Perinatal/ Infant Health – 2025 Plan

Priority: Improve perinatal/infant outcomes through early and adequate prenatal care services including Gestational Diabetes and anemia screening

The latest perinatal mortality rate in the FSM shows a decreased in 2023. Yet, the data continues to paint a scenario that unplanned pregnancy, late access and inadequate prenatal care, and poverty play a significant role in poor birth outcomes, causing additional stressors on the family, community, the health care system and the government. About 19 percent of pregnant women attended prenatal clinic beginning of the first trimester last reporting year. Lack of screening for gestational diabetes during prenatal care effects newborn outcomes.                      

YAP MCH 2025 Plan:

GDM:

MCH Program will work closely with CHC and the Health assistant on the importance of 1st trimester booking in prenatal. MCH Program will do more health awareness in the community and in the island as well on the importance of the early booking and GDM Screening in prenatal. MCH program will also have to work closely with the V6AI radio station and other communication agencies to contact at least 5 health awareness on the importance of early booking in the clinic and the prevention of GDM among mothers of child bearing age. MCH Program will make sure the GDM mothers will have to go through the complete gestational diabetes screening during prenatal visit. MCH program will ensure all GDM mothers screens at the appropriate weeks of gestation (26wks-28wks gestation The Program will ensure the clinic will have enough adequate supplies available in the clinic for GDM screening. MCH Program will work closely with national to support in fund of all supplies in screening of GDM case in pregnant mothers.

1st Trimester Visit

MCH program will contact at least 5 health awareness on the importance of 1st Trimester visit to the clinic. The program will ensure that all new mothers have a full understanding what are the consequences they will get if they don’t show up in the clinic at the early booking. MCH will work closely with the Health Assistance in insuring that all mother for high-risk criteria will have to be shown in the clinic at their 1st Trimester period in order to capture all screening that should be done. MCH program will also work closely with National in seeking supporting fund to help Primary Health in bring in OB from the island when they are in need to be attend to high-risk clinic or attend to the OBGYN Doctor.

Breastfeeding:

MCH Program will work closely with the women group in the community to impliment a breastfeeding group that can support all mother of child bearing age in the community on the importance of breastfeeding. MCH Program will make sure that group of women in the community will receive a full educational training on the importance of exclusive breastfeeding and all the consequences in term of not doing the goods for your baby. MCH program will ensure that 5 or more health awareness should be initiated on the importance of breastfeeding in the community and out in the island as well during an outreach activity. MCH Program will work closely with the Yap leaders to educate them on the importance of breastfeeding so they can increase the maternity leave back to six months after delivery. MCH Program will work closely with the clinical nurses to ensure all delivery mothers must exclusively breastfeed their babies before discharge. MCH will work with individuals to initiate the breastfeeding group.  MCH wishes to do more education on manual express for mother going back to work and school just right after delivery.

CHUUK MCH 2025 Plan:

For 2025, MCH Program staff will work closely with Dispensary office to provide appropriate screening tools for basic Antenatal care (e.g. blood pressure apparatus, portable scale, height measurement and glucometer and hemoglobin meter, supplement medications- iron with folic acid and prenatal vitamin and etc.) for health assistants so that ANC services is fully provided to pregnant women in early trimester. In addition to this, MCH program to secure travel funds for MCH Program staff/field nurse to provide ANC services during Public Health outreaches. Furthermore, MCH Program to work with Dispensary office and JICA to utilize the internet access at the Dispensaries in outer islands for telehealth purposes, data reporting/educational information to health assistants (e.g create a web page/chat-based community on messenger and etc).

GDM screening will be a mandatory screening for all pregnant women with the age of gestation of 24-28 weeks in Public Health and at the Community Health Centers and make appropriate referral for GDM positive patients to the ANC High Risk clinic for further management. MCH Program to procure more screening supplies for GDM and Anemia screening.

POHNPEI MCH 2025 Plan:

Continue to collaborate with FP to send all clients to ANC first visit clinic as soon as possible pregnancy test is found positive. Same process goes for all dispensaries providing preg. tests to their clients. The reduce the number of clients not coming back for first visit, the MCH program will provide blue books to all clients tested positive for pregnancy on the same visit and counsel on importance of early visit.

Conduct a meeting with Kolonia CHC to agree to have all first visits to CHC to be referred to Public Health to ensure all the necessary labs and ANC services are provided to ANC clients.

Work with OBGYN and administration to draft a letter/memo to Genesis to request for monthly data sharing of number of ANC clients seen & gestational age at first ANC visit among other data as deemed needed by the program.

Development and printing of educational materials highlighting the importance of early booking and danger sign of pregnancy for pregnant women to look out for and be encouraged to come to ANC early. Educational awareness materials to include radio talks, digital board messages, brochures to be given to mothers in postpartum to be aware in their next pregnancy. MCH will work with the PH educator and outreach coordinator of PH provide at least one educational awareness in each of the 5 municipals in Pohnpei on said topics during the outreach activities. Upon availability of ships going to outer islands, the same awareness will be done in the dispensaries of the outer islands, however, advanced arrangements will be made with the dispensary health assistants to ensure community participation.

Collaborate with administration - Chief of medical services and laboratory to ensure all GDM testing equipment and supplies are adequate to avoid stock out. This will be done by including a GDM screening supply checklist component in monthly reporting forms to ensure monthly update on the state of equipment and number of supplies in stock. Once supplies are considered.

MCH coordinator will ensure that the technical working group for the MCH Project with JICA will insert into the revision of all manual and PPM’s to state that GDM testing for pregnant women is mandatory at 24 – 28 weeks. 

KOSRAE MCH 2025 Plan:

The MCH Program plans on having community workshops which will be done in all the hamlets in each of the four municipalities in Kosrae from April – June 2025. These awareness workshops will be addressing the importance of early booking and other women’s health issues.

The program will partner up with the Diabetes Program-NCD and the Kosrae Laboratory to ensure there is enough glucose syrup and screening supplies available for the GDM screening for pregnant women and other potential female clients. The program will also continue its routine with clinical services such as conducting GDM and anemia screening in pregnant women.

The MCH program will continue to utilize the breast feeding support groups to provide breastfeeding support services especially to new mothers. Their services will be extended to other mothers who may have other health problems.