.

MAGNITUDE OF MATERNAL AND

CHILD HEALTH PROBLEMS
 Qudrat un nissa
 Msc nursing
 OBG
 Introduction

 Maternal and child health is recognized as one of the significant

components of Family Welfare. Health of both mother and
children is a matter of Public Health concern. It is also being
observed that the deaths of mothers and children are the major
contributors to mortality in any community in India. Maternal
and Child Health care services are essential and specialized
services because mothers and children have special health needs
which are not catered to by general health care services.
DEFINITION OF MATERNAL AND
CHILD HEALTH

 Maternal and Child Health (MCH) refers to a package of

comprehensive health care services which are developed to meet
promotive, preventive, curative, rehabilitative health care of
mothers and children
. OBJECTIVES OF MATERNAL AND
CHILD HEALTH


To reduce maternal, infant and childhood mortality and morbidity.

 To reduce perinatal and neonatal mortality and morbidity.

 Promoting and satisfying safe sex life

 .Regulate fertility so as to have wanted and healthy children when desired.
 Provide basic maternal and child Health Care to all mothers and children.
 Promote and protect health of mothers.
 To promote reproductive health.
 To promote physical and psychological development of children and adolescents with in the
family.
DEFINITION OF MATERNAL HEALTH
/REPRODUCTIVE HEALTH
  Maternal Health is now referred as "Reproductive Health” (RH).
According to WHO it is defined as a state of complete physical,
mental and social wellbeing and not merely the absence of
disease or infirmity in all matters relating to the reproductive
system and its functions and processes.
GOALS OF MATERNAL AND CHILD
HEALTH SERVICES 
 To ensure the birth of a healthy infant to every expectant mother.
 To provide services to promote the healthy growth and development of children up to
the age of under- five- years.
 To identify health problems in mother and children at an early stage and initiate
proper treatment.
 To prevent malnutrition in mothers and children.
 To promote family planning services to improve the health of mothers and children.
 To prevent communicable and non- communicable diseases in mothers and children.
 To educate the mothers on improvement of their own and their children’s health
MATERNAL HEALTH PROBLEMS

  The Maternal Health Problems are as follows:-

 I. Nutritional Problems
 a)Malnutrition b)Nutritional Anaemia
 II. Infection Problems a)Reproductive Tract Infections ( RTIs)/
Sexually Transmitted Infection (STI) b)Infection in general
c)Puerperal Sepsis
 III. Disturbances and Menstruation
 IV. Mature Gravidas
 V. Adolescent Gravida
 VI. Adolescent Parents Problems
NUTRITIONAL PROBLEMS
A.MALNUTRITIO
 Malnutrition is a very common problem among women who are
discriminated and underprivileged. Pregnant and nursing mothers are
especially prone to the effects of malnutrition. Malnutrition can cause
poor resistance, abortion, anaemia, miscarriage or premature delivery,
low birth weight baby (<2.5kg), eclampsia, postpartum haemorrhage.
These conditions can cause fatal effects on mothers, unborn and new
born babies. Malnutrition in women needs to be prevented and treated
by some of the direct measures such as nutrition education, modification
and improvement of dietary intake before, during and after pregnancy,
supplementation of diet, distribution of iron and folic acids tablets,
subsidizing of food items and their fortification and enrichment
B.NUTRITIONAL ANAEMIA

  Anaemia in pregnancy is defined as a haemoglobin concentration

of less than 11g%.Anemia is a condition in which concentration
of haemoglobin in the red blood cell is reduced. Haemoglobin is
essential for life. It carries oxygen to all parts of the body for its
development and day to day function. It also maintains the
immune system which provides resistance to infection. Therefore,
an anaemia person acquires infection easily. Brain also gets less
oxygen if a person is anaemic.
MAGNITUDE OF THE PROBLEM

