Republic of the Philippines

SULTAN KUDARAT STATE UNIVERSITY

COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING
GOALS AND PHILISOPHIES OF MATERNAL 2. Maternal and child health nursing is community
centered; the health of families depends on and
AND CHILD HEALTH NURSING
influences the health of communities.
 Obstetrics, or the care of women during childbirth, 3. Maternal and child health nursing is evidence
is derived from the Greek word obstare, which based, because this is the means whereby critical
means "to keep watch." knowledge increases.
4. A maternal and child health nurse serves as an
 Pediatrics is a word derived from the Greek word advocate to protect the rights of all family members,
pais, meaning "child." including the fetus.
5. Maternal and child health nursing includes a high
 The care of childbearing and childrearing families is degree of independent nursing functions, because
a major focus of nursing practice, because to have teaching and counseling are major interventions.
healthy adults you must have healthy children. 6. Promoting health and disease prevention are
important nursing roles because these protect the
 To have healthy children, it is important to promote health of the next generation.
the health of the childbearing woman and her family 7. Maternal and child health nurses serve as important
from the time before children are born until they resources for families during childbearing and
reach adulthood childrearing as these can be extremely stressful
times in a life cycle.
 That makes both pre-conceptual and prenatal care 8. Personal, cultural, and religious attitudes and
essential contributions to the health of a woman and beliefs influence the meaning and impact of
fetus and to a family's emotional preparation for childbearing and childrearing on families.
childbearing and childrearing. 9. Circumstances such as illness or pregnancy are
meaningful only in the context of a total life.
 As children grow, families need continued health 10. Maternal and child health nursing is a challenging
supervision and support. As children reach maturity role for nurses and a major factor in keeping
and plan for their own families, a new cycle begins families well and optimally functioning.
and new support becomes necessary.
 In all settings and types of care, keeping the family
 The nurse's role in all these phases focuses on at the center of care or considering the family as the
promoting healthy growth and development of the primary unit of care is an essential goal.
child and family in both health and illness (Nearns,
2009).  This is because the level of a family's functioning
affects the health status of its members
PRIMARY GOAL OF MATERNAL AND CHILD (Vonderheid, Norr, & Handler, 2007).
HEALTH NURSING CARE
 If a family's level of functioning is low, the
 Can be stated simply as the promotion and emotional, physical, and social health and potential
maintenance of optimal family health to ensure of individuals in that family can be adversely
cycles of optimal childbearing and childrearing. affected.

 The goals of maternal and child health nursing care  A healthy family, on the other hand, establishes an
are necessarily broad because the scope of environment conducive to growth and health-
practice (the range of services and care that may be promoting behaviors that sustain family members
provided by a nurse based on state requirements) is during crises.
so broad.
 Similarly, the health of an individual and his or her
RANGE OF PRACTICE ability to function strongly influence the health of
1. Pre-conceptual health care family members and overall family functioning.
2. Care of women during three trimesters of
pregnancy and the puerperium (the 6 weeks after  For these reasons, a family-centered approach
childbirth, sometimes termed the fourth trimester of enables nurses to better understand individuals and
pregnancy) their effect on others and, in turn, to provide holistic
3. Care of infants during the perinatal period (6 weeks care.
before conception to 6 weeks after birth)
4. Care of children adolescence from birth through COMMON MEASURES TO ENSURE FAMILY-
5. Care in settings as varied as the birthing room, the CENTERED MATERNAL AND CHILD
pediatric intensive care unit, and the home. HEALTH CARE
PHILOSOPHY OF MATERNAL AND CHILD HEALTH PRINCIPLES
NURSING
1. The family is the basic unit of society.
1. Maternal and child health nursing is family centered; 2. Families come in many different forms and sizes
assessment must include both family and individual and represent racial, ethnic, cultural, and
assessment data. socioeconomic diversity.
3. Children grow both individually and as part of a
family.
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 Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY
COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING

