The Maternal and Child Health (MCH) problems in India (and other developing countries) are:

1. Malnutrition
   • Most people in the developing countries are malnourished
   • Malnutrition has a significant impact on the vulnerable groups – pregnant women, lactating women and children
   • It can result in maternal complications such as
     • anemia
     • post partum haemorrhage
     • toxemia of pregnancy
     • low birth weight  in baby
   • Children are most affected in utreo and during period of weaning
   • Malnourished children are more susceptible to infections
   • Interventions to prevent malnutrition can be direct and indirect
     • Direct measures
       • Food supplementation
       • Food fortification
       • Iron and folic acid supplementation
       • Nutritional education
     • Indirect measures
       • Food hygiene
       • Education
       • Environmental sanitation
       • Vaccination to prevent disease
       • Provision for clean drinking water
2. Infection
   • Although infections have been controlled to a great extend in developed countries, they continue to be a major problem in developing countries
   • Maternal infection can result in
     • IUGR
     • low birth weight
     • abortions
     • peurperal sepsis
   • Upto 25 percent of pregnant women have urinary tract infection
   • Cytomegalovirus, herpes and toxoplasma infection are also seen among mothers
   • Children are at risk for diarrhoeal diseases, respiratory tract diseases and skin conditions
   • Infections can be controlled by
     • adequate nutrition
     • sanitation
     • immunization
     • better primary health care services
3. Uncontrolled reproduction
   • Unregulated fertility has adverse effects on both mother and children
   • Decrease in birth spacing results in inadequate care for the existing child and risk of more complications during pregnancy ( such as anemia, IUGR, abortion)
   • The risk increases greatly after the 4th pregnancy
   • Hence family planning services form an important part of MCH programs
   • Measures like Intrauterine contraceptive device, oral contraceptive pills, long acting injectable medroxy progesterone acetate, female sterilisation and barrier methods can be used

1. Prevention of low birth weight – Direct and Indirect Interventions
2. Importance of diet in pregnancy
3. Congenital rubella
4. Maternal Death – Definition