Midwife-led Initiatives: Midwife Clinic (CCDS), Princess Margaret Hospital, Hong Kong Background Positive development of a child is highly associated with the health of a pregnant woman and the background of the family. Comprehensive Child Development Service (CCDS) programme was implemented in Hong Kong in 2005. The programme is aimed at improving the health of children and families through integrated services in the community including those provided by the Department of Health, the Hospital Authority, the Social Welfare Department, the Educational Council and non-government organizations. It includes early identification and referral of those in need so as to provide better care and health outcomes and a positive life course for children and families. Midwife Clinic The Midwife Clinic was established by the CCDS in Princess Margaret Hospital, Hong Kong in May 2006. Midwives plays a significant role in the CCDS programme. Three groups of pregnant women are targeted: teenagers, women with mental health problems, and those with substance abuse problems. Midwives act as independent practitioners providing comprehensive assessment, health counseling and making appropriate referral to required social services for the women as needed throughout their childbearing period. A case conference is held weekly with a paediatrician and social worker to discuss the management plan. This will help women to understand the impact of adverse health-related behaviours on their own health and on the development of their babies. When the mother and babies are discharged home, midwives will make telephone counseling to ensure they have access to the required social services. Evaluation By 2010, CCDS midwives had recruited 262 women to the programme (58.4 percent with mental health problems, 21.4 percent with substance abuse problems and 11.5 percent teenage pregnancy). Twenty-one percent required social worker referral for financial support. Women with mental health problems were followed up by a psychiatric nurse. For the birth outcomes, 89 percent of women were term gestation, 58 percent had a normal delivery, 14 percent had an instrumental delivery, and 28 percent had a caesarean delivery. Thirty-nine percent of the babies required neonatal admission, and six babies required foster care. Some of the mothers reflected that midwives helped them to improve their relationships with family members and their adverse lifestyle habits. Many said they are more positive and confident in their parenting role. Prepared by: Sylvia Fung, ICM Prepared as a background document for The State of the World’s Midwifery 2011 - launched June 2011 Disclaimer: While all efforts have been made to verify the information in this document, responsibility for the contents and presentation rest with the author(s). The views and opinions expressed in the document do not necessarily correspond with those of the State of the World’s Midwifery 2011 Editorial Committee.
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