Maternal, Newborn, Child, and Adolescent Health
This is the highest-weight clinical domain for CHO selection: antenatal care, safe delivery, newborn and child care, immunisation, and adolescent services.
Antenatal and delivery care
- Register the pregnancy early; at least four ANC visits (WHO now recommends eight contacts) with BP, weight, haemoglobin, urine albumin and sugar, blood group, HIV, syphilis and one ultrasound.
- IFA (60 mg elemental iron with 500 µg folic acid) daily from the second trimester for 180 days, plus calcium 500 mg twice daily; Td two doses, or one if a dose was received within three years.
- PMSMA on the 9th of every month; JSSK provides free delivery, drugs, diagnostics, diet and transport; JSY is the cash incentive for institutional delivery.
- Active management of the third stage of labour prevents postpartum haemorrhage; misoprostol 600 µg orally is the community-level option when oxytocin cold chain is not available.
Newborn and child care
- Vitamin K 1 mg IM at birth; BCG, OPV-0 and hepatitis B birth dose within 24 hours; exclusive breastfeeding for six months, complementary feeding from six months; MR at 9–12 months and 16–24 months.
- Diarrhoea: low-osmolarity ORS plus zinc - 10 mg/day below 6 months, 20 mg/day for older children, both for 14 days.
Worked example
A 9-month-old with acute watery diarrhoea and no dehydration: give ORS after every loose stool (about 50–100 mL), zinc 20 mg daily for 14 days, continue breastfeeding, counsel the mother on danger signs, and review in five days if not improving.
Traps
- Stopping zinc when diarrhoea stops; the course is 14 days.
- Advising water, honey or prelacteal feeds in the first six months.
- Forgetting the second MR dose.