Building Capacities of Women's Groups on Women's Health VILLAGE LEVEL TRAINING MODULES
Item
- Title
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Building Capacities of Women's
Groups on Women's Health
VILLAGE LEVEL TRAINING MODULES - extracted text
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Building Capacities of Women's
Groups on Women's Health
Village Level Training Modules
August 99
Developed by
CHETNA, Ahmedabad
for
Ministry of Health and Family Welfare, New Delhi
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Gender and Empowerment
Village Level Training Manual
2 Hours
Learning Objectives
At the end of the session the participants will leam about:
•
•
•
the difference between sex and gender
how women’s gender roles and responsibilities affects their health and lives
how women collectively ( by organizing together) can achieve equality
Design
Time in Minutes
Topic
Method/Mf erials
40
Meaning of sex and gender
50
Gender roles and responsibilities of
women and its effect on health in a life
cycle approach
Importance of organizing women to bring
about the desired change
Sharing of experiences
and discussion_______
Activity 1
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Activity 2
J Material Required:
Activity 1 and 2 given at the back of this chapter
Note to the trainer
1
Welcome the group by saying,
4
,
.
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Dear sisters”, Even after 50 years of Independence, girls and women in India are considered
rov^rareT
’J?6
°f 3 daughter is often not celebrated, she is denied adequate
love, care nutrition and health care. The saying “ Butter for boys and buttermilk for qirls” is still
a reality Some families go to the extent of killing their daughters even before they are born
haremTfhoenCT SUCh bLalariu gender discrimination and injustice within the family not only
harms the girls/women but the entire family and the whole community.
Y
Y
Village Level Training Module: Gender and Empowerment
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communities be happy ifh'LroZtheirmembe8"011 'S haallhy? Then how '-an families and
Therefore it is necessaty to chLlenoe and chan/6
Unhappy and uSeated?
that let us understand why things are SX^heVare^5^ ,State °f
'n °rder t0 do
that I amPa Woman? Ask the partieX^X^hare^th^5
they do not want to share. Ou? Xe e
was 10 years old, I came back hnmP in fhol f
?
dark outside, due to the winter season Mv
about-'When did 1 realize
D° nOt force any°ne *
expenences such as: When I
friends' 11 was little
> Using Activity 1 discuss the effect of women's gender roles on their health and lives.
> chTnSitXto^^
Reiher collectively howwe can
Important messages for women
: LhmOb'0,09iCa' ?r p.bysical construction is called sex. They are
created by nature, and are
same in every family, community or country.
have^otlseen created by“ G«“n are C*d °e"d-- T^se differences
and boys women and men Thlp^iS dlfferences CTeates inequalities between girls
they are mXoXted
erenCeS arS n’ainly pa,riarchal'
™ans That
■>
I
differentrattitudesSbeehara* 'ensio?,s a"d “nflicts between men and
women which favour to men This results J>°mStinte .r0 as/responsibili,'ss among men and
exploitation and vio.ence aU“ S'^cSS
* gain^“ntroXZliv^
thispro“-™men
but to question these inequalities we should take together t™ke action"18 7 One'fa”women
Village Level Training Module: Gender and Empowerment
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1
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Our Role in Creating Gender equality in the society:
As a Family Member:
•
•
•
•
•
•
Celebrate daughter’s birth with joy and happiness
Household work and child caring is not only women’s work, every capable person should
share it
Include women of the family in the decision making process of the family matters
Ensure that men of the family do not beat women/girls
Your daughter has the right to marry whom she wants to marry
Ensure that no taunts are made at the girls.
t
As Men of the House:
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•
•
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Encourage girls/women to learn life useful skills.
Give care, love and education to girls as much as your son.
Share the work with women members of the family
Men and women need each other equally so share household work, child care and
decisions of the family members equally
As a Women Group Member:
•
If you come to know any girl/women harassed discriminated or violated by the
family/community support to women and try to explain to the family and community
members the importance of women members in the family.
•
Organize regular meeting with women, men and other influential members of the
community to discuss the gender aspect.
As a Panchayat Member:
•
•
•
•
Indian constitution and law gives equal rights to men and women. Know about these laws
and regulations and discuss them with both men and women
If any woman has committed suicide or has been killed due to dowry demands or any
other harassment help the parental family to file the First Information Report ( FIR)
If any girl is marrying before the age of 18 years in your village. Stop such marriages.
Create some space for women where they can talk to each other and organize them to take
necessary action against discrimination and violence.
Village Level Training Module: Gender and Empowerment
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1
Objective: To sensitize women about the discriminatory gender roles of women
Method:
AsMhe women to discuss the following, ii
> Two things which
>
>
>
wishes. 35 qUeS l0n * 6y haVe 10 dlscuss ”11at “nslraints they will face to fulfill their
"eiety^cts^er WeShh°W,heSe “pectations of the family
Activity 2:
Objectives: To understand the importance of organizing women for empowerment
Method:
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> Ask women to stand i
> ASX one womanthe circ|e
> A°; ^er the mside participant as a goat and outside one as a tiger
>
“^XthX ^t&r,he peopie hoidin9 *he hands
' Sd1 as XCr“t 90at'
>
°ther ambers of the group are asked to come
In this way, the game can be repeated for 2-3 times.
Questions to be asked:
To the tiger:
>
>
>
What efforts did he make to catch the goat?
What was hfe feeling when he caught the goat?
What was hts feeling when he failed to catch the goat?
Village Level Training Module: Gender and Empowerment
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To the goat:
> What efforts did she make to save herself?
> What was her feeling when tiger caught her?
> What was her feeling when tiger failed to catch her?
To the women of the circle:
> What efforts did they make to save the goat?
> If they were not able to save the goat, what were the reasons'?
> If they saved the goat, what strategy did they use?
Sum up the discussion by explaining the importance of organizing women. Women are like
goats who lack power and strength and tiger is a like man who has power and strength.
Relate to the participants standing on the circle as a women’s group. You may use ask the
following questions to lead the discussion:
>
How we can built stronger organization of women, to gain
more power and strength and to
gain more control over own lives and health?
> What should be the role of each woman to make organizations stronger?
> What. actMt'es should be undertaken by this organization to make our lives and health
P©UQi f
Village Level Training Module: Gender and Empowerment
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Af
NUTRITION AND WOMEN'S HEALTH
Village Level Training Module
2 hours.
Learning Objectives
At the end of the session the participants will learn about:
•
•
•
•
functions of food and importance of different kinds of foods
how to preserve nutrients and increase the nutritive value of food
nutritional requirements during pregnancy and lactation
nutritional anaemia and its prevention
Design
Time in minutes
40
30
20
30
Topic__________
Functions of food and importance of
balanced diet
Preserving nutrients and increasing
nutritive value of foods__________
Nutritional requirements of women
during special conditions
Nutritional anaemia and ways to
prevent it
Method/materials
Discussion with help of
Activity 1
_______
Discussion with help of
counseling cards 1 and 2
Discussions with the help
of counseling card 3
Discussion with help of
activity 2
Material required
Photocopy counseling cards 1,2 and 3 and stick them separately on a card
board. Drawing sheets given in activity 1 in as many copies as the number of the
^^^tS'/h0Se t0° y0U may Photoc°Py and keep ready before the session.
Finally the story given in activity 2 will be necessary to discuss anaemia.
Note to the trainer
Welcome the group by saying,
’
Dear sisters, food and nutrition are very important to keep us healthy. It is
n
^SH a7t 0,UnderSland thG imPortance of different foods and its need in our
' Le 7,'un7rstand what and how to eat to keep ourselves healthy and
away from nutritional deficiencies.
Nutrition and Women’s Health
Village Level Training Module
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sk the participants what foods they consume daily and why. Introduce the
functions of different foods with help of activity 1. Emphasize the importance
fn cn an.Ced diet f°rthe entire famiiy- Spend some time in discussing how due
to social reasons like eating last, leftovers and the least women do not get a
balanced diet.
a
7'th thJ he'P °f counselin9 card 1, how to preserve nutrients of our
.A. d Jn/lte Participants t0 share ways to increase nutritional value of food
With help of counseling card 2 share the information.
With the help of counseling card 3, discuss special food requirements of the
women during pregnancy and lactation.
Discuss nutritional anaemia as a social evil with help of activity 2 and ways of
Preventmg it. Encourage participants to relate it to their personal experiences
ana plan for future action.
Important Messages for the Village Women
V Different foods, have different functions in our body, all of them should be
consumed.
* Lhfnndare^\S t0 P,LeSerVe nUtrients in the f00d as we" as ^crease nutrition
of food without spending extra money, learn to use them
❖
. Sancy*S'Son"0" dUrin°
eSpe°ia"y duri"9
❖ Nutrition status of women is directly related to their social status
, educate the
community towards improvement of social status.
❖
♦ vaf
seasor,ai and locally available foods are the best.
v Women need more iron, calcium and protein rich foods during menstruation
pregnancy and lactation. Always eat supplementary nutrition available from ’
. an9anwad| along with regular food at home during pregnancy and lactation.
v During illness eat little food in more frequently
Our Role in Providing Balanced Diet to Women
As a Family Member
♦ Do not discriminate in distribution of food between your son and daughter
* ggrl|Jy9hters are e9ual|y important. Do not wean her away from the breast
♦ Distribute household responsibility among all the family members
* food3™'^ mernders need t0 eat tcQether this will ensure equal distribution of
♦ Provide more food during pregnancy and lactation.
As Men in the Family
Nutrition and Women's Health
Village Level Training Module
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♦
amourtS for^T
enSUre lha*She is als0 eatin3 adecluale
♦
XXXfXtnTo
a
^
^
e9ual
“
°
f
f
°°
d
♦
♦
5rXioxr
when the requirement of food is more for women.
e9nancy-,actatl0n
♦ Buy and consume green leafy vegetables and seasonal fruits
♦ Develop a kitchen garden.
As a Member of Women’s Group
♦
In co-ordination with the ANM or Anganwadi worker, organise awareness
stagedShe^lSe span on'
ba'anCed
f°r WOman at diff0re"'
♦
XSi^XX
“
bZX^S
l
a
nd
0,,ha
*
oa
Thi
s
♦
or’through'oWACRA/IROP p8ZmmeaC,iVi'ieS
♦
NG°S
=
yo^S
♦
°f
and reSPMt™ ~a dePartments
En“u^9e eligible pregnant women and lactating mothers and children to
“XTeXa?c^^ fee*9 U"dar?~ “ld
As a Panchayat Member
♦
♦
♦
♦
♦
♦
and nuMo'n390 mee"n9S
edUCa'ion camps on the
related to food
™9de9poeXe™nTJenXTen 9arden’arrange ,0 9at
Allot land for village vegetable garden
Enaourage equal treatment and food distribution in your own and in homes of
Nutrition and Women’s Health
Village Level Training Module
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Activity 1 Food and its Functions
Objective
To help participants learn different functions of food arid importance of each food.
Material required
mTn^'/thTnZr^P^8/ tf]e drawin9 sheet 9iven be,ow in as mult'P|e copies as
shee^ 3 hS partopants' ai°n9 with colour pastels. You may photocopy the
Method
•
•
•
Distribute the sheet to each participant and place the colours in between.
Ask participants to colour the drawings on the sheet.
Discuss each function and foods given with each.
Discuss how can we make our daily diet more balanced
and nutritious.
Nutrition and Women's Health
Village Level Training Module
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Fill colours in the illustrations
Energy giving
All cereals and tubers, sugar, jaggery,
oil and clarified butter (ghee)
Protection from illness
All vegetables, fruits, milk and milk
products, meat, fish, poultry, and
germinated cereals and pulses
Keeping eyes healthy
Growth and development
Milk and milk products like yogurt and
butter milk, pulses, ground nuts, meat fish
and poultry
Keeping blood healthy
Green leafy vegetables, jaggery consumed
along with sour fruits and germinated
pulses
s^"ow and oran9e ,rui,s and
Nutrition and Women's Health
Village Level Training Module
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--------------- ----------, green leafy
5
counseling cord 1
How to increase the nutritive value of food
Prepare foods by mixing cereals and pulses in preparations
1. Mix Moong dal (green gram), channa dal (chick peas), udad dal (black gram) in
equal proportion and cook, you may also add green leafy vegetable to it.
2. Mix wheat, chana and bajara flours in equal proportion and make chapatis(
wheat bread).
Germinate pulses
1. Soak moong, chana and any other available whole pulses and legumes
together in equal proportions for 4 hours in water. Tie them in a wet muslin
cloth. Let it remain for 12 hours. The germ will come out. Cook them and eat
with rice or chapati.
Ferment a mixture of cereals and pulses and make local fermented items.
2. Recipe for Dhokla: Mix rice and udad (split black grams) in 2/3 and 1/3
proportions. SoaJ< them in water for 6 hours. Grind them and let it remain for 12
hours. The mixture will get fermented. Add salt and spread it on a thali (metal
plate). Steam cook.
Note. As per region give a fermented recipe. Dhokala is fermented snack very
popular in Gujarat, in South India it is Idli.
Counseling Card 2
How to preserve nutrients?
1. Those vegetables which can be eaten raw are best eaten raw after thorough
washing.
2. Wash fruits and vegetable before cutting them.
3. Do not remove a thick peel from fruits and vegetables.
4. Cover the vessel and cook on slow fire. Do not over cook.
5. Do not heat food repeatedly.
6.. Do not add baking soda to food.
