And those areas that have large populations with poor

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and those areas that have large populations with poor and less educated mothers, and GIDAs will be prioritized. These areas are at higher risk from adverse maternal and neonatal outcomes. A desired outcome for the integrated MNCHN Strategy is to make the least progressive and most vulnerable areas to move more rapidly and catch-up with the rest of the localities in the country. It is critical for DOH to always be reminded and for localities to understand that as the local conditions differ, the approach, pathway, and pace towards reaching this goal also vary. However, any action towards this desired endpoint is a step to the right direction even if it is short of the ideal and should be encouraged. 2.3.1. MNCHN Core Package of Services The MNCHN Core Package of Services consists of interventions that will be delivered for each life stage: pre-pregnancy, pregnancy, delivery, and the post- partum and newborn periods. Most of these services require minimal cost and can be delivered by health workers as part of their routine functions with some that may require additional training and minimal investments in facilities. The intervention in the MNCHN core package of services that were found effective in preventing deaths and in improving the health of mothers and children include the following: 1. Pre-pregnancy: provision of iron and folate supplementation, advice on family planning and healthy lifestyle, provision of family planning services, prevention and management of infection and lifestyle-related diseases. In 8 Stages of life cycle refer to events during pre-pregnancy, pregnancy, birth and delivery, post-delivery, and newborn periods.
MNCHN Strategy 11 particular, modern family planning reduces unmet need and unwanted pregnancies that expose mothers to unnecessary risk from pregnancy and childbirth. Unwanted pregnancies are also associated with poorer health outcomes for both mother and her newborn. Effective provision of FP services can potentially reduce maternal deaths by around 20 percent 9 . This alsoencompass adolescent health services, deworming of women of reproductive age (to reduce other causes of iron deficiency anemia), nutritional counseling, oral health. 2. Pregnancy: first prenatal visit at first trimester, at least 4 prenatal visits throughout the course of pregnancy to detect and manage danger signs and complications of pregnancy, provision of iron and folate supplementation for 3 months, iodine supplementation and 2 tetanus toxoid immunization, counselling on healthy lifestyle and breastfeeding, prevention and management of infection, as well as oral health services. While the contribution of antenatal care in anticipating and preventing maternal and newborn emergencies is unclear, components of prenatal care remain effective in reducing perinatal deaths 10 and serves as a venue for birth planning and promotion of facility based deliveries.

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