Maternal, Child and Adolescent Health
Core concepts
Maternal, newborn, child, and adolescent health is organized around the continuum of care from pre-pregnancy through delivery, postnatal care, childhood, and adolescence. Know antenatal care contacts, danger signs, skilled birth attendance, emergency obstetric and newborn care, postnatal timing, exclusive breastfeeding, complementary feeding, growth monitoring, immunization, integrated management of childhood illness, and adolescent-friendly services. Understand maternal mortality ratio, neonatal and under-5 mortality rates, perinatal mortality, and their denominators. Family planning, safe abortion care where lawful, and prevention of mother-to-child transmission are core components.
Traps
The maternal mortality ratio uses live births as the denominator, not all women. Maternal mortality rate uses women of reproductive age. Antenatal visits are not the same as WHO-recommended contacts. Postnatal care must start within 24 hours, not at six weeks. Exclusive breastfeeding means no water or other liquids for about six months. Child mortality rates use live births or children as specified. Adolescent health is not simply paediatric care with older patients.
Worked example
A district records 12 maternal deaths and 24,000 live births in a year. Maternal mortality ratio = 12/24,000 × 100,000 = 50 per 100,000 live births. If the district has 600,000 women aged 15–49, the maternal mortality rate = 12/600,000 × 100,000 = 2 per 100,000 women of reproductive age.
Rule of thumb
Every maternal and child contact is an opportunity for screening, prevention, and health promotion.