MALNUTRITION
Malnutrition is a widespread problem in poor nations. Children and women who are becoming mothers or breastfeeding are especially at risk for malnutrition. Pregnancy problems that might occur from malnutrition include:
- Maternal depletion: Mothers who experience maternal depletion after giving birth are unable to recover nutritionally, hormonally, or emotionally.
- Anaemia
- Post-partum and Ante-partum haemorrhage
- Toxaemia of pregnancy: It is a pregnancy complication marked by elevated blood pressure and symptoms of damage to other organ systems such as the liver or kidneys.
- Low birth weight in baby
Critical periods in a child’s life when he or she is most prone to malnutrition:
- Period of Intra-uterine: Children born with adequate birth weight have lower mortality even under poor environmental conditions
- Period of Weaning: Severe malnutrition coincides with the usual age of weaning
Malnourished children: Malnourished children are not only more susceptible to infections, but the severity of disease caused by infections is greater in malnourished children than in well-nourished children. As a result, improving, protecting, and promoting nutritional status is a critical component of MCH treatment. There are both direct and indirect interventions for improving the nutrition of mothers and children.
- Direct interventions for improving nutritional status are: Supplementary feeding programs e.g., ICDS, mid-day meal Food fortification e.g. Iodine, iron fortification of salt, Vitamins A and D fortification of vegetable oils, Iron and folic acid tablet distribution as well as Nutritional education.
- Indirect interventions are ones that do not include direct nutrition delivery but ultimately enhance nutritional status: Immunisation is used to control infections. Infections drain nutrition in general, therefore eliminating them would enhance nutritional status. Because some illnesses, such as measles, are known to specifically promote PEM, vitamin A insufficiency, and other nutritional deficiencies, measles vaccination would indirectly conserve nutrition by preventing measles. Food hygiene, provision for safe drinking water, environmental sanitation, education, education provides people with nutrition information.
INFECTION
Infections cause increased morbidity and death in both the mother and the newborn. While the risk of infections is low in high-income nations, they remain a big problem in developing countries such as India.
Infection during pregnancy can result in-
- IUGR and low birth weight
- Congenital malformations in the foetus e.g., Rubella
- Abortions
- Puerperal sepsis
Cytomegalovirus, herpes and toxoplasma infection are some of the infections seen among pregnant women
In addition, 25 percent of pregnant women in rural areas have at least one bout of urinary tract infection
Infection in the child:
- The risk begins with delivery and then increases
- Almost a third of the period of infancy may be afflicted by infections in developing countries
Children are at risk for
- Diarrhoeal disease
- Respiratory tract infection and
- Skin infections
- Some regions of the country have increased risk of TB and malaria also
Frequent infections may precipitate severe PEM and anaemia
These conditions lead to traditions, taboos which may further aggravate the condition; therefore prevention and treatment of infections is a major activity of MCH care. Infections can be controlled by- Immunization- children in developing countries need to be immunized against the major six infections covered under WHO’s EPI
- TB
- Diphtheria
- Whooping cough
- Tetanus
- Measles and
- Polio
UNREGULATED FERTILITY
It is adversely affecting the health of both, the mother and the child such as Severe anaemia, Abortion, Antepartum hemorrhage, High maternal mortality, the risk increasing significantly after the 4th pregnancy.
In other hand Adverse effects on the child: Low birth weight, Anaemia, High perinatal mortality, the risk increasing greatly after the 4th pregnancy.
FAMILY PLANNING
Family planning services are an important component of MCH services since they have been found to have a significant impact on both the mother’s and the child’s health. Furthermore, new and safer intrauterine contraceptive devices, oral contraceptive tablets, long acting injectable medroxy progesterone acetate, female sterilisation, and barrier techniques are now accessible. Services can also be provided by peripheral health workers. In reality, some countries intend to incorporate family life instruction within the school curriculum.
Reference:
- Release of NFHS-5 (2019-21) – Compendium of Factsheets | Ministry of Health and Family Welfare | GOI [Internet]. [cited 2023 Sep 23]. Available from: https://main.mohfw.gov.in/basicpage-14
- SRS – Maternal Mortality Bulletin | Government of India [Internet]. [cited 2023 Sep 23]. Available from: https://censusindia.gov.in/census.website/data/SRSMMB
- Government of India | Office of the Registrar General & Census Commissioner, India [Internet]. [cited 2023 Sep 23]. Available from: https://censusindia.gov.in/census.website/data/SRSSTAT
- Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division: executive summary [Internet]. [cited 2023 Sep 23]. Available from: https://www.who.int/publications-detail-redirect/9789240069251
- Maternal health [Internet]. [cited 2023 Sep 23]. Available from: https://www.who.int/health-topics/maternal-health
- Pradhan Mantri Surakshit Matritva Abhiyan | PMSMA [Internet]. [cited 2023 Sep 23]. Available from: https://pmsma.mohfw.gov.in/
- Anemia Mukt Bharat [Internet]. [cited 2023 Sep 23]. Available from: https://anemiamuktbharat.info/
- SUMAN | Surakshit Matritva Aashwashan [Internet]. [cited 2023 Sep 23]. Available from: https://suman.mohfw.gov.in/
- Labour room & Quality Improvement Initiative :: National Health Mission [Internet]. [cited 2023 Sep 23]. Available from: https://nhm.gov.in/index1.php?lang=1&level=3&sublinkid=1307&lid=690
- Preventive Medicine in Obstetrics, Pediatrics and Geriatrics; Park’s Textbook of Preventive and Social Medicine, 23rd ed.