BASIC FIRST AID COURSE - HOW TO COPE WITH DIARRHOEA · Community Health

BASIC FIRST AID COURSE - HOW TO COPE WITH DIARRHOEA

Item

Title: BASIC FIRST AID COURSE - HOW TO COPE WITH DIARRHOEA
extracted text: Ch 3-»9t

PROJECT PROPOSAL ANNEX 15

J

SDA-RF-CH-3.4.pdf

BASIC FIRST AID COURSE - HOW TO COPE WITH DIARRHOEA

Time:

4 hours

Reference material: * Learn More About Diarrhoea
* Learn More About Breast-feeding/Weaning
* Comic - The Story of Ts’epo
* Summary - First Aid in Diarrhoea Treatment
Before the course the trainer should prepare:
* Reference material
* Water, sugar and salt, ORS package, pots
for mixing solution
* Baby for demonstration
* Participants for role-play
After the course the participants should know:
* First Aid in Diarrhoea Treatment
* How to mix oral rehydration solution
* When to seek medical attention
# How to discuss diarrhoea treatment and
prevention at home visits
Pirtle.‘.-jftDvs personal task after the course:
* To visit 10 neighbouring families and

talk about diarrhoea

BASIC FIRST AID COURSE - HOW TO COPE WITH DIARRHOEA
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

Approx.
Lecture
Time

i
i
i
i
i
i
i
i
i
i

Content

| 1. What is
0.15 I diarrhoea?
_______ i

i
i
i
i

0.45 II
_______ I

I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I

2. FIRST AID
in Diarrhoea
Treatment

3. Signs of
Dehydration/
Dryness

I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I

Lesson Objectives

* More than 3 loose stools

per 24 hours
* Diarrhoea is DANGEROUS
Increase fluids

# Continue breast-feeding
* Continue feeding

* Watch for dehydration
* Watch for DANGER signs
# Sunken eyes/fontanelle
# Skin pinch
* Weakness
* Dry mouth/thirst
* Lack of urine/tears

I 4. How to treat | * Mix sugar/salt solution
1 1 water
0.60 | Diarrhoea at home |
I
i
8 tsp. sugar
I
i
I
i
1 tsp. salt
I
i
I
i
or local recipe
I
i
I
i *
Mix ORS
I
i
i
I
Instructions on
I
i
I
i
package
I
i
I
i * 1/2-1 cup for each watery
i
I
I
i
stool
I
i
_______ I

I
I

5.

I
I
I
I
I
I
I
I
I
I

rous?
DANGER signs

Why is

0.15 i Diarrhoea dange

i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

Know when to seek medical
attention
Dehydration
* Severe diarrhoea
* Severe vomiting
* Fever
* Bloody stools

i
i
i
i
i
i
i
i
i
.i
i
i

Method

| Lecture

i
i
i
.i
i
i

] Lecture/
| Discussion

i
i
i
i
i
,i
i
i
i
i
i
i

Ii

i
i
,i
i
i
i
i

Lecture/
Discussion/
Demonstra
tion

| Demonstra| tion

i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

| Discussion
i
i
i
i
i
i
i
i
i
i

TIME:

i
i

| Class Activit
i
i
i
i
i
i
i
i

I

i
i
i
i
i
i

I

i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

Bring baby t
class for
demonstratio

| Mix solution,
| Taste!

i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I

__________ I

I

6. How can
0.15 ; diarrhoea be
I
I prevented

__________ I

I

I
I
I
I
I
I
I

7. Summary
0.30 I FIRST AID in
I
I diarrhoea
I
I treatment

_________ I

I

I
I
I
1
I
I
I
I
I
I
I

I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I

* Breast-feeding
* Clean weaning foods
* Hand- washing
* Safe disposal of stools
* Clean water for drinking
* Measles immunization

