U4: MATERNAL AND CHILD HEALTH Flashcards
Included in the biomedical foundation of public health
Maternal and Child Health
Maternal and Child Health includes?
the mother and child
When does MCH start?
conception and perinatally
T/F: Triple burden of disease involves maternal and child health.
True
T/F: Social problems and inequities that happen in women is also a part of MCH.
True
T/F: Proper child spacing for women is part of MCH.
True
This refers to the loss of healthcare during pregnancy, including no prenatal check-ups and loss of nutrition in mothers due to the bone formation in babies.
proper child spacing for women
Key nutrient: used for proper cell division
Folic Acid
Key nutrients needed in pregnancy
- Folic Acid
- Iron Supplementations
- Vitamin B12
This refers to the effects of maternal stress to the genetics of the child.
Epigenetics
They are people involved in the delivery and care
Primary Health Workers (Midwives and nurses)
Essential Healthcare Programs
β Family Health Program
β Prevention and Control of NCDs and CDs
β Environmental Health and Sanitation
β Vaccinations, immunizations, etc.
Works with local public health departments, organizations, and other providers to assure quality health services
WHO Philippines
Measures of the responsiveness of the public health system to women and their families
- Crude Birth Rate
- General Fertility Rate
Primary Areas of Work Focus
lessen the risk of maternal deaths
Increasing health birth outcomes
Primary Areas of Work Focus
Newborn screening, children with special healthcare needs, observed from birth to 21 years old
Promoting and assuring comprehensive primary
care for children
Primary Areas of Work Focus
Promoting health lifestyles among school-age
youth of?
ages 6-21
Primary Areas of Work Focus
Promoting access to?
safe, health child care
Primary Areas of Work Focus
Caring for mothers from ____ until?
pre-conception until post-conception
40% of maternal mortality is related to?
labor, delivery, puerperium
Predisposing factors of MCH Programs
- Hard deliveries
- Preeclampsia
- Lack of access to health service
- Postpartum hemorrhage
Hypertension during normal delivery
Preeclampsia
Pregnant woman can avail the free prenatal services at their respective health center
Antenatal Registration
Ante
before
Prenatal services
- Blood pressure
- Multivitamins
- Necessary nutrients from milk
Used to prevent ultrastructural and brain defects
Lipids, DHA and others
Vit B9 or Folic Acid
Necessary nutrients from milk
Series of 2 doses of tetanus toxoid must be
received by a pregnant woman
Tetanus Toxoid Immunization
How many doses of tetanus toxoid must be received by a pregnant woman?
2 doses
When is tetanus toxoid vaccine given?
- 1 month before delivery
- 3 booster shots after child birth
How many booster shots of tetanus toxoid should be given after child birth?
3 booster shots
Micronutrient Supplementation
Vitamin A and Iron supplements
Prevents anemia and Vitamin A deficiency
Vitamin A and Iron supplements
Women who are diagnosed as under high risk pregnancy
Treatment of Diseases and Other Conditions
Prevention of Preeclampsia
monitoring of blood pressure during delivery
Frequency of Prenatal Visits
First Visit
before 4 months or during the 1st trimester
Frequency of Prenatal Visits
Second Visit
during the 2nd trimester
Frequency of Prenatal Visits
Third Visit
during the 3rd trimester
Frequency of Prenatal Visits
Every 2 weeks
8 months until post-conception
TT1
Minimum Age Interval
as early as possible during pregnancy
TT1
Percent Protected
80%
TT2
Minimum Age Interval
At least 4 weeks later
TT2
Percent Protected
80%
TT2
Duration of Protection
3 years
TT3
Minimum Age Interval
At least 6 months later
TT3
Percent Protected
90%
TT3
Duration of Protection
5 years
TT4
Minimum Age Interval
At least 1 year later
TT4
Percent Protected
99%
TT4
Duration of Protection
10 years
TT5
Minimum Age Interval
At least 1 year later
TT5
Percent Protected
99%
TT5
Duration of Protection
lifetime
Protects against tetanus for mothers and prevents neonatal tetanus in their newborn infants
Tetanus Toxoid
Paralytic toxin of Clostridium tetani
(anaerobic bacterium)
Tetanus
A national mandated priority public health program to attain the countryβs national health development
Family Planning Program
A health intervention program and an important tool for the improvement of the health and welfare of mothers, children and
other members of the family.
Family Planning Program
Provides information and services for the couples of reproductive age to plan their family according to their beliefs and circumstances
through legally and medically acceptable family planning
Family Planning Program
T/F: There is no correlation in no. of children and disease present in the children
False
no time of recovery for women
Principles in Family Planning Program
Each family has the right and duty to determine the
desired number of children they might have and when they might have them.
