- Antenatal Care
- Postnatal Care
- Child health services
Organisation Chart of the Maternal & Child Health Department of KK Bandar Sg Petani
ANTENATAL CARE
The chart beside shows the order in which the antenatal cases are handled. A new case is registered, followed by a physical examination done by the doctors, and a battery of lab tests which includes UPT, Rubella status, HIV status, Hb levels and other standard pregnancy tests.
Upon booking, the examinations are done by a HO or MO. An ultrasound will be done depending on the gestational age. An initial colour coding is also done on the red book. The red book is a maternal healthcare record book. There are 2 red books; one for the mother which is the KIK/ 1(a) / 96 / Home-based card & the other for the clinic KIK/1(b)/96r. An overall assessment is done based on all these tests. In case of any problems detected, the case will be seen by the specialist in KK Kuala Muda and then referred to the main hospital. An uncomplicated case is given the standard antenatal medications and given date for subsequent appointments.
During the visits, the mothers are reviewed by the nurses and again colour coded according to the risk factors. The colours are white, green, yellow and red, with each having its own set of criterias as stated in the KIK / 1(b) / 96r. Throughout the course of the pregnancy the colors may change according to the condition of the mother and foetus. Downgrading of a colour code can only be done by a specialist.
Other functions of the visits include ATT injections; 2 doses for a primi and 1 for a multiparous woman, ultrasound to check fetal progress and other lab tests to ensure wellbeing of both mother and fetus. A routine antenatal visit schedule for an uncomplicated pregnancy
would be as stated below:
- 1st 28weeks - 4 weeks once
- 28-36weeks - 2 weeks once
- more than 36weeks - weekly once
The 'red book' and the colour coding system is shown. The colour coding at the left corner shows the area code and the right shows the risk factors' coding system.
POSTNATAL CARE
Under postnatal care, mainly two services are provided. 1st is the pre pregnancy care of mothers and the other is family planning services. The programmes under this unit is mainly conducted by the nurses.
(a) Pre pregnancy Care - In case of high risk pregnancies, 1 month following delivery, the mother is referred to the PPC unit, which comes under the general OPD of KK Kuala Muda. Examinations are done and the mothers are given counselling on subsequ
ent pregnancies. Folic acid supplements may be given.
(b) Family planning- Counselling sessions are provided to inform mothers the importance of spacing between pregnancies and other related issues. Contraceptive methods are also discussed and provided here.
(c) Pap Smear - usually done 6 months following the continuous intake of contraceptive pills. Done yearly for women of reproductive age group.
*This section was not discussed in detail as Family Planning was scheduled for Day 3 in KK Bakar Arang.
CHILD HEALTH CARE
The child health care system begins following delivery. During the neonatal phase, home visits are conducted by the nurses. The purpose is to ensure wellbeing of the child, proper postdelivery care and most importantly to check for jaundice. The home visit is done daily for the 1st 14 days, if the child is suspected to have jaundice, the mother must immediately bring the child to district health office for a serum bilirubin (SB) test, following which they will be referred for treatment, depending on level of bilirubin. If no jaundice was found during the 14 day home visit, the subsequent visit is only done on day 20 to confirm absence of jaundice. Apart from that, the anthropometric measurements of the child is also recorded on day 10 and 20. These measurements are plotted on the child health and development record card. Once the home visits are stopped the mother is required to bring the child for subsequent assessments in the DHO.
The chart beside shows the sequence of events in a child healthcare visit at KK Kuala Muda.
These visits are done until the child is 5 years old. The frequency and timing of the visits may vary. In most cases the child is brought according to the vaccination schedule. Generally the following is done during the visits:
i. anthropometry
ii. developmental assessment
iii. nutritional assessment
iv. vaccination
The objectives here are to ensure optimum growth and development of the child and for complete immunization before school entry. This also acts as a entry point to provide care for children with special needs.
School health programmes are also conducted by this unit.
Prepared by,
Sheela Rajan
Sheela, thank you for the post.We had the same activity at Sik today. Prof. Narayan and Dr. Ladish were with us. They asked us few questions and this information can get from the sister.
ReplyDeleteThe questions are:
1.) What is the number of antenatal mother registered in the district in 2010/2011?
What is the follow up rate of the antenatal mother at first trimester, second trimester and third trimester?
How is the data being collected?
2.) What is the action plan if the mother does not follow up or has shifted to other place?
3.) What is the coverage rate of (antitetanus toxoid (ATT), ultrasound, MGTT) for antenatal mother in the district?
Below which level we said that the coverage is inadequate? What is the action plan if the coverage is low?
4.) At which gestational age, the antenatal mother will be given the tetanus toxoid?
5.) At which gestational age, ultrasound will be done for antenatal mother?
6.) What is the maternal mortality rate in the district?
7.) About the colour coding system, what is the percentage of the antenatal mother that fall in each category?
8 )For the immigrants, do they have to pay for the services? How much do they have to pay? What is the action plan if they do not follow up due to some other reasons (such as not afford to pay, etc)?
9.) For family planning, what is the most common method of contraception preferred in the district?
Hope the information helps.
Thank you.
Thank you for the info Cheng Foong. I will try to get the information as soon as possible and update it later.
ReplyDelete