Mental Health
NCD
RMNCH+A
Adolescent Health
SMDs
Diabetes
Epilepsy and Dementia
3 common cancers
Suicide
Family Planning
C&AMHDs
Child Health
Alcohol Use
SUDs
CMDs (including post partum depression)
Hypertension
Maternal Health
Depression
CMDs
Adolescent Boy 15yrs+
Lactating Mother
30+ Lactating Mother
Adolescent
Post Abortion
Eligible couple Male/ Adolescent Male
30+Population
Eligible couple Male
Eligible Couple Female
Adolescent Girl 15yrs+
All Population cohorts
30+ Women
Pregnant Woman
Adolescent- 10-14 years
Child and Adolescent
High school Adolescent
Neonate
Middle school Adolescent
School Going Adolescent
Adolescent Girl 10-19 years
30+ Pregnant Woman
Young Child
Primary school Adolescent
Alodescent Female
All Govt Program
DMHP
SUMAN
National Telehealth Programme of India- TeleMANAS
UIP
JSY
AMB
Peer Educator Programme
HBNC
FBNC
RKSK
SAANS
MAA
JSSK
NFPP - PAIUCD Scheme
National Family Planning Program
ICDS
School Health and Wellness Programme
Weekly Iron and Folic Supplementation
RBSK
NP-NCD
NFPP - Family Planning Indemnity Scheme
NMHP
NFPP - Enhanced/HFD Compensation Scheme
Mission Parivar Vikas
NTEP
NFPP - PPIUCD Scheme
Antara Program
HBYC
Menstrual Health Scheme
PMSMA
Neonatal and Infant health
Care in Pregnancy and Child-birth
Screening and Basic management of Mental health ailments
Prevention, Screening and Management of NonCommunicable diseases
Family planning, contraceptive services and other reproductive care services
Childhood and Adolescent health care services including immunization
All Point Of Service Delivery
School
Community/VHND
AFHC
HWC-PHC
AWC
HWC-SHC
Post-intervention services- 45 mins
1st Examination/ 1st PNC Visit (within 48hrs)
Intervention services
Pre- Intervention services
General Family Planning Services
HBYC VISIT 3 (9 months)
Early identification and Screening
6th Home Visit (Day-28)
Identification and Detection
ANC (2)
6th PNC Visit
3rd Home Visit (Day-7)
Diagnosis
Health Promotion
Post- Intervention services
1st Examination of NewBorn/ Home Visit (Day 1)
ANC (3)
HBYC VISIT-5 (15 months)
Management and Follow up
Management and Follow-Up
ANC (1)
4th PNC Visit
5th PNC Visit
HBYC VISIT2 (6 months)
ANC (4)
Post-intervention services- 15 mins
7th PNC Visit
Vaccination Schedule-3 month 2 weeks
Teleconsultation
HBYC VISIT-4 (12 months)
7th Home Visit (Day-42)
Vaccination schedule-24 months
2nd Home Visit (Day-3)
Vaccination Schedule-16-24 months
3rd PNC Visit
Intra Partum Care
Treatment
Pre-intervention services (every 15 in after premedication)
Intervention and Preventive care Measures
HBYC VISIT 1(3 months)
Health education and outreach
Intranatal Care
Post-intervention services- 1 hr
2nd PNC Visit
5th Home Visit (Day-21)
Post-intervention services- 2 hr
Post-intervention services- 4 hr
Post-intervention services- 3 hr
4th Home Visit (Day-14)
All Service Provider
RSBK teams
ANM
Health and Wellness Ambassadors
MPW
MO
ASHA
Mobile health teams
Peer educators - Saathiya
School teachers
Counsellor
AWW
SN
Trained Counsellor
DEIC team
MPW-Male
CHO
Testis
Follow-up- Implant
Reproductive/ sexual history
Signs of anaemia- pale conjunctiva1
Medical history (general)
Providing Medications to the patients
Create patient support groups
mobility of uterus1
Sex during pregnancy Counselling
Check for breastfeeding problems
Follow up for diagnosed patients with NCDs, Ensuring compliance to treatment
Counselling- Method Specific For PAIUCD
Counselling- Family Planning
IFA supplementation
Pelvic Examination1
MPA Administration
Type of MPA administered
Examination- Foetal movement
Examination- Temperature (Measure axilla and record)
Obstetric history
Auscultation of heart1
Gynaecological problems
Motor Delay1
Check-MUAC
Check for having any breastfeeding problems
Reactive Airway Disease1
Any Bleeding Disorder
Examination- Foetal Lie and Presentation
Blood Sugar Test
Diet and rest Counselling
Administration- Centchroman (Ormeloxifene)
Registration- IUCD card to be issued to the client
Rh typing/ HBsAg Test
Check if unconscious/ having fits
Date of Injection
Check pallor
Check for Major congenital Malfunction
Immunisation- Rota-1
Information and counselling for improving dietary intake and for taking actions for prevention of intestinal worm infestation.
