Mother and child comunity

Maternal, Newborn and Child Health

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FATIMA AWAD
(taina)

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What is
Maternal, Ne
wborn, and
Child Health
(MNCH)


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(MNCH) refers to an effective
and integrated continuum of
care that delivers basic
services to mothers and their
infants at critical points , and
to children in their first five
years of life, with the goal of
ensuring the health and
survival.

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These include:1.better prenatal care,

2.having a skilled health
assistant during birth,

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3.access to emergency obstetrics
and newborn care,

4.postnatal visits,and antibiotics
to treat infections of mothers and
newborns.

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5.Adequate nutrition and
education to improve health, and
good hygiene practices are also
key.


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 The lifetime risk of a women dying
from pregnancy-related causes
(maternal death) in the developing
world is 1 per 76, compared with 1
per 8,000 in the industrialized
world.


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Of all deaths worldwide among
pregnant women, infants, and
children under age 5, about 99
percent occur in developing
countries.

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•In UK, Europe and USA and
until the Second World War
organized antenatal care was
not available to all people.


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In sudan 90% of mothers
deliver at home and attended
to by midwives or sometimes
by general practioners.

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•The maternity care
services, are mainly at
the level of the local
community ever since
the start of midwifery
training in 1921.

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•The health system in this
country is based on the
primary
health
care
approach
since
its
inception more than 70
years ago.

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•Sudan is committed to
the Alma Ata
Declaration of
1978, and the adoption
of primary health care
policy.

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In september 2000,the primary
health care changed into
Millennium Development
Goals,which has 8 goals have
agreed to try to achieve by the
year 2015,MDG4 and MDG5(to
reduce child death and improve
maternal health).

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In spite of all efforts at all
levels of health care to
improve the health of the
mother and newborn ,still
mortility rate is high.


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MODTHER KHALIFA

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Maternal mortality
• A maternal death is defined as "the
death of a women while pregnant or
within 42 days of termination of
pregnancy, irrespective of the duration
and site of the pregnancy, from any
cause related to or aggravated by the
pregnancy or its management but not
from accidental or incidental causes.

26

• To reduce maternal deaths globally
we need to assure that effective
services are provided for improving
overall maternal health .


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• Causes of maternal mortality
• Women die as a result of complications
during and following pregnancy and
childbirth.
• Most of these complications develop
during pregnancy.

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• Other complications may exist before
pregnancy but are worsened during
pregnancy.


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35

50
15


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• In developing countries, conditions
related to pregnancy and childbirth
constitute the second leading causes
(after HIV/AIDS) of death among
women of reproductive age.


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• The state of maternal health mirrors
the gap between the rich and the
poor.
• Only 1% of maternal deaths occur in
high-income countries.


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• Also, maternal mortality is higher in
rural areas and among poorer and less
educated communities.

• Of the 1000 women who die every
day, 570 live in sub-Saharan Africa, 300
in South Asia and five in high-income
countries.

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• Many of these deaths could be
prevented if information on family
planning and contraceptives were
available and put into practice.


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• One target of the Millennium
Development Goals (MDGs) is to
reduce the maternal mortality ratio
by three quarters between 1990 and
2015.


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• So far, progress has been slow. Since
1990 the global maternal mortality
ratio has declined by only 2.3%
annually instead of the 5.5% needed
to achieve MDG 5, aimed at
improving maternal health.

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• The main obstacle to progress
towards better health for mothers is
the lack of skilled care.
• This is aggravated by a global
shortage of qualified health workers.

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Integrated Management of Pregnancy and
Childbirth (IMPAC)

• IMPAC - Integrated Management of
Pregnancy and Childbirth is the package
of guidelines and tools which is central to
the Department's technical assistance
activities to support countries in strategic
and systematic ways to improve
maternal, perinatal and newborn health .

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• IMPAC offers a framework in which
national policies, programs and
action plans can be elaborated.
• It targets health systems, health
workers, as well as health
promotion.

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• Health systems
• On the health systems level, the
approach aims at improving not only the
access to, but also the quality of essential
and emergency care
• Health workers
• To improve the skills and competencies
of health care workers is the second
strategy of the IMPAC approach

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• Health Promotion
• To better respond to women and
newborn's health needs and to increase
the utilization of available health
services, programmes need to
implement interventions to improve
health in the home and to involve
women, families and community
actors, including other sectors, to identify
key problems and solutions to reaching

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MOHAMMED FARAG

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Safe Motherhood
• Is one of the important components of
Reproductive Health.
• Means ensuring that all women receive
the care they need, to be safe and
healthy throughout pregnancy and
childbirth.
• The ability of a mother to have Safe &
Healthy pregnancy & Child Birth.

