LESSON PLAN

Name of supervisor: Respected Mrs. sandeep kaur

Name of student teacher: gurjeet kaur
Class: M.Sc. 1st year
Subject: community health nursing
Topic: MCH services
Date: 9-1-2018
Time: 45 min.
Place: G.N.M. 3rd Year class room
A.V.Aids: flash cards , chart, black board
Method of teaching: Lecture cum discussion method
General Objective: At the end group will be able to answer the question related to mch
services
Specific Objective: At the end of the topic the group will be able to :
-Explain the definition
-describe the objective
-enlist the indicator.
-explain the components
-explain the trends of MCH services
-describe the principles of MCH services
-explain the fuctions nurse

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Serial Specific Tim Content Teaching A.V.Aids evaluatio
numb objective e learning n
er activities
1) To 2 INTRODUCTION: My self Student
maintain min Gurjeet kaur.I am student of teacher
IPR with msc first year in national gave self
group. institute of nursing. introducti
on

2) To 2 Ask the question like what you lecture

review min know about mother child cum
the t services discussio
previous n method
knowled
ge of
group

3) To 3 Today I am going to present Student

announc min my topic on MCH services teacher
e the t announce
topic the topic

4) To 3 mother and child not only Student black Give the

introduc min constitute a large group , but teacher board introducti
e the they also vulnerable and introduce on of the
topic special group. they comprises the topic topic
71.4% of population of the
developing countries .in india
women of child bearing age
constitute 22.2% and children

2
 under 15 years of age about
35.3% of total population

5) To 3 maternal and child health Lecture black What is

define min services can be defined as cum board MCH
the MCH promoting , preventive , discussio services
services therapeutic facility or care for n method
the mother and child
6) To 7 Goal: Improve the health and lecture black Explain
describe min well-being of women, infants, cum board the
children and families.
the Morbidity and Mortality discussio objective
 Reduce the rate of fetal and
objective n method of MCH
infant deaths
of MCH  Reduce the 1-year mortality services
services rate for infants with Down
syndrome
 Reduce the rate of child
deaths
 Reduce the rate of
adolescent and young adult
deaths
 Reduce the rate of maternal
mortality
 Reduce maternal illness and
complications due to
pregnancy (complications
during hospitalized labor
and delivery)
 Reduce cesarean births
among low-risk women
 Reduce low birth weight
(LBW) and very low birth
weight (VLBW)
 Reduce preterm births
Pregnancy Health and
Behaviors
 Increase the proportion of
pregnant women who

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 receive early and adequate
prenatal care
 Increase abstinence from
alcohol, cigarettes, and illicit
drugs among pregnant
women
 (Developmental) Increase
the proportion of pregnant
women who attend a series
of prepared childbirth
classes
 (Developmental) Increase
the proportion of mothers
who achieve a
recommended weight gain
during their pregnancies
Preconception Health and
Behaviors
 Increase the proportion of
women of childbearing
potential with intake of at
least 400 μg of folic acid
from fortified foods or
dietary supplements
 Reduce the proportion of
women of childbearing
potential who have low red
blood cell folate
concentrations
 Increase the proportion of
women delivering a live
birth who received
preconception care services
and practiced key
recommended
preconception health
behaviors
 Reduce the proportion of
persons aged 18 to 44 years
who have impaired
fecundity (i.e., a physical
barrier preventing
pregnancy or carrying a
pregnancy to term)

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 Postpartum Health and
Behavior
 (Developmental) Reduce
postpartum relapse of
smoking among women
who quit smoking during
pregnancy
 (Developmental) Increase
the proportion of women
giving birth who attend a
postpartum care visit with a
health worker
Infant Care
 Increase the proportion of
infants who are put to sleep
on their backs
 Increase the proportion of
infants who are breastfed
 Increase the proportion of
employers that have
worksite lactation support
programs
 Reduce the proportion of
breastfed newborns who
receive formula
supplementation within the
first 2 days of life
 Increase the proportion of
live births that occur in
facilities that provide
recommended care for
lactating mothers and their
babies
Disability and Other
Impairments
 Reduce the occurrence of
fetal alcohol syndrome
(FAS)
 Reduce the proportion of
children diagnosed with a
disorder through newborn
blood spot screening who
experience developmental
delay requiring special

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 education services
 Reduce the proportion of
children with cerebral palsy
born as low birth weight
infants (less than 2,500
grams)
 Reduce occurrence of
neural tube defects
 Increase the proportion of
young children with an
Autism Spectrum Disorder
(ASD) and other
developmental delays who
are screened, evaluated,
and enrolled in early
intervention services in a
timely manner
Health Services
 Increase the proportion of
children, including those
with special health care
needs, who have access to a
medical home
 Increase the proportion of
children with special health
care needs who receive
their care in family-
centered, comprehensive,
coordinated systems
 Increase appropriate
newborn blood-spot
screening and follow-up
testing
 Increase the proportion of
very low birth weight
(VLBW) infants born at level
III hospitals or subspecialty
perinatal centers

