��CHAPTER - 2��REPRODUCTIVE, MATERNAL, NEWBORN, CHILD AND ADOLESCENT HEALTH (REVIEW FROM OBG NURSING AND APPLICATION IN COMMUNITY SETTING)�

INTRODUCTION

Reproductive health, which addresses various aspects of the reproductive system throughout an individual’s life, is essential to overall health and well-being.

• Good reproductive health requires a comprehensive approach, which includes..
• Education
• Healthcare services
• Supportive policies

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• HEALTH OF CHILDREN

The health of children is also greatly impacted by providing access to clean water, sanitary conditions, and education.

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• REPRODUCTIVE HEALTH

Modern contraceptive usage is rising along with increased means of awareness and accessibility. Initiatives and family planning programs helping to bring about this transformation.

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• MATERNAL HEALTH

Improved healthcare services have resulted in a dramatic decrease in maternal death rates.

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• CHILD HEALTH

India’s child health data show both continued difficulties and significant advancements.90% of children now receive the recommended childhood immunizations.

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�TRENDS IN MATERNAL AND CHILD HEALTH�

Mother and childcare have emerged as a top priority in primary healthcare globally.

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• MODERN AND CONTEMPORARY ASPECTS
• Integrated Care

Maternal and child health services were segmented into different categories, such as antenatal care, childcare, and family planning.

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• Risk-Based Approach

Early identification of risks among mothers and infants.

• Manpower Evolution
• ANMs
• TBAs
• MPWs
• ASHAs
• NGOs

• Refocused Expertise

This approach not only enhances the quality of care but also ensures that services are more accessible, culturally appropriate, and responsive to communities.

• Primary Healthcare

Provides essential information and resources for the protection and promotion of maternal and child health.

• Reproductive and Child Health

The Janani Suraksha Yojana provides financial assistance to pregnant women for institutional deliveries, ensuring safe childbirth.

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MATERNAL MORTALITY DETERMINANTS

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Death of a woman during pregnancy or within 42 days of the end of pregnancy caused by conditions related to the pregnancy.

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• MEDICAL CAUSES OF MATERNAL MORTALITY

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• Hemorrhage
• Pregnancy-induced hypertensive diseases
• Puerperal sepsis

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• SOCIO-ECONOMIC AND DEMOGRAPHIC FACTORS

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• Education
• Income levels
• Healthcare infrastructure
• Uterine rupture
• Anemia
• Infection
• Unsafe abortion
• Poor management of delivery

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• CULTURAL FACTORS

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• Low status of women
• Polygamy and early marriage
• Underfeeding and dietary practices
• Delay in seeking care

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HEALTHCARE POLICIES AND ACCESSIBILITY

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• Maternal health programs: To reduce maternal mortality.
• Insurance coverage: Access to insurance can alleviate the financial burden of healthcare.
• Transportation facilities: Timely and reliable transportation.
• Family planning services: Easy access to family planning services helps reduce the risk.

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CURRENT ISSUES AND CHALLENGES

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• Healthcare inequity: The availability of healthcare facilities.
• Quality of care: Difficult to provide uniform, high-quality treatment in all regions.
• Health education: Lack of widespread implementation of education.
• Policy implementation: Different states have various levels of effective policy implementation.

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GOVERNMENT INITIATIVES AND FUTURE STEPS�CURRENT STATUS OF KEY RMNCH+N/RCH INDICATORS

ANTENATAL CARE�

Antenatal care involves regular monitoring of a pregnant woman to monitor fetal development and ensure the health of both mother and baby.

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• AIM

To monitor and promote the health of both the mother and fetus, prevent complications, and prepare for childbirth.

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OBJECTIVES�

ANTENATAL VISITS AND EXAMINATIONS�

• Pregnant women undergo antenatal, often called prenatal check-ups to track the health and development of both the mother and the fetus.

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• Key Points
• Prenatal Visits According to WHO and Indian Guidelines

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WORLD HEALTH ORGANIZATION (WHO)

GUIDELINES (2016)

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First visit: Before 12 weeks of gestation.

Second visit: At 20 weeks.

Third visit: At 26 weeks.

Fourth visit: At 30 weeks.

Fifth visit: At 34 weeks.

Sixth visit: At 36 weeks.

Seventh visit: At 38 weeks.

Eighth visit: At 40 weeks

• INDIAN GUIDELINES (NATIONAL HEALTH MISSION)

The visits are scheduled as follows:

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First visit: Up to 12 weeks (as early as possible).

Second visit: Between 14 and 26 weeks.

Third visit: Between 28 and 34 weeks.

Fourth visit: Between 36 and 40 weeks

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First Trimester (0–12 Weeks)�

• Initial Visit (First Trimester)

A. History collection

• Obstetrical history
• Pregnancy outcomes
• Complications
• Delivery history

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• Gynaecological history
• Menstrual history
• Contraceptive use
• Gynaecological conditions

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• Present medical history
• Chronic conditions
• Recent illnesses or surgeries
• Medications
• Allergies

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• Family medical history
• Genetic disorders
• Chronic diseases
• Pregnancy complications

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B. Calculation of expected date of delivery

• Nagel’s rule
• Formula: EDD = LMP + 280 days (or 40 weeks)

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C. Physical examination

• General health

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• Abdominal examination
• Pelvic examination

D. Infection screening

• Urinalysis
• Vaginal swabs
• Additional tests
• Blood tests
• Ultrasound

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�Second Trimester (13–26 Weeks)�Routine visits�

• Routine visits

A. History review

• Update on symptoms
• Medical history changes

B. Physical examination

• General health
• Vital signs and weight
• Symptom management

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• First Maneuver: Fundal Grip

Objective: To determine which fetal part is at the fundus (the upper part of the uterus).

• Second Maneuver: Umbilical Grip

Objective: To identify the location of the fetal back and limbs.

• Third Maneuver: Pawlik’s Grip (Pelvic Grip)

Objective: To determine the presenting part (head or breech) and its engagement in the pelvis.

• Fourth Maneuver: Cephalic Grip

Objective: To assess the position of the fetal head in relation to the pelvic inlet.

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C. Infection screening

• Urinalysis
• Blood glucose testing
• Glucose challenge test
• Follow-up Test
• Additional tests
• Ultrasound
• Amniocentesis

E. Counselling and education

• Discuss birth plan
• Prepare for the third trimester

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Third Trimester (27–40 Weeks)

A. Routine visits

• History Review

B. Physical examination

• Abdominal examination
• Infection screening
• Additional tests
• Labor preparation
• Education and counselling

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NUTRITION DURING PREGNANCY �

• Pregnancy-related nutrition is essential for the mother and the unborn child’s health and development.

