sanitation
● Grow Affordable and Clean Energy
● Create Decent Work and Economic
Growth
Infrastructure
● Reduce Inequality
● Sustainable Cities and Communities
● Influence Responsible Consumption
and Production
● Organize Climate Action
● Develop Life Below Water
● Advance Life On Land
● Guarantee Peace, Justice, and
Strong Institutions
● Build Partnerships for the Goals
As part of the Global Strategy and goal of
Ending Preventable Maternal Mortality,
WHO is working with partners towards:
● addressing inequalities in access to
and quality of reproductive,
maternal, and newborn health care
services;
● ensuring universal health coverage
for comprehensive reproductive,
maternal, and new-born health care;
● addressing all causes of maternal
mortality, reproductive and maternal
morbidities, and related disabilities;
and
● strengthening health systems to
collect high quality data in order to
 respond to the needs and priorities
of women and girls; and
● ensuring accountability in order to
improve quality of care and equity
CURRENT TRENDS IN PERINATAL &
WOMEN’S HEALTH CARE
● High quality, longer lives free of
preventable disease, disability, injury
& premature death.
● Achieve health equity, eliminate
disparities, & improve the health of
all groups
● Create social & physical
environment that promote good
health
● Promote quality of life, healthy
development, & healthy behaviours
across all life stage
FAMILY CENTERED CARE
● Care describes safe, high-quality
care that recognizes & adapts to
both the physical & psychosocial
needs of the family, including the
new-born.
PRINCIPLES OF FAMILY-CENTERED
CARE
● Childbirth is usually a normal,
healthy event in the life of a family.
● Childbirth affects the entire family, &
family relationships will need to be
restructured.
● Families can make decisions about
care if they are given adequate
information & professional support.
● Maintain & focus on family or other
support can benefit a woman as she
seeks to maintain health
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JCIA SAFETY AND QUALITY
5 core measures for perinatal;
1. Decrease the rate of elective
deliveries
2. Decrease the rate of CS birth
3. Increase the rate of antenatal
administration of steroids in preterm
labor
4. Decrease the rate of new-born
septicaemia or bacteraemia
5. Increase the rate of exclusive
breastfeeding.
INTERNATIONAL PATIENT SAFETY
GOALS
1. Identify patient correctly
2. Improve effective communication
3. Improve the safety of high-alert
medications
4. Ensure correct site, correct
procedure, correct patient surgery
5. Reduce the risk of healthcare
associated infections.
YOUR 5 MOMENTS FOR HAND
HYGIENE
● Before patient contact
● Before aseptic task
● After body fluid exposure
● After patient contact
● After contact with patients &
surroundings
6. Reduce the risk of patient harm
resulting from fall (x)
FAMILY HEALTH NURSING
DEFINITION OF FAMILY
● Group of persons usually living
together and composed of the head
and other persons related to the
head by blood, marriage or adoption
(US Census Bureau,2005)
● Social unit interacting with the larger
society
● Two or more persons who are joined
together by bonds of sharing
emotional closeness and who
identify themselves as being part of
the family.
DEFINITION OF FAMILY HEALTH
● Family is a source for the day to day
living and health of its members
● Family provides its individual
members with key resources for
healthful living, including food,
clothing, shelter, a sense of
self-worth and access to medical
care
● It is a socioeconomic process
THE FAMILY
● Family works together
● Family organize itself against
potential threats
● Depends on the structure
● Provision of family-centered care
STRUCTURE OF THE FAMILY: DEFINE
● Also called family composition
● Consist of individual, each with
socially recognized status and
position who interact with one
another on a regular, recurring basis
(Henson, Gedaly-Duff and Kaakinen,
2005)
● Family is the smallest unit in the
society
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FAMILY PURPOSE
● To ensure survival of the unit and its
individual members
● To continue the society and it’s
knowledge , customs, values and
beliefs
● It establishes a primary connection
with a group responsible for a
person until that person becomes
independent
FAMILY FUNCTION
Refers to the interactions of family
members, especially the quality of
relationships and interactions (Bomar 2004)
Purpose:
● To meet the need of the society
● To meet the need of the individual
● To provide sustenance and support
in the 5 areas of wholeness:
physical, emotional , intellectual,
social, spiritual
FAMILY TASK/ROLES
Are changing and often are not well defined
each family has a task:
● Problem solver
● Decision maker
● Health manager
PHYSICAL SUSTENANCE
● The family is responsible for meeting
each member’s needs for food,
clothing , shelter and protection from
harm including illness.
● “the wage earner”
ALLOCATION OF RESOURCES
● The family determines which needs
have priority and what resources will
be used to meet those needs.
● “the financial manager”
EMOTIONAL SUPPORT Economic function
● The process of parental attachment ● Whole family works as team
to a child begins before birth and (fishing,farming)
continues throughout life
● Parent child relationships to STATUS PLACEMENT
emotional adjustments later in life ● Society is characterized by a
● Children imitate the behavior of hierarchy of its members into social
family members classes
● Good behaviors rewarded and bad ● The family confers its societal rank
punished on the children
● Welfare and protection ● “the gatekeeper”
● “the nurturer”
MAINTENANCE OF ORDER
INTELLECTUAL STIMULATION ● Opening effective means of
● Parents read to the unborn children communication among family
and play music to provide early members, establishing family values,
stimulation enforcing common regulations for all
● The need for intellectual family members
development continues throughout
life DIVISION OF LABOR
● Who fulfill certain roles
SOCIALIZATION ● In times of illness/ death roles may
● Preparing children to live in the change Reproduction , recruitment
community and to interact with and release of family member
people outside the home
● Child learns rules of the society and FAMILY STRUCTURE
the culture in which the family lives; Traditional ● Consist of married couple
its language, values, ethics and nuclear and their biological
acceptable behaviors family children
● Family teaches proper way or ● They live together
including the siblings
accepted norms ● No other persons are
● Transmission of culture of a social present
group
Nuclear ● Composed of two parents
● For children “family is the first
family and their children (either
teacher” biological or adopted) who
share a common
SPIRITUALITY household.
● Parents are not
● The values and meaning in life
necessarily married
● Religion ● No other relatives or non
relatives are present in the
Procreation household
● Reproductive function and child Dyad family ● Consisting only of
rearing husband and wife, such as
● Continuity of the family (surnames) newly married couples and