7. Keep cooked food covered.
8. Do not drain extra water from rice, either keep exact proportion or use the
rice water in preparation of other vegetable or dal.
Nutrition and Women’s Health
Village Level Training Module
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Counseling Cord 3
Nutritional Requirements of Women during Pregnancy and
Lactation
Type of Food
Quantity per day
During
pregnancy
During
lactation
Cereals
35 grams
60 grams
Pulses
15 grams
30 grams
Milk
100 grams
100 grams
Fat
Sugar
10 grams
40 grams
10 grams
On an average, eat more quantity of food, whatever you eat.
Include a variety of foods in your daily diet as much as possible.
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Nutrition and Women’s Health
Village Level Training Module
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Activity 2 Kanta's Story-Anaemia a Social Illness
Objective
To sensitize the participants about the social causes of nutritional anaemia among
women and how to prevent it.
Material required
You will need a copy of this story. You may also write it down on a flip chart in biq
letters for the few literate participants.
Method
•
•
•
•
Read out the story to the participants.
Ask them if the story sounds familiar. Discuss the symptoms and causes of
nutritional anaemia, emphasizing on the social aspects.
Discuss prevention of nutritional anaemia.
Encourage women to make plans action to prevent anaemia at home and in the
communities among women and girls.
Kanta's story
This is Kanta. She gets up early in the morning and starts doing household work, like
cleaning the house, milching cows, making tea for the family members etc. She gets
tired She sits down on a floor. Shanta, Kanta's mother-in-law “Shanta, You get tired
easily. What is the matter?" Kanta: "I feel very tired." Shanta: "Even I find it difficult to
work now a days."
Kanta talks about it to her husband. He does not pay attention. He says, "This is
problem of women, what can I do?" Kanta's friend Radha comes to go to the field for
work.
Radha. What is matter Kanta? You look very tired." Radha looks at Kanta and says,
• I'
'Your eyes and face are pale, you have become very weak. Let us go to health
worker".
Jamana the health worker looks at Kanta and says ,“You have become pale. You are
anaemic.„\/\/hat do you eat?" Kanta: "I eat whatever left after feeding everyone".
Jamana: "Do you cook green vegetables?" Kanta: "I have too much work in the
house. I do not get time to clean the leafy vegetables." Jamna: "This is the reason for
your weakness. Doing too much work and eating whatever is left over." Jamna: "Milk,
pulses, green vegetables and jaggery keep the blood red. You are not eating all this.
Eat amala, guava and lemon also. I will come to your and talk to your husband and
mother-in-law".
Nutrition and Women’s Health
Village Level Training Module
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Jamana discusses about the treatment and prevention of anaemia with Kanta's
husband. She gives iron tablets to Kanta and Shanta. She askes Kanta's
husband to help her in household work, and all the members to eat together.
Kanta and Shanta have also started taking iron tablets. All the family members
eat together now, this way everyone sees to it that Kanta and Shanta also gets
vegetables. Kanta's husband and children helps in cleaning the vegetables.
Jamana the health worker along with Anganwadi worker, Kanta, Shanta and
Radha organise a village meeting to discuss about anaemia with women men
and children.
Every one participates in the meeting enthusiastically. Men also attend and were
very happy to get new information on foods and nutrition needs of children,
women, men, and old people. They wanted to be active partners in the Nutrition
Campaign.
Together they decide to grow a community kitchen garden on the village land in
co-operation with the Panchayat. Most of them also started the process of
planning a kitchen garden of their own to improve food production. The women
decided to ensure that the shop of Public Distribution System runs regularly and
gives appropriate rations to all.
Nutrition and Women’s Health
Village Level Training Module
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WOMEN’S WOQK
ueaitu
Village Level Training Module
2 hours.
Learning Objectives
At the end of the session the participants will learn about
•
»
relation between women’s work and health
various occupations leading to health problems
some useful exercises and herbal remedies to address the health problems
besign
Time in minutes
30
30
30
30
Topic_____________________
Relation between work and
women's health_____________
Health problems related to work
Some exercises to overcome health
problems due to work___________
Some herbal remedies to health
problems
Method/materials______
Discussion with help of
stories 1 and 2__________
Discussion with the help of
illustrations 1 to 4_______
Discussion with help of
chart on exercises_______
Discussion with help of
charts on herbal remedies
Material required
Copy of the stories given behind. Copy the illustrations and charts given here and stick
them on a card board.
Note to the trainer
Welcome the group by saying.
Dear sisters, as we know women’s work never ends. We work the whole day and often
our health gets affected because of that. Today we will learn how some kind of work can
lead to some special health problems and some of the ways to overcome it."
•
Ask the participants to list down the number of tasks they do daily. Ask them about
the repetitive work that they have to do and if that leads to any special aches or
pains. Note down the responses. With help of stories 1 and 2 introduce the effect of
Women’s Work and Health
Village Level Training Module
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work on women’s health. Discuss specific problems with help of illustrations 1 to 4
tncourage sharing of experiences related to problems.
With help of charts, inform them about useful exercises. If possible demonstrate
some of the exercises. Invite participants to join you. Ask information about local
exercises it any.
Hrf|USS S?me °f
herbal remedies 9'ven in charts on remedies. Invite sharinq of
local practices and remedies.
y
orwomenwoVkers" reSP0nS'b'lity 33 a member of different 9rouPs 'n improving health
Important Messages for the Village Women
❖ Women suffer from special health problems due to workinq conditions Adopt
•
correct postures while working.
’
H
❖ for SZ and Xt
y^uS"9 SeXUa"y
SPeC'a"y
❖ Exercise regularly.
Linkages Between Work and Health
Overwork>
Inside home
Outside home
Child bearing
Child care y
f Undemutrition’
'Eating last and least
No control over food
X
Food taboos.
4
Having a male child is considered essential
V
Low socio-economic status
0
and price rise
Religious beliefs
Women's Work and Health
Village Level Training Module
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Our role in improving the health of women workers
As a Family Member
•
•
•
Some of the health complaints about your family member could be work related.
Which may be household work or work outside home. Learn about the effects of
work on health. Consult a doctor and inform her/ him of the occupation before the
illness becomes serious.
Learn about the rules of the workplace. Unite to demand basic facilities like safety
equipmenL equal working hours and wages, creche services.
Encourage women to talk about sexual exploitation at the work place. Solicit support
from women’s group and Sarpanch.
As Men of the House
•
•
Women are overburdened with work. Share household work with her.
Do not ignore the health complaints of the woman or girls, encourage them to share
them and accompany them for treatmenL
As a Women’s Groups Member
•
•
•
•
Discuss the health problems of your group members and try to link your work and
health.
‘ Try to address work related issues of your group members.
Try to improve technical skills of your group members. You can contact local NGOs
or Govt, programs to train your members in different training courses.
Act as a pressure group to demand better facilities and wages for the group
members.
As a Panchayat AVember
•
•
•
Ensure that work places in your villages are women friendly. Adopt adequate safety
measures and provide opportunities for development.
Ensure that working places and agencies provide equal wages and have equal
working hours for men and women workers.
Adopt strict measures against women worker’s exploitation.
Women’s Work and Health
Village Level Training Module
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Story 1 Life of Salma
| Salma is 15 years old. She lived in
I Kolipada village. She was one
among the four children born to
Sabina and Yusuf.
When Salma turned 17, her parents
married her to Mohammed who
worked in Mumbai. They lived in a
small hutment. Salma joined
Mohammed at work on this site,
where he worked to construct a 12
storied building. She used to lift
bricks, concrete, wood, iron and
other materials required on different
floors.
Within six months, she was pregnant
but had a miscarriage during the
third month. She conceived again
but she had shivering and high fever
during the second month and had a
miscarriaae aaain.
Women’s Work and Health
Village Level Training Module
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Salma is pregnant again. This time,
she was very careful. When she was
seven months pregnant, her foot
slipped while she was carrying
bricks on the sixth floor.
She broke her hand and had a
premature labour. Salma was too
weak to continue working.
Mohammed could not earn enough
to buy medicines as well as food.
After narrating this story ask the following
question
What was the reason of Salma’s ill health?
What will be the end of the story? Why?
Does any one from us have a similar story? (encouraqe women to share their
Whatne^dV!;'1 ^OtlV?e
t0 “ab°Ut 1116 reasons for their health concern)
wnat need to be done to improve women's health.
Women's Work and Health
Village Level Training Module
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Story 2 Story of Boriovi Village
Soriavi is a small village. People in
this village are aware and active.
I
Village women have formed Vikas
Mahila Mandal, which looks after
various issues of the community.
Mangy is the leader of this group.
Most women in this group were
involved in collecting tendu leaves
used for rolling beedies.
Women’s Work and Health
Village Level Training Module
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One day when they had their
monthly meeting, Champa, one of
their members appeared extremely
disturbed. Noticing this, other
members tried to include her in the
discussion, but she appeared very
upset. After some time, she shared
her worries. “ I work hard to collect
the leaves. I spend my entire day
and yet the thekedar (contractor)
gives me only 5 rupees for a
kilogram of leaves. This is too little
to meet my expenses. My mother is
ill and I have to take her to the
hospital every week arid buy her
medicines. Today he asked me to
come to his home and collect my
money. I am angry.”
“Yes, I also feel that the money is
too little compared to the work I do
and he misbehaves” said
Rukhsana. “Yes we also feel the
same way" other members also
expressed anguish.
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Women’s Work and Health
Village Level Training Module
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[Mangy realized that the entire group
I feit the need to improve the
situation. She said, “ We all fee! the
same way. What do you think can
we do?" "het us stop collectinq
leaves. The thekedar will learn a
lesson “ said Dhapubai. "No. My
husband is a good friend of the
Hawaldar. Let us ask him to thrash
the thekedar,” said Sunita. Rama
said "But we are poor we need the
money. If we do such things, the
thekedar will stop taking leaves from
us and we will loose in the long run. n
Tracy said, “the thekedar is very
powerful. He has lots of strong men,
how will we face him.” After listening
to all this, Laxmi a member of
Panchayat, suggested “why don’t we
talk to the thekedar directly and
place our demands as a group. If we
are together, he will listen. I will
represent our village Panchayat. If
he does not listen I will try to solve
the problem through Panchayat."
The members found this meaning
full and listed their demands.______
Mangy prepared a memorandum
based on this collective demand.
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Women’s Work and Health
Village Level Training Module
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They met the thekedar and after
much arguments, pursuing and
negotiations, he agreed to his
mistake and vowed not to
misbehave with any women. He also
fixed the price for the leaves at ■
Rs.15 per kilogram. They also were
able to convince the thekedar for a
joint insurance scheme to meet the
health needs of women collectors.
The women were happy.
Ask the following questions
What were the problems?
are different ways in which they tried to solve their problem?
Why did they decide to talk about their demand to the thekedar?
What would you do in such s situation? Why?
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Women’s Work and Health
Village Level Training Module
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Chart 1
Some Useful Exercises
To strengthen the respiratory system
> Pranayam is an excellent breathing exercise. Breathe out. Hold your breath till as
much time as you can. Slowly breathe in deeply. Hold your breath for as much as
you can and breathe out. Do this for at least three times in the morning or at
bedtime.
> Lie on your back, fold your knees on your chest. Hold in this position for 10-15
seconds as your breath deeply. Breathe out and gently rock your body while
bringing your knees even closer to your chest. Repeat two or three times.
> Lie on your back with your arms straight out from your sides. Bend your knees and
then move them slowly to one side. At the same time, turn your head to the opposite
side trying to keep your shoulders flat on the ground. Stay in this position as you
breathe in and out a few more times. Then raise your knees to the centre and slowly
bring them over to the other side. Turn your head the other way. Repeat this
exercise 2 times on both sides or until you feel release in your lower back.
> Lie on your back with your knees bent. Flatten your lower back on to the floor.
Slowly tighten your lower abdominal and buttock muscles and holds as you count to
3. Keep breathing as you hold and relax. Repeat two or three times.
When your work involves standing or sitting for long hours, do each
of these exercises when you feel stiff or have pain and aches
Head. Roll your head in clock-wise and then anti clockwise direction
Shoulders: Move them up and roll them in circular motions and pull your shoulder
blades together behind your back.
Waist and upper body: With your straight back, turn from the hip to face the side.
For stress end emotional problems
>
>
>
>
Meditate for about 10 minutes in the morning or at bedtime.
You may want to sit in front of an idol and chant some mantras using tulsi beads
You may want to worship and pray.
Or simply sit with folded legs, close your eyes and concentrate on your breathing.
With gradual practice, you will learn to put your thoughts and emotions away and
reach a thought free state.
> Shavasan -lying
lying like a corpse- is an excellent yoga asana to relax your whole body.
Sleep on your back with hands close to your sides and palms facing upwards. Close
your eyes and relax. Take deep breaths and concentrate on breathing. You may like
to do this just before falling asleep.
i
*
* *
«***•*••
.
Women's Work and Health
Village Level Training Module
■■m
14
01■ill i n■Il him
I
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Chart 2
A few herbal remedies
For nausea and vomiting
J
> Take a peacock feather. Separate the central blue colored semicircular part. Burn it
in a copper vessel. Take the ash with honey or water.
