Maternal and Child Health Services during Lockdown Situation

Maternal and Child Health Services during Lockdown Situation Dr. Ajay Khera Commissioner (MCH) Ministry of Health and Family Welfare Government of India

Maternal and Child Health Services during Lockdown Situation • Maternal and Child Health Services have been identified as essential services particularly for pregnant women in the last trimester and high risk pregnant women during COVID 19 Pandemic. • Pregnant women and children are at risk like general population and there is no evidence of risk during vaginal delivery and no evidence of perinatal transmission. • Prevention of infection, Nutrition and Psychological well being of mothers in crisis situation (Covid-19) is of paramount importance and this has bearing on the MCH Outcome.

Maternal and Child Health Services during Lockdown Situation • Pregnant women with no identified complications should be advised to delay routine ANC visits, but inform the ASHA telephonically about any complications related to pregnancy or with fever, cough or breathing difficulty. • However, PMSMA and VHSND services have been suspended to follow the concept of social distancing. • If pregnant women proactively seek ANC services on PMSMA days, they must be provided antenatal care including Tetanus toxoid injection as per protocols following Infection Control measures.

Maternal and Child Health Services during Lockdown Situation • ANM and ASHA to list and follow up HRPs to ensure early detection of complications, referral and follow up. • Telephonic contact by ASHAs / ANMs to HRPs during last trimester to ascertain status is to be encouraged but Home based follow up to be provided if necessary. (ASHAs/ANMs to follow all precautions while visiting the household). • Each pregnant woman (to be delivered in next two months) to be linked with the appropriate health facility for delivery

Maternal and Child Health Services during Lockdown Situation • The Obstetric emergencies are managed based on medical assessment and unnecessary C – Section should be avoided. • In case of home deliveries, immediate visits to be made by ANM or CHO (where available) to assess the health of the woman and new-born. Facilitate timely referral in case of any complication using the dedicated 102/ Janani express vehicles.

Maternal and Child Health Services during Lockdown Situation • Medical and surgical abortion services to be ensured at appropriate facility level, with appropriate infection prevention measures including counselling for post abortion care and provision of contraception. • The early initiation of breastfeeding/ KMC services are promoted irrespective of Covid-19 status. If mother is Covid-19 positive, she can also breastfed the newborn by using mask and hygiene. • Immunization services should be continued at facility level however, VHSNDs have been postponed till April 15, 2020

Maternal and Child Health Services during Lockdown Situation • ASHAs should inform telephonically to households with children as per immunization schedule and facilitate access to immunization services at the nearest SHC/PHC. • Admission to SNCU and NBSU to be continued as per existing guidelines however sick neonates born to a mother with suspected or proven COVID-19 infection to be managed in separate isolation facility with all necessary services and equipment.

Maternal and Child Health Services during Lockdown Situation • The nutrition, academic and private sector community should continue to provide services to mother reporting to the facilities by adopting infection control measures. • In case of suspected COVID-19 infection in mother/sick child, ASHA/ ANM should refer to nearest COVID-19 management facility. • All health care providers must follow infection control measures and identify early suspected cases of Covid-19 based on Standard Case definition.

Maternal and Child Health Services during Lockdown Situation • 102/108 Ambulatory services/ Janani Express are available for any emergency situation. • For any Covid-19 related guidance, the helpline number is 1075 / 01123978046. • Covid-19 Psycho Socio behavior helpline - +918046110007

Key Messages • Pregnant women don’t have extra risk during Covid-19 and there is no current evidence to suggest trans-placental transmission of Covid -19 virus, No traces of virus found in breast milk and no risk during vaginal delivery • Pregnant women must take all precautions to prevent infection namely social distancing, hand washing and cough hygiene. Health care personnel also must take infection control/PP measures • All COVID 19 suspected/positive mothers to be notified and managed in Isolation units using infection control practices • All pregnant women must take care of nutrition, mental well being, physical activity and adequate sleep within the house during lockdown situation.

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