Immunisation- Penta-1
Classes on yoga and meditation
abnormal vaginal discharge1
Vit-A-3
marital status
Fever1
Check for Cleft Lip & Palate
Last used contraceptive1
Quaterly thematic adolescent health days
Check for Congenital Cataract
Registration for Male Sterlisation- No Scalpel Vasectomy
Screening for breast cancer
Number of living children1
Vitamin A-1
Post- insertion instructions
Have you abstained from sexual intercourse since your last menstrual period, delivery, abortion or miscarriage
Check for any breastfeeding problems
Signs of anaemia- pale skin1
date of abortion/MTP1
Abstained from sexual intercourse since the last monthly bleeding/ delivery/ abortion or miscarriage
Examination- Diarrhea/ Dysentry
Check whether child is irritable/ restless/ jittery
Check for Minor birth trauma
H/O Blood Transfusion1
Sepsis Investigation
Post Removal Counselling
Timing
Post-operative instructions given verbally
Follow up Counselling
After Child Birth Counselling
Provision- Tab Albendazole
Bleeding Examination
Information and counselling for taking actions for prevention of intestinal worm infestation.
amount of flow1
Site of Implant insertion
Detecting pregnancy
Check for Bleeding from any sites
had a baby in the last 4 weeks?
Counselling- Method Specific For MPA
Counselling- Method Specific For Implant
pouch of Douglas - tenderness1
IUCD removal
Healthy lifestyle tips e.g. balanced diet, exercise, sleep hygiene, and stress management
external genitalia- lesions1
Date of Implant insertion (dd/mm/yy)
Complication readiness Counselling
Sick child identification
Odema Assessment
Otitis Media1
History of systemic illness
Vision Impairment1
pouch of Douglas - mass1
Check for Perinatal asphyxia
Suprapubic tenderness1
Examination Umblical Cord
Monthly meeting for STIs, HIV, High risk behaviour
Convulsive disorder1
Initiate Breastfeeding
Removal of Implant
Rheumatic Heart Disease only at school
Pulse Assessment
Cognitive Delay1
Incisional Vasectomy
external genitalia - abnormalities1
Distributing drugs to households, If required
Monthly meeting for Counselling on nutrition
Hydrocele
Jaundice1
Check for Respiratiory Distress (rate >60, no retraction)
Diabetes1
Occupation1
Menstrual Changes
Look for convulsions, coma and feeding problems
Community level Follow Up
Counselling- Post removal
Provision - ORS
Patient counselled for postoperative instructions
Reproductive intention
temperature1
Check for Minor malformation
Malaria1
Medical History
Community Based Assessment Checklist (CBAC)- Risk Assessment
Counselling- Method Specific For COC
Check body weight
Various Tools
General Examination
Weekly, 1 Iron and Folic Acid tablet, Each tablet containing 60 mg elemental iron + 500 mcg Folic Acid, sugar-coated, blue color
Counselling- Follow-up
Check- Vitamin A status
Varicocele
pelvic tenderness1
Family history
Breast Examinatiom
Check for Severe Pallor
Is mother having any breastfeeding problems
Vitamin D Deficiency, (Rickets)
Post-operative instructions given in writing
Screening for Oral cancer
active PID1
Counselling- Parenting
Language Delay1
Respiration Assessment
Post Insertion Counselling
IFA supplementation Counselling
Labour Care
Number of Spontaneous Abortions1
Check- Measles vaccine status
Convulsive Disorders
Alcohol Use Disorder Identification Test (AUDIT) for alcohol use disorders
regularity of periods1
None/IUCD/ Condoms/ Oral pills/ Any other
Pedal oedema
Speculum examination
Check for Hypothermia temp<36C
Provision of Condoms
Improving psychosocial competencies at individual and family level e.g. through basic psychoeducation, psychological first aid, basic suicide risk assessment/management
Time1
Check -Childhood Diseases
Registration- Subdermal Implant and Card
Examination- Malformation/ birth Injury
Examination- Temperature
Stitch removal
Check for excessive Bleeding
current pregnancy status1
Skin conditions (Scabies, Fungal Infection and Eczema)
Have you had abortion/ miscarriage in last 12 days
Severe Acute Malnutrition , SAM/Stunting
Spouse status of sterlisation
IUCD Insertion- Note date and type (380A / 375)
Check for unconciousness/ having fits
Did your menstrual period start within past 12 days
Is mother unconcious/ having fits
Check for pain
History- Symptoms
Examination- Genital tract infection
Have a baby less than 6 months ago, are you fully or nearly fully breastfeeding and have you had no monthly bleeding since then?
