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158 still births were recorded giving a still birth rate of 11.73 per 1,000 births.

263. The average annual 'case load' for each midwife was 280, a slight rise on the previous year's figure of 267. The range of this case load is wide and varied from $3 for the midwife on Lamma Island to 773 at San Hui.

264. The frequency of ante-natal attendances continues to improve slowly. The average number of attendances per case was 3.31, but 21.32% of the mothers delivered had had no ante-natal care; this latter figure was 22.74% in 1957.

265. There are 1.439 midwives registered in the Colony but only 200 are in active private practice, 177 of these are employed in small matemity homes and 23 do domiciliary work only. Twice as many midwives practise in Kowloon as in Hong Kong.

266. Private midwives delivered 38,498 cases during the year, an average case load of 192. The number of live births was 38.199, which is over one third of all births registered in 1958. The figures for ante- natal attendances are almost identical with those recorded by Govern- ment District Midwives, the average attendances per case being 3.40%. The percentage of cases delivered without any ante-natal care was 16.94%.

267. Regular inspection and supervision of private maternity homes is carried out by the Supervisor of Midwives; 719 visits to the 129 homes on the register were made during the year. Particular attention is paid to the hygiene of the premises, to maternity equipment and to records.

268. A very encouraging increase was recorded in the number of B.C.G. vaccinations given to infants within a few days of birth. This anti-tuberculosis measure is being increasingly advocated and has been again successfully pursued this year; 45% of the babies delivered by midwives in 1958 received B.C.G, vaccination. Of the 23,257 vaccina- tions recorded, 79.52% were carried out by Government midwives and the remainder by midwives in private practice. Vaccine is provided free of charge to all medical practitioners and midwives in the Colony.

269. The vaccination of infants against smallpox also continued to be offered as a routine and 49,671 primary vaccinations were performed by midwives during 1958.

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MATERNAL AND CHILD HRAITH

270. This Service provides, for the general public, ante-natal and post-natal care and infant welfare and toddler care up to school age. The main emphasis is on preventive medicine and health education. The Service operates from 7 full-time and 21 part-time centres.

271. Existing services have been developed and expanded during the year and a new full-time centre was opened in May 1958 at the Central District Clinic; a part-time centre has also been established at the clinic on Peng Chau Island. 37 ante-natal sessions are now held weekly, as against 34 in 1957. Post-natal sessions have also been increased from 14 to 15 each week. 77 infant and child health clinic sessions are conducted each week and a total of 303,031 attendances was recorded for 1958.

272. The immunization of children against infectious disease is an important part of the preventive work of Maternal and Child Health Clinics. The majority of infants now attending these clinics have already received B.C.G. vaccine without preliminary tuberculin testing, but much time is given to seeking out and testing those who have not been vaccinated: 8,270 children were tested and 6,975 negative reactors vaccinated in 1958.

273, Immunization against diphtheria was offered throughout the year; for infants between three and six months of age. a combined vaccine against diphtheria. whooping cough and retanus is used; in later months diphtheria toxoid alone is employed, 29.926 immunizations were recorded.

274. Dietary supplements were provided to both mothers and children by means of milk powder and vitamin capsules supplied by U.N.I.C.E.F. and canned protein foods, meat and liver from C.AR.E. Other forms of milk powder, protein food and vitamins are also supplied by Government for distribution in these clinics.

275. Health education forms a major part of the work of this service, particularly by means of home visits by Health Visitors. The increased staff of Health Visitors made it possible to extend this service.

276. Liaison and co-operation with the Registrar of Births and Deaths has resulted in the notification to the Maternal and Child Health Staff of the names and addresses of all new births registered; as a result, 37,846 visits were made to individual homes in 1958.

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