> Soak a teaspoonful of foeniculum (variali, saunf) in a clay vessel, through the night.
In the morning, mash the soaked foeniculum, add sugar candy as per taste and
drink it on empty stomach. Can be prepared immediately using powdered
foeniculum.
> Drink plenty of fresh buttermilk, lemon sherbet, and curds and coconut water.
For a sunstroke
> Wrap a white cotton cloth over your head and wear shoes/slippers while working in
the sun.
> Take frequent breaks and sit under the shade.
Wear cotton clothes that fully cover your body.
> Drink at least 10-12 glasses of water and also other fluids like lemon water,
buttermilk etc.
. ..
> Include onions in your meals.
Drink 1/4th cup of onion juice before getting out in the sun.
> Boil one unripe mango and squeeze its pulp. Mask it and mix it in 2 glasses of water.
Add roasted jeera powder, salt, jaggery/sugar and mint leaves according to taste.
Drink it several times during the day.
For skin infection and allergies
Wash the affected part with plenty of water. Do not use soap.
Boil Margosa (Neem) leaves in water till the water turns yellowish green (Water and
neerrHeaves taken according to the need). Use this water for bathing and washing
> Rub
I
the inner bark of neem trunk and prepare a paste. Apply paste on affected part.
> If it itches, apply coconut oil.
Women’s Work and Health
Village Level Training Module
15
For respiratory/breathing problems
<amla’ p0Wderwilh hone>' °rwater Eat them tn plenty
>
>
>
For aches and pains
> BoiNeaves of nagod (Vitex negundo). Take its steam or wash the parts with its
>
>
Heat leaves of castor on hot plate and tie it on the affected part.
massage using oil heated with garlic and ajwain will also help soothe you.
Women's Work and Health
Village Level Training Module
16
Violence and Women's Health
■
■
Village Level Training Module
2 hours and 30 minutes.
Learning Objectives
At the end of the session the participants will learn about
•
•
•
gender violence faced by women
types of violence
linkages between violence and health
Design
Time in
minutes
60
30
60
Topic
Understanding types of violence on
women in the life cycle and gender
violence______
Places where violence takes place
Linkages between violence and
health
Training method
Discussions with the help
of Activity 1
Discussions with the help
of Activity 2
Discussion
Material Required
Fhp charts, markers or black board and chalk. Small pieces of papers for activity 1.
Note for the Trainer
Welcome the participants. You may start the session by saying,
Dear friends, today we are going to discuss the topic of violence There are violence
Some of the participants might themselves be victims of violence be
prepared to handle their emotions
Violence and Women's Health
Village Level Training Module
i
•
Ask the participants to share their ideas about violence on women. Note if any
body mentions violence beyond physical violence. Introduce Activity 1. At the end
of the exercise lead the discussion towards types of violence on women in life
cycle and gender violence.
Introduce activity 2 . This exercise will help you to discuss scarcity of safe places
for women. Ask the participants to list different places where violence takes place.
Also encourage them to list down the persons.
Now you can lead the discussion towards effect of violence on women's health in
special condition like, pregnancy, childbirth etc.
Discuss what is the role of different individuals in the society to prevent violence
against women. Encourage participants to decide on some resolutions at the end
of the session.
Important Messages for the Village Women
Violence against women can be more than just physical. Taunts, denial of
opportunities, verbal abuse, stopping communication, not giving money to her
etc. are also various forms of violence. Realise them and stop them.
v Violence against any woman is as bad, as violence against womankind, speak up
if any woman is made a victim of violence, be it on self or others.
❖ Speak up against violence within home and outside. Do not keep quiet due to
social pressure.
❖ Violence against women is a social concern, it is not merely a domestic affair
Raise your voice against it.
v Women have a low status in the society. More often than not, they are used by
men to ventilate their frustrations and exert power. It is not her fault or destiny to
suffer from violence.
❖ Women may face violence in various forms through out her life cycle:
1. Prenatal: Sex-selective abortion (aborting a fetus if they come to
know that the infant is a girl), battering (beating and improper
treatment) during pregnancy (emotional and physical effects on the
woman; effects on birth outcome); coerced (forced) pregnancy (for
example, mass or gang rape).
2. Infancy: Female infanticide (killing of girls under one year of age);
emotional and physical abuse (discriminatory treatment); differential
access to food and medical care for girl infants.
3. Childhood: child marriage; genital mutilation (cutting the genitals);
sexual abuse (improper treatment) by family members and
strangers; differential access to food and medical care; involving
children in sex work.
4. Adolescence: Sexual abuse (discriminatory treatment) at home and
in the workplace; eve-teasing (making fun of), molestation (giving
trouble), rape, sexual harassment (bother sexually); forced sex
work; trafficking (illegal trade) in women.
Violence and Women’s Health
Village Level Training Module
2
(
5. Adult women: Adult women face domestic violence the most. The
most common form of violence against women within their families
are-men may kick, bite, slap, they may burn them or throw acid in
their faces; they may beat or rape them, with body parts or sharp
objects; they may insert various objects in their genitals, and they
may use deadly weapons to stab or shoot them.
6- Reproductive Age: Marital rape (husband forcing sex on wife);
dowry abuse (treating a woman badly for dowry) and murders;'
partner homicide (when a partner kills another partner);
psychological abuse (mental harassment and torture); sexual abuse
in the workplace; sexual harassment; rape; abuse of women with
disabilities.
7. Old Age: Abuse of widows and elder women.
❖ There are many different ways that a man tries to gain power c. cr
over a woman,
Physical violence is one of them. But all types of violence can hurt
ta woman.
1 ■ ^motional Abuse: The man insults the woman, puts her down, or
makes her think she is going crazy.
2. gpntrollinq Money: The man tries to keep the woman from getting a
job or earning her own money. He makes her ask him for any
money that she needs. Or the man says that the abuse did not really
happen, that it was not serious, or that it was the woman’s fault. He
may force her to work and then take the money she earns,
3. glaming her The man passes on the blame of anything bad that
happens to him or the family, on the woman.
4. Cgntrollinq mobility: The man controls everything the woman does—
who she meets and talks to and where she goes.
5. Making threats: The man uses a look, action tone of voice, or
makes threats that make the woman feel afraid that he will hurt her.
One out of five women, worldwide, is a victim of rape. Most
of them know their attackers. Young girls are the most
frequent targets. Forty to sixty percent of all known sexual
assaults are committed against girls of age 15 years and
_________ _________
Violence and Women’s Health
Village Level Training Module
younger
3
Where and by Whom violence take place
Where violence
takes place
Home
Work Place
School/ colleges
Hostel
Public places: Bus
stand, railway
station, while
travelling in this,
roadside, Cinema
Theatre, in
forest/farms.
By whom
Types of violence
Husband, Father,
Brother, Other
relatives uncle,
brother-in-law etc.
Mental torture, wife
beating, rape, bride
burning, Compulsion for
sex- work to earn money
for the family.
Women are pressurized to
undergo sex determination
test, they face
discrimination & neglect
Eve teasing(making fun),
molestation(trouble), rape
Molestation, eve teasing, rape
Landlord,contractor,
supervisor,
Male Colleague
Students, Teachers,
Eve teasing, molestation, rape
Students, warden
By any men
Eve teasing, Molestation, rape
Eve Teasing, molestation
~
Trust your own feelings. It is
better to offend someone if
you are wrong than to be
raped!
■
i
Violence and Women Health
. Village Level Training Module V
•
■
4
*
i
)
I
❖ Violence has direct relation with women's physical and mental health. Understand
how violence affects women’s health in life cycle:
Pregnancy: Sometimes women become pregnant to avoid being
beaten, even when they know they are too weak. However, violence
increases during pregnancy as compared to any other situation.
Violence against women during pregnancy causes miscarriages and
premature deliveries that severely endanger both the health of the
mother and the life of the child. Pregnancy becomes an excuse to
control diet and activities of women.
Unwanted pregnancies are often the result of violent acts such as
rape and incest (sexual relations among close relatives) or by affecting
a woman’s ability to negotiate contraceptive use. In a study in Mumbai,
India, 20% of all pregnancies of adolescent abortion seekers occurred
because of forced sex, 10 % from rape by a male domestic servant, 6%
from incest, and 4 % from other rapes.
Childbirth: Force and pressure are exerted on the woman’s abdomen
or women are made to travel on a bumpy road to hasten labor. This
may result in rupture of the womb and death of woman. Sticks and
sharp objects are inserted in the vagina to induce abortion. This may
result in rupture of womb or sepsis. At times, their partners abandon
women and they face the anxiety and trauma of labor alone.
Lactation: The infant can be the victim of direct aggression and result
of the frustration faced by the mother for bearing a girl/child as well as
through the effect violence has on the production of breast milk.
Infertility: Domestic violence is typically seen to increase when a
woman is “suspected” of being infertile. This has often led not just to
violence, but to desertion.
STD including HIV/AIDS: As with unwanted pregnancy, women are
more vulnerable to contract sexually transmitted diseases (STDs)
because they are unable to negotiate protection. Women with STDs ‘
have higher risk of complications during pregnancy, including sepsis,
spontaneous abortion and premature birth. Some STDs increase a
woman’s vulnerability to the HIV virus, as well. Violent sexual assault
may also increase risk because resulting tears to delicate vaginal tissue
allow the virus easier entry into the bloodstream. With HIV/AIDS, the
consequences are usually fatal for the woman and possibly for her
children as well.
Violence and Women’s Health
Village Level Training Module
5
Homicide: Numerous studies report that husband, in-laws, brother-inlaw etc kill most women who die of homicide. Dowry is very common in
our country. This custom can be fatal for the woman whose parents are
unable to meet demands for gifts or money. Violence that begins with
threats may end in forced “suicide", death from injuries, or homicide.
Mental Health: This is a key intersection between violence and health,
i.e. violence is seen to not just affect women’s health, but more
specifically affect mental health. The most important issue in the
relationship between violence and mental health are depression and
low self-esteem. Depression is most, but the effects can include
reduction of strehgth, lack of energy, insomnia and tiredness.
Serious pain and injuries: Broken bones, bums, black eyes, cuts,
bruises, as well as headaches, belly pain, and muscle, pain that may
continue for many years after the abuse has taken place.
Our role in Creating Social Awareness about Violence against
Women
As a Member of Family
•
•
•
•
•
If a man is committing a crime by violating the woman's right to live free from
physical harm, or by killing her. Challenge and stop his actions.
Respect every family member and provide equal opportunity of growth to all.
If a woman or girl feels uncomfortable about meeting any relative, do not insist on
meeting him. Always accompany the woman or girl when the meeting is
unavoidable.
When female members of family complain against any male relative or unknown
person, listen to her and act. Do not blame her or her actions for the violence
towards her.
If any woman or girl becomes victim of rape or other violence provide support to
her and reassure her that it was not her fault.
As Men of the House
•
•
•
•
•
•
Do not physically or mentally abuse your mother, wife, daughter or daughter-inlaw.
Respect women's opinion and ensure equal opportunity for all family members.
Support the woman if she thinks she doesn’t like some male relative.
Take good care of woman who might have suffered violence and reassure her.
Keep away from vices like alcohol, gambling, tobacco, etc.
Educate friends and society to stop violence towards women.
Violence and Women's Health
Village Level Training Module
6
sb
(
•
Encourage open and honest dialogue with each other about what each expect
from a sexual relationship.
As a Women’s Group Member
•
•
•
•
•
•
• I
Educate the community about violence towards women and take action to stop it.
Ensure no woman suffers from wife-beating in your village.
Arrange for counseling center or temporary stay homes for women who are
victims of rape or violence.
Provide legal education to women and men against violence.
Provide gender sensitization training to various groups in village.
Encourage women to speak up against violence and trust her.
As a Panchayat Member
•
•
•
•
•
Respect all members of Panchayat equally, be it men or women.
Stop domestic violence in the village.
Arrange legal advise programmes for the village community.
Educate men to keep away from vices like gambling and alcohol.
Encourage women and community to speak up against violence and trust her.
Tolerating injustice, is as bad. as doing it. Speak up against
Violence and Women’s Health
Village Level Training Module
7
Z7 -7
Activity 1-Life Line
Objective
To sensitize the participants about gender violence faced by women. To review the
visible and invisible instances of violence women that face.
Material Required
Small pieces of papers. Flip charts and sketch pens
Method
> Ask the participants to think for five minutes and then let them list down different
types of violence that they are aware of. They may list down different types of
domestic violence and sexual violence. Few example of gender violence may also
> Now ask the participants to remember their life experiences and ask them to list
down the experiences of violence during their following ages.
5-10 years
10-20 years
20-25 years
25 and above
> Take four flip charts. Write one age group on one flip chart. Display the four flip
>
charts on the floor or on a wall in a sequence.
Ask the participants to display their experiences on the flip chart age wise. Do not
force the participants to write their names on the paper. If they want, they may do
> Once they complete the task, ask them to read.
> Try to generate discussion from the data collected. Try to link the kinds of similar
experience the group member has.
> Lead the discussion towards type of violence on women in life cycle. Also focus
on gender violence which is most widespread violence.
> Add if necessary, encourage participants to share personal experiences.
Violence and Women's Health
Village Level Training Module
g
)
Activity 2- My Safe Space
Objective
To sensitize the participants about the scarcity of safe space for women.