Responsible Parenthood
Principles in Family Planning Program
Beyond responsible parenthood is?
Responsible Parenting
Principles in Family Planning Program
The proper upbringing and education of children so that they grow up to be upright, productive and civic-minded citizens.
Responsible Parenthood
Principles in Family Planning Program
The 1987 Constitution states that the government protects the sanctity of life.
Respect for Life
T/F: Abortion is not a family planning method.
True
Principles in Family Planning Program
Refers to the interval between pregnancies
Birth Spacing
Principles in Family Planning Program
Ideal birth spacing
3 years
Principles in Family Planning Program
Enables women to recover their health, improves womenβs potential to be more productive
Birth Spacing
Principles in Family Planning Program
Upholding and ensuring the rights of couples to determine the number and spacing of their children
Informed Choice
Principles in Family Planning Program
Reminding couples that planning size of their families have a direct bearing on the quality of their children
informed Choice
Family Planning Program
Total Fertility Rate
3.5 children/women
Principles in Family Planning Program
Goal
To provide universal access to family planning information and services
Principles in Family Planning Program
Objective
To help couples and individuals achieve their desired family size within the context of responsible parenthood
Principles in Family Planning Program
Health centers offer?
Birth Control Pills (BCPs), Barrier methods
Principles in Family Planning Program
Hospitals offer?
Tubal ligation, Vasectomy
Types of Family Planning
Natural
- Standard days method
- Lactational Amenorrhea Method
- Basal Body Temperature
- Billings Ovulation/Cervical Mucus Method
- Symptothermal
Types of FP: Natural
To check when a woman is ovulating
Standard days method
Types of FP: Natural
Not 100% effective, Supposed to be after giving birth, during the
breastfeeding portion, post-nataly
Lactational Amenorrhea Method
Types of FP: Natural
To check when the woman will ovulate
Basal Body Temperature
Types of FP: Natural
Women check the thickness of their cervical mucus
Billings Ovulation/Cervical Mucus Method
Types of Family Planning
Artificial
- Condom
- Injectables
- Oral Contraceptive Pills
- Intrauterine Device (IUD)
Types of FP: Artificial
Device that prevents the egg from reaching the fallopian tube
Intrauterine Device (IUD)
Types of FP: Artificial
Contraceptives
Condom, Injectables, Oral Contraceptive Pills
Types of Family Planning
Permanent
- Vasectomy
- Bilateral Tubal Ligation
Types of FP: Permanent
Cuts supply of sperm to semen, takes 3 days to be healed after doing post-surgical procedure
Vasectomy
T/F: Individuals who underwent vasectomy should follow 7 days of artificial method to ensure that there is no sperm or fertilization that will take place.
False
1 month
Types of FP: Permanent
βTubes tiedβ or βLigateβ, surgical procedure that creates permanent contraception, or sterilization
Bilateral Tubal Ligations
Vulnerable age
groups for common childhood diseases
Newborns, infants, children
Common Childhood Diseases
Measles and Chickenpox
Child Health Programs
- Infant and Young Child Feeding
- Newborn Screening (NBS)
- Expanded Program on Immunization (EPI)
- Management of Childhood Illnesses
- Micronutrient Supplementation
- Dental Health
- Early Child Development
- Child Health Injuries
Goal of Child Health Program
Reduce morbidity and mortality rates for children 0-9 years, High replacement rate
Measure of good public health methods
Replacement rate
Infant and Young Child Feeding
affects schooling and literacy
Iron Deficiency Anemia
Infant and Young Child Feeding
Important for thyroid hormone synthesis
Iodine
Infant and Young Child Feeding
Overactivity of thyroid
Graves Diseases
Infant and Young Child Feeding
All salt should be iodized when selling to the market
Asin law
Infant and Young Child Feeding
Important factor that can prevent infant and childhood morbidity and mortality, done during the 1st half year of life
Breastfeeding
Infant and Young Child Feeding
Passed from mom to infant through breastfeeding
natural immunity
Infant and Young Child Feeding
first milk that comes from the mother
Colostrum
Infant and Young Child Feeding
Exclusive breastfeeding
Up to 2 months
Infant and Young Child Feeding
Skin contact with the mom and baby
Rooming In
Infant and Young Child Feeding
may cause diarrhea due to different composition
cowβs milk
T/F: Some times cowβs milk is used in rooming in.
True
T/F: Malnutrition leads
to generational diabetes according to Dutch Hunger Studies.
