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Question 26: How should the services and modalities of PNC be adjusted?
As per requirements to curb the spread of COVlD-19,the modalities and services of PNC shall be adjusted accordingly.
(1) lnformation referral: Delivery facilities should refer the information of discharged mothers to the community or township where they reside, and MCH workers or village doctors in the jurisdiction should be updated on the information of the mothers in a timely manner.
(2) Timing and frequency of PNC: PNC should be delivered to new mothers within 7 days and on the 28th day after childbirth. According to the requirements of essential public health services, PNC visits should be made by township health facilities, village clinics or community health service centers, with the number of visits increased for mothers with severe comorbidities or complications.
(3) Modalities of PNC visits: The PNC modalities may be determined based on the local context. For low-risk mothers, PNC may be delivered remotely via telephone,WeChat, video, etc. For mothers of high-risk pregnancy,at least one home visit should be made available.
(4) PNC package: On top of the routine tasks, PNC should be provided with a focus on understanding COVlD-19 related issues and providing targeted guidance,which mainly includes:
1) Understanding general conditions, the status of the delivery and recovery, uterine involution and breastfeeding as well as mental health assessment of new mothers.
2) lnvestigation of COVlD-19 related symptoms, such as cough, fever, fatigue, or nasal congestion, runny nose,sore throat, myalgia and diarrhea.
3) Guidance on the home-based maternal care and precautions; guidance on breastfeeding and care for infants and young children; identification of risk factors during puerperium, and guidance on seeking medical attention for new mothers and their families when necessary.
(5) Every effort should be made to ensure effective COVlD-19 related management and follow-up visits while delivering PNC for pregnant women discharged from delivery hospitals, with reference to relevant protocols,and to urge them to attend follow-up visits in the second and fourth weeks after discharge.