Material
Flip charts and sketch Pens
Method
•
Encourage each participant to create her safe spaces on chart paper. Each
individual will define (if they are illiterate they can speak when they present) safe
space, draw an image of it.
• Ask the participants to share these safe spaces with the larger group.
• This exercise is part of internalization process. The participants will examine
safety in their context and identify areas in their lives where they do not feel safe.
• Encourage the participants to share their experiences, which will help the group to
realizing the scarcity of safe spaces in women’s lives.
I
Violence and Women's Health
Village Level Training Module
9
WOMEN'S MENTAL HEALTH
Village Level Training Module
2 hours.
Learning Objectives
At the end of the session the participants will learn about:
•
•
importance of mental health for women
some ways to cope with mental stress
Design
Time in minutes
60
60
Topic_____
Importance of mental health for the
overall wellbeing of women and
ways to cope with mental stress
How to relax and be free from stress
Method/materials
Discussion with help of
activity 1
Activity 2
Material required
Story given in activity 1. You may also copy the story on a big flip chart in big letters.
Women’s Mental Health
Village Level Training Module
T1
1
i/C
No+e to the trainer
Welcome the group by saying,
understand what stress does to us and how we can cope with it."
dn'tho6 particip^nts ^at happens when they feel stressed and depressed Whom
do they go to when they feel the need to talk to someone? How do they cope with
stress at home and the burden of work?
X P
Emphasize the importance of mental health and well being for women. Narrate the
story given m activity 1 with help of flip charts. Encourage women to get engaged in
shanng personal experiences and discuss need to form self-help groups.
n the end, discuss our role as representatives of different groups in village to
maintain and promote the mental well being of women and community at large.
Important Messages for the Village Women
❖ Mental well being is as, if not more, important as physical well being.
’ wh?hn c°hUS nf9,9'n9 or comPla'ning against one person can lead to low self esteem
which is harmful for mental health.
’
y Share household work among each capable member of the family
"
and each member °f ,he fami|y *°talk freely and
A DnnA^? fam'ly ™ember respectfully with love and affection and on an equal basis
. Do not engage in tobacco or alcohol use, it can lead to mental disturbances within
the family due to loss of money and misbehaviour.
Our role to improve Communities’ Mental Health
As a Family Member:
•
•
•
Share household work among each capable member of the family.
Give privacy to husband and wife and each member’s of the family to talk freely and
communicate with each other.
Treat each family member respectfully with love and affection and on an equal basis
Provide freedom and enabling environment to each family member to discuss their
problems.
Family decisions should be taken after discussion with concerned family members
and with their consent.
Do not harass or discriminate any family member
Women's Mental Health
Village Level Training Module
2
•
Parents should not impose their views/decisions on daughter, daughter in-law and
other members of the family. Each member of the family has a right to take the
decisions of her/his own life such as whom to marry, when to marry, education, etc.
As Men of the House:
•
•
•
•
•
You should treat your wife as a respectful human being and share all your economic
and other problems with her.
Do not waste money in alcohol, tobacco and gambling. It is a root cause for breaking
the family.
Spend some time with your wife in talking and sharing your days experiences.
Spend time in pleasurable activities together.
Share household responsibilities. Household work is family's work and not only
women's work.
If you see any signs and symptoms of depression in your wife give her emotional
support. In extreme cases, you may have to take her to the psychologist.
As a Member of a Women's Group:
•
•
•
•
•
•
•
If there is any woman in the village suffering from mental problem, support her.
Women need more love, affection and respect in such a condition.
Try to listen and respect each other in the group.
Learn and teach relaxation exercises.
Organize awareness campaigns in coordination with local NGOs and GOs to
improve self-esteem and empower each other.
Start savings and credit group. Give special sanction to credit for women's own
health.
Organize income generating activities for women.
See that women take advantage of welfare scheme sanctioned by Government for
them.
As a Panchayat Member:
•
•
•
•
•
Organise awareness meetings and camps about mental health.
Encourage men and elders of the house to take care of daughters-in-law of the
house.
If you come to know of any woman going through mental problem, counsel family
members to support and provide her medical help.
Encourage everyone to behave respectfully with each other, irrespective of caste
creed or sex.
Get income generation programmes for your village, through which women can
come together and talk to each other and share their problems while they also earn.
Women's Mental Health
Village Level Training Module
i 1
3
Activity 1 Mental Health,
a Major Concern of Women
Objectives
‘
In Xat|iZ™Tbeinngab0U‘importan“ °f
health for vromen and it's effect
J°fencoura9e participants to think about ways of coping with stress for their own
Material required
' chart
XX.SSS*
’*lhe sl^on a flip
and stick it if there are few literate participants.
Method
• Read out the story of Radha given below to the group
• Based on the story ask the group to perform a role-play.
Radha'sVtory1 thS r°le'Play aSk the questions Siven along with the story.
She,h3S ?•Sma" children- Her father-in-law is sick. Every day she has to
fetch water from a long distance, cook, clean house and clothes Her husband drinks
feCeOat°food Radhn ' He SP!ndS a'm°St a" family inCOme in a,coho1 so no money is left
o eat food. Radha is very unhappy and feels sad/nervous most of the time she feels
cryng has difficulty in sleeping, has lost interest in life, she always has a headache
and digestion problem, lack of energy and concentration. Sometimes^he also thinks of
suicide to get away from this situation.
f
Roshan a close friend of Radha went to meet her. Roshan feels that something is
RadS fo'mppHh^ Radha ab°Ut Radha Shared herfee,ings
her. Roshan took
Radha to meet the women s group. Roshan encouraged Radha to share her story
Other women expressed that they also had similar problem. They shared their story
LlidalityP
Sharin9 eaCh Other'S pr°blem and suddenly felt a feeling of
‘hiL9™P.fe9ularl^ 1116 Qroup met the viitape health worker
Tnn^h9 th d
* They au9h hem some exercises for relaxation (yoga)
om9Anb?Hthe women s 9roup'. PHC' ICDS programme, and social welfare department
orgamzeci awareness campaign for the families and communities to know women's
mental health needs. They organized an exhibition also.
Women's Mental Health
Village Level Training Module
4
I \
(
The villagers attended the camp. They went through the exhibition. Radha's family
members also participated. They understood Radha's situation. Radha's husband took
an oath that he will not drink alcohol and not beat his wife. Radha's mother-in-law came
forward to support Radha.
Ask the following questions at the end of the role play:
What was the main reason for Radha's mental stress?
What helped Radha to relax and felt free of stress
Do you relate with Radha's story? (Encourage them to share their experiences and how
they cope up).
Activity 2: Learn to Relax
Objective
To enable relaxing among people who are suffering from stress.
Method
x
X
X
X
X
In a quiet place where everyone can sit down (preferably lie down), the facilitator
asks the group to follow these instructions:
Close your eyes and imagine a safe, peaceful place where you would like to be. This
might be on a mountain, by a lake or ocean, or in a field.
Keep thinking about this place as you breathe deeply. Let your body relax. You can
suggest each organ, starting from your right leg, to relax.
If it helps, think of a positive thought, such as “I am at peace”, “I am safe".
Keep breathing, focusing either on the safe place or the thought. Do this for about 20
minutes.
A woman can also practice this exercise at home whenever she has any difficulty in
sleeping, or feels tense and afraid. Breathing deeply helps calm nervous feelings.
If you start to feel uncomfortable or frightened at any time during this relaxation
exercise, open your eyes and breathe deeply.
Women's Mental Health
Village Level Training Module
5
ACCESS TO HEALTH CARE
s
Village Level Training Module
1 hour and 30 minutes.
Learning Objectives
At the end of the session the participants will learn about:
reasons for women's poor access to primary health care
information on health care and other facilities available in the village and nearby
•
•
Design
| Time in
minutes
30
60
Topic
Method and Material
Reasons for women’s poor access to
primary health______
Health services at village level
Discussion
Discussion and
information sharing
Material Required
^nd n“pXT'6 ,rOm
V"la9e 10 PHC
Black b°^
Note for the Trainers
You may start the session by saying,
Dear friends, many people in the villages die or suffer from illnesses oarticularlv
hPlnffS a"d chl dren because lhey do not know whom to contact or 'where to no for
help in emergences. Besides, parllcnlady women do not have access due o her
andsoc^So^av we"will %[eSp°hnsibKes and her ^ondary status in the family
service y
CUSS howwe can i'”l,rove lhe adcess to health care
^SJirthe partlcipa2ts when any body is ill in the family where they do go? List down
Weh
o? othfr"seS SPng home remedies'90''601"’6"1 SerViC6S) a"d
/Access to Health Care
Village Level Training Module
i
servicesproperly, discuss the^probtem a(theheanhs" d°not,haveaccess 10 health
family level. Encourage sharing of personal exp^enH'^
socio-^rtural/
’
^d%X°y^
List them on the
other person tL g,ves hea.m
andwh^eto co ta",'
of the area and show various health facilities and workers are"ofated.
any
maP
mem^who’they^wnCgo^for'helpfo^ffereist^ ’TrVa’lad'e 'n d'ff9rentfacilities. Ask
preventive services and for dCn
aC"?,eS and whom ,0 “n,ac>
distribution centres(an(I fXer Se^dennt k° ,e" *hem abOU'the dru9
malaria are available.
‘
inTe^ariouX's0
where essential medicines for
aC1'Ve rOleinCreaSin9 accesscare by Women
Important Messages for the Village Women
♦> Constraints of the Health Care Services:
State Reasons
Long distances
’i
Inconvenient timings
Non availability of health personnel
specially lady doctor
Lack of proper supply of medicines/no
proper medical equipment
Lack of services for women in a
holistic perspective. (Services are
available only for the family planning).
lmPr°perand insultmgbehaviouTby
the health personnel________
No facilities for support services for
the field worker (non-availability of
Societal Reasons
Overburden of work on women
(no time to go)
Low self-esteem (negligence of
own health problem)___________
Low priority given to women’s
health___________
Secondary socio/economic status
Family does not give the
importance to women's health and
is not ready to spend money on
them
creches, food etc.)
Access to Health Care
Village Level Training Module
2
i
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■
I
h;;
❖ People who provides the health services at the village level:
Dais: You must always use the services of a trained dai to conduct deliveries safely.
Most trained dais have been provided with a kit which has scissors/blade to cut the
baby’s cord and thread to tie the cord.
’
Anganwadi Worker: She runs the anganwadi for children 0-6 years and provides
services for pregnant and breast feeding mothers. The anganwadi worker is expected to
visit homes to enquire about the health of the mothers and children. As well as co
ordinate with the ANM for the anti-natal check-up, tetanus-toxide vaccination and iron
folic acid tablets course.
In an anganwadi, supplementary foods are available for women who are pregnant and
lactating and children 0-6 years with extra foods for the malnourished.
t
Children are also weighed regularly to see whether they are growing properly.
Anganwadi also has medicines for diarrhoea, fever, coughs, colds, cuts, burns, boils,
worms etc.
ft
In some anganwadi(s), the health worker make regular visits and organise
immunisations for children to prevent illnesses like tuberculosis (TB), polio, tetanus,
whooping cough, diphtheria and measles. Injections are also given to pregnant mothers
to protect them and their new-born babies from tetanus.
: .r
Sub-Center is available or approximately every five villages (5,000 population), there
should be a government sub-health-centre (Which has a female and a male health
worker.
»
The following services are available at the sub-health centre level.
For children:
• Immunisation.
• Iron tablets for weak children
• Vitamin A solution
t'-
For women:
.
• Examination of pregnant women and tetanus toxide injections
• Iron tablets for pregnant and lactating women
During Childbirth:
• Referral services for mothers if any problems arise during pregnancy, delivery
of afterwards.
/Access to Health Care
Village Level Training Module
'1
3
/H
Breast Feeding Mothers:
• Family planning advice and devices.
The female worker is responsible for the above activities.
Other diseases
■
• Treatment of malaria cases
• Follow-up of TB, Leprosy, cases
Chlorinating well to clean the well water to prevent illnesses like diarrhoea.
• Spraying walls with DDT to prevent mosquitoes from sitting on the wall.
The male worker is responsible for the above activities.
’❖ Where to go for services:
For simple illnesses like
-> Anganwadi worker
Fever, diarrhoea etc
-> Sub-centre
For pregnancy check-up
-y Sub-centre
For tetanus toxoid
-> Sub-centre
For iron tablets in pregnacy-} Sub-centre
For delivery
-> Trained dai, female health worker
For care after delivery
Trained dai, female health worker
For care of the new born
Trained dai, female health worker
Family planning advice
-> Female health wdrker
Immunisation
-y sub-centre
Vitamin A
-> Sub-centre
Cholirination of well
-> Male haelth Worker
Supplementary nutrition ->Anganwadi
for children, pregnant
and breastfeeding mothers
All the above services by anganwadi worker, sub-centre worker and PHC doctor and
workers are free of cost. It is your right to demand those services.
Our Role in Ensuring Access of Health Care to Women
As a Member of Family
•
•
•
Share responsibilities of housework.
Encourage women of the house to share their problems and take them seriously.
Take illness seriously and get help of village health care services. If there is problem
in accessing services take up the issue with panchayat members.
Access to Health Care
Village Level Training Module
4
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. H (J
5’' f? . )
r
I
•
If necessary accompany the woman to the PHC or the district level hospital during
emergency without delay.
