Millennium Goal #5

Improve Maternal Health

Target

a: Reduce by 3 quarters the maternal mortality ratio Target b: Achieve by 2015, universal access to reproductive health

Maternal Care Program A. Provision of Regular and Quality Maternal Care Services regular and quality pre-natal care - PE: weight, height, BP-taking - Perform head-to-toe assessment; abdominal exam & fundic height measurement - Tetanus Toxoid Immunization
Strategies:

Prenatal Visits (schedule) DOH Sentrong Sigla 1st visit 4 to 16 wks

2nd visit 17 to 28 wks 3rd visit 29 to 36 wks 4th visit 37 to 40 wks

Period of Pregnancy

As early in pregnancy as possible before four months or during the first trimester
During the 2nd trimester During the 3rd trimester After 8th month of pregnancy till delivery

Vaccine

Minimum Age/Interval As early as possible during pregnancy At least 4 weeks later At least 6 months later At least 1 year later At least 1 year later

Percent Protected

Duration of Protection

TT1 TT2 TT3

Note: usually given 5-6 months of pregnancy

80% 95%

Infants born to mother will be protected from neonatal tetanus Gives 3 years protection for the mother Infants born to mother will be protected from NT Gives 5 years protection for the mother Infant born is protected from NT Gives 10 years protection for the mother Gives lifetime protection for the mother All infants born to the mother will protected

TT4
TT5

99%
99%

Maternal Care Program Iron supplementation

given from 5th mo. of pregnancy to 2mos postpartum (100-120 mg orally/day for 210 days)
Vitamin

A
4th

10,000 IU twice a week starting on the month of pregnancy.

Do

not give before 4th month, it may cause congenital problems in the baby. Laboratory exam:
Heat-acetic acid test & Benedicts test

Oral/Dental exam

Benedicts test: (to test sugar if mother is diabetic or not) Collect urine specimen before meals. Put 5 ml. of Benedicts solution in to the test tube. Heat the Benedicts solution; there should be no color change. (if the color of the solution is altered upon heating, it is considered contaminated) Add 8-10 drops of urine. Heat the Benedicts solution w/ urine (do not boil) Interpretation of Results: Blue (-) Green + Yellow ++ Orange +++ Red ++++

Heat & Acetic acid Test: (to test protein in urine) Collect urine before meals. Imaginary divide the test tube into three parts. Put 2/3 parts of urine into the test tube. Heat the test tube w/ urine; note the color change (this may be due to amorphous urates) Add 1/3 part of acetic acid or just a few drops, do not heat the solution. Acetic acid tends to explode when heated. Cloudiness indicates Albuminuria

 Pre-natal counseling Provision of safe delivery care - all birth attendants shall ensure clean and safe deliveries at home or at the facilities (Rural Health Units (RHU)/hospitals) - at-risk pregnancies and mothers must be immediately referred to the nearest institution - untrained Hilots who actively practice must be identified, trained and supervised by a personnel of the nearest Barangay Health Service/RHU trained on maternal care.

 Provision of quality postpartum care Proper schedule of follow-up must be followed: - 1st postpartum visit for home deliveries must be done within 24 hours after delivery - 2nd, done at least 1 week after delivery - 3rd, done 2-4 weeks after 2nd visit

Attendants must be aware of the early signs, symptoms and complications. They should follow the 3 CLEANS: CLEAN Hands CLEAN Surface CLEAN Cord B. Improvement of the health personnels capabilities on newborn care, midwifery thru trainings. Trainings for hilots must also be conducted.

C. Improvement on the quality of care at the First Referral Level D. Prevention of unwanted pregnancies through family planning services E. Prevention and management of Sexually Transmitted Infection

F. Promotion of Appropriate health practices G. Upgrade reporting services H. Mobilize political commitment and community involvement to provide support to basic health care delivery

Family Planning Program:

Artificial Methods Natural Methods

ESSENTIAL HEALTH CARE PACKAGE IN PREGNANCY CARE 1. Antenatal registration 2. Tetanus toxoid immunization 3. Macronutrient & micronutrient supplement 4. Treatment of diseases & other conditions 5. Early detection & management of complications 6. Clean & safe delivery 7. Support of breastfeeding 8. Family planning counselling 9. STD/HIV/AIDS prevention & management 10. Oral or Dental care

DOH Effort : National Family Planning Program in 23 in 93 EO 119 gave a legal mandate to the program from United Nation Declaration of Human Rights, which considers Family Planning as a basic human right. Goal: Universal access to family planning info & services Policies: - to improve family welfare with main focus on: i. womans health ii. safe motherhood iii. child survival - to promote family solidarity and responsible parenthood

In Health for more in 94 DOH effort: Buwan ng Masayang Pamilya National Focus: Alay sa Pamilya II - an activity that promotes the National Family Planning Program

3 FACTORS CONTRIBUTING TO PREGNANCY RELATED ILLNESS AND DEATH AMONG MOTHERS AND INFANTS: 1. too early pregnancy from previous pregnancy 2. pregnancy before age 20 or after age 35 3. pregnancy after the 4th baby