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• BALANCED DIET
• High Protein Diet
• Vitamin C
• Vitamin B12
• Vitamin D
• Calcium
• Fibres
• Folic Acid and Iron
• Hydration
• Omega-3 Fatty Acids
• Limit Certain Foods
• Small, Frequent Meals

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ANTENATAL COUNSELLING

Definition :- It is occurs during pregnancy to provide expectant parents with information and support. Prenatal counselling is approached as follows:

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Education on Prenatal Care

Exercise, Physical Activity

Nutritional Guidance

Breastfeeding

Emotional Support

Fetal Development Education

Childbirth Preparation

Family planning

• OTHERS ARE
• Family Involvement
• Community Resources Referral
• Cultural Competence
• Continuity of Care

CALCIUM AND IRON SUPPLEMENTATION IN PREGNANCY

• Calcium Supplementation

Calcium supplements during pregnancy are essential for the development of the baby’s bones, heart, nerves, and muscles, as well as the mother’s bone density.

• Recommended Intake Pregnant women consume between 1,500 and 2,000 mg of calcium per day, especially in populations with poor calcium intake.
• Sources Dairy products, fortified meals, leafy green vegetables.

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• Iron Supplementation

Iron supplements are necessary throughout pregnancy to support increased blood volume and the growth of the fetus and placenta.

• Recommended Intake

Pregnant women take a daily iron supplement with 30 to 60 milligrams of elemental iron and 400 micrograms of folic acid.

• Sources Lean meats, chicken, fish, legumes, fortified cereals, and dark green leafy vegetables are dietary sources of iron.

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• ANTENATAL CARE AT HEALTH CENTRE LEVEL�

Antenatal care at the health center level is crucial for protecting the health and well-being of both the developing fetus and the expectant mother.

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AIM:- To identify health risks early, promote healthy practices, and prepare mothers for delivery and postnatal care.

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• BIRTH PREPAREDNESS

To improve maternal and neonatal health by educating expectant mothers and their families about early prenatal care, labor signs, safe delivery practices.

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Definition:-

To providing expecting mothers and their families information and resources they need to safe and healthy pregnancy, delivery, and postpartum period.

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Components of Birth Preparedness�

• Antenatal Education
• Identification of High-Risk Pregnancies
• Developing Birth Plans
• Access to Skilled Birth Attendance
• Emergency Preparedness
• Family and Community Support
• Postpartum Care and Follow-Up

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• HIGH-RISK APPROACH; SCREENING/ EARLY IDENTIFICATION AND PRIMARY MANAGEMENT OF COMPLICATIONS OF DISORDERS

It involves identifying specific risk factors—such as pre-existing medical conditions, advanced maternal age, and lifestyle factors—and delivering specialized care to manage and mitigate these risks.

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• ANTEPARTUM HEMORRHAGE

Introduction

APH is one of the most life-threatening obstetric conditions. It can cause complications in approximately 2-5% of pregnancies. It has a major impact on maternal and perinatal mortality and morbidity throughout pregnancy and childbirth.

• Definition :- APH is defined as any amount of bleeding from the genital tract after 28 weeks of gestation and before the onset of labor.

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Types

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• Placenta previa Abruptio placenta

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PLACENTA PREVIA�

• Definition :- Abnormal condition in which the placenta implants in the lower segment of the uterus.
• Causes :-
• Previous cesarean section
• Previous placenta previa
• Multiple pregnancies
• Advanced maternal age
• Uterine surgery
• Multiparty
• Smoking

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TYPES OF PLACENTA PREVIA

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TYPE 1 Low-lying implanted lower in the uterus does not cover the cervical os.

TYPE 2 Marginal Placenta is located on the margin of the cervix, touches cervix does not cover it.

TYPE 3 Incomplete or partial placenta partially covers the cervical os but does not entirely restrict it.

TYPE 4 Complete or partial placenta fully covers the cervical opening.

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�SIGNS AND SYMPTOMS OF PLACENTA PREVIA�

• Painless vaginal bleeding
• Uterus becomes soft
• Bleeding in resting position and is not associated with physical activity
• Mild abdominal cramps
• Discomfort
• Irregular uterine contraction

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DIAGNOSIS

• Ultrasound
• Clinical history
• Follow-up ultrasound

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Management of Placenta Previa

• Hospitalize for close monitoring
• Ensure pelvic rest
• Ultrasounds to monitor placenta position.
• Administer corticosteroids
• Provide blood transfusions
• Plan for cesarean delivery
• Perform emergency cesarean if uncontrolled bleeding or fetal distress
• Monitor for postpartum hemorrhage
• Counselling on future pregnancy risks.

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Abruptio Placenta

There is premature separation of the placenta partially or completely from the uterine wall before the onset of labor.

• Causes
• Trauma
• Hypertension
• Previous abruption
• Premature membrane rupture
• Smoking and substance abuse

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Types of Abruption

• Revealed abruption
• Concealed abruption
• Mixed abruption

GRADES

• Grade 1
• Grade 2
• Grade 3

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• Grade 1 Characterized by a small amount of bleeding, mild uterine contractions..

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• Grade 2 Mild to moderate bleeding, uterine contractions.

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• Grade 3 Moderate to severe bleeding or concealed hemorrhage, uterine contractions.

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Sign and symptoms

• Vaginal bleeding
• Abdominal discomfort
• Back pain
• Fetal distress

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• Screening/Early Identification of Antepartum Hemorrhage
• Screening
• History and symptoms
• Risk factors
• Ultrasound
• Clinical evaluation
• Ultrasound imaging
• Laboratory tests
• Fetal monitoring

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Management of Abruptio Placenta

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• Stabilize the mother with IV fluids, oxygen.
• Continuous monitoring .
• Ultrasound for assessment.
• Provide observation, bed rest
• Monitoring non- stress tests.
• Administer blood transfusions.
• Emotional support to the mother and family
• Manage risk factors .

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Roles and Responsibilities

• Health education and promotion
• Prenatal care education
• Emergency preparedness

Early Detection and Referral

• Home visits
• Screening and assessment
• Timely Referral
• Communication and advocacy
• Postpartum care

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Education about future pregnancies

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• Surveillance
• Reporting

PRE-ECLAMPSIA

• Introduction In which hypertension and proteinuria develop after 20 weeks of gestation in a previously woman who previously had normal blood pressure.

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Symptoms

• Mild symptoms
• Alarming symptoms
• Headache
• Disturbed Sleep
• Diminished urinary output
• Epigastric pain
• Eye symptoms
• Signs
• Abnormal weight gain
• Rise of blood pressure
• Oedema

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• Screening

To identify women who are at risk of developing preeclampsia due to many variables such as maternal age, obesity, diabetes, hypertension etc.

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• Early Identification

To identify headaches, dizziness, increased blood, pressure, proteinuria, swelling (oedema) and belly discomfort.