As Men of the House
•
•
•
Encourage women to go for early treatment in case of any illness.
Save money for any health emergency in house.
Ensure regular visits of ANM in the village and her access to women and see that
anganwadi runs properly.
As a Women's Group Member
•
•
•
•
•
•
Get as much information about various services available at the village level and
disseminate it among men and women in village.
Ensure regular visit of ANM in the village and her access to women.
Arrange with the help of panchayat members to get a lady doctor in the nearest
PHC.
Ensure regular and proper running of Anganwadi in the village.
Ensure supply of proper medicine in the sub-center to PHC levels with help of
panchayat members. Complain to authorities at district level if action is not taken.
Encourage men to be sensitive women's health and well being.
As a Panchayat Member
•
•
•
•
•
•
Ensure proper functioning of various health services in your village including, training
of dai, running of anganwadi and regular visits of ANM.
Ensure regular visit of ANM in your village and her access to village women.
Ensure that the drug distribution depot and sub-centers have regular supply of
drugs. Approach authority at district level if necessary to ensure it
Encourage men and women to give due importance to women’s health problems.
Arrange for lady doctor in the nearest PHC.
Arrange for transportation to district hospital in case of health emergency in village.
The new PHC law gives powers to the PHC to pay to
a lady doctor to come three hours, twice a week to
a PHC where there is no women doctor. It is your
right to get health services free of cost at the
village level
1 i
Access to Health Care
Village Level Training Module
5
’
’
i
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i 1
I
i
” i(-
rs:.
(.
Traditional Health and Healing Practices (THHP)
Village Level Training Module
Time 4 hours
Learning objectives:
At the end of this training the participants will learn about:
•
•
•
•
Health seeking behaviour of women.
Local health care providers in their area.
Traditional health and healing practices in the life cycle.
Herbal remedies useful for women’s neglected health problems.
Design
Time
30 minutes
30 minutes
2 hours
Topic_________________________
Health seeking behaviour of women
Locally available health and healing
resources
__________________
Useful practices and identifying the
herbs useful in life cycle.
Methodology______
Role play, Activity 1
Resource mapping,
Activity 2__________
Discussion,
demonstration,
illustrations, field visit
(Activity 3-5)
Material Required:
Flip charts, markers, different items required for thq activities.
Village Level Module: Traditional Health and Healing Practices
1
Note to the trainer
•«l
Welcome the women's group by saying
"Dear Sisters,
"’Others to maintain positive health.
raT15 V,'^1 cooling diet in summer or
drinking herbal decoctions. These
' rhTDaftradX
‘
lhe back'4,lhis chaP"*
™:Sse&Sd 1';^
*cuss the strengths of
L«related
Important messages for village women.
■
Heal,h and Healin9 Prac,ices’
P™™"5
*
!Slth
'S provided at homes’ by local healers (Dai's, Bhagat, Oza etc ) bv
vaidyas, homeopaths (sugar pills) and in hospitals.
'
’
SyJOmer? pract,ice differen‘ forms of traditional healing. Dai is a traditional healer
who plays a key role during pregnancy, childbirth and childcare.
Village Level Module: Traditional Health and Healing Practices
2
..v,
)
(
MALARIA AND WOMEN'S HEALTH
Village Level Training Module
1 hour.
Learning Objectives
At the end of the session the participants will learn about:
•
•
cause, spread and symptoms of malaria
prevention of malaria
Design
Time in minutes
60
Topic _________________
Cause, spread symptoms and
prevention of malaria
Method/materials
Discussion with help of
activity 1_________
Material required
The story given in activity 1. You may also copy the story on a large flip chart in
big letters.
Note to the trainer
Welcome the group by saying,
"Dear sisters, today we are going to discuss malaria. We have all suffered from
malaria and therefore we are familiar with its signs and symptoms, today we will
understand it better. So that we can protect ourselves and our dear ones from it."
•
•
•
Ask participants what happens when any one suffers from malaria. Keep
noting down the points. Ask them if anyone can tell how does it spread and
what causes it, again note down the answers.
Ask the group how can we prevent malaria from,happening. Narrate the story
given in activity 1 with help of flip charts.
Discuss our role as representatives of different groups in village to prevent
malaria.
Malaria and Women's Health
Village Level Training Module
i
Important Messages for the Village Women
Do not let water stagnate or logged near your house.
Keep all the water containers covered.
Do not let water stagnate or logged next to stand post.-Drain off the logged
water.
Make sure that the malaria worker comes to your village regularly to spray the
houses with anti malarial liquid and distribution of chloroquine tablets
Always complete the course of 10 chloroquine tablets given by malaria worker
if you get malaria.
❖ Make sure that when you get malaria you eat well, otherwise you will feel very
weak.
Our Role in Prevention of Malaria
As a Family Members
Do not let water stagnate or logged next to your house.
Always cover water storage containers.
Get your house sprayed regularly with anti mosquito spray. Never wipe the
spots of the sprayed liquid.
Let the health worker take your blood sample for the malaria detected.
If possible use a mosquito net for sleeping.
Before going to sleep apply neem oil on your uncovered body parts.
Fumigate your house with neem leaves.
Always complete the course of chloroquine.
Give complete rest to the diseased person.
•
•
•
•
•
•
•
•
•
As Men of the House
Malaria leads to severe weakness.
Make sure that women of your family complete the course of chloroquine
along with a course of iron tablets.
• Ensure that she eats enough food. She needs to eat leafy vegetables, citrus
fruits like, amala, guava, and lemon and dais like mung dal, udad dal, chana
dal etc.
• Make sure that she eats along with you and in adequate quantities
•
•
As a Women's Group Member
•
Keep a watch that there is no water stagnate or logged next to the stand-post
or hand pump. Take help of the village women and men to drain the water if it
is logged. If necessary inform the Panchayat for the financial assistance.
Malaria and Women’s Health
Village Level Training Module
2
b1?
•
•
•
Make ensure that the health worker regularly visits the village. If he is not
coming regularly, inform the Panchayat who will take necessary action at
Public Health Centre level.
Yqu must be aware that Malaria workers has to
1. Collect
‘
the blood sample for the investigation of Malaria infection
2. To prevent Malaria he has to spray the house with anti Malarial liquid
and impart health education
3. To treat Malaria he has to give chloroquine tablets
Regularly during the women’s group meeting organize health education class
to prevent Malaria
As a Panchayat Member
’
Ensure that the malaria worker comes to your village regularly. If he does not
come inform the Primary Health Centre and take necessary action.
5nC°U:a^thS ViHa9e people t0 get their bl00d tested for Malaria when they
have high fever.
’
Never let water stagnate or logged next to stand-post or hand pump. If the
water is logged you could drain it to the school garden. If that is not possible
plant some vegetables. These vegetables can then be given to the
Anganwadi as a supplementary nutrition food for the children.
Activity 1 Malaria, a Major Concern of Rampur Village
Objectives
•
To explain spread, symptoms, treatment and prevention of malaria
To sensitize participants regarding our responsibility in preventing malaria.
Material required
Fhp charts g'VBn below. You may photocopy these charts and stick them on a
card board separately and write the messages behind each chart Or you mav
PithArheSe piCtures and make a set for yourself. Please use the same^ext
either cases, you may change the look and styles of the figures.
Method
•
•
•
•
Hold the flip chart at the height where everyone can see
Read the messages behind each chart as if you are reading a story.
otop and discuss where ever necessary.
It is better to prepare and read story prior to the session for smoother flow.
Malaria and Women's Health
Village Level Training Module
3
Card 1
*
This is Rampur village. Everyone lives peacefully here.
Malaria and Women's Health
Village Level Training Module
4
f.H
Card 2
i
Champahen is the Sarpanch of Rampur. She ensured the availability drinking water
in the village. However the water is logged next to the stand-post.
Malaria and Women’s Health
Village Level Training Module
1
5
Card 3
Many people in Rampur are found to be suffering from Malaria.
Malaria and Women’s Health
Village Level Training Module
6
I
Card 4
Malaria spreads when mosquitoes bite. When a mosquito bites a person suffering
from malaria and then bites a healthy person, the healthy person may develop
malaria in next 2-3 days.
i
Malaria and Women’s Health
Village Level Training Module
7
Card 5
l
)
The person with Malaria shivers and gets fever, has severe headache the fever
recedes with perspiration. Malaria fever usually comes on alternate day.
Malaria and Women’s Health
Village Level Training Module
8
(
Card 6
I
(
Malaria and Women’s Health
Village Level Training Module
4
9
7^’
Card 7
Next day villagers get together. They drain water logged near the stand post.
Malaria and Women’s Health
Village Level Training Module
10
Card 8
The children cover the water puddles and pour used oil in the large pits.
Malaria and Women’s Health
Village Level Training Module
ii
Card 9
The villagers covered the big water storage containers. They also fumigated their
houses with neem leaves and started using mosquito net. Some started applying
the neem oil on the uncovered body parts before going to sleep.
Malaria and Women’s Health
Village Level Training Module
12
(
Card 10
Samjubai did the blood test of the people with malaria, and started distributing the
chloroquine tablets.
Malaria and Women’s Health
Village Level Training Module
13
Card 11
He encouraged the people to complete the course, take iron folic acid tablets to
treat anemia and eat leafy vegetables, citrus fruits like lemon amala and quava and
pulses like tur dal, chana dal, udad dal, mung dal etc.
’
9
Mulariu and Women's Health
Village Level Training Module
14
Card 12
I
I
With everyone’s help and Champaben’s enthusiasm and follow up Rampur village
could control Malaria.
Malaria and Women's Health
Village Level Training Module
15
TB
\A/r>AACM'a ueaitu
Village Level Training Module
1 iiuui and 30 minutes.
Learnina Objective?
At the end of the session the participants will learn about:
•
«
spread and symptoms of TB
prevention of TB
besisn
| Time in minutes I Te^pic
|30
Spread and prevention of TB
I
Fsn
| 30
I Understanding TB and its effect
women's health____________
I Pi evention of TB
Method/materials
Discussion with help of ~
story given at the end of
the chapter
Discussion Vvith the help of
chart_________ ________
Discussion with I ieip of
picture cards
Mn+erial required
Copy the story given behind. Chart and picture cards. You may photocopy them
from here and stick on a card board.
Note to the trainer
Welcome the group by saying.
Dear sisters, we have experienced that in our villages, many people arc infected bv
TB. Let us spend some time today to understand what is TB. how is it spread, what
are its symptoms and how can we prevent it. Women have special problems ifthev
become victims of TB. And due to our social circumstances they are more prone to
become T.B. patients."
1
~
‘
I
I TB is curable I
TB and Women's Health
Village Level Training Module
fl
i
'1'1
•
Ask the participants if they know of any TB patients. Ask them about the sions
spread and symptoms of TB patients usinq story qiven below
Lead the discussion to effect of TB on women's health with the helo of chart
Send s
exoXS6
,0
PerS°"al
' SXSESSSbehlnd’ Emphasi“u,e use of ■
Important Messages for the Village Women
c*
* ™'s spread by cou9hing- When a person sufferinq from TB couqhs the
becom™ “ZXe to m h"6™
by 3 normal person
❖ Symptoms of TB
•
•
•
•
•
Loss of weight
Loss of Appetite
Low grade fever especially during the evening
Coughing
Blood in sputum
❖ Prevention of TB
•
Immunize your child with BCG at birth.
' S
- •
If it is not possible to
Se^XEto
totget
1
°
the sunlight inside the house.
’
•
•
??!!near the kitChen roof is essential t01st the Chula smoke
out or the house.
Maintain cleanliness in the house.
Keep the personal belongings of a patient
«------- a separate. Boil while
ashing their clothes and towels. Be supportive to them.
Treatment of TB
•
•
Xlways complete the T.B. treatment. Even if you start feeling
well do not stop the treatment.
Take enough rest
Eat nutritious food like, pulses, legumes, milk and milk product,
TB
cercal e+c.
Village Level Training Module
~
)
-1?
Our Role in Prevention of TB
As a Family Member
•
•
«
•
•
•
Do not hide the disease. TB is curable.
Keep the house well ventilated. Let the sunlight enter your house
Get a glass tile fixed on the roof to let the sun light it
In a kitchen always have the ventilation next to the roof to let the smoke
go out
of the house.
Teach your children good habits e.g. not to spit indiscriminately and every
where. Such habits spread disease
Eat protein rich foods like pulses/dals, chana, chola etc.
As ALen of the House
i
I
•
•
•
•
•
Be aware that all members of the family get equal nutrition.
Treat the woman TB patient with respect and sympathy.
Take care that nobody coughs constantly, if they do, consult the doctor.
If woman is over worked find ways to reduce her burden, by providing her
assistance or counseling other members of family.
Ensure the patient completes her/his treatment.
As a Women’s Group Member
If you come to know that any woman is suffering from TB motivate and support
nL Te"
£
*
viHage'H916
,ami,v membere ais°to ™ «
PanChayat 80(1 or9anize 30 TB awareness program in your
As a Panchayat Member
•
•
•
Help the community to procure glass tiles and get it fixed on the roof.
Encourage to ensure the ventilation in the house:
With the help of the PHC team organize TB detection camp and awareness
camp.
