200. Midwives in private practice attended 41.4% of all births, the great majority of these taking place in small maternity homes of from two to six beds. The Supervisor of Midwives, a Government Senior Medical and Health Officer, is responsible for the regular inspections of such homes and for the general supervision of the work of the midwives; in this task, she is assisted by a qualified Health Visitor. The work under- taken in 1963 by the private midwives is outlined in Table 25.
TABLE 23
PRIVATE MIDWIFERY SERVICE 1963
Number of midwives in active practice
Number of registered maternity home
Number of beds
--+
-
0-2 years and for toddlers aged 2-5 years. Close liaison is maintained between maternity hospitals and the Maternal and Child Health Service to ensure the after-care of infants requiring special attention. The work performed during 1963, as compared with that of 1962, is detailed in Table 26.
TABLE 26
MATERNAL AND CHILD HEALTH SERVICE 1962-63
7563
1963
No. of full time centres
9
12
J
196
No. of subsidiary centres
21
21
109
No. of ante-natal sessions each year
2,195
2,413
SIO
New ante-natal attendances
23,203
25,897
44.187
Total ante-natal attendances
98.245
111.324
-་་
Number of post-natal sessions cach year.
931
914
New post-natal attendances
5,023
5,233
Total post-naral altendances
ILL
6,560
6,987
Number of infant welfare and toddler sessions
each year
5,103
5.268
44,348
73,920
417.760
632,328
9,989
13,194
69,774
92,358
83.231
89,616
Maternity home deliveries
Domiciliary deliveries
Total deliveries
1,595 45.722
201. All midwives are trained to perform vaccinations against smallpox and to administer B.C.G. to new-bom infants. It is due to the efforts. of these midwives, both Government and private, that 83.44% of all children born in 1963 received B.C.G. protection, a measure which has resulted in a dramatic fall in child mortality from tuberculosis. In addition, refresher courses are held at the Tsan Yuk Hospital for midwives in private practice.
MATERNAL AND CHILD HEALTH SERVICE
202. In this most important and popular aspect of the work of Depart- ment, which is maintained on a well-baby' clinic basis, the emphasis is on health education and the prevention of disease. All facilities are provided without charge, and, once discase is detected and unless the ailment is minor, the child concerned is referred to the appropriate branch of the curative service for investigation and any necessary treat- ment. When cured, the patient is encouraged to return to the relevant Maternal and Child Health Clinic. Health Education programmes for groups of mothers in the clinics and of individuals during home visits are permanent and continuing activities of the Health Visitors. In the clinics, all forms of group health education are available such as simple talks, film and puppet shows and flannelgraph illustrations; practical demonstrations and group discussions are also widely used, the choice of medium depending on the subject and on the audience.
203. Clinics are held in both full-time and part-time centres and there are sessions for ante-natal and post-natal cases, for infants aged
46
New infant welfare attendances Total infant welfare attendances New toddler welfare attendances Total toddler attendances Total home visits
204. Two full-time centres were opened during the year-the Robert Black Health Centre in August, 1963, and the Li Po Chun Health Centre in March, 1964. Following the opening of the former centre, the twice- weekly infant clinics, previously held in the nearby Wong Tai Sin Resettle- ment Estate, were discontinued. Two subsidiary centres were opened, one at the Li Cheng Uk Resettlement Estate in September, 1963 and the other in the Kam Tin Health Centre in January, 1964. The total attend- ances at the clinics for infants and toddlers increased by 29.6% and new attendances by 16.6%. Only 0.13% of those attending for the first time showed any abnormality.
205. Immunization against diphtheria, whooping-cough and telanus is given as a routine, using triple vaccine. Smallpox vaccination is given where necessary and children not known to have received B.C.G, who are tuberculin positive but without signs of active disease are given prophylactic L.N.A.H. for a period of one year.
206. The Colony-wide average attendance at each ante-natal session was 46, as against 44 in 1962, and the average number of attendances by each expectant mother was four. Post-natal sessions are the least
47
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