WOMEN’S REPRODUCTIVE HEALTH

NORMS

1. Increase the percentage of pregnant women receiving antenatal care (ANC) from the existing level to at least 70%.

2. Increase the deliveries in institutions by trained birth attendants from the existing level to at least 75%.

3. Reduce the proportion of pre-term deliveries and low birth weight babies by at least 20%.

4. Reduce the proportion of births in women below 16 years and 16-18 years from the existing level (13.2% in 1998).

1.1 Midwifery protocols
1.2 Contraception protocols
1.3 Termination of pregnancy protocols
1.4 Sterilisation act
1.5 All Provincial circulars and policy guidelines regarding women’s health issues
1.6 A library of suitable references and learning material on women’s health issues

2.1 Delivery set
2.2 Neonatal resuscitation trolley
2.3 Specula
2.4 Fetalscope
2.5 Women’s Health charts

3.1 Ferrous and folic acid tablets
3.2 Oxytocin
3.3 Vit K injections
3.4 Contraceptive barrier methods e.g. condoms
3.5 Vaginal contraceptives e.g. spermicidal jelly
3.6 Intrauterine contraceptive devices
3.7 Injectable hormonal contraceptives
3.8 Oral hormonal contraceptives
3.9 Post-coital contraceptives

4.1 Nurses receive training in the perinatal education programme (PEP), contraception and post-abortion care management.
4.2 Staff are able to take a history and perform a physical examination and tests according to protocols and guidelines.
4.3 Staff provide routine management, observations and service according to the ANC protocol at each step of the pregnancy including at least three visits during pregnancy.
4.4 Staff provide education and counselling to each pregnant woman and partner on monitoring signs of problems (e.g. bleeding), nutrition, child feeding and weaning, STDs / HIV, delivery, newborn and child care, advanced maternal age, family planning and child spacing.
4.5 Staff offer appropriate counselling, advice and service to pregnant women requesting termination of pregnancy.
4.6 At least one member of staff is able to:-

4.6.1 Deliver uncomplicated pregnancies.
4.6.2 Make routine observations according to the postnatal care protocol.
4.6.3 Make usual routine observations and select and prescribe appropriate family planning methods according to national protocol.
4.6.4 Screen, advice and refer infertility cases as per national guidelines.
4.6.5 Conduct breast cancer and cervical screening for women older than 35 years as per protocols.
4.6.6 Conduct home visits to provide support and supervise care.
4.6.7 Provide appropriate adolescent/youth services on family planning, sexuality, health education and counselling.

5.1 Information is given to mothers on booking for delivery, child preventive care, education about child feeding and the introduction of solid food.
5.2 Further information is given to mothers on the care of breasts, vaginal bleeding and scars, signs of hypertension, diabetes, anaemia, return to usual physical efforts, labour rights, rights of the child and advice on family planning.
5.3 Patients are given group education.
5.4 Patients’ relatives and the community receive continuous, appropriate high quality information on the importance of antenatal care and institutional deliveries.
5.5 Information, education and counselling are offered to adolescents and youth.

6.1 All information on cases and outcome of deliveries are correctly recorded on the register.
6.2 All registers and monthly reports are kept up to date.

7.1 The clinic has sensitised, and receives support from, the community health committee about the positive encouragement of attendance at clinic of all pregnant women.
7.2 Staff conduct regular home visits using a home visit checklist.

8.1 All referrals within and outside the clinic are motivated and indications for referral written clearly on the referral form.
8.2 Patients with need for additional health or social services are referred according to protocols.
8.3 Referrals from traditional birth attendants (TBA) should be encouraged and associated with the training of the TBAs and follow up of the training.

9. Collaboration

9.1 Clinic staff collaborate with social welfare for social assistance and other role players.
9.2 Clinic staff collaborate with clinic health committee, the civic organisations and workplaces in the catchment area to enhance health promotion.

1. At least one clinic staff member trained to recognize, counsel, treat manage and refer most common conditions.

2. Clinic staff receive regular genetic training and update from the regional genetic cordinator.

3. Clinic staff receive support from visiting specialist, clinical geneticist and other academic experts.

1. The clinic has the latest copy of the Human Genetics Guidelines for Management and Prevention of Genetic Disorders, Birth Defects and Disabilities.

2.1 .

3.1 List of drugs in accordance with the Essential Drugs List

4.1 At least one clinic staff is able to recognize, counsel, treat, manage and refer most common genetic conditions

5.1 Referrals for further support as per guidelines

6.1 Provide posters, pamphlets and other educational materials on genetics for patients.
6.2 All patients and caretakers receive health education on genetic disorders, birth defects and disabilities.
6.3 Encourage women to procreate at the ideal reproductive age (25-35 years) to reduce the risk of chromosomal abnormalities.
6.4 Educate women to avoid exposure to teratogens during pregnancy e.g. alcohol, recreational drugs and certain chemical and infecting agents.

7.1 Notification forms to notify genetic disorders and birth defects in the immediate post-natal period and later in life.

8.1 Clinic staff to work with South African Inherited Disorders Association and other NGOs and CBOs to support affected individuals and families at community level.

9.1 Clinic staff collaborate with social workers, physiotherapists, speech therapists and other support staff to provide comprehensive care.
9.2 Clinic staff to work with South African Inherited Disorders Association, school teachers, and other NGOs and CBOs to provide information and raise awareness on genetic disorders, birth defects and disabilities.