1. MCH – Introduction
A.A.TRIVEDI

2. MCH (Maternal and Child Health)
MCH is a promotive, preventive curative and rehabilitative health care to mother and children.
Health care to a special and vulnerable group
Children of < 5yrs of age
Female of reproductive age group (15-45 yrs )
MCH care includes all the activities which promotes health and prevent health problem of mother and child.

3. Why women and children Forms priority group in any community
Forms 60-70% of population in developing countries
In India
Women (15-45) – 19%
Children (<5yrs) – 40%
Vulnerable to disease, disability and death
Women – Child bearing
Children – Growth
Development
Survival

4. Objectives of MCH care
Reduction of morbidity and mortality rates for mother and child
Promotion of reproductive health
Promotion of physical and psychological development of children.

5. Components of MCH care (Sub areas)
Maternal health
Family planning
Child health
School health
Handicapped children
Care of children in special settings like day Care centers

6. Why - Mother and child combined ?
Considered as one unit –
During ante-natal period child is a part of mother only and obtain all his building material and oxygen from mother.
Child health depends on health of mother
Healthy mother provides healthy child
Certain diseases of mother during pregnancy have effects on foetus
Even after birth child is dependant on mother for nutrition up to 6 – 9 months of life.
Mother and child un-seperable – post-natal care.
Mother is first teacher of child

7. Who provide MCH care In past MCH services were fragmented
Current trend is to provide MCH services and Family planning services through Family Welfare services.
MCH services should be flexible based on local community needs which are based on
Social and economical status
Local customs and traditions
Status of women
Level of urbanization and migration
An Obstratisian and Pediatrician joins hands and link themselves with PSM

8. Common MCH problems Malnutrition Infection
Consequences of unregulated fertility
Pregnant female
LBW, Anemia, PPH,
Nursing women
Children
Two most important period are intrauterine life and weaning period

9. Common MCH problems Infection Consequences of Uncotrolled Fertility
Maternal infection can cause
Growth retardation
Abortion
LBW
Puerperal sepsis
Infection of children
Diarrhoea
RTI
Chronic infection like Malaria, Tb
Consequences of Uncotrolled Fertility
Increase prevalence of LBW
Anemia
APH

10. Maternal Health
Each year in India, 30 million women experience pregnancy and 27 million have a live birth
Of these, over 100,000 maternal deaths and one million newborn deaths occur annually.
Despite a series of programmatic initiatives, there is little evidence that maternity has become significantly safer over the last 20 years.
Current MMR is 407/ live births

12. Child Health Each year 27 million infants are born in India.
Around 10% of them do not even survive to 5 years of age.
Nearly half of the under 5 deaths occur in neonatal period.
Over the decades there has been a declining trend in infant mortality rate, neonatal mortality rate and still birth rate.
Prematurity is a major cause for both neonatal and infant deaths

14. COMMON CAUSES OF IMR

15. COMMON CAUSES OF NMR

16. Evolution of Maternal and Child health programmes in India
Year
Milestones
1952
Family Planning Programme adopted by Govt. of India (GOI)
1961
Dept. of Family Planning created in Ministry of Health
1971
Medical Termination of Pregnancy Act (MTP Act)  1971
1977
Renaming of Family Planning to Family Welfare
1978
Expanded Programme on Immunization (EPI)
1985
Universal Immunization Programme (UIP)+ National Oral Rehydration Therapy (ORT) Programme
1992
Child Survival and Safe Motherhood Programme (CSSM)
1996
Target-free approach
1997
Reproductive and Child Health Programme -1 (RCH-1)
2005
Reproductive and Child Health Programme -2 (RCH-2)

17. IMCI – IMNCI
Focus on the young infant: Since a significant proportion of child mortality is centered in the first few months of life;
Inclusion of essential newborn care in the programme.
Development of a protocol for Home Visits by field functionaries like ANMs and anganwari workers for all newborns in the first week of life.

18. What is IMNCI
Standardized case management of sick newborns and children
Focus on the most common causes of mortality
Nutrition assessment and counselling for all sick infants and children
Home care for newborns to
promote exclusive breastfeeding
prevent hypothermia
improve illness recognition & timely care seeking

19. POSSIBLE SERIOUS BACTERIAL INFECTION SEVERE JAUNDICE
Yellow palms and soles or
Age less than 24 hours or
Age 14 days or more.
SEVERE
JAUNDICE Ø
Treat to prevent low blood sugar.
Warm the young infant by Skin to Skin contact if
temperature less than 35.5 o
C (or feels
cold to
touch) while waiting for referral to be arranged.
Advise mother how to keep the
young
infant warm
on the way to t
he hospital.
Palms and soles not yellow .
Follow up in 2 days
Give home care
Advise the mother when to return immediatel y C
onvulsions or
Fast breathing (60 breaths per
minute or more) or
Severe chest indrawing or
Nasal flaring or
Grunting o r
Bulging fontanelle or
Many skin pustules or a big boil or
If axillary temperature 37.5
C or
above (or feels hot to touc
h) or
Lethargic or unconscious or
POSSIBLE
SERIOUS
BACTERIAL
INFECTION
Give first dose of intramuscular a
mpicillin and
gentamicin
Warm the young infant by Ski
n to Skin contact if
temperature less than 36.5
C (or feels cold to
touch) while arranging referral.
Advise mother ho
w to keep the
on the way to the hospital.
Refer URGENTLY to hospital #
Umbilicus red or draining pus or
LOCAL Ø
Give oral co -
trimoxazole or amoxycillin
for 5 days.
Pus discharge from ear or
BACTERIAL Ø
Teach mother to treat local infections at home.
Skin pustules.
INFECTION Ø
Follow up in 2 days.
Temperature
35.5 -
36. 4 o C or Ø
Warm the baby using Skin to Skin contact for 1 hour
Feels cold to touch.
LOW BODY
and REASSESS.
TEMPERATURE Ø
Treat to prevent low blood sugar.

20. MAKE EVERY MOTHER
AND CHILD COUNT
THANK YOU