288 Chapter 11 NURSE-MANAGED MATERNAL CARE IN THE COMMUNITY Maria Brigette T. Lao-Nario INTRODUCTION The role of nurses and mid,.,,;ves is twofold-to help create positive situations and opportunities for women exp<?riencing pregnancy, birtlting and the postnatal period. The other role is lo pro,ridc care based on available evidence that becomes the basis for clinical judgment and interventions. Republic Act No. 9173, an act provi<'lin g fa,; a more responsive nursing profession, states thatthe practice of ursi J1g includes but not limited to unursi11g care dudng conception, labor, deliuery, infoncy... As independent nurse pr-actitioner·s, nurses are primarily responsible for the promotion of health, prevention of illness". (1) This law sets the basis for nursing practice on materna l care. The government bas set goals for the he. ilth sector which are intended to help attain better health outcomes, a more responsive health system and a more equitable health financing. The goals pertainjng to mothers and the newborn are listed below together with b:iseline indicators from the 2003 National Health Demograph ic Survey (2,3): 1. Maternal mortality is reduced from 172/100,00 LB to 90/100,ooo LB 2. Perinatal mortality is i:educed from 2-4 perinatal deatbs/1.,ooo LB to 18 perinat11l dcaths/1,ooo LB 3. Low birth weigh I infants are ceduced from 12~ to 10% 4. Risk factors assm:i Mcd with maternal morbidity and mortalit y are reduced through accomplishing the fol lo1,11ing: 4. 1 the prevalence rate of iron deficiency anemia among the pregnant is reduced from 43. 9% to :J8% 4. 2 Total contraceptive prevalence is inct·eased from 48. 9% to 80% 4. 3 Modem natural and artilficial prevalence is increased from 33. 4% to 60% 4. 4 Percentage or deliveries assisted by skilled birth attendants in a health care facility is increased from 53. 9% to 70% 4. 5 Percentage or postpartum visit within the 1st week of delivery is increased from 51% to 80% 5. Neonatnl mortality is reduced to 10 deaths/1,ooo LB fron1 t7 deatl1s /1,ooo Lll 6. Neonatal tetanus is reduced to less than one case/ 1,000 LB from 0. 07/1,000 LB Special attention is net!Cled oo the nutritional state of women. The woman 's state of nutrition before and during pregnancy is vital for a good pregnancy outcome. For example, maternal undernutrition is common in some parts of Asia whei:e more 