True
Breastfeeding
Giving only breast milk to infants, recommended for up to 6 months
Exclusive Breastfeeding
Breastfeeding
Benefits for Infant
- A complete food for thebinfants
- Strengthen immune system thus preventing infections
- Increases IQ points for exclusively breastfed children
Breastfeeding
Benefits for Mothers
- Reduces excessive blood loss after birth due to
prolactin - Natural method of delaying pregnancies
- Reduces the risk of ovarian and breast cancers due to hormonal changes
Products covered by this law consists of breast milk substitute (e.g. infant formula, other milk products, bottle fed complementary foods)
Milk Code (EO 51)
Requires both public and private institution to promote rooming-in, it encourages and supports
the practice of breastfeeding
Rooming-In Breastfeeding Act of 1992 (RA 7600)
An act establishing the Philippine food
fortification program and for other purpose, Can be seen in pancit canton with the sun logo (sangkap pinoy)
Food Fortification Law (RA 8976)
Vital in the promotion of
optimal health and to compensate for the loss of
nutrients during processing and storage of food.
Food Fortification Law
Food Fortification Law
The law requires mandatory food fortification of?
staple foods
Food Fortification Law
Staple foods under the mandatory food fortification
Rice, flour, edible oil, sugar
Food Fortification Law
Voluntary Fortification
Processed food and food
products (Vitamin A, Iron, Iodine)
T/F: White rice have no B vitamins, only carbohydrates.
True
Addition of one or more
essential nutrients to food, whether or not it is
normally contained in the food, for the purpose of
preventing or correcting a demonstrated deficiency
of one or more nutrients in the population or specific population groups
Fortification
Public health program
aimed at the early identification of infants who are affected by certain genetic/metabolic/infectious conditions
Newborn Screening Act of 2004 (RA 9288)
Newborn Screening
Loss of enzyme called which is necessary for
glycolysis to happen
G6PD
Newborn Screening
When is it ideally done?
48th-72nd hour but may also be done after 24 hours from birth
Newborn Screening
The filter card is sent to?
Newborn Screening Center (NSC)
T/F: The NBS detects early genetics, not genetic consequences.
False
opposite
Newborn Screening
Early genetics
Amniocentesis and paracentesis
Newborn Screening
Results from the lack or absence of thyroid
hormone which is essential for the physical and
mental development of a child
Congenital Hypothyroidism
Newborn Screening
Is an endocrine disorder that causes severe salt
loss, dehydration, and abnormally high levels of
male sex hormones in both boys and girls
Congenital Adrenal Hyperplasia (CAH)
Newborn Screening
Babies with CAH may die within?
7-14 days
Newborn Screening
Is a condition in which babies are unable to process galactose, the sugar present in milk
Galactosemia (GAL)
Newborn Screening
What does accumulation of excessive galactose cause?
liver damage, brain damage, cataracts, mental retardation
T/F: In GAL, they cannot have lactose as galactose is a component of this.
True
Newborn Screening
Is a rare condition in which the baby cannot properly use one of the building blocks of
Phenylalanine
Phenylketonuria (PKU)
Newborn Screening
What does accumulation of excessive phenylalanine cause?
brain damage
Newborn Screening
Is a condition where the body lacks the enzyme
called G6PD
Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency
Newborn Screening
Signs and Symptoms of G6PD Deficiency
Hemolytic anemia
T/F: In G6PD, the RBC will lyse if you introduce something that does not promote oxidative stress.
False
promotes oxidative stress
Newborn Screening: Effect if Not Screened
CH
Severe Mental Retardation
Newborn Screening: Effect if Not Screened
CAH
Death
Newborn Screening: Effect if Not Screened
GAL
Death or Cataracts
Newborn Screening: Effect if Not Screened
PKU
Severe Mental Retardation
Newborn Screening: Effect if Not Screened
G6PD Deficiency
Severe anemia, Kernicterus
Launched in July 1976 by the DOH in
cooperation with WHO and UNICEF
Expanded Program on Immunization (EPI)
Expanded Program on Immunization (EPI)
Objective
To reduce the morbidity
and mortality among infants and children (amongst vaccine preventable diseases) caused by the seven
childhood diseases
Expanded Program on Immunization (EPI)
dose of BCG
1
Expanded Program on Immunization (EPI)
BCG stands for?
bacille Calmette-Guerin
Expanded Program on Immunization (EPI)
doses of OPV
3
Expanded Program on Immunization (EPI)
OPV stands for?
Oral Polio Vaccine
Expanded Program on Immunization (EPI)
doses of DPT
3
Expanded Program on Immunization (EPI)
DPT stands for?
Diphtheria-pertussis-tetanus
Expanded Program on Immunization (EPI)
doses of HB?
3
Expanded Program on Immunization (EPI)
HB stands for?
