Maternal and Child Health Care
This domain tests antenatal, intranatal and postnatal care, recognition of danger signs, breastfeeding and complementary feeding, and the National Immunization Schedule - high-yield, fact-heavy content.
Core rules
- Antenatal care: register early; at least four visits; record weight, blood pressure, haemoglobin, urine albumin and sugar, blood group, HIV, VDRL and HBsAg; give iron-folic acid and calcium; tetanus-diphtheria immunisation.
- Danger signs needing immediate referral: bleeding per vaginum, severe headache with blurred vision, convulsions, high fever, reduced fetal movement, leaking, swelling of face and hands.
- Postnatal care: check mother within 24 hours and again on days 3, 7 and 42; initiate breastfeeding within one hour; exclusive breastfeeding for 6 months; complementary feeding starts at 6 months while breastfeeding continues to 2 years.
- Colostrum is the first yellow milk - it is rich in antibodies and must never be discarded.
- National Immunization Schedule: at birth - BCG, OPV-0, hepatitis B; at 6, 10 and 14 weeks - pentavalent, OPV, PCV and rotavirus; at 9–12 months - measles-rubella 1 and JE 1; at 16–24 months - MR 2 and DPT booster; vitamin A from 9 months, six-monthly to 5 years.
- Record everything on the Mother and Child Protection card; institutional delivery is supported by JSY/JSSK.
Worked example
A woman at 32 weeks has a blood pressure of 160/110 mmHg, proteinuria and blurred vision. Reasoning: the combination indicates severe pre-eclampsia with impending eclampsia. Do not wait for the next routine visit - refer immediately to a facility with magnesium sulphate and delivery capability, keeping the patient quiet and on her side.
Traps that cost marks
Discarding colostrum; giving water, honey or ghutti to a newborn; starting complementary feeds before 6 months; confusing MR (measles-rubella) with other vaccines' timing; treating a convulsion at home instead of referring.