Self-Assessment Questions (SAQs) for Study Session 1
Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.
SAQ 1.1 (tests Learning Outcome 1.1)
The following is a list of key terms used in this study session, each with a definition. Which of the definitions below are (i) fully correct, (ii) partially correct, and (iii) wrong. Write a short sentence for each of the partially correct or wrong definitions, using the term correctly.
- a.Neonate — a newborn baby.
- b.Postnatal care (PNC) — care given to the baby immediately after birth.
- c.Neonatal mortality rate — the number of babies, in every 1,000 live births, who die within the first 28 days of their life.
- d.Early neonatal period — the time just after delivery and through the first seven days of life.
- e.Maternal Mortality Ratio (MMR) — the number of mothers who die giving birth.
- f.Early neonatal mortality rate — the number of babies who die just after delivery.
- g.Neonatal period — from birth to the 28th day after the birth.
- h.Gas exchange — what citizens of the US engage in when they go to the petrol station.
- i.Neonatal jaundice — a condition which can occur when the newborn’s liver is unable fully to detoxify the blood.
- a.Correct: neonate is a newborn baby.
- b.Partially correct: it is the care given to the baby and the mother immediately after birth and for the first 6 weeks of life.
- c.Correct: the neonatal mortality rate is newborn deaths in the first 28 days, per 1,000 live births.
- d.Correct: the early neonatal period is from birth to the first seven days.
- e.Partially correct: it is the number of mothers who die during birth and as a result of complications immediately following childbirth. In Ethiopia the MMR is very high with around 673 deaths per 100,000 live births. Note that whereas the neonatal mortality rate is measured per 1,000 live births, the MMR is measured per 100,000 live births.
- f.Wrong: it is the number of deaths in the first week of life per 1,000 live births. This is also very high in Ethiopia, with around 39 deaths per 1,000 live births.
- g.Correct: the neonatal period is from birth to the 28th day.
- h.Wrong: it is the process in which our lungs absorb oxygen and release waste carbon dioxide. It occurs from the moment of birth.
- i.Correct: in more detail what happens is that the liver fails to remove a protein called bilirubin, which is released in the process of breaking down ‘old’ red blood cells. A sign of neonatal jaundice (i.e. a build-up of bilirubin) is when the skin appears yellow, especially on the baby’s palms and soles.
SAQ 1.2 (test Learning Outcome 1.2 and 1.5)
Imagine that you are trying to convince the Ethiopian Finance Minister to put more money into postnatal health care and he wants the evidence as to why. Write a short letter outlining the key points that you would emphasise.
There are many points you could make to the Finance Minister. Here are some of the key ones:
- Ethiopia has some of the highest rates of maternal mortality and early neonatal mortality in the world (you could quote him the actual figures).
- The period of greatest risk (i.e. just after delivery and in the first seven days of life and up to 28 days) is also when there is the lowest coverage of maternal and child health care in Ethiopia.
- High quality postnatal care has to happen in the first few hours or it is too late, but also that effective postnatal intervention has the potential to reduce the neonatal mortality by 10-27%. This will help Ethiopia meet the Millennium Development Goals to reduce maternal and child deaths.
- We already know the main causes of death in the postnatal period (you could give him the list) and we broadly know what to do about them – it is mainly a question of a trained health worker being there to do it.
- You might also point out that to be really effective, postnatal care needs also to involve the community (getting them engaged in the whole process, facilitating behaviour-change from harmful traditional practices, etc.), and explain to him how you will be doing this, e.g. talking to key ‘gatekeepers’ and enlisting the help of the Traditional Birth Attendants (TBAs) in the community.
SAQ 1.3 (tests Learning Outcome 1.3 and 1.4)
You have done a good job persuading the Finance Minister, but he has asked the Health Minister to check that you really know what you are talking about. She asks you to list the key signs for potential complications that you should look out for in a postnatal mother and the main danger signs in the newborn baby. What would you write in your list?
Danger signs in the postnatal mother:
Key signs to look for include dehydration, a poorly contracted uterus, fresh bleeding, a drop in blood pressure and a rising pulse. Longer term dangers to be aware of include blood clots and depression.
Danger signs in the newborn:
Immediate things to check: is the baby breastfeeding properly, is the skin colour normal or yellowish, is there any fever, is the baby cold or too warm to the touch, is the breathing normal, is there any bleeding, has the baby got swollen or red eyelids? You would also check if the baby is preterm so as to know if it is at increased risk for some complications.You probably got most of these. If not, or if you can’t remember what they indicate, re-read Section 1.5.2 ‘Evaluating the newborn baby’.
Summary of Study Session 1