NURSING INTERVENTIONS 3. HEALTH RESTORATION

1. Consider the family as a whole as well as its  Promptly diagnosing and treating illness using
individual members. interventions that will return client to wellness most
2. Assess families for strengths as well as for specific rapidly
needs or challenges.  →Caring for a woman during a complication of
3. Respect diversity in families as a unique quality of pregnancy or a child during an acute illness
that family.
4. Share or initiate information on health planning with 4.HEALTH REHABILITATION
family members so that care is family oriented.  Preventing further complications from an illness;
5. Encourage family bonding through rooming-in in bringing an ill client back to an optimal state of
both maternal and child health hospital settings. wellness or helping a client to accept inevitable
6. Encourage families to give care to a newborn or ill death
child.  Encouraging a woman with gestational trophoblastic
7. Family members affect other members; individual disease to continue therapy or a child with a renal
members affect the total family group. transplant to continue To take necessary
8. Encourage family and sibling visits in the hospital to medications
promote family contacts.
9. Participate in early hospital discharge programs to THE NURSING PROCESS
reunite families as soon as possible.
 Nursing care, at its best, is designed and
10. Include developmental stimulation in nursing care.
implemented in a thorough manner, using an
11. Encourage families to reach out to their community
organized series of steps, to ensure quality and
so that family members are not isolated from their
consistency of care (Carpenito, 2007).
community or from each other.
 The nursing process, a form of problem solving
based on the scientific method, serves as the basis
STANDARDS OF MATERNAL AND CHILD for assessing, making a nursing diagnosis,
HEALTH NURSING PRACTICE planning, organizing, and evaluating care.
 The importance a society places on human life can  Because nurses rarely work in isolation but rather
best be measured by the concern it places on its as a member of a health care team or unit,
most vulnerable members-its elderly, multidisciplinary care maps are included throughout
disadvantaged, and youngest citizens. the text to demonstrate the use of the nursing
process for selected clients, provide examples of
 To promote consistency and ensure quality nursing critical thinking, and clanty nursing care for specific
care and outcomes in these areas, specialty client needs
organizations have developed guidelines for care in  These also serve to accentuate the increasingly
their specific areas of nursing practice. important role of the nurse as a coordinator of client
care and member of a collaborative team.
A FRAMEWORK FOR MATERNAL AND
CHILD HEALTH NURSING CARE EVIDENCE-BASED PRACTICE
Maternal and child health nursing can be visualized within a  Evidence-based practice is the conscientious,
framework in which nurses, using nursing process, nursing explicit, and judicious use of current best evidence
theory, and evidence-based practice, care for families during in making decisions about the care of patients
childbearing and childrearing years through four phases of (Foxcroft & Cole, 2009).
health care:  Evidence can be a combination of research, clinical
1. Health promotion expertise, and patient preferences when all three
2. Health maintenance combine in decision making.
3. Health restoration
4. Health rehabilitation THE WORTH OF EVIDENCE IS RANKED ACCORDING
TO:
1. HEALTH PROMOTION
 Educating clients to be aware of good health 1. Level I
through teaching and role modeling  Evidence obtained from at least one
 Teaching women the importance of rubella properly designed randomized controlled
immunization before pregnancy; teaching children trial.
the importance of safer sex practices 2. Lovel II
 Evidence obtained from well-designed
2. HEALTH MAINTENANCE controlled trials without randomization,
 Intervening to maintain health when risk of illness is well- designed cohort or case-control
present analytic studies, or multiple time series
 Encouraging women to come for prenatal care; with or without an intervention,
teaching parents the importance of safeguarding
their home by childproofing it against poisoning

19 |G R A C I A N J O L E S B E S I N - B S N
 Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY
COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING
 Evidence obtained from dramatic results in 3. What is the effect of market-driven health care
uncontrolled trials might also be regarded on the quality of maternal-child nursing care?
as this type of evidence.
4. What active measures can nurses take to
reduce the incidence of child or intimate partner
abuse?

5. How can nurses best help families cope

NURSING RESEARCH with the stress of long-term illness?