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• Primary Management
• Keeping an eye on the mother’s blood pressure, urine production.
• To control blood pressure & prevent complications.
• Using non-stress testing
• Plan for delivery if preeclampsia worsens
• Community Education and Support
• Follow-Up and Monitoring

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ECLAMPSIA

• Definition

The occurrence of convulsions or comas unrelated to other cerebral conditions during pregnancy or postpartum in patients with signs and symptoms of preeclampsia.

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• Prevalence

It is complication of severe pre-eclampsia, It is a rare condition that affects about 3% of pregnant women with pre-eclampsia.

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Clinical Features

• Premonitory phase
• Tonic phase
• Clonic phase
• Recovery phase/stage of coma

Screening/Early identification

Rule out the risk factors

• Maternal age ≥40 years.
• Multiple pregnancies.
• Chronic HTN.
• Diabetes mellitus.
• Pre-existing chronic kidney disease.

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Assess for clinical presentations such as..

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• Headache (usually frontal).
• Hyper- reflexia.
• Nausea and vomiting.
• Generalized oedema
• Right upper quadrant pain.
• Visual disturbances.

PRIMARY MANAGEMENT

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• Immediate seizure management
• Blood pressure control
• Maternal and fetal monitoring
• Delivery planning
• Postpartum care
• Support and follow-up

ANEMIA

• Also called lack of blood.
• It is a condition that develops when your blood pressure a lower than normal amount of healthy RBCs.

Types

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• Iron deficiency anemia
• Vitamin B12 deficiency anemia
• Folate - deficiency anemia

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SCREENING OF ANEMIA IN PREGNANCY

• First antenatal visit.
• The second screening test is done before the third trimester starts.

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POSSIBLE SYMPTOMS ARE:-

• Tiredness
• Shortness of breath
• Discoloration of skin: pale and blue
• Dizziness and lightheadedness
• Chest pain
• Cold hands and feet

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PRIMARY MANAGEMENT

• Iron prophylaxis
• Vitamin supplements:
• Role of Deworming
• Spacing between two pregnancies
• Early screening

TREATMENT

• Iron supplements
• Dietary Changes
• Vit C
• Bood transfusion
• Erythropoitin

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• MODES OF TREATMENT AS PER REQUIREMENT

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• Oral iron supplements Iron for treating IDA in pregnancy is 120 mg/dl.
• Parenteral iron therapy
• Blood transfusion

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GESTATIONAL DIABETES MALLITUS

• Presence of Impaired Glucose Tolerance (IGT) that occurs or is first identified during pregnancy.

RISK FACTORS

• Presence of diabetes in immediate family members
• Overweight baby weighing 4 kg or more
• Hyperplasia found during autopsy
• Presence of polyhydramnios
• Persistent glycosuria
• Age over 30 years
• Obesity

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SCREENING FOR GESTATIONAL DIABETES MELLITUS

• Screening tests
• Glucose challenge test (GCT)
• Oral glucose tolerance test (OGTT)
• Diagnostic criteria
• Testing to determine glucose control
• Care and management
• Postpartum follow-up
• Education and support

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• EARLY IDENTIFICATION OF COMPLICATIONS
• Fetal monitoring
• Maternal monitoring
• Blood pressure monitoring
• Assessment for polyhydramnios
• PRIMARY MANAGEMENT OF COMPLICATIONS
• Nutritional counselling
• Physical activity
• Glycaemic control
• Education and support

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HYPOTHYROIDISM

• Pregnancy-related hypothyroidism is body produces inadequate thyroid hormones.

HYPOTHYROIDISM STAGES

• Subclinical hypothyroidism
• Overt hypothyroidism

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SCREENING FOR HYPOTHYROIDISM

• Risk assessment
• Thyroid Function Tests (TFTs)
• Universal newborn screening

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NATIONAL GUIDELINES FOR SCREENING OF HYPOTHYROIDISM DURING PREGNANCY

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• Screening first antenatal visit
• Screening during the first trimester
• Primary screening test for TSH
• Treatment with levothyroxine
• TSH every 4-6 weeks
• Postpartum reassessment TSH weeks after delivery

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• EARLY IDENTIFICATION OF COMPLICATIONS
• Symptom recognition
• Regular monitoring
• Assessment for complications
• PRIMARY MANAGEMENT OF COMPLICATIONS
• Hormone Replacement Therapy
• Individualized Treatment Plans
• Education and Lifestyle Modification
• Monitoring and Adjustment

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SYPHILIS

• Sexually transmitted infection (STI) caused by the bacteria treponema pallidum.

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SIGNS AND SYMPTOMS

• Primary Syphilis
• Painless chancre
• Lymphadenopathy

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• SCREENING
• Routine Syphilis Screening
• Treponemal Tests
• Venereal Disease Research Laboratory [Vdrl] Or Rapid Plasma Reagin [Rpr] Tests.

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• PRIMARY MANAGEMENT
• Antibiotics
• penicillin G benzathine
• To stop the disease from getting worse and lower the chance of complications, syphilis must be treated early.

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COMPLICATIONS

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• Gummatous syphilis, neurosyphilis, and cardiovascular syphilis
• Neurosyphilis cause dementia
• Destructive lesions in the skin, bones, and liver
• Follow-Up and Monitoring

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PREVENTION

Promoting safe sexual behaviour, using condoms, doing regular STI testing

KEY ELEMENTS IN NURSING DOCUMENTATION AND REPORTING�

NORMAL LABOR—PROCESS, ONSET, STAGES OF LABOR�

PROCESS OF LABOR�

First Stage

• Latent phase
• Active phase
• Transient stage

Second Stage

• Propulsive phase
• Expulsive phase

Third Stage

• Placental separation
• Schultz method
• Matthew-Duncan method
• Decent
• Placental expulsion

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ONSET OF LABOR

It is also known as the start of delivery.

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Hormonal Changes

Hormones have an important function in the initiation of labor

• Progesterone
• Oxytocin
• Prostaglandins

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MONITORING AND ACTIVE MANAGEMENT OF DIFFERENT STAGES OF LABOR�

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LABOR

The whole birthing process, starting with the initiation of regular contractions in the uterus and concluding with the placenta being expelled.

�STAGES�

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• First stage: The cervix fully dilates after regular contractions start.
• Second stage: Complete cervical dilatation till the baby is born.
• Third stage: From the baby’s birth until the discharge of placenta.