 More than half of the pregnant women during pregnancy suffer from
anemia.13%are severely anaemic. Haemoglobin is less than 7 gm/ decilitre.
 1/5 of all maternal deaths are attributed to anaemia during pregnancy.
 More than half of the adolescent girls are anaemic Anaemia during
pregnancy leads to :
 20% of maternal deaths
 3 times greater risk of premature delivery and LBW babies
 9 times greater risk of perinatal mortality
 Irrecoverable brain damage in infants born to severe anaemic mother.
 PREVENTION OF NUTRITIONAL
ANAEMIA
 Promoting consumption of iron rich food
 Promoting growth of iron rich at home will increase the
availability of iron in food, like spinach, lemon, amala , etc.
 Promoting consumption of iron and folic acid supplements.
INFECTION PROBLEMS A.REPRODUCTIVE
TRACT INFECTIONS/STD

 RTIs include a variety of bacterial, viral and protozoal infections

of the lower and upper reproductive tract of both sexes. RTIs pose
a threat to women’s lives and well being throughout the world.
 Vaginal discharge is amongst the first 25% reasons to consult a
doctor. 40% gynaecological OPD attendance is because of RTIs
and 16 % of gynaecological admissions and due to pelvic
inflammatory disease (PID)
 CAUSE OF RTI/STD

  Infections caused by overgrowth of organism normally found in

the vaginal tract are known as endogenous infection. These
infections are associated with inadequate personal, sexual and
menstrual hygienic practices.
  Sexually Transmitted Diseases (STDs) are a specific group of
communicable diseases that are transmitted through sexual contact.
  Infections which are due to inadequate medical procedures such
as unsafe abortion, unsafe delivery or unhygienic IUD insertion are
known as iatrogenic infections
SIGNS AND SYMPTOMS OF RTI IN
WOMEN: 
 Increased discharge from the vagina that looks and smells different from ( change in amount, colour and smell)
 Pain or burning while urinating.
 Painful or painless sores, blisters or warts on or near the genitals.
 Pain on one or both sides of lower abdomen.
 Irregular menstrual periods.
 Pain or bleeding during intercourse.
 Rash on the entire body or just on the palms and soles.
 Swelling on one or both sides of the groins. In Men:
 Symptoms usually appear within 2-3 days or a couple of weeks or even months after having sex with an infected
partner are:
 Pus or discharge from the penis.
 Burning or pain while urinating.
 Painful or painless sores, blisters or warts on or near the penis.
 Pain in one or both the testicles
PREVENTION OF RTI/STD

   Identify the women with RTIs/STI

 Refer the women to medical officer of PHC promptl y for
examination and treatment.
 Identify sexual partners and ensure their treatment.
 Advice correct use of condom during every sexual act.
 Provide counselling/health education to individuals, family and
community.
INFECTION IN GENERAL

   The women during pregnancy, especially in underdeveloped

areas and developing countries are at risk of contact infection.
Many women get infected with herpes simplex virus,
cytomegalovirus, protozoon which causes toxoplasmosis Coli
causing nephritis or cystitis.Infection during pregnancy can cause
various harmful effects e.g. retardation of foetal growth, abortion,
low birth weight baby and puerperal sepsis. It is very important
that women during pregnancy need to alert and careful regarding
prevention and control of infection.
PUEPERAL SEPSIS