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 “empty nesters”
● Two people living together
Blended ● Also called reconstituted
family/step family
family ● It includes at least one
stepparent, step siblings or
half-sibling
● E.g if both partners in the
marriage bring children
from previous marriage
Extended ● Consist of one or more
family nuclear families plus other
relatives, often crossing
generations to include
grandparents, aunts,
uncles and cousins
Single ● Children born out of
parent wedlock, divorce, death,
family desertion or single
parenthood
Binuclear ● Refers to parents
continuing the parenting
role while terminating the
spousal unit
Polygamous ● Spouses in polygamous
mating
● Also called compound
family
● Polygyny (multiple wives)
● Polyandry (multiple
husbands)
Communal ● People who share home
making and child rearing
functions and help
overcome the problem of
interpersonal isolation or
loneliness
● All children are
responsibility of adult
members
Gay or ● Two people of the same
Lesbian sex live together , bound
(LGBT) by formal or informal
commitment with or
without children.
● Children maybe result of
heterosexual mating,
product of foster child,
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artificial insemination,
surrogacy
Cohabitation ● Couples live together but
are not married
● “live-in” , “common-law”
● The children in this family
maybe a result of earlier
union
● Families maybe long
lasting
● Cohabiting couple may
eventually marry
● Sometimes such families
are less stable and
temporary
Adoptive ● Traditional or non
family traditional
● There are variety of
adoption available
THE FOSTER FAMILY
● Children whose parents can no
longer care for them may be placed
in a foster or substitute home by a
child protection agency.
CHARACTERISTICS OF A HEALTHY
FAMILY
1. Members interact with each other,
they communicate and listen
repeatedly.
2. Can establish priorities. Members
understand the family needs and
priority.
3. Healthy families affirm, support and
respect each other.
4. The members engage in flexible
roles, relationships, share power,
respond to change, support the
growth and autonomy of others and
engage in decision-making that
affects them.
5. The family teaches societal values
and beliefs and shares a spiritual
core.
 6. Healthy families foster responsibility suggests factors that promote
and value service to others. adaptation to stress
7. Healthy families have a sense of ● Families encounter stressors that
play and humor and share leisure affect change in the family (e.g. birth
time. of a baby, death, unemployment,
8. Healthy families have the ability to illness, marriage)
cope with stress and crisis and grow
from problems. They know when to DEVELOPMENTAL THEORY
seek help from professionals. ● Is an outgrowth of several theories
of development
IMPORTANT THEORIES IN FAMILY ● Addresses family change over time
NURSING
● Family Nursing Theories DUVALL'S DEVELOPMENTAL STAGES
● Family Systems Theories Stage 1: ● Reestablish couple
● Family Development and Life Cycle Marriage and identity
Theory an ● Realign relationships with
● Family Stress Theory Independent extended family
Home: The ● Make decisions regarding
● Bio-Ecological System Theory joining of parenthood
● Nursing Theories families
○ Newman Concept of Family
Stage 2: ● Integrate the infant into
○ Roy’s Concept of Family
Families with the family unit
○ King’s Concept Family infants ● Accommodate to new
○ Roger’s Concept of Family parenting and
grandparenting roles
● Maintain marital bonds
FAMILY THEORIES
● Can be used to describe families Stage 3: ● Socialize children
and how family unit responds to Families with ● Parents and children
events both within and outside the preschool adjust to separation
family Stage 4: ● Children develop peer
Families with relations
FAMILY SYSTEMS THEORY school ● Parents adjust to their
● Viewed as a system that continually children children’s peer and
school influences
interacts with its members and the
environment Stage 5: ● Adolescents develop
● Change in one family member Families With increasing autonomy
teenagers ● Parents refocus on
creates a change in other members
midlife , marital and
which in turn results in a new a career issues
change in other member ● Parents begin a shift
● Interaction in the family is important toward concern for the
older generation
● Family relationship
Stage 6: ● Parents and young adults
FAMILY STRESS THEORY Families as establish independent
● Family stress theory explains how launching identities
centers ● Parents negotiate marital
families react to stressful events and