* Revise
* Remember important points

i
i
i
i

| Discussion
i
i
i
i
i
i
i
i
i
i
i
i

[ Role play
I song

i
i
i
i
i
i
i
i
i
i
i
i
i
i

i
i—
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

First Aide

Chose actors:
* mother
* father
* baby with
diarrhoea
* old lady
with
trad.views
* First Aide

PROMOTION OF IMMUNIZATION

Time:

2 hours

Reference material:

* Learn More About Immunization
* Comic - Why Immunization?
* True and False

Before the course the trainer needs to prepare:
* Reference material
* Immunization schedule used in the community
* Immunization cards from some families and
also some blank cards
* Find out when and where immunization is
available in the community

After the course the participants should know:
* The names of the 6 vaccine-preventable diseases
* The importance of full immunization
* The immunization schedule and the card so
they can detect if children and pregnant
women are not fully immunized
* When and where immunization is available in
the community

Participants’s personal task after the course:
* To visit 10 neighbouring families, check
immunization cards and find out if children
and women are fully immunized. If not, tell
when and where immunization is available and
encourage parents to take the children for
immunization.

TIME:

BASIC FIRST AID COURSE - IMMUNIZATION
i
i
t
i
i
i
i
i
i
i_
i
i
i
i
i
i
i
i.
i
i
i
i
i
i
i
i
i
i
i
i
i
i.
i
i
i
i
i
i
i
i
i
i
i
i.
i
i
i
i
i
i
i
i
i
i
i
i
i
i,
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

Approx.

Lecture
Time

i
i
i
i
i
i
i
i
i
i

Content

I 1. Immunization
0.15 ! in the community
i
i
i
i

' 2. Vaccine0.30 | Preventable'i Diseases
1
1
1
1
1
1
1

0.45

i
i
i
i
i
i
i
i
i

Lesson Objectives

' * When?
| * Where?
i
i
i
i

| To know the names and signs:
| * Tetanus
' * Whooping cough (Pertussis)
[ * Measles
| * Tuberculosis
I * Poliomyelitis

1
1
i
1
1
1
1
1________________________

i
,i
i #
i
i
i
i
i
i *
i
i
i
i
. i_______________

1
1
1
1
1
1
1
1
1
1

i
_i__________

Immunization
| Schedule

[ 4. Immunization
| Record

; 5.

0.30 | Summary

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1________________________

All children should be
fully immunized before
1 year
Women: 2 doses of
tetanus

i
i

i
i

|

i
i
i
i
i
i

Method] Class Activity |
i
i
i
i
i
i

|
| Students
| Reporting of | finding out
| students' before lesson
i
i
i
i

i
i
i
i

i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
.i
i
i

i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

| Lecture

Lecture/
Demonstra
tion

| * Be able to find children
i
who are not fully immunized | Exercice
i
i
| with
by looking at record
i
i Immunization
i
i
i
i
i
i cards from
i
i
i
i community
i
| * Revise
i * Remember important points
i
i * Promote Immunization in
i
i
the community
i
i

i

i
i
i
i
i
i
i
i
i
i
i.
i

2 hs

i
i
i
i

| Role Play
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i
i

'

__________________

Chose actors
* mother at
home
* women nega
tive to immu
nization
* First Aider
promoting
Immunization

•

19161986

UNITED NATIONS CHILDREN'S FUND

40 Years for Children

REGIONAL OFFICE FOR SOUTH CENTRAL ASIA

unicef @

UNICEF HOUSE, 73, LODI ESTATE
NEW DELHI-110003 INDIA
TELEPHONE : 690401
CABLE ADDRESS : UNICEF NEW DELHI
TELEX : 3161464 (UNCF-IN)

United Natrons Children’s Fund

HS/6. LM41

New Delhi, 25 April 1988

Dear Friend:

SUB: Your General Body Meeting & Action
for Proper Diarrhoea Management.
Government of India/Ministry of Health & Family Welfare is
drawing up a National Diarrhoea Management Plan with
participation of UNICEF, WHO and local NGO’s. Dr Mira Shiva is
among the small team of people who are preparing this draft.
The following proposals contain some guiding principles for the
Plan:
I.

