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MATERNAL AND NEONATAL HEALTH. By J. MTENGEZO VICTORIA HOTEL 17 TH JUNE, 2009. OUTLINE. MDGs - MNH Core Competencies- MNH Content outline Learning guides and checklists Exercises. Goal 4: Reduce Child Mortality Rate.
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MATERNAL AND NEONATAL HEALTH By J. MTENGEZO VICTORIA HOTEL 17TH JUNE, 2009
OUTLINE • MDGs - MNH • Core Competencies- MNH • Content outline • Learning guides and checklists • Exercises
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
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
CC.1. The student will be able to provide individualised focused antenatal care. • Brief review of: • Focused Antenatal care • Services offered at the antenatal clinic
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
Key Focused Antenatal care messages • Investigations • Hb, • Grouping • urinalysis • VDRL or PRP • HIV
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
CLINICAL • Health Education on RH topics for individuals and groups
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
CC. 2 • MATERNAL CONDITION • Psychological care • Physical care • FETAL CONDITION • Fetal heart rate • Moulding • Colour of liquor • Caput succedaneum
CC. 2 • PROGRESS OF LABOUR • Uterine contraction • Cervical dilatation • Descent of presenting part
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
CLINICAL • Conduct admission procedure, delivery of baby and placenta
CC. 3. The student will be able to prevent and manage obstructed labour. • Definition • Diagnosis • Causes • Signs and symptoms • Early signs • Late signs
CC. 3 • MANAGEMENT • Health centre level • Hospital level
CLINICAL • Manage woman with obstructed labour
CC. 4 The 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
CLINICAL • Conduct vacuum extraction
CC. 5 The 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
CLINICAL • Conduct breech delivery
CC. 6 The student will be able to perform manual removal of retained placenta. • Definition • Predisposing factors • Demonstration of actual procedure
CLINICAL • Conduct manual removal of retained placenta
CC. 7 The 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 3rd stage and immediately after placenta delivery
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
CC. 7 • Prevent and manage Primary post partum Haemorhage
CC. 8 The students will be able to manage a client with severe pre-eclampsia and eclampsia. • Definition • Signs and symptoms • Prevention of eclampsia • Management
CLINICAL • Manage woman with severe pre-eclampsia and eclampsia
CC.9A The 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
CC.9 B. The students will be able to manage a newborn baby • Management of the newborn • Immediate care • Subsequent care • Danger signs
CLINICAL • Manage the woman and baby during post partum period
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
CLINICAL • Manage a woman with an abortion
Excercises • Assignments, case studies, role play, and knowledge assessment- Refer page 115
?/COMMENTS • Thank you