Beruflich Dokumente
Kultur Dokumente
SESSION OBJECTIVES
Review the pertinent issues concerning womens
reproductive health and well being
Review the national objectives for health
concerning womens health
Review the strategies to achieve optimum womanmothers health
BACKGROUND
150 million women in developing countries will
become pregnant yearly (WHO)
600,000 will die.
The average maternal mortality ratio (MMR)
estimated at 400 per 100,000 live births.
At least 7 million pregnancies will result in still
births or infant deaths in the first week of life due
to pregnancy related complications.
Childbirth must not carry with the risk of death or
disability for the woman and her infant.
Preventable deaths due to pregnancy and
childbirth are both too high in developing
countries.
In the Philippines, the situation of mothers
although better than the average from developing
countries, has not change much in the last 5 - 10
years.
There are 14 million Filipino women in the
reproductive age group ( 15 -49 years old ).
Of this, 9 million are married or have partners, 6
million are considered to be at risk if they become
pregnant because :
1.) They are either too young (less than 20 years
old)
2.) Too old (more than 35 years old)
3.) Have more than four pregnancies
4.) Have too close or un spaced pregnancies
(less than 15 months)
5.) Too sick, mostly anemic or underweight
Average fertility rate of 3.7 (number of children per
woman),
Estimated 2.3 million women are expected to get
pregnant every year.
Two million of those who become pregnant will
deliver.
VISION
Healthy empowered Filipino mothers able to make
decisions for themselves and their families and to
contribute to the socio-economic development of
the Philippines
Page 1 of 11
FCM III
MISSION
The Department of Health (DOH) in partnership
with the Local Government Units (LGUs), private
sector and other agencies concerned with the
health of Mothers shall commit to lead and provide
quality maternal health services to make
pregnancy, childbirth and motherhood a safe
experience for all mothers.
GOAL
To improve the well-being of mothers through a
comprehensive approach of providing, preventing,
promotive, curative and rehabilitative health care
PROJECT AREAS
World Bank Assisted Provinces (36) Rehabilitation
and construction of rural health units (RHUs)
barangay health stations (BHS).
ADB Assisted Provinces (41) Rehabilitation and
construction of Provincial hospitals, District
hospitals, RHUs and BHS.
SPECIFIC STRATEGIES
Training "To have all births attended by a
knowledgeable, caring and skilled health care
provider"
Information Dissemination "To make informed
decision and promote better health seeking
behavior"
Social Mobilization - "Multi-sectoral participation
and cooperation for action towards a common goal
through self-reliant efforts."
Community Participation - "Encourage the bottomup approach to problem-solving and decisionmaking"
Promotion of gender sensitivity at all levels - "All
humans are born free and equal in dignity and
rights."
Quality Assurance Schemes - "Sentrong Sigla
Concept"
Maternal Mortality Audit "No blame system of
investigating maternal deaths."
Upgrading Facilities and Equipment for Obstetric
Emergencies "Every pregnancy faces risks.
There is no such thing as a no risk pregnancy."
Making Quality Care Accessible - "Every woman
has a right to safe delivery and quality maternal
care services".
Page 2 of 11
FCM III
VISION
Filipino women fully participating in decision
making on their health and able to access quality
health services from competent, caring,
communicative and gender responsive health care
providers.
MISSION
Develop a gender sensitive health care system,
promoting women's health and is responsive to all
her needs.
GOAL
Institutionalization of the woman's perspective in
all program and services at all levels of the health
care delivery system
STRATEGIES
Capability Building
Gender Sensitivity Training and Mainstreaming.
Information, Education and
Advocacy campaigns
Community organizing
Research
Legislative lobbying
Collaboration with non-government
Organization and women's group.