Religion
Imunisation- Hepatitis B
number of abortion/MTP1
Examination- Meconium
Breast Examination
Counselling- Method Specific For Female Sterlisation
Examination- Foetal Heart Rate
Follow up for psychosocial interventions and treatment adherence support
Prevention of substance abuse, Sexual & Reproductive Health, Violence Prevention, Unintentional Injury, Road safety, Nutrition, Meditation and Yoga, Literacy
Check for Superficial Infection
mass1
Micro-birth planning
Basic Intervention
number of pregnancies1
Enlarged groin nodes1
Ultrasound Anomaly Scan
Check unconciousness/ having fits
Mobilization for screening
Initiate a treatment plan: Medications and counselling on lifestyle modifications
duration1
Provision- ORS
Rheumatic Heart Disease (only at school)
Place pad for bleeding and assess if the bleeding is heavy1
Provide: medicine dispensation,psychosocial interventions and community based follow up
Patient feeling well
age of youngest child1
Counselling- Complimentary Breastfeeding
Counselling for Baby
Provision- IFA Syrup
Pre-Insertion Instruction
Identification- Pneumonia
Abdominal Examination1
DPT Booster-1
Check for Club Foot
Immunisation- OPV
gross abnormalities1
Record- Length and Height
Medical history (general):
Hernia
Preparing for Discharge- Ensure that the baby is warm, breathing normally, and accepting and retaining breast milk, and that the cord is clean.
general condition1
Pre- Removal Instruction
Neuro-motor Impairment (CP)
Encourage use of condoms for STI protection, as appropriate.
Ask whether IUCD is still in place/ expelled
Examination- Extensive genital injury
Heart Disease1
Monthly/ fortnightly Thematic assembly and answering questions
Date of removal of Implant
Pre- Removal Counselling
IPV-2
Some other problems reported
Examination- Eyes
Check Respiratory Rate
Supply of drugs
Medical record of the Pregnant Woman for EDD
tenderness of the adnexa1
Examination- Breast Milk
Check for vaginal bleeding
Immunisation- PCV-1
Blood Pressure Assessment
Provision of Meals
Check State of mind
Pain
using a reliable contraceptive method consistently and correctly since your last monthly bleeding, delivery, abortion or miscarriage?
Epididymitis
Check for coma, convulsion, encephalopathy
uterine abnormalities1
Quaterly Parent Teacher meetings
Ask- Breastfeeding Status
Passed urine
Had a baby less than 6 months ago, fully or nearly fully breastfeeding and have had no monthly bleeding since then
Stage of Labour
Blood Group Test
Awareness building and, stigma and discrimination reduction activities
Drying and Warming
position of uterus1
Counselling- Hand Washing
Screening for NCDs-Hypertension
Weight Measurement
shape of uterus1
Vaginal discharge
Family Planning Counselling
Check for Apnea or Gasping respiration
Reason for discontinuation1
Counselling- Birth Preparedness
Examination- Discharge
body weight1
Asthma1
Diagnose Hypertension and/ or DM
Dysmenorrhoea1
Counselling- Pre-removal
JE-1
Provide basic interventions
Behaviour Disorder (Autism)1
size of uterus1
Counselling- Deworming
Assessment- Condition
Vaginal Examination
Patient Health Questionnaires 2 (PHQ 2) in CBAC form
Check for Congenital Heart Diseases
Last monthly bleeding start within the past 7 days (if the client is opting for IUCD, this window may be expanded to 12 days)?
Mental Illness1
Examination- Fundal Height
Screening of target groups and early detection of Anemic cases
Urine Test- Protein
Preparing for discharge
Check-up
cervix - purulent cervicitis1
Dental Caries1
Check Epididymis
Provide treatment adherence support for ensuring compliance of medications and recognising complications/red flags that would need referral
Administration- COC
Assessment- Dehydration
Rota-3
Screening for NCDs-DM
signs of pregnancy1
Check- Development Delay
Active Enumeration of Population & registration of families
Post- removal Instruction
Antenatal History Check
Immunisation- Vitamin K
Weekly 2 hours session with 15-20 boys and girls (with PE kits)
Breastfeding counselling
Pallor Assessment
Lungs
Check Sedation
respiratory rate1
Contraceptive history
length of cycle1
Counselling- Exclusive Breastfeeding
Jaundice Assessment
Due Date of next injection
Check- immunisation Status
Vital Signs: Monitoring
Check for any breastfeeding problems
Monthly meeting for Counselling on early marriage
Check -Deficiencies
Screening Clients- interval IUCD
Urine examination for sugar
Oral glucose tolerance test
Sanitary napkin provided to adolescent females of 10-19 years
Diet Assessment
Check for severe respiratory distress (rate>70, severe retractions, grunts)
Check for Non emergency or non priority sign
Check -Defects at Birth
Check for breastfeeding problems
Skin of scrotum
Check for Central Cyanosis
Breast and Pelvic Examination
Number of living choldren1
MR-1
Screen for warning signs (PAINS)
Check Gestation time
Monthly meeting for counselling on Management of Menstrual Problems
Check for wound discharge
Vitamin A-2
Had a miscarriage or abortion in the past 7 days (if the client is opting for IUCD, this window may be expanded to 12 days)?