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•The Safe Motherhood Initiative is a
worldwide effort that aims to increase
attention to and reduce the devastating
numbers of women that suffer death or
serious illness every year.


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• Making motherhood safe for the
world’s women calls for national
governments, funding agencies, and
non-governmental organizations (NGOs)
to make maternal health an urgent
health priority and to ensure that the
necessary political and financial support
is dedicated to this effort.

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•In order to reduce life-threatening risks
and reduce mortality, good-quality
maternal health services by trained
health workers must be available and
must be used.
•Therefore, safe motherhood strategies
must be comprehensive in nature; even
when quality health services are
available, other limiting factors can get in
the way of women using these
services, such as social, economic and
cultural factors

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Safe Motherhood includes antenatal
care, delivery care (including skilled
assistance for delivery with appropriate
referral for women with obstetric
complications) and postnatal
care, including care of the baby and
breastfeeding support. Sexually
transmitted disease (STD)/ HIV/ AIDS
prevention and management, family
planning services.

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BASIC MATERNITY CARE

postpartum care

Clean/Safe
Delivery

FAMILY PLANING

ANTINATAL CARE

SAFE MOTHERHOOD

PRIMARY HEALTH CARE
EQUITY FOR WOMEN

Health policy

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Prenatal care is a type of preventative care
with the goal of providing regular check-ups
that allow doctors or midwives to treat and
prevent potential health problems throughout
the course of the pregnancy while promoting
healthy lifestyles that benefit both mother and
child.

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• During check-ups, women will receive
medical information over maternal
physiological changes in
pregnancy, biological changes, and
prenatal nutrition including prenatal
vitamins. Recommendations on
management and healthy lifestyle
changes are also made during regular
check-ups

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Family planning allows individuals and
couples to anticipate and attain their
desired number of children and the spacing
and timing of their births. It is achieved
through use of contraceptive methods and
the treatment of involuntary infertility. A
woman’s ability to space and limit her
pregnancies has a direct impact on her
health and well-being as well as on the
outcome of each pregnancy

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Clean save delivary
•
•
•
•
•
•
•

Clean hand
Clean surface
Clean cord tie
Clean blade
Clean cord stumb
Clean towel
Clean water

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Postpartum Care Since up to 50 per cent of
maternal deaths occurs after delivery, a
midwife or a trained and supervised TBA
should visit all mothers as soon as possible
within the first 24-48 hours after birth.
The midwife or TBA should assess the
mother's general condition and recovery
after childbirth and identify any special
needs.
This attention is particularly important when
the woman is alone as head of the family..

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The postpartum visit provides an occasion for
assessing and discussing issues of
cleanliness, care of the
newborn, breastfeeding and appropriate
methods and timing of family planning .
Health providers should support early and
exclusive breastfeeding, and discuss proper
nutrition with the mother.
Iron folate tablets should be continued and
Vitamin A and iodised oil/ salt should be
provided when necessary.

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• During the postpartum visit, the health
and well being of the newborn should
also be assessed and its birth weight
measured.
• Newborns should be referred to the
under-five clinic to start
immunisations, growth monitoring and
other well-child services.

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• Community Health Workers (CHW) and
TBAs should be trained for appropriate
referral of postpartum
complications, such as
haemorrhage, sepsis, perineal
trauma, breastfeeding problems, and
newborn complications, such as
prematurity or failure to thrive, that
may require additional surveillance

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Abd albasit

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Reproductive Health
Learning Objectives
• Learn to define Reproductive health
• Understand the concept and importance of
RH
• Describe the components of RH package


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Reproductive Health
It is a state of complete physical, mental and
social well-being and not merely absence of
disease or infirmity, in all matters relating to
reproductive system and to its functions and
processes.
Reproductive health care is defined as the
constellation of methods, techniques and
services that contribute to reproductive health
and well-being through preventing and solving
reproductive health problems.