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 relationship
FAMILY HEALTH
● Condition including the promotion
Stage 7: ● Reinvest in couple and maintenance of physical,
Middle-aged identity with concurrent mental, spiritual, and social health
families development of
independent interest for the family unit and for individual
● Realign relationships to family member
include in-laws and
grandchildren
FAMILY HEALTH NURSING CARE
● Deal with disabilities and
death of older generation ● Thinking, caring and working with
families
Stage 8: ● Shift from work role to ● Compose a philosophy and process
Aging leisure and semi
of interacting with clients and how
families retirement of full
retirement the nurse collects information and
● Maintain couple and implement intervention
individual functioning
while adapting to the
aging process OBJECTIVE OF FAMILY HEALTH
● Prepare to own and NURSING
dealing with the loss of 1. And identify health, nursing needs
spouse and or siblings and problems of each member
and other peers
2. To ensure family’s understanding
and acceptance of those needs and
BIO-ECOLOGICAL SYSTEM THEORY problems
● Developed by Urie Bron Fenbrenner 3. Provide health services with the
(1997) active participation of the family
● This theory describes how 4. To help families develop abilities to
environment and systems outside deal with their health needs and
the family influence the development health problems independently
of a child over time 5. To help family perform their
● Very useful to help identify stresses developmental functions and tasks
and potential resources that can 6. To help family make intelligent use of
affect family adaptation promotive, preventive, therapeutic,
and rehabilitative health and allied
FAMILY HEALTH NURSING PROCESS facilities and services in the
community
FAMILY NURSING 7. To educate, counsel and guide
Directed towards maximizing the health and family members.
well-being of all individuals within family
systems PRINCIPLES OF FAMILY HEALTH
● primary care provided to the NURSING
patients of all ages ranging from 1. Provide services without
infant to geriatric discrimination
● Health and illness centered on the 2. Periodic and continuous appraisal
family and evaluate situation

FINEZA, GAOR, GARZON (2NU04)