Immunisation- OPV-1
Post-operative instructions given verbally and in writing
Hearing Impairment1
Educational status
PCV-2
Menstrual history
Minilap Tubectomy
Sexual Problems1
Last monthly bleeding started within the past 7 days (if the client is opting for IUCD, this window may be expanded to 12 days)
Counselling- Post Insertion
Post Partum Counselling
Have you been using a reliable contraceptive method correctly and consistently since your last menstrual period, delivery, abortion or miscarriage
Type of Inj
Screening for Cervical cancer
Check - Developmental delay and disability
Vaginal bleeding1
Identify persons with potential MNS conditions in the community using the CIDT tool
Check for any breastfeeding problems
Semen analysis
Number of Induced Abortions1
Assess healing
Personal information
Anemia1
Provide Post-operative Instruction Card
Health, growth and, development, Personal safety, Nutrition and physical activity, Hygiene practices, Prevention of Diseases like Malaria, Dengue, TB, worms, infestation, diarrhoea and vaccine-preventable diseases
Post-operative Counselling
Individual and family counselling
Heart
Check for Bleeding
Basic psychosocial and basic psychological counselling
Monthly meeting for self esteem and negotiation
Haemoglobin Test
Date of last used contraceptive1
Immunisation- TT injection
PCV booster
Counselling- Method Specific For Centchroman (Ormeloxifene)
Counselling- General Family Planning
Check for Down’s Syndrome
Raising awareness about NCDs
Application cum Consent Form for Sterilization Operation
Hypertension1
Wound discharge
Recent medical Illness1
Bimanual examination1
Amenorrheic1
State of mind (Sound mind/ not of sound mind)
Follow up and discharge in consultation with psychiatrist at STC
Check- meconium
Do you have a baby less than 6 months old? Are you fully/ nearly fully breast feeding, and have you not had menstrual bleeding since then
Whether PPIUCD
Masses1
RTI/STI/PID1
e-Sanjeevani consultation with specialists
Check for Shock (cold periphery, CFT>3secs weak and fast pulse)
pallor1
Allergies to medication1
Identify red flags
Take Home Ration
Check for wound bleeding
mass in cul de sac1
Number of child
Check for Severe Jaundice
Check for Cold Stress (temp 36.4-36C)
Discharge
Surgical scars1
Check for Posseting
Examination- Incomplete abortion
Pregnancy test
History of drug intake, allergies, intake of habit-forming or harmful substances, blood transfusion
Goitre
Have you had a baby in last 4 week
Post-operative instructions verbally and in writing
Check for Neural Tube Defect
Wound bleeding
Previous Surgery1
Both vas palpable
Signs of anaemia- systolic murmurs1
OPV-3
Community Based Assessment Checklist (CBAC)-Early Detection
Gynecological problems (Female Sterilization)1
Auscultation of lungs1
Urine Test- Sugar
Examination- Colour
Ask- Complimentary Feed Status
cervical motion tenderness1
Counselling- Nutrition
Physical Examination
blood pressure1
Counselling- Method Specific For Interval IUCD
Urine examination for albumin
liver disorder1
Immunisation- BCG
Absence of infection
Administration- POP
Check Pulse1
Examination- Weight
Assess woman’s overall satisfaction with the method, and check for any problems the client might be facing.
Check for Congenital Deafness
Measure- Weight
Penta-3
Post Operative Instruction Card
Check for Transitional Stools
Counselling- Method Specific For POP
Date of Last Child Birth/abortion…
Patient Health Questionnaire (PHQ-9) for depression
Examination- Speech /Fits
Check mother is alive
Monthly meeting for Counselling on Menstrual hygiene
Supportive care
date of last childbirth1
Check for Developmental Dysplasia of the Hip
Proactive follow up calls with prior consent
Uterus Examination
Check for Abdominal distension
Monthly meeting for Counselling on contraceptive choices
Registration and MCP card
IUCD Insertion
Prostatitis
Vitamin A Deficiency (Bitot Spot)1
Assess for common side effects (e.g. an increase in the amount or duration of menstrual bleeding, increase in pain/cramping with period, or spotting/light bleeding between periods) if the client complains against them
Clinically diagnose
Had a miscarriage or abortion in the past 7 days (if the client is opting for IUCD, this window may be expanded to 12 days)
nutritional status1
Calcium Supplementation
Check for unconciousness/ fits
Psychosocial interventions
Any other problem
Implant insertion
Distribution of safe motherhood booklet
Abdomen Pain Assessment
Date of last menstrual period (LMP)1
Currently on medication (if yes specify)1
age of child
Examination - Breathing
Immunisation- IPV-1
mode of delivery1
Currently Lactating1
MR-2
JE-2
Post Natal History
Puberty, Eye care, oral hygiene
Blood Loss Estimation
Age1
Provision of Tab (Albendazole)
Registration- MPA
OPV-Booster
Initiate pharmacological treatment
Counselling- Method Specific For PPIUCD
Check for vaginal discharge
Due date of follow-up visit
Domestic violence Counselling
Currently on medication
Check for Jaundice
Monthly meeting for Counselling on gender issues
Bath- Delay the baby’s first bath to 24 hours after birth.