Diarrhoea is a "Non-governmental concern, a peoples
concern" — major response must be to mobilize private
response:

- household self care
- practitioners
-ORT producers, retailers
II.

Our ’’emphasis is on ORT" — it must be promoted for all
cases seeking therapy as The Best Treatment for all cases

- only then can we drive out other therapy
- public wants a "product" — if we don’t give ORT
they will get something we don’t want —
antidiarrhoeals, etc
- alternatives can be explained/offered (SSS etc)
- product must be standardized (within limits).
III.

MANAGEMENT is a key ingredient
- policy precise and clear
- adequacy of staff — desirability of contracted,
time-limited tasks: "package" entire portions of
the programme as units to be contracted
- clear authority to act, responsibility delegated —
to staff, to contractors, to periphery
- clear job description, tasks, targets each level of
the system
- resources available and timely release of funds.

IV.

Diarrhoea Disease Control is predominantly a MATTER OF
BEHAVIOUR — The predominant strategy is to reinforce
proper and effective behaviour (use of fluids, food, use
of ORT) by providers and clients alike. Therefore:
- All personnel must be actively involved in using
ORT — knowledge levels are already high but use is
low. More lectures or printed matter will not do
— trainees must experience ORT and provide
experience to others. Training must be active —
orientation alone will not suffice.

UNICEF

-2- Communication through all channels will reinforce and
make credible the messages from health personnel.
Everyone must be hearing the same messages fro...
everywhere at the same time: Radio, schools, chemists
as well as from health personnel.

V.

Diarrhoea Disease Control depends upon SIMULTANEOUS action
— training, media, social action, marketing — Unlike EPI,
cannot be phased into a given population.
— Cut across all levels at once — Research, private
industry, medical colleges, indigenous healers, mass
media, marketing, communication, schools.
- Integration and use of all resources at once to
iclude :

• Technology Missions — Immunization, Literacy,
Water, Communications
• Government — Health, Social Welfare,
Education, Public Industry, Agencies and
Institutions

• Private Sector — Professional Organization,
NGOs, Pharmaceutical industry, Market networks,
Advertising, Service Organizations
- Therefore, need to coordinate all activities in a
given area — say a state or region of the country.
We would like to incorporate into this plan the full
measure of voluntary health sectors capability, commitment and
readiness for action with regard to the biggest infant killer.
May we request you to kindly think, discuss and communicate
what the voluntary health sector, in your opinion, can do both
individually and collectively to broaden implementation? Please
also look at the following questions:

1)

Can we launch a country-wide training programme for our
hospitals and dispensaries in Diarrhoea Management?
Is
it appropriate to revive the famous VHAI 6*bl formula
in this context?

2)

Can your institution set up an ORT corner within it
(for details of ORT corner please see attached note)?

3)

Can your institution take a lead in bringing together
all the other health facilities in your town, city or
district so that you can declare your town, city and
district as

a dehydration free zone?

How many mothers can you reach with the home-based
diarrhoea management messages in the next two years?
5)

6)

A nationwide study has shown the incalculable harm that
doctors, and those who claim to be doctors, do in
wrongly advising mothers on various issues related to
Diarrhoea Management.
What kind of an educational or
contact programme would you like to do to counter this?
The same study has also shown the enormous potential of
school teachers in educating mothers. Will you be aDLe
to mobilize various educators within your area on this
topic if you were given material to use in schools?

7)

Would you be able to influence the religious, political
and social leaders in your area to speak up on behalf
of the vast number of children who could die of
diarrhoea? Would any religion or group-specific
communication material help?

8)

Will you be able to organize communication activities
for local melas and festivals on saving the lives of
infants and young children? If so, how many such
events will take place in your area in the next 2
years? What kind of support would you need to make
this possible?

