|
Pre-Natal
|
Delivery
|
Post-Partum
|
Birth-Spacing
|
Prevention/Treatment
of RTIs and STDs
|
Adolescent
Reproductive Health (ARH)
|
| (*)Information
and counselling on family planning, breast-feeding, nutrition,
iron and folate supplement. |
Recognition and early
detection of complications (for example, haemorrhage, eclampsia,
prolonged/ obstructed/labour) and referral
to hospital. |
Recognition and early
detection and emergency management of post-partum complications
(for example, haemorrhage, sepsis, eclampsia)
and referral to hospital. |
(*)Sexuality and
gender information and counselling, community mobilisation and
education for adolescents, youth, men and women. |
STD/HIV education
and prevention of spread of infections. |
Information and services
to adolescents with privacy, confidentiality and non-judgmental
manner. |
| (*)Education on prevention
of RTIs and STDs during pregnancy. |
Clean and safe (atraumatic)
delivery, with proper supervision. |
(*)Promotion and
support of breast-feeding/ exclusive breast-feeding. |
CBDs participation
in contraceptive service delivery and management
of method-related side effects. |
Referral to health
centres/hospitals for women with RTIs/STDs symptoms. |
Peer education programme. |
| Advice on
tetanus toxoid immunisation. |
Transport arrangement
for sending mothers with complications to hospital. |
(*)Information
and services for family planning, nutrition and post-partum
care and exercise. |
Counselling and provision
of contraceptive methods for post-abortion women. |
Prevention of infections
including opthalmia neonatorum and cord infections. |
Advocacy activities
to influence parents, key persons and the public on
the importance of adolescent health. |
| Treatment of existing
conditions (for example: hookworm, malaria, tuberculosis, esp.
for malaria in infected areas). |
-
|
(*)Education
on STD/HIV prevention. |
-
|
Routine prophylaxis
for gonococcal infection of the newborn. |
-
|
| Recognition, early
detection of complications (eclampsia/pre-eclampsia, bleeding,
threatened abortion, diabetes). |
-
|
Education on care
of low- birth weight infants (2,000 to 2,500
grams). |
-
|
-
|
-
|
| Referral to health
centre/hospital for women with RTIs and STDs symptoms. |
-
|
-
|
-
|
-
|
-
|
Note: Generally, these
RH services are to be introduced or strengthened.
(*) "Missed opportunities"
in the provision of RH care.
Table 2 Services
at the Health Centre Level
|
Pre-Natal
|
Delivery
|
Post-Partum
|
Birth-Spacing
|
Prevention/Treatment
of RTIs and STDs Health
|
Adolescent
Reproductive (ARH)
|
| (*)Counselling and
educationon breast-feeding, nutrition,birth-spacing, rest and
exercise etc. |
Recognition of complications
e.g. early rupture of membranes, prolapse of cord, haemorrhage,obstructed
labour and referral for hospital delivery. |
Provision of routine
post- natal care.
|
Contraceptive service
delivery Ð provision of a wide range of contraceptives to
facilitate choice including management of side-effects. |
Education on preventionand
spread of RTIs/ STDsto adolescents, men and women. |
Information and services
in a non-judgmental and youth-friendly manner.
|
| (*)Education
on prevention of RTIs and STDs during pregnancy. |
Prophylaxis treatment
for gonococcal or opththalma neonatorum infections of the newborn. |
(*)Provision of breast-feeding
support including management of breast complications /exclusive
breast-feeding. |
Referral for tubal
ligation.
|
Treatment for symptomatic
men and women based on guidelines. |
Peer education and
peer counselling.
|
| Early detection and
management of complications (eclampsia/ pre-eclampsia, bleeding,
abortion, anaemia). |
Detection and management
or referral of post-partum complications. |
(*)Information
on birth- spacing.
|
Post-abortion counselling
as well as provision of a suitable contraceptive method. |
Provision of condoms.
|
Education programmes
for parents, key persons and other youths on ARH. |
Detection and management
of pregnant women with RTIs and STDs.
|
-
|
(*)Nutrition education,
iron and folate supplements.
|
(*)Sexual and
gender information and counselling.
|
Refer women and men
with severe symptoms (for example, vaginal discharge
pain at lower abdomen,
uretheral discharge, genital ulcers and swelling at groin or scrotum). |
-
|
| Tetanus toxoid immunisation. |
-
|
Care of pueperium
and initial treatment of puerperal sepsis. |
-
|
Partner notification
and referral. |
-
|
| Prophylaxis treatment
for malaria infested areas. |
-
|
Resuscitation,
management
of neo-natal
hypothermia. |
-
|
-
|
-
|
Iron/folate supplements.
Ante-natal syphllis
screening.
Referral for complications
and STDs. |
-
|
Management of low-weight
infants. |
-
|
-
|
-
|
Note: Generally,
these RH services are to be introduced or strengthened.
(*) "Missed opportunities"
in the provision of RH care.