Name1
Abdominal distension
Check fever
Tuberculosis1
Examination- Abdomen
pulse
have or ever had breast cancer
Stimulating community dialogue and remove myths, misconceptions and taboos and stigma related to mental health, epilepsy and dementia via group information sessions
Breathlessness on exertion, palpitations
Have Polycystic ovarian disease
Signs of anaemia- pale conjunctiva
Postpartum-care and hygiene, nutrition, contraception device, registration of birth, management of danger signs
amount of flow
Have you been told by a medical professional that you have STI in last 3 months?
details of breast-feeding
Malignant or benign trophoblastic disease
The necessity of taking IFA and the dangers associated with anaemia Emphasise the importance of a high protein diet, including items such as black gram, groundnuts, ragi, whole grains, milk, eggs, meat and nuts, for anaemic women. Encourage the woman to t
mobility of uterus
Check Respiration
Assess breathing
Check - Sleepiness and conciousness
Community awareness to empower service users to increase the demand for and access to MNS services.
Ask mother whether she has started complimentary breastfeeding
Examine the perineum, lower vagina and vulva for tears
Vitamin-D Deficiency, (Rickets)
Skin Conditions
pouch of Douglas - tenderness
Cleft Lip & Palate
A. Pelvic adequacy B. Progress of labour C. Stage of labour
Connecting people with available mental health services
Pelvic Examination
external genitalia- lesions
Measure the temperature of the child
Test used for Haemoglobin Estimation,
Test used for the detection of pre-eclampsia, which (along with eclampsia)
Reduced urine output or burning on micturition
Is the baby preterm?
All pregnant women need to be given one tablet of IFA (100 mg elemental iron and 0.5 mg folic acid) every day for at least 100 days, starting after first trimester/ From fourth month
ever been told you have high blood pressure
Safe Mother Booklet given
Shortness of breath
Enable positive behaviour modifications, treatment compliance, and encouraging patients to go the sub centre for regular check-up of BP/blood glucose.
Check for Number of times mother is taking full meals in 24hrs
Creating awareness about mental health disorders, risk factors and symptoms to watch out for
Bleeding Disorder
Auscultation of heart
Congenital Deafness
Otitis Media
Difficulty drinking or feeding
have a serious liver disease or jaundice (yellow skin or eyes)
Measurement of woman's weight
Diarrhoea (loose stools)
currently, have a blood clot in your legs or lungs?
Vision Impairment
Motor Delay
type of abortion
pouch of Douglas - mass
Suprapubic tenderness
Down’s Syndrome
Reactive Airway Disease
Taking drugs (that might be harmful to the foetus)
Vomiting
Convulsive disorder
Albendazole for deworming
Cognitive Delay
external genitalia - abnormalities
Jaundice
Blood in sputum
Check- Burn
Normal diet three times in a day
Diabetes2
Temperature of the baby (Measure axilla and record)
planning major surgery that will keep you from walking for one week or more
Encourage the woman to bath or wash herself and her genitals at the onset of labour.Encourage the woman to empty her bladder frequently. Remind her to pass urine every two hours or so.
Ulcers /patch /growth in the mouth that has not healed in two weeks
abnormal vaginal discharge
ever been told you have breast cancer
Fever
Last used contraceptive
Create a list of individuals of age 30 or above
number of deliveries
Occupation
1. Maintain hygiene while handling the baby. 2. Delay the baby’s fi rst bath to beyond 24 hours after birth. 3. In cool weather, the baby’s head and feet should be covered and he/she should be dressed in extra clothing. The baby must be kept warm at all t
Creating awareness and sensitivity through sustained advocacy, on social issues that are risk factors for developing distress/mental health conditions, especially in women and children
ever had a stroke, blood clot in your legs or lungs, heart attack or other serious heart problems?
Post-abortion complications
Delivery of twin
Look for Pallor, examine the woman’s conjunctiva, nails, tongue, oral mucosa and palms
Delivery of an infant with congenital abnormalities
Have Chronic illness, like tuberculosis or renal disease
temperature
Check for respiratory rate .
Examination of oedema over the ankles and shin by pressing your thumb, can be suspected if a woman complains of abnormal tightening of any rings on her fingers
Speculum examination of the vagina and cervix
Postpartum endometritis/metritis or puerperal sepsis
Number of living children
Measurement of fundal height
One IFA tablet daily for three months
Family History of Diabetes
Epilespsy
currently breastfeeding a baby less than 6 weeks old
Malaria
Signs of anaemia- rapid pulse (> 100/min)
Diet and rest Exclusive breastfeeding Need to take iron tablets Family planning Hygiene to prevent infection of mother and her baby Avoiding sexual intercourse till perineal wound heals When to return for follow-up Complete immunisation of b
Had diabetes for more than 20 years or damage to arteries, vision, kidneys or nervous system caused by diabetes
Signs of anaemia- pale skin
date of abortion/MTP
Is the baby crying incessantly or passing urine less than 6 times a day
Test for Malaria Detection
Contraceptive(s) used in the past, if any, and experience with it.
Yellowness in eyes or skin: Jaundice
Are you taking rifampicin or rifabutin for tuberculosis or other illness?