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ASSESSMENT OF THE PROGRESS OF LABOR�

�SUPPORTIVE CARE DURING LABOR�

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• Continuous emotional support and reassurance
• Physical comfort measures
• Encouragement and positive reinforcement
• Pain relief options
• Ensuring hydration and nutrition
• Monitoring and assessing well-being
• Advocacy for preferences and birth plan
• Clear communication and information sharing
• Involving the birth partner
• Immediate postpartum support
• Emotional support for managing anxiety

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�MANAGEMENT OF THE FIRST STAGE OF LABOR�

• Providing psychological and emotional support
• Create a supportive environment
• Regular bladder and bowel care
• Fetal heart rate should be assessed
• Pain Management
• Partograph

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�SECOND STAGE OF LABOR MANAGEMENT�

• Lithotomy position
• Monitor the fetal heart rate
• Encourage make strong bearing-down
• Provide continuous support
• calm and focused environment
• Assess the progress of labor
• baby’s head is delivered check umbilical cord
• Encourage continue pushing
• provide initial care
• Baby is born monitor the mother for signs of hemorrhage

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�MANAGEMENT OF THE THIRD STAGE OF LABOR�

• Examine the Placenta
• Signs of Placental Separation

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Management Techniques

• Active Management
• Care During Labor

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CARE OF WOMEN AFTER LABOR

• To optimize the health and welfare of the mother and the infant, postpartum care is essential Postpartum care is essential to support a safe and healthy transition.

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• The following provides comprehensive information on the scope of care offered……

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EARLY IDENTIFICATION, PRIMARY� MANAGEMENT, REFERRAL AND FOLLOW-UP�

PRETERM LABOR

A baby born before 37 weeks gestation is referred to as a preterm birth.

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CLASSIFICATION

• Late preterm
• Moderately preterm
• Very preterm
• Extremely preterm

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CAUSES�

• Maternal age
• Multiple pregnancies
• Infections
• high blood pressure
• smoking or substance abuse

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COMPLICATIONS

• Respiratory distress syndrome
• Intraventricular haemorrhage
• Necrotizing enterocolitis

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FETAL DISTRESS

• Definition:- Indicators of reduced fetal well- being during pregnancy or childbirth.

CAUSES

• Maternal health conditions
• Placental abnormalities
• Umbilical cord issues
• Intrauterine infections

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�SIGNS AND SYMPTOMS�

• Abnormal fetal heart rate
• Meconium-stained amniotic fluid
• Decreased fetal movement
• Abnormal maternal vital signs

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�EARLY IDENTIFICATION

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• Regular prenatal assessments
• Assessment of maternal risk factors
• Fetal monitoring:
• Observation of fetal movement

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�PRIMARY MANAGEMENT�

• Maternal positioning
• Oxygen administration
• Intravenous fluid administration
• Non-pharmacological interventions
• Referral
• Follow-Up

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PROLONGED LABOR

When the total duration of both the first and second stages exceed an arbitrary limit of 18 hours.

CAUSES

First Stage of Labor (Cervical Dilation)

Latent phase

• Inefficient uterine contractions
• Unfavourable cervix
• Excessive sedation or analgesia

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Active phase

• Cephalopelvic disproportion (CPD)
• Malpresentation
• Hypotonic uterine dysfunction

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Second Stage of Labor

• Exhaustion
• Epidural anesthesia
• Fetal macrosomia
• Malpresentation

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Third Stage of Labor

• Placenta accreta
• Uterine atony
• Retained placenta

SIGNS AND SYMPTOMS

• Slow or minimal cervical dilation
• Weak or irregular contractions
• Contractions that become weaker
• Maternal exhaustion
• Maternal fatigue and exhaustion
• Excessive bleeding or hemorrhage
• Incomplete uterine contractions

DIAGNOSIS

• Partogram
• Assessing the frequency
• Assessing the heart rate
• Watching for symptoms of tiredness

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EARLY MANAGEMENT

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• Track cervical dilation
• Assess contraction strength
• fetal heart rate monitoring
• assess amniotic fluid
• Review maternal history

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PRIMARY MANAGEMENT

• Administer oxytocin
• adequate hydration with IV fluids
• Provide pain relief
• Support maternal rest and nutrition
• Prepare for possible instrumental delivery, cesarean
• Referral
• Follow-up

OBSTRUCTED LABOR�

In which labor progress is slowed due to a physical obstruction in the birth canal.

CAUSES

• Cephalopelvic disproportion (CPD)
• Malpresentation
• Malposition
• Uterine fibroids
• Pelvic abnormalities
• Contracted pelvis

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SIGNS AND SYMPTOMS�

• Prolonged labor
• Absence of fetal descent
• Severe maternal pain
• Fetal distress
• Abnormal vaginal discharge
• Abnormal fetal movements

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Diagnosis�

• Clinical assessment and history.
• Vaginal examination
• Use of a partogram
• Ultrasound
• Assessment of contraction
• Pelvic examination

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�EARLY IDENTIFICATION/PRIMARY MANAGEMENT��

• Monitor labor progress
• Vaginal exams
• Observe contraction
• Monitor fetal heart rate
• Administer Oxytocin
• Provide pain relief
• Prepare for cesarean section
• Support and comfort the mother
• Referral and Follow-Up

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VAGINAL AND PERINEAL TEARS

The tissue surrounding the vagina and perineum (the space between the vagina and the anus) may stretch or tear during delivery.

TYPES OF TEARS

• First-degree tear
• Second-degree tear
• Third-degree tear
• Fourth-degree tear

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CAUSES�

• Rapid or forceful delivery.
• Large baby size.
• Use of forceps or vacuum.
• Previous vaginal or Perineal Trauma.

SIGNS AND SYMPTOMS

• Pain or discomfort
• Swelling and bruising
• Bleeding
• Difficulty urinating
• Changes in sensation

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�EARLY IDENTIFICATION�

• Monitor for Continuous
• Observe the Perineal
• Listen to the patient’s complaints of sharp
• Perform a careful inspection
• Check for the presence of a hematoma
• Pain during urination

NURSING MANAGEMENT

• Assessment
• Pain management
• Wound care
• Monitoring
• Education
• Emotional support
• Referral
• Follow-Up

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�RUPTURED UTERUS�

Dangerous complication of delivery that occurs when the uterine muscle wall rips, enabling the baby to enter the mother’s abdomen.

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CAUSES

• Previous uterine surgery, like a caesarean section.
• Difficult or prolonged labor.
• Trauma to the abdomen.
• Weakening of the uterine wall.

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� SIGNS AND SYMPTOMS

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• Sudden, severe abdominal pain.
• Rapid heart rate.
• Drop in blood pressure.
• Vaginal bleeding.
• Loss of fetal heart rate.

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�EARLY IDENTIFICATION/NURSING MANAGEMENT��

• Monitor the patient closely
• Observe fetal heart rate
• Palpate the abdomen for changes
• Watch for signs of maternal shock
• Emergency response
• Emergency transportation
• First aid
• Emotional support
• Communication

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CARE OF THE NEWBORN IMMEDIATELY AFTER BIRTH�

• Newborn Care :- To support an infant’s health and well-being in the first few weeks of life and just after delivery.

