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Maternal & Child Health (MCH) | Top

Maternal & Child Health (MCH)

Posted by: | on May 27, 2014

Maternal & Child Health (MCH)

Maternal & Child Health (MCH)

Pakistan is one of the countries with a high maternal and infant mortality rates. Women, especially pregnant women suffer even at primary care level due to a lack of properly trained and skill health care worker in the community.To overcome this issue the Mother & Child Health Care Centre, training Institute has been established.

Mother and Child Health

It is a branch of Public Health which is planned for the supervision of health of mother and child not only Physical but also Mental, Social & Emotional Health.

Aims & Objectives

The main aims and objectives of MCH include,

  1. Making available the best possible care during pregnancy, labour and puerperium.
  2. Providing best possible care to the children while they are growing and are vulnerable.

Reasons for MCH Services

MCH Services

MCH services are key to achieve an acceptable level of health.

Basic Characteristics of MCH Services

  1. Target oriented services – well defined objective.
  2. To achieve the target special functions & activities are to be carried out.

Levels of Prevention in MCH

a)     Primary prevention

b)    Secondary prevention

c)     Tertiary prevention


a)   Primary Prevention

Activities designed to promote

b)   Secondary Prevention

c)    Tertiary Prevention

Goals of MCH Services

Aims / Objectives

The Aims/Objectives are to be Achieved Through

Components of MCH

Main components of the MCH are following,

  1. Maternal Care
  2. Child Care
  3. Others (Miscellaneous)

1.     Maternal care

Child care



2.     Child health

  1. Infant mortality rate
  2. Under five mortality rate

Maternity Cycle

There are following stages in maternal cycle.

  1. Fertilization
  2. Antenatal Care
  3. Intra natal Care
  4. Postnatal Care

Antenatal Care

Antenatal care is the care of woman during pregnancy.


  1.  To promote, protect and maintain the health of mother during pregnancy.
  2. To detect “HIGH RISK” cases and give them special care.
  3. To foresee complications and prevent them.
  4. To remove anxiety and dread associated with delivery
  5. To reduce maternal infant mortality and morbidity.
  6. To teach the mother elements of child care nutrition, personal hygiene, and environmental sanitation.
  7. Referral, in case of any risk factor associated.
  8. Recommend hospital birth for high risk pregnancy.
  9. To sensitize the mother to the need for FAMILY PLANNING ,including advice to cases seeking medical termination of pregnancy; and
  10. To attend to the under -5 accompanying the mother

Antenatal Visits

History on First Visit

  1. Name
  2. Age
  3. Address
  4. Date of last menstrual period (LMP)
  5. Calculate EDD
  6. Gravidity (no. of pregnancies)
  7. Ask about risk factors during pregnancy as
  8. H/o spotting, bleeding
  9. Burning micturition
  10. Foul smelling vaginal discharge
  11. Headache, vomiting
  12. Previous injuries, especially to pelvis.
  13. Any medical problem like hypertension diabetes TB.

Medications Currently Being Taken


  1. General Physical Examination
  1. P/A  Examination (according  To period of gestation)
  2. Assess fundal height

Preventive Services for Mothers

Preventive services for mother includes,

  1. Prenatal Services
  2. Lab Investigations
  3. Subsequent Visits

Prenatal Services

a)     Health  History

b)    Physical Examination

c)     Lab investigations

d)    Complete urine

e)     Stool examination

f)      C/B count, Hb

g)     Serological exam

Lab Investigations

On subsequent visits

  1. Physical examination
  1. Lab Tests
  1. Iron folic acid supplements
  2. Immunization against tetanus
  3. Instructions on nutrition, family planning, self-care, delivery and parenthood.
  4. Home visiting by female health worker or trained Dais.
  5. Referral services where necessary

Risk Approaches

Risk Factors

  1. Elderly primi less than18yrs (30 YRS)
  2. Short stature primi (LESS THAN 140 CM)
  3. Weight :underweight ,overweight ,when no weight gain
  4. Gravida: multi gravida having 5 or more children
  5. malpresentation
  6. Ante partum Hemorrhage
  7. Pre-eclampsia and eclampsia
  8. Anemia
  9. Twins hydromnios
  10. Previous stillbirth, intra uterine death, manual removal of placenta
  11. Prolonged pregnancy 14 days –EDD
  12. H/O Previous C-Section or Instrumental Delivery
  13. Pregnancy assessment with general diseases renal ,diabetes TB ,liver disease
  14. Elderly grand multipara

Any other problem associated with current pregnancy

E.O.C. (Essential Obstetric Care)

Eight essential obstetric functions are following,

  1. Surgical functions.
  2. Anesthetic function.
  3. Medical treatment.
  4. Blood replacement.
  5. Manual removal of placenta.
  6. Family planning functions.
  7. Management of women at particular risk.
  8. Neonatal special care.

Intranatal Care

a)     Nutrition

b)    Child health

c)     Family

Routine Delivery Care

Danger Signals during Labour

3’ Delay Model

a)                  They may not recognize the signs of life threatening complication (Delay one)

b)                They may postpone deciding to seek care (delay two)

c)                 It may postpone take too long to reach appropriate care (delay three) Women may receive substandard or slow care at health facilities (delay four)

Postnatal care

Postnatal Visits

1st Visit: within 12 hours

2nd Visit: 3rd Day

3rd Visit: 7th Day

After Delivery (Mothers)

After Delivery (Newborn)

Care of the Infant

Immunization of Mother

Current Programs in MCH

Health Personals providing MCH Services

  1. Lady Health Visitors (LHVs)
  2. Midwife
  3. Trained Dai
  4. Traditional Birth Attendants (TBAs)

Lady Health Visitor

  1. Incharge of MCH centre
  2. Provides Static MCH services
  3. Conducts Home visiting


a)     Matric

b)    One year Midwifery course form Midwifery school

c)     Nurse Midwife She is a qualified Nurse who receives one year Midwifery Training form Midwifery school

Trained Dai

A trained Dai is a trained person who receives one year training from MCH center. She is regular employ a health department.

Traditional birth attendant (TBA)

Person who has learnt the skill through practice or working with predecessor and assists in child birth, having no or little formal organizational training is called Trained TBA.TBAs receive training (15 days – 3 month ) on clean and safe delivery

Duties of LHV

  1. Lady Health Visitor Course
  2. Registered LHV with PNC

Prenatal Care

Delivery Care

a)     Arrange referral postnatal complication

b)    Advise care of their health

c)     Advise mothers on family planning & child spacing

Care of the Infant

Supervision of Trained Dais / TBAs / LHWs

Nutrition Advice

Notifications to Authorities

The LHV will report to the Assistant Director or Municipal Health Officer or concerned health authorities through prescribed channel on:


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