Protection for the mother and the child you have to

This preview shows page 165 - 168 out of 235 pages.

protection for the mother and the child.You have to explain to the family as well what postpartum care, newbornscreening and FP counseling/services mean.By explaining all of these, more than just asking them to so you could fill up theform, you educate the family about the value of Birth Plan and make the familylearn about proper maternal care.Sections C, D & E will be filled up by the health provider. However, you may stillexplain to the family the rationale for these sections and how these will help thefamily.Sample filled-out Birth PlanBIRTH PLANPart I: To be filled out by the couple with the assistance of the navigatorAName of Mother:(Last name, First name)Rosario, G.Age:(in years)23Name of Husband:(Last name, First name)Rosario, L.Age:(in years)25Name of Navigator:(Last name, First name)Cruz, D.GMP Family No.:123Referred to Health Provider:(indicate name of Midwife,Nurse or Doctor)Anita R.Scheduleddateofconsult:(MM/DD/YY)Feb 20, 2009Reason for referral:[x ] For Pre-natalservices[] for postpartum care[] for newborn careBHealth goals:(pls. check)[ x]to have monthly pre-natalcheck up ( at least 4 visits);[x ] at least 1 visit duringthe1st trimester;[x ]at least 1 visit during the2ndtrimester;[ x]at least 2 visits in the 3rdtrimesterTo have baby delivered by:[] physician[] nurse[x ] midwife[x ] to deliver in a healthfacility[ x ] to receive postpartumcare[ x] to have our baby receivenewborn screening[] others, pls. specify:_____________________
8Annex E[]toreceiveFPcounselling/servicesPart II: To be filled by health provider (midwife, nurse ordoctor)CProvider for Prenatal/Post-partum care: Anita ReyesDate of 1stPNC visit:(MM/DD/YY) Feb 19, 2009Date of 2ndPNC visit:Date of 3rdPNC visit:Date of 4thPNC visit:DPLEASE FILL OUT ALL SECTIONS OF THE MOTHER & CHILD BOOK, to include:*Birth Plan (page 13 in the Mother & Child Book)* Who will deliver my baby?Midwife*Where will I deliver?HealthCenter*HowmuchshouldIprepare?3,000.00*Who will accompany me?Husband & NavigatorWho will take care of the children?Mother in-law* other relevant information about pregnancy preparation and special concerns* preparation for giving birth*warning signs during pregnancyEPhilhealth Claims, if applicableDocuments neededSubmit toWhen to submit/ff upFor automatic deduction:DulyaccomplishedPhilHealthClaimForm1(original)Billing sectionPrior to discharge fromhospital/lying-in clinicClear copy of Member DataRecord (MDR).For Direct Filing/Reimbursement:PhilHealth Claim Form2 (to be filled up by thehospitalandattendingphysicians)nearest PhilHealth Officewithin 60 days afterdeliveryOfficial receipts orhospital and doctor's waiverOperative record forsurgical procedures performedBaby's birth certificate(LCR authenticated)EXPECTED DATE OF COMPLETION OF THIS PLAN: September2009
Annex E95.Reproductive Health PlanExplain to the family what a Reproductive Health Plan is. Help them understandhow the form can serve as an instrument for reaching their RH goalGuide the family in filling out the name, name of husband, their ages and yourname as the navigator.

Upload your study docs or become a

Course Hero member to access this document

Upload your study docs or become a

Course Hero member to access this document

End of preview. Want to read all 235 pages?

Upload your study docs or become a

Course Hero member to access this document

Term
Spring
Professor
N/A
Tags
Obstetrics, maternal death, MNCHN Strategy

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture