Safe Motherhood Initiatives & Maternal Mortality Audits — MDC LICENSE Viva & Clinical Scenarios (Maternal and Child Health Programmes)

Exam-style safe motherhood initiatives & maternal mortality audits viva scenarios with examiner probes and model answers for Community Health and Public Health…

Scenarios covered

• SCENARIO 1: A 24-year-old Primigravida at 38 weeks gestation is brought to a district hospital in an unconscious state following three episodes of generalized tonic-clonic seizures at a primary health center located 45 kilometers away. The referral note indicates she presented with a blood pressure of 170/110 mmHg and 3+ proteinuria but received no medication prior to transfer due to lack of supplies. The patient dies two hours after arrival due to intracranial hemorrhage. As the District Director of Health Services and Lead Medical Officer, outline the systematic steps you will undertake to investigate,
• SCENARIO 2: In a rural district with an estimated population of 120,000 and 4,800 expected deliveries annually, the annual health sector review reveals a Maternal Mortality Ratio of 450 per 100,000 live births. Fifty-five percent of these maternal deaths are attributed to postpartum hemorrhage occurring either at home or in transit. Develop a comprehensive public health intervention plan addressing the Three Delays to reduce maternal deaths from postpartum hemorrhage in this district.
• SCENARIO 3: Differentiate clearly between Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency Obstetric and Newborn Care (CEmONC) by their signal functions. Describe the operational requirements and clinical governance structures needed to upgrade a sub-district health center to a fully functioning BEmONC facility.
• SCENARIO 4: During a maternal death audit meeting at a municipal hospital, tension arises between the midwifery staff and the attending medical officers regarding the delayed administration of blood products to a patient with ruptured uterus. As the chair of the facility MPDSR committee, describe how you would conduct this review to ensure a non-punitive, systems-focused audit that leads to sustainable clinical governance reform.