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Concept of Reproductive Health
It implies that
• couples have the ability to reproduce and regulate
their fertility
• women are able to go through pregnancy and
child birth safely
• outcome of the pregnancy is successful in terms of
maternal and infant survival and well-being and
• couples are able to have sexual relations free of
the fear of pregnancy and of contracting any
disease

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Every minute in the world

380 women become pregnant

190 of these did not plan or do not
wish the pregnancy


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Every minute in the world

110 women experience a pregnancyrelated complication

40 women have an unsafe abortion

1 woman dies from a pregnancy
related issue

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Reproductive Health Package


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RH Package Offers-Following
Services


Comprehensive family planning for
and males;

·

Maternal health care including safe motherhood,
and pre and post abortion care for
complications;

·

Infant Health Care;

·

Management of reproductive health related
problems of adolescents;

females

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Reproductive Health Package
contd…

Management of other reproductive
health related problems of women;
Prevention and management of
RTIs/STIs and HIV/AIDS;
Management of infertility;
Detection of breast and cervical
cancers;
Management of reproductive health
related issues of men.

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FAMILY PLANNING
The adult lifetime risk of maternal
death (the probability that a 15-year-old
female will die eventually from a
maternal cause:
1. 1 in 31 in sub-Saharan Africa,
2. 1 in 11 in Afghanistan,
3.1 in 4300 in developed regions.
4. In Belgium, the risk is 1: 10 900.
IN WHO 2010.

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• Quality family planning services bring a
wide range of benefits to women, their
families and society.


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Benefit of family planning
A. Preventing pregnancy-related health
risks in women
B. Reducing infant mortality
C. Helping to prevent HIV/AIDS
D. Reducing the need for unsafe abortion
E. Empowering people
F. Reducing adolescent pregnancies
G. Slowing population growth

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• Fertility control is achieved through the
usage of contraceptive methods. This
has been practiced by men and women
for so many years.
• Countries and communities differ very
much in their knowledge, attitude and
practice towards fertility control issue.

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The Ideal Contraceptive:
• There is no one method that will suit
everyone and individuals may use
different methods of contraception at
different stage of their lives.


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• The ideal contraceptive is characterized
by:
• Highly effective.
• No side effects.

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• Independent sexual intercourse.
• Rapidly reversible (fertility comes back
quickly).
• Cheap.
• Widespread availability.
• Acceptable to all cultures and religions.
• Does not require administration by
healthcare workers.
• Easily distributed.

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• A-Hormonal Contraception
1-Combined Oral Contraceptive Pill (COC
or the Pill).
2-Progestogen-only Contraception


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• B-intrauterine Contraception
• C-Barrier Methods of Contraception
• D-Natural Family Planning Methods


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• Emergency Contraception (EC)


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3mad adam

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• Key facts
• 7.6 million children under the age of five
die every year,.
• Over two-thirds of these early child
deaths are due to conditions are
• pneumonia, diarrhoea, malaria and
health problems during the first month
of life.
• Over one third of all child deaths due to
malnutrition.

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• Over 70% of all child deaths occur in
Africa and South-East Asia. Within
countries, child mortality is higher in
rural areas, and among poorer and less
educated families.


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• Neonates
• More than three million babies die
every year in their first month of life ,a
similar number are stillborn and 75%
occur in the first week.
• the mother can increase her child's
chance of survival and good health by
attending antenatal care
consultations, being immunized against
tetanus, and avoiding smoking and use
of alcohol.

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• After birth, essential care of a newborn
should include:
1. ensuring that the baby is breathing;
2. starting the newborn on exclusive
breastfeeding right way;
3. keeping the baby warm,washing hands
before touching the baby.
4. Sick babies must be taken immediately
to a trained health care provider.

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Causes of Neonatal Deaths, Sudan, Source: World Health
Statistics, 2006

Neonatal Tetanus
Sepsis
Asphyxia
Diarrhoel Diseases
Congenital anomalies
Preterm Birth
Others

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• Children under five
• Over two thirds of child deaths are due
diseases that are preventable and treatable
through simple affordable interventions
such as immunization and attenuated
nutrition . Strengthening health systems to
provide such interventions to all children
will save many young lives.

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Total Neonatal Deaths
Pneumonia
Diarrhoel Diseases
Malaria

Other Causes

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FACTS OF BREASTFEEDING


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• 1-WHO recommends
• exclusive breastfeeding for the first six
months(180 days) of life. At six
months, other foods should
complement breastfeeding for up to
two years or more.
• breastfeeding should begin within an
hour of birth
bottles should be avoided.

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• 2- diarrhoea and pneumonia
are two primary causes of child
mortality . Breast milk is readily
available and affordable, which helps to
ensure that infants get adequate
sustenance.


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• 3-Health benefits for infants
• Breast milk is the ideal food for
newborns and infants. It gives infants all
the nutrients they need for healthy
development. It is safe and contains
antibodies that help protect infants
from common childhood illnesses .


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• 4-Benefits for mothers
• Breastfeeding also benefits mothers. It
reduces risks of breast and ovarian
cancer later in life, helps women return
to their pre-pregnancy weight
faster, and lowers rates of obesity.


