NONursing Officer HubGandaki Province · Level 7
Paper II · Unit 8 · 10%

Domiciliary Midwifery Services

Complete step-by-step revision notes with examiner-focused MCQs and likely subjective questions.

How to use

Read the concept, reproduce the steps from memory, then answer the possible questions.

Revision target

Complete one topic, ten MCQs and one written answer before marking it revised.

Topic 1

Birth preparedness and complication readiness

Core meaning: Birth preparedness anticipates routine birth and emergencies.

Step-by-step learning

Choose skilled provider and place

Prefer safe skilled care.

Plan transport and money

Include emergency route.

Identify blood donor/support

Where relevant.

Teach danger signs

Pregnancy, labour, postpartum and newborn.

Document and follow up

Update plan during ANC.

Key points to remember

  • Preparedness reduces first and second delays.
  • Home delivery should not be promoted when safer skilled facility care is accessible.
Possible MCQs
  • Which items belong in a birth-preparedness plan?
Possible subjective questions
  • Explain birth preparedness and complication readiness.
Topic 2

Basic emergency obstetric care

Core meaning: Emergency obstetric care addresses major causes of maternal and newborn death.

Step-by-step learning

Recognise emergency

Bleeding, hypertension, sepsis, obstruction and severe illness.

Stabilise ABC

Resuscitation and monitoring.

Give indicated first-line care

Within scope and protocol.

Refer rapidly

Communicate and accompany as needed.

Continue monitoring

Document all actions.

Key points to remember

  • Do not delay referral for complete diagnosis when danger is clear.
  • Use current BEmONC signal-function guidance.
Possible MCQs
  • What is the first action in obstetric emergency?
Possible subjective questions
  • Discuss components and referral role in basic emergency obstetric care.
Topic 3

Clean delivery, postnatal and post-abortion care

Core meaning: Safe care prevents infection, haemorrhage and delayed complications.

Step-by-step learning

Clean practices

Hands, surface, cord and instruments.

Assess mother and newborn

Bleeding, vital signs, feeding and danger signs.

Support breastfeeding and warmth

Early essential care.

Post-abortion care

Treat complications, counsel and offer voluntary contraception.

Refer and follow

For danger signs or incomplete recovery.

Key points to remember

  • Respectful, confidential and nonjudgmental care is essential.
  • Postnatal danger signs need urgent referral.
Possible MCQs
  • What are clean-delivery principles?
Possible subjective questions
  • Describe postnatal care and post-abortion care.
Topic 4

Supervision and roles of community health personnel

Core meaning: Domiciliary services require clear roles, supervision, referral and teamwork.

Step-by-step learning

Clarify scope

Nursing officer, public-health nurse, staff nurse, ANM/AHW and community workers.

Delegate safely

Match competence and policy.

Supervise supportively

Observe, coach and correct.

Coordinate referral

Facility and emergency contacts.

Review records

Coverage, quality and outcomes.

Key points to remember

  • Some older role titles in the syllabus may have changed; learn current equivalents.
  • Accountability remains with appropriate supervisory level.
Possible MCQs
  • What is supportive supervision?
Possible subjective questions
  • Explain roles of a Community Nursing Officer and frontline workers in domiciliary midwifery.