Check for pulse rate
Look for signs of Jaundice, yellowish discolouration of the skin and sclera
H/O Blood Transfusion
number of pregnancies
Check for Diarrhea/ Dystentry
history of pelvic tuberculosi
Respiratory disease
Bleeding between periods
MPA Card to be issued
Enlarged groin nodes
Breech or transverse presentation
Measurement of Foetal Health Rate
pelvic tenderness
Measurement of the woman’s blood pressure
history of genital tract cancer
After the delivery of the placenta, check to see if the uterus is well contracted (i.e. it is hard and round)
Amount of physical activity
duration
Does she want to have more children, if yes, when does she want to get pregnant?
number of abortions (spontaneous/ induced)
Meausre Blood Pressure
Ensure that the uterus is hard and is not bleeding
SAM/Stunting
Immunisation to Prevent Polio
Normal Swelling or Oozing Pus
Chorioamnionitis
Place pad for bleeding and assess if the bleeding is heavy
have gallbladder disease now or take medication for gallbladder disease?
Note down Date and Type of IUCD(380 A/ 375) insertion
To breastfeed, including colostrum feeding, within an hour of the birth. Ask her to take warm fluids, eat well, take adequate rest, sleep and maintain hygiene. Th e latter would include maintaining perineal hygiene, taking a bath every day and washing her
Check if all limbs Limp
Problem- Frestfeeding
history of sexually transmitted diseases in partner
Past experience with family planning method; reasons for discontinuing the method, if previously used; desire for spacing between births or limiting family size; previous use of IUCD and side effects experienced, if any
age of youngest child
Presence of common symptoms of cancer (oral, cervical, breast)
active PID
Vulva and perinuem examination for tear/swelling/pus discharge, Lochia examination, Abdominal examination for uterine tenderness
Family History of Heart disease
Measure and record temperature
Anaemia
Abdominal Examination2
Previous stillbirth or neonatal loss
History of caesarean section
Language Delay
number of abortions/ MTP
Acute purulent discharge
Recent history of jaundice or liver disease
gross abnormalities
Check for Normal Swelling or Oozing Pus
Ante-Partum Haemorrhage (APH)
Spinal deformities, such as scoliosis/kyphosis/polio
Foul smelling vaginal discharge
Neural Tube Defect
Learning Disorder
Number of Spontaneous Abortions
Mobilization of community members to attend screening
AIDS and neither clinically well nor on antiretroviral therapy
Surgery on the reproductive tract
Check for Sunken eyes
Empowering community with self care tips for promoting mental health and help individuals/family/community cope with difficult situations
regularity of periods
general condition
Clinical Breast Examination (CBE)
Measure Weight and record on MCP Card and Identify Growth Flattering
Enumeration through Individual health cards having unique ID/AADHAR number
Whether PPIUCD?
To investigate about Rh factor
Informing the woman about the dates of antenatal visits, schedule for TT injections and the EDD. Identifying the place of delivery and the person who would conduct the delivery. Identifying a referral facility and the mode of referral.
Check the number of times mother is taking full meals in 24hrs
Is the baby being fed properly (whenever hungry or at least 7-8 times in 24 hrs)
Neuro-Motor Impairment
Time
Difficulty in opening mouth
Check for meconium/ blood stained amniotic fluid
Heart Disease
Pregnant Woman should be advised to eat more than her normal diet throughout her pregnancy Other members of the family especially those who take decisions regarding the type of food brought home and/or to be given to the pregnant woman such as the woman’s
Attention Deficit Hyperactivity Disorder
Cervical hyperplasia
At what time baby was first fed?
any pelvic disease
menstrual cycle details including regularity of periods (regular or irregular)
Date- Last Menstrual Period (LMP), Expected Date of Delivery (EDD) is calculated
Implant Card To be issued to the client
current pregnancy status
Attacks of breathlessness/asthma
Convulsions
What was given as the first feed to baby after birth
Spread awareness and counsel on the effects of tobacco consumption, alcohol use, obesity, family history, lack of exercise, unhealthy diets.
Check for pallor
Lump in the breast
Rh negative in the previous pregnancy
Blood transfusion
Right Arm or Left Arm
Admission for Pregnancy Hypertension, pre-eclampsia or eclampsia
Measure the woman’s blood pressure
have cirrhosis of the liver, a liver infection or liver tumor? (Are her eyes or skin unusually yellow? [signs of jaundice])
Pus on Umblicus
flow (excessive or normal)
Check for lower abdominal tenderness and masses
number of abortion/MTP
tenderness of the adnexa
Checkfor Pallor, examine the woman’s conjunctiva, nails, tongue, oral mucosa and palms
Conduct a P/V examination to decide the stage of labour (as mentioned later in this section)
Test for Tuberculosis detection
Has the baby received Hept B
taking medications for seizures
Anything Unusual
Assessment of Foetal movements for foetal well-being
Blood stained discharge from the nipple
mass
STIs or RTIs
rule out conditions like STI or PID, pregnancy or expulsion of IUCD
Check if mother having no milk or perceives less breast milk
have or have you ever had breast cancer
Is the breastfeeding continued?
Do you sometimes see a bright area of lost vision in the eye before a very bad headache (migraine aura)?
