Maternal Care and Services

MATERNAL CARE AND SERVICES
SCOPE OF MATERNAL CARE

AND SERVICES
 Maternal Care encompasses the package of health

interventions and services that must be provided to
women from the time they become pregnant, during
delivery and postpartum period which is up to 42
days after delivery.
FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

Manual of Procedures version 2018
PRENATAL PACKAGE
1. Prenatal Visits
◦ At least 4 visits throughout the course of pregnancy.
◦ Prenatal assessment
2. Micronutrient Supplementation
3. Tetanus Toxoid Immunization
4. Promotion of exclusive breastfeeding, Newborn

Screening (NBS), and infant immunization.
PRENATAL PACKAGE
5. Counselling on healthy lifestyle with focus on smoking

cessation, healthy diet, nutrition, regular exercise, STI and
HIV prevention and oral health.
6. Early detection and management of complications of

pregnancy.
7. Prevention and management of other conditions where

indicated : hypertension, anemia, diabetes, TB, Malaria,
schistosomiasis and STI/HIV/AIDS.
8. Birth Planning and promotion of Facility-Based delivery.

Prenatal Care
• Nutritional status by measurement of body mass index

• Immunization against Tetanus diphtheria (2 doses for first pregnancy, at least
3doses for 2nd or more pregnancy)
• Micronutrient supplementation of iron with folic acid (some LGUs have
separate iron and folic acid), calcium carbonate, iodine capsule
• One dose of deworming (anti-helminthic)tablet
• STI Testing: Syphilis, Hepatitis B and HIV
• Laboratory Testing: complete blood count or hemoglobin &hematocrit
count, gestational diabetes

POSTPARTUM PACKAGE
1. Postpartum visits: within 72 hrs and on the 7th day

postpartum check for conditions such as bleeding or
infections.
2. Micronutrient Supplementation.
3. Counselling on nutrition, child care, family planning and

other available services.
Postpartum Care
• Given with at least 2 postpartum check-ups together with their newborns

within 7 days after delivery
• Micronutrient supplementation of iron with folic acid for 3 months
• Provision of 1 dose of Vitamin A supplementation within 1 month after

delivery

Master list for Pregnant Women
National Safe Motherhood Program
PREGNANCY TRACKING
Year: ____________________________ Birthing Center: ____________________________

Region: ____________________________ Address: ____________________________
Province: ____________________________ Referral Center: ____________________________
Municipality: ____________________________ Address: ____________________________
Barangay: ____________________________
No. Name Age Gravidity Parity Expected Date of Antenatal Care Check-Ups Pregnancy Outcome Mother and Child Civil Registration
(LN, FN, MI) Delivery (Date) (Place a check) Postnatal Check-ups (Date)
(Date)
1st tri = up 2nd tri = 3rd tri = 28 weeks AOG Live birth Preterm Stillbirth Abortion Day of Within 7 Livebirth Maternal Stillbirth Early
to 12 weeks 13-27 weeks and more Birth Discharge/ days after Death Newborn
and 6 days and 6 days 24 hours birth Death
AOG AOG after birth (0-7 days)
1
10
Name of BHW: _________________________ Barangay Health Station: _________________________

Name of Midwife: _________________________ Rural Health Unit: _________________________
1st tri = up to 12 weeks and 6 days
AOG (at least 1 check-up)
2 tri = 13-27weeks and 6days
nd
AOG (at least 1 check-up)

3 tri = 28 weeks AOG and more
rd
(at least 2 check-ups)
GRAVIDA – number of pregnancies

