Presented by;

Lt Hafiza Saba
Faculty;
Maj Najma
Meskeen

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Maternal and child health

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Maternal and child health

Objectives
At the end of this session the learnerns will be able
to know;
Definition of MCH
Goals and objectives of MCH
Factors affecting MCH in Pakistan
History of MCH in Pakistan
Statistics of MCH in Pakistan in comparison to
other counteries of world
Causes of Maternal Mortality and Infant Mortality
in Pakistan
How we can Improve Maternal and Child Health in
Pakistan
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Definition
MCH

refers to the promotive,

preventive,curative and
Rehabilitative health care of mothers and
children
(BT Basavanthappa,community health
nursing)

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Goals of MCH
Ensure comprehensive prenatal and postnatal care
Assure access to care for low income women and

children
Reduce infant,maternal and childhood mortality and
morbidity
Increase health assessments, diagnosis and
Treatment
Ensure access to preventive, and rehabilitative
services
Assure family-centered, community-based systems
of coordinated care
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Objectives of MCH
To reduce maternal,infant and childhood

mortality and morbidity

To promote reprodutive health
To promote physical and psychological
development of children and adolescent

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Factors affecting MCH in

Pakistan
Socioeconomic condition
Traditional and legal structure of society
Educational opportunities
Family environment
Adolescent health
Status of women
Nutrition

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History of Maternal and

Child Health in pakistan
Home Delieveries
Use of herbs and other home remedies
Dais
Maternal and child health programme i.e

GOBI-FFF and Safe Motherhood programme

Maternal and child health services
Maternal and child health mission

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History of Maternal and

Child
Health
in pakistan
Health clinics
for women and children, hiring
midwifes and nurses to educate and care for
pregnant women and their children
Visiting nurses at home
Midwife training by government

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History of Maternal and

Child Health in pakistan
MCH Services
The Childrens Bureau was the first federal
agency within the U.S to focus exclusively on
improving the lives of children and families.Its
elements were
Infant and maternal death
Child labor
Child health and nutrition
Family economic security
Abused and neglected children
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Maternal & Child health

in
Pakistan
180.71
millions total population
Total Fertility rate in pakistan is 3.4 per

women
Delieveries at home are 76%
Total MCH centers in Pakistan are 903 only
530,000 women die each year due to

causes of pregnancy.

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Maternal & Child health in

Pakistan
MDG NO 4
Reduse Child Mortality
IMR should be <40/1000 live births> by year 2015
In pakistan it is (63/1000 live births) by year 2013
MDG NO 5
Improve Maternal Health
MMR should be <1.4/1000 live births> by year 2015
In pakistan it is (3.5/1000 live births) by year 2013
MDG NO 6 Combat HIV/AIDS,malaria& other diseases
Halt spread of HIV/AIDS by year 2015

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Maternal Health
Maternal Mortality
the death of a woman
while pregnant or within 42 days of termination
of pregnancy, from any cause related to or
aggarvated by the pregnancy or its management
but not from accidental or incidental causes

(BT Basavanthappa,community health

nursing)
The death of the mother is intimately related
to the health and well-being of their children.
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Maternal Health
Causes of Maternal Mortality
The leading causes of maternal death are
classified as;
Direct
Indirect

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Causes of Maternal
Direct causes
Mortality

Those related to obstetric complications of

pregnancy, labor ,delivery and the post-partum

periods.
Hemorrhage (uncontrolled bleeding) 25 %
Sepsis (infection) 15%
Hypertensive Disorders 12%
Prolonged or Obstructed Labor 08%
Unsafe Abortion 13%
Direct causes account for 80% of maternal death
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Causes of Maternal
Indirect causes
Mortality

Those relating to pre-existing medical conditions

such as;
Anemia, malaria, hepatitis, heart disease, and
HIV/AIDS can increase the risk of maternal death.
Accounts for approximately 20% of maternal
deaths.
Risk of adverse outcomes can be reduced through
prenatal identification and treatment as well as
the availability of appropriate basic emergency
obstetric care (EmOC) at the time of delivery.
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Child Health
Infant mortality rate 63/1000 live births in

pakistan
Under five mortality rate 86.5/1000 live births
in pakistan
Perinatal mortality rate 70/1000 live births in
pakistan
The times of birth and the time of weaning are
the two most dangerous times in the life of a child

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Child Health
More than 10 million children die each year

from preventable diseases. 27,000 deaths per

day.

About 6 million children die per year

worldwide, aged 1 month to 5 years

About 4 million newborn die in first month

of life (40 % of all child deaths).

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Child Health
Which countries have the largest problems?
India
2,402,000 child deaths each
year
Nigeria
834,000
China
784,000
Pakistan
565,000
Bangladash
484,000
Ethiopia
472,000

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Child Health
The Index of Infant Mortality has Diminished
Since the 1960s in Pakistan
1960
2000

175/1000 births
75/1000 birth

United Nations Millennium Development

Goals
are to diminish Infant Deaths to
25/1000 by the year 2015
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Child Health
Causes of Death of Newborn to One Month
of Age
Born before due date
Pneumonia/Sepsis
Asphyxia
Tetanus
Diarrhea

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27%
25%
23%
7%
3%

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Child Health
Causes of Infant Death Between One Month
and 5 years
Pneumonia
Diarrhea
Malaria
Measles
HIV/AIDS
Injuries
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30%
27%
13%
6%
5%
5%
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As A Health Care
Professional What We
Can Do?

Assure that mothers are in good health

when they become pregnant to provide

sufficient milk at the time of birth.
Prevent Adolescent Pregnancies
Safe abortion sevices
Effective control of STD and RTI
Prevention and management of infertility
Family Planning
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As A Health Care
Professional What We
Early detection and treatment of reproductive tract
Can
Do?
malignances
Offer Voluntary Counseling and Testing (VCT) to detect HIV

infections in pregnant mothers before they give birth. The

Importance of Literacy, Pure Water, Food
and Health Care
We cannot wait until governments build schools and train
teachers to make women literate
Education about menstural hyiegen
Distribution of nutrition and hygiene information

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As A Health Care
Professional What We
Newborn
care and management of early liufe
Can
Do?

complications
Nutritional management in pretem babies
Educate about time of weaning
Prevent deafness and cleft palate
Prevent malaria by providing nets impregnated with
insecticides
Provide inexpensive treatments for:
A. Antibiotics for pneumonia
B. Oral solutions for diarrhea

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Recommendations
Pakistan continue efforts to increase

coverage of high-quality services including

family planning, antenatal and postnatal care,
skilled delivery and emergency obstetric care.
To reduce under-five mortality rate, there is a
need for huge investment in health services
for pregnant women and the newborn baby,
including the prevention of preterm births and
stillbirths and scale-up of effective low-cost
interventions, it stated.
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Questions and
Discussion

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