TB and Women’s Health
Village Level Training Module
3
Sonu's story
I
This is Sonu. At the end of the day she gets extremely tired and
exhausted.
TB and Women’s Health
Village Level Training Module
4
toh|iveTkeOthferade fe''er' She ’hinkS "iS dl'e t0 Ove'work' She continues
One day she met her friend Ranu. She is a health worker She asked
Sonu X°s" -N^00^3 weak' " alS0 seems yo^XTghr.
oonu says, No, it is duo to ovar work”.
y
•3
TB and Women’s Health
Village Level Training Module
n
5
ei
Next day Ranu visited Sonu in the evening. She realized that Sonu has
fever. She was coughing too. Ranu suspected TB. She asked Sonu to
get her sputum tested. Sonu was frightened. She says,"Do not talk
about such a thing. My husband will throw me out of the house”.
Ranu went and explain it to the husband. The husband aot anary and
asked Ranu to leave the house.
TB and Women’s Health
Village Level Training Module
6
)
I II
One day Ranu called Sonu to their home. She told her to net the sputum
test done and start treatment. Sonu agreed but she was worried. She
did not have money. Ranu explained that TB treatment is free of cost.
Sony got the TB test done. It was positive. She started the treatment.
After one month she felt better. She told her husband that she has
started the treatment and she feels good now. Her husband Mohan
r^nIZ-ed?ISKm,S!^e’ He 03116(1 Ranu and aPo|og'zed. Ranu explained to
bonu s husband the need to ensure the full treatment.
c»
TB and Women’s Health
Village Level Training Module
7
Ranu and Sonu called the neighbors and talked to them about TB. Thev
gave the example of Sonu. She focused on the prevention and
treatment of TB. Sohan who was living in the neighbourhood came
forward and mentioned that he has symptoms of TB and would like to
get his treatment done.
Chart
TB and Women’s Health
She fears that her
employee may
dismiss her
She fears that her
husband will leave
her or her daughter
will not get a suitor
Why woman
avoid seeking
treatment of TB
She is not informed
about place for
treatment of TB
TB and Woman’s Health
Village Level Training Module
She does not
have control on
money and
therefore lack
of mobility
Picture Card
Prevention of TB
Immunize your child with BCG at birth.
to iZXX out XXUT COOking is d°n-n the store (chule) is essential
TB and Women’s Health
Village Level Training Module
9
Rs
Cj
TB and Woman’s Health
Village Level Training Module
10
WATER, SANITATION AND WOMEN'S HEALTH
Village Level Training Module
2 hours.
Learning Objectives
At the end of the session the participants will learn about
♦ importance of consuming safe water.
♦ ways of purifying water.
♦ water borne diseases, especially diarrhoea.
♦ importance of sanitation and methods of maintaining good sanitation.
Design
Time in
minutes
30
Topic
30
30
30
Diarhh'oea, dehydration and rehydration
Other water borne diseases_____
Sanitation
Contamination of water
Method/material
Discussion using
illustrations 1 to 4
Demonstration/activity i
Discussions
Discussions using
illustrations 5 to 9
Material required
lucV'them^n^rdbnAMb1"'1' V? T7 photocoPy each of the
illustrations and
stick them on cardboard separately. For activity 1. a bucket with water a clastic baa
of Ka^rraw
°n/t
3 mU9’ 'f y°U Want to demonstrate the preparation'"
Kanji, raw material mentioned in the recipe along with a cooking stove.
Note to trainer
Welcome the participants and tell them. 'Today we are aoina to
and sanitation. Water is source of t.fe. but if contan^^
nhnnt
immense suffenng death. Therefore dnnk only safe water. Safe water is imnortant
alongwith personal hygiene and environmental sanitation."
* X^X^™tol3^ssab‘““rtom,na,ion"^,era,dWBren>
* ^usSon^6 feCeS tO m°Uth r°Ute f°r infeCti°n °f diarrhoea ^ing the
Water, Sanitation and Women’s Health
Village Level Training Module
i
£"1
Introduce activity 1. Discuss severity of dehydration and ways of rehydration.
Encourage useful local ways of rehydration.
❖ Discuss importance of good sanitation in the village, which can include safe
water supply, water and waste disposal and use of latrines, with the help of
illustrations 6 to 10.
♦ Explain the role of various individuals in our society for improving the situation of
water and sanitation in our village. Encourage women to add to that, according
to local realities. Pick up one or two points to make an action plan.
Important Messages for the Village Women
c
❖
Avoid drinking water from pond or any such stagnant water source.
❖ Keep nails cut/trimmed since germs get logged in nails which later contaminates
water or food when we eat with hands or remove water out of a pot putting our
❖ Always keep food covered. Avoid eating stale food.
Use a ladle to remove water from a pot otherwise you might contaminate it while
taking out of pot.
❖ Always wash vegetables and fruits before consumption.
❖ Always wash hands before eating, cooking and feeding a child and after
defecation.
❖ Diarrhoea can lead to dehydration, which can kill. Prevent dehydration by
frequently giving liquids like ORS.
❖ Children are more at risk of diarrhoea.
v Take the patient to doctor if diarrhoea continues for more than three days.
❖ Motivate people to build latrines and use them.
Use latrines for defecation. (If there are no latrines, dig a hole in ground,
defecate and put mud on it)
v Take extra care during diarrhoea by drinking boiled water and keep surrounding
cIcsrL
Water is a scarce resource, use it carefully
Water, Sanitation and Women’s Health
Village Level Training Module
2
)
Our role in Creating Social Awareness about Water and
Sanitation
As a Member of Family
•
•
•
Distribute house work equally among all the members.
Contribute in keep environment clean.
Insist on personal hygiene for all the family members.
As Men of the House
•
•
•
Assist women in house hold work.
Insist on personal hygiene of all the family members.
If you do not have latrine, arrange to get it built with help of panchayat
programmes.
As a Women's Group Member
'
membe6 drinkinS Water source in y°ur village with the help of panchayat
•
•
Get information and programmes like low cost latrines.
Ensure availability of ORS packets in your village.
Educate people about dangers of dehydration due to diarrhoea and propagate
rehydration.
H y
Prevent water logging at all available water sources.
•
As a Panchayat Member
•
•
Ensure safe drinking water source in you villaqe
Ensure programmes for low cost latrines and other sanitation facilities in your
viuciyt?.
ANM^e people about Personal hygiene and water borne diseases with help of
•
Do not allow water logging at the stand post
^rH°Ura?e Vllla9e for
community kitchen garden or individual kitchen
dep^enT1
Water‘
t0 9St SeedS frOm the resPective government
utpcll u 1 Id IL
Water, Sanitation and Women's Health
Village Level Training Module
<3
3
Activity 1 Diarrhoea, dehydration and rehydration
Objective:
To sensitise women regarding the importance of rehydration for the patients of
diarrhoea, through demonstration.
Material required:
You will need a plastic bag with picture of a child on it, bucket, water and cup
Method:
♦ child3 KamiT
plaSt‘C ba9 above 1116 buckeL Assume the bag is a
♦
♦
♦
♦
Ask another person to fill the bag with water, this means Ramu is healthy
Ask a person to pierce a hole at the bottom of bag, means Ramu had diarrhoea
Let the water flow in buckeL
happened" 'M6 Water rema’nS in the bag’ ask the Participants what has
♦
♦
♦
♦
Discuss the symptoms of dehydration.
Ask one participant now to pour water from the top.
Explain the phenomena of rehydration.
Discuss which liquids could be given locally during diarrhoea. If possible
demonstrate preparation of Kanji to the group.
Preparation of Kanji:
♦
♦
♦
♦
♦
♦
♦
♦
Take a handfull of rice (20-25 grams).
Wash it.
Boil it until the rice becomes soft.
Crush the rice with a spoon.
Add water and make the liquid upto 600 ml.
Boil it again till bubbles start forminq.
Remove from heat and add pinch of salt and crushed cumin seeds.
Give this preparation to the person with diarrhoea at frequent intervals.
Water, Sanitation and Women’s Health
Village Level Training Module
4
0,6
Illustration 1
Water, Sanitation and Health
Contamination of water at the source
; Enlar9e this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Wafer, Sanitation and Women's Health
Village Level Training Module
1
5
^1(
Illustration 2
Water, Sanitation and Health
Contamination of water on way to the home
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Wafer. Sanitation and Women's Health
6
Village Level Training Module
I
[
Illustration 3
Water, Sanitation and Health
Contamination of water at the storage
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Water, Sanitation and Women's Health
Village Level Training Module
7
Illustration 4
Water, Sanitation and Health
Contamination of water during use
Note: ^
r ‘,arge this i|lustrat'°n cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Water, Sanitation and Women’s Health
Village Level Training Module
8
Illustration 5
Water, Sanitation and Health
Feces to mouth route of infection
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Water, Sanitation and Women’s Health
Village Level Training Module
1
9
Illustration 6
Water, Sanitation and Health
Low cost sanitation facilities would include latrines, garbage disposal and
proper water supply and disposal systems
4
r9e th'S ’IIustration cut and Paste it on the cardboard or transfer it
on a transparency for use during training.
Water, Sanitation and Women's Health
Village Level Training Module
10
)
s {.-J:.
II
Illustration 7
Water, Sanitation and Health
Wastewater, if not disposed, will become a mosquito breeding ground and
promote water borne diseases
nn i Enlarge this *llustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
transfer it
Water, Sanitation and Women’s Health
Village Level Training Module
11
Illustration 8
Water, Sanitation and Health
The best way to arranae
we for wastewater disposal is to build water drains
in the backyard or community kitchen garden
Note. Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Water, Sanitation and Women’s Health
Village Level Training Module
12
^8.
Illustration 9
Water, Sanitation and Health
If there is no kitchen garden, soak pits can I
be developed as shown in the
, long and deep
card. The pit is one foot wide.
on a transparency fo^Ls^du^
IVafer. Sanitation and Women's Health
Village Level Training Module
M
11 °n the cardboard or transfer it
13
Illustration 10
Water, Sanitation and Health
Low-cost latrines can be built one per house or aroup of houses. You will
require help from experts to get measurements in water seal-latrines
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Water, Sanitation and Women's Health
Village Level Training Module
14
n
REPRODUCTIVE AND CHILD HEALTH
OUR GROWTH: THE FEMALE AND MALE
REPRODUCTIVE SYSTEMS
Village Level Training Module
1 hour.
Learning Objectives
At the end of the session the participants will learn about:
•
to provide information about male and female reproductive systems.
to provide information about menstruation and sensitise the participants about
its natural course.
Design
Time in minutes
30
Topic
Understanding reproductive health
/ ••
30
Understanding menstruation
Method/materials
Discussion with help of
illustrations land 2
Discussion with help of
illustration 3
Material required
Photocopy of the illustrations 1,2 and 3 from here.
Note to the trainer
Welcome the group by saying,
“Dear sisters, all of us were young girls once. All of us have felt some
apprehension and confusion due to the changes happening in our body when we
grew up Many of us have already become mothers and yet we do not really
understand why we menstruate and what is the male reproductive structure
Today we will learn about reproductive systems of female and male and
understand more about menstruation."
Our Growth: The Female and Male Reproductive Systems
fM-UO
0S23S
■
\c{
n AV
Ask the participants how they felt when they had the first menstruation. Ask
hem how much they know about the male and female reproductive systems
Nets the responses. Explain the female and male reproductive systems with’
the help of illustrations 1 and 2. And match the responses of participants.
♦\yitMhe help °f lllustralion 3- exPlain the process of menstruation. Emphasize
menstmat'3 nOthin9 d'rty about menstruation- Discuss the myths related to
Important Messages for the Village Women
♦♦♦ During puberty boys and girls start showing secondary sexual
characteristics of growth.
v Menstruation is a natural biological process. Do not consider it dirty.
v You can perform all the daily routine during menstruation.
v Do not ask your daughter to keep away from social contacts during
menstruation. It affects their self esteem.
Our Role in Creating Awareness about Our Body
As a Family Member
•
•
•
•
•
Explain to our elders that menstruation is not dirty.
Show them the charts of male and female reproductive systems and the
process of menstruation.
Let young girls carry out their normal routine during menstruation if they do
not have pains or discomfort.
Let her enter the kitchen and do not prohibit her from touching any family
members. This will strengthen her self-confidence and she will also accept
menstruation as a normal process.
Explain to the adolescent boys about the male and female reproductive
system and process of menstruation emphasizing that it is a natural process
and there is nothing dirty about it.
As Men of the House
•
•
•
•
Ensure proper diet for both girls and boys in the family.
Understand psychological pressure on girls and women during menstruation
and provide support.
Participate and encourage boys in the family to participate in household work.
Get educated yourself about male and female reproductive systems and also
educate the boys in the family. Encourage them to share their anxieties and
worries of growing up with you.
Our Growth: The Female and Male Reproductive Systems
2
As a Women's Group Member
' j==S=E=S.
Make sure that all girls of your community get equal treatment and status as
As a Panchayat Member
■
sex edu“,ion sessions for
..........