(Include fetal death & abortion)
PARITIY – number of deliveries
(include fetal death except abortion)
TARGET CLIENT LIST FOR MATERNAL CARE AND SERVICES
Immunization Status Micronutrient Supplementation Nutritional Assessment Deworming Infectious Disease Surveillance
(Write the BMI for 1st Tri) Tablet
(Date Given)
(2nd or 3rd Tri)
(10) (11) (12) (13) (14)
Date Tetanus diptheria (Td) FIM Status Iron sulfate with Folic Acid Calcium Carbonate Iodine Capsules Low: Normal: High: Syphilis Screening Hepatitis B HIV
or Tetanus Toxoid (TT) Date and Number of Tablets Given Date and Number of Tablets Date 2 capsules given < 18.5 18.5 - 22.9 ≥ 23.0 (RPR or RDT Screening Screening
Given Result) (Result of HBsAg
given Date
Test) Screened
Td1/ Td2/ Td3/ Td4/ Td5/ (√ or X) 1st visit 2nd visit 3rd visit 4th visit 2nd visit 3rd visit 4th visit 1st visit Date + positive Date + positive
TT1 TT2 TT3 TT4 TT5 (1st tri) (2nd tri) (3rd tri) (3rd tri) (2nd tri) (3rd tri) (3rd tri) (1st tri)
- negative - negative
#: #: #: #: #: #: #:
d: d: d: d: d: d: d:
#: #: #: #: #: #: #:
d: d: d: d: d: d: d:
#: #: #: #: #: #: #:
d: d: d: d: d: d: d:
#: #: #: #: #: #: #:
Td d: d: d: Interval
d: d: d: d:
#: #: #: #: #: #: #:
Dose d: d: d: d: d: d: d:
#: #: #: #: #: #: #:
Td 1 As early as
d: possible
d: d: during
d: d: 1 d:pregnancy
st
d: or
even in a #:non-pregnant
#: #: #:
child-bearing
#: #: #:
age
d: d: d: d: d: d: d:
women #: #: #: #: #: #: #:
d: d: d: d: d: d: d:
Td 2 4 weeks after
#: #:1 dose
st
#: #: #: #: #:
d: d: d: d: d: d: d:
Td 3 6 months#: after
#: Td2#: #: #: #: #:
d: d: d: d: d: d: d:
Td 4 1 year after Td3
TARGET CLIENT LIST FOR
MATERNAL CARE & SERVICES



Family Health Care and Services
MATERNAL CARE & SERVICES
Indicator Definition
Pre-natal
1. Proportion of Refers to the number of pregnant women with at least 4 prenatal check-ups
pregnant women w/ at (availed as follows among the total estimated number of pregnant women in
least 4 prenatal check- the population):
ups
1st tri = up to 12 weeks and 6 days AOG (at least 1 check-up)
Disaggregated by: 2nd tri = 13-27 weeks and 6 days AOG (at least 1 check-up)
 10-14 y/o 3rd tri = 28 weeks AOG and more (at least 2 check-ups)
 15-19 y/o
 20-49 y/o Include clients given care by private facilities with the following conditions:
 Existing reporting system
 Intervention provided to private facilities
 Reporting forms submitted to public facilities

B. Maternal Care and Services

Indicator Definition Formula
Pre-natal
2. Proportion of pregnant women Computation of BMI:
according to their nutritional BMI=weight in kg
status (height in m)2
Formula:
BMI= Wt (kg) Target:
Ht (m)2 Low BMI : less than 30%
High BMI : less than 5%
Example:
Wt= 55 kg
Ht= 168 cm 100cm = 1m
BMI= Wt (kg) = 55kg = 55
Ht (m)2 (1.68)2 2.82
BMI = 19.50 (normal)
Department Memorandum No. 2017-0093
* If client received 3 doses of Td from routine/childhood
immunization,
give 2 doses during the 1st pregnancy & 1 dose in each
succeeding pregnancy.
*If client received 5 doses of Td (3 Penta from

routine/childhood immunization, booster dose of Td
during Grade 1 and 7, should be given one dose of Td
vaccine at least 4 weeks before delivery.


Pre-natal
6. Proportion of pregnant women Refers to the number of pregnant women who have taken complete
who completed doses of calcium doses of calcium carbonate starting at 20 th week until delivery
carbonate supplementation among the total estimated number of pregnant women in the
population
Disaggregated by:
 10-14 years old Dosage: 1.25g tablet with 500 mg elemental calcium, 1 tab 3x
 15-19 years old times a day starting at 20th week until delivery
 20-49 years old
Source: Include whether DOH-supplied, LGU procured or out of
pocket
Note: To be given starting 2nd trimester. If pregnant women failed to
visit the health facility at 2nd trimester, calcium carbonate may still
be given in the third trimester

Family
Family Health Care and
and Services
Services

Pre-natal
7. Proportion of pregnant women given iodine Refers to the number of pregnant women given
capsules iodine capsules among the total number of
estimated pregnant women in the population

