Prenatal Home-Based and Postnatal Home Care - Concept Map
Home-Based Maternal and Newborn Care Delivery in the Philippine Primary Health System
Related concepts
Bag Technique & Clean Home Care
Sub concepts
- Clean working surface preparation
- Hand washing protocol
- Prevention of cross-contamination
- Organization of equipment and supplies
- Aseptic handling of articles
Relationship to central
Foundation for safe, infection-free home visits
Prenatal Home-Based Care (ANC)
Sub concepts
- Four minimum ANC visits schedule
- Risk assessment and history
- Physical assessment procedures
- Micronutrient supplementation (Iron-FA, Calcium, Deworming)
- Tetanus immunization (TT/Td)
- Laboratory screening
- Health teaching on danger signs
- Birth plan development
Relationship to central
First contact point in MNCHN continuum; prevention-focused
Danger Signs Recognition & Referral
Sub concepts
- Pregnancy danger signs
- Postpartum danger signs
- Newborn danger signs
- Referral pathways to BEmONC/CEmONC
- Urgent transport arrangements
Relationship to central
Detect-and-refer core competency; prevents maternal deaths
Birth Planning (Obstetric Preparedness)
Sub concepts
- Facility and skilled attendant selection
- Transport and backup plan
- Financial preparation and savings
- Blood donor identification
- Companion and childcare arrangements
- Labor sign recognition
Relationship to central
Addresses three delays; family-centered decision-making
Postnatal Home Care (Mother & Newborn)
Sub concepts
- Postpartum mother assessment
- Newborn assessment and care
- Exclusive breastfeeding support
- Cord care and hygiene
- Thermal management and kangaroo care
- Newborn screening (heel prick 24-72 hours)
- Immunization (BCG, Hepatitis B, EPI schedule)
- Postpartum danger signs monitoring
Relationship to central
High-risk period (first 24-72 hours critical); two-patient assessment
DOH Standards & MNCHN Programs
Sub concepts
- Four ANC minimum visits
- Two postpartum check-ups (24 hours, 7 days)
- Expanded Newborn Screening protocol
- Unang Yakap (first embrace) program
- EINC (Essential Intrapartum and Newborn Care)
- Target Client List (TCL) and FHSIS documentation
Relationship to central
Policy framework guiding home visit scheduling and content
Record Keeping & Community Tracking
Sub concepts
- Mother-and-child health records
- Target Client List maintenance
- FHSIS (Field Health Services Information System)
- Defaulter tracking
- Maternal and neonatal outcome indicators
Relationship to central
Data management for continuity and accountability
Concept connections
- Bag TechniquePrenatal Home-Based CareBag technique is the enabling methodology that allows safe, clean delivery of ANC content in the home environment
- Prenatal Home-Based CareDanger Signs RecognitionEvery ANC contact includes teaching of pregnancy danger signs as a core safety measure
- Danger Signs RecognitionReferral PathwaysDetection of any danger sign triggers midwife referral responsibility; detect-and-refer is the core competency
- Birth PlanningPrenatal Home-Based CareBirth plan is developed during ANC visits; it operationalizes the three-delays prevention strategy
- Birth PlanningFacility DeliveryWritten birth plan ensures seamless transition from home to facility when labor begins
- Postnatal Home CareNewborn AssessmentNewborn assessment is integral to every postnatal home visit; two patients assessed together
- Postnatal Home CareMother AssessmentPostpartum mother assessment at 24h and 7 days is parallel and equally important to newborn care
- Newborn AssessmentDanger Signs RecognitionNewborn danger signs assessment is a critical detect-and-refer competency in the postnatal period
- Newborn AssessmentImmunization and ScreeningDuring postnatal visits, midwife confirms birth doses, arranges heel prick screening and hearing screen
- Prenatal Home-Based CareRecord Keeping and DocumentationEach ANC visit is recorded in TCL and FHSIS, creating continuity and enabling defaulter follow-up
- Postnatal Home CareRecord Keeping and DocumentationEach postnatal visit findings are recorded in MCP, TCL, and FHSIS for outcome tracking
- DOH Standards and ProgramsPrenatal Home-Based CareDOH minimum four-visit standard and Unang Yakap program guide the frequency and content of ANC
- DOH Standards and ProgramsPostnatal Home CareDOH two-visit postpartum minimum (24h and 7 days) standard frames the intensity of early follow-up
- Bag TechniqueInfection PreventionBag technique is the operationalized method of infection prevention in non-sterile home environment
- Prenatal Home-Based CareMicronutrient SupplementationIron-FA, calcium, and deworming are provided and counseled during ANC visits
- Prenatal Home-Based CareTetanus ImmunizationTT/Td is given during ANC following 5-dose schedule; protects mother and newborn
- Birth PlanningThree-Delays PreventionBirth plan directly addresses three delays: access (transport), decision (companion/attendant), quality (funds/blood donor)
- Newborn AssessmentExclusive Breastfeeding SupportAt every postnatal visit, midwife assesses breastfeeding and provides counseling to ensure exclusivity
- Newborn AssessmentCord Care MonitoringCord care assessment (clean and dry) is performed at every postnatal visit; infection is a danger sign
- Mother AssessmentFamily Planning CounselingFamily planning counseling and options are reviewed during postpartum visits, preparing for birth spacing
Diagrams
Complete Concept Map: Prenatal Home-Based and Postnatal Home Care
Master concept map showing the hierarchy and relationships of all key topics in prenatal home-based and postnatal home care. The central concept branches into seven major domains: Bag Technique (foundation of safe home visits), Prenatal Home Care (ANC package), Danger Signs Recognition (detect-and-refer), Birth Planning (preparedness), Postnatal Care (mother and newborn), and Documentation (continuity). Each branch expands into specific competencies and procedures relevant to the PRC licensure exam.