Maternal Care:
Strengthening existing maternal care services
of the DOH and LGU hospitals through the
provision, on a nationwide basis of :
Micronutrients (iodine, iron, Vitamin A.) to
pregnant women and lactating mother
Obstetrical kits for midwives
Traditional birth attendant (TBA) kits
Disposable home delivery kits for low-income
Emergency obstetrical drug and supplies
Civil Works:
Improving the quality of services in, and
accessibility of, first referral level hospital and
health units through:
Upgrading 92 obstetric facilities of selected first
level hospital
Renovating 234 rural health units
Upgrading of 344 selected barangay health
stations
Construction of 15 maternity waiting homes and
10 lying-in clinics in selected health facilities
Provision of necessary drugs and medical
supplies and equipment and furniture.
Training:
Provisional of in-service training gendersensitive for regional and provincial public
sector health providers responsible for
delivering maternal care
Development, piloting and expansion of
distance learning programs.
Logistics:
Strengthening logistics services and
capabilities of the public health system, so as to
improve the supply of drugs and medicines,
reagents and other medical supplies to health
service facilities.
Strengthening the capacity of the DOH to
provide guidance, technical assistance, training
and logistical and financial support for the
proper implementations of the national public
health programs.
Community Participation and Development:
Strengthening the capabilities of NGOs involved in
women's health issues in selected areas and
establishing partnerships between the NGOs, the
DOH, the LGUs and local communities and other
advocacy groups involved.
Reproductive Tract Infection:
Page 3 of 11
FCM III
PRE-CONCEPTIONAL CARE
Every woman who is planning to become pregnant
should have a health check-up to:
Ensure that she is physically ready
Detect any medical problems that need
treatment
Find out if she has to observe any special
precautions during pregnancy and
childbirth
BUILDING OR IRON RESERVES
A woman who intends to become pregnant should
build up her nutritional iron reserves because she
will need more iron during her pregnancy.
Sources of iron:
Meat, fish, poultry - the iron they contain can be
absorbed easily in the body
Green and leafy vegetables, cereals, and legumes
- Vitamin C is needed to enhance absorption of
iron from these foods.
AVOIDANCE OF EXPOSURES
Active or passive smoking, alcohol, intake of some
drugs, x-rays and exposure to harmful chemicals
such as pesticides used in the home or farm can
Page 4 of 11
FCM III
PRENATAL CARE
Uncover risk conditions that may result in maternal
complications and deaths
Identify common maternal complications and/or
causes of maternal deaths are bleeding, infection,
hypertensive disease of pregnancy and obstructed
labor.
Prenatal care may identify women who are at risk
for bleeding, infection, hypertensive disease of
pregnancy, obstructed labor and other conditions.
Measures can be taken to avoid or treat any
problems early, before the condition becomes
serious or life-threatening.
PRENATAL CARE
Regular prenatal check - ups are important. One
or two visits are NOT enough to identify problems.
Only regular monitoring, will enable early detection
and management of most problems. Prenatal
check - ups include various activities that are
intended to identify and/or prevent problems that
may develop during pregnancy, delivery and
postpartum. These include:
Taking the client's medical history and doing a
physical examination to identify conditions in
the mother and her baby that will need closer
follow - ups and/or treatment.
Giving iron/folate supplement to prevent or
treat anemia
Giving tetanus toxoid immunization to prevent
neonatal tetanus
Giving malaria prophylaxis if it is needed
Giving advice on nutrition, hygiene,
breastfeeding, avoidance of unhealthy
practices during pregnancy, preparations for
delivery, neonatal care, family planning and
other related concerns
Managing diseases and other problems that
may affect the pregnancy
Referring the client to another facility if there
are problems that need further intervention.
RISK CONDITIONS & DANGER SIGNS
Maternal age younger than 20 years or older than
35 years. A primigravida whose height is less than
145 cm.
Less than two years between deliveries.