:
Menstruation is natural process
there is nothing dirty about it
Our Growth: The Female and Male Reproductive Systems
3
Illustration 1
Female Reproductive System
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Our Growth: The Female and Male Reproductive Systems
4
(
Illustration 2
Male Reproductive System
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Our Growth: The Female and Male Reproductive Systems
1
5
Illustration 3
Process of Menstruation
<5
transfer it
rowth. The Female and Male Reproductive Systems
6
<0^
Menstruation
There are four different parts of a women's reproductive
system. These are the vagina (birth canal) Uterus
(womb), two ovaries (egg sacs) and two fallopian tubes
(egg tubes). The egg sacs contain several ova. Between
the age of 10 and 18 these ovas start maturing. Every
month an ovum is released from the egg sac to reach the
womb through the tubes. This is called ovulation. Just as
there are ova in women and girls, men/boys have sperms.
The menstruation cycle is of 25 to 30 days. This cycle is
different for every woman. Every month when the ovum
leaves the ovary a layer of blood and mucus starts
forming in the womb.
As time passes, this layer becomes thicker. At the time
of ovulation, if sexual intercourse takes place then there
are chances of the woman conceiving. After conception,
this layer provides nutrition to the growing foetus. But if
conception does not take place then the layer formed on
the wall of the womb disintegrates. That is why the womb
sheds this lining along with the ovum every month. This is
what we call menstruation, which lasts for 4-6 days on an
average.
Our Growth: The Female and Male Reproductive Systems
7
1
REPRODUCTIVE AND CHILD HEALTH
CONCEPTION
Village Level Training Module
1 hour.
Learning Objectives
At the end of the session the participants will learn :
•
•
to provide information about conception.
to sensitize the participants about sex determination by providinq scientific
information
Design
Time in minutes
30
Topic_________ ______
How does conception take place?
30
How is the sex of the child
determined
Method/materials____
Discussion using
illustration 1__________
Discussion using activity
1(and illustration 2)
Material required
Copy of the illustrations 1 and 2, you may photocopy them from here. Some rice
and pulses or different coloured stones.
Note to the trainer
Welcome the group by saying,
S°^ety 'S a ma'e dominated'
girl is bom, women are
ShG Z f°rCed t0 keep on deliverin9 children till she finally gives birth
9 ‘mJS When She fai/s t0 9ive birth t0 a ma,e child hcr husband
mames. These actions affect women's physical and mental health. To prevent
this agony, we all must know how the sex of the child is determined and create
awareness in our community so they do not blame women for it.”
H
Conception
Village Level Training Module
,1
i
conception^Mhe Sng'the ilSL^on T"0" ‘’“"S' DiSCUSS ,he topic 0'
• h;"3dSB?sf
awar/ness abou^x^TeXttoTmember" Spreadl^
Important Messages for the Village Women
❖ Conception
possibility of conception^hXen^in'o i°r h° d%s has the greatest
place during these davs thp cna 11to18 days- If intercourse takes
enter the vagina of the female
are mil,ions in number
they swim upwards towards the « 6 spe,7ris are hi9h,y motile and
sperm unites with the egg TNs isralte^ferf?9 f^besT°n|y one
❖ Sex determination
1' md eggPf
“iS determinecl al the time of union of the sperm
2
Treat boys and girls equally, both
are your children
i
Conception
Village Level Training Module
2
Our Role in Creating Social Awareness on Sex Determination
As a Family Member
•
•
•
Do not blame women for giving birth to a girl child. Human beings are
important, not a boy or a girl.
Explain the elders of the family how sex of the child is determined.
Inform the men of the family about how the sex of the child is determined. .
As Men of the House
•
•
In the community if man is blaming his wife for giving birth to girl child, provide
the scientific information to him and the family members.
Create awareness about sex determination among men and the adolescent
boys.
As a Women's Group Member
•
•
•
If in some families women are tortured or blamed for the sex of the new born
child, as a group you take an initiative to go and explain the scientific facts
You may take help of the ANM Health Worker.
Organize an awareness program on sex determination through the Primary
Health Centre team. They have appropriate charts to explain it.
If you come to know that in the nearby town sex determination test is
conducted, through your Panchayat you can inform the district health officer
and take legal action.
As a Panchayat Member
•
•
It is important that in your village all the men and women, girls and boys get
an equal status. Create awareness about it. You may organize an awareness
program through the local Non Government Organizations.
If you come to know that in your area or in near by town sex determination
Sion to stop11^
may inf°rm
Dislrict Health Officer and take legal
SEX DETERMINATION TEST IS LEGALLY
BANNED IN OUR COUNTRY
Conception
Village Level Training Module
I
n
3
/Activity-1 A game of rice
and pulses
Objective
To explain the process of sex determination
Material Required
Rice and pulses
’ Method
’
Ask the participants to form 2 circles. One outer and one inner
their fisT PartlC'PantS riCe and some of them P^ses and ask them to close
.
iJhnn p.articiPants t0 run in a circle until the bell rings. When the rinqinq of
nln h ?Pf ?Sy mUSt make a pair
the Partner in the adjacent circle
the riXlslmkrParlner and 366 if a * °r a boy is bom- (lending on
!Lb_°lh_lha Partners have similar grains then it is a girl but if one partner has
rice and the other pulse then it is a boy.
At
£___
At tnA
the AnH
end nf
of tho
the Hamn
game reinforce •information
about gender equality.
•
•
—- •
•• •
■W
■
v<4
AhX v»z y -
Conception
Village Level Training Module
4
)
\.VK
(
Illustration 1
Conception
Conception
Village Level Training Module
5
r-
, -v'■
\\^
Illustration 2
Sex determination
%•
There are two types of chromosomes in the sperm
(XV). One type of chromosome (X) is responsible
for giving birth to girls and the other type (Y) for
boys.
The egg contains same type of chromosome (X). If
the Y chromosome of the sperm unites with the X
chromosome of the female then a boy is born.
Whereas the union of X chromosome of the male
and female produces a girl. The sex of the child
depends on the union of chromosomes, which is
co-incidental.
Conception
Village Level Training Module
6
ADOLESCENT HEALTH AND DEVELOPMENT
Village Level Training Module
This chapter will talk more about mental and emotional
development than physical development. Topics like physiology and
anatomy of female and male bodies, pregnancy, childbirth, sex
determination and abortion are already covered in Reproductive
and Child Health Chapter. If this section is taught first include
all those topics here.
1 hour.
!•
Learning Objectives
At the end of the sessions, women will be sensitized about:
♦ adolescent needs and characteristics.
♦ the problems of adolescent girls because of gender discrimination.
Design:
Time in
minutes
30____
30
Topic
Method/material
Needs of adolescents__________ ____
Gender discrimination against adolescent
girls in society
Discussion and Activity 1
Discussion
Material required
Photocopy picture cards as given in activity 1 or draw the same illustrations on a
paper and stick them on cardboard and separate out each of them.
Note to trainers
Welcome the participants by saying,
"Dear sisters, today we are going to remember our past and plan for our
children's better future. We are going to discuss the needs and problems of
adolescents."
Adolescent Health and Development
Village Level Training Module
♦ Discuss characteristics and needs of adolescents with the help of activity-1.
♦ Head discussions to effect of gender discrimination against girls.
♦ Explain the role of various individuals in society to change this, encouraging
women to add to that according to local realities. Pick up one or two points to
Important Messages for the Village Women
•> Adolescents need help and support from you.
❖ Adolescents are capable.individuals; do not control them.
❖ Sexual attraction towards opposite sex is very natural during adolescence for
both, girls and boys.
❖ The mind and body of adolescents are not yet ready to take responsibility of a
family, do not marry off your sons and daughters early.
❖ Gender discrimination during adolescence results in low self-esteem and poor
physical, mental and social development of girls. It also forces boys to take
early responsibility of the family.
❖ This is the time when they develop self-identity; most of their revolt is an
attempt to establish themselves not a fight with adults.
Our role in health and development of adolescents
Family members
1. Listen to opinions and ideas of young people in family wfien taking decisions
2.
3.
4.
5.
6.
7.
8.
about family. If their ideas and opinion are useful tell to get involved in
decision making on their own, even if you forget to involve them.
When you have a problem with the way they behave or when they do not
listen to you. Find time and opportunity to tell them that how their behaviour
has affected you and why were you asking them to behave differently.
Try to find opportunities for their development and education. Ask their
opinion for their marriage if you can.
Talk to them about how common is sexual attraction during adolescence.
Share your experiences with them. If you cannot impart sex education,
arrange for it with help of anyone in village or village nurse.
At any cost, stop child marriages in the family. Do not marry the girl before
she is atleast 18 years old.
Let your daughter, son and daughter-in-law if she is young, go to school.
Do not treat girls and boys differently.
In case of emergency or problems (like need for abortion, alcoholism,
vandalism), remember that they are you children. They need your guidance
and support not your anger.
Adolescent Health and Development
Village Level Training Module
!
(
As men of the house
1. Treat boys and girls equally. Be aware that nobody in the house treats them
differently. For example, insist that your daughter and her mother will also eat
when you and your son are eating.
2. Create an atmosphere at home where children can talk to you without being
afraid of you.
3. Get information about options available to your son and daughter after they
finish the maximum education available at village level.
4. Try to keep away from addictions yourself, this will keep your children away
from them. Even if they do get addicted you will be able to control them better
if you yourself are not addicted.
5. Be a friend to your son and encourage you wife to be a friend to your
daughter (the best would be when all are friends to each other).
As o Women’s Group
1. Invite adolescent girls to at least one meeting a month and invite their
opinions of the matters of the group.
2. Educate women in village about the needs of adolescents.
3. Prevent child marriage.
4. Ensure that girls and women are treated equally as men and boys.
5. Educate women and men about contraceptives and spacing.
6. With assistance from panchayat get government programmes for training of
adolescents into vocational trades.
Role of Panchoyat
1. Find out if the government programmes like Scheme 1 and Scheme 2 of
Integrated Child Development Scheme covers your village.
2. Take advantage of schemes like Training for Rural Youth in Self-Employment
(TRYSEM) and such other for your village.
3. Ensure basic amenities at the doorstep so that, girls do not have to spend
time in fetching water, fodder, etc.
4. Educate talks in village on needs of adolescents with help of village nurse or
multi-purpose health worker.
5. Do not allow child marriages to occur in your village.
6. Encourage health workers to educate people on spacing and contraception.
Adolescent Health and Development
Village Level Training Module
Activity 1 Picture cards
Objective:
To sensitise the women about the problems of adolescents with specific focus on
Material required:
You will require picture cards as given in the activity. You may photocopy
these cards and stick them on cardboard. Cut each picture separately and
make a set.
Method:
♦ Show the following pictures to the women.
♦ Do not talk for some time.
♦ Ask them the questions given below and discuss. Encourage them to relate
self-experiences.
Jeevan and his son are eating, while his
wife and daughter Shanti are serving.
There is very little food left in the vessel.
Adolescent Health and Development
Village Level Training Module
Christi likes to glance at her in the mirror
and look at the boys in the village. Her
mother is beating her because she thinks
Christi is a bad girl.
Rehana is married at the age of 15 years;
her husband is in grade nine. Her motherin-law says they don’t have anyone to help
in the house so her son was married early.
Kali has just recovered from pregnancy for
second time and she is 18 years. They
have no food at home and her husband
beats her up if she refuses to have sex
with him.
Does this happen in our villages? What do we do about it?
Do we see the group of boys and girls move around in village who are neither in
school, nor in earned employment.
While girls do a lot of housework, what do the boys do?
What thoughts come'to our mind when we see them?
Why do such thoughts come?
Are our attitudes towards this age group based on logic and reality?
Have tried to understand why adolescents behave as they do?
Do we remember how we were when we were young? Are our children very
different? Can we provide support to them, which we needed but did not get?
Adolescent Health and Development
Village Level Training Module
S'
REPRODUCTIVE AND CHILD HEALTH
CARE DURING PREGNANCY
Village Level Training Module
2 hours.
Learning Objectives
At the end of the session the participants will learn about
•
•
•
•
changes in the body of woman during pregnancy
care during pregnancy
monitoring position and condition of fetous
health risks during pregnancy
Design
Time in minutes
30
30
Topic
______________
Understanding pregnancy and body
changes__________________
Care during pregnancy
30
Monitoring fetous
30
Health risks during pregnancy
Method/materials
Discussion
Discussion with the help of
activity 1
__________
Practical Demonstration
(instructions given behind)
and discussion_________
Discussion using the
counseling card
Material required
Copy of the story in activity 1. Also write it on a big flip chart in bio letter and stick
it on wall. Photocopy counseling cards from here. Arrange to invite a pregnant
woman from the village (it is better if you have more than one) for demonstration
of fetous monitoring.
Care During Pregnancy
Village Level Training Module
i
Note to the trainer
Welcome the group by saying.
Dear sisters, most of us have gone through the joys and sorrows of pregnancy.
Let us get more information about that very important condition in our life for our
own benefit and for the benefit of our friends and relatives.n
•
•
•
•
Invite participants to share their experiences of pregnancy. Summarize the
important changes during pregnancy in the body of women. Add any points if
necessary.
With the help of activity 1, highlight the points on Care during Pregnancy.
Encourage sharing of experiences and traditional practices. Encourage
harmless practices and discourage harmful practices like food taboos,
depending on the cultural beliefs.
Ask the participants, how often and through what method do they monitor the
fetous growth and position. Lead the discussions to the ways of monitorinq
die fetous position and condition. Invite pregnant women to demonstrate(refer
instructions given behind). (If you have more than one woman, and if women
do not mind, encourage the participants to examine them)
Continue the discussions towards risks during pregnancy with the help of the
counseling card. Again invite participants to share experiences and problems
they faced during pregnancy and how did they cope with it.
