“Health for All” in Uganda Starts with Sahmyook Univ., S. Korea
Happy Family through FP & MCHI
Family Planning & Mother-Child Health Improvement (FP & MCHI) Introduction
Contents The KOICA (Korea international cooperation agency) and Sahmyook University have joined together to promote health practices in LUWERO District, Uganda. The time at which mothers start of antenatal care visits is at 5-6months and monitoring and detection of complications is late and limited. The institutional deliveries and deliveries supervised by trained personnel have
1.
Family Planning
01
2.
Pre conception care
10
3.
Antenatal care
12
4.
Labour and delivery care
20
5.
Postnatal care
22
6.
Nutrition
25
7.
Breast feeding
29
8.
Immunization
32
9.
Elimination of mother to child transmission
35
10.
HIV / AIDS
37
11.
Childhood illness
43
remained low, with only 52% of all deliveries being conducted by trained staff. This implies that one 48% of deliveries occur in communities away from skilled attendance and this means that if complications occur women are unlikely to be assisted in time . It can be inferred that even the rest of the community members have limited information and they can’t help in referral. Therefore this training manual and flip chart on maternal and child health / family planning is designed to increase community awareness and demand for the utilization of health services for quality antenatal care, supervised delivery, post natal care, immunization and family planning. This training manual and flip chart will help nurses/ midwives to deliver key messages to the community members to improve community capacity to respond to the needs of women during pregnancy, child birth , after delivery, child survival, and family planning.
Lesson 1
Family Planning
Lesson 1
Family Planning 2
Which one is better?
Lesson 1
Family Planning 3
Which one is better?
Lesson 1
Family Planning 4
When couples think for family planning?
Family Planning 5
Lesson 1
Short Acting methods
●
Pills
●
●
Diaphram
Injection
●
●
Condom(male, female)
Spermicides
Family Planning 6
Lesson 1
Long Acting methods
●
Implants
●
IUD
●
Female Sterilzation
●
Vasectomy
Family Planning 7
Lesson 1
Precaution : Women should take when using birth control pills
1. Do not smoke; especially if you are over 35 It can cause heart problems
2. Examine the breasts carefully every month for lumps or possible signs of cancer
3. If possible, have your blood pressure measured every 6 month
Family Planning 8
Lesson 1
Natural methods
â—?
The counting days
â—?
The mucus method
Family Planning 9
Lesson 1
Home methods
â—?
Withdrawal
â—?
Breast feeding for the first 6 months (LAM)
Lesson 2
Pre conception care
Pre conception care 11
Lesson 2
Pre paration for babies
●
Health centre
●
Hospital
●
Church
Lesson 3
Lesson 3
Antenatal care
Lesson 3
Antenatal care 13
Visit health centre
Lesson 3
Antenatal care 14
What are the signs that a woman is pregnant?
Lesson 3
Antenatal care 15
What care should a woman have during pregnancy?
Antenatal care 16
Lesson 3
What should a pregnant woman do to protect her health?
â—? â—?
Get Tetanus Toxoid (TT) immunization
Take anti malarial tablets (fansidar) at the fourth and seventh month of pregnancy
Antenatal care 17
Lesson 3
What should a pregnant woman eat?
●
Protective Foods
●
Body Building Foods
●
Energy Giving Foods
Antenatal care 18
Lesson 3
What are the danger signs during pregnancy? ●
●
Any vaginal bleeding
Severe headache
●
●
Mother filting or having convulsion
Exessive vomiting
●
●
Severe abdominal pain
Swelling of face hands, arms & legs
●
Fever
Antenatal care 19
Lesson 3
What is included in birth plan?
4 pairs of gloves
Basin
Plastic sheet (Ekiveera)
Gauze (material for dressing that can be bought from a phamacy)
3 pieces of string (about 20cm each)
Soap
Razor blade
Clean clothing for you
Sanitary pads
Sugar and tea leaves
Requirements in the mama kit
Baby clothing
Money for emergencies e.g Transport & other needs
Lesson 4
Lesson 4
Labour and delivery care
Lesson 4
Labour and delivery care 21
Labour and delivery care
Danger sign
Lesson 5
Postnatal care
Postnatal care 23
Lesson 5
messages given to the mother about Vit.A
â—?
