Maternal and Child Health

Maternal Health
Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and even death.

Maternal Death
According to the WHO maternal death is: the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

Causes of maternal deaths

The major complications that account for 80% of all maternal deaths are:
severe bleeding (mostly bleeding after childbirth) infections (usually after childbirth) high blood pressure during pregnancy (pre-eclampsia and eclampsia) unsafe abortion. obstructed labour

The remainder are caused by or associated with diseases such as malaria, and AIDS during pregnancy.

Maternal Health Services

Family Planning Antenatal Care Intrapartum Care Postnatal Care

Child Health
Terms: Neonate : from birth up to four weeks(one months) Infant: from birth up to one year Under-five child: from birth up to 59 months

Child Health
6.6 million children under the age of five died in 2012. More than half of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions. Children in sub-Saharan Africa are about over 16 times more likely to die before the age of five than children in developed regions.

Child Health
A child's risk of dying is highest in the neonatal period, the first 28 days of life. 44% of child deaths under the age of five take place during the neonatal period. Safe childbirth and effective neonatal care are essential to prevent these deaths.

Child Health
Causes of death during the neonatal period: Preterm birth Intrapartum related complications (birth asphyxia or lack of breathing at birth Infections cause most neonatal deaths.

Child Health
Leading causes of death in under-five children are:
Pneumonia Preterm birth complications Birth asphyxia, Diarrhoea Malaria

About 45% of all child deaths are linked to malnutrition. Making children more vulnerable to severe diseases

Child Health
Child care services: Care of the newborn Vaccination Growth monitoring and nutrition Integrated Management of Childhood illnesses (IMCI)

Why are maternal and child health combined?

Mother and child health are related: The Health of the mother before and during pregnancy affects the health of the child Mothers usually bring their children when seeking care for themselves

Maternal Health
Family Planning

Family Planning
Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is achieved through: 1. Use of contraceptive methods 2. The treatment of infertility

Contraceptive Methods
Types of contraceptive methods: 1. Modern 2. Traditional

Modern Contraceptive Methods

Method Description How it works

Combined oral contraceptives (COCs) or the pill Progestogen-only pills (POPs)

Contains two hormones (estrogen and progestogen) Contains only progestogen hormone,

Prevents the release of eggs from the ovaries (ovulation) Thickens cervical mucous to block sperm and egg from meeting and prevents ovulation Same mechanism as POPs

Implants

Small, flexible rods or capsules placed under the skin of the upper arm; contains progestogen

Progestogen only injectables

Injected into the muscle every 2 or 3 months,

Same mechanism as POPs

Modern Contraceptive Methods

Method Description How it works

Monthly injectables or combined injectable contraceptives (CIC)

Injected monthly into the muscle, contains estrogen and progestogen

Same mechanism as COCs

Intrauterine device Small flexible plastic (IUD): copper containing device containing copper sleeves or wire that is inserted into the uterus Intrauterine device (IUD) A T-shaped plastic levo-norgestrel device inserted into the uterus that steadily releases small amounts of levonorgestrel each day

Copper component damages sperm and prevents it from meeting the egg Suppresses the growth of the lining of uterus (endometrium)

Modern Contraceptive Methods

Method Description How it works

Male condoms

Sheaths or coverings

Forms a barrier to prevent sperm and egg from meeting

Female condoms

Sheaths, or linings, that Forms a barrier to fit loosely inside a prevent sperm and egg woman's vagina, made from meeting of thin, transparent, soft plastic film Permanent contraception to block or cut the vas deferens tubes that carry sperm from the testicles Keeps sperm out of ejaculated semen

Male sterilization (vasectomy)

Modern Contraceptive Methods

Method Description How it works

Female sterilization (tubal ligation)

Lactational amenorrhea method (LAM

Permanent contraception Eggs are blocked from to block or cut the meeting sperm fallopian tubes
Temporary contraception Prevents the release of for new mothers whose eggs from the ovaries MP has not returned; (ovulation) requires exclusive breastfeeding day and night of an infant less than 6 months old Prevents ovulation

Emergency contraception Progestogen-only pills (levonorgestrel 1.5 mg) taken to prevent pregnancy up to 5 days after unprotected sex

Traditional Contraceptive Methods

Method Description How it works

Withdrawal (coitus interruptus)

Man ejaculates outside the vagina, keeping semen away from external genitalia Calendar-based methods: monitoring fertile days in menstrual cycle; symptom-based methods: monitoring cervical mucus and body temperature

Tries to keep sperm out of the woman's body, preventing fertilization The couple prevents pregnancy by avoiding unprotected vaginal sex during most fertile days, usually by abstaining or by using condoms

Fertility awareness methods (natural family planning or periodic abstinence

Eligibility Criteria for Contraceptive Use

PERSONAL CHARACTERISTICS AND REPRODUCTIVE HISTORY( age, parity, breastfeeding, past ectopic pregnancy, obesity) CARDIOVASCULAR DISEASE(DVT, HBP, stroke, valvular disease) RHEUMATIC DISEASES (SLE) NEUROLOGIC CONDITIONS( headache, epilepsy, depressive D) REPRODUCTIVE TRACT INFECTIONS AND DISORDERS ( vaginal bleeding, tumours, breast diseases, STIs,

Eligibility Criteria for Contraceptive Use

OTHER INFECTIONS (TB, Schistosomasis, Malaria) ENDOCRINE CONDITIONS (diabetes M, thyroid problems) ENDOCRINE CONDITIONS GASTROINTESTINAL CONDITIONS( liver conditions) ANAEMIAS DRUG INTERACTIONS

Benefits of family planning

Preventing pregnancy-related health risks in women Allows spacing of pregnancies and can delay pregnancies in young women at increased risk of health problems and death from early childbearing, Can prevent pregnancies among older women who also face increased risks. By reducing rates of unintended pregnancies, it reduces the need for unsafe abortion.

Benefits of family planning

Reducing infant mortality Family planning can prevent closely spaced and ill-timed pregnancies and births Infants of mothers who die as a result of giving birth also have a greater risk of death and poor health

Benefits of family planning

Helping to prevent HIV/AIDS Family planning reduces the risk of unintended pregnancies among women living with HIV Male and female condoms provide dual protection against against STIs including HIV.

Benefits of family planning

Empowering people and enhancing education Family planning enables people to make informed choices about their sexual and reproductive health. Family planning represents an opportunity for women for enhanced education and participation in public life Children with fewer siblings tend to stay in school longer than those with many siblings.

Benefits of family planning

Slowing population growth Family planning is key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment, and national and regional development efforts.

Who provides family planning?

It is important that family planning is widely available and easily accessible through midwives and other trained health workers Midwives are trained to provide locally available and culturally acceptable contraceptive methods. Other trained health workers, for example community health workers, also provide counseling and some family planning methods, For methods such as sterilization, women and men need to be referred to a clinician.

Contraceptive use
Contraceptive use has increased in many parts of the world, especially in Asia and Latin America, but continues to be low in sub-Saharan Africa. Globally, use of modern contraception has risen slightly, from 54% in 1990 to 57% in 2012. Use of contraception by men makes up a relatively small subset of the above prevalence rates. The modern contraceptive methods for men are limited to male condoms and sterilization (vasectomy).

Global unmet need for contraception

An estimated 222 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception. Reasons for this include:
limited choice of methods; limited access to contraception Fear or experience of side-effects; cultural or religious opposition; poor quality of available services; gender-based barriers.