Ever been told one has high blood pressure
12 strips (@ 15 tablets per strip)
Severe allergic state
signs of pregnancy
uterine abnormalities
Preterm births
dysmenorrhea
Has the baby received OPV
Postpartum/ Post-abortion/ Interval
History of illness and other medical conditions in the past or at present
Have you been told by a medical professional that you have any type of genital cancers, trophoblastic disease or pelvic tuberculosis?
mode of delivery (vaginal/ cesarean)
Creating awareness about treatable conditions like Epilepsy
Respiratory tract infection (RTI)/ sexually transmitted infection (STI); human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS)
All limbs Limp
Check for cracked nipples
2nd follow-up
Check feer for swelling
Detection of pregnancy via urine examination using a pregnancy test kit
Address
respiratory rate
Check if Restless and irritable
Conduct Blood Sugar test
Check for Engorged Breast
Unresolved postpartum hemorrhage
length of cycle
recent history of postpartum/post abortion infections
Rheumatic Heart Disease
Puerperal sepsis
Cry weak stopped
position of uterus
Congenital Cataract
More than 18 hours from rupture of membranes to delivery of the baby
Has the baby received BCG
Have you had more than one sexual partners in last 3 months?
Weight of previous baby
Ration Provided from Aganwadi Centre
Generalized swelling of the body, puffiness of the face
Difficulty in breathing, palpitations, easy fatigability
smoke cigarettes
Serious liver disease or jaundice (yellow skin or eyes)
breastfeeding status
Ensuring Monthly supply of drugs for NCD
Check if Drinks eagerly, thirsty
The dates of her subsequent antenatal visits and emphasise the importance of making all these visits in time. Help all pregnant women to reach a decision regarding the health care provider they want for conducting their delivery. An SBA should be preferre
shape of uterus
Ever been told one has diabetes (high sugar in your blood)
Inquire about the woman’s history of labour, Check the woman’s record for history of the present pregnancy, e.g. the haemoglobin status, TT immunisation, Rh status, any complications and any other significant history
Reason for discontinuation
High risk of exposure to STIs like Gonorrhoea or Chlamydia
Weight of the baby
Husband's Name
Thalassaemia or h/o repeated blood transfusion
body weight
Check number of times mother is taking full meals in 24hrs
Asthma
number of abortions
Estimate the amount of blood loss throughout the third stage of labour and immediately afterwards. If the bleeding has stopped, observe the woman for the next 24 hours. Examine the perineum, lower vagina and vulva for tears
Dysmenorrhoea
any intermenstrual bleeding
Number of living choldren
Improving mental health literacy for early recognition, management or prevention of mental health conditions, encouraging positive lifestyle changes, generating empathy and support for distressful situations (individual or societal), reducing stigma and
Congenital anomaly
check for signs of infection
Behaviour Disorder (Autism)
size of uterus
Check for Hardness
Cry weak /stopped
A Mother and Child Protection Card is issued and duly completed at all stages for every pregnant Woman registered
Tobacco and alcohol consumption
Coughing more than 2 weeks
Hearing Impairment
Has your partner been told that he has an STI or do you know he has any symptom (example: penile discharge) in last 3 months?
Duration of Marriage
1st follow up
Counselling for patients on treament for adhering to medicine schedule and lifestyle modifications
Test used to diagnose women with gestational diabetes
bleeding after intercourse
Mental Illness
Perineal injuries/tears
Check if Not able to drink or drinking poorly
Sexual Problems
Change in shape and size of breast
Cough
Is the baby being kept warm (near mother, clothed and wrapped properly)
Oral Visual Examination (OVE)
The husband and immediate family members of the pregnant woman should be briefed about the serious consequences that violence could have on the pregnancy, on the woman’s health and on the physical and mental health of the child to be born. Th e woman hers
Check for Lethargic or unconscious
Sub-umbilical approach
Check for Breast Abscess
Developmental Dysplasia of Hip
Are you taking medication for seizures? Are you taking rifampicin or rifabutin for tuberculosis or other illness?
Known distorted uterine cavity (uterine septum, fibroid uterus, etc.)
Ultrasound Scan used to identify complication
cervix - purulent cervicitis
Dental Caries
Vaginal bleeding
Measurement of waist circumference
Ever had a stroke, blood clot in your legs or lungs, or heart attack
Recognising danger signs during pregnancy, labour and aft er delivery/abortion
Gynecological problems (Female Sterilization)
Auscultation of lungs
Is umblical cord bleeding
Motivate and share challenges and success related to life style changes, behaviour modification, reduction of substance abuse and adherence to treatment should be created.
have a serious liver disease?
Counsel for recognising danger signs during pregnancy, labour and after delivery
have cirrhosis of the liver, a liver infection or liver tumor? (Are her eyes or skin unusually yellow? [signs of jaundice]) Have you ever had jaundice when using COCs?
Recurrent early abortion
Talipes (club foot)
Goiter
past or current history of sexually transmitted diseases (abnormal vaginal discharge, lower abdominal pain)
cervical motion tenderness
Respiratory rate more than 60 per minute
History of fits
blood pressure
Number of Induced Abortions
Are you HIV positive or have developed AIDS?
