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