7) To enlist 10 antenatal care Lecture transparen what are

the mint cum cy the
Every woman wishes to have a
compone Antenatal care is the systemic discussio compone

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nt of n method nts of
supervision of women during
MCH MCH
pregnancy to monitor the
services progress of foetal growth and service
to ascertain the well-being of
the mother and the foetus.
A proper antenatal check-up
provides necessary care to the
mother and helps identify any
complications of pregnancy
such as anaemia, pre-
eclampsia and hypertension
etc. in the mother and
slow/inadequate growth of
the foetus.
Antenatal care allows for the
timely management of
complications through referral
to an appropriate facility for
further treatment.
It also provides opportunity to
prepare a birth plan and
identify the facility for delivery
and referral in case of
complications.
As provider of ante natal care,
you are involved in ensuring a
healthy outcome both for the
mother and her baby.
However, one must realise
that even with the most
effective screening tools, one
cannot predict which woman
will develop pregnancy-
related complications during
and immediately after child
birth.

You must therefore:

_ Recognise that ‘Every
pregnancy is special and every
pregnant woman must receive
special care’.
_ Complications being

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unpredictable may happen in
any pregnancy/child birth and
we should be ready to deal
with them if and whenever
they happen.
_ Ensure that ANC is used as
an opportunity to detect and
treat existing problems, e.g.
essential hypertension.
_ Prepare the woman and her
family for the eventuality of
an emergency.
_ Make sure that services to
manage obstetric
emergencies are available on
time.

Care during Pregnancy—

Antenatal Care

Quality ANC has several

components,

A. A few primary steps:

_ Ensure early registration and
see to it that the first check-
up is conducted within 12
weeks (first three months of
pregnancy).
_ Track every pregnancy for
conducting at least four
antenatal check-ups (including
the first visit for registration),
keeping in mind all the
essential components listed
under section B.
_ Administer two doses of TT
injection.
_ Provide at least 100 tablets
of IFA.

B. Essential components of
every antenatal check-up:

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_ Take the patient’s history.
_ Conduct a physical
examination–measure the
weight, blood pressure and
respiratory rate and check for
pallor and oedema.
_ Conduct abdominal
palpation for foetal growth,
foetal lie and auscultation of
Foetal
Heart Sound (FHS) according
to the stage of pregnancy.
_ Carry out laboratory
investigations, such as
haemoglobin estimation and
urine tests for sugar and
proteins).

C. Desirable components
_ Determine the blood group,
including the Rh factor.
_ Conduct the Venereal
Disease Research Laboratory
(VDRL)/Rapid Plasma Reagin
(RPR) test to rule out syphilis.
_ Test the woman for Human
Immunodeficiency Virus (HIV).
_ Check the blood sugar.
_ Carry out the Hepatitis B
Surface Antigen (HBsAg) test.

D. Counselling
_ Help the woman to plan and
prepare for birth (birth
preparedness/micro birth
plan).
This should include deciding
on the place of delivery and
the presence of an attendant
at the time of the delivery.
_ Advantages of institutional
deliveries and risks involved in
home deliveries.

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_ Advise the woman on where
to go if an emergency arises,
and how to arrange for
transportation, money and
blood donors in case of an
emergency.
_ Educate the woman and her
family members on signs of
labour and danger signs of
obstetric complications.
_ Emphasise the importance
of seeking ANC and PNC.
_ Advise on diet (nutrition)
and rest
_ Inform the woman about
breastfeeding, including
exclusive breastfeeding.
_ Provide information on sex
during pregnancy
_ Warn against domestic
violence (explain the
consequences of violence on a
pregnant woman and her
foetus).
_ Promote family planning
_ Inform the woman about
the Janani Suraksha Yojana
(JSY)/any other incentives
offered by the state.
*Tie up with the nearest
Integrated Counselling and
Testing Centre
(ICTC)/Prevention of Parent-
to-Child Transmission (PPTCT)
facility for counselling and
testing for HIV.

post natal care:

Home visit

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The first Maternal and Child
Health visit is usually
completed at your home and
is a chance for you and your
nurse to get to know each
other and talk about any
concerns.