Check for temperature
Consumption of alcohol, tobacco
liver disorder
High BP
External genitalia examination
In case the woman suffers from haemorrhage, knowledge regarding her blood group would come in handy if blood transfusions have to be arranged, helping to save precious time and the Life of the woman
Anemia
Check Pulse
a pelvic examination to ensure that the IUCD is still in place
ever been told that you have a rheumatic disease, such as lupus?
any lump or discharge from breast
Determination of foetal lie and presentation by fundal palpation, lateral palpation and pelvic grip
Pregnant Woman should be informed that It is safe to have sex throughout pregnancy, as long as the pregnancy is uncomplicated.
Excessive bleeding after delivery
Do you think your partner has had more than one sexual partners in last 3 months?
history of ectopic pregnancy, vesicular mole
Date of the first day of her last menstrual period (LMP), Calulate EDD
have several conditions that could increase your chances of heart disease (coronary artery disease) or stroke, such as older age, smoking, high blood pressure or diabetes?
Check for Pallor, examine the woman’s conjunctiva, nails, tongue, oral mucosa and palms
Date of last used contraceptive
had a baby in the last 3 weeks and you are not breastfeedin
date of last childbirth
Feeding Less/Stop
Prolonged or Obstructed labour, including dystocia
Severe headache/blurring of vision
Congenital Heart Disease
Check if Skin pinch goes back very slowly
Calculate Weight for Height (WFH)
Hypertension2
Mother says the baby is 'cold to touch' or baby has fever with a temperature>99 degree F0 (37.2 degree C)
Vitamin A Deficiency (Bitot Spot)
Do you have bleeding between menstrual periods that is unusual for you, or bleeding after intercourse?
Whether Interval IUCD?
Amenorrheic
Recent medical Illness
Bimanual examination
Any change in the tone of voice
nutritional status
Test used to diagnose women with gestational diabetes.
speculum examinations and visualization with acetic acid
Check for Foul smelling discharge
Check if mother speaking abnormally or having fits
Recording health events (screening/diagnosis/treatment/complications) in health card
ever been told you have breast cancer?
Alert/ 0—Alert 1—Drowsy 2—Sleeping/arousable 3—Not arousable
Estimate the amount of blood loss throughout the third stage of labour and immediately afterwards
Severe pain in the abdomen
history of pelvic tuberculosis
NA
Bleeding after menopause
Date of last menstrual period (LMP)
Currently on medication (if yes specify)
Masses
RTI/STI/PID
Filling up family/household folder
Treatment for infertility
Vaginal discharge/itching/leaking of watery fluid
Check for Nipple colour, Flakes, itchy etc
have bleeding between menstrual periods, which is unusual for you, or bleeding after intercourse
pallor
mode of delivery
Currently Lactating
Decreased or absent foetal movement
Observation of the size and shape of the nipples for the presence of inverted or flat nipples, crusting and soreness of the nipples. Examination should also include palpatation for any lumps or tenderness
breastfeeding a baby less than 6 months old
Allergies to medication
have bleeding between menstrual periods, which is unusual for you, or bleeding after intercourse (sex)?
Check-injury
Is baby alive?
Woman should be advised on birth spacing or limiting, as necessary. Explain to her and her husband that if after the delivery she is not exclusively breastfeeding and has unprotected sex, she can become pregnant as early as six weeks after delivery. It is
mass in cul de sac
Distended abdomen or mother says baby vomits often
Age
Bleeding/spotting between periods or after intercourse
Check for abdominal pain
Weight recording and plotting on growth chart
Renal disease
past or current history of pelvic infections
Chest in drawing
Test used for Haemoglobin Estimation
Surgical scars
How did the baby take feed, Forcefully, weakly couldnot breastfed, had to feed with spoon, nor breatfed not spoon
Chest in-drawing
Chest Indrawing
have a serious problem now with a blood clot in your legs or lungs
Name
Do you get throbbing, severe head pain, often on one side of the head that can last from a few hours to several days and can cause nausea or vomiting (migraine headaches)?
Allergies to drugs
Extensive genital trauma
Previous Surgery
Signs of anaemia- systolic murmurs
Tuberculosis
Family history of high blood pressure
Nutrition Support
Intervention and Treatment
Mobilization and Awareness
Routine Newborn care
Case Detection
Intervention
Pregnancy Screening
Provision of Sanitary Napkins
Early Identification and screening
Risk Assessment
Registration
Follow up
Nutrition Supplementation
General Examination
History Taking
Regular supplies and treatment adherence
Diagnosis
Immunization
Health and wellness day celebration
Clinical Examination/ Investigation
Education session - PE kit
Abdominal Examination
Registration of Subdermal Implant
E-Sanjeevani
Early Detection
Pregnancy Confirmation and Registration
Counselling
Regular Supply and Treatment Adherence
International Yoga Day celebration
Age appropriate learning - healthy behaviour, prevention of diseases
Weekly Supplementation - IFA
Identification and Pregnancy Detection
Recordkeeping
Screening
Physical Examination
Follow-up
IEC and community mobilisation
Management of Labour
Population Enumeration
Discharge
Laboratory Investigations
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