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• 5-Long-term benefits for children
• the immediate benefits for
children, breastfeeding contributes to a
lifetime of good health. have lower
blood pressure and lower cholesterol, as
well as lower rates of
overweight, obesity and type-2 diabetes

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• 6-Why not infant formula?
• Infant formula does not contain the
antibodies found in breast milk.
Malnutrition can result from overdiluting formula to "stretch" supplies.


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INJURIES OF CHILDREN


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• Injuries of children
• Nearly 90% of injuries to children are
the result of unintentional or
"accidental" incidents.
• Around 830 000 children die from such
injuries every year, nearly 2300 each
day. More than 1000 of these children
could be saved if proven injury
prevention measures were applied
worldwide.

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• Causes of Injuries
1. Road traffic crashes
2. drowning
3. burns
4. falls
5. poisoning
are leading to causes child death from
injuries.

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Causes

Around

Road traffic crashes

cause of death among children ages 10 to 19

Drowning

Around the world 480 children die from drowning
every day

Burns

Globally, 260 children die from burns every day.

Falls

130 children die from falls every day.

Poisoning

125 children die from poisoning daily.

Poverty

They are more likely to live in hazardous conditions residing in homes with open fires, unprotected
Maternal,
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windows,Newborn androofs and stairs,
unsafe Child Health

• Prevention
 public awareness about injury
prevention and providing better childoriented emergency care.


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Arwa abd alwahab

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The most common causes of
neonatal deaths are preterm
birth complications, newborn
infections and birth asphyxia.
They account for over 80% of all
global neonatal deaths.


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Care of the preterm and/or lowbirth-weight newborn
Preterm birth is the most common direct
cause of newborn mortality. Preterm birth
and being small for gestational age
(SGA), which are the reasons for lowbirth-weight (LBW), are also important
indirect causes of neonatal deaths.


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**LBW contributes to 60% to 80% of all
neonatal deaths.
**The global prevalence of LBW is
15.5%, which amounts to about 20 million
LBW infants born each year, 96.5% of them in
developing country


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Countries can reduce their neonatal and
infant mortality rates by improving the
care for the mother during pregnancy
and childbirth and of LBW infants.


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. Experience from developed and low- and
middle-income countries has clearly
shown that appropriate care of LBW
infants, including :
1- feeding,
2- temperature maintenance,
3- hygienic cord and skin care,
4- and early detection,
5-treatment of infections,
6- complications including : respiratory
distress syndrome can substantially
reduce mortality

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Interventions to improve care during
pregnancy, childbirth and the
postnatatal period as well as feeding are
likely to improve the immediate and
longer-term health and well-being of
the individual infant and have a
significant impact on neonatal and
infant mortality at a population level.

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Kangaroo mother care" is a method of
care of preterm infants weighing less
than 2 kg. It includes:
1- exclusive frequent of breastfeeding
2- skin-to-skin contact and support for the
mother-infant diet, and has been shown
to reduce mortality in hospital-based
studies in low- and middle-income
countries.

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Kangaroo mother care


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Management of newborn illness and
complications
A newborn baby who is born preterm or
has a potentially life-threatening
problem is in an emergency situation
requiring immediate diagnosis and
management. Delay in identification of
the problem or in providing the correct
management may be fatal.

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Preterm and/or low birth weight infants
need special care, including additional
attention to breastfeeding and breastmilk feeding and to keeping them warm
at home and in health facilities..


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Those with preterm birth
complications, including :
respiratory problems, need
appropriate treatment in hospitals


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Appropriate care during labour and
childbirth combined with neonatal
resuscitation, when needed, can
substantially reduce mortality due to
birth asphyxia. Newborns with severe
asphyxia need post-resuscitation care in
hospitals.

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Early identification of newborn infections
with prompt and appropriate antibiotic
treatment will substantially reduce
mortality due to newborn sepsis and
pneumonia.


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Newborns with serious infections need
intramuscular or intravenous antibiotics
and supportive care in hospitals. Where
hospital referral is not
possible, intramuscular antibiotics
delivered by skilled health-care
providers will save lives.

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Other common newborn problems are
jaundice, eye infections and
diarrhoea, which may be managed at
health facilities or hospitals depending
on their severity.


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The Integrated Management of Childhood
Illness (IMCI) training materials and
Essential Newborn Care Course aim to
improve skills of health-care staff for
managing newborn illness at first level
health facilities.


