Maternal and Child Health in Pakistan

Presented by; Lt Hafiza Saba Faculty; Maj Najma Meskeen

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Maternal and child health

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Objectives
At the end of this session the learnerns will be able to know; Definition of MCH Goals and objectives of MCH Factors affecting MCH in Pakistan History of MCH in Pakistan Statistics of MCH in Pakistan in comparison to other counteries of world Causes of Maternal Mortality and Infant Mortality in Pakistan How we can Improve Maternal and Child Health in Pakistan
Maternal and child health

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Definition
MCH

refers to the promotive, preventive,curative and Rehabilitative health care of mothers and children (BT Basavanthappa,community health nursing)

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Goals of MCH
Ensure comprehensive prenatal and postnatal care
Assure access to care for low income women and

children Reduce infant,maternal and childhood mortality and morbidity Increase health assessments, diagnosis and Treatment Ensure access to preventive, and rehabilitative services Assure family-centered, community-based systems of coordinated care
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Objectives of MCH
To reduce maternal,infant and childhood mortality

and morbidity To promote reprodutive health To promote physical and psychological development of children and adolescent

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Factors affecting MCH in Pakistan

Socioeconomic condition
Traditional and legal structure of society Educational opportunities Family environment Adolescent health Status of women Nutrition

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History of Maternal and Child Health in pakistan

Home Delieveries Use of herbs and other home remedies

Dais
Maternal and child health programme i.e GOBI-FFF

and Safe Motherhood programme Maternal and child health services Maternal and child health mission

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History of Maternal and Child Health in pakistan

Health clinics for women and children, hiring

midwifes and nurses to educate and care for pregnant women and their children Visiting nurses at home Midwife training by government

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History of Maternal and Child Health in pakistan

MCH Services The Childrens Bureau was the first federal agency within the U.S to focus exclusively on improving the lives of children and families.Its elements were Infant and maternal death Child labor Child health and nutrition Family economic security Abused and neglected children
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Maternal & Child health in Pakistan

180.71 millions total population
Total Fertility rate in pakistan is 3.4 per women Delieveries at home are 76% Total MCH centers in Pakistan are 903 only

530,000 women die each year due to causes of pregnancy.

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Maternal & Child health in Pakistan

MDG NO 4 Reduse Child Mortality IMR should be <40/1000 live births> by year 2015 In pakistan it is (63/1000 live births) by year 2013 MDG NO 5 Improve Maternal Health MMR should be <1.4/1000 live births> by year 2015 In pakistan it is (3.5/1000 live births) by year 2013 MDG NO 6 Combat HIV/AIDS,malaria& other diseases Halt spread of HIV/AIDS by year 2015

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Maternal Health
Maternal Mortality the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggarvated by the pregnancy or its management but not from accidental or incidental causes

(BT Basavanthappa,community health nursing) The death of the mother is intimately related to the health and well-being of their children.
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Maternal Health
Causes of Maternal Mortality The leading causes of maternal death are classified as; Direct Indirect

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Causes of Maternal Mortality

Direct causes Those related to obstetric complications of pregnancy,

labor ,delivery and the post-partum periods. Hemorrhage (uncontrolled bleeding) 25 % Sepsis (infection) 15% Hypertensive Disorders 12% Prolonged or Obstructed Labor 08% Unsafe Abortion 13% Direct causes account for 80% of maternal death
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Causes of Maternal Mortality

Indirect causes Those relating to pre-existing medical conditions such as; Anemia, malaria, hepatitis, heart disease, and HIV/AIDS can increase the risk of maternal death. Accounts for approximately 20% of maternal deaths. Risk of adverse outcomes can be reduced through prenatal identification and treatment as well as the availability of appropriate basic emergency obstetric care (EmOC) at the time of delivery.
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Child Health
Infant mortality rate 63/1000 live births in pakistan
Under five mortality rate 86.5/1000 live births in

pakistan Perinatal mortality rate 70/1000 live births in pakistan

The times of birth and the time of weaning are the two most dangerous times in the life of a child

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Child Health
More than 10 million children die each year from

preventable diseases. 27,000 deaths per day.

About 6 million children die per year worldwide,

aged 1 month to 5 years

About 4 million newborn die in first month of life

(40 % of all child deaths).

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Child Health
Which countries have the largest problems? India 2,402,000 child deaths each year Nigeria 834,000 China 784,000 Pakistan 565,000 Bangladash 484,000 Ethiopia 472,000

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Child Health
The Index of Infant Mortality has Diminished Since the 1960s in Pakistan
1960 2000

175/1000 births 75/1000 birth

United Nations Millennium Development Goals are to diminish Infant Deaths to 25/1000 by the year 2015

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Child Health
Causes of Death of Newborn to One Month of Age
Born before due date Pneumonia/Sepsis

Asphyxia
Tetanus Diarrhea

27% 25% 23% 7% 3%

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Child Health
Causes of Infant Death Between One Month and 5 years
Pneumonia

Diarrhea
Malaria Measles

HIV/AIDS
Injuries
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30% 27% 13% 6% 5% 5%

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As A Health Care Professional What We Can Do?

Assure that mothers are in good health when they become pregnant to provide sufficient milk at the time of birth.

Prevent Adolescent Pregnancies

Safe abortion sevices Effective control of STD and RTI Prevention and management of infertility Family Planning
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As A Health Care Professional What We Can Do?

Early detection and treatment of reproductive tract

malignances
Offer Voluntary Counseling and Testing (VCT) to detect

HIV infections in pregnant mothers before they give birth. The Importance of Literacy, Pure Water, Food and Health Care We cannot wait until governments build schools and train teachers to make women literate

Education about menstural hyiegen Distribution of nutrition and hygiene information

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As A Health Care Professional What We Can Do?

Newborn care and management of early liufe

complications Nutritional management in pretem babies Educate about time of weaning Prevent deafness and cleft palate Prevent malaria by providing nets impregnated with insecticides Provide inexpensive treatments for:
A. Antibiotics for pneumonia B. Oral solutions for diarrhea
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Recommendations
Pakistan continue efforts to increase coverage of high-

quality services including family planning, antenatal and postnatal care, skilled delivery and emergency obstetric care. To reduce under-five mortality rate, there is a need for huge investment in health services for pregnant women and the newborn baby, including the prevention of preterm births and stillbirths and scaleup of effective low-cost interventions, it stated.

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Questions and Discussion

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