Maternal and Child Health

1.    1. The population covered under a sub-centre is 6000 and the birth rate recorded is 20 per 1000 population. Calculate the requirement of pentavalent vaccine for 1 year for this sub-centre. 

1.     What is the total number of expected pregnancies in a year?

A. 

Population of sub centre = 6000

Birth rate = 20/1000

CBR = No. of live births   x 1000

           Total population

No. of live births (No. of beneficiaries) = 20 x 6000     = 120

                                                                                          1000

Pentavalent vaccine given at 6, 10, 14 weeks (3 doses)

No of doses required = No. of beneficiaries x wastage multiplication factor (WMF) x No. of doses

                              = 120 x 1.11 x 3 = 399.6

1 vial of pentavalent vaccine contains 10 doses

No. of vials required = (No. of beneficiaries x no. of doses x wastage multiplication factor)/doses per vial.

Therefore no. of pentavalent vials required for one year = 399.6 = 39.96

                                                                                               10

= 40 vials

B.                                      

Expected no of live births (Y) = 20 x 6000     = 120

                                                      1000

             10% of pregnancies are lost as abortions & stillbirths

        The total number of expected pregnancies (Z) = Y + 10% of Y

        Therefore total no. of expected pregnancies in a year = 120 + 12 = 132

2. Bibin, a 15 month old boy weighing 10 kg is suffering from diarrhea for the past 3 days. His eyes are sunken. Mouth and tongue are dry. He is irritable and eager to drink water. Calculate the volume of ORS to be given to this child? What are the danger signs which should prompt the caretaker to seek immediate medical care?

He is suffering from ADD – Some dehydration. So he should be treated according to plan B.

Volume = 75 ml x 10 = 750 ml to be given in first 4 hours

50 – 100 ml after each loose stool

Danger signs- lethargic, drowsy, sunken eyes, not feeding, skin pinch goes back very slowly (> 2 seconds)

1.    3. Arya, a 3 year old girl weighing 13 kg is suffering from diarrhea since today morning. She has passed 10 loose stools. She is lethargic, not drinking anything.  She has sunken eyes and her skin pinch goes back very slowly. Calculate the amount of fluids to be given to this patient? What is the dose and role of zinc supplements in this case?

She is suffering from ADD – Severe dehydration. So she should be treated according to Plan C

100ml/kg RL or NS= 1300 mliv

Children - 30 ml/kg in 30 minutes (390ml)

70 ml/kg in 2½ hours (910 ml)

Zinc – 20 mg daily for 10-14 days

Lowers the duration and severity and incidence of diarrhea in the next 2-3 months