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Care of the HIV-exposed or infected
newborn
A woman infected with HIV, however, can
transmit the virus to her child during
pregnancy, labour or delivery, or through
breastfeeding. The dilemma has been to
balance the risk of infants acquiring HIV
infection through breastfeeding with the
increased risk of death from causes other
than HIV, in particular malnutrition and
serious illnesses such as diarrhoea and
pneumonia, due to not breastfeeding

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*An estimated 430 000 children were newly
infected with HIV in 2008, over 90% of them
through mother-to-child transmission
(MTCT).
* Prevention of mother-to-child transmission
(PMTCT) of HIV has been at the forefront of
global HIV prevention efforts since
1998, following the success of the shortcourse zidovudine and single-dose nevirapine
clinical trials in reducing transmission.

.

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*These trials offered the promise of a
relatively simple, low-cost intervention
that could substantially reduce the risk
of HIV transmission from mother to
baby.
*Research and programme experience
over the past ten years has
demonstrated newer and more effective
ways to prevent new pediatric HIV
infections, particularly
in high-burden, low-resource settings

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In recent years which shows that
giving antiretroviral drugs (ARVs) to
either the HIV-infected mother or
HIV-exposed infant can significantly
reduce risk of the transmitting HIV
through breastfeeding

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121

Mayada ishag

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Key facts
Between 1990 and 2010, under-five
mortality dropped by 35% worldwide.
every day, nearly 21 000 children underfive die mostly from preventable causes.


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99% of all under-five deaths occur in
developing countries.

Three-quarters of all child deaths are
mainly due to preventable causes:
• neonatal conditions,
• pneumonia,
• diarrhoea,
• Malaria
• measles. .

124

Distribution of mortality rates
• Three-quarters of all under-five deaths
are concentrated in just two regions of
the world: 46% in the African region and
28% in South-east Asia.
• . More than half of all these deaths
were clustered in only 5 countries:
China, Ethiopia, India, Nigeria, and
Pakistan.

125


126

Causes of mortality
• Almost half of under-five deaths are due
to infectious diseases. Pneumonia is the
largest single cause of death in children
less than five years of age, and is
responsible for nearly 1.4 million
deaths.


127

• every year Malnutrition contributes to
more than one-third of all under-five.
Patterns of the distribution of causes of
death vary widely between deaths
region.


128

• The lowest proportion of neonatal
deaths occurred in the African Region. In
the Americas, Europe and South-East
Asia, a high proportion of under-five
child deaths occurred during the
neonatal period.


129

Newborn health epidemiology
• Key facts
• Maternal, perinatal and newborn health
and mortality are closely linked and the
risk of dying from neonatal conditions
can be lessened by improved access to
skilled care at birth.


130

• interventions provided during
pregnancy and birth for the mothers
and immediate post partum/postnatal
period (within 48 hours).
• Every day, about 8000 newborn babies
die from preventable causes.


131

Neonatal mortality
• Deaths that occur among babies less
than 28 days of life (neonatal period)
account for about 40% of all under-five
deaths. The risk of dying during the
neonatal period is highest closest to
birth and decreases over the
subsequent days and weeks: up to 50%
of neonatal deaths.

132

• occur within the first 24 hours of life and
about 75% during the first week of life.
In 2010, an estimated 3.1 million babies
died during their first month of life.


133

Distribution
–70% of all neonatal deaths were
concentrated in just two regions of
the world: the African Region and
South-east Asia. More than half (53%)
of all these deaths were clustered in
only five countries:
India, Nigeria, Pakistan,china
,ethiobia.

134

Causes of neonatal mortality
• Among the 3.1 million deaths that
occurred among babies 0-28 days of
life, about one third were due to
infections (including
pneumonia, sepsis, neonatal tetanus
and diarrhea).
• Preterm birth complications caused
another one million deaths among
newborn babies. Birth asphyxia was the
third major cause of death in this early

135

Shahlaa abdeen

136


137

• Children need food of appropriate
quantity and quality for optimal
growth and development.
If their nutritional intake is
inadequate they will fail to gain
weight or lose it and will
subsequently fail to grow in height.

138

1-Element of major food(nutrient big)
fat-carbohydrate- protein.
2-Nutrients minutes
(micronutrients)vitamin-minerals.
3-Water and fiber.


139

Division of the new food pyramid


140

Poor nutrition may begin with the
child from the womb of the mother
,extend this effect during the first
years of the life.


141

The vitamin A of the most important
micro nutrients needed by children of
mucous membrane and membrane eye
and skin and helps growth.