Dosage: Iodized oil fluid oral 500 mg equivalent
Disaggregated by: to 200mg elemental iodine, 2 capsules, single
 10-14 years old dose
 15-19 years old (preferably given during the 1st trimester)
 20-49 years old

Family
and Services
Services

Pre-natal
8. Proportion of pregnant women given one Refers to the proportion of pregnant
dose of deworming tablet women given one dose of deworming
tablet preferably during the 2nd or 3rd
Disaggregated by: trimester among the total number of
 10-14 years old
 15-19 years old
estimated pregnant women in the
 20-49 years old population.

Dosage: 1 deworming tablet


Intra-Partum and Delivery Outcome
18. Total Number of deliveries Total number of women who delivered a live baby and still
birth/fetal death at a given period
Disaggregated by:
 10-14 years old Note:
 15-19 years old Complete delivery refers to the delivery of the newborn /fetus
 20-49 years old (whether dead or alive) upto the complete expulsion of the
placenta from the mother’s womb.
Multiple births by a woman is counted as 1 delivery
Deliveries by caesarian section and assisted vaginal delivery are
included in this count.
Abortion/miscarriage is not included in the counts of deliveries

Deliveries should be reported by place of occurrence.

Family
and Services
Services
19. Proportion of Live births by Refers to the number of babies born alive (newborns) who weigh
Birth weight 2500 grams and greater, less than 2500 grams and with unknown
weight among total live births.
Disaggregated by:
 Low birth weight Birth weight is the first weight of the infant obtained after birth.
For livebirths, birth weight should preferably be measured before
 Normal birth weight
significant postnatal weight loss has occurred.
 Unknown birth weight Low Birth Weight: livebirths with weights less than 2500 grams
Normal Birth Weight: ivebirths with weights equal to or greater
than 2500 grams.
Unknown Birth Weight: livebirths whose weights at birth are not
known.
Live births should be reported by place of occurrence

Family
Family Health
Health Care
Care and
and Services
Services
20. Proportion of deliveries Refers to the number of births attended by skilled health professionals
attended by skilled among the estimated total number of deliveries
health professionals
Skilled health professionals: Sometimes referred to as skilled
Disaggregated by: attendants. These are licensed midwives, doctors or nurses who have
 10-14 years old been educated and trained to proficiency in the skills needed to
 15-19 years old manage normal and complicated pregnancies, childbirth and the
 20-49 years old immediate postnatal period, and in the identification, management and
referral of complications in women and newborns.

This definition excludes traditional birth attendants whether
trained or not.


Family Health
Health Care and
and Services
21. Proportion of facility-based Refers to the number of deliveries in health facilities among
deliveries the estimated total number of deliveries

Facility-Based Delivery: refers to deliveries in clinics, BHS,
Disaggregated by: RHUs, lying-ins, birthing clinics, hospitals, DOH-licensed
 10-14 years old ambulance (AO 2010-0003 & AO 2016-0029)
 15-19 years old
 20-49 years old Note: birth in the emergency transport (e.g. jeepney, tricycle,
taxis, vehicles labelled as ambulance but is ill-equipped, no
emergency drugs and no trained staff) is not considered a
facility based delivery


Family

22. Proportion of deliveries by type (vaginal or Refers to the number of deliveries by type
cesarean section) (vaginal and caesarian section) among estimated
total number of deliveries.
Disaggregated by:
 10-14 years old Vaginal: refers to deliveries by normal
 15-19 years old spontaneous delivery (NSD) and assisted vaginal
 20-49 years old deliveries such as vacuum and forceps

Cesarean Section: refers to deliveries by caesarian
section


Family Health
Health Care and
and Services

23. Proportion of Refers to the number of pregnancy by outcome among the estimated
Pregnancy by Outcome number of deliveries

Disaggregated by: Full Term Birth. The complete expulsion or extraction of a live fetus from the
 10-14 years old mother’s womb, with 37-42 weeks age of gestation and shows evidence of
life such as voluntary movement, heartbeat, pulsation of the umbilical cord, for
 15-19 years old
however brief a time and whether or not the umbilical cord or placenta is
 20-49 years old intact.
Pre Term Birth. The complete expulsion or extraction of a live fetus from the
mother’s womb, with 22-36 weeks age of gestation and shows evidence of
life such as voluntary movement, heartbeat, pulsation of the umbilical cord,
for however brief a time and whether or not the umbilical cord or placenta is
intact.

