Training Manual for Preventive Malaria - Ministry of Health
Training Manual for Preventive Malaria - Ministry of Health
Training Manual for Preventive Malaria - Ministry of Health
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Table 1. Components <strong>of</strong> Antenatal Care Visits<br />
ACTIVITY FIRST VISIT (16 weeks*) SECOND VISIT (24–28 weeks) THIRD VISIT (32 weeks) FOURTH VISIT (36 weeks)<br />
ASSESSMENT<br />
CARE<br />
PROVISION<br />
RECORD<br />
Conduct a thorough assessment:<br />
• Ask about problems/danger signs<br />
• History: menstrual and<br />
contraceptive history, present<br />
pregnancy, obstetric history,<br />
medical and surgical history,<br />
family history, STI history, Drug<br />
history, lactation history<br />
• Physical examination: general<br />
well-being; blood pressure;<br />
breasts, pelvis, abdomen, genitals<br />
• Testing: haemoglobin levels Hb,<br />
sickling, electrophoresis, VDRL,<br />
Blood group and RH, Stool and<br />
Urine R/E<br />
To:<br />
• Detect s/s <strong>of</strong> complications or<br />
diseases<br />
• Calculate EDD/gestational age<br />
• Determine if normal progress<br />
• Appropriate care/referral <strong>for</strong><br />
problems identified<br />
• Voluntary counselling and testing<br />
<strong>for</strong> HIV<br />
• Development <strong>of</strong> birth plan<br />
(including review <strong>of</strong> danger signs<br />
and complication readiness)<br />
• Initiation <strong>of</strong> preventive measures:<br />
• If after 16 weeks, first dose <strong>of</strong> IPT<br />
• TT and iron/folate if appropriate<br />
• <strong>Health</strong> messages/counselling on<br />
issues such as malaria prevention<br />
through IPT and ITNs, nutrition,<br />
common discom<strong>for</strong>ts<br />
Conduct a targeted assessment:<br />
• Ask about problems/danger signs<br />
• History: problems/changes since<br />
last visit<br />
• Physical examination: general<br />
well-being, blood pressure,<br />
abdomen (including FHR), other<br />
elements as indicated<br />
• Testing: as indicated to:<br />
• Detect s/s <strong>of</strong> malaria and other<br />
complications or diseases<br />
• Confirm EDD and normal<br />
progress<br />
• Continuation or revision (if<br />
appropriate) <strong>of</strong> plan <strong>of</strong> care<br />
• Appropriate care/referral <strong>for</strong><br />
problems identified<br />
• Further development/review <strong>of</strong><br />
birth plan<br />
• Continuation <strong>of</strong> preventive<br />
measures:<br />
• Dose <strong>of</strong> IPT if appropriate<br />
• TT and iron/folate if appropriate<br />
• <strong>Health</strong> messages/counselling<br />
continued on issues such as<br />
malaria prevention through IPT<br />
and ITNs, STI prevention<br />
Conduct a targeted assessment:<br />
• Ask about problems/danger<br />
signs<br />
• History: problems/changes since<br />
last visit<br />
• Physical examination: general<br />
well-being, blood pressure,<br />
abdomen (including FHR), other<br />
elements as indicated<br />
• Testing: as indicated to:<br />
• Detect s/s <strong>of</strong> malaria and other<br />
complications or diseases<br />
• Confirm EDD and normal<br />
progress<br />
• Continuation or revision (if<br />
appropriate) <strong>of</strong> plan <strong>of</strong> care<br />
• Appropriate care/referral <strong>for</strong><br />
problems identified<br />
• Further development/review <strong>of</strong><br />
birth plan<br />
• Continuation <strong>of</strong> preventive<br />
measures:<br />
• Dose <strong>of</strong> IPT if appropriate<br />
• TT and iron/folate if appropriate<br />
• <strong>Health</strong> messages/counselling<br />
continued on issues such as<br />
malaria prevention through IPT<br />
and ITNs, hygiene<br />
Conduct a targeted assessment:<br />
• Ask about problems/danger signs<br />
• History: problems/changes since<br />
last visit<br />
• Physical examination: general<br />
well-being, blood pressure,<br />
abdomen (including FHR and<br />
foetal presentation), other<br />
elements as indicated<br />
• Testing: as indicated to:<br />
• Detect s/s <strong>of</strong> malaria and other<br />
complications or diseases<br />
• Confirm EDD and normal<br />
progress<br />
• Identify mal-presentation<br />
• Continuation or revision (if<br />
appropriate) <strong>of</strong> plan <strong>of</strong> care<br />
• Appropriate care/referral <strong>for</strong><br />
problems identified<br />
• Finalization <strong>of</strong> birth plan<br />
• Continuation <strong>of</strong> preventive<br />
measures:<br />
• Dose <strong>of</strong> IPT if appropriate<br />
• TT and iron/folate if appropriate<br />
• <strong>Health</strong> messages/counselling<br />
continued on issues such as<br />
malaria prevention through IPT<br />
and ITNs, family planning,<br />
newborn care, signs <strong>of</strong> labour<br />
Be<strong>for</strong>e each visit, review records from the last ANC visit if available. During the visit, record findings, care provided, and date <strong>of</strong> next ANC visit.<br />
*Or when the woman first thinks she is pregnant<br />
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