Focused Prenatal Care
- Focused four antenatal visits by skilled provider—a midwife, nurse, doctor to detect any problems
- Birth preparedness and complications readiness planning with family
- Detection and management of co-existing conditions and complications
- HIV-voluntary counseling and testing
- Counseling for breast feeding, family planning, danger signs, HIV/STIs and nutrition
- Treatment of diagnosed infections, i.e., syphilis, gonorrhea or tuberculosis
- Tetanus toxoid (2 doses)
- Iron and folate-for 6 months or pregnancy, 60mg iron and 400 cg of folate, for areas with >40% anemia continue same dosage for 3 months postpartum
- Helminth Presumptive treatment – studies shown that eradication of hookworms can reduce moderate and severe anemia by 42-56%
- Routine treatment of malaria- reduces low birth weight
Services Provided For Each Antenatal Care Visit
| Visit | Service to be provided | Purpose of service | Equipment/supplies needed |
| 1st visit or registration | A personal medical history is taken | To diagnose pregnancy and identify any complications during previous pregnancies | |
| Thorough physical and abdominal exam | To detect and manage any co-existing condition or complication: TB, Malaria, STDS | Stethoscope, speculum | |
| Check blood pressure | To identify and manage hypertension | Blood pressure apparatus and stethoscope | |
| Blood testing | Test for anemia, STDs, blood group typing | VDRL kit, hemoglobinometer | |
| Urine test | Test for proteinuria/albumin for pre-eclampsia and sugar for diabetes | Dipsticks | |
| Weight measured | Establish baseline weight | Scale | |
| Registration of pregnant woman | To effectively track the completeness of care and pregnancy outcomes | Registration form/pregnancy register | |
| First dose of Tetanus Toxoid | Prevention of tetanus in newborn and mother | Vaccine | |
| Provide 3 month supply of Iron and Folate | Prevention of anemia | Adult Iron and folate tablets | |
| Counsel on need for 3 ANC visits, healthy diet, need for rest and signs of an emergency | To prevent and prepare for possible complications | Flipcharts, teaching aids | |
| 2nd visit (4th-6th month) |
Check blood pressure | Detect and manage hypertension | Blood pressure apparatus and stethoscope |
| Do an abdominal and physical exam | To detect and manage any co-existing condition or complication. Refer to expert medical care if a sign of an emergency is detected( vaginal bleeding, blurring vision with severe headache, convulsions) | ||
| Check hemoglobin | Detect anemia | Hemoglobinometer | |
| Urine test | Protein/albumin | Dipsticks | |
| Second dose of Tetanus Toxoid | |||
| Provide 3 additional months supply of Iron and Folate | Prevent anemia | Adult tablets | |
| Review Nutrition, need for rest, signs of emergency | Prevent and prepare for complications | ||
| Treat for malaria Cloroquine 1 gm now then 500 mg. in 1 wk | Prevent severe anemia | Slides | |
| Treat for (worms) Albendazole 400 mg X 1 or mebendazole 500 mg X 1 | Prevent severe anemia | Stool test | |
| 3rd visit (8th month) |
Check blood pressure | Detect and manage hypertension | Blood pressure apparatus |
| Do an abdominal and physical exam | To detect and manage any do-existing condition or complication. Refer if indicated. | Stethoscope and fetoscope | |
| Provide additional Iron and folate | Prevent anemia | Adult tablets | |
| Assist woman and family in developing a birth preparedness/complication readiness plan-selection of birth place, attendants | To be prepared for a safe and clean delivery and in the event of an emergency | Birth Kit if available Clean sheets |
|
| Treat for malaria Cloroquine 1 gm now then 500 mg. in 1 wk | Prevent severe anemia | Slides | |
| Treat for (worms) Albendazole 400 mg X 1 or mebendazole 500 mg X 1 | Prevent severe anemia | Stool test | |
| 4th visit (9th month) |
Check blood pressure | To detect and manage hypertension | Blood pressure apparatus |
| Do abdominal and physical exam | To detect and manage any co-existing complication, Refer if indicated | Stethoscope or fetoscope | |
| Counsel on breast feeding, birth spacing, Postpartum care, newborn care | To prevent unwanted pregnancies and too closely spaced pregnancies To Prevent complications |
Flipcharts, teaching aids | |
| Review birth preparedness and complication readiness plan | To prevent an delays in case of an emergency |
