1. By J. MTENGEZO VICTORIA HOTEL 17 TH JUNE, 2009

2. OUTLINE MDGs - MNH Core Competencies- MNH Content outline Learning guides and checklists Exercises

3. Goal 4: Reduce Child Mortality Rate Target 5: reduce by two thirds, between 1990 and 2015, the under five mortality rate Indicators traced: - under five mortality rate - Infant Mortality Rate - Proportion of 1 year old children immunized against measles

4. Under-Five Mortality Rate

5. Infant Mortality Rate

6. Proportion of 1-Year Old Children Immunized Against Measles

7. Goal 5: Improving Maternal Health Target 6: reduce by three quarters,the maternal mortality ratio Indicators traced: - Maternal Mortality ratio - Proportion of births attended by skilled Health Personnel

8. Maternal Mortality Rate

9. Proportion of Births Attended by Skilled Health personnel

10. C C.1.The student will be able to provide individualised focused antenatal care. Brief review of: Focused Antenatal care Services offered at the antenatal clinic

11. Key Focused Antenatal care messages Importance of focused antenatal care Basic information on focused antenatal care services Birth preparedness Early Detection and treatment of complications History taking Physical Examination (refer to checklist for information) -General examination -Obstetrical

12. Key Focused Antenatal care messages Investigations Hb, Grouping urinalysis VDRL or PRP HIV

13. Management Identification and treatment of existing problems Health education nutrition Personal hygiene Rest/exercises PMTCT Birth plan Prevention of conditions or diseases Danger signs and complications of pregnancy Refer where necessary

14. CLINICAL Health Education on RH topics for individuals and groups

15. CC2.The student will be able to assess and manage a woman in labour and delivery. ADMISSION PROCEDURE History taking Physical examination (head to toe) Laboratory investigations

16. CC. 2 MATERNAL CONDITION Psychological care Physical care FETAL CONDITION Fetal heart rate Moulding Colour of liquor Caput succedaneum

17. CC. 2 PROGRESS OF LABOUR Uterine contraction Cervical dilatation Descent of presenting part

18. CC. 2 SECOND STAGE MANAGEMENT Definition Preparation for the delivery Actual delivery Documentation ACTIVE MANAGEMENT OF THIRD STAGE OF LABOUR Definition Controlled cord traction Immediate care

19. CLINICAL Conduct admission procedure, delivery of baby and placenta

20. CC. 3.The student will be able to prevent and manage obstructed labour. Definition Diagnosis Causes Signs and symptoms Early signs Late signs

21. CC.3 MANAGEMENT Health centre level Hospital level

22. CLINICAL Manage woman with obstructed labour

23. CC.4The student should be able to perform Vacuum Extraction Definition Indication Contra indication Criteria for performing vacuum extraction Complication of vacuum extraction Care of vacuum extractor set Demonstration of actual procedure

24. CLINICAL Conduct vacuum extraction

25. CC.5The student will be able to conduct breech delivery. Types of breech presentation Diagnosis of breech presentation Preparation for breech delivery Actual Breech delivery : Burns marshal Lovset manoeuvre Maurice smellie manoeuvre Complication of breech

26. CLINICAL Conduct breech delivery

27. CC.6The student will be able to perform manual removal of retained placenta. Definition Predisposing factors Demonstration of actual procedure

28. CLINICAL Conduct manual removal of retained placenta

29. CC.7The student will be able to prevent and manage Primary post partum Haemorhage Definition Causes Risk factors Strategies for prevention Antenatally During labour and delivery During 3 rd stage and immediately after placenta delivery

30. CC.7 Strategies for management Inspection of the perineum, vaginal and cervical tears Repair of tears Manual removal of placenta Bimanual compression Aortic compression Demonstration of actual procedures

31. CC.7 Prevent and manage Primary post partum Haemorhage

32. CC.8The students will be able to manage a client with severe pre-eclampsia and eclampsia. Definition Signs and symptoms Prevention of eclampsia Management

33. CLINICAL Manage woman with severe pre-eclampsia and eclampsia

34. CC.9AThe student will be able to assess and manage a woman during post partum period Management of a postnatal mother History taking Physical examination Laboratory investigations Counselling of the post partum mother Complications

35. CC.9 B. The students will be able to manage a newborn baby Management of the newborn Immediate care Subsequent care Danger signs

36. CLINICAL Manage the woman and baby during post partum period

37. cc.10. The student will be able to provide post abortion care Provision of PAC Services PAC services Rapid assessment of the patient Pelvic examination MVA procedure

38. CLINICAL Manage a woman with an abortion

39. Excercises Assignments, case studies, role play, and knowledge assessment- Refer page 115

40. ?/COMMENTS Thank you