S1: Maternal and Infant public health CHECK ILOs BEFORE LEARNING Flashcards
What are the three domains of public health?
Health improvement
Health protection
Healthcare public health
What is meant by maternal health?
- Health of women during pregnancy, childbirth and postpartum period
- Encompasses the healthcare dimensions of family planning, pre-conception, prenatal and postnatal care
- Ensure a positive and fulfilling experience in most cases and reduce maternal morbidity and mortality in other cases
Why the antenatal and newborn screening period a good opportunity for health promotion?
During this period women (and babies) are in regular contact with health professionals
Plenty of opportunity to give advice about health and wellbeing, screening for health conditions etc…
What factors impact the birth experience?
Wider context - Socio-cultural context - Housing and sanitation - Family/peer support - Infrastructure More specific → Empowerment → General health → Access to healthcare → Skilled birth attendance → Socioeconomic → Health literacy → Advocacy
How can maternal health be measured?
Maternal mortality ratio
Calculated:
- All maternal deaths occurring within a reference period (usually 1 year) / total number of live births occurring within the reference period
- X100,000
represents the risk associated with each pregnancy
What are the pros and cons to this method of measuring maternal health?
Pros
- Good indicators of general population health plus the status of women, health services etc…
- Advocacy purposes
- Methods to get around missing data
Cons
- Doesn’t not include all pregnancies in the denominator → only the ones that resulted in live births → misses out deaths associated with unsafe abortion, miscarriage etc…
- Difficult to get data required
- Does not detail causes of mortality
Define maternal death?
ICD-10, death of a women while pregnant or within42 days of the end of pregnancy (excluding accidental or incidental causes)
- Direct
- Indirect
Define late maternal death?
Indirect or direct causes >42 days but <1 year post pregnancy
Why do women die?
Bleeding Infection High BP Delivery complications Unsafe abortion
What are the underlying causes to the causes of maternal death?
- Lack of antenatal care (high BP, unsafe abortion)
- Lack of intrapartum care (delivery complications)
- Lack of postnatal care (infection, bleeding)
Caused by
- Poverty
- Distance
- Lack of information
- Inadequate services
- Cultural practices
What are the three phases to delay to seeking or receiving adequate care?
Phase 1 delay → A delay in deciding to seek care
Phase 2 delay → A delay in reaching an adequate health care facility
Phase 3 delay → A delay in receiving adequate care once at a facility
Not exclusive, can feed into each other but any one can then be fatal
Why is it important to recognise and change inequalities in maternal health and care?
Far reaching consequences
Affects the child throughout life
Inequalities before birth have an impact throughout life at each stage and affects life expectancy
What is important to remember about maternal care?
No just about the pregnancy
About the freedom to decide, if, when and how often to do so
Women should be able to decide safely not to have pregnancies
What can be done about maternal mortality?
- Addressing inequalities in access to and quality of reproductive, maternal and newborn health care services
- Ensuring universal health coverage for comprehensive reproductive, maternal and newborn health care
- Addressing all causes of maternal mortality, reproductive and maternal morbidities and related disabilities
- Strengthening health systems to collect high quality data in order to respond to the needs and priorities of women and girls
- Ensuring accountability in order to improve quality of care and equity
- Timely management and treatment can make the difference between life and death for the mother and the baby
Why does morbidity need to be considered as well?
- Birth injury e.g. fistula can lead to disability and stigmatisation
- Psychological morbidity - mental illness
