The role of maternal and child health clinics in education and prevention: a case study from Papua New Guinea.
This paper describes a behavioural study of the infant nutrition and family planning education components of selected maternal and child health clinics in Madang Province in Papua New Guinea. Staff of six (6) clinic teams were observed during 18 rural and urban clinics and the content and length of the nurses' interactions with the 254 mothers of 340 children recorded. Three-quarters (71%) of the interactions took less than 2 minutes. Family planning advice was rarely given. The amount of time the nurse spent with mother and child primarily depended on whether the child was sick or well, rather than on his/her nutritional status. Nutritional advice, when offered (to mothers of 27% of children below 80% WFA), was given in response to WFA alone, independently of health status, age and rate of growth. It is suggested that the low priority given to nutrition and family planning education is the result of inadequate supervision, complex reporting systems, the routine nature of the work, preference of nurses for structured clinical tasks and nurses' attitudes to clients and contraception. Clinics would be more effective if oriented around problems rather than tasks, and families rather than individuals. This would also give nurses the satisfaction of seeing the goals and results of their work. It is suggested that the MCH system would benefit from innovative pilot programmes which address the special problems of remote areas and derive from primary health care principles.
D001291:Attitude of Health Personnel; D002675:Child, Preschool; D005193:Family Planning Services; D005260:Female; D006266:Health Education; D006268:Health Facilities; D058016:Health Facility Administration; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008430:Maternal-Child Health Centers / Q000458:organization & administration; D008499:Medical Records; D009723:Nurse-Patient Relations; D010219:Papua New Guinea; D011315:Preventive Medicine; D012380:Role