Every 6 months until he/she is five years old
Postnatal care 24
Lesson 5
The newborn’s danger sign
●
Baby breathing with difficulty
●
Baby not able to breastfeed well
●
●
Weak baby
Baby with a reddened area surrounding cord is discharging smelly pus
●
Baby with a hot body(fever)
●
Baby has had convulsion
Lesson 6
Lesson 6
Nutrition
Lesson 6
Nutrition 26
The recommended diet for health living
Lesson 6
Nutrition 27
What are the effects of poor nutrition?
Nutrition 28
Lesson 6
Key nutrition messages The First 6 months YES
●
From 6 months to 2 years ●
Breast milk
Breast milk and nothing else ●
●
Cow, goat or powdered milk
other well-cooked, nutritious foods
NO
The Best diet for small children
Lesson 7
Lesson 7
Breast feeding
Breast feeding 30
Lesson 7
The importance of breast feeding To Baby : To Mother : ●
It helps to stop bleeding after delivery and facilitates involution
●
Breast feeding is birth spacing, exclusive breast feeding reduces total potential fertility before six (6) months post partum It reduces family expenditure burden on artificial feeds
●
Colostrum (the first thick yellow milky)
●
Helps clean the baby’s stomach and eliminate the first black stools
Lesson 7
Breast feeding 31
Mother-Child attachment From 6 months up to 2 years, continue to breast feed the baby until two years or beyond as breast milk continues to be the baby’s major source of energy and nutrients Report any difficulty in breast feeding the baby to the health workers immediately
Lesson 8
Lesson 8
Immunization
Immunization 33
Lesson 8
Health Centre
Immunization is one of the ways and means of preventing and controlling childhood diseases
Lesson 8
Immunization 34
The childhood immunizable diseases ● Tuberculosis ● Polio ● Diphtheria, Purtusis (Whooping cough) ● Tetanus ● Pneumonia ● meningitis ● Measles ● Diarrhea
Lesson 9
Lesson 9
Elimination of mother to child transmission
Lesson 9
Elimination of mother to child transmission 36
How is HIV transmitted from mother to child?
Lesson 10
HIV / AIDS
HIV/AIDS 38
Lesson 10
How does someone get HIV infection? My turn next
●
Unprotected sex
●
Using an unsterlized needle or syringe
●
Pregnancy
●
Blood tranfusions
Lesson 10
The signs of AIDS
HIV/AIDS 39
● Loss of body weight ● Diarrhea on and off all the time for more than one month ● Continuously fever for more than one month ● A bad cough lasting more than one month ● Very weak and tired all the time ● Swollen glands anywhere in body ● Sores in the mouth and throat ● Lack appetite ● A headache and sometimes vomits
Lesson 10
HIV/AIDS 40
How can one prevent HIV infection? ● All persons intending to get married should first test for HIV ● All persons intending to have unprotected sexual intercourse should also test for HIV first to make sure that they are not infected ● All married people should remain faithful to their partners ● Always use a condom when having sex with people whose HIV status you do not know ● Women intending to get pregnant should first test for HIV ● Anyone infected with any other Sexually Transmitted Diseases (STD) should immediately seek for treatment from a trained health worker ● We should avoid sharing sharp skin piercing or cutting instruments ● HIV positive pregnant women should seek for Elimination of Mother to Child Transmission Services
REMEMBER, HIV INFECTION CAN BE PREVENTED THOUGH ABSTINENCE, FAITHFULNESS AND BY CORRECT AND CONSISTENT USE OF CONDOMS
Lesson 10 Lesson Lesson 10 10
HIV/AIDS 41 HIV/AIDS HIV/AIDS 41
If it is confirmed that the person has HIV, what should one do or not do? If If it it is is confirmed confirmed that that the the person person has has HIV, HIV, what what should should one one do do or or not not do? do? ● Use a condom correctly and consistently if you must have sexual intercourse ● ● Use Use a a condom condom correctly correctly and and consistently consistently if if you you must must have have sexual sexual intercourse intercourse ● Get immediate treatment for any sickness ● ● Get Get immediate immediate treatment treatment for for any any sickness sickness ● Have a lot of rest ● ● Have Have a a lot lot of of rest rest ● Eat nutritious foods ● ● Eat Eat nutritious nutritious foods foods ● For pregnant mothers seek for elimination of Mothers to Child