On The Second Day...Family Health Development Progamme...

Posted by Chuah Gim Seah,Pavitra,Jycinta, Lalitha...

For the second day, we are given a brief talk about the Family Health Development Programme by Matron Che Hasnah and Sister Hasnah Wong about Maternal and Child Care Services..

Family Health Development Unit is one of the Division of Public Health, District Health Offficer Sungai Petani

•This unit is responsible for ensuring quality services to all walks of life in primary facilities with main focus on the development of family health, such as pregnant women, children, adolescents and elderly

•The unit is headed by the Medical Health Officer and assisted by the Chief Public Health Nurse and Nurse.

•In general, this unit is divided into two main services and Family Health Services Nutrition Services.

                              (A)           Maternal Health Care

The services which are provided by the government to all the pregnant mother extends from antennal to postnatal stage.

(1) Antenatal care

         Each pregnant mother will present to the Klinik Kesihatan or Klinik Desa for registration. According to the standard operational procedures of the Klinik, for registration purposes, it is managed by dividing the pregnant mothers into first-time-registration and repetitive-registration groups.

         New Case (First Registration) à Open up a new Red Antenatal CardàAntropometric Measurement (weight, height, blood pressure)àLaboratory Investigation (urine and blood test)àAppointment with health officeràInterpretation of urine and blood test resultàDivision into Normal Pregnancy group or High-Risk Pregnancy group

Urine and Blood Test which were carried out in the clinic during their booking(first visit) are:

1.     ABO and RH Grouping

2.     VDRL ± TPHA

3.     Hb

4.     HIV (Rapid Test)

5.     Urine FEME

6.     Blood glucose level

         Colour coded system is introduced in our Malaysian healthcare system for Maternal Health. This colour coding plays an essential role in referring high risk pregnancy towards tertiary hospital which is well-equip with specialists and facilities. Subsequently, the quality of care is well tailored to the situation of patients. We have basically four colour code:

(a)  Red: High Risk Pregnancy (Eclampsia, Pre-Eclampsia not in well controlled, Postpartum Hemorrhage, Puerperal Sepsis, Urinary Retention, Pregnant Mother who delivered at home, Rhesus Negative Mother who delivered at home, Deep Vein Thrombosis or Pulmonary Embolism, Heart Diseases, Anemic in poor controlled, Status Asthmaticus, Infection of episiotomy site or Caesarian site). These required immediate admission to the hospital

(b) Yellow: Referral to Medical Officer at Klinik Kesihatan

(c)  Green: Referral to Medical Officer or House Officer

(d) White: Normal pregnancy which are allowed to deliver at home or hospital

         On the subsequent visits to the antenatal clinic, ultrasound is done at least twice in pregnant mother for anomalies scan and assessment of fetal growth. Apart from this, vaccination of Tetanus Toxoid is given to all pregnant mothers. Two dose is given whereby the first dose is at 14^th week of gestational week, followed by second dose at 4-6^th week after the first dose.

(2) Post-Natal Care

         The health care nurses will make home visit to the mothers’ house for the first 10 days after delivery of the baby and 20^th day.  During these visits, the healthcare nurses will check on the episiotomy site of the mother as well as records of vital signs of the mother. All of these data will be placed in the Red Antenatal Card for references and monitoring purposes. Besides, healthcare nurses will check upon the baby for signs of jaundice. They will teach the mother on how to bathe the baby as per request by the mothers.

(3) After Delivery

         At the maternal and child health clinic, there is a family planning unit for couples. For every couples who come for registration, they will again be devided into old and new case groups. A counselling session will be schedule and carry out to determine the desire of child bearing of the couple. For primary infertility cases, a general examination will be performed and referred to specialists in hospitals. On the other hands, for couples who have complete their family, they will be receiving information and advices on the available contraceptive methods. Contraceptive devices which are provided in the clinic are medication such as contraceptive pills, intrauterine devices. All of these are free of charge.

(B)Child Care services

        Each baby will be provided with a growth chart and developmental milestone assessment card. They will attend follow up in the clinic for assessment purposes as well as for immunisation. If there is any suspicious cases of malnutrition or developmentaL delay, they will be referred to family physician for further consultation.