There are 18 easily accessible health centres scattered in various catchments areas delivering primary health care for families. MCH package is one of the important units in each health center and considered as the backbone of preventive services, activities are carried out by teams of 3 - 9 family physicians, or general practitioners, 1-3 community health nurses, 1-3 MCH practical nurses, one midwife and one MCH supervisor (trained family physician).

Services include:-

Child Screening (0 - 6 years):
Developmental assessment of apparently health children to detect developmental delay is now regarded as an important function for the primary child care services in Bahrain. The objective is to identify children for whom warrant further investigations.

Early recognition of developmental delay is important in order to treat what is treatable, prevent or minimize secondary handicaps, recognize a child's strength as well as weakness, and to help parents to understand their child's problems so that they will be able to follow a continuity plan of care and management.

Child developmental screening of the newborns has started in all of the health centers since 1986 where every baby is followed up at the ages of 2mos, 4mos, 6 mos, 9mos, 1 year, 18 mos, 1 year, 2 years, 3 years and 6 years by their family doctors and community health nurses.

The screening is well integrated within the routine health center services, where the family doctor examines and screens the child in his own consultation room using the least equipments required.

There is a very good registration system where defaulters of screening and immunizations could be easily detected on daily basis. Children at risk have a special registration and a closer follow up.

Home visits are done by MCH and community health nurses using special cars provided by the Ministry of Health, one in each health center.

Immunizations (EPI):-
Immunization is one of the important services in primary health care, coverage rate for initial vaccinations is as high as 98% for DPT and polio, 100% for measles and 95% for hepatitis B.

Antenatal, postnatal and family planning services:-
These services are provided in all of the health centers, fully integrated within the primary health care services. Activities are carried out by teams of family doctors, community health nurses, MCH nurses, midwives and clerks.

Appointment system has been introduced successfully, patients at higher risk are referred to the hospital to be seen by the specialists there. A guideline for maternity care has been issued and periodically updated to be used by all of the staff involved.

Attendance rate for pregnant women is as high as 99%, while the rate for PN/FP is 54%.

Contraceptive pills & Intrauterine devices are provided free of charge.

Women screening services:-
This is a screening program of women for cancer Breast & Cervix, identified risk groups are referred for further investigation (e.g colposcepy, mammography …..etc.) at the hospital, such a service is provided in all of the health centers since December 1992.

Premarital counseling service:-
This service is available in all of the health centers (Since Jan. 1993) as part of general preventive care.

The idea of such counseling is identification and reduction of reproduction & genetic risks, based on screening, risk assessment, health promotion, and intervention programs, with a very special emphasis on haemoglobinopathies. High risk couples are referred to the genetic department at the hospital.

MCH supervisory system:-
A group of MCH supervisors has been established, one in each health center. Their role is:-

• Day to day supervision of MCH services in their health center.
• Training of doctors and nurses in their health center.
• Regular meetings.
• Discussing and re-evaluating referred cases of child screening to secondary care.
• Reporting to the Regional Medical Officers & MCH Coordinator.
  

MCH Computerization:-
All of the MCH sections in health centers have been enquired by computers to help Improving Information system, this includes mother & child registration, appointments, health & social risk factors.

Protocols & Guidelines:-
Protocols & guidelines have been developed for each service which is used by the staff to provide a high quality service to the community.

Role of other agencies:-
The Ministry of labour and social affairs offers several programs for the development of women & children such as the productive units in which women are involved in learning crafts for example, sewing.

The various social development projects are implemented through the network of 7 social centers which are located through out the major regions of Bahrain.

The social centers provide community services such as nurseries for preschool children.

The general organization for youth & sport has a special child section which is involved in planning for children by the year of 2000 through the coordinating committee with members from all of the relevant governmental and non governmental organizations.

They have established a number of child development centers, child science center, child library …etc.

There are 27 non-Governmental Agencies out of which five are women's associations & one is maternal & child care association. These are very active in reaching Bahraini women & children and meeting their needs. The main goal is to develop women & children from all aspects. These associations are working closely with Ministry of Health in Bahrain especially in the area of health education programs.

The non governmental associations such as Bahrain society for child development, Bahrain medical society, Bahrain family planning association and Bahrain nursing society are involved in promoting women's & child's health and development.

The Ministry of Information has established as advisory committee on family and child programs that is multidisciplinary and multisectorial in nature. This advisory committee assesses and evaluates the various programs that are directed to the family and delivered through the radio and television. They have also established a nursery for the children of staff working in the Ministry.