ByJ. MTENGEZO

VICTORIA HOTEL17TH JUNE, 2009

OUTLINEMDGs - MNH Core Competencies- MNHContent outlineLearning guides and checklistsExercises

Goal 4: Reduce Child Mortality RateTarget 5: reduce by two thirds, between 1990

and 2015, the under five mortality rate

Indicators traced:- under five mortality rate- Infant Mortality Rate- Proportion of 1 year old children immunized

against measles

Under-Five Mortality Rate

Infant Mortality Rate

Proportion of 1-Year Old Children Immunized Against Measles

Goal 5: Improving Maternal HealthTarget 6: reduce by three quarters,the

maternal mortality ratio

Indicators traced:- Maternal Mortality ratio- Proportion of births attended by skilled Health

Personnel

Maternal Mortality Rate

Proportion of Births Attended by Skilled Health personnel

C

C.1.The student will be able to provide individualised focused antenatal care.

Brief review of:Focused Antenatal care Services offered at the antenatal clinic

Key Focused Antenatal care messages

Importance of focused antenatal careBasic information on focused antenatal care

services Birth preparedness Early Detection and treatment of complications

History takingPhysical Examination (refer to checklist for

information)-General examination-Obstetrical

Key Focused Antenatal care messagesInvestigations

Hb,Grouping urinalysisVDRL or PRPHIV

ManagementIdentification and treatment of existing

problemsHealth education

nutritionPersonal hygieneRest/exercisesPMTCTBirth planPrevention of conditions or diseases Danger signs and complications of pregnancy

Refer where necessary

CLINICALHealth Education on RH topics for individuals

and groups

CC2. The student will be able to assess and manage a woman in labour and delivery.ADMISSION PROCEDURE

History takingPhysical examination (head to toe)Laboratory investigations

CC. 2MATERNAL CONDITION

Psychological carePhysical care

 FETAL CONDITION

Fetal heart rateMouldingColour of liquorCaput succedaneum

CC. 2PROGRESS OF LABOUR

Uterine contraction Cervical dilatationDescent of presenting part

CC. 2SECOND STAGE MANAGEMENT

DefinitionPreparation for the deliveryActual deliveryDocumentation

ACTIVE MANAGEMENT OF THIRD STAGE OF LABOURDefinitionControlled cord traction Immediate care

CLINICAL Conduct admission procedure, delivery of

baby and placenta

CC. 3. The student will be able to prevent and manage obstructed labour. Definition DiagnosisCausesSigns and symptoms

Early signsLate signs

CC. 3MANAGEMENT

Health centre levelHospital level

CLINICALManage woman with obstructed labour

CC. 4 The student should be able to perform Vacuum ExtractionDefinitionIndicationContra indicationCriteria for performing vacuum extractionComplication of vacuum extractionCare of vacuum extractor setDemonstration of actual procedure

CLINICALConduct vacuum extraction

CC. 5 The student will be able to conduct breech delivery.Types of breech presentationDiagnosis of breech presentationPreparation for breech deliveryActual Breech delivery :

Burns marshalLovset manoeuvreMaurice smellie manoeuvre

Complication of breech

CLINICALConduct breech delivery

CC. 6 The student will be able to perform manual removal of retained placenta.DefinitionPredisposing factorsDemonstration of actual procedure

CLINICALConduct manual removal of retained placenta

CC. 7 The student will be able to prevent and manage Primary post partum HaemorhageDefinitionCausesRisk factorsStrategies for prevention

AntenatallyDuring labour and deliveryDuring 3rd stage and immediately after

placenta delivery

CC. 7Strategies for management

Inspection of the perineum, vaginal and cervical tears

Repair of tearsManual removal of placentaBimanual compressionAortic compression

Demonstration of actual procedures

CC. 7Prevent and manage Primary post partum

Haemorhage

CC. 8 The students will be able to manage a client with severe pre-eclampsia and eclampsia.Definition Signs and symptomsPrevention of eclampsiaManagement

CLINICALManage woman with severe pre-eclampsia

and eclampsia

CC.9A The student will be able to assess and manage a woman during post partum periodManagement of a postnatal mother

History takingPhysical examination Laboratory investigationsCounselling of the post partum motherComplications

CC.9 B. The students will be able to manage a newborn baby Management of the newborn

Immediate careSubsequent careDanger signs

CLINICALManage the woman and baby during post

partum period

cc.10. The student will be able to provide post abortion careProvision of PAC Services

PAC servicesRapid assessment of the patientPelvic examinationMVA procedure

CLINICALManage a woman with an abortion

ExcercisesAssignments, case studies, role play, and

knowledge assessment- Refer page 115

?/COMMENTS

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