  It is mainly due to infection during labour and after delivery because of lack of personal
hygiene, insanitary conditions, septic procedures, etc. This may lead to inflammation of
ovaries, fallopian tubes, endometrium, cervix and vagina. Many time leucorrhoea may
persist for years. Some times secondary sterility may follow after acute or chronic
salpingitis. Chronic infections of cervix may predispose to cancer of the cervix. It requires
proper preparations for confinement by the mother, conduct of deliveries by trained and
skilful dais, midwives etc. And availability of equipment's and supplies etc. It is mainly
due to infection during labour and after delivery because of lack of personal hygiene,
insanitary conditions, septic procedures, etc. This may lead to inflammation of ovaries,
fallopian tubes, endometrium, cervix and vagina. Many time leucorrhoea may persist for
years. Some times secondary sterility may follow after acute or chronic salpingitis.
Chronic infections of cervix may predispose to cancer of the cervix. It requires proper
preparations for confinement by the mother, conduct of deliveries by trained and skilful
dais, midwives etc. And availability of equipment’s and supplies etc.
DISTURBANCE AND MENSTRUTION
 Amenorrhoea, , dysmenorrhoea, hypermenorrh oea/ menorrhagia and ,
metrorrhagia. Menstruation is perceived as a particular problem for
women
 HEALTH TEACHING REGARDING MENSTRUATION
 Knowledge of the physiological process.  Factors that may alter the
menstrual cycle, stress, fatigue, exercise, acute or chronic illness,
changes in climate, or working hours and pregnancy.
 Personal hygiene
 Mild Exercise
 Diet
 Sex during menstruation
MATURE GRAVIDAS

 The pregnant woman over 35 years faces

unique problems. The primigravida in this age
category has generally decided to postpone
child bearing until her career is well established
 They feel unable to take care of themselves and
often have little experience in relying on others
during times of need.
 The educational level of the client must be
considered when recommending literature.
ADOLESCENT GRAVIDAS
 The adolescent mother and her family create a
particularly difficult problem. The need can be so
extensive that care will be fragmented and ineffective
unless and interdisciplinary team approach
coordinates the school, social and health care services.
 The mean age of menarche is around12 years.42% of
girls and 64 % of young boys are sexually active by
age of 18.A family’s reaction to teen age pregnancy
varies considerably. In certain ethnic and cultural
groups, teenage parenting is common.
 Sex education and family planning helps the
adolescent gravida
ADOLESCENT PARENTS PROBLEMS

 Adolescent parents are rarely able to support themselves and

their children. Optimally, the family should be involved early.
Detailed arrangements must be worked out, and allowing
enough time before delivery makes the crisis less
overwhelming. Building on supplementing family resources
and only substituting for families when absolutely necessary
is believed to be the most effective way to help adolescents
and their infants.
 Today, a pregnant woman has three choices, to abort, to have
the child place it for foster care or adoption, or to have the
child and raise it. Adolescents parents have the same choices,
but may need to guided through the decision making process.
UNREGULATED FERTILITY

  Unregulated fertility has been recognized to cause many

maternal health hazards. These include abortions, miscarriage,
premature deliveries, low birth weight babies,APH etc All these
health hazards are responsible for high maternal and perinatal
mortality. It is being recognized to regulate fertility by integrated
and comprehensive approach in family welfare services which
include effective measures related to reproductive health, child
health and family planning
ABORTIONS
  20% of maternal mortality is directly related to
abortion related causes. The number of abortions is on
the increase because of unwanted pregnancies. Medical
Termination of Pregnancy (MTP) has been legalized
under the MTP Act of 1971, under certain conditions.
By and large abortions are still done by quacks and
unauthorized persons in the rural areas. This is mainly
due to lack of access to safe abortion clinics, non-
availability of such clinics, poor financial resources to
reach to clinics in urban areas, lack of information
about the availability of safe abortions clinics, lack of
privacy and impersonal atmosphere in the Government
run clinics and reluctance of unmarried or widowed.
COMPLICATIONS OF DELIVERIES

   In India most of the deliveries take place at home under

unhygienic environment and mostly by untrained dais lacking
obstetric skill. Often various health hazards results in such as
perineal tears, cervical damage, prolapse and displacement of
uterus, fetal distress, postpartum haemorrhage etc. Thus it is very
important to have properly trained, skilful and qualified health
workers, adequate facilities and well linked referral units where
skilful and efficient emergency care can be given to save mother
and baby.
INFERTILITY