Transmission of HIV and ● ● For For pregnant pregnant mothers mothers seek seek for for elimination elimination of of Mothers Mothers to to Child Child Transmission Transmission of of HIV HIV and and voluntary counseling and Testing Services voluntary voluntary counseling counseling and and Testing Testing Services Services ● Seek advice from a trained health worker if you are going to use Anti Retro Viral Drugs ● ● Seek Seek advice advice from from a a trained trained health health worker worker if if you you are are going going to to use use Anti Anti Retro Retro Viral Viral Drugs Drugs ● It a doctor recommends ARVs for you, use them as instructed to avoid drug resistance ● ● It It a a doctor doctor recommends recommends ARVs ARVs for for you, you, use use them them as as instructed instructed to to avoid avoid drug drug resistance resistance You should NOT do the following : You You should should NOT NOT do do the the following following :: ● Work very hard or do anything that can make you feel very tired ● ● Work Work very very hard hard or or do do anything anything that that can can make make you you feel feel very very tired tired ● Smoke tobacco or drink alcohol ● ● Smoke Smoke tobacco tobacco or or drink drink alcohol alcohol ● Have unprotected sex ● ● Have Have unprotected unprotected sex sex
HIV/A H HIV/AIDS 42 HIV/AIDS 42 How should family member and friends takesuffering care afrom person suffering fro How should family member friends takeofcare of aAIDS? person suffer How should family member and friends take care ofand a person should family member person suffering from AIDS? person suffering from AIDS? eaaof a How person suffering from AIDS?and friends take care of a person suffering from AIDS? Lesson 10 Lesson 10 Lesson 10 Lesson 10 HIV/AIDS 42 HIV/AIDS HIV/AIDS 42 42
● Use a correctly if you must intercoi ● condom Use condom correctly and consistently if youhave mustsexual have sexual ● Use a condom correctly and a consistently ifand youconsistently must have sexual intercourse ● Use aintercourse condom consistently ifthe you must suffering have sexual intercourse ust have sexual intercourse ●correctly Not reject or isolate thefrom person suffering from AIDS ust have sexual ● person Notand reject or isolate person from AIDS u must sexual intercourse ●have Not reject or isolate the suffering AIDS ● Not reject or isolate person suffering frommoral AIDS SAIDS ● Give the person alland necessary and material support he/shehe/she may ne S ●the Give the person all necessary moral and may material m ● Give the person all necessary moral material support he/she needsupport
● Give the person all necessary moral and material support he/she may need upport he/she may need ● Participate in the care of the sick person support he/she may need ● Participate in the care of the sick person rial support he/she may need ● Participate in the care of the sick person ● Participate the care of the sick person ● Wear or plastic gloves before touching blood, open sores woun ●rubber Wear rubber or plastic gloves before touching blood, open or sores or ● Wear rubber orinplastic gloves before touching blood, open sores or wounds,
● Wear rubber plastic glovesstools before touching blood, open sores or wounds, d, open sores or wounds, bloody stools or bloody vomit vomit od, open sores or wounds, bloody or bloody blood, open sores or wounds, bloody stools oror bloody vomit bloody stools or bloody vomit ● Handle soiled or bloody clothes, beddings and towels with care ● Handle or bloody clothes, beddings and towels with care ● Handle soiled or bloody clothes, soiled beddings and towels with care
● Handle soiled bloody clothes, beddings towels with care els with care ●orWash or bloody clothes, beddings and towels in howor water with so wels with care ● soiled Wash soiled or bloody clothes, beddings and in how water w towels care ●with Wash soiled or bloody clothes, beddings and and towels in how water withtowels soap ● Wash soiled or bloody clothes, beddings and towels in how water with soap or s water with soap or water to which JIK has been lsin inhow how water with soap or water to which JIK hasadded been added owels in how water with soap or been water to which JIK has added water to which JIK has been added ● After attending to your the to patient, wash your hands thoroughly with soap ● After attending the patient, wash your hands thoroughly withand so ● After attending to the patient, wash hands thoroughly with soap and water