Family
23. Proportion of
Pregnancy by Outcome Fetal Death. Also known as “stillbirth,” is the death of a fetus in
utero that has reached a birth weight of 500 grams, or if birth weight
Disaggregated by: is unavailable, gestational age of 22 weeks and above or crown-to-
 10-14 years old heel length of 25 centimeters. The death is evidenced by the absence
 15-19 years old of any sign of life upon extraction from the mother’s womb.
 20-49 years old

Abortion/Miscarriage. Termination of pregnancy before the fetus
becomes viable. (before the 20th week of pregnancy).
Also includes abortus whose weight is < 500 grams regardless of
AOG.


Family
and Services
Services
Post-Partum Care
24. Proportion of post-partum women together Refers to the no. of post-partum women together
with their newborn who completed at least 2 with their newborn who completed at least 2 check-
post partum check-ups. ups among the estimated total number of PP women
in the population

Disaggregated by: 2 Post-partum check-ups refers to check-ups
 10-14 years old provided by the midwife/nurse/MHO to the mother
 15-19 years old together with their newborn within 1 week after
 20-49 years old delivery

Note:
Postpartum women who had stillbirth should also
have 2 postpartum check-ups

Family
and Services
Services

Post-Partum Care
24. Proportion of post-partum women together First check-up should be within 24 hours after
with their newborn who completed at least 2 delivery or before the mother is discharged
check-ups. from the birthing facility. Delivery in the health
facility considered as first check-up.
Disaggregated by:
Second check-up is provided by the
 10-14 years old
midwife/nurse/MHO to the mother together
 15-19 years old
with their newborn within 7 days after delivery
 20-49 years old
Postpartum check-up can be provided in a
health facility or at home.

Family Health
Health Care and
and Services

Post-Partum Care
25. Proportion of post-partum women who Refers to the number of post-partum women
completed iron with folic acid who completed iron with folic acid
supplementation supplementation among the estimated total
number of PP women in the population
Disaggregated by:
 10-14 years old Complete Iron with Folic Acid
 15-19 years old Supplementation refers to 60 mg of Iron with
 20-49 years old 400 mcg Folic acid, once a day for 3 months or
a total of 90 tablets. If postpartum mother did
not take full course of 90 tablets, she will not be
reported.


Family
and Services
Services

Post-Partum Care
26. Proportion of post-partum women with Refers to the number of post-partum women
Vitamin A supplementation with Vitamin A supplementation among the
estimated total number of PP women in the
Disaggregated by: population
 10-14 years old
 15-19 years old Vitamin A supplementation Refers to 200.000
 20-49 years old I.U. of Vitamin A capsule given to PP women
within 1 month after delivery


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MATERNAL CARE AND SERVICES

SCOPE OF MATERNAL CARE

 Maternal Care encompasses the package of health

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

3. Tetanus Toxoid Immunization

4. Promotion of exclusive breastfeeding, Newborn

5. Counselling on healthy lifestyle with focus on smoking

6. Early detection and management of complications of

7. Prevention and management of other conditions where

8. Birth Planning and promotion of Facility-Based delivery.

• Nutritional status by measurement of body mass index

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

1. Postpartum visits: within 72 hrs and on the 7th day

3. Counselling on nutrition, child care, family planning and

• Given with at least 2 postpartum check-ups together with their newborns

• Micronutrient supplementation of iron with folic acid for 3 months

• Provision of 1 dose of Vitamin A supplementation within 1 month after

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

Year: ____________________________ Birthing Center: ____________________________

Name of BHW: _________________________ Barangay Health Station: _________________________

AOG (at least 1 check-up)

(at least 2 check-ups)

GRAVIDA – number of pregnancies

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

*If client received 5 doses of Td (3 Penta from

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

Live births should be reported by place of occurrence

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

B. Maternal Care and Services

FIELD HEALTH SERVICES INFORMATION SYSTEM (FHSIS)

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Year: Birthing Center:

Name of BHW: _ Barangay Health Station: _