 Bodies of professional knowledge grow and expand
to the extent that people in that profession plan and 6. How can nurses help prevent violence such as
carry out research. homicide in communities and modify the effects of
violence on families?
 Nursing research, the controlled investigation of
problems that have implications for nursing practice, 7. What do maternal-child health nurses need to
provides evidence for practice and justification for know about alternative therapies such as herbal
implementing activities for outcome achievement, remedies to keep their practices current?
ultimately resulting in improved and cost-effective
patient care. NURSING THEORY
 One of the requirements of a profession (together
 A classic example of how the results of nursing with other critical determinants, such as member-
research can influence nursing practice is the set standards, monitoring of practice quality, and
application of the research carried out by Rubin participation in research) is that the concentration of
(1963) on a mother's approach to her newborn discipline's knowledge flows from a base of
established theory.
 Before the publication of this study, nurses
assumed that a woman who did not immediately  Nursing theorists offer helpful ways to view clients
hold and cuddle her infant at birth was a "cold" or so that nursing activities can best meet client
unfeeling mother. needs-for example, by seeing a pregnant woman
not simply as a physical form but as a dynamic
 After observing a multitude of new mothers, Rubin force with important psychosocial needs, or by
concluded that attachment is not a spontaneous viewing children as extensions or active members
procedure; rather, it more commonly begins with of a family as well as independent beings
only fingertip touching
 Only with this broad theoretical focus can nurses
 Armed with Rubin's findings and integrating these appreciate the significant effect on a family of a
findings into practice, nurses became better able to child's illness or of the introduction of a new
differentiate healthy from unhealthy bonding member
behavior in postpartum women.
 Another issue most nursing theorists address is
 Women who did not follow this step-by-step pattern how nurses should be viewed or what the goals of
of attachment were no longer categorized as nursing care should be.
unfeeling.
 Extensive changes in the scope of maternal and
 By documenting these healthy and unhealthy child health nursing have occurred as health
parameters, nurses can identify women who do not promotion, or keeping parents and children well,
follow a healthy pattern, and interventions can be has become a greater priority.
planned and instituted to help these mothers gain a
stronger attachment to their new infants. A CHANGING DISCIPLINE
 Evidence-based practice requires ongoing research  At the beginning of the 20th century, the infant
to substantiate current actions as well as to provide mortality rate in the country (ie, the number of
guidelines for future actions. infants per 1000 births who die during the first year
of life) was greater than 100 per 1000.
 Some examples of current questions that warrant
nursing investigation in the area of maternal and  In response to efforts to lower this rate, health care
child health nursing include the following shifted from a treatment focus to a preventive one,
dramatically changing the scope of maternal and
1. What is the most effective stimulus to child health nursing.
encourage women to come for prenatal care or
parents to bring children for health  Research on the benefits of early prenatal care led
maintenance care? to a major national effort to provide prenatal care to
2. How much self-care should young children be all pregnant women through prenatal nursing
expected (or encouraged) to provide during an services (home visits) and clinics.
illness?