142

Deficiency
• the signs of Vit A deficiency are
predominantly occular include:
1. night blindness
2. conjuctival xerosis
3. bitots spots
4. corneal xerosis
5. keratomalacia
extraoccular manifestation include follicular
hyper keratosis , anorexia and growth
retardation.

143

Factors Affecting
Nutritional Status
1-Mother’s attributes
2-State of nutrition during
pregnancy
4-Feeding pattern(Exclusive breast feeding
for 6month)
5-Weaning & supplementation
6-Illness

144

Breast feeding
(Exclusive breast feeding for 6month)
nutritionally adequate and safe
complementary feeding starting
from the age of 6 months with
continued breast feeding up
to2years of age or beyond


145

Exclusive breast feeding for 6month)
nutritionally adequate and safe
complementary feeding starting from
the age of 6 months with continued
breast feeding up to2years of age or
beyond


146

• Colostrum is the special milk that is
secreted in the first 2-3 days after delivery.
It is produced small amount about 40-50ml
on the first day colostrum is rich in white
cell and antibodies especially IGA and it
contain large percentage of protein
,mineral, fat soluble vitamin (A-K-E)
colostrum provide important immune
protection to an infant.

147

Weaning
• Gradual change from an all-milk diet to a
diet composed of a variety of foods(6 mos)
• Early abrupt weaning
– Marsamus
– Infections
– kwashiorkor

• Late weaning
– PEM

148


149

Supplementary Feeding


150

Supplementary Feeding
Start at 6 months of age with small
amount of food and increase quantity as
the child gets older, while maintaining
frequent breast feeding .
Should be :.
1-rich in energy ,protein and micronutrient
2-not spicy or salty
3-easy for the child to eat and liked
4-locally available and affordable .

151

Indications of Good Nutrition
1-Body weight gain.
2-Behavioral development
3-Bowel movements
4-Sleeping habit
5-Developed motor coordination
6-Well-formed muscles

152

ORAL REHYDRATION SULIOTION

• WHAT IS ORAL
REHYDRATION
SOLUTION???


153

Oral rehydration salt


154

ORS program

• First started in 1986-1987
• Implemented through MCH programs
• ORS packet are supplied by central
government


155

principle

• Glucose when given orally enhances
intestinal absorption of water and salt
• Thus it can correct electrolyte and water
deficit


156

AIM

To correct the water and
electrolyte deficit
To prevent dehydration
Reduce mortality


157

• Oral rehydration therapy, (also called
ORT, oral rehydration salts or
solutions (ORS), or oral electrolyte), is
a simple, cheap, and effective
treatment for diarrhea-related
dehydration.


158

• Oral rehydration therapy is
widely considered to be the
best method for combating
the dehydration caused by
diarrhea and/or vomiting.


159

It consists of :.
sodium chloride 3.5g
Potassium chloride 1.5g
Trisodium citrate 2.9g
Glucose anhydrous 20.0g


160

IN WHAT CONDITION IT CAN BE
GIVEN
• 1- ALL AGE GROUP
• 2- ALL AETIOLOGIES
• 3- ALL COUNTRIES


161

How to administrate
Rules


162


163

<2yers:- give 1-2 teaspoon every 2-3
minutes
Older children :- offer frequent sips out of
cup
Adult:- drink as much as they can
Give the estimated with in 4 hrs


164

If the child vomits
• Wait for 10 minutes
• Give a teaspoonful every 2-3
minute


165

cost

free

free
free
free


166

How to prepare it ?


167

If ORS packet are not available
• Table salt (5gm) +sugar (20 gm) in 1L
of drinking water
• Administrate till the diarrhea stops
• Earlier the treatment is instituted
better is for the patient


168

Achievement and benefits
Low cost treatment
Treatment of the patient in their own
homes
Ingredients are inexpensive 0f readily
available
Mortality rate in the cholera has been
reduced to 0.11% from 49.3%

169


170

Reem abd almuhsen

171

• Immunization, is the process by which
an individual's immune system becomes
fortified against an agent.
• Vaccines against microorganisms that
cause diseases can prepare the body's
immune system, thus helping to fight or
prevent an infection.

172

• The Expanded Programme of
Immunization (EPI) was established in
1974 through a World Health
organization resolution to build on the
success of the global smallpox
eradication programme, and to ensure
that all children in all countries
benefited from life-saving vaccines.

173

• Immunization against vaccinepreventable diseases is essential to
reaching MDG4 on reducing underfive mortality by two thirds
• United Nations General Assembly
Special Session goals by 2015:
(i) Ensure full immunization of
children under one year of age.
(ii) Vitamin A Deficiency Elimination.