● After attending to the patient, wash your hands thoroughly with soap and water oroughly with soap and oroughly with soap andwater water s thoroughly with soap and water
Lesson 11
Lesson 11
Childhood illness
Lesson 11
Childhood illness 44
Malaria disease What are the signs and symptoms of a person who has malaria? ● cold and begins to shiver ● weak and gets tires easily ● pains in the joints and muscles ● poor appetite for food ● sweating and then the body cools down after few hours and gets not again
Childhood illness 45
Lesson 11
Malaria disease What should a care-taker do when the child is sick? Cool him/ her body down by wiping it with a cloth socked slightly in warm water ● Give the child plenty of cold water and freshly made up juices from fruits like oranges, pineapples, passion fruits etc. ● Cloth the child in light clothing when feeling hot ● Seek medical treatment within 2 hours of child becoming sick of recognition of sings and symptoms ● Give the child medicine and complete the dose
Childhood illness 46
Lesson 11
Malaria disease Prevention of malaria Children should always sleep under the mosquito nets Close the doors and windows early before it is dark Destroy all bleeding places like broken bottles, tins, pots etc. Drain all the pot holes
Lesson 11
Childhood illness 47
TUBERCULOSIS How does one get TB?
Tuberculosis is passed on from one person to another very easily When a person suffering from tuberculosis coughs, he / she spreads the TB germs in the air
Lesson 11
neumonia
Lesson 11
Childhood illness 48
Childhood illness 48
Pneumonia
Pneumonia
How can a child get pne How can a child get pneumonia? child get pneumonia?
When he /she has whooping not been immunized especially agains ● When he /she has not been immunized●especially against cough,
hemophilus influenza type b and measles munized especially against whooping cough, hemophilus influenza type b and measles
d measles
When the 1st child has beento breastfed during the 1st six ● When the child has not been breastfed●during six (6)not months gain immunity
eastfed during the 1st six months to gain immunity against the disease against the(6) disease ● Stays in the dumb and dirty environment ● Stays in the dumb and dirty environment
ironment
Stayshave in crowded people have coughs ● Stays in crowded place, especially where ● people coughs,place, colds,especially and otherwhere lung diseases
Where she /is hecold is not kept warm when the weather is co where people●have coughs, diseases Where she colds, / he isand notother kept lung warm when●the weather
m when the weather cold ● Whenisshe breathes in dust or smoke ● When she breathes in dust or smoke
moke
● When the child is born with HIV
● When the child is born with HIV
Childhood illness 49
Lesson 11
Pneumonia What should we do to prevent a child from getting pneumonia? ● Make sure she completes the immunization schedule (5 times before one year of age) ● Breast feed the child for the 1st six (6) months without giving them any additional foods or drinks to strengthen his / her body’s defense against diseases ● For children more than six (6) months old, in addition to breast milk, feed him / her well on food such as milk, millet flour, rice, maize, vegetables, fish, meat, eggs, fruits and fresh juices ● Keep him / her warm when the weather is cold ● Do not expose him / her to smoke or dust ● Do not let him / her sleep in a crowded room, especially where there people with colds, coughs and other lung infections ● Mother should always keep their babies and themselves clean
Lesson11 11 Lesson Lesson 11Lesson 11 Childhood illness
Childhood illness 50
ia
50
Childhoodillness illness 50 50 Childhood Childhood Childhood illness illness 50
Pneumonia Pneumonia Pneumonia Pneumonia
Howto tocare carefor foraachild childafter afterhaving havingbeen beentreated treatedat athome? home? How How toHow care for care a child for aafter childhaving after having been treated been treated at home? at hom been treated atto home? en treated at home?