20 |G R A C I A N J O L E S B E S I N - B S N
 Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY
COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING
 Today, thanks to these and other community health SERVICE  Available  Achieve
measures (such as efforts to encourage DELIVERY Essential Adequate
breastfeeding, increased immunization, and injury Quality Health Facility
prevention). well as many technological advances, Health Care And HRH
the infant mortality rate has fallen. At Ratios
Appropriate  Attain Targets
 The infant mortality rate for Philippines in 2019 was Level For Basic
19.239 deaths per 1000 live births, a 2.16% decline Services
from 2018. (Immunization
 The infant mortality rate for Philippines in 2020 was Rates, Facility
18.815 deaths per 1000 live births, a 2.2% decline Based
from 2019, Deliveries,
Etc.)
 Medical technology has contributed to a number REGULATION  Ensure  Reduced
of important advances in maternal and child Safe, High Mean Market
health: Quality, And Price Of
Affordable Service, ;Abs
1. 1 Childhood diseases such as measles and Health And
poliomyelitis are almost eradicated through Products, Medicines.
immunization: Service,  Reduce
2. Specific genes responsible for many inherited Devices And Incidence Of
diseases have been identified, Facilities. Adverse
3. Stem cell therapy may make it possible in the Health Events
next few years to replace diseased cells with Due To Poor
new growth cells; Quality Of
4. New fertility drugs and techniques allow more Products And
couples than ever before to conceive; and Services (E.G,
5. The ability to delay preterm birth and improve Antimicrobial
life for premature infants has grown Resistance,
dramatically. Postoperative
Complications,
 In addition, a growing trend toward health care Etc.)
consumerism, or self-care, has made childbearing GOVERNANCE  Strengthen  Improve
and childrearing families active participants in their Capacity, Ratings In
own health monitoring and care. Coordination SWS And
And Support Other
 Health care consumerism has also moved care To People Government
from hospitals to community sites such as retail Centered Trust Surveys
shopping malls and from long-term hospital stays to Sdns.  Reduced
overnight surgical and emergent care settings.  Leading A Stock-Outs,
Participatory Improve
NATIONAL HEALTH GOALS Approach. Utilization Of
Budget, And
THE NATIONAL OBJECTIVES FOR HEALTH (NOH) Increase % Of
2017-2022 Facilities With
Emrs
 Serves as the medium-term roadmap of the
Philippines towards achieving universal healthcare
(UHC).  This ultimately leads to the three major goals that the
Philippine Health Agenda aspires for:
 It specifies the objectives, strategies and targets of
1. Better health outcomes with no major disparity
the Department of Health (DOH) FOURmula One
among population groups;
Plus for Health (F1 Plus for Health) built along the
2. Financial risk protection for all especially the poor,
health system pillars of financing service delivery,
marginalized and vulnerable; and
regulation, governance and performance
3. A responsive health system which makes Filipinos
accountability.
feel respected, valued and empowered.
PILLAR OBJECTIVE PERFORMANCE
MEASURE
 Many of these objectives directly involve maternal and
FINANCING  Sustain  Increase In
child health care, because improving the health of this
Investment Share Of
young age group will have such long-term effects.
in health Philhealth And
 Ensure Government
1. Increase quality and years of healthy life
equitable Expenditure
2. Eliminate health disparities
and Efficient (DOH And
Use LGU) In Total
 National health goals are intended to help citizens more
Health
easily understand the importance of health promotion
Expenditure.
21 |G R A C I A N J O L E S B E S I N - B S N
 Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY
COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING
and disease prevention and to encourage wide
participation in improving health in the next decade. 5. RESPONSIBLE SEXUAL BEHAVIOR
 Unintended pregnancies and sexually transmitted
 It is important for maternal and child health nurses to be infections (STIs), including infection with the human
familiar with these goals because nurses play such a immunodeficiency virus that causes AIDS, can
vital role in helping the nation achieve these objectives result from unprotected sexual behavior.
through both practice and research.  The objectives selected to measure progress in
this area are:

 The goals also serve as the basis for grant funding and 1 Increase the proportion of adolescents who abstain
financing of evidence based practice. from sexual intercourse or use condoms if currently
sexually active.
FOCUS ON NATIONAL HEALTH GOALS 2 Increase the proportion of sexually active adults
who use condoms.
LEADING HEALTH INDICATORS
6. MENTAL HEALTH
1. PHYSICAL ACTIVITY  Mental illness is the third most common disability in
 Regular physical activity throughout life is important the Philippines.
for maintaining a healthy body. enhancing  Around 6 million Filipinos are estimated to live with
psychological well-being, and preventing premature depression and/or anxiety, making the Philippines
death. the country with the third highest rate of mental
health problems in the Western Pacific Region
 The objectives selected to measure progress in  Of all mental illnesses, depression is the most
this area are: common disorder.
1. Increase the proportion of adolescents who engage  Major depression is the leading cause of disability
in vigorous physical activity that promotes and is the cause of more than two thirds of suicides
cardiorespiratory fitness 3 or more days per week each year.
for 20 or more minutes per occasion.  The objective selected to measure progress in
2. Increase the proportion of adults who engage this area is to:
regularly, preferably daily, in moderate physical 1. Increase the proportion of adults including
activity for at least 30 minutes per day. postpartum depression who receive
treatment.
2. OVERWEIGHT AND OBESITY
 Overweight and obesity are major contributors to 7. INJURY AND VIOLENCE
many preventable causes of death.  More Filipinos die each day from injuries, due
 The objectives selected to measure progress in primarily to motor vehicle crashes, firearms,
this area are: poisonings, suffocation, falls, fires, and drowning.
1. Reduce the proportion of children and adolescents  The risk of injury is so great that most persons
who are overweight or obese. sustain a significant injury at some time during their
2. Reduce the proportion of adults who are obese. lives.
 The objectives selected to measure progress in
3. TOBACCO USE this area are:
 Cigarette smoking is the single most preventable 1 Reduce deaths caused by motor vehicle crashes.
cause of disease and death in different countries. 2 Reduce homicides.
 Smoking results in more deaths each year in the
than AIDS, alcohol, cocaine, heroin, homicide, 8. ENVIRONMENTAL QUALITY
suicide, motor vehicle crashes, and fires combined.  An estimated 25% of preventable illnesses
 The objectives selected to measure progress in worldwide can be attributed to poor environmental
this area are: quality.
1 Reduce cigarette smoking by adolescents.  It is associated with premature deaths and health-
2 Reduce cigarette smoking by adults. related costs annually.
 The objectives selected to measure progress in
4. SUBSTANCE ABUSE this area are:
 Alcohol and illicit drug use are associated with 1. Reduce the proportion of persons exposed to air
many of this country's most serious problems, that does not meet the health-based standards for
including violence, injury, and HIV infection. ozone.
 The objectives selected to measure progress in 2. Reduce the proportion of nonsmokers exposed to
this area are: environmental tobacco smoke.
1. Increase the proportion of adolescents not using
alcohol or any illicit drugs during the past 30 days. 9. IMMUNIZATION
2. Reduce the proportion of adults using any illicit drug  Vaccines are among the greatest public health
during the past 30 days. achievements of the 20th century.
3. Reduce the proportion of adults or adolescents  Immunizations can prevent disability and death from
engaging in binge drinking of alcoholic beverages infectious diseases for individuals and can help
during the past month. control the spread of infections within communities.