More than four deliveries
A previous difficult delivery
A previous caesarean section
A previous miscarriage or stillbirth
A previous premature or low-birth-weight baby
A history of, or current, bleeding
Page 5 of 11
FCM III
PREVENTING TETANUS
Receiving tetanus immunization (5 doses for
lifetime protection)
Ensuring a clean delivery
Keeping the cord clean
TETANUS IMMUNIZATION SCHEDULE
DOSE
TIMING
PERIOD OF
PROTECTION
st
TT1
1 contact
None
TT2
1 month after TT1
3 years
TT3
6 months after
5 years
TT2
TT4
1 year after TT3
10 years
TT5
1 year after TT4
All child bearing
years
NUTRITION IN PREGNANCY
PROTEIN will make the mother's body and baby
grow. - example of food sources are fish, meat,
beans, eggs and milk.
CALCIUM will keep gums and teeth healthy, and
help in the growth and development of bones and
hair. - example of food sources are cheese, dilis
and shellfish.
IODINE will prevent goiter, promote proper mental
and physical development of the growing fetus. example of food sources are seafoods like
seaweeds, alamang, fish, tahong, halaan, tulya
and iodized salt
IRON will prevent anemia, increase production of
red blood cells. Sources of iron are dried dilis,
tulingan, alamang, seaweeds, tahong, liver,
internal organs, malunggay, camote tops, gabi
leaves, petchay, saluyot, alugbati, kangkong,
whole grain cereal.
Iron Supplementation:
A pregnant woman should take 120 mg of
elemental iron and 1 mg folate daily for three to
four months with meals
Lactating women should take 120 mg
elemental iron and 1 mg folate daily for 2
months post-partum with meals
Tea and coffee inhibits iron absorption while
fruit juices do not.
CARBOHYDRATES will provide energy needed
by the mother in her daily activities. Food rich in
carbohydrates are rice, corn, cassava, camote,
bread, and other bakery products such as cakes,
Page 6 of 11
FCM III
DENTAL HEALTH
Submit for dental examination. The gums of
pregnant women usually becomes tender and can
bleed easily during brushing. Eat vitamin C - rich
foods to keep teeth and gums healthy.
Mothers should brush their teeth every after meal.
AVOIDANCE OF:
Avoid cigarettes, alcoholic drinks, too much coffee,
excessive soft drinks and sweets. They should
avoid taking any medicine not prescribed by their
doctor.
Excessive softdrinks and sweets may lead to rapid
weight increase which may endanger the mother
and her child.
Cigarettes may result in the baby's low birth
weight, while use of unprescribed medicine or
alcohol may cause congenital deformities or even
death of the child.
EMERGENCY OBSTETRIC CARE
Constipation
Hemorrhoids
Heartburn
Morning sickness/nausea and vomiting
Varicose veins
Vaginal discharge
Leg cramps
Backache
FCM III
FCM III
The woman is in
the third trimester
and the pain
comes and goes
Labor
Painful urination
Urinary infection
Spotting only
Profuse bleeding
with passage of
clots
Profuse bleeding
which has now
stopped
Septic abortion
Incomplete
abortion
Molar pregnancy
Completed
abortion
Give amoxycillin
1gm. PO.
Fluid
replacement;
Give paracetamol
500mg. PO is
there is fever.
Refer to the
hospital
immediately
Give ergometrine
0.2 mg
Fluid
replacement.
Refer to the
hospital
immediately with
a friend or
relative willing to
donate blood.
Advise rest for 3
days.
Fluid replacement
Give ferrous
sulfate 60 mg
with folic acid; 2
tablets daily for 2
Threatened
abortion
months.
Advise her to
practice family
planning.
If the mother is
very pale. Refer
her to the
hospital. She may
need a blood
transfusion
Advice bed rest
until 3 days after
the bleeding has
stopped.
Advice avoidance
of sexual
intercourse for 1
week after the
bleeding has
stopped.
Refer to the
hospital if
bleeding and/or
pain gets worse
or if bleeding
continues
Page 9 of 11
FCM III
FCM III
OTHER RECOMMENDATIONS
Encourage the post-partum woman to bathe daily
Keep the perineum clean especially if she has
stitches
Use sanitary napkins as perineal pads
Encourage mobilization to help the uterus return
back to normal size
Encourage her to eat all food types except if there
is medical restriction
Page 11 of 11