9)

Will you be able to influence your radio station, TV
centre and editors of the largest newspapers and
periodicals circulated in your area to invest their
time and space in confronting the biggest killer of our
times — if you were given the materials?

10) As you are probably aware, the Indian Medical
Association has already launched an ORT campaign.
Would you like to work with them and supplement their
efforts? What other professional organizations can you
mobilize for this purpose?
11) What do you see as your role in retraining a vast area
of health and child development workers like ANMs,
Community Health Guides, AWWs etc that are in your
area? How many of such people would be able to retrain
actively to demonstrate ORT in the next two years?
12) Can you identify the kind of communication material you
woulJ require to engage in a Diarrhoea Management
Programme for your area — the language in which it
would be required, numbers and other specifications?
What is currently available (or will shortly be) is:

-4(i) Better Care During Diarrhoea (booklet)

— for literates and general public

(ii)

Flip Charts — for health workers

(iii) Training Modules (video)
— for doctors

(iv) Understanding & Managing Acute Diarrhoea
in infants and Young Children (booklet)
— for doctors

(v)

Communication Kit
— for opinion leaders

13) What other ideas do you have to make Diarrhoea
Management a potent communication plan and a reality in
your area?
14) What other voluntary networks can you mobilize?
15) What coverage can we tally-of, all together million?
10’s of millions or even more?
If you can spare some time answering these questions, both
individually
in
\ as well asgroups,
and return them to us
immediately, we will be most obliged. U
We will then get back to
you later with more concrete ideas on which we may be able to
work together.
Best personal regards,
Yours sincerely,

Rolf C. Carriere
Chief, Health & Nutrition
Attachment

TO ALL BIBERS OF VHAI - GENERAL BODY
- ORGANIZING SECRETARIES
- PROGRAM STAFF

J.
(i)

i.

EEgggrL-tberapy for diarrhoea is given;
( Determine by observation if possible.
)
( Please circle
Y for Yes and N for Mo)

Y

N

Al1 patients are assessed and patient register filled for each.

Y

N

All patients given fluids before being sent hone-

Y

N

All mild and moderately dehydrated cases receive ORT (not
intravenous) and recorded on case form.

Y

N

Antidiarrhoeal drugs are not given.

Y

N

Antib-otics are given only for dysentery, high fever, severe
malnutrition and cholera.

Y

N

All mothers of diarrhoea patients, even neo dehydrated cases, get
full teaching about ORT.

Y

N

Mother teaching always includes ORT preparation by mother.

Y

N

ORT flyers are used by health workers to teach mothers about ORT.

Y

N

Every mother receives an ORT flyer to take home.

Y

N

Teaching always covers the following four aspects of effective
home diarrhoea treatment:
Y

N

Correct ORT preparation

Y

N

Correct ORT administration

Y

N

Correct feeding during and after diarrhoea

Y

N

Correct seif-referra1, recognition of signs of
dehydration

Y

N

All patients are weighed, nutritional status determined and
receive a return appointment.

Y

N

Doctor and nurses frequently wash their hands with spap and water.

/

(ii)

2.

E^i±i^.gs are adeqLiateJp^
and^support^g^j3ati^_YLc„a^^

Y

N

ORT area appears specially set-up, separate from other activities-

Y

N

Furniture (ORT chairs, Egypt model, if available) adequate for
convenient ORT administration by mother.

Y

N

Places adequate for average maximum number of diarrhcea patients
□RT/diarrhoea related posters are:
Y
Y

N
N

on the wall in the ORT comer and/or room
used by the staff for teaching

Y

N

A variety of locally used containers of various sizes are
present, and are used to help mothers learn to measure water
accurately for ORT mixing.

Y

N

Paediatric weighing scales are present and working-

f

Media: SDA-RF-CH-3.4.pdf

Position: 3746 (2 views)