Homecare careisisvery veryimportant importantto toaachild childwith withpneumonia pneumoniaafter aftertreatment treatment ●●Home ●●Home care ● Home ischild verycare important is very to important acare, childyou with tomust apneumonia child with pneumonia after treatment after treatment er treatment To give your a good home : ● To give your child a good home care, you must : eatment ● To givethe your ●child To child give ayour good child home a good care,home you must care,: you must : - Feed well during illness
- Feed the child well during illness - -Feed child - Feed well(the during childillness well during illness thethe child six months oldbreast breastfeed feedhim himor orher herad adoften oftenas asthe thechild childwants wantsto tofeed feed - IfIfthe child isissix (66 ) )months old the child is -is Ifsix the (6child ) months issix sixold (6)breast months feed oldhim him breast or food her feed ad him often or her as the admaize, child oftenwants as thevegetables, to child feed wants to feed s the child-- wants to feed -If If the child older than months – feed on such as rice, meal, If the child is older than six months – feed him on food such as rice, maize, meal, vegetables, child wants to feed -meal, Ifbeans, the child is - If older the eggs, child thanis six older months than–six feed months himfruits on– food feed such him on asfood rice, such maize, asmeal, rice, maize, vegetables, meal, vegetables, e, maize, vegetables, fish, milk, soft matooke, millet, and vegetable oils beans, fish, milk, eggs, soft matooke, millet, fruits and vegetable oils ize, meal, -vegetables, beans, fish, milk, beans, eggs, fish, soft milk, matooke, eggs, soft millet, matooke, fruits and millet, vegetable fruits and oils vegetable oils oils Give him / her more fluids such as breast milk, water or homemade soups - Give him / her more fluids such as breast milk, water or homemade soups - Give him /much hersuch more fluids such as water breastor milk, water orsoups homemade soups himchild / her more fluids as breast milk, homemade de soups -- -Give Letthe the feed as asshe she wants Let child feed as much as wants ups -is Let the child feed as much asashe wants - -Let thechild child feed as much as because she wants If the not eating well of blocked nose,clear clearititusing usingaasoft softcloth cloth - If the child is not eating well because of a blocked nose, -child Ifnot theone child is not eating well of aor blocked clear itcloth using a soft cloth - -Ifcloth the child is eating well because of abecause blocked nose, clearshe itnose, using a soft sing a soft Giving the extra meal each day for a week until / he regains normal weight - Giving the child one extra meal each day for a week or until she / he regains normal weight ahe soft cloth - Giving child oneeach extra meal dayor for a week shenormal / he regains normal weight - Giving the child onethe extra meal day foreach a week until she / or heuntil regains weight regains normal weight
gains normal weight
Childhood illness 51
Lesson 11
Diarrhea diseases What causes diarrhea diseases?
●
Man defecating
●
Whole family infected
● Drinking water that is collected from contaminated water sources or kept in dirty pots, buckets, bottles, jerry cans, cups or other dirty containers ● Eating food which is not properly cooked etc.
