UNIT 3.0

TOPIC: ANTENATAL CARE

Instructional Materials: 

• White board & Marker

• Posters

• Pictures

• Measuring tape

• Weighing scale

• Multi dip stick/Combi 2

Teaching Method:

• Lectures

• Discussions

• Brainstorming

• Demonstration

Types of Assessment: 

• Q&A, 

• Assignment

• MCQ

• Return demonstration

Learning Objectives: At the end of the lesson the students will be able to;

• Describe Focused Antenatal care (FANC) 

• Describe the 2016 WHO ANC model

• Identify the general services provided during ANC clinics

• Describe the ANC contacts and what they entails

• Discuss the danger signs in pregnancy and how to manage them

• Discuss the Elimination of Mother to Child Transmission of HIV Infection

3.0 Introduction 

Antenatal Care (ANC) is the advice, supervision and attention given to pregnant women. The care given to women is specialized in order to obtain and maintain a state of good health throughout pregnancy and improve chances of having safe delivery of a healthy live baby at term. ANC entails a number of interactions, activities, procedures which are systematically carried out in order to maintain both maternal and fetal wellbeing.

3.1 FOCUSED ANTENATAL CARE (FANC)

• FANC is defined as an evidence-based, client centered and goal directed care provided by skilled health providers with emphasis on quality rather than frequency of visit.

• FANC entails a minimum number of 4 ANC clinical visits, each of which has specific items of client assessment, education, and care to ensure the prevention of or early detection and prompt management of complications. A major new focus is on birth planning and emergency preparedness.

The traditional approach to ANC, assumes that more visits means better outcome for mother and baby these visits includes about 12 clinic visits and women are classified by risk category to determine their chances of complications and the level of care they need.

However, recent evidence suggests that the focused antenatal care (FANC) model, which was developed in the 1990s, is associated with more perinatal deaths than ANC models that comprise at least eight contacts between the pregnant woman or adolescent girl and the health care provider. A secondary analysis of the World Health Organization’s (WHO’s) ANC Trial suggests that the increase in perinatal mortality rate is more likely due to an increase in stillbirths. These findings and other evidence informed the development of WHO’s 2016 ANC recommendations.

The Goals of FANC

• Health Promotion

It is the process of promoting and maintaining the physical, mental and social health of a mother and her baby by providing education on key issues related to pregnancy, childbirth, and encourages an appropriate health seeking behaviour. It addresses individual needs, gestational age and most prevalent health issue. It includes education and counselling the following:-

1. Danger signs of complications during pregnancy and labour: 

2. Nutrition

3. Infection Prevention

4. Importance of Exercise.

5. Family Planning

6. Prevention of HIV/STI 

7. HIV Counseling and Testing

8. Immunizations 

      9. Malaria Control and Prevention in Pregnancy

• Prevention of Complications of Pregnancy and Childbirth

Two simple preventive measures have proven to be effective in reducing maternal and neonatal death: 

           1. Tetanus toxoid Immunization

2. Iron and Folate Supplementation

3. IPT for malaria, and 

4, other treatment for hookworm, vitamin A, and iodine supplementation.

• Early Detection and Prompt Management of Problems

This is the process of detecting and managing complications during pregnancy, whether medical, surgical or obstetric. It is carried out through interview and proper examination by the skilled health provider so as to detect any problem that might affects the woman’s pregnancy and requires additional care. Conditions that could severely affect the mother or baby if left untreated includes: HIV, STIs, TB, Anaemia, Pre-eclampsia, abnormal fetal position after 36 weeks (indicative of a life-threatening condition), malaria.

          Early treatment of these conditions can mean the difference between death and survival for the woman and her newborn.