Al Neelain University- Faculty of Medicine
semester 7
Primary Health Care Course
Maternal & Child Health
Dr.Abeer Abuzeid Atta El Mannan
Session outlines
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What is MCH care?
Why maternal and child health are linked?
Common MCH problems in Sudan.
Recent trends in MCH care services.
The service components of MCH care.
The main MCH indicators.
MCH care
• Care provided to special group in population
which is especially vulnerable to disease,
disability or death (i.e children and women in
reproductive age group (15-44))
Why mothers and children are linked?
• Constitute large group of population
• Constitute a vulnerable (high-risk ) group
• Sickness and deaths among mothers and
children is largely preventable
• Improving health of mothers and children we
contribute the health of general population
Why Consider Mother and Child as
one unit?
• The fetus is part of the mother during the
antenatal period
• Child health is closely related to maternal health
• Certain maternal diseases during pregnancy have
their effects upon the fetus
• After birth ,the child is dependent on mother
• In the care cycles mother and child services are
inseparable in most occasions
• The mother is the first teacher of child
MCH services
• Encompass curative, preventive,and promotive .
Subareas include:
• Maternal health
• Family planning
• Child health
• School health
• Handicapped children
• Care of children in special settings e.g day care
centers .
Recent trends in mch care
• Using integrated approch instead of vertical
programmes
• Using risk approach for beter use of scarce
resources.
• Improving manpower skills including wide
range of health workers .e.g professionals +
field workers.
• Primary health care is essential for making
services availavle to all
MCH problems
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Low birth weight
Congenital malformations
Behavioural problems
Reducation of maternal and child mortality
&morbidity
Spacing of pregnancies
Prevention of communicable diseases
Improvement of nutrition
Promoting the acceptance of health practices.
Common MCH problems in Sudan
A high disease burden and inadequate health services leave children
exposed to the risks of :
• Acute watery diarrhea, malaria, measles .
• Severe underweight, with 35 per cent suffering from stunting.
• Nearly 40 per cent of the population does not have access to clean
water, with nearly 65 per cent not having access to adequate
sanitation.
• The net primary school attendance rates averaged 71.8 per cent,
although only 62.7 per cent actually completed primary school.
• More than a third (37.6 per cent) of girls marry before the age of
18.
• Female genital mutilation and cutting affects 87.6 per cent of
women .
Common MCH problems in Sudan
(Cont)
• While 69 per cent of mothers receive ante-natal care, less than half
of those receiving such care benefited from basic procedures such
as checking blood pressure.
• Only 49 per cent of births take place with the help of a trained
health worker.
• Only 19 per cent of births take place in a health facility.
• More than 10 per cent of all pregnancies result in stillbirths.
• Complications in pregnancy and childbirth, combined with a lack of
adequate obstetric care services, leaves Sudan with one of the
world's highest mortality ratios at 1,107 deaths per 100,000 live
births.
Common MCH problems in
Sudan(cont)
• Only one-third of infants are exclusively breastfed in Sudan for the first six
months of their life
• One-tenth of children under the age of five are severly underweight,
• More than 15 per centof children are severely stunted, while just over 3
per cent are severely wasted.
• Consumption of iodised salt - vital in prevention against goitre and a
valuable contributor to a child's mental and physical development - is just
11 per cent.
• More than 20 per cent of children under the age of five have never
received vitamin A supplements, critical to strengthening immunity to
disease.
Common MCH problems in Sudan
(cont)
• Less than one-third of children receive all the
recommended vaccinations before their first
birthday.
• The proportion of fully immunized children
ranges amongst states from a high of 72 per
cent to a low of just 5.5 per cent.
Common MCH problems in Sudan
(Cont)
• While more than a third of households have access to a mosquito net,
only 18 per cent use an insecticide-treated net - the most effective
protection against malaria.
• Less than 30 per cent of children under the age of five sleep under such a
net. Very few young children - 2.6 per cent - receive anti-malarial
treatment within 24 hours of showing symptoms of the disease.
• Infants also face societal threats in parts of Sudan. An average of 110 new
born babies were being abandoned in Khartoum every month, with half
estimated to die before receiving any assistance.
• Economic pressure on families, and the stigma associated with children
born out of wedlock are major factors leading to abandonment.
The stages in maternity cycle
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Fertilization
Antenatal or prenatal period
Intranatal period
Post-natal period
Interconceptional period
Childhood age-periods
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Infancy (up to one year of age )
Neonatal period (first 28 days of life)
Post neonatal period (28the day to 1 year)
Preschool age (1-4 years )
School age ( 5-14 years)
Indicators of MCH
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Maternal mortality ratio
Mortality in infancy and childhood
Perinatal mortality rate
Neonatal mortality rate
Post-neonatal mortality rate infant mortality rate
1-4 mortality rate
Under5 mortality rate
Child survival rate.
National MCH indicators
(Unicef Sudan- Latest estimates )
• Under-five mortality rate of 83 deaths per 1,000
live births.
• The infant mortality rate is 60 deaths per 1,000
live births.
• Maternal mortality ratio of 215 deaths per
100,000 live births.
• Nearly half of children have not been fully
immunized.
• Nearly 60% of children have their births
registered.
Assignment
• For each MCH indicator ;
1. Provide a definition
2. State the formula for caculating it
3. Mention main causes of mortality measured
by that specific indictor
4. State how to prevent mortality measured by
that indicator.
Thank you