Self-Assessment Questions (SAQs) for Study Session 4
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 4.1 (tests Learning Outcomes 4.1 and 4.3)
You are planning the postnatal care of a mother with a preterm baby who is also a low birth weight baby. Define these classifications. Then set out your planned schedule of care indicating how (and why) it differs from the schedule of care that you would plan for a normal weight, full term baby.
A preterm baby is one delivered before 37 weeks of gestation. A low birth weight baby is defined as one weighing less than 2,500 gm. Ideally, given that this baby is preterm, you would hope that the family would have alerted you in time to be present at the birth. If not then you need to get there as quickly as possible within the first 24 hours. After that: you will need to plan your visits for the third, fifth, seventh and tenth days after the birth and then during the sixth week after birth. The visits on the fifth and tenth days are additional to the kind of schedule you would have for a normal delivery, and this reflects the greater risks of the early neonatal period (the first seven days) if the baby is premature or low weight.
SAQ 4.2 (tests Learning Outcome 4.2)
In an ideal world, all Ethiopian mothers would go to a high quality health facility for their postnatal care. What are the main reasons why this is not currently feasible and why is the home visit therefore so important?
The main barriers to facility-based postnatal care are set out in Section 4.1.1. Check your answers with the points made there. Did you think of any other barriers, perhaps from your own experience? If so, that’s good.
Home visits are so critical in the postnatal period because of the huge difference that home visits can make to the overall survival rates of newborns. Studies of the South Asian experience have indicated reductions in mortality of between 30% and 61% through home visits. The kind of interventions are set out in Section 4.1.2.
SAQ 4.3 (tests Learning Outcomes 4.4, 4.5 and 4.6)
You are planning a visit to Abrihet. She is a young mother who had her first baby 10 days ago. You have visited her before, but she is very shy and it is taking you time to get to know her and her family. You are getting ready to leave and wondering how you can gain everybody’s confidence.
- a.While packing your bag, you think about checking whether you have everything you need for a postnatal visit and you write a quick reminder to yourself for next time. What did you write?
- b.Then you also write down a few further thoughts about things to remember when you meet Abrihet next time. What did you write?
Here are some things you might have written down:
Things I must remember to check have not run out – Vitamin A capsules, iron tablets, tetracycline ointment etc. and soap!
Clean towel? Wrist watch? Enough counselling and screening cards? Record book, pen and referral forms?
All the usual equipment that stay in the bag: scales, stethoscope, blood pressure apparatus, thermometer, etc.
And I had better remember to check if I look clean and neat myself!
But how am I going to get Abrihet to feel more comfortable? These are just a few of the questions I might ask myself:
‘Perhaps I am not using enough local terms, so maybe her family thinks I don’t respect their customs. I wonder if I sound too bold and pushy – must remember to be gentle and to give plenty of time for more general conversation so she begins to relax. It’s so difficult as there is so much to do, that I am often in too much of a rush. I know she listens to me but perhaps I am overwhelming her with too much advice. I’ll try a bit more praise and do more listening myself this time and maybe that will help’.
Summary of Study Session 4