Hepatitis B
Expanded Program on Immunization (EPI)
doses of Measles vaccine
1
Expanded Program on Immunization (EPI)
All vaccines should be given when?
before childβs 1st birthday
Expanded Program on Immunization (EPI)
Side effect of BCG
Keloidal scars
T/F: Hepatitis vaccines are usually twinrix (A and B)
True
Expanded Program on Immunization (EPI)
MMRV stands for?
Measles-Mumps-Rubella-Varicella
Expanded Program on Immunization (EPI)
Rubeola or red rash
Measles
Expanded Program on Immunization (EPI)
German measles or tigdas
Rubella
signed by President Benigno Aquino III in July 26, 2010
Mandatory Infants and Children Health Immunization Act of 2011 (RA 10152)
This program includes basic immunization for
children under 5 including other types determined by the Secretary of Health
Mandatory Infants and Children Health Immunization Act of 2011 (RA 10152)
Four major strategies of Mandatory Immunization Act
- Sustaining high routine
FIC coverage of at least
90% - Sustaining polio free country for global
certification - Eliminating measles by 2008
- Eliminating neonatal tetanus by 2008
Process by which vaccines are introduced into the body before injection sets in.
Immunization
T/F: It is safe and immunologically effective to administer all EPI vaccines on the same day at different sites of the body.
True
T/F: Moderate fever, malnutrition, mild respiratory infection, cough, diarrhea and vomiting are not contraindicated to vaccination.
True
Contraindicated to a child
who has had convulsion or shock within 3 days
of the previous dose.
DPT 2 and DPT 3
This must not be given to individuals who are
immunosuppressed due to malignant disease,
therapy with immunosuppressive agents or
irradiation.
Live vaccines (BCG)
T/F: Repeat BCG vaccination if the child does develop a scar (keloid) after the first injection.
False
does not develop
___ immunization shall be given to all school entrants both in private and public schools regardless of the presence or absence of keloidal scar.
BCG
BCG
Minimum age at 1st dose
Birth or anytime after birth
BCG
Reason
It protects infants from TB meningitis and TB infections
DPT
Minimum age at 1st dose
6 weeks
DPT
Minimum interval between doses
4 weeks
DPT
Reason
It reduces the chance of pertussis
OPV
Minimum age at 1st dose
6 weeks after birth
OPV
Minimum interval between doses
4 weeks
OPV
Reason
Protection against Polio
Disease
Hepa B
Minimum age at 1st dose
At birth
Hepa B
Minimum interval (1st to 2nd dose)
6 weeks interval
Hepa B
Minimum interval (2nd to 3rd dose)
8 weeks interval
Vaccines that are most sensitive to heat
- OPV (Live attenuated)
- Measles (Freeze Dried)
Storage temperature for vaccines most sensitive to heat
-15 to -25C at the freezer
Vaccines that are least sensitive to heat
- DPT/Hep B
- BCG (freeze dried)
- Tetanus Toxoid
Storage temperature for vaccines least sensitive to heat
2 to 8 C in the refrigerator
Dose, Route and Site of Administration
BCG
0.05ml, Intradermal, Right Deltoid Region
Dose, Route and Site of Administration
DPT
0.5ml, Intramuscular, Upper outer portion of thigh
Dose, Route and Site of Administration
OPV
2 drops, Oral, Mouth
Dose, Route and Site of Administration
Measles
0.5ml, Subcutaeneous, Outer part of the arm
Dose, Route and Site of Administration
Hepa B
0.5ml, Intramuscular, Upper outer portion of thigh
Dose, Route and Site of Administration
Tetanus toxoid
0.5ml, Intramuscular, Deltoid Region
Common nutritional deficiencies
Vitamin A, Iron, Iodine
Nutrition Program
Goal
To improve the quality of life of Filipinos through better nutrition, improved health and increased productivity
Nutrition Program
Programs and projects
- Micronutrient supplementation
- Food fortification
- Nurition Information
- Communication and Education
- Home, School and Community Food Production
- Food Assistance.
One of the interventions to address the health
and nutritional needs of infants and children and
improve their growth and survival.
Micronutrient Supplementation
Twice-a-year distribution of Vitamin A capsules
through the βAraw ng Sangkap Pinoyβ (ASAP)
Micronutrient Supplementation
Approach adopted to provide micronutrient
supplements to 6-71 months old preschoolers on a nationwide scale.
Garantisadong Pambata or Child Health Week
T/F: Quarterly weighing of children is being done and is in line with surveillance.
True
Goal of Dental Health
Attainment of improved quality of life through promotion of oral health and quality oral health
care.
Dental Health Objectives
- The prevalence of dental caries is reduced
- The prevalence of periodontal (gums) disease is reduced
- Dental caries experience is reduced
- The proportion of Orally Fit Children (OFC) 12-71
months old is increased