22 |G R A C I A N J O L E S B E S I N - B S N
 Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY
COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING
 The objectives selected to measure progress in  Although pregnancy is generally considered a well
this area are: state, some women think of themselves as ill during
1. Increase the proportion of young children who this period.
receive all vaccines that have been recommended
for universal administration.  A more objective view of health is provided by using
2. Increase the proportion of non-institutionalized national or regional health statistics.
adults who are vaccinated annually against
influenza and ever vaccinated against  A number of statistical terms are commonly used to
pneumococcal disease. express the outcomes of pregnancies and births
and to describe maternal and child health. Such
statistics are useful for comparisons among areas
and for planning of future health care needs.
10. ACCESS TO HEALTH CARE
 Strong predictors of access to quality health care  Statistics require accurate recording, collection, and
include having health insurance, a higher income analysis, and nurses play a major role in the
level, and a regular primary care provider or other accurate collection and recording of these data that
source of ongoing health care. allow the nation's present and future health to be
 Use of clinical preventive services, such as early described.
prenatal care, can serve as indicators of access to
quality health care services. 1. BIRTH RATE
 The objectives selected to measure progress in  The birth rate for Philippines in 2020 was 20.177
this area are: births per 1000 people, a 0.98% decline from 2019.
1. Increase the proportion of persons with health  The birth rate for Philippines in 2019 was 20.377
insurance. births per 1000 people, a 0.97% decline from 2018.
2. Increase the proportion of persons who have a  The birth rate for Philippines in 2018 was 20.576
specific source of ongoing care. births per 1000 people, a 3.31% decline from 2017.
3. Increase the proportion of pregnant women who  Three babies are born every minute in the
begin prenatal care in the first trimester of Philippines, according to Commission on Population
pregnancy. (POPCOM)