 3. Proper maintenance of records and
reports
4. Provide continuous services
5. Health education, guidance and
supervision as integral part of family
health nursing
6. Maintain good IPR
7. Plan and provide family health
nursing with active participation of
family
8. Services should be realistic in terms
of resources available
9. Encouraged to contribute towards
community health
APPROACHES TO FAMILY NURSING
1. Family as context
● Family prime focus on individual
● Serves as strength to individual
health and illness issues
● As nurse, interest is more on the
individual, and realized that
family influences the health of
the person (Paul , Ebenezer,
2020)
2. Family as client
● The family is the prime focus and
individual secondary
● The focus is on the family as
whole
● Reacts to event when family
member experience health issue
(Paul Ebenezer, 2020)
● Minutes provisions of basic
needs ( food, shelter, clothing,
affection, and education)
● The family supports spouses or
partners by meeting effective,
sexual and socioeconomic
needs.
● The family is the critical source -
Health promotion and wellness
activities
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● Thee family unit, any dysfunction
such as (illness, injury, and
separation) Affects the members
and unit a whole
● “Case finding”
● “Improving nursing care” -
provide better and more holistic
care, utilize services
3. Family as a system
● Focus is the family as client
● Focus on the individual and
family as a whole at the same
time
● The interaction among the family
members become the target of
nursing intervention (Paul
Ebenezer 2020)
● Interacts with larger units outside
the family (supra system) and
with smaller units inside the
family
● Three subsystem in the family:
○ Parent-child
○ Marital
○ Sibling- Sibling
4. Family as component of the society
● Family seems as many institution
in the society along with health,
and education, religious, and
financial institutions
● Family the basic unit of society
● Part of larger system in the
society
FAMILY HEALTH NURSING PROCESS
● Systematic steps to assess the
health needs
● Plan, implement and evaluate the
services
● Health problems and their solutions
 ● Achieve goals of health promotion, b. Objective data
prevention and control of health ● Observation of the house
problems ● Observation of family
interactions
COMPONENT OF FAMILY HEALTH c. Subjective data
NURSING PROCESS d. Reported experiences of the family
● Assessment of client's problem members
● Diagnosis ● Reported observations of
● Planning significant others
● Implementation ● Completion assessment
● Evaluation instrument by family
members
FAMILY HEALTH ASSESSMENT e. Written and oral information from
1. Establish a good working referrals
relationship ● Reports from agencies
2. Assessment of health needs working with family
● Family structure, characteristics ● Reports from other health
and dynamics team members
● Socio-economic and cultural
characteristics ASSESSMENT OF HEALTH PROBLEMS
● Home and environment Health deficits
● Health status of each member ● Failure in health maintenance
● Values and practices on health ● Diagnosed/suspected illness of a
promotion, maintenance and family member
disease prevention ● Sadden or untimely death, illness or
disability
METHOD OF DATA COLLECTION ● Failure to adapt
Family Assessment ● Deviations in growth and
● Observation development
● Physical examination ● Personality disorders
● Interview (past/present) listen
● Health record review HEALTH THREAT PRACTICES
● Laboratory/Diagnostic test ● Condition which predisposes to
disease, accident, poor or retarded
growth and development
FAMILY NURSING PROCESS ● Example incomplete immunization
Family Assessment
a. Client interviews: relative to past or FORESEEABLE CRISIS/STRESS
present events: ● Dissipated fields of unusual
● Questioning and Listening demands on the individual or family
● Genogram (diagram of ● Example: pregnancy, retirement,
family, generation) unemployment
● Ecomap (r/t other units of
community) ASSESSMENT OF FAMILIES

FINEZA, GAOR, GARZON (2NU04)

 1. Environmental condition b. Prompt treatment: encourage
2. Health status to go to appropriate health
3. Family health practices care facility/ limit disability
4. Family eg. suspected abuse.

FAMILY NURSING GOAL EXAMPLE OF SECONDARY

The framework of levels of prevention PREVENTION
explains the goal of family nursing. 1. APE
1. Primary prevention 2. Pap smear
● To optimal health and to 3. BSE for women 20 years and above
increase the person's 4. Annual guaiac test and rectal exam
resistance to illness for clients 50 years and above
● Family health promotion
○ Health attitudes, 3. Tertiary prevention
behavior and values are ● To support the client the client's
learned in the family achievement of successful
adaptation two known risks,
EXAMPLE OF PRIMARY PREVENTION optimal reconstitution and or
1. Quit smoking establishment of high level
2. Exercise regularly wellness
3. Eat well balanced diet ○ Eg. Monitoring CBG
4. Risk reduction ○ Rehab - PT post CVA
5. Risk appraisal ○ Cardiac Rehab post MI
○ Speech Path post
HEALTH PROMOTION laryngectomy
Activities directed toward increasing the
level of well-being and self-actualization
(Pende, 1987)
● Please individual in taking control
and responsibility for their health risk
● Activities to improve the health those
who are not initially healthy
● Activities that promote healthy
lifestyle
● Nutritional awareness, stress
reduction, mental health.

2. Secondary prevention
Health maintenance.
a. Early diagnosis: assess high
risk behaviour, screening and
detection of family pathology
or dysfunction.

FINEZA, GAOR, GARZON (2NU04)