 Infertility is both medical and social problem Even if the

fault/defect is in the male partner, usually it is the woman who is
labelled and is socially not treated properly by the family and the
society. Therefore this problem is to be considered medically as
well as socially. There is need to have empathetic attitude
towards childlessness of woman by society
UTERINE PROLAPSE

   Uterine prolapse is the major problem in women of hilly

region. Women working at construction sites, climbing heights, or
digging and ground or climbing 2-3 storey with heavy weights
are predisposed to prolapse uterus. Certain child birth practices
such as fundal pressure during labour, pulling the baby etc. Lead
to prolapse of the uterus, especially when the mother is weak and
malnourished. Uterine prolapse may cause lot of inconvenience
to mother and predispose her to infection. Hence the need for
trained and skilful dais and midwives, improvement of working
conditions and education of women.
CANCER OF CERVIX

   Cancer of the cervix is very common among

Indian women. There are various factors which
contribute to the prevalence of cancer of cervix.
These are early marriage and early pregnancy,
multiple child birth, poor hygiene by the male
partner, multiple partners, and repeated infections.
Most of these factors are pertaining to sociocultural
aspects of a community and families are imply
involving attitudinal change in these practices to
prevent the occurrence of cancer of the cervix.
CHILD HEALTH PROBLEM
CHILD HEALTH PROBLEMS

 CHILD HEALTH PROBLEMS

 Nutritional deficiency Problems a) Malnutrition b) Vitamin
Deficiency c) Iron Deficiency d) Low Birth Weight
 Infectious Diseases a)Tuberculosis b)Diphtheria c)Pertussis
(Whooping Cough) d)Tetanus e)Poliomyelitis f)Measles
 Problems of Neonates a)Hyper bilirubinaemia b)Hypothermia
c)Neo-natal tetanus d)Birth asphyxia
NUTRITIONAL DEFICENCY PROBLEMS
MALNUTRITION
 The primary cause of malnutrition is inadequate and faulty diet.
Apart from poverty and other socio economic factors,
environmental factors also play an important role in aggravating
the dietary deficiency diseases. These precipitating factors are the
widespread chronic infections among the poor living under
conditions of poor environmental sanitation and personal hygiene
REASONS OF MALNUTRITION IN
INDIA
 Food availability
 Poverty
 Population problem
 Socio factors-diet ,caste ,alcohol
PROTEIN ENERGY MALNUTRITION

 Protein Energy Malnutrition is defined as a range of pathological

conditions arising from coincident lack of varying proportions of
protein and calorie, occurring most frequently in infants and
young children and often associated with infection. -WHO 1973
 CLINICAL FORMS OF PEM
 : KWASHIORKOR
 MARASMUS
 CONTD

 KWASHIORKOR:
Kwashiorkor is the condition of
deficiency of protein with an adequate
supply of calories.
 MARASMUS: Marasmus results
from general malnutrition of both
calories and protein. It is common
occurrence in underdeveloped
countries.
CAUSES OF PEM

 a)Nutritional Factors
  Poor caring practices include
  Not feeding the sick children.
  Not providing the adequate complementary feeding.
  Not supporting mothers to breast- feed adequately.
  Non – breastfed.
  Late weaning.
  Inadequate supplementation.
  Failure to feed during illness.
  Failure to increase to caloric intake immediately after the illness. 
Contd...

 b)Non – Nutritional Factor

 Due to poverty, mother is not able to provide sufficient food to the child
resulting in under nutrition.
 Non- immunization
 Improper growth monitoring.
 Poor weight gain during adolescence
 Poor environmental and personal hygiene.
 Illiteracy
 Large family
SIGNS OF SYMPTOMS OF PEM
VITAMIN DEFICIENCY VITAMIN A
DEFICIENCY

  Vitamin A deficiency is a major nutritional problem affecting young children leading to

blindness. In India about 5 – 7 % children suffer annually from eye damage caused by
vitamin A Deficiency
 . CLINICAL FORMS OF SEVERE VITAMIN A DEFICIENCY:
 Xeropthalmia
 Night blindness
 Bitot spots
 Conjunctival xerosis
 Corneal xerosis
 Keratomalacia
 Corneal scars
 MANAGEMENT OF PEM

 Adequate nutritious diet either by breastfeeding or a proper weaning diet.