This visit will focus on:

 safe sleeping
 safety in the home
 immunisations
 feeding including
breastfeeding
 how play helps
learning and
development
 family relationships
and wellbeing.
Remember, you and your
nurse can talk about other
issues/concerns if they aris

2 Weeks

This is usually your first visit to

the local Maternal and Child
Health centre. At this and
each other consultation you
and your Maternal and Child
Health nurse will discuss the
growth, health and
development of your baby.

This consultation will focus

on:

 Birth registration
 Immunisations

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  Feeding including
breastfeeding
 How play helps
learning and
development
 Safety in the car
 Safety in the home
 Family relationships
and wellbeing
 Hearing Screen (VIHSP)
 Eye check: Red Eye
Reflex.
Remember, you and your
nurse can talk about other
issues/concerns if they arise.

Please tell the nurse if your

baby:

 is not making any

sounds
 is not looking into your
eyes.

4 Weeks

At this consultation your

Maternal and Child Health
nurse will discuss the
importance of health and
wellbeing for every family
member.

This consultation will focus

on:

 safe sleeping
 feeding including
breastfeeding
 the health and

12
 wellbeing of the whole
family
 how play helps
learning and
development
 immunisations
 safety
 where to find
parenting information
– Raising Children
Network
 birth registration
 Hearing Screen (VIHSP)
Remember, you and your
nurse can talk about other
issues/concerns if they aris

8 Months

At this consultation the nurse

will review your child's
growth, health and
development and complete a
hearing risk assessment.

This consultation will focus

on:

 your Parents’
Evaluation of
Development Status
(PEDS) questions in
your My Health,
Learning and
Development Record (r
emember to complete
these questions before
the visit if you can)
 poisons information

13
  preventing injuries
 taking care of your
child's teeth
 how to be sun smart
 how play helps
learning and
development
 immunisations
 Hearing Screen (VIHSP)
 family relationships
and wellbeing.

12 Months

At this consultation your

childs growth, health and
development will be
reviewed.

This consultation will focus

on:

 your Parents'
Evaluation of
Development Status
(PEDS)questions in
your My Health,
Learning and
Development Record (r
emember to complete
these questions before
the visit if you can)
 helping your child to
eat healthy food
 taking care of your
child's teeth
 how to be sun smart
 how play helps
learning and

14
 development
 family relationships
and wellbeing
 immunisations.

18 Months

At this consultation the

Maternal and Child Health
nurse will review your child's
growth, health and
development and as well as
their new teeth.

This consultation will focus

on:

 your Parents'
Evaluation of
Development Status
(PEDS) questions in
your My Health,
Learning and
Development
Record (remember to
complete these
questions before the
visit if you can)
 helping your child to
eat healthy food
 taking care of your
child's teeth
 how to be sun smart
 how play helps
learning and
development
 family relationships
and wellbeing
 immunisations
 preventing injuries.

15
Remember, you and your
nurse can talk about other
issues/concerns if they arise.

Please tell the nurse if your

child is:

 not enjoying eye

contact or cuddles
with you
 not coming to you for
affection or comfort
 not understanding any
words
 not pointing or waving
 not trying to
communicate with you
 not showing any signs
of pretend play
 not walking.

2 Years

At this consultation your

toddler's growth, health and
development will be reviewed
and kindergarten enrolment
will be discussed.

This consultation will focus

on:

 your Parents'
Evaluation of
Development Status
(PEDS) questions in
your My Health,
Learning and
Development
Record (remember to
complete these

16
 questions before the
visit if you can)
 helping your child to
eat healthy food
 taking care of your
child's teeth
 how to be sun smart
 how play helps
learning and
development
 immunisations
 preventing injuries
 Kindergarten
enrolment
 family relationships
and wellbeing.

8) enlist the 3 -maternal mortality rate below lecture black What are
indicator min 1 cum board the
of MCH -infant mortality rate below 30 discussio indicator
services -death rate of 1-4 year old age n method of MCH
group below 10 services.
-size of family 2-3 members
-perinatal mortality rate 30-35

9) To 2 following trend: lecture black Explain

explain min -integration of care cum board about the
the -risk approach discussio trend
recent -man power changes n method.
trend in -primary health care
MCH -reproductive and child health

17
 services
10) To 3 -consultation and participation Student black what are
explain min -access and availability teacher board the
the -primacy of prevention used principles
principle -capacity building lecture of MCH
s -equity cum services .
-family centered discussio
-inclusion n method.
-partnership
-quality
11) To 6 . Caregiver Lecture black What are
 The caregiver role has
describe min cum board the
traditionally included
the those activities that assist discussio function
function the client physically and n method of nurse
psychologically while
of nurse preserving the client’s
dignity. Caregiving
encompasses the
physical, psychosocial,
developmental, cultural
and spiritual levels.
2. Communicator
 Communication is an
integral to all nursing
roles. Nurses
communicate with the
client, support persons,
other health
professionals, and people
in the community. In the
role of communicator,
nurses identify client
problems and then
communicate these
verbally or in writing to
other members of the
health team. The quality
of a nurse’s
communication is an