Table 3 Services at District Hospital Level
|
Pre-Natal
|
Delivery
|
Post-Partum
|
Birth-Spacing
|
Prevention/Treatment
of RTIs and STDs
|
Adolescent
Reproductive Health (ARH)
|
| (*)Counselling and
education on breast-feeding, nutrition, birth-spacing, rest,
exercise,etc. |
Detection of complications
and referral for provincial hospital delivery. |
Provision of routine
post- natal care through five post-partum visits. |
Information, education
and counselling on family planning. |
Sexuality and gender
information, education and counselling for adolescents,
youth, men and women on prevention and spread of
infections. |
Provision of information
and services in a non-judgmental and youth-friendly
manner. |
| (*)Education on prevention
of RTIs and STDs. |
Routine prophylaxis
for gonococcal infection in the newborn. |
Provision of
breast-feeding support, exclusive breast-feeding. |
Provision of a wide
range of contraceptives including IUDs if available. |
Provision of
condoms. |
Health talks on ARH
to young people, community leaders, parents and other adults. |
| Immunisation for
tetanus prevention during pregnancy. |
Arrangement
of transport for referral cases. |
(*)Provisions of
birth- spacing counselling and
services. |
Counselling and management
of cases referred for method-related side effects. |
Management/Treatment
for symptomatic men and women based on guidelines. |
-
|
| Detection and referral
of cases with complicated pregnancies. |
Obtain feedback of
cases referred. |
(*)Provision of nutrition
education and iron and folate supplements. |
Referral for tubal
ligation. |
Diagnosis and treatment
of some infections and referral of others. |
-
|
| Routine prophylaxis
for malaria in endemic areas. |
-
|
Management of women
referred with complications from the community centres or
clinics. |
Provide birth-spacing
counselling for post-abortion women. |
Partner notification,
treatment and referral. |
-
|
| Treatment of malaria. |
-
|
Treatment of puerperal
sepsis. |
-
|
Routine syphilis
testing in ante-natal women. |
-
|
| Treatment of tuberculosis. |
-
|
Resuscitation for
asphyxia of the newborn. |
-
|
Routine prophylaxis
for gonococcal infection of the newborn. |
-
|
| Provision of ante-natal
services at clinics through outreach. |
-
|
Management
of neonatal hypothermia. |
-
|
Management of referred
cases and feedback to the referral
source. |
-
|
| Detection and management
of complications e.g. hypertension, pre-eclampsia, malaria, tuberculosis
and diabetes |
-
|
Referral for complications
arising after delivery and obtain feedback from the source. |
-
|
-
|
-
|
| Referral for hospital
delivery in cases with complications. |
-
|
-
|
-
|
-
|
-
|
| Routine testing for
syphilis.Diagnosis and treatment of selected RTIs and STDs
and referral for others. |
-
|
-
|
-
|
-
|
-
|
| Management of referred
cases and feedback to referral source. |
-
|
Management of low
birth weight 2,000-2,500 grams) infants
by feeding, temperature control and prevention of
infections including opthalmia neonatorum and
cord. |
-
|
-
|
-
|
Note: Generally, these
RH services are to be introduced or strengthened.
(*) "Missed opportunities"
in the provision of RH care.
Table 4 Services at the Provincial Hospital
|
Pre-Natal
|
Delivery
|
Post-Partum
|
Birth-Spacing
|
Prevention/Treatment
of RTIs and STDs
|
Adolescent
Reproductive Health (ARH)
|
| (*)Counselling and
education for breast-feeding, nutrition, birth-spacing,
rest, exercise, etc. |
Provision of institutional
delivery services. |
Provision of post-natal
care through five post-partum visits. |
Sexuality and gender
information, education and counselling. |
Sexuality and gender
information, education and counselling for adolescents,
youth, men and women on prevention and spread of the infections. |
Provision of information
and services in a non-judgmental
and youth-friendly manner. |
| (*)Education on the
prevention of RTIs and STDs during pregnancy. |
Treatment of
pregnancy complications. |
(*)Provision
of breast-feeding support, exclusive breast-feeding. |
Providing a wide
range of contraceptive methods including insertion of IUD
when necessary and performing tubal ligation. |
Provision
of condoms. |
-
|
| Immunisation for
tetanus prevention. |
Routine prophylaxis
for gonococcal infection in the newborn. |
(*)Provisions
of birth-spacing counselling and services. |
-
|
Management and treatment
for symptomatic men and women based on guidelines. |
-
|
| Provision of ante-natal
service at clinics. |
Management
of obstetrical emergencies. |
(*)Provision
of nutrition education and iron/folate supplements. |
-
|
-
|
-
|
| Management of cases
with complications. |
Arrangement of transport
for obstetrical emergencies. |
Treatment of puerperal
sepsis. |
Counselling and
management of cases referred for side effects, method-related
problems, and change of method where indicated. |
Limited laboratory
diagnosis and treatment. |
-
|
| Routine prophylaxis
for malaria in endemic areas. |
Management of referred
cases and feedback to referral source. |
Manual removal of
retained placenta. |
Provide birth-spacing
counselling for post-abortion women. |
Partner notification
and treatment. |
-
|
| Treatment of malaria. |
-
|
Resuscitation for
asphyxia of the newborn. |
-
|
Routine syphilis
testing in ante-natal women. |
-
|
| Treatment of tuberculosis. |
-
|
Management of neonatal
hypothermia. |
-
|
Routine prophylaxis
for gonococcal infection of the newborn. |
-
|
| Routine testing for
syphilis. |
-
|
Management of referred
cases and feedback to referral source. |
-
|
Management of referred
cases and feedback to referral source. |
-
|
| Diagnosis and treatment
of RTIs and STDs. |
-
|
Management of low
birth weight (2,000-2,500 grams) infants by feeding, temperature
control and infection prevention methods. |
-
|
-
|
-
|
| Management of referred
cases and feedback to referral system. |
-
|
-
|
-
|
-
|
-
|
| Provision of ferrous
sulphate. |
-
|
-
|
-
|
-
|
-
|
Note: Generally, these
RH services are to be introduced or strengthened.
|