 5 grams of protein/ kg body weight/day should be given for the existing
weight.
 Rehydration with an oral rehydration solution that also replaces electrolytes
 . Treatment of infections. Medications such as antibiotics and antidiarrheal.
 Health education
 Diet rich in fat and calories is given
 Vitamin A should be given
 Folic acid should be given
MANAGEMENT OF VITAMIN A
DEFICIENCY
Immediately on diagnosis, water soluble 1,00,000 IU of vitamin A
intramuscularly can be given for corneal xerosis, ulcer, keratomal
-acia, xerophthalmia, severe infection and malnutrition.

 Immediately on diagnosis for less severe forms like night

blindness, conjunctival xerosis, Bitot’s spot, oil solutions as
palmitate 2, 00,000 IU can be given orally.
  On second day oil solution of 2, 00, 000 IU orally should be
given prior to the discharge from the hospital.
PREVENTIVE MEASURES

  Nutrition and health education should be given to the mothers.

 Pregnant and lactating mothers should be encouraged to consume
dark green leafy vegetables and yellow or orange fruits so that there
is sufficient storage in vitamin A in the liver of new born.
 Mothers should be motivated to feed their children as vitamin A
present in the milk is adequate for 3 to 6 months of infant’s life.
 The weaning diet should be consist of dark green leafy vegetables,
yellow or orange fruits, whole milk, butter, fish and egg.
 Monitor vitamin A periodically.
. VITAMIN D DEFICIENCY

 Deficiency of vitamin D causes rickets in young children in the

age group of 6 months to 2 years. It reduces calcifications of
bones which affects growth of bones and cause deformity of
bones such as curved legs, pigeon chest, rickety rosary, deformed
pelvis. There is delayed teething, standing and walking. It is no
more a serious problem because of improvement in child health
care services, socio-cultural practices, plenty of available
sunshine. Food rich in vitamin D such as butter, cheese, egg yolk,
liver, fortified food such as milk, Vanaspati oil etc. Fish liver oil
is very good source of vitamin D .
IRON DEFICIENCY

 The iron deficiency causes nutritional anaemia in children. About

50% of children have anaemia. It is due to malnutrition. It usually
leads to various others problems such as general weakness
affecting work performance, reduced immunity and resistance to
infections resulting in increased morbidity and mortality. It
affects physical and psychological behaviour of the children.
Anaemia is aggravated by worm infestation and malarial
parasites.
ROLE OF NURSE IN IRON DEFICIENCY

 Encourage mothers and family members to monitor growth and development

of their children and to bring them to health centres for regular check up and
record weight, height etc.
 Ensure 100% coverage of administration of vitamin A mega doses to
children.
 Help and guide health workers and mothers detect early cases of malnutrition
and other nutritional deficiencies such as vitamin A, iron and vitamin D and
refer them to health centres as the need to be.
 Guide and supervise health workers to participate in nutrition programmes
like Integrated Child Development Scheme, Nutritional Anaemia prophylaxis
programme, midday meal programme.
LOW BIRTH WEIGHT

 Low birthweight is a major public health

problem in many developing countries.
About 30 %of babies born in India are low
birth weight as compared to 4%in some
developed countries. In countries when the
proportion of low birth weight is high the
majority are suffering from fetal growth
retardation.
 The causes of LBW are malnutrition
,anaemia ,infection ,high parity ,smoking ,etc.
 CLASSIFICATION OF LBW
 Preterm babies: Babies born before 37weeks or less than 259 days.
 Small for date: Infants birth weight below 10th percentile for the gestational age
 MANAGEMENT OF LBW NEWBORN
 Provide warmth
 Exclusive breast feeding
 Prevent infections
 Teach mother to recognize danger signs
 PREVENTION OF LBW BABIES
 Increasing food intake
 Controlling infection

