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  1. 1

    Strengthening maternal and child health programmes through primary health care. Guidelines for countries of the Eastern Mediterranean Region. Based on the deliberations of the Intercountry Meeting on the Integration of MCH into Primary Health Care, Amman, Jordan, 11-15 December 1988.

    World Health Organization [WHO]. Regional Office for the Eastern Mediterranean [EMRO]

    Alexandria, Egypt, WHO, EMRO, 1991. 75 p. (WHO EMRO Technical Publication No. 18)

    All countries in the WHO Eastern Mediterranean Region (EMRO) have had maternal and child health (MCH) programs for many years, yet maternal mortality and morbidity and infant mortality remain high. The EMRO office in Jordan, recognizing this dilemma, convened a meeting of national managers from the 22 EMRO member states to discuss how to integrate MCH programs with primary health care (PHC). The meeting resulted in the publication of guidelines and goals to help each country integrate MCH into PHC which would strengthen MCH services and improve MCH status. The managers noted the need to switch from a pregnancy-oriented approach to a holistic approach in which MCH/PHC programs and society consider women as more than childbearers. MCH/PHC programs and society need to be concerned about the well-being of females beginning with infancy and should place considerable health promotion for girls during the pubertal spurt and adolescence. They should also promote prevention of iron deficiency anemia in women. Since maternal mortality is especially high is EMRO, the national managers clearly laid out approaches for health services to reduce maternal mortality caused by obstetrical complications. They also recognized the need for a practical alternative to obstetric care provided by health workers--training traditional birth attendants in each village. They also provided guidance on improving prenatal care to reduce perinatal and neonatal mortality such as vaccination of every pregnant woman with the tetanus toxoid. Since the causes of death in the postneonatal period, MCH/PHC programs need to take action to reduce malnutrition and infection. For example, they must promote breast feeding for at least the first 6 months of life. The managers suggested the implementation of the Child Survival and Development Strategy which includes growth monitoring.
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  2. 2

    Meeting of principal investigators of risk approach study in MCH care, report of an intercountry meeting, Rangoon, Burma, 30 December 1985-3 January 1986.

    World Health Organization [WHO]

    [Unpublished] 1986 Sep 5. ii, 42 p. (SEA/MCH/183; RAS/85/P23)

    Objectives of the intercountry meeting of principal investigators of risk approach study in maternal-child health (MCH) care were: 1) to review the results of the risk approach studies in Burma, India, and Thailand that have been done to identify research design and method problems, and to propose solutions for improved study; 2) to identify research issues relevant to study, and applying the risk strategy; 3) to explore the devices for application of the risk approach results in delivery of MCH/family planning (FP); and 4) to find further areas for research. In Burma, some problems were: there were no proper patient records; and staff was not being scheduled properly. There was a drop in the overall incidence of low birth weight deliveries from 21% in 1977-78 to 10-16% in 1983-83. The Indian project was started in January 1981, and lasted until the end of December, 1984. Study design was a "before and after" model. The overall risk detection rate was 80%. In Thailand a "before and after" model was used in 136 villages of 18 subdistricts in the Bang Pa In district of Ayuthaya Province. The before intervention situation took place in 1977-78; the after period runs from May, 1980 to April, 1983. Overall results show better coverage of prenatal, natal, and child care; and improvement in diarrhea and tetanus morbidity in newborns. The Amphur Nong Rua area of Khon Kaen was chosen as the 2nd Thailand project area. Its population is 77,209 (1983) living in 116 villages. A stratified random sampling technique was used. All women who miscarried or delivered from January 1, 9182 to December 31, 1983 and all infants born to these mothers were included. The health system of Bhutan is discussed, as well as health organization in Burma, India, Indonesia, Nepal, Sri Lanka, and Thailand. Researchable issues include low birth weight, social-behavioral, nutritional deficiency, and mental health studies. An action program is described.
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