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• Immediate Care:-

Drying and warming, Clear airway, Stimulate breathing.

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• Initial Physical Examination:-

Breathing, Heart rate, Color, Muscle tone, Congenital anomalies.

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APGAR SCORE�

• Total score = 10
• 7–10 score = Normal
• 4–6 = Moderately depressed
• 0–3 = Severely depressed

• MANAGEMENT
• Temperature Regulation
• Umbilical Cord Care
• Assessment of Vital Signs
• Eye CareBreastfeeding Support
• Immunization and Screening
• Vitamin K Administration
• Prophylactic Measures
• Blood Glucose Monitoring
• Parent Education
• Follow-Up Care

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MAINTENANCE OF RECORDS AND REPORTS IN CHC�

• Maternal and Child health records and reports typically maintained in (CHCs) include:

Antenatal care records , Labor and delivery records, Postpartum care records, Newborn care records, Immunization records, Family planning records, Child health records, Nutritional assessment and Counselling record, Health education ,follow-up reports.

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ROLE OF NURSES IN MAINTAINING RECORDS AND REPORTS RELATED TO MCH CARE�

• Accurate Documentation
• Timely Updates
• Confidentiality and Privacy
• Monitoring and Reporting
• Coordination of Care
• Quality Assurance
• Education and Training
• Patient Education
• Compliance and Legal Responsibilities

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USE OF SAFE CHILDBIRTH CHECKLIST �

Tool to assist healthcare providers and expectant mothers in preparing for a safe delivery.

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• Childbirth Preparation Checklist

Before Birth (On Admission to Facility)

• Assessment
• Supplies Check
• Birth Plan and Preparation
• HIV and Syphilis Testing

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• During Birth (Just Before Pushing or C-Section)
• Monitor Fetal Health
• Prevent Infection
• Use of Oxytocin
• Monitor Maternal Condition:

After Birth (Within 1 Hour of Birth)

• Immediate Newborn Care
• Maternal Care
• Postpartum (Within 24 Hours of Birth)
• Newborn Monitoring
• Vaccinations and Medications
• Maternal Monitoring
• Counseling

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LEGAL PREPARATIONS

• Birth certificate form (filled out)
• Hospital registration papers
• seamless birthing experience
• Verify that the delivery room or home birth setting,
• Evaluate the mother’s vital signs
• Encourage and offer emotional support
• Provide suitable and safe pain management
• Encourage the movement
• Encourage good communication
• Record all aspects of the labor and delivery process

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SKILLS-BASED APPROACH, (SBA) MODULE

An educational approach that emphasizes the development of real-world skills and competencies via learning and evaluation.

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KEY COMPONENTS

• Skill Development
• Practical Training
• Assessment Methods

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BENEFITS OF SBA

• Improves learning
• Relevance to the real world
• Skill mastery

APPLICATION ACROSS DISCIPLINES

SBA is applicable to many different academic departments useful in occupations that need hands- on abilities.

• Continuous Improvement
• Adaptability

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ORGANIZATION OF LABOR ROOM

Organizing the labor room entails ensuring that the environment is secure, pleasant, and well equipped.

Labor Room Space and Layout

• Design and size
• Zoning

Labor Table/Delivery Area

• Positioning
• Adjustable labor table

Newborn Care Area

• Proximity to the delivery area
• Radiant warmer

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• Nursing Station :- Central location, Equipment and supplies.
• Patient records
• Hand Washing Area
• Lighting:- Adequate lighting, Emergency lighting
• Power Supply:- Uninterrupted power supply (UPS), Power outlets
• Emergency Equipment and Medication Storage
• Clean and Comfortable Environment
• Essential Equipment and Supplies
• Privacy and Dignity and Comfort Measures

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• Communication and Documentation
• Emergency Preparedness
• Cultural Sensitivity
• Prepare for Neonatal Care
• Staff Coordination

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POSTPARTUM CARE

The care given to a woman and her infant in the first six weeks following delivery is known as postpartum care.

OBJECTIVES

• Aid in the mother’s postpartum physical recovery
• Assist the mother emotionally
• Assist with breastfeeding
• Provide information
• Provide dietary
• Handle any pain or discomfort
• Arrange follow-up consultations

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• POSTNATAL VISITS
• First visit
• Second visit
• Third visit
• Subsequent visits

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CARE OF THE BABY AND THE MOTHER

CARE OF THE BABY

• Postpartum Vitals Monitoring
• Appropriate Feeding and Nutrition
• Immunizations
• Health Screening and Tests
• Environment for Growth and Thriving
• Overall Well-Being and Support

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CARE OF MOTHER

BREAST FEEDING

• Breastfeeding is the process of giving a child breast milk directly from the breast or expressed milk.

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• BENEFITS FOR THE BABY
• Nutritional value
• Immune support
• Digestibility
• Development

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• BENEFITS FOR THE MOTHER
• Bonding
• Health
• Weight loss
• PROCESS OF BREASTFEEDING
• Latch-on
• Milk release
• Feeding
• BREASTFEEDING TYPES
• Exclusive breastfeeding
• Mixed feeding

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• ADVICE

The World Health Organization (WHO) recommends nursing exclusively for the first six months of life.

BREASTFEEDING TECHNIQUE

• Appropriate Latch
• Positioning
• Frequency
• Duration

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• Establishing Milk Supply
• Common Problems and Fixes
• Sore nipples
• Engorgement
• Low milk supply
• Mastitis
• Diet and Nutrition
• Weaning

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DIET DURING LACTATION

During lactation, the Recommended Dietary Allowances (RDA) give guidance for the daily intake of key nutrients required to maintain the health.

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• Macronutrients
• Protein
• Carbohydrates
• Fats
• Micronutrients
• Iron
• Calcium
• Vitamins
• Hydration
• Calorie Requirement

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HEALTH COUNSELLING

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• Health counselling during the postpartum period is crucial for the well-being of both the mother and newborn. Some key areas to focus on are:

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EARLY IDENTIFICATION, PRIMARY MANAGEMENT, REFERRAL, AND FOLLOW-UP� OF COMPLICATIONS

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POSTPARTUM COMPLICATIONS

• Postpartum Haemorrhage :- Postpartum Hemorrhage (PPH) is defined as excessive bleeding following childbirth.

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THE DANGER SIGNS OF POSTPARTUM HEMORRHAGE

• Feeling dizzy or lightheaded
• Rapid heartbeat
• Pale or clammy skin
• Passing large blood clots

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EARLY IDENTIFICATION OF POSTPARTUM HEMORRHAGE

• Monitor the amount of bleeding
• Assess uterine tone
• Check vital signs
• Review placental delivery
• Assess for signs of infection
• Educate and encourage

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POSTPARTUM SHOCK

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• This condition can result in organ dysfunction or failure if not promptly treated.