TRENDS IN THE MATERNAL AND CHILD 2. FERTILITY RATE

POPULATION HEALTH NURSING  The term fertility rate reflects what proportion of
 The maternal and child population is constantly women who could have babies are having them.
changing because of changes in social structure,  Fertility rates may be low in countries troubled by
variations in family lifestyle, and changing patterns famine, war, or disease.
of illness.  The fertility rate for Philippines in 2020 was 2.530
 Client advocacy, participating in cost- containment births per woman, a 0.98% decline from 2019. The
measures, focusing on health education, and fertility rate for Philippines in 2019 was 2.555 births
creating new nursing roles are ways in which per woman, a 0.97% decline from 2018.
nurses have adapted to these changes.
 Client advocacy is safeguarding and advancing the 3. FETAL DEATH RATE
interests of clients and their families.  Fetal death is defined as the death in utero of a
child (fetus) weighing 500 g or more, roughly the
 The role includes: weight of a fetus of 20 weeks' or more pregnancy.
1. Knowing the health care services available in a  Fetal deaths may occur because of maternal factors
community such as:
2. Establishing a relationship with families a) Maternal disease
3. Helping them make informed choices about b) Premature cervical dilation
what course of action or service would be best c) Maternal malnutrition
for them d) Fetal factors such as fetal disease,
chromosome abnormality, or poor
MEASURING MATERNAL AND CHILD placental attachment
HEALTH  Many fetal deaths occur for reasons that are
unknown
 Measuring maternal and child health is not as
simple as defining a client as ill or well because  The fetal death rate is important in evaluating the
individual clients and health care practitioners may health of a nation because it reflects the overall
have different perspectives on illness and wellness. quality of maternal health and prenatal care
 The emphasis on both pre-conceptual and prenatal
 For example, some children with chronic but care has helped to reduce this rate.
controllable asthma think of themselves as well;
others with the same degree of involvement 4. NEONATAL DEATH RATE
consider themselves ill.  The first 28 days of life are known as the neonatal
period, and an infant during this time is known as a
neonate

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 Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY
COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING
 The neonatal death rate reflects not only the quality 12%, compared with approximately 5% for white
of care available to women during pregnancy and and Asian women (Eldridge & Sutton, 2009).
childbirth but also the quality of care available to
infants during the first month of life.  Because teenage pregnancy leads to increased
premature births, this can result in infants being
 In 2019, neonatal mortality rate for Philippines was born who are not as well prepared as others to face
13.3 deaths per 1,000 live births. Neonatal mortality extra uterine life (Hamilton et al., 2007).
rate of Philippines fell gradually from 25.7 deaths
per 1,000 live births in 1970 to 13.3 deaths per  Fortunately, the proportion of pregnant women who
1,000 live births in 2019 receive prenatal care is increasing.

 In 2019, neonatal mortality rate for Philippines was  Early prenatal care is important, because it
13.3 deaths per 1,000 live births. Neonatal mortality identifies potential risks and allows preventive
rate of Philippines fell gradually from 25.7 deaths strategies to help reduce complications of
per 1,000 live births in 1970 to 13.3 deaths per pregnancy.
1,000 live births in 2019
 The leading causes of infant mortality during the  The main causes of infant death problems that
first4 weeks of life are: prematurity (early occur at birth or shortly thereafter. Before antibiotics
gestational age or low birth weight of less than 2500 and formula sterilization practices became
g ([17%]) and congenital malformations (20%). available, gastrointestinal disease was a leading
cause of infant death.
5. PERINATAL DEATH RATE
 The perinatal period is the time period beginning  By advocating breastfeeding and teaching mothers
when a fetus reaches 500 g (about week 20 of strict adherence to good sanitary practices, health
pregnancy) and ending about 4 to 6 weeks after care practitioners help ensure that gastrointestinal
birth. infection does not again become a major factor in
 Perinatal death rate is the number of deaths of infant mortality.
fetuses weighing more than 500 g and within the
first 28 days of life per 1000 live births.  Today, major causes of mortality are:
 The perinatal death rate is the sum of the fetal and a. Prematurity
neonatal rates. b. low birth weight
c. congenital malformations
6. INFANT MORTALITY RATE d. sudden infant death syndrome (SIDS)
 Number of deaths per 1000 live births occurring at
birth or in the first 12 months of life.  SIDS is the sudden death of an infant less than 1
 The infant mortality rate of a country is an index of year of age that cannot be explained after a
its general health because it measures the: thorough investigation of the cause of death is
a) a: Quality of pregnancy care conducted (Sahni, Fifer, & Myers, 2007).
b) b. Nutrition
c) C. Sanitation  Nurses have been instrumental in reducing the
d) d. Infant health number of these deaths as they are the health
professionals who most often discuss newborn care
 This rate is the traditional standard used to compare with new parents (Esposito, Hegyi, & Ostfeld,
the health care of a nation with that of previous 2007).
years or of other countries.
7. MATERNAL MORTALITY RATE
 Because of health care advances and  The maternal mortality rate is the number of
improvements in child care, the infant mortality rate maternal deaths that occur as a direct result of the
has been steadily declining in recent years. reproductive process per 100,000 live births.