174

• World Health organization (WHO) and goals
by 2015: (i) Polio Eradication, (ii) Measles
Mortality Reduction, (iii) Maternal and
Neonatal Tetanus Elimination (MNTE).
• For example, in 2010 an estimated 109
million children under the age of one were
vaccinated with three doses of diphtheriatetanus-pertussis (DTP3) vaccine.


175

• Therefore, every death case or
disability of preventable disease is
unacceptable.
• The EPI started in 1976 in Sudan
and sience then smallpox has been
eradicated.


176

EPI schedule in Sudan
AGE

VACCINE

At birth

BCG + polio (zero dose )

6 week

DPT + hepatitis b + H influenza
+polio+ ROTA
+polio+ ROTA

10 week
14 week

+polio

9 MONTH

MEASELS

177

• BCG is a vaccine against tuberculosis . At
best the vaccine is effective in
preventing tuberculosis for duration of
15 years.


178

• Polio vaccine are used
through the world to
compact poliomyelitis . It can
be administrated orally or can
be injected . The two vaccines
have eliminate polio from
most countries in worldwide
and reduce the world
incidence from an estimated
350000 cases in 1988 to 1.652
case in 2007.

179

• Rota vaccine protects
children from
rotavirus which lead
to sever diarrhea
among infants and
young children . Each
year an estimate
453.000 child die from
diarrheal disease
caused by rotavirus.

180

• Measles still remains a
leading cause of death
among young children
Although there is no
cure, a highly
effective, safe vaccine is
available , nowdays thier
is another booster dose
at 18 month of age .


181

• Maternal and neonatal tetanus deaths can be
easily prevented by hygienic delivery and
cord care practices, and/or by immunizing
mothers with tetanus vaccine.


182

• Child has painful muscle contraction from
tetanus


183

• Heptities B vaccine helps to protect
against heptities B , which is a very
serious and fatel condition ,their is
amonth interval between the first
and second dose and after 6
monthes the thired dose.

184

• This woman is suffering from liver cancer
caused by hepatitis B


185

Progress of immunization in sudan
•
•
•
•
•

From 1980-2010
Diphtheria 587 ------------------ one case
Polio 4151 -----------------------zero case
Measles 50168 ---------------- 680 case
Pertussis 28631 -------------- 209 case


186

• Despite the massive international efforts to
eliminate and eradicate vaccine preventable.
diseases they still known to be found due to
:• 1.financial condition.
• 2.difficulty in reaching all parts of sudan.
• 3.poor education about the diseases and
their complication.

187

Ferdos babeker

188

Adolescence health
Adolescence represents a stage
of life characterized by
significant
biological, psychosocial, and
cognitive development; a stage
of transference from childhood
to adulthood.
1


189

introduction
• This category population aged 10 – 19
years- was thought to be the least one
having health problems; this is because
most of their problems are ignored even
by themselves.
• Globally, 1.4 millions deaths occur each
year among adolescents due to road
traffic accidents, complications during
pregnancy and child
2
birth, suicide, violence, and HIV/ AIDS.

190

•Towards the end of the last decade, the
issue of adolescents’ health starts to
attract the attention of the health
programmers both in the developed and
developing countries.
•. Sudan’s national health policy doesn’t
mention adolescents’ health specifically .
3


191

.

•To keep space with the other
countries,
the
government
established the adolescent health
unit to constitute with the child
health the IMCI and Adolescent
Health Programme .
4


192

•The program has in place :_
•a national level plan of action,
• a budget for activities, and a
national taskforce.
• Besides, different institutions,
NGOs have interest in adolescent
health but are working in a
fragmented and scattered manner.
5

193

On adolescent health concern with:~

1The state of adolescent health
2HIV and young people

3Early pregnancy and childbirth
6


194

.

4Malnutrition
5Mental health
6Tobacco use
7Harmful drinking of alcohol
8Violence
9Injuries and road safety

7


195

Adolescent health epidemiology
Mortality
In last years. 2.6 million young people
died (10-24 years) and most of these
deaths were preventable. Ninetyseven percent of these deaths (2.56
million) occur in low and middle income.

8


196

mortality occurs in:
•Almost two thirds of the 2.6 million deaths
among young people were in sub-Saharan
Africa and southeast Asia, (1.67 million).
•Pronounced rises in mortality rates were
recorded from early adolescence (10–14
years) to young adulthood (20–24
years), but reasons varied by region and
sex.