 Early detection of conditions or problems and treatment of disorders

INFECTIOUS PROBLEMS
TUBERCULOSIS
 It is a communicable disease suffered by all ages. It is a problem
in community. It is an infectious disease caused by
mycobacterium tubercul osis. The major source of infection is
infected sputum of persons having tuberculosis who are either not
being treated or not being fully treated.
 Tuberculosis affects all age group. The incidence of infections
increases sharply from infancy to adolescence. 1% of children in
the age group under five are infected with tubercle bacilli as
evidenced by tuberculin test.
 MAGNITUDE OF PROBLEM:
 15 million cases of infectious tuberculosis at present  2-3
million cases are added every year
 1-2 million people die every year.
 PREVENTION AND CONTROL OF
TUBERCULOSIS 
 Specific protection by BCG.
 Improving general health and resistance of
children
 Early identification and treatment
 Regular treatment and follow up
 Educate parents family members and community
 Health supervisor must supervise and guide health
workers.
DIPHTHERIA
  Diphtheria is very serious disease because if
it is not treated immediately it leads to high
mortality. It is caused by Corynebacterium
diphtheria. Diphtheria is transmitted by
direct droplet and direct airborne. The
incidences of diphtheria are highest in the
age group of 1-3 years. incubation period of
disease is 3-4 days.
MAGNITUDE OF THE PROBLEM

 Diphtheria is a worldwide problem in most

developed countries owing to routine children
vaccination. In India, it is an endemic disease.
Fatality rate on an average is about 10 % which
has changed little in the past 50 years in
untreated cases and about 5 % in treated cases.
PREVENTION AND CONTROL OF
DIPHTHERIA
 Diphtheria is preventable by specific protection by
immunization of all children with diphtheria toxoid.
 The children should be immunized as early as possible
so as to protect them before they lose their natural
immunity.
 The immunization of diphtheria is done by combined or
mixed vaccines which include diphtheria, pertussis and
tetanus vaccine (DPT).
PERTUSIS(WHOOPING COUGH
 Whooping cough is an acute infectious disease
causing complications and high mortality in
many parts of the world. It is caused by
Bordetella Pertussis. The source of infection is
infected human being
 The period of incubation usually ranges from 7
– 14 days, but in any case not more than 21
days.
 Prevalence is more in children living in
overcrowded homes and slums. The disease
affects trachea, bronchi and bronchioles
. MAGNITUDE OF THE PROBLEM
 Whooping cough: occurs endemically and epidemically in tropical countries.
Since the reporti ng of whooping cough is inadequate, reliable information about
the incidence of this diseases lacking in most countries. About 10 percent of all
whooping cough cases and about half of the death occur in children under one
year.
 PREVENTION AND CONTROL OF WHOOPING COUGH
 The occurrences of pertussis can be prevented by immunization of children which
is done in combinations with diphtheria and tetanus.
 The child either having or suspected having whooping cough should be isolated
as far as possible
 The usual treatment is administration of antibiotic to control secondary infections
 Clothes, fomites should be disinfected and discarded properly to prevent spread
of infections
TETANUS
  Tetanus is an acute and highly fatal disease. It is caused by
clostridium tetani which is as pore forming bacteria
 Infections enter the body through injury which gets
contaminated
 Infections can take place by many other ways for example during
delivery and after delivery, while cutting the cord and thereafter
by improper care of the cord, extraction of teeth, injections,
tattooing, gangrenous foot, otitis media etc.
 The usual average incubation period ranges from 6-10 days.
 The mortality rate is very high (40-80%). It is highest in
neonatal tetanus (80-90%).
MAGNITUDE OF THE PROBLEM