 In 2019, infant mortality rate for Philippines was  From 2000 to 2017, the global maternal mortality
21.6 deaths per 1,000 live births. Infant mortality ratio declined by 38 per cent - from 342 deaths to
rate of Philippines fell gradually from 55.3 deaths 211 deaths per 100,000 live births, according to UN
per 1,000 live births in 1970 to 21.6 deaths per inter-agency estimates. This translates into an
1,000 live births in 2019. average annual rate of reduction of 2.9 per cent.

 Unfortunately, infant mortality is not equal for all  In 2017, maternal mortality ratio for Philippines was
people. The mortality rate for African American 121 deaths per 100,000 live births.
infants, for example, is almost 15%.
 Maternal mortality ratio of Philippines fell gradually
 This difference in infant deaths is thought to be from 156 deaths per 100,000 live births in 2003 to
related to the higher proportion of births to young 121 deaths per 100,000 live births in 2017.
African American mothers, unequal provision of
health care, and the higher percentage of low-birth-  This dramatic decrease can be attributed to
weight babies born to African American women: improved pre-conceptual, prenatal, labor and birth,
and postpartum care such as:
24 |G R A C I A N J O L E S B E S I N - B S N
 Republic of the Philippines
SULTAN KUDARAT STATE UNIVERSITY
COLLEGE OF HEALTH AND SCIENCES
NCM 109-MATERNAL AND CHILD HEALTH NURSING
a. Increased participation of women in 2. Malignant neoplasms
prenatal care 3. Assault or homicide
b. Greater detection of disorders such as 4. Intentional self-harm (suicide)
ectopic pregnancy or placenta previa and 5. Congenital malformation sand chromosomal
prevention of related complications abnormalities
through the use of ultrasound
c. Increased control of complications D. 15-24 YEARS
associated with hypertension of pregnancy 1. Unintentional injuries (accidents)
d. Decreased use of anesthesia with 2. Assault or homicide
childbirth 3. Intentional self-harm (suicide)
4. Malignant neoplasms 5. Diseases of the heart
 For most of the 20th century, uterine hemorrhage
and infection were the leading causes of death 9. CHILD MORBIDITY RATE
during pregnancy and childbirth.  Under-five mortality rate is the probability per 1,000
that a newborn baby will die before reaching age
 This has changed because of the increased ability five, if subject to current age- specific mortality
to prevent or control hemorrhage and infection; rates.
 In 2019, child mortality rate for Philippines was 27.3
 At the moment, hypertensive disorders have deaths per 1,000 live births. Child mortality rate of
become the leading causes of death in childbirth. Philippines fell gradually from 83.8 deaths per 1,000
live births in 1970 to 27.3 deaths per 1,000 live
 Pregnancy-induced hypertension adds to births in 2019.
preexisting hypertensive disorders, especially in
older women.

 Nurses who are alert to the signs and symptoms of

hypertension are invaluable guardians of the health
of pregnant and postpartum women.

8. CHILDHOOD MORTALITY RATE

 Childhood mortality rate: Number of deaths per
1000 population in children, 1 to 14 years of age.

 Under-five mortality rate is the probability per 1,000

that a newborn baby will die before reaching age
five, if subject to current age- specific mortality
rates.

 In 2019, child mortality rate for Philippines was 27.3

deaths per 1,000 live births. Child mortality rate of
Philippines fell gradually from 83.8 deaths per 1,000
live births in 1970 to 27.3 deaths per 1,000 live
births in 2019.

MAJOR CAUSES OF DEATH IN CHILDHOOD

A. UNDER 1 YEAR
1. Congenital malformations and chromosomal
abnormalities
2. Disorders related to short gestation age and low
birth weight
3. Sudden infant death syndrome
4. Newborn affected by maternal
5. Unintentional injuries (accidents) complications of
pregnancy

B. 1-4 YEARS
1. Unintentional injuries (accidents)
2. Congenital malformations and chromosomal
abnormalities
3. Malignant neoplasms
4. Assault or homicide
5. Diseases of the heart

C. 5-14 YEARS
1. Unintentional injuries (accidents)
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