Lesson 11 Lesson 11 Lesson Lesson 11 11
Childhood illness Childhood illness Childhood Childhood illness illness
Diarrhea diseases Diarrhea diseases
How does food and water get How does food and water get contaminated by the germs? contaminated by the germs? Defecating in the bush and not throwing children’s feces in the latrines, Defecating in the bush and not throwing children’s feces in the latrines, Defecating in the bush and not throwing children’s feces in the Defecating in the bush and not throwing children’s feces in the latrines, latrines, thus leaving feces scattered around the home thus leaving feces scattered around the home thus leaving feces scattered around the thus leaving feces scattered around the home home These feces may end up in water sources such as rivers, streams and wells These feces may end up in water sources such as rivers, streams and wells These feces may end up in water sources such as rivers, streams and These feces may end up in water sources such as rivers, streams and wells wells Flies that step on the feces may contaminate the uncovered food Flies that step on the feces may contaminate the uncovered food Flies that step on the feces may contaminate the uncovered Flies that step on the feces may contaminate the uncovered food food Bad food handling and storage i.e use dirty hands, uncovered Bad food handling and storage i.e use dirty hands, uncovered Bad food handling and storage i.e use dirty hands, Bad food handling and storage i.e use dirty hands, uncovered uncovered
52 52 52 52
Childhood illness 53 53 Childhood illness
Lesson 11 Lesson 11
Diarrhea diseases Diarrhea diseases What are the signs and symptom of What are the signs and symptom of diarrheal disease? diarrheal disease? ● Passing lose or watery stools (feces) three or more times in a day ● Passing lose or watery stools (feces) three or more times in a day ● Thirst as a result of excessive loss of water from ● Thirst as a result of excessive loss of water from
the body (dehydration) resulting in sunken and tireless eyes the body (dehydration) resulting in sunken and tireless eyes
● Passing little or no urine ● Passing little or no urine
● A person loses weight and becomes thin very fast ● A person loses weight and becomes thin very fast
● Dropping in of the s “oft spot” (fontanelle) on the top of the child’s head ● Dropping in of the s “oft spot” (fontanelle) on the top of the child’s head ● Abdominal pain ● Abdominal pain
● In the case of dysentery, lose stool with blood ● In the case of dysentery, lose stool with blood
Childhood illness 54
Lesson 11
Diarrhea diseases How can you prevent diarrheal disease? ● Good hygiene and sanitation ● Practice, good water and food handling practices Water handling: ● Collect water from a safe source e.g protected spring or well ● Boil the water before drinking it ● Keep drinking water in a clean, covered pots, bucket or other clean containers ● Use a clean cup to draw drinking water or where possible pour water into a cup ● Proper food handling
Lesson 11 Lesson 11
Childhood illness 55 Childhood illness 55
Diarrhea diseases Diarrhea diseases
What should you do when a child or What should you do when a child or any person has diarrhea? any person has diarrhea? ● Continue feeding the child or person and give plenty of fluids to prevent dehydration ● Continue feeding thethan child or person and give plenty of fluids to prevent dehydration ● Give more fluid usual ● Give morewater, fluid than ● Give oral usual re-hydration salts (ORS) or nay locally available drinks or ● Giveliquids water, such oral re-hydration (ORS) or nay locally available drinks or as soup, ricesalts water or fruit juice liquids such as soup, rice water or to fruit juice ● Give a cup (Tumpeco) of fluid drink after each stool ● Give a cup (Tumpeco) of fluid ● Continue feeding the childto drink after each stool ● Continue child breast feed him / her normally ● If thefeeding child isthe an infant, ● If the is anis infant, breast her ● Ifchild the child 6 months or feed olderhim and/ is nonormally longer being breast fed, ● If thefeed child is 6 months or older and nohas longer being breast fed, him/her normally when he is /she diarrhea feed him/her normally /sheas has ● Allow him / her to when eat ashe much hediarrhea /she wants ● Allow himafter / her to as much asstopped, he /she wants ● Even theeat diarrhea has give him / her an extra meal a day for one week ● Even after the diarrhea has stopped, give him / her an extra meal a day for one week
Lesson 11
Childhood illness 56
Pink Eye (Conjunctivitis) Do not let a child with pink eye play or sleep with others If he does not get well in a few days, see a health worker
Lesson 11
Childhood illness 57
Earache and ear infections Earache and ear infections The infection often begins after a few days with a cold or a stuffy nose The fever may rise, and the child often cries or rubs the side of his head
Happy Family through FP & MCHI “Health for All” in Uganda Happy Family through FP & MCHI Starts with Sahmyook Univ., S. Korea
“Health for All” in Uganda Starts with Sahmyook Univ., S. Korea
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