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Care of mother and baby at the health centre: a practical guide. Report of a technical working group.
Geneva, Switzerland, WHO, Division of Family Health, Maternal Health and Safe Motherhood Programme, 1994. , 55 p. (Safe Motherhood Practical Guide; WHO/FHE/MSM/94.2)This report is designed for health planners and program managers to improve access to health and to decentralize maternal and newborn health care. It covers secondary care services that traditional birth attendants (TBAs), midwives, and other nonphysician health workers in health centers can perform. Specifically, it defines the tasks and skills required to provide comprehensive care of mother and infant at the health center and in the community. It also looks at the role of the health center in training, supervision, and continuing logistic support for community based care. The first chapter examines the health center's role in maternal health and the 3 approaches to integrated care: vertical integration, integration across time, and horizontal integration. The next chapter reviews the essential elements of obstetric and neonatal care, including sexually transmitted diseases and HIV/AIDS. Topics discussed in the chapter on developing and maintaining a functional referral system include referral protocols, functional links with referral centers, obstetric first aid, maternity waiting homes, transport and communication, and reception of referred cases in referral centers. Institutional support mechanisms (chapter 4) are training; teamwork and supervision; logistics, maintenance, and essential drugs and supplies; management, communication, and interpersonal skills; and data collection and research. Topics included in the chapter on community support systems are TBA training and retraining, integrating the TBA into the health care system, IEC, and community support mechanisms for the health of mothers and newborns. The last chapter revolves around evaluation and monitoring, including estimating catchment area and coverage, monitoring quality of care for mothers and newborns, performance indicators, record keeping, and home-based maternal records.