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DANGER SIGNS OF POSTPARTUM SHOCK�

• Persistent heavy bleeding
• Sudden collapse or loss of consciousness
• Rapid, weak, or irregular pulse
• Severe drop in blood pressure
• Cold, clammy, or pale skin.

DANGER SIGNS OF POSTPARTUM SHOCK�

• Persistent heavy bleeding
• Sudden collapse or loss of consciousness
• Rapid, weak, or irregular pulse
• Severe drop in blood pressure

EARLY IDENTIFICATION OF POSTPARTUM SHOCK

• Rapid heart rate (tachycardia)
• Low blood pressure (hypotension)
• Pale, cold, or clammy skin
• Dizziness or confusion

Primary Management of Postpartum Shock

• Administer high-flow oxygen.
• Establish IV access and provide rapid fluid replacement
• Control the source of bleeding

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• Referral and Follow-Up of Complications
• Follow-up visits to assess recovery
• Long-term monitoring for potential emotional

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�PUERPERAL SEPSIS

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It occurs after childbirth, miscarriage, or abortion, usually within the first 6 weeks of postpartum.

DANGER SIGNS OF BREAST CONDITIONS�

• Severe or worsening breast pain.
• Persistent fever or chills.
• Extensive redness, warmth, or swelling in the breast.
• Severe fatigue or malaise.
• Early Identification of Puerperal Sepsis
• Primary Management of Puerperal Sepsis
• Referral and Follow-Up of Complications

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BREAST CONDITIONS

• Breast engorgement
• Mastitis
• Nipple pain and cracking
• Breast abscess
• Galactorrhea

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PRIMARY MANAGEMENT OF BREAST CONDITIONS�

• Breast engorgement
• Mastitis
• Nipple pain and cracking
• Plugged milk ducts
• Galactorrhea
• Referral and Follow-Up of Complications of Breast Conditions

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POSTPARTUM DEPRESSION (PPD)�

• Postpartum depression is a type of mood disorder that occurs after childbirth.
• THE DANGER SIGNS OF POSTPARTUM DEPRESSION
• Extreme fatigue or loss of energy.
• Changes in appetite or weight.
• Difficulty bonding with your baby.
• Intense irritability or anger.
• Difficulty concentrating or making decisions.
• Feelings of guilt, worthlessness, or inadequacy

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PRIMARY MANAGEMENT OF POSTPARTUM DEPRESSION (PPD)�

• Medications (if needed)
• Antidepressants
• Antianxiety medications
• Psychotherapy combined with medication
• Hormonal therapy
• Referral and Follow-Up of Postpartum Depression (PPD)

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��POSTPARTUM VISITS BY HEALTHCARE PROVIDERS�

To assist new mothers and advance the health of both mothers and babies.

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HOME VISITS

Individualized care and support in a comfortable setting. Timings of initial visit are 1-2 weeks after birth.

• Physical Health Assessment
• Perineal healing
• Breast health
• Breastfeeding Support
• Newborn Care Education
• Nutritional Counselling

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NEWBORN AND CHILDCARE�

• Essential Newborn Care
• Thermal Care
• Immediate Skin-to-Skin Contact
• Early Breastfeeding Initiation
• Neonatal Resuscitation
• Umbilical Cord Care
• Immunizations
• Monitoring and Evaluation
• Counselling and Support

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��MANAGEMENT OF COMMON NEONATAL PROBLEMS�

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Neonatal Jaundice :- It is an excessive accumulation of unconjugated bilirubin in the blood more than 5 mg/dl.

TYPES ARE…

• Physiological Jaundice
• Breastfeeding Jaundice
• Hemolytic Jaundice
• Breast Milk Jaundice
• Prematurity-Related Jaundice Pathological Jaundice
• Cephalohematoma-Induced Jaundice
• Conjugated (Cholestatic) Jaundice
• Crigler-Najjar Syndrome
• Neonatal Sepsis-Related Jaundice

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ROLE OF NURSES

• Monitor the baby’s hydration and skin condition during phototherapy.
• Educate parents about the importance of frequent feeding.

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RESPIRATORY DISTRESS SYNDROME (RDS)�

This Syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity of the lungs.

CAUSES

RDS among neonates is due to:

• Insufficiency of surfactant production
• Structural immaturity of the lungs

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RDS OF NONPULMONARY ORIGIN IS DUE TO:

• Sepsis
• Cardiac defects (structural or functional)
• Exposure to cold
• Airway obstruction

CLINICAL MANIFESTATIONS

• Tachypnea <80 to 120 breaths per minute initially
• Dyspnea
• Pronounced intercostals or substernal retractions
• Fine inspiratory crackles
• Audible expiratory grunt

MANAGEMENT�

• Oxygen therapy
• Surfactant replacement therapy
• Mechanical ventilation

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ROLE OF NURSES

• Monitor respiratory rate, oxygen saturation
• Maintain a neutral thermal environment

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HYPOGLYCEMIA�

• Hypoglycemia abnormally low levels of glucose (blood sugar) blood glucose level below 40 mg/dL within the first 24 hours of life.

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• CAUSES: Low blood sugar levels, common in infants of diabetic mothers, preterm infants, and those with low birth weight.
• SYMPTOMS: Jitteriness, poor feeding, lethargy, and seizures etc.

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• MANAGEMENT
• Early and frequent feeding
• IV glucose
• Monitoring

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• ROLE OF NURSES
• Monitor blood glucose levels
• Educate parents about feeding

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NEONATAL SEPSIS�

• Bacterial infection in the bloodstream.
• Neonates are highly susceptible to infection as they have immature immunity.

CAUSES

• Different types of bacteria
• From the mother before or during delivery.
• Haemophilus influenza, citrobacter, enterobacter, coagulase-negative staphylococci, and streptococcus.

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• SYMPTOMS: Temperature instability, poor feeding, lethargy, irritability, respiratory distress, and jaundice.

MANAGEMENT

• Antibiotic therapy
• Supportive care
• Blood cultures

ROLE OF NURSES

• Monitor vital
• Provide family support

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HYPOTHERMIA�

• Where the body temperature drops below the normal range required for proper metabolic and bodily functions below 36.5°C (97.7°F).

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• CAUSES: Inability to regulate body temperature or low-birth-weight infants.

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• SYMPTOMS: Cold skin, lethargy, poor feeding, slow heart rate, and respiratory distres etc.

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MANAGEMENT�

• Kangaroo care
• Radiant warmers
• Monitoring temperature

ROLE OF NURSES

• Maintain the neonate in a thermo-neutral environ-ment.
• Educate parents about proper clothing for the infant.

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MECONIUM ASPIRATION SYNDROME (MAS)

• Newborn inhales meconium-stained amniotic fluid into the lungs before, during, or immediately after birth.

