MOTHER AND CHILD HEALTH :Justifications for the provision of MCH Care

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MOTHER AND CHILD HEALTH

Maternal and child health (MCH) care is the health service provided to mothers (women in their child bearing age) and children. The targets for MCH are all women in their reproductive age groups, i.e., 15 - 49 years of age, children, school age population and adolescents. Throughout the world, especially in the developing countries, there is an increasing concern and interest in maternal and child health care. This commitment towards MCH care gains further strength after the World Summit for Children, 1991, which gave serious consideration and outlined major areas to be addressed in the provision of Maternal and Child Health Care services.

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Justifications for the provision of MCH Care

1. Mothers and children make up over 2/3 of the whole population. Women in reproductive age (15 - 49) constitute 21%, pregnant women, 4.5%, children under 5, 47%, children under 5, 18%, under 3: 12% and infants: 4%. (This working estimate is very important in developing countries for project planning and implementation)

2 Maternal mortality is an adverse outcome of many pregnancies. Miscarriage, induced abortion, and other factors, are causes for over 40 percent of the pregnancies in developing countries to result in complications, illnesses, or permanent disability for the mother or child. About 80 percent of maternal deaths in are directed obstetric deaths. They result "from obstetric complications of the pregnant state (pregnancy, labour, and puerperium), from intervention, omissions, incorrect treatment, or from a chain of events resulting from any of the above.

3 Mast pregnant women in the developing world receive insufficient or no prenatal care and deliver without help from appropriately trained health care providers. More than 7 million newborn  deaths are believed to result from maternal health problems and their mismanagement.

4. Poorly time mantel pregnancies curry high risks of morbidity and mortality. as well as social and economic costs, particularly to the adolescent and many unwanted pregnancies end in unsafe abortion.

S. Poor maternal health hurts women's productivity, their families' welfare, and socio-economic development.

6. Large number of women suffers severe chronic illnesses that can be exacerbated by pregnancy and the mother's weakened immune system and levels of these illnesses are extremely high.

7. Infectious diseases like malaria are more prevalent in pregnant women than in non-pregnant women (most common in the first pregnancy). In addition, an increasing number of pregnant women are testing positive for the human immunodeficiency virus. In Sub Saharan Africa, 3 million women are estimated to be infected with the AIDS virus and a woman with HIV has a 25 to 40 percent chance of passing the infection on to her fetus in the womb or at birth.

8. Many women suffer pregnancy-related disabilities like uterine prolapse long after delivery due to carly marriage and childbearing and high fertility.

9. Nutritional problems are severe among pregnant mothers and 60 to 70 percent of pregnant women in developing countries are estimated to be anaemic. Women with poor nutritional status are more likely to deliver a low-birth - weight infant.

10. Majority of perinatal deaths are associated with maternal complications, poor management techniques during labour and delivery, and maternal health and nutritional status before and during pregnancy.

11. The large majority of pregnancies that end in a maternal death also result in fetal or perinatal death. Among infants who survive the death of the mother, fewer than 10 percent live beyond their first birthday.

12. Ante partum haemorrhage, eclampsia, and other complications are associated with large number of perinatal deaths each year in developing countries plus considerable suffering and poor growth and development for those infants who survive.

13. Development impairments among children due to poor management during labour and delivery.

14. Low birth weight babies. Because many women are fed less, marry carly, carry a heavy workload, and spend a considerable portion of their lifespan in pregnancy and lactation, they are exposed to persistent low nutritional status and high-energy expenditure. This predisposes mothers to bear low-birth weight infants.

15. Women often lack access to relevant information, trained providers and supplies, emergency transport, and other essential services.

16. Cultural attitudes and practices impede women's use of services that are available.

17. Children whose earliest years are faced by hunger or disease or whose minds are not stimulated by appropriate interaction with adults and their environment will experience grave and negative consequence throughout their lives-and so does society as they would be less contributory member.

Given the magnitude of these problems and the interventions available, much has not been done. Most of these problems are silent. They remain, to a large extent, uncounted and unreported. Maternal and child health programmes should focus on addressing these problems, clarifying policy and program alternatives and identifying cost-effective health-related program interventions that are likely to reduce maternal and child morbidity and mortality.

These outlined issues do not only show the importance of MCH care to the health of mothers and children or their immediate problems. Rather, they show the role and necessity of MCH çıre in the welfare of the family, the community and the country as a whole. Thus, MCH care an issue that has to be addressed in terms of national productivity and futurity of a country.

The specific objectives of MCH Care focuses on the reduction of maternal, perinatal infant and childhood mortality and morbidity and the promotion of reproductive health and the physical and psychosocial development of the child and adolescent within the family.

Objectives and Targets of WHO

1. To reduce maternal morbidity and mortality due to pregnancy and child birth.

2. To reduce morbidity and mortality due to unsafe abortion

3. To reduce perinatal and neonatal morbidity and mortality.

4. To promote reproductive health awareness for young children.

5. To increase knowledge of reproductive biology and promote responsible behaviour of adolescents regarding contraception, safe sex and prevention of sexually transmitted infections.

6. To reduce the levels of unwanted pregnancies in all women of reproductive age.

7. To reduce the incidence and prevalence of sexually transmitted infections, in order to reduce the transmission of HIV infection.

8. To reduce the incidence and prevalence of cervical cancer .

9. To reduce female genital mutilation and provide approparaite care for females who have already undergone genital mutilation. 

10. To reduce domestic and sexual violence and ensure proper mananagment of the victims.