01.2. Phase II
iii. Reproductive Health – (Lectures - 25 hours + Tutorials - 3 hours)
Learning Objectives |
Content |
Activity |
Time |
Describe Reproductive Health concepts |
Definition of RH/ Components of RH Family health program in Sri Lanka – objectives and strategies Safe motherhood Mother Baby package Life cycle approach |
Lecture |
1 |
Describe pre-natal, natal and post-natal care |
The need for provision of field maternal and child care The role of MOH, PHN and PHM in the provision of maternal care, Pre conceptual counseling, Antenatal care Objectives of home visits Clinic activities – health education, Anthropometric measurements, Investigations, Vitamin, Mineral and Food supplementation, Immunization, Proper maintenance of records and returns Screening for high risk conditions and referral |
Lecture / Clerkship |
1 |
Natal care Importance of hospital delivery The need for trained assistance for home deliveries Hospital delivery: Infection control at the labour room Post natal Visits Objectives of home visits for mother and neonates Early identification of puerperal complications and referral, Nutrition during lactation |
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Describe child health services |
Child health services – Institutional and Field Role of public health staff in delivery of child health services. |
Clerkship |
|
Describe activities of the CWC |
Organization Facilities available |
Clerkship |
|
Describe Infant feeding practices |
Breast feeding: Composition of breast milk, Advantages – mother & infant, Contraindications, Assessment of adequacy Formula feeding: Concepts of formulae I,II,& III Special formulae, Advantages & Disadvantages Absolute indications Complementary feeding: Concepts of complementary feeding, Planning to complementary feeding, Value of different complementary foods (CF), Conjee, Fruit juices, homemade CF, Commercial CF Composition / Constitution, Frequency Errors/ Misconceptions |
Lecture |
2 |
Describe feeding during second year |
Appetite during this period Disadvantages of force feeding Self selection of diet Self feeding/ Independence of a child eating habits |
Lecture |
½ |
Describe Nutritional assessment methods |
At national and individual level Anthropometric, Biochemical, Bio physical Clinical, Dietary assessment Advantages and disadvantages of each method |
Lecture Clerkship |
1 |
Interpret nutritional status using different classifications |
Gomez’s classification Waterlow classification Welcome classification |
Lecture |
½ |
Describe the Child Health Development Record (CHDR) |
Content of CHDR Growth monitoring Early detection of PCM / Growth faltering, Underweight, Wasting and Stunting Management of PCM Advantages and limitations of the CHDR |
Lecture Clerkship |
1 |
Describe failure to thrive (FTT) |
Definition Causes: Nutritional deprivation Pathological conditions Investigation of FTT Principles of management |
Lecture |
1 ½ |
Describe the nutritional status |
Epidemiology of malnutrition: Under nutrition, Obesity Sri Lankan situation with regard to Protein Energy Malnutrition (PEM ) Kwashiorkor & Marasmus: Clinical picture/ Investigations Management principles Diet formulation/ Feeding methods Nutritional advice/ Follow up Childhood obesity: Identification/ Management Complications |
Lecture |
1 |
Describe nutritional anaemia |
Definition Prevalence – global and National, Aetiology Importance as a public health problem Prevention |
Lecture |
1 |
Describe IDD |
Classification (WHO) Prevalence – global and national Aetiology Importance as a public health problem Prevention |
Lecture |
½ |
Describe vitamin A deficiency |
Classification (WHO) Prevalence Aetiology Importance as a public health problem Prevention |
Lecture |
½ |
Describe community approach in preventing nutritional deficiencies |
Food related programs Health related programs Nutritional education |
Lecture |
1 |
Describe the current EPI programme |
EPI program Cold chain Management of ‘missed immunisation’ and absence of BCG scar Contraindications -absolute, relative, false Adverse Events Following Immunisation and management Non EPI vaccines and their advantages Vaccination coverage |
Lecture/ Clerkship |
1 |
Describe mental health promotion in childhood |
Concepts of ECCD Life skills Parenting skills Services available |
Lecture/ Clerkship |
1 |
Describe the school health services |
School health programme: Objectives Components Deficiencies |
Lecture/ Clerkship |
1 |
Describe adolescent health |
Importance Health problems – social and mental Nutrition, Future changes |
Lecture |
1 |
Describe methods of minimizing childhood mortality |
Millennium Development Goals (MDG) Childhood mortality rates: Still birth rate Perinatal mortality rate (PMR) Neonatal mortality rate (NMR) Infant mortality rate (IMR) Child mortality rate Main causes of childhood mortality Methods / strategies to minimize childhood mortality |
Lecture |
1 ½ |
Describe different family planning methods available in SL |
Benefits, Classification of FP methods Each method to be described in terms of Mode of action, Indications and contraindications Eligibility criteria, Effectiveness, effective period & return of fertility, Side effects and management, Relevant Advice, Follow up Counseling – “GATHER” Emergency contraception |
Lecture/ Clerkship |
3 |
Describe the fertility control policy in Sri Lanka |
Measures of fertility – CBR, GFR,ASSR, ASFR, TFR, GRR, NRR, Replacement level fertility Goals, targets and objectives Contraceptive prevalence and FP indicators Incentives offered Unmet need of FP |
Lecture |
1 |
Describe measures of preventing maternal deaths |
Definition of maternal death Epidemiology The need for investigation |
Lecture |
1 |
Describe gender issues |
Equity, Gender discrimination Violence against women Issues of human rights |
Lecture |
1 |
Describe activities of Well Woman Clinic |
Objectives Activities |
Lecture/ Clerkship |
½ |
Describe monitoring and evaluation of maternal and child health services |
Importance of monitoring and evaluation Indicators – ante and post natal and outcome indicators |
Lecture |
½ |
RECOMMENDED READING MATERIAL
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Park, K 2007, ‘Nutrition and Health : Assessment of Nutritional Status’, in Park’s Text Book of Preventive and Social Medicine pp. 515- 518, Banarsidas Bhanot Publishers, Jabalpur, India
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Park, K 2007, ‘Nutrition and Health : Nutritional Problems in Public Health’, in Park’s Text Book of Preventive and Social Medicine pp. 506- 512, Banarsidas Bhanot Publishers, Jabalpur, India
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Epidemiological Unit 2002, ‘Immunization Handbook’, Ministry of Health, Nutrition and Welfare, Colombo.
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Duty list of PHM
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Conducting Antenatal Clinic, General circular no. 01-24/2004, Ministry of Health, Sri Lanka.
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Conducting Postnatal Clinic, General Circular no. 01-27/2004, Ministry of Health, Sri Lanka.
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Guidelines on Infant and Young Child Feeding, Circular Letter. FHB/FD/WHO/01-P, Ministry of Health, Sri Lanka.
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Vitamin A Mega-dose Supplementation- Revised schedule, Circular no. 01/05/2009.
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School Health Programme, General Circular no. 01/37/2007, Ministry of health.
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National Maternal and Child Health Policy
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WHO Medical Eligibility Criteria for starting Contraceptive Methods. Click here
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Family Health Bureau, 2009, Overview of Maternal Mortality Reduction in Sri Lanka FHB Circular on Definition of maternal deaths Click here