18
 important factor in
nursing care.
3. Teacher
 As a teacher, the nurse
helps clients learn about
their health and the
health care procedures
they need to perform to
restore or maintain their
health. The nurse
assesses the client’s
learning needs and
readiness to learn, sets
specific learning goals in
conjunction with the
client, enacts teaching
strategies and measures
learning.
4. Client advocate
 Client advocate acts to
protect the client. In this
role the nurse may
represent the client’s
needs and wishes to
other health
professionals, such as
relaying the client’s
wishes for information to
the physician. They also
assist clients in exercising
their rights and help
them speak up for
themselves.
5. Counselor
 Counseling is a process of
helping a client to
recognize and cope with
stressful psychologic or
social problems, to
developed improved
interpersonal
relationships, and to
promote personal
growth. It involves

19
 providing emotional,
intellectual, and
psychologic support.
6. Change agent
 The nurse acts as a
change agent when
assisting others, that is,
clients, to make
modifications in their
own behavior. Nurses
also often act to make
changes in a system such
as clinical care, if it is not
helping a client return to
health.
7. Leader
 A leader influences
others to work together
to accomplish a specific
goal. The leader role can
be employed at different
levels; individual client,
family, groups of clients,
colleagues, or the
community. Effective
leadership is a learned
process requiring an
understanding of the
needs and goals that
motivate people, the
knowledge to apply the
leadership skills, and the
interpersonal skills to
influence others.
8. Manager
 The nurse manages the
nursing care of
individuals, families, and
communities. The nurse-
manager also delegates
nursing activities to
ancillary workers and
other nurses, and
supervises and evaluates

20
 their performance.
9. Case manager
 Nurse case managers
work with the
multidisciplinary health
care team to measure the
effectiveness of the case
management plan and to
monitor outcomes.
10. Research consumer –
nurses often use research to
improve client care. In a
clinical area nurses need to:
 Have some awareness of
the process and language
of research
 Be sensitive to issues
related to protecting the
rights of human subjects
 Participate in
identification of
significant researchable
problems
 Be a discriminating
consumer of research
findings
Expanded role of the nurse

1. Clinical Specialists
 Is a nurse who has
completed a master’s
degree in specialty and
has considerable clinical
expertise in that
specialty. She provides
expert care to individuals,
participates in educating
health care professionals
and ancillary, acts as a
clinical consultant and
participates in research.
2. Nurse Practitioner
 Is a nurse who has
completed either as

21
 certificate program or a
master’s degree in a
specialty and is also
certified by the
appropriate specialty
organization. She is
skilled at making nursing
assessments, performing
P. E., counseling, teaching
and treating minor and
self- limiting illness.
3. Nurse-midwife
 A nurse who has
completed a program in
midwifery; provides
prenatal and postnatal
care and delivers babies
to woman with
uncomplicated
pregnancies.
4. Nurse anesthetist
 A nurse who completed
the course of study in an
anesthesia school and
carries out pre-operative
status of clients.
5. Nurse Educator
 A nurse usually with
advanced degree, who
beaches in clinical or
educational settings,
teaches theoretical
knowledge, clinical skills
and conduct research.
6. Nurse Entrepreneur
 A nurse who has an
advanced degree, and
manages health-related
business.
7. Nurse administrator
 A nurse who functions at
various levels of
management in health
settings; responsible for

22
 the management and
administration of
resources and personnel
involved in giving patient
care.

17) To 2 student teacher summarize the Student

summari min topic today we learn about teacher
ze the MCH services summariz
topic e the
topic

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BIBLIOGRAPHY:

PARK.K,PREVENTIVE AND SOCIAL MEDICINE,22th EDITION 2013,PUBLISHED BY

PREMNAGAR , JABALPUR , pg no.481,514

PARK K,ESSENTIAL OF COMMUNITY HEALTH NURSING , 4 TH EDITION

2014 ,PUBLISHED BY PREMNAGAR,JABALPUR,pg.no.278-280

RAO SUNDER KASTHURI Mrs. Dr,AN INTRODUCTION TO COMMUNITY HEALTH

NURSING ,4th EDITION 2005 PUBLISHED BY B.I PUBLICATION pvt ltd

SWARNKAR KESHAV ,COMMUNITY HEALTH NURSING , 2ND EDITION

2007 ,PUBLISHED BY N.R BROTHERS page no. 83-87

www.google.com

www.linkdin.com

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