Important Messages for the Village Women
❖ Changes during pregnancy
1. The egg and sperm meet in the fallopian tube. The sex of the baby is
decided immediately. The embryo implants itself in the inner lining of
the womb.
w
2. The womb grows within the hipbone during the first three months.
Hence it is not possible to confirm pregnancy by abdominal
examination.
3. Various changes in the woman's body include increase in the size of
breast, darkening of the nipple and areola, increase in the size of the
abdomen, development of lines on the abdomen and the occasional
itching on the abdomen.
4. If the woman is looked after, provided with adequate and appropriate
food, rest and mental peace, the womb increases about one and a half
inches (measuring two fingers) every month.
5. The womb grows to reach the naval region by the fifth month. From the
seventh month onwards, it grows about three inches (a measurement
of four fingers) by every month. If the growth of abdomen is less than
this, it should be considered as a risk factor.
Care During Pregnancy
Village Level Training Module
2
If the womb does not reach the naval region by the fifth
montn ana tnen does not grow by four fingers every month, it
v It is very important to monitor the position and condition of the fetous. The
position will give us an idea of the kind of delivery the woman might have and
condition will help us understand the general health of the baby and the
woman.
❖ Care during pregnancy
1. Get the woman s name registered with the ANM and also enroll her in
the Anganwadi.
2. The ANM should examine her at least three times, first during
registration, second after six months and at the onset of the ninth
month.
3. She should eat the locally available foods, many times during the day.
Include more amounts of cereals, pulses green leafy vegetables in her
daily diet. She should also consume the supplementary nutrition that
she receives from the Anganwadi regularly.
4.
°r^er husband should avoid tobacco, smoking biddies or drinking
5. She should avoid lifting heavy weights, exertion and injury on her
abdomen.
6. The woman should consume the iron tablets given by ANM daily with a
glass of buttermilk. She should complete the course of 100 tablets.
7. She should be given two injections to protect against Tetanus Toxoid
by the ANM.
8. The family should behave affectionately with her and take care of her
and her needs.
9. The woman should have a delivery kit from ANM in the seventh month.
She should understand its use and gave it to the Dai, when she has
labour pains.
*** doctor'immed^^e|COnCiitiOnS
extreme^ risky during the pregnancy consult
rt
1. Pain in abdomen (before labour)
2. Extreme pallor(severe anemia)
3. Swelling on feet and body and High blood pressure
4. Excessive bleeding
5. Convulsions
Care During Pregnancy
Village Level Training Module
3
IM
Our Role in Creating Social Awareness regarding Care of
Woman during Pregnancy
As a Family Member
®
•
•
•
•
•
•
•
•
Look after pregnant women with care and affection
Provide encouragement and moral support.
Ensure that she gets enough food to eat to meet the demands of growing
fetous and herself.
y
Register her name with the ANM and ensure that she gets all the care.
Ensure that she eats the food provided to her at the Anganwadi.
Share the work so that she gets some rest.
Do not beat or kick her, particularly on the abdomen.
Keep some money in the house to meet the expenses in case of
emergencies.
Take the woman to district hospital if you observe any danger signs.
As a Man of the House
•
•
•
•
•
•
Ensure that the woman gets necessary and appropriate nutrition during
pregnancy.
Take her out periodically and keep her happy.
Do not beat or harass her.
Avoid sex with her.
Do not smoke or use tobacco since the smoke or sniff can entre in her body
through her breath causing harm to fetous.
Avoid alcohol for peace at the home.
As a Women’s Group Member
•
•
•
•
•
When women are pregnant, specially ensure that they get supplementary
food from the Anganwadi centre.
Ensure that the ANM visits the village regularly and provides services to the
women.
Enable a communication channel to handle emergencies.
Ensure that transport facilities are available in the village.
Seo that the needy families get financial support from the panchayat to shift
the woman during the delivery to the hospital in case of emergencies.
Care During Pregnancy
Village Level Training Module
4
\^
(
As a Panchayat member
•
•
•
•
Ensure regular visits of ANM to your village.
Ensure efficient running of anganwadi in your village.
Ensure that you have a trained dia in your village, if she is untrained arrange
for her training.
Provide transportation support for emergency during pregnancy and child
birth.
Activity 1 Ramila's Story
Objective
To educate the participants regarding the care necessary during pregnancy.
Material required
Copy of the story given below. You may also write it in big letter on the flip chart.
Method
•
•
•
Read out the story to the participants.
Ask them to read out the care necessary of the pregnant woman depicted in
the story.
Invite sharing of experiences among women.
Care During Pregnancy
Village Level Training Module
5
Ramila’s STroy
Ramila has been married for two years. She has missed her
periods for the second time. She has severe nausea early in
the morning. She feels that she is pregnant. She consults
Radha, who is a leader of a women's group. On her advice,
she takes the following measures.
She gets her name registered with the ANM and also enrolls
herself in the Anganwadi.
Care During Pregnancy
Village Level Training Module
6
The ANM examines her three times, first during registration,
second after six months and third when the ninth month sets
in.
She eats locally available seasonal foods, several times
including fruits and vegetables during the day. The food is
simple, fresh and home cooked. She remembers to
consume at least 8 glasses of water daily. She includes
more amounts of cereals, pulses green leafy vegetables and
seasonal fruits in her diet. She also consumes the
supplementary nutrition that she receives from the
Anganwadi centred regularly.
Care During Pregnancy
Village Level Training Module
7
176
Based on the Dai s advice, she does not consume tobacco,
smoke biddies, drink alcohol and food from vendors, and
uncovered also makes her husband avoid them. She does
not eat clay or bricks as many other pregnant women do.
'i
She avoids lifting heavy weights, exertion and injury on h^r
abdomen.
Care During Pregnancy
Village Level Training Module
8
nt
The ANM gives her iron tablets, which she remembers to
take daily, at bedtime with a glass of buttermilk. She
completes the course of 100 tablets.
The ANM gives her two injections to protect against Tetanus
Toxoid.
' '
Care During Pregnancy
Village Level Training Module
9
The Dai advises her to look after herself and keep clean.
She takes bath daily and slowly massages her nipple.
I
Her family is affectionate and they look after her. She and
her family are happy and excited about arrival of the baby.
Care During Pregnancy
Village Level Training Module
10
The ANM gave her a delivery kit during the seventh month.
She understood its use and gave it to the Dai, when she had
labour pains.
I
After nine months, Radha gave birth to a daughter. She and
her baby are safe and healthy.
ii
I
Instructions for Monitoring the Position and Condition of the
Foetus
There are three ways of monitoring:
Observation
•
•
•
In the normal position (head down) abdomen is oval shaped
If the baby is in upside down (head up) position, abdomen is broader at base
In transverse position, the abdomen becomes large of pot shaped
Care During Pregnancy
Village Level Training Module
11
1 2°i
Listening to the heart beat
»
•
«
•
In the head down position, the heart sound is heard just below the navel
region
Any other part down, heartbeat is heard above the navel
In case of twins, heart sound is heard above the navel
If it is a transverse lie, heart beat is heard parallel to the mother's navel
Touching the abdomen
•
•
Feeling for the fetal head. It is hard and round.
Feel whether it is up (towards the chest), down (towards the legs), towards
the sides or there are two heads.
Observe fetal movements (kicks) and note the changes.
Care During Pregnancy
Village Level Training Module
12
\SO
Counseling Card
Risks during pregnancy
The following five conditions are extremely risky
•
•
•
•
Pain in abdomen (before labour)
Extreme paiior(severe anemia)
Swelling on feet and body and High blood pressure
Excessive bleeding
• Convulsions
In any of the above conditions
Do not waste time. Refer the woman to the First Referral Unit (FRU) or
a District Hospital where there are facilities for blood transfusion,
Operation theater, Anesthetist and Obstetrician.
Under the RCH program the Panchayat has emergency funds to the
provide money to needy families incase of medical emergency.
There are other conditions, which increase the probability of
complications during pregnancy and childbirth. They are:
•
•
•
•
•
Age less than 18 or more than 35 years
Height less than 145 cms.
Weight less than 40 Kg. Or weight gain less than 10 kg
More than 4 children
Large abdomen or old scar on abdomen
It is better to be careful. Prepare for delivery and save money for
emergency. Also keep transport facilities ready for emergency.
Care During Pregnancy
Village Level Training Module
13
REPRODUCTIVE AND CHILD HEALTH
CHILDBIRTH AND CARE AFTER CHILDBIRTH
Village Level Training Module
2 hours.
Learning Objectives
At the end of the session the participants will learn about
♦
♦
♦
♦
dos and don’ts of three stages of labour during childbirth.
the importance and necessity of cleanliness during childbirth.
care of woman and infant after childbirth.
complications during labour and after childbirth.
Design
Time in
minutes
60
30
30
Topic
Method/material
Stages of Jabour during childbirth and
precautions during these stages_______
Care of woman and infant after childbirth
Discussions and
information sharing
Discussion with the help
activity 1____________
Discussions
Probable complications during and after
childbirth
Material required
Copy of the story in activity 1 as number of participants.
Note to the trainer
Welcome the group by saying,
“Dear sisters, today we are going to talk about childbirth, the experience most of us
have gone through. Childbirth is one of the most important and intense occasions in a
woman's life. It is necessary for us to get appropriate information on this subject for our
own well being and that of our infants’.”
Childbirth and Care after Childbirth
Village Level Training Module
i
•
•
•
•
Invite participants to share their experiences of childbirth. Discuss various stages of
labour during childbirth through experiences emphasizing on the dos and don’ts of
the stages. If possible narrate some bad experiences due to harmful practices or
negligence during childbirth.
Lead the discussion to importance of hygiene during childbirth with special emphasis
on the five cleans.
Continue the discussions leading it towards care of the woman and infant after
childbirth.
End the session after discussing the risk factors and complications during and after
childbirth. Encourage sharing of experiences by participants providing scientific
discussions where ever necessary.
Important Messages for the Village Women
❖ Stages of labour
The beginning:
The womb begins to contract and relax and the woman has pain. This opens the
mouth of the womb and the foetus is pushed down.
_ _________
Do__________
Inform the Dai or ANM immediately.
Relax and keep moving. Rest when you
feel tired._______
Take the pain gradually as they come. Do
not apply force,_____
Breathe deeply.
_ _____________ Do not______________
Push or apply external pSressure on the
abdomen to hasten the labour._________
Break the amniotic sac with nails or blade.
Give an injection to speed up the labour.
Insert hands/ other substances in the
vagina. ________
Drink plenty of energy giving fluids like
jaggery water, black pepper and ginger
decoction, tea, milk etc.
___________
Ask the Dai/other women to massage your
back, abdomen, thighs etc.
Childbirth and Care after Childbirth
Village Level Training Module
2
■
i
Second stage when the pains become stronger:
The pains become stronger and unbearable. The interval between two
contractions decreases. The womb’s mouth opens up and the bag of water
breaks. The woman may feel the urge to pass stools. The contractions become
more severe and frequent and the baby is delivered.
________________ Do_______________
Allow the woman to scream.___________
Sitting in squatting position would help the
baby to come out fast,________________
Bear down when there is a contraction.
Support the perineum with a cloth pad.
______________ Do not________ _
Pull the baby out with force.___________
Cut the genitals of woman with a blade to
broaden the passage.____________ '
Insert fingers in the vagina to examine
foetus movement.___________________
Push or apply external force on the
abdomen.
Wrap the baby in a cloth and put it to
breast immediately.______________
Wrap the baby in a cloth and put it to
breast immediately.______________
Cut the cord after the pulsation stop.
The third stage of labour:
When the placenta starts to separate, there is a gush of blood, the womb
hardens and the cord becomes loose.
________________ Do________
Wait for the placenta to come out.
Wrap the baby in a cloth and put it on
breast.____________________________
Ask the woman to push after the placenta
separates._________________________
See that the placenta is complete.______
Bury it in the ground.
______________ Do not__________
Wait for more than 30 minutes for the
placenta to come out.____________
Pull the placenta.
Push the abdomen.
Remove the placenta by hand.
❖ The five cleans
Clean surface. (Avoid using dirty rags and or grass)
Clean hands. (Wash hands thoroughly with soap and water)
Clean blade. (Do not cut the cord with sickle or rusted knife)
Clean thread. (Use clean sterilised thread available in delivery kit)
Clean stump. (Avoid putting anything on it and keep it dry)
Child Birth and Care after Birth
3
\/illona I m/oZ Traininn A/z-wfu/o
t ?/i
❖ Care of the woman after she gives birth
•
•
Eat foods that are rich in energy.
Drink herbal preparations (show decoction of jaggery and bishops weed seeds,
ginger and milk, ladoos made from flour, gum and other herbs etc).
Eat food provided at the Anganwadi.
Take an oil massage and bath with warm water.
Take bath daily with warm water and wash the genitals as well as the pad.
If there is a local practice, takeTumigation in the genitals.
Lie in bed at least for 10 days.
Take 1 iron tablet daily after meals and complete the course of 100 tablets.
Give only breast milk up to four months of age.
Introduce complementary foods along with breast milk.
•
•
•