  It is one of the leading causes of infant mortality

  5 to 10 percent of neonatal deaths in Calcutta were due to tetanus
 PREVENTION AND CONTROL OF TETANUS 
 T.T immunization is done soon after road injury especially if T.T
immunizationsu
 T.T immunization are not done with in 5 years.
  In addition, all wounds and injuries should be thoroughly cleaned and
covered with sterilized dressing aseptically.
  Tetanus can be prevented by active immunization by tetanus toxoid of all
antenatal mothers and children according to national immunization schedule
POLIOMYELITIS
 Poliomyelitis is a crippling disease as it causes
lameness. It is caused by virus. The virus is found
only in human beings. The source of infections is
human faeces and or pharyngeal secretions of an
infected person
 . The disease occurs in children under five years of
age, but mostly between 6 months and 3 years.
 The incubation period ranges from 3 to 35 days
but usually the clinical signs appear 7to 14 days
after the infections
 PREVENTION AND CONTROL OF
POLIOMYELITIS 
  Poliomyelitis is prevented and eradicated by immunization
of all infants by 6months of age. Ther e are two types of
vaccines which are used. These are inactivated polio vaccine
(IPV) and Oral Polio Vaccine (OPV). Three doses of OPV at
an interval of one month each are recommended by WHO.
 The immunization must be completed by six months; one
booster dose is to begiven at 12-18 months later.
 The health worker must educate parents and family
members about the importance of polio immunization and
motivate them for the same.
MEASLES
   Measles is a worldwide endemic disease. It
occurs more in the winter months.
 children in the age group of 6 months to 3
years are the most susceptible.
 Incubation period 10 days but it ranges from 8
to 16 days. The common complications which
can occur during measles include Broncho-
pneumonia, diarrhoea ,otitis media,
encephalitis etc. depending upon the
nutritional status and general body resistance
of the child.
PREVENTION AND CONTROL MEASLES

 The occurrence of measles can be prevented completely

by achieving an immunization level of 95 percent and
by continuing immunization of children of successive
generation.
 As per National Immunization Programme,
immunization must be done at the age of 9 months by
giving a single dose of 0.5ml of live attenuated vaccine
subcutaneously.
 Health education of people at large to educate about
prevention and control of measles
PROBLEMS OF NEONATES
HYPERBILIRUBINEMIA

 This condition refers to excessive presence of

bilirubin in the blood. It is indicated as pallor of
the skin and eyes. It is either due to physiological
jaundice, RH or ABO incompatibility.
 Physiological jaundice usually disappears with in
days with phototherapy. Jaundice due to RH
incompatibility occurs due to 24 hours and
requires blood transfusion.
HYPOTHERMIA
 The new born baby may go into hypothermia
within one hour of birth, with the temperature
(axillary) falling below 36.5 degree c (97.7
degree F). This happens if proper precautions
are not taken to prevent chilling of the baby.
The woman in the family and birth attendant
should be made aware about drying the baby
after birth, providing skin to skin contact with
the mother and initiating breast feeding
within an hour of birth. Hypothermia is
harmful to the new born, increasing the risk
of the morbidity and mortality.
NEONATAL TETANUS

