Dr.Awatif Alam

Content:- Rationale Background *EMRO & WHO Objectives Components Principles for developing MCH services Information system Periods of Maternal Health Care Child Care Programme Childhood Health Problems.

Health Profile in Saudi Arabia: I. Population Growth: * Estimated population was 12.574, and 19 million (1990) and 1995, with a growth rate of 3.8%. Why? II. Health Indicators: *Life expectancy at birth > 70 yrs. *Infant mortality rate= 21/1,000 live births. *Under-5 mortality rate= 31/1,000 live births. *Adult mortality rate = 165/1,000 adults (age 15 – 60 yrs)

HEALTH POLICY AND STRATEGY:- Saudi Arabia is committed to the goal of “Health For All” by yr. 2000. Principles of PHC adopted in S.A. in 1980. A Ministerial Decree called for comprehensive approach to h. services and integration of services with MCH Centers. Main strategy of PHC is to ensure providing optimum health care to vulnerable groups e.g. pregnant woman, and preschool children.

PATTERN OF MCH:- A .The culture pattern. B .Genetic consideration. C .Level of development of community.

OBJECTIVES OF MCH SERVICES: 1. Reduction in maternal, perinatal, infant and childhood Mortality & Morbidity. 2. Promotion of reproductive health. 3. Promotion of physical and psychological development of child and adolescent within the family.

METHODOLOGY FOR APPLICATION: Detection. High risk management. Equity in coverage. Follow up.

Rationale for reproductive health: Evidences:- Each year > 200 million women become pregnant. > 50 million experience acute pregnancy related complications. 15 million develop long-term disabilities. 585,000 die annually. (UNICEF)

Poor maternal health and nutritional status. Inappropriate management of labor is responsible for about 75% of 7.5 million annual perinatal deaths. [Reproductive Health is one of the most neglected health problems in the world. Interventions are available, but policies are inappropriate.]

(ICPD 1994) Reproductive Health Policy: Linking rep. health policies to girls’ education, status of women and overall poverty reduction. Preventing unwanted pregnancies. Facilitating safe pregnancy, delivery and motherhood by preventing and managing pregnancy complications. Promoting positive health practices e.g. early treatment of STDs., delayed marriages, birth spacing and education.

COMPONENTS OF MCH SERVICES:- A. Promotive. B. Preventive. C. Curative. For Developing Appropriate MCH Services: 1. Adaptation to ecology and needs. 2. Real community participation.

3. Within economic constraints* 4. Integration within general h. services. 5. “At – risk” in focus. 6. Education. 7. Trained staff. 8. Guided evaluation. 9. Acceptable within national development planning activities. * Re-assess priorities ** Consider cost-effectiveness

INFORMATION SYSTEMS AND MCH SERVICES:- (Monitor events, report them, complete records). Useful data for building MCH information system include: 1. Births. 2. Marriages. 3. Divorce. 4. Deaths. 5 . Mortality. 6 . Morbidity. 7 . Use of services. To be categorized by Age and sex.

SPECIFIC DATA ON UTILIZATION OF HEALTH SERVICES INCLUDE: Prenatal Care Mechanisms for referral of ill mothers to high risk centers and rate of return and follow-up. Data on availability and use of non-medical prenatal services i.e. nutrition, education and other programs. Data on screening tests done.

PERIODS OF MATERNAL CARE: I. Before Pregnancy:- (> 15 yrs.) for physical and psychological preparation to bear responsibility. II. Antenatal Care: Aims:- Promote, protect and maintain health. Detect high risk. Foresee complications to apply prevention. Relieve fear and anxiety. Teach elements of child care, nutrition, hygiene and environmental sanitation. Infant and Maternal “Morbidity + Mortality” To attend the < 5 yrs. accompanying the mother. To promote mutual trust.

III. Intra-natal Care:- AIMS: Asepsis Minimum injury to mother and newborn. Preparedness to deal with complications. (prolonged labor – ante partum hemorrhage convulsions malpr.) Care of baby at delivery. Place of delivery  sound scientific judgment.*

IV. Post-Natal Care: Aims: Health restoration. Check adequacy of breast feeding. Provide basic health education. (Evaluate effect of antenatal Care)?!