Family health

• Reproductive Health is a state of complete physical, mental, and social well-being related to the reproductive system and its functions
• The family is the basic unit of human social organization, consisting of the father, mother, and their biological and/or adopted children
• Health is a state of physical, mental, social, financial, psychological, and spiritual well-being, not just the absence of disease
• Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, from causes related to or aggravated by the pregnancy
• Live birth is the complete expulsion or extraction of a product of conception from its mother, which shows evidence of life
• A skilled health attendant is an accredited health professional trained to manage normal pregnancies, childbirth, and postnatal periods, and identify complications
• Counts are the number of cases of a disease or health problem under study, useful for resource allocation
• Proportions are the numerator part of the denominator, expressed as a percentage over a base of 100
• Ratios relate events to the source population without implying a specific relationship between the numerator and denominator
• Rates are time-specific proportions that relate events to a population base over a given time period
• Indicators are measurable information used to determine if a program is being implemented as expected, markers of health status, service provision, or resource availability
• Total fertility rate is the total number of children a woman would have by the end of her reproductive period, not affected by the age structure of the female population
• Contraceptive prevalence is the percentage of women of reproductive age using a contraceptive method at a particular point in time
• Low birth weight prevalence is the percentage of live births weighing less than 2500 g, a predictor of survival
• Maternal mortality ratio is the number of maternal deaths per 100,000 live births from causes associated with pregnancy and childbirth
• Births attended by skilled health personnel is the percentage of births attended by skilled health personnel, indicating safe motherhood program effectiveness
• Availability of basic essential obstetric care is the number of facilities with functioning basic care per 500,000 population
• Antenatal care coverage is the proportion of women attended by skilled health personnel at least once during pregnancy
• Availability of comprehensive essential obstetric care is the number of facilities with functioning comprehensive care per 500,000 population
• Perinatal mortality rate is the number of perinatal deaths per 1000 total births, reflecting viability till the first week after birth
• Positive syphilis serology prevalence in pregnant women is the percentage of pregnant women with positive syphilis serology attending antenatal clinics
• Prevalence of anaemia in women is the percentage of women with haemoglobin levels below specified thresholds
• Percentage of obstetric and gynaecological admissions owing to abortion is the percentage of admissions due to abortion at service delivery points
• Reported prevalence of women with FGM is the percentage of women reporting to have undergone FGM in a community survey
• Prevalence of infertility in women is the percentage of women at risk of pregnancy trying for two years or more
• Reported incidence of urethritis in men is the percentage of men reporting at least one episode of urethritis in the last 12 months
• HIV prevalence in pregnant women is the percentage of pregnant women attending antenatal clinics sero-positive for HIV
• Knowledge of HIV-related prevention practices is the percentage of respondents correctly identifying ways to prevent HIV transmission
• Infant mortality rate is the number of infant deaths under one year of age per 1000 live births during the same time interval
• Infant mortality rate is used as an overall index of a nation's health status, reflecting maternal and infant health, and life expectancy at birth
• Infant mortality rate is sensitive to socio-economic conditions and changes in population health
• Mortality Indicators of Maternal and Child Health (MCH) care include:

  • Maternal mortality ratio/rate
  • Mortality in infancy and childhood:
  • Perinatal mortality rate
  • Neonatal mortality rate
  • Post-neonatal mortality rate
  • Infant mortality rate
  • Under 5 mortality rate
  • Child death rate
• MM Ratio: Annual number of maternal deaths due to pregnancy, childbirth, and puerperal conditions ÷ total live births * 100,000

  • Represents the risk associated with each pregnancy

  Maternal mortality rate: Annual number of maternal deaths due to pregnancy, childbirth, and puerperal conditions ÷ total women aged 15-49 years * 1000

  • MM ratio provides information on the risk associated with each pregnancy
  • MM rate gives information on both the risk and frequency of exposure to the risk by the women
• NMR: Annual number of deaths in the first 28 days ÷ annual number of live births * 1000

  IMR: Annual number of deaths in the first year ÷ Number of live births in a year * 1000

  U5MR: Annual number of deaths under 5 years ÷ number of live births in a year * 1000

  SBR: Annual number of foetal deaths after 28 weeks gestation ÷ Total number of births in a year * 1000

  Perinatal mortality rate: Annual number of stillbirths and deaths in the first 7 days ÷ total number of births in a year * 1000
• Child death rate: Annual number of deaths of children aged 1-4 years ÷ Total number of children aged 1-4 years in a year
• Factors affecting Infant mortality:

  • Biological Factors
  • Economic Factors
  • Socio-cultural Factors
  • Birth weight
  • Age of the mother
  • Birth order
  • Birth spacing
  • Multiple births
  • Family size
  • High fertility
  • Availability/accessibility to quality health care
  • Environment of the home
  • Breastfeeding
  • Early marriages
  • Maternal education
  • Broken families
  • Illegitimacy
  • Harmful child rearing practices
• Risk Assessment for High-Risk Pregnancy:

  • Previous bad obstetrics history
  • Existing medical conditions
  • Mother's age
  • Mother's weight and height
  • Pregnancy history
  • Birth interval
• Ways to Improve Maternal and Newborn Health:

  • Before and during Pregnancy
  • During Pregnancy
  • During and After delivery
  • In the first month of life
  • Lowering MMR
  • Risk Assessment for High-Risk Pregnancy
• Identification of "at risk" infants:

  • Birth weight <2.5kg
  • Twins
  • Birth order of 5 and more
  • Artificial feeding
  • Failure to gain weight
  • Children with PEM, diarrhea
  • Working class mother/one parent
• Leading Causes of Mortality:

  • Infants: Malaria, Diarrheal diseases, Respiratory tract infections/Pneumonia, Malnutrition, Vaccine-preventable diseases
  • Under 5: Malaria, Diarrhea, RTIs, Measles, Malnutrition, Injuries
  • Maternal Mortality: Hemorrhage, Sepsis/Infection, Unsafe abortion, Eclampsia/Toxaemia, Obstructed labor, Anaemia