Nutri Sci Lec 20 Maternal and Child Health

Maternal malnutrition can be ___

Intergenerational

Maternal health refers to…

The health of women during pregnancy, childbirth, and the postnatal period

Early childhood, particularly the first years of life, impacts the long term..

social, cognitive, emotional, and physical development

Maternal health is a __ __

Human right

Internal factors

biological factors that affect women

External factors

social factors that affect women

Accountability

Ability to hold people responsible for their actions that violate human rights

Equality

All human beings hold the same value

Non-discrimination

No one is to be denied their rights due to factors such as race, sex, socioeconomic status, nationality, etc

Meaningful Participation

Includes engagement in all aspects of public life and at all levels of decision making, including legislative, executive and local government

Maternal mortality ratio

the number of maternal deaths per 100,000 livebirths per unit time

Maternal deaths

Deaths that are pregnancy related while a woman is pregnant, or within 42 days of pregnancy termination

Globally, maternal mortality has __ over time

decreased

Where is the maternal mortality rate highest?

Sub-saharan Africa

Where are maternal mortality rates lowest?

Belarus, Poland, Italy, Norway

maternal mortality is __ associated with wealth

inversely

Causes of maternal mortality

• Sepsis and other infections

• Complications of unsafe abortion

• Haemorrhage

• Indirect causes

• Hypertensive disorders

• Obstructed labor

The majority of maternal deaths are __

preventable

Maternal mortality is the US is __ as it __ elsewhere. Why?

• rising, declines

• Super expensive healthcare system, access to abortion has been restricted

Black women have__ the maternal mortality rate of other races. They are also __ likely to be believed when they experience pain/express health concerns

>3x, less

Child mortality

the percent of newborns who die by specified age per unit time

Infant def

<1 year of age

Neonatal

refers to the first 28 days of life

Stunting def

low height for age

Wasting def

low weight for height

What is overweight for children <5 defined as

BMI greater than 2 standard deviations above the WHO growth reference median

What is obesity for children <5 defined as

BMI greater than 3 standard deviations

Despite significant progress, __ children die everyday

15,000

Globally, __ is 3 times more prevalent than __

Stunting, wasting

What two regions is stunting highest in

Sub-Saharan Africa and South Asia

In 2018, __ M stunted and __ M wasted

149, 49.5

While global stunting and wasting in children is declining, __ is rising

Obesity

Overweightness is increasing in both __ and __ income countries

Low and high

__ in childhood increases risk of noncommunicable disease in adulthood

Malnutrition

What is the nutrition transition?

Framework for describing the economic, demographic/social, and technological shifts occurring during development that impact the food environment, dietary patterns, and health outcomes

The US has the highest __ compared to other high income countries

Infant mortality rate, ~6 deaths per 1,000 live births

Within the US, the states with the highest IMR have more than __ the rates than those with the lowest IMR

Double

Direct Interventions to improve maternal and child health?

• Education and engagement of mothers

• Improving access to high-quality health care

• Increasing resources and training for care providers

• Preventing malnutrition through proactive nutrition interventions

• Implementation of policies supporting women’s/maternal and familial health

Indirect interventions for maternal and child health

• Improving access to resources

• Improving the environment

• Reducing poverty

• Addressing structural/systemic biases

• Promoting gender equality

What is Kangaroo mother care

Skin-to-skin contact between a mother and her preterm or LBW infant to help regulate temperature, promote breast feeding, and improve survival rates; required education!!

Also, enhanced emergency obstetric care achieved through training of community health workers to manage emergencies more effectively

What were the outcomes of kangaroo mother care?

Reduction in neonatal deaths, better trained community health workers, process for continual improvement in maternal health care centers

Program components of TUBAraMURE program in Burundi

1. Nutritious supplementary foods

2. Health-strengthening activities and promotion of the use of preventative and curative health services

3. Health care and hygiene and nutrition education

Results of the TUBAraMURE Program in Burundi

• Reduced maternal anemia

• Increased maternal health and nutrition knowledge

• Improved weight for height and hemoglobin in children

• Reduced morbidity in children

Universal Maternal care in India

Policies that support maternal care:

• Every birth should be attended by a skilled healthcare professional

• Free antenatal care

• Free delivery and newborn care

Continuum of care approach, scaleup of nation-wide emergency referral systems and maternal deaths audits, process for continual improvement of governance and management of health services

Outcome of universal maternal care in India

Maternal mortality ratio declined from 130 to 97 deaths per 100,000 live births

Examples of interventions in the US

• Supplemental Nutrition Program for Women, Infants and Children

• California