11

197

Cause of adolescent mortality_
6%

15%
12%

female death due to maternal condition
death due to HIV and TB
death due to traffic accident
death due to violence
death due to suicide

11%
14%
12

198

.

Disability adjusted life years
Its measure of over all disease burden
expressed as the number of year lost due
to ill health ,disability or early death

13

199

.

Disability adjusted life years (DALY)
•The total number of incident DALYs in those
aged 10–24 years was about 236 million,
representing 15.5% of total DALYs for all age
groups.
• Africa had the highest rate of DALYs for
this age group, which was 2.5 times greater
than in high-income countries.
14


200

.

.
•Worldwide, there is three main causes of DALY for 10–
24- old which is:_
Years

1 neuropsychiatric disorders (45%)
2unintentional injuries (12%)
3infectious and parasitic disease(10%)

15

201

•But here in Sudan the infectious
and parasitic disease is more
common cause of DALY between
10-24years

16

202

Risk factors
The main risk factors for DALYs in
the world is:_
•alcohol (7% of DALYs)
•unsafe sex (4%)
•iron deficiency (3%)
•lack of contraception (2%)
•illicit drug use (2%)
17

203

•But the major risk factor in
Sudan is:_ iron deficiency, un
safe water and hygiene

18


204

•. However, there are still substantial data
gaps and uncertain particularly for causes
of death and levels of adolescent and adult
mortality in Africa and parts of Asia

19

205

Thanks
20

206

Yosif abd alrahman

207

School health program:
Definition of school health:

all the activities and services provided in
schools to enhance the health of the pupil
and the staff in the educational field
physically, psychologically and socially
through programs and activities
concerned with health through the
health system

208

justification for the establishment of
health promoting school
•The children represent in most countries
at least a quarter of the population.
• Easy access to the school environment.
•Teachers have influential educational
role among students and schools.
• Ability of transmission of health
awareness from school to the family and
society.

209

•The school is the starting point for
effective health promotion through:
1-prevention .
2-early detection
3-intervention whenever possible


210

Objectives:
•1 Raise awareness of health education
within the school community
• 2Provision of curative services and
health care in schools.
•3Improve health of school environment.
•4Building the capacity of
workers in the field of school
health.

211

•5Contribute in building a healthy
balanced diet.
•6Motivation and capacity in confronting
and combating epidemics and endemic
diseases.
•7Promote the mental health of students
and workers in the education field.
•8Activation of physical activity in schools
for the health of the body

212

Health school can be achieved by:

1 Fresh water safe for drinking and use.
2Safe means of sanitation
3Protection from infectious
diseases.
4protection from violence
5Protection from smoking and
drugs.

213

Specific component of school health include:
1school health services
a initial medical examination on the new
students
b periodic check-ups (for fourth grade
and seventh and second secondary)
c activities of the health survey and
to identify priority health problems
d First aid procedures

214

e emergency care
f early detection of health problems
g vaccination programs against infectious
diseases
h care of pupils with special needs
i Oral health care and dentistry
j eye-care and vision consideration
k care of ear, nose and throat

215

2 /. school health education
A / messages at the morning program
B / Exhibitions
C / wall newspapers
D / Health lectures, video presentations
E / the curriculum


216

3 / Environmental Health School
Is the environment of the school
community to protect against
direct injury or disease and
promote health and provide
preventive measures and
positions against the known risk
factors that can lead to diseases
or health problems or disability in
the future.

217

• These include:
1- Furniture and study aids
2- A sufficient number of toilets
3- School canteens
4- Classes of health (the space 'lighting
and ventilation)
5- Sporting field
6- Shady areas and places of worship
7- Sewage

218

4 / Mental Health based on primary health
care for detecting the
emotional, psychological mental and
educational problems.
5/ school feeding : Aimed at the
administration's plan to cover some of the
schools with a healthy school meal
,distribution of preventive doses of vitamin
A .Ensure the safety of the food vendors
outside schools and to provide safe and
clean canteen services.

219

6/ physical

health including holidays , rest
between classes. Physical activities and
this is done in coordination with the
Department of Student Activity
7 / community involvement : Associations
and councils of parents and teachers.
Community participation in planning for
school health programs


220

8/ promoting the health of school staff
by :
Health insurance for workers in
schools. Vaccination against diseases
(meningitis). Services, safe motherhood
and reproductive health. Tobacco
Control (School of smoke-free)

221

*Basic constraints of the program:
1-Poor coordination
2-Training
3- Movements of the trainers
4- The school environment
5- Coverage of private schools
6- Inactivation of some components of
school health
7-Lack of fund

222

Mother and child comunity

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