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• CAUSES: Aspiration of meconium-stained amniotic fluid.
• SYMPTOMS: Rapid or labored breathing, cyanosis, Decreased oxygen levels

MANAGEMENT

Suctioning

Oxygen therapy

Ventilation support

Surfactant therapy

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ROLE OF NURSES

• Monitor for signs of respiratory distress and ensure the baby is well-oxygenated.
• Assist in resuscitation.

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NECROTIZING ENTEROCOLITIS (NEC)

A serious gastrointestinal disease that primarily affects premature infants

• CAUSES: Inflammation and infection in the intestines.
• SYMPTOMS: Abdominal distension, feeding intolerance, bloody stools etc.
• ROLE OF NURSES
• Monitor abdominal girth, stool characteristics, and signs of infection.
• Educate parents about the signs and symptoms of NEC.

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PERINATAL ASPHYXIA

Also known as fetal asphyxia, refers to a condition in which a fetus experiences a lack of oxygen and nutrient supply before birth.

• CAUSES: Lack of oxygen before, during, or after birth etc
• SYMPTOMS: Poor muscle tone, lack of breathing etc
• ROLE OF NURSES
• Provide support during resuscitation and post- resuscitation care.
• Monitor for neurological outcomes and long-term complications.

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PNEUMONIA

Inflammatory condition of the lungs, primarily affecting the alveoli.

• ETIOLOGY:- Bacterial infections / Viral infections
• SIGNS AND SYMPTOMS:- Cough (often productive with sputum), Fever and chills, Shortness of breath, Chest pain or discomfort.
• DIAGNOSTIC TESTS
• Chest X-ray
• Complete Blood Count (CBC)
• Blood Cultures
• Sputum Culture

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TREATMENT�

• Antibiotics (for bacterial pneumonia)
• Antiviral medications (for viral pneumonia)
• Antifungal medications (for fungal pneumonia)
• Cough medicine

PREVENTION: Promoting preventative measures, such as exclusive breastfeeding, sufficient nutrition, excellent hygiene habits, timely vaccines.

DIARRHEA

Frequent passage of loose, watery stools, often occurring three or more times in a day.

ETIOLOGY

• Infections
• Food-Related Causes
• Medications
• Chemotherapy drugs
• Digestive Disorders
• OTHER CAUSES
• Stress or anxiety
• Hormonal disorders

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• SIGNS AND SYMPTOMS
• Frequent, loose, or watery stools
• Abdominal cramps or pain
• Urgency to have a bowel movement
• Nausea and vomiting and Blood or mucus in stools

DIAGNOSTIC TESTS

• Stool Analysis
• Blood Tests
• Complete blood count (CBC
• Other Tests
• Endoscopy
• Hydrogen breath test

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MANAGEMENT OF DIARRHEA

• Rehydration
• Dietary Adjustments
• Medications
• Treatment of Underlying Causes
• Preventive Measures
• Prevention: Promoting preventive measures, such as rotavirus vaccination.

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SEPSIS

Life-threatening condition occurs when the body’s immune response to an infection goes into overdrive, leading to widespread inflammation, organ dysfunction.

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ETIOLOGY caused by an infection

• Bacterial infections, viral infections, fungal infections.

SIGNS AND SYMPTOMS: Cyanosis, hypotension, Difficulty breathing or respiratory failure, Multi-organ dysfunction.

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LABORATORY TESTS

• Blood cultures
• CBC
• C-reactive protein
• Urine cultures
• Imaging

MANAGEMENT

• Immediate and Intensive Care
• Monitoring and Supportive Care
• Adjunct therapies
• Nutritional Support

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PREVENTION

• Vaccination
• Infection control practices
• Prompt treatment of infections

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SCREENING FOR CONGENITAL ANOMALIES AND REFERRAL

It is also known as a congenital anomaly or birth defect present at birth and deviates from the typical development of the body.

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IMNCI MODULE

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• Integrated Management of Neonatal and Childhood Illness) is an integrated strategy designed to manage common childhood diseases. This approach involves:
• Proper assessment and multi-diagnosis
• Combined treatment
• Cost-effectiveness
• Prevention and promotion
• Standardized management

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MANAGEMENT PROCESS�

• It involves a thorough assess- ment, which includes evaluating both the health and illness status of the child.

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• Danger Signs
• Signs and Symptoms of Illnesses
• Nutritional and Immunization Status
• Other Problems

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IDENTIFICATION AND CLASSIFICATION OF CONDITIONS AND TREATMENT

• Red (Urgent/Pre-Referral)
• Yellow (Treatment and Instructions at Health Facility)
• Green (Counselling on Home Management)

SIMPLE TREATMENT INSTRUCTIONS AND COUNSELLING FOR THE CARETAKER

• Feeding and Hydration
• Treatment of Local Infections
• When to Return Immediately
• Follow-Up

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• Under-5 clinics are healthcare facilities specifically designed to cater to the needs of children under five years old.

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• Care in Illness :- This involves diagnosing and treating illnesses and conditions that affect young children.

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• Family Planning:- Family planning services help families make informed decisions about reproduction and childbearing.

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• Growth Monitoring:- Growth monitoring tracks a child’s physical development over time.
• Preventive care:- aims to prevent illnesses before they occur. In an under-5 clinic Health Education
• Health education:- involves providing parents and caregivers with information and resources to support their child’s health.
• Promotion of health and education
• Developmental assessment and growth monitoring
• Preventive healthcare services
• Services for immunization

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ADOLESCENT HEALTH

• Introduction :- The period of life between childhood and adulthood, known as adolescence, lasts from the ages of 10 to 19.

Common Health Problems and Risk Factors in Adolescents

• Health Problems During Adolescence
• Sexual and Reproductive Health Issues
• Pubertal Issues
• Psychosocial Issues
• Nutritional Issues
• Adolescent Mental Health
• Sleep Disorders

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RISK FACTORS IN ADOLESCENT GIRLS AND BOYS

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• Girls: Risk factors for girls include gender-based violence, sexual exploitation, and early marriage.
• Boys: Boys may experience risks related to physi- cal violence, risky behaviours such as substance abuse.
• Both: Common risks for both genders include accidents and injuries due to unsafe behaviour.
• Sexuality-related problems: Adolescence is a developmental phase marked by sexual maturation.

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AWARENESS ABOUT THE LEGAL AGE OF MARRIAGE

Promoting the rights and well-being of people, especially young girls who can be susceptible to early marriage.

• Age of marriage for males is 21 years, females is 18.

OBJECTIVES

• Educate communities
• Promote awareness
• Encourage adherence to legal standards
• Importance of Awareness
• Prevention of child marriage
• Protection of rights
• Promotion of education

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NUTRITIONAL STATUS OF ADOLESCENTS�

• Adolescents’ eating habits, level of nutritional awareness, and lifestyle choices all have a significant role in their general health and development.

