CHAPTER OUTLINE THE MATERNAL, NEWBORN, AND CHILD HEALTH

AND NUTRITION (MNCHN) STRATEGY

 The current maternal and child health and  In its response to the maternal and child health
nutrition situation situation, the DOH takes into consideration the
 The maternal, newborn, and child health and interrelatedness of
nutrition (MNCHN) strategy - A. direct threats to the life of mothers and
- The MNCHN core package of services children that necessitate immediate health
- MNCHN service delivery network care and risk management
 The reproductive health program - B. underlying socioeconomic conditions that
 The Philippine family planning program (PFPP) hinder the provision and utilization of
 Newborn screening maternal, newborn, and child health and
 Expanded program on immunization nutrition (MNCHN) core package of services.
 Infant and young child feeding The following are the four key to strategies of
MNCHN:
 Integrated management of childhood illness: an
1. Ensuring universal access to and utilization of an
overview
MNCHN core package of services and
THE CURRENT MATERNAL AND CHILD HEALTH
interventions
AND NUTRITION SITUATION
2. Establishment of a service delivery network at
 Pregnancy and childbirth still pose a great risk to
all levels of care to provide the package of
Filipino women of reproductive age maternal
services and interventions;
mortality rate is still high: 162 per 100, 000 live
3. Organized use of instruments for health systems
births (NSO, 2006)
development to bring all localities to create and
 Complications include hypertension, post partum, sustain their service delivery networks
hemorrhage, severe infections, and other medical 4. Rapid build – up of institutional capacities of
problems arising DOH and Philhealth, being the lead national
 Poor birth spacing, maternal malnutrition, unsafe agencies that will provide support to local
abortions and presence of concurrent infections planning and development
 Neonatal deaths within the first week of life are The MNCHN strategy aims for:
often due to asphyxia, prematurity, severe - Every pregnancy to be wanted, planned and
infections, congenital anomalies, newborn tetanus, supported
and other causes - Every pregnancy to be adequately managed
 More than 59% of births take place at home, with throughout its course
more than 25% of the births attended by - Every delivery to be facility based and
traditional birth attendants or hilots (DOH- managed by skilled births attendants/skilled
NEC,2008) health professionals
 This contributes to the three delays that lead to - Every mother and newborn pair to secure
maternal and neonatal deaths: proper post partum and newborn care with
- Delay in identification of complications smooth transitions to the women’s health care
- Delay in referral; and package for the mother and child survival
- Delay in the management of complications package for the newborn
 The likelihood of maternal and neonatal death The MNCHN core packages of services
increases with identified risk factors, namely Pre- pregnancy package
(DOH, 2008): 1. Nutrition
- Having mistimed, unplanned, unwanted and - Nutritional counseling;
unsupported pregnancy - Promotion and provision of micronutrient
- Not securing adequate care during the supplements:
pregnancy 2. Promotion of healthy lifestyle
- Delivering without skilled birth attendance, 3. Advice on family planning and provisions of
i.e attendance by skilled midwives, nurses, or family planning services
physicians, and not having access to 4. Prevention and management of lifestyle related
emergency obstetric and neonatal care; and diseases
- Not having proper postpartum and postnatal 5. Prevention and management of infection
care for the mother and newborn 6. Counseling on STI/HIV/AIDS, nutrition, personal
hygiene, and the consequences of abortion

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 7. adolescent health services
8. provision of oral health services

Pre – natal package

1. Prenatal visits (atleast 4 through pregnancy) and
prenatal assessment
2. Micronutrient supplement
3. Tetanus toxoid immunization
4. Promotion of exclusive breastfeeding, newborn
screening and infant immunization
5. Counseling on healthy lifestyle
6. Early detection and management of complications
of pregnancy
7. Prevention and management of other conditions
where indicated: hypertension, anemia, diabetes,
tuberculosis, malaria, schistosomiasis,
STI/HIV/AIDS
8. Birth planning and promotion of facility based
delivery
Home – based Mothers Record (HBMR)
 HBMR is a simplified record of history of present
and past pregnancies, and measures of the TBA,
BHW, or health professional
 HBMR has been concluded to:
- Provides a means of promoting continuity of
care through a woman’s reproductive life;
- Promotes early recognition of women who are
at risk at developing conditions
- Encourages self care where appropriate and
referral suited to the needs of the woman;
- Supports initiation of appropriate care
- Serves as a useful record of care and health
information and source of health statistics;
and
- Guides the health workers in providing for the
health educational needs of the client
Childbirth Package
1. Skilled birth attendance/skilled health
professional assisted delivery and facility based
deliveries including the use of partograph
2. Proper management of pregnancy and delivery
complications and newborn complications
- DOH, philhealth, and who recommend
Essential Intrapartum and Newborn Care
(EINC) or unang yakap
3. Access to basic emergency obstetric and newborn
care (BEmONC) or comprehensive emergency
obstetric and newborn care (CEmONC) services.
Post Partum Package
1. Port partum visits: within 72hrs and on the 7th day
post partum check
2. Micronutrient supplementation
3. Counseling on nutrition, child care, family
planning and other available services

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