Maternal and Child Health
Overview
Maternal and Child Health tests antenatal, intrapartum, postnatal and newborn care, family planning, and the immunisation schedule - the content most often applied in sub-centre and community practice.
Antenatal care
- Register early; at least four visits (WHO now recommends eight contacts).
- Check weight, blood pressure, haemoglobin and urine; give iron–folic acid and tetanus–diphtheria (Td) immunisation.
- Danger signs needing urgent referral: vaginal bleeding, severe headache, blurred vision, convulsions, high fever, reduced fetal movement, leaking fluid.
Postnatal and newborn care
- Exclusive breastfeeding for six months, starting within one hour; colostrum is the first feed and must not be discarded.
- Complementary feeding from six months with continued breastfeeding to two years.
- Newborn danger signs: not feeding, fast breathing, chest indrawing, fever or hypothermia, jaundice, convulsions.
Immunisation (Universal Immunisation Programme)
At birth: BCG, OPV-0, hepatitis B. At 6, 10 and 14 weeks: pentavalent, OPV, rotavirus, PCV (and fIPV at 6 and 14 weeks). At 9 months: measles–rubella. Boosters follow later.
Worked example
A woman at 34 weeks has a severe headache and blurred vision, and her blood pressure is 150/100 mmHg. Reasoning: this suggests pre-eclampsia. Do not treat as a minor headache - check urine protein, notify the medical officer and arrange urgent referral, because eclampsia can follow.
Traps that cost marks
- Advising water or other feeds before six months.
- Discarding colostrum.
- Missing that bleeding in pregnancy is always an emergency.