Major Nutrition Concerns in Adolescents

Undernutrition :- Adolescent undernutrition is a major problem, especially in low- and middle-income nations.

Micronutrient Deficiencies :- Undernutrition, also known as “hidden hunger,” happens when teenagers don’t get enough vitamins and minerals in their diet.

Overnutrition (Obesity):- Obesity is the result of overnutrition, which is defined as consuming plenty of calories and harmful meals.

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CONTRIBUTING FACTORS TO VARIOUS NUTRITIONAL PROBLEMS

• Socio-Economic Status
• Gender Disparity
• Lack of Knowledge about Proper Nutrition and Healthy Eating Practices
• Faulty Traditional or Cultural Practices

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GOVERNMENT INITIATIVES�

• MID-DAY MEAL SCHEME (MDMS)

Mid Day Meal Scheme was started in India from 15th August 1995, which is popularly known as the Mid-Day Meal Scheme.

OBJECTIVES:

• Nutritional improvement
• educational enhancement
• Social equity
• Community participation

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NATIONAL IRON PLUS INITIATIVE

• The Indian government’s Ministry of Health and Family Welfare introduced the National Iron Plus Initiative (NIPI) in 2013.
• OBJECTIVES
• Reduce the prevalence and severity of anemia
• Improve general health and nutritional status through regular iron.
• KEY COMPONENTS
• Iron and Folic Acid Supplementation

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ICDS SERVICE:- OCTOBER 2, 1975.

The Integrated Child Development Services (ICDS) initiative is one of the Government of India’s major programs aimed at improving children’s health, nutrition, and developmental outcomes.

OBJECTIVES

• Improve the nutritional and health status of children aged 0 to 6 years.
• Reduce mortality, morbidity, malnutrition, and school dropout rates.

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KEY SERVICES

• Additional nutrition
• Immunization
• Health check-ups
• Pre-school non-formal education

NATIONAL PROGRAMS

RMNCH+A APPROACH

Reproductive, Maternal, Newborn, Child, and Adolescent Health plus Nutrition.

AIM:- To improve the health outcomes of women, children, and adolescents, Reduce Maternal and Child Mortality, Promote Health Equity, Enhance Nutritional Status, Infrastructure Development

• Human Resource Development
• Supply Chain Management
• Health Information Systems

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STRATEGIES AND INTERVENTIONS ACROSS LIFE STAGES

• Reproductive Health
• Maternal Health
• Newborn Health
• Child Health
• Adolescent Health

PROGRAM MANAGEMENT

• Leadership and Governance
• Community Engagement
• Monitoring and Evaluation Systems
• Data Collection and Reporting

EVALUATION

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• ROLE OF COMMUNITY HEALTH NURSE IN RCH PROGRAM
• Conduct regular health screening
• Provide education
• Promote immunization
• Coordinate with other healthcare providers
• Maintain accurate records and report

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UNIVERSAL IMMUNIZATION PROGRAM (UIP) AS PER GOVERNMENT OF INDIA GUIDELINES�

Aims to prevent vaccine- preventable illnesses by offering free immunizations to all children in the nation.

Objectives :-To lower disease-related death and morbidity, To get complete vaccination.

Key Components of the UIP

• Vaccine Coverage
• Cold Chain and Logistics
• Vaccination Schedule
• Monitoring and Evaluation
• Training and Capacity Building
• Community Mobilization

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ACHIEVEMENTS

• Polio-Free Status
• Increased Coverage
• Reduction in Disease Incidence

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RASHTRIYA BAL SWASTHYA KARYAKRAM (RBSK)—CHILDREN

Government of India project under the National Health Mission (NHM) that aims to identify and treat children from birth to age eighteen at an early age.

OBJECTIVES:- Early Identification and intervention

• Early diagnosis and treatment of health issues
• Comprehensive health screening
• Conduct thorough and organized health screenings

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• KEY COMPONENTS
• Screening and Intervention
• Service Delivery
• Health Conditions to be Screened
• Referral and Treatment
• CHALLENGES
• Infrastructure and Resource Constraints
• Follow-Up and Continuity of Care
• Data Management

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RASHTRIYA KISHORE SWASTHYA KARYAKRAM (RKSK)—ADOLESCENTS

The goal of ensuring adolescents’ health and well-being via comprehensive health services and interventions, the program acknowledges the particular issues that they encounter.

OBJECTIVES OF RKSK

• Holistic Health
• Informed Decision-Making
• Address Vulnerabilities

KEY COMPONENTS OF RKSK

• Health Promotion

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• Preventive Health Services
• Clinical Services

Priority Areas of RKSK

• Nutrition
• Sexual and Reproductive Health
• Mental Health
• Substance Abuse

Monitoring and Evaluation

• Data Collection and Reporting
• Performance Monitoring
• Impact Evaluation

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Achievements

• Increased Awareness
• Improved Access to Services
• Empowerment

Challenges

• Stigma and Cultural Barriers
• Sustaining Engagement
• Resource Constraints

Conclusion

• Through clinical, preventative, and promotional services, the Rashtriya Kishor Swasthya Karyakram (RKSK) offers a holistic approach to adolescent health.

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• NATIONAL EDUCATION POLICY 2020

On July 29, 2020, India announced the National Education Policy (NEP) 2020.

OBJECTIVES

• Holistic and Multidisciplinary Education
• Universal Access to Education
• Equity and Inclusion
• Early Childhood Care and Education (ECCE)
• Use of Technology
• Higher Education Reform
• Curriculum and Pedagogy Reform
• Governance and Regulation

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KEY FEATURES:-

• School Education
• Early Childhood Care and Education (ECCE)
• Curriculum and Pedagogy Reform
• Mother Tongue/Regional Language
• Assessment Reforms
• Language Learning
• Higher Education
• Undergraduate Education
• National Research Foundation (NRF)
• Technology in Education

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The Pradhan Mantri Kaushal Vikas Yojana (PMKVY)

It is a skill development project launched by the Government of India to provide industry-relevant skill training to youngsters across the country.

OBJECTIVES ARE:-

• To improve skills and employability of Indian youth
• Skill development and Certification
• Recognition of prior learning (RPL)
• Encourage entrepreneurship
• Quality assurance
• Jobs generation and Inclusivity

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NAI MANZIL SCHEME

• The Government of India introduced the Nai Manzil Scheme on August 8, 2015, It seeks to give educational and skill development opportunities to minority youth who are school dropouts .
• OBJECTIVES :-
• Education and skill development
• Employability
• Inclusive growth
• Empowerment

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BENEFITS:-

• Education completion
• Skill enhancement
• Empowerment

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PM MUDRA YOJANA

DIGITAL INDIA