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Table 2 Proposed signal functions for PNC with essential content and components to be assessed and outline of required equipment drugs and consumables

From: Essential components of postnatal care – a systematic literature review and development of signal functions to guide monitoring and evaluation

Signal Function Components Essential equipment, drugs and consumablesa
1.Screening for (pre-)Eclampsia Measure BP BP machine and stethoscope
Test urine for proteinuria Urine dip-stix, urine containers
2.Prevention and management of Anaemia in the mother Measure Haemoglobin (Hb) HemoCue® machine and cuvettes, or laboratory measurement of HB e.g. Coulter counter
Provide ferrous sulphate with folic acid
Nutritional advice
Ferrous sulphate tablets (preferably combined with folic acid)
3.Prevention and management of Malaria in mother and baby Provide bed nets Bed nets (preferably insecticide-treated)
Test for malaria in case of fever and provide treatment for malaria positive women and babies Thermometer
Malaria rapid test, or, malaria microscopy done in lab
Drugs for treatment of malaria.b including; artemisinin-based combination therapy (ACT) or artesunate inj or Arthemeter inj for treatment (or as specified in national guidelines)
4.Prevention and management of HIV in mother and baby Test for HIV HIV rapid diagnostic test (RDT) (single or combined with syphilis RDT) and/or laboratory
Provide Prevention of Mother to Child Transmission Care (PMTC)
Provide anti-retroviral drugs (ARV) for mother and baby
Drugsb for treatment of HIV positive women and babies pregnancy and prevention of maternal to child transmission (PMTCT)
5.Prevention and management of Tuberculosis (TB) in mother and baby Test for TB (sputum Ziehl–Neelsen stain or Gen expert point of care testing) Sputum pots, Lab for sputum Ziehl–Neelsen staining
or Gen expert point-of-care testing
First line TB drugs (preferred) Drugsb for treatment of tuberculosis (TB) in women and children
BCG vaccination for newborn BCG vaccination
6.Screening and counselling for mental health and domestic violence in the mother Screening tools
Counselling services
EPDS, WHO or other self-reporting questionnaire or other tool for mental health screening
Screening tool for domestic violence/intimate partner violence
Referral pathway for counselling and support
7.Assessment of growth and development of the baby Assess growth—weight and length Weighing scale, length measurement table
Care of the low-birth weight baby Provide Kangaroo Mother Care (KMC)
Examination of the new-born baby for congenital abnormalities Consultation area including for examination and environment facilitating respectful personalised care
8. Cord Care in the baby Inspection and protection of cord Chloorhexidine (4%) applied to the cord in areas of high neonatal mortality (≥ 30 per 1000)
9. Vaccination of the baby Including e.g. Polio, Hepatitis B and BCG at birth and Polio, Rotavirus, Pentavelant at 6 weeks ( subsequent vaccinations at 8, 12 and 16 weeks including Measles Diptheria, Tetanus, Whooping cough) Vaccins (BCG, Polio-drops, Hepatitis B)
BCG and Hepatitis B in areas of high incidence or high risk populations or as per national protocol
10. Clinical examination of the mother Examination of fundal height and check for lochia
Check perineum and any wounds (e.g. Caesarean Section scar)
Examination of the legs to check for Deep Vein Thrombosis (DVT)
Examination area with couch b
Antibiotics
11. Counselling for and support to exclusive breastfeeding of the baby Consultation
Examination of the breasts
Consultation area including for examination and environment facilitating respectful personalised care
12. Offer contraception/family planning Consultation IUD, progesterone only pill, Depo Provera, condoms
IUD insertion kit
13. Health promotion and advice for the mother Advise on perineal care, bladder care, pelvic exercises, resumption of sexual activity Consultation area including environment facilitating respectful personalised care
14. Debriefing following birth for the mother and counselling for danger signs in mother and baby Consultation Consultation area including environment facilitating respectful personalised care
  1. aAssumes availability of essential consumables such as non-sterile gloves, needles, syringes or capillary tubes, skin swabs, tourniquet and cotton wool.
  2. bAll drugs as per national protocol – can vary and needs to be specified for each country.