 Neo- Natal tetanus is the common problem. It is usually due to sepsis

caused by uncleaned delivery and cord care.
 Considering the preventable nature of NNT, WHO has resolved to
eliminate NNT by aiming to reduce the incidence to less than 1 case per
1000 live births. The same goal is accepted by the Indian Government.
The following actions are implemented…
 100 percent coverage of pregnant women with two doses of Tetanus
Toxoid (T.T.)
 100 percent clean deliveries.
 Surveillance of neonatal deaths and investigations of tetanus.
BIRTH ASPHYXIA
 Birth asphyxia is characterized by absent or depressed breathing at birth.
Difficulty in initial breathing is due to variety of reasons such as prolonged
or obstructed labour, prematurity, infection etc. often it can be anticipated.
The following actions should be taken to reduce neonatal deaths due to
birth asphyxia.
 To keep ready the necessary equipment's for management of birth
asphyxia.
 Clearing of air passage immediately as the child is born.
 Ventilating with mask or bag and mask.
 Cardiac massage when brady- cardia persists.
 Mouth to mouth breathing when necessary.
 Training of health workers in the assessment and management of birth
asphyxia.
FACTORS INFLUENCING MATERNAL
AND CHILD HEALTH 
   Maternal health
 Sexuality factor
 Nutrition
 Environmental factor
 Psychological factor
 Ethnic and socio cultural aspects factor
 Lifestyle factors
MATERNAL FACTOR
 As maternal age advances, so does the rate of
aneuploidy. The result is increased rates of
pregnancy loss and birth of infants with
chromosomal anomalies. Most women and men are
aware that advanced maternal age (older than 35
years) may affect a pregnancy adversely. This
awareness is the direct outcome of the adoption
.Information and the considerable media exposure
about this issue through public service campaigns
SEXUALITY FACTOR
 Both the client and her partner may express concerns about
sexuality and intercourse during pregnancy. Although there is
no reason why the healthy woman need abstain from
intercourse or orgasm during pregnancy, some sources suggest
that women should avoid coitus and orgasm in the last 4 weeks
of pregnancy.
  Nipple stimulation, vaginal penetration, or orgasm may
cause uterine contractions secondary to the release of
prostaglandins and oxytocin. Therefore women who are
predisposed to preterm labour or threatened abortion
NUTRITION
 During pregnancy changes must occur to ensure
that gestation progresses and both mother and
fetus remain healthy.
 Nutrition has critical role in pregnancy
outcomes maternal nutritional status at
conception and throughout gestation greatly
influences not only the mother’s health but also
that of the fetus.
 Adequate folate status, which helps prevent
neural tube defects, and control of blood glucose
level, which improves the abilities to conceive
and to give birth to a healthy newborn.
ENVIRONMENTAL FACTOR

 Environmental factor also influence on maternal and child

health. So we have to know about the environment in which the
woman and partner reside and work .Men exposed to toxic
substances such as heat, radiation, viruses, bacteria, alcohol, and
prescription and recreational drugs are more likely to have
decreased morphologically and genetically normal sperm in a
single ejaculate. This results in reproductive failure
preconception and post fertilization. Women exposed to similar
toxic agents experience diminished ovarian reserver, poor
endometrial lining development, and abnormal fetal
development. Likewise, chronic and acute diseases decrease
fecundity and increase fetal wastage.
PSYCHOLOGICAL FACTOR

  Environmental factors such as emotional stress, anxiety, fears,

frustrations, broken homes, poverty and many others can lead to
mental illness. The psychosocial environment at home or school
is an essential factor for health. Children exposed to happy and
healthy homes make them physically and mentally healthy
ETHINIC AND SOCIO CULTURAL
FACTOR
 Culture and family must be viewed simultaneously for,
regardless of the family type, it remains the basic unit of
society and influences human development over the life
span.
 Religious beliefs and practices are part of cultural and
familial heritage and influence health care behaviours.
Within the neighbourhood and community
LIFE STYLE FACTORS

   Health is related deeply to life- style which includes ways of living, personal hygiene, habits and
behaviour. A healthy lifestyle helps to promote health and poor lifestyle has ill effects on health.
 HEALTHY LIFE STYLE CHOICES OF MCH
 Regular exercise
 Weight control
 Avoidance of saturated fats
 Alcohol and Tobacco avoidance
 Seat beat use
 Immunisation updates
 Regular dental check up
 Regular health maintenance.
CONCLUSION
 Maternal and child health is
recognized as one of the significant
components of Family Welfare.
Health of both mother and children
is a matter of Public Health concern