Bag Technique Procedural Flow (Setup and Safe Use)
Step-by-step flowchart of proper bag technique on arrival and during a home visit. Emphasizes the critical sequence: place bag on clean surface, wash hands BEFORE removing articles, take only needed items (keeping inside of bag clean), perform care, clean and replace items, wash hands again, document, and arrange follow-up. This is a high-yield procedural topic for the MLE.
Prenatal ANC Contacts Schedule and Content Framework
Visual timeline of the DOH-standard four ANC contacts with content at each visit. First contact focuses on baseline risk assessment and history; second on micronutrients and TT/Td; third on complete assessment, labs, and danger signs; fourth on fetal positioning and birth plan finalization. Integrated decision points show referral triggers (high-risk, anemia, abnormal labs, transport barriers). Light blue = baseline visits; orange = third trimester; red = referral; yellow = support coordination.
Danger Signs Recognition and Referral Decision Tree
Decision tree showing recognition of all ten major pregnancy danger signs (from the reference document) with appropriate referral action. Each danger sign branches to a referral with clinical reasoning. If no danger signs are present, the midwife continues routine care, health teaching, and documentation. Red shading = urgent/referral; green = normal care continuation. This is critical for the detect-and-refer competency.
Birth Plan Components and Three-Delays Prevention
Birth plan development process showing how each element addresses one of the three delays in emergency obstetric care. Delay 1 (access/geographic): facility location and transport. Delay 2 (decision): companion presence and agreed-upon skilled attendant. Delay 3 (quality): funds, blood donor, and facility capability. A written, family-endorsed plan ensures that when labor signs appear, the response is rehearsed and rapid, not panicked.
Postnatal Home Care: Mother Assessment Sequence (24 Hours and Day 7)
Structured postpartum mother assessment at both critical time points: 24-hour (immediate) and 7-day check. At 24 hours: baseline vitals, uterine tone, lochia quality, perineal healing, breastfeeding support, bladder function. At day 7: involution progress, wound healing, depression screening, iron and FP counseling. Integrated referral triggers for all postpartum danger signs (bleeding, infection, breast, thromboembolic, eclampsia). Records go to MCP, TCL, and FHSIS.
Newborn Assessment and Care in Postnatal Home Visits
Comprehensive newborn assessment framework at early visits (24-72 hours) and day 7. Early period focuses on critical danger signs (temperature, feeding, cord, infection), confirming birth doses (BCG, HB), and arranging heel prick screening and hearing screen. Day 7 focuses on growth/feeding, cord healing, jaundice, infection, and EPI schedule. Eight newborn danger signs trigger immediate referral. All findings recorded in MCP and FHSIS with immunization follow-up scheduled.
Maternal and Newborn Care Journey Through Home Visits
State diagram showing the complete journey of a mother and newborn through home-based prenatal and postnatal care. Pathways branch at critical decision points: risk detection in pregnancy (refer to specialist), danger signs in postpartum (refer to BEmONC), and newborn complications (newborn referral). Normal pathway follows ANC visits → birth plan finalization → facility delivery → early postnatal (24h) → day 7 → 6-week review. All referral pathways eventually return to the main care continuum. Demonstrates how midwife maintains the unbroken MNCHN chain.
Distribution of Danger Signs Across Pregnancy, Postpartum, and Newborn Periods
Pie chart showing the proportion of danger signs the midwife must recognize across three critical periods. Newborn danger signs comprise 40% (highlighting the complexity of early neonatal assessment), postpartum 27% (emphasizing maternal morbidity/mortality risk in days 1-7), and pregnancy 33% (chronic risk throughout 40 weeks). This visual reinforces that the midwife's role is not singular but multi-faceted across the continuum, with particular focus on the two high-risk periods (pregnancy and early newborn).