Antenatal Care |
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Registration (within first trimester)
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Physical examination (weight, blood pressure, abdominal examination)
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Ensuring consumption of iron-folic acid (IFA) tablets (100 IFA for all pregnant women or 200 IFA for pregnant women with anemia)
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Essential lab investigations (Hb%, pregnancy test, urine for albumin/sugar) including blood grouping and pH typing, wet mount
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Assured referral linkages for complicated pregnancies and deliveries
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Management and provision of all emergency obstetric and newborn care for complications other than those requiring blood transfusion or surgery
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Linkages with nearest Integrated Counseling and Testing Centre/Prevention of Parent-to-Child Transmission (ICTC/PPTCT) Centre for voluntary counselling and testing services
| All BEmONC services plus: |
Intranatal Care |
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Normal delivery with use of partograph
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Active management of third stage of labor
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Identification and referral for danger signs
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Pre-referral management for obstetric emergencies (eclampsia, postpartum hemorrhage, shock)
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Assured referral linkages with higher facilities
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Episiotomy and suturing cervical tear
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Assisted vaginal deliveries (outlet forceps, vacuum)
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Stabilization of patients with obstetric emergencies (eclampsia, postpartum hemorrhage, sepsis, shock)
| All BEmONC services plus:-
Round-the-clock maternal care services
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Management of obstructed labor
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Surgical interventions such as cesarean section
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Comprehensive management of all obstetric emergencies (pregnancy-induced hypertension/eclampsia, sepsis, postpartum hemorrhage, retained placenta, shock)
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In-house blood bank/blood storage center
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Referral linkages with higher facilities including medical colleges
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Newborn Services-
Neonatal resuscitation
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Warmth
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Infection prevention
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Initiation of breastfeeding within an hour of birth and exclusive breastfeeding thereafter
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Screening for congenital anomalies
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Weighing of newborns
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Antenatal corticosteroids to the mother in case of preterm babies to prevent Respiratory Distress Syndrome (RDS)
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Immediate care of low birth weight (LBW) newborns (>1800 g to <2500 g)
| Newborn ServicesAll BEmONC services plus: |
Postnatal Care |
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Minimum 6 hours' stay post delivery
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48 hours' stay post delivery and all postnatal services for days 0 and 3 for mother and baby
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Counseling for feeding, nutrition, family planning, hygiene, immunization, and postnatal check-up
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Home visits on days 3, 7, and 42 for mother and baby
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Additional visits for the newborn on days 14, 21, and 28
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Additional visits may be necessary for LBW and sick newborns
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Stabilization of mother with postnatal emergencies (postpartum hemorrhage, sepsis, shock, retained placenta)
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Timely referral of women with postnatal complications
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Referral linkages with higher facilities
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Timely identification of danger signs and complications and referral of mother and baby
| All BEmONC services plus:-
Clinical management of all maternal emergencies such as postpartum hemorrhage, puerperal sepsis, eclampsia, breast abscess, postsurgical complication, shock, and any other postnatal complications such as RH incompatibility
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Newborn Services-
Warmth
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Hygiene and cord care
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Identification, management, and referral of sick neonates, LBW, and preterm newborns
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Care of LBW newborns (<2500 g)
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Zero day immunization–OPV (oral polio vaccine), BCG (bacille Calmette-Guerin for tuberculosis), Hepatitis B
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Care of LBW newborns (>1800 g to <2500 g)
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Referral services for newborns <1800 g and other newborn complications
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Management of sepsis
| Newborn ServicesAll BEmONC services plus:-
Newborn care in district hospitals through Sick Newborn Care Unit (SNCU)
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Management of complications
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Care of very LBW newborns (<1800 g)
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Establish referral linkages with higher facilities
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