ORGANIZING A VISIT Receive and you can about what you are doing.If she is Begin each routine visit If follow-up visit is within a week,and if no respond immediately unconscious,talk to the companion. (for the woman and/or the baby) other complaints: Ensure and respect privacy during Assess the woman for the specific condition Receive every woman and newborn baby examination and discussion. Greet the woman and offer her a seat. requinng follow-up only seeking care immediately after arrival(or If she came with a baby and the baby is ■Introduce yourself -Compare with earlier assessment and organize reception by another provider). well,ask the companion to take care of the Ask her name(and the name of the baby). re-classify. Perform Ouick Check on all new incoming baby during the maternal examination and ■Ask her: If a follow-up visit is more than a week after women and babies and those in the waiting treatment -Why did you come?For yourself or for your the initial examination(but not the next room,especially if no-one is receiving themE2 baby? scheduled visit): At the first emergency sign on Quick Care of woman or baby referred for For a scheduled (routine)visit? Repeat the whole assessment as required Check,begin emergency assessment and For specificcomplaints about you or your special care to secondary level facility for an antenatal,post-abortion,postpartum management(RAM)EE for the woman,or baby? or newborn visit according to the schedule examine the newborn When a woman or baby is referred to a First or follow-up visit? If antenatal visit,revise the birth plan. If she is in labour,accompany her to an secondary level care facility because of Do you want to include your companion or appropriate place and follow the steps as in a specific problem or complications,the other family member(parent if adolescent) Childbirth:labour,delivery and immediate During the visit underlying assumption of the Guide is that. in the examination and discussion? postpartum care Dib2s at referral level,the woman/baby will be If the woman is recently delivered,assess the Explain all procedures, If she has priority signs,examine her assessed.treated,counselled and advised baby or ask to see the baby if not with the mother. Ask permission before undertaking an immediately using Antenatal care, on follow-up for that particular condition/ If antenatal care,always revise the birth plan at examination or test. Postpartum or Post-abortion care charts complication. the end of the visit after completing the chart. Keep the woman informed throughout. C1-C19E1E10B18-822 Follow-up for that specific condition will be For a postpartum visit,if she came with the Discuss findings with her (and her partner) If no emergency or priority sign on RAM or not either: baby,also examine the baby: Ensure privacy during the examination and in labour,invite her to wait in the waiting room. organized by the referral facility or Follow the appropriate charts according discussion. If baby is newly born,looks small,examine written instructions will be given to the to pregnancy status/age of the baby and immediately.Do not let the mother wait in the woman/baby for the skilled attendant at purpose of visit. At the end of the visit queue. the primary level who referred the woman/ Follow all steps on the chart and in relevant Ask the woman if she has any questions. 告 baby. boxes. Summarize the most important messages with her. Begin each emergency care visit the woman/baby will be advised to go for a Unless the condition of the woman or the Encourage her to return for a routine visit(tell ■Introduce yourself.. follow-up visit within 2 weeks according to baby requires urgent referral to hospital,give her when)and if she has any concerns. severity of the condition. Ask the name of the woman. preventive measures if due even if the woman Fill the Home-Based Maternal Record(HBMR) Routine care continues at the primary care has a condition"in yellow"that requires and give her the approprate information sheet 5 Encourage the companion to stay with the woman Explain all procedures,ask permission, level where it was initiated. special treatment. Ask her if there are any points which need to be and keep the woman informed as much as discussed and would she like support for this A5A5 PRINCIPLES OF GOOD CARE Receive and respond immediately Receive every woman and newborn baby seeking care immediately after arrival (or organize reception by another provider). N Perform Quick Check on all new incoming women and babies and those in the waiting room, especially if no-one is receiving them B2 . N At the first emergency sign on Quick Check, begin emergency assessment and management (RAM) B1-B7 for the woman, or examine the newborn J1-J11 . N If she is in labour, accompany her to an appropriate place and follow the steps as in Childbirth: labour, delivery and immediate postpartum care D1-D29 . N If she has priority signs, examine her immediately using Antenatal care, Postpartum or Post-abortion care charts C1-C19 E1-E10 B18-B22. N If no emergency or priority sign on RAM or not in labour, invite her to wait in the waiting room. N If baby is newly born, looks small, examine immediately. Do not let the mother wait in the queue. Begin each emergency care visit N Introduce yourself. N Ask the name of the woman. N Encourage the companion to stay with the woman. N Explain all procedures, ask permission, and keep the woman informed as much as you can about what you are doing. If she is unconscious, talk to the companion. N Ensure and respect privacy during examination and discussion. N If she came with a baby and the baby is well, ask the companion to take care of the baby during the maternal examination and treatment. Care of woman or baby referred for special care to secondary level facility N When a woman or baby is referred to a secondary level care facility because of a specific problem or complications, the underlying assumption of the Guide is that, at referral level, the woman/baby will be assessed, treated, counselled and advised on follow-up for that particular condition/ complication. N Follow-up for that specific condition will be either: ¡ organized by the referral facility or ¡ written instructions will be given to the woman/baby for the skilled attendant at the primary level who referred the woman/ baby. ¡ the woman/baby will be advised to go for a follow-up visit within 2 weeks according to severity of the condition. N Routine care continues at the primary care level where it was initiated. Begin each routine visit (for the woman and/or the baby) N Greet the woman and offer her a seat. N Introduce yourself. N Ask her name (and the name of the baby). N Ask her: ¡ Why did you come? For yourself or for your baby? ¡ For a scheduled (routine) visit? ¡ For specific complaints about you or your baby? ¡ First or follow-up visit? ¡ Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion? N If the woman is recently delivered, assess the baby or ask to see the baby if not with the mother. N If antenatal care, always revise the birth plan at the end of the visit after completing the chart. N For a postpartum visit, if she came with the baby, also examine the baby: ¡ Follow the appropriate charts according to pregnancy status/age of the baby and purpose of visit. ¡ Follow all steps on the chart and in relevant boxes. N Unless the condition of the woman or the baby requires urgent referral to hospital, give preventive measures if due even if the woman has a condition "in yellow" that requires special treatment. N If follow-up visit is within a week, and if no other complaints: ¡ Assess the woman for the specific condition requiring follow-up only ¡ Compare with earlier assessment and re-classify. N If a follow-up visit is more than a week after the initial examination (but not the next scheduled visit): ¡ Repeat the whole assessment as required for an antenatal, post-abortion, postpartum or newborn visit according to the schedule ¡ If antenatal visit, revise the birth plan. During the visit N Explain all procedures, N Ask permission before undertaking an examination or test. N Keep the woman informed throughout. Discuss findings with her (and her partner). N Ensure privacy during the examination and discussion. At the end of the visit N Ask the woman if she has any questions. N Summarize the most important messages with her. N Encourage her to return for a routine visit (tell her when) and if she has any concerns. N Fill the Home-Based Maternal Record (HBMR) and give her the appropriate information sheet. N Ask her if there are any points which need to be discussed and would she like support for this. ORGANIZING A VISIT