Village Health & Nutrition Day (VHND/ MCHN

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State Institute of Health & Family Welfare, Jaipur

MCHN Day
Ø Organized once every month preferably on Wednesdays Ø For those villages that have been left out, on any other day of the same month) Ø At the AWC in the village Ø Mobilization by ASHAs, AWWs Ø

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Services on MCHN Day
Ø All pregnant women are to be registered Ø ANC for Registered pregnant women Ø Dropout pregnant women eligible for ANC are to be tracked and services are to be provided to them Ø Vaccination to All eligible children below one year Ø All dropout children who do not receive vaccines as per the scheduled doses are to be vaccinated

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Ø Vitamin A solution, to children Ø All children- weighed, weight being plotted on a card and managed appropriately in order to combat malnutrition Ø Anti-TB drugs are to be given to patients of TB Ø All eligible couples are to be given condoms and OCPs referrals are to be made for other contraceptive services Ø Supplementary nutrition is to be provided to underweight children •
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Issues for Discussion
Ø Danger signs during pregnancy Ø Importance of institutional delivery and where to go for delivery Ø Importance of seeking post-natal care Ø Counseling on ENBC Ø Registration for the JSY Ø Counseling for better nutrition Ø Exclusive Breastfeeding Ø Weaning and complementary feeding Ø
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Ø Care during diarrhea and home management Ø Care during acute respiratory infections Ø Prevention of malaria, TB, and other communicable diseases Ø Prevention of HIV/AIDS Ø Prevention of STIs Ø Dangers of sex selection Ø Age at marriage

Ø
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Ø Importance of safe drinking water Ø Personal hygiene Ø Household sanitation Ø Education of children Ø Information on RTIs, STIs, HIV and AIDS Ø Disease outbreak Ø Disaster management

Ø
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Identify Cases Needing Special Attention
Ø Identify children with disabilities Ø Identify children with Grade III and Grade IV for referral Ø Identify severe cases of anemia Ø Identify pregnant women who need hospitalization

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Ø Identify cases of Malaria, TB, leprosy, and Kala Azar Ø Identify problems of the old and the destitute Ø Pay special attention to the SC, ST, the minorities, and the weaker sections Ø Reproductive & Child Health Program (RCH) •
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ASHA & MCHN day
Actions to be taken before the Village Health and Nutrition Day: Ø Visit all households and get to know all the families particularly poor households, especially SC/ST families Ø Make a list of pregnant women Ø Make a list of women who need to come for ANC for first time or for repeat visits Ø Make a list of infants who need immunization, were left out or droppedout

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Ø Make a list of children who need care for malnutrition Ø Make a list of children who were missed during the pulse polio round Ø Make a list of children with special needs, particularly girl children Ø Make a list of TB patients who need antiTB drugs Ø Coordinate with the AWW and the ANM Ø
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ASHA: on MCHN day
Ø Ensure that all listed women come for services Ø Ensure that all listed children come for services Ø Ensure that malnourished children come for consultation with the ANM Ø Ensure supplementary nutrition to children with special needs Ø Ensure that all listed TB patients collect their drugs Ø Assist the ANM and the AWW Ø
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MCHN Day: Role of AWW
Ø Ensure that the AWC is clean Ø Ensure availability of clean drinking water during the VHND Ø Ensure a place with privacy at the AWC for ANC Ø Keep an adequate number of MCH cards Ø Coordinate activities with the ASHA and the ANM

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MCHN Day: Role of ANM
Ø Ensure that the VHND is held without fail. Make alternative arrangements in case the ANM is on leave Ø Ensure supplies reach the site well before the day's activities begin Ø Ensure that all instruments, drugs, and other materials are in place Ø Carry communication materials

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Ø Ensure that adequate money is available for disbursement to the ASHA Ø Ensure reporting of the VHND to the MO in charge of the PHC Ø Coordinate with the ASHA and the AWW Ø

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MCHN DAY: Role of PRI
Ø Ensure that the members of the VHSC are available to support the sessions Ø Ensure participation of schoolteachers and PRI members Ø Ensure availability of clean drinking water, proper sanitation, and convenient approach to the AWC for participating in the VHND by all Ø

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Service Package
Ø Maternal Health Ø Early registration of pregnancies Ø Focused ANC Ø Referral for women with signs of complications during pregnancy and those needing emergency care Ø Referral for safe abortion to approved MTP centres Ø Counseling on ØEducation of girls Ø
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ØAge at marriage ØCare during pregnancy ØDanger signs during pregnancy ØBirth preparedness ØImportance of nutrition ØInstitutional delivery ØIdentification of referral transport ØAvailability of funds under the JSY for referral transport Ø
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Ø Post-natal care Ø Breastfeeding and complementary feeding Ø Care of a newborn Ø Contraception Ø Organizing group discussions on maternal deaths, if any; that have occurred during the previous month in order to identify and analyze the possible causes
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Who should Owe Responsibility for MCHN Day
Ø ASHA Ø AWW Ø PRI member Ø Helper of AWW Ø Staff to come from outside the village Ø ANMs Ø Male MPW (if available) Ø ASHA facilitators (if available)

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Check List for Supervision of MCHN
Ø General information: Session site, availability of staff, timings displayed Ø Cold chain: Vaccine carrier with ice packs, VVM's status on vaccine vials Ø Availability of essential supplies in adequate quantities Ø Procedure of vaccination, especially injection safety Ø Availability of communication and counseling materials Ø
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Ø Record review for ØWomen and children from vulnerable communities ØImmunization for children scheduled to arrive ØFollow-up activities for ANC ØBlood films collected for MP Ø

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Ø Disposal of AD syringes Ø Client satisfaction: Exit interviews with some clients about the dates of repeat visits for immunization, birth preparedness, and the institution identified for delivery Ø Disbursement of incentives to ASHA for mobilizing clients to get immunization Ø

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MCHN Week: Guidelines
Ø Vaccination sites ØAWW ØSchools ØUrban dispensaries ØPrivate clinics Ø Team ØVaccinator ØANM/Nursing staff/ ANMs/LHVs of CHC/MPWs
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Ø Social mobilizers ØAWW/ PRI/ NGO/ Local women Ø Timing ØBegin at 10:00 am not more than two sessions/ day

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Outcomes of MCHN Day
Ø 100% coverage with preventive and promotive interventions, especially for pregnant women, children, and adolescents Ø Preventive and promotive coverage for the National Disease Control Programs Ø Increased awareness about the determinants of health such as nutrition, sanitation, timely care

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Ø Improved knowledge about the services offered under the various Nutritional Health Programs Ø Greater emphasis on the community's role in making the health system responsive to the health needs of the community and in demanding and ensuring accountability Ø

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Thank You

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