Maternal and Child Health
Maternal and Child Health tests the routine care that keeps mothers and babies alive: antenatal checks, danger-sign recognition, safe delivery, newborn care and child growth and immunisation.
Core rules
- Antenatal care: at least four focused visits under national guidance, with WHO recommending eight contacts. Each visit records weight, blood pressure, haemoglobin, urine albumin, fundal height and fetal heart rate. Give iron-folic acid and calcium supplementation and two doses of TT or one of Td.
- Danger signs needing immediate referral: bleeding from the vagina, severe headache with blurred vision, convulsions, high fever, reduced or absent fetal movement, leaking of fluid, swelling of the face and hands.
- Postnatal care: check mother and baby at 24 hours, 3 days, 7 days and 6 weeks; watch for postpartum haemorrhage, sepsis and depression.
- Newborn care: breastfeed within one hour, exclusive breastfeeding for six months, skin-to-skin kangaroo mother care for low birth weight babies, keep the baby warm, cord care dry and clean, BCG, OPV-0 and hepatitis B at birth.
- Childhood diarrhoea: ORS after every loose stool plus zinc for 14 days; continue feeding. pneumonia signs - fast breathing and chest indrawing - need referral.
Worked example
A woman at 32 weeks has BP 150/100 mmHg, puffy face and a severe headache. Reasoning: hypertension after 20 weeks with proteinuria-type symptoms suggests pre-eclampsia, and headache signals possible impending eclampsia. She must not be sent home with a painkiller; arrange immediate referral with documentation of BP and gestation.
Traps that cost marks
- Advising prelacteal feeds or water in the first six months.
- Treating a newborn's fast breathing as normal newborn rate, which is higher than an adult's but has a limit.
- Stopping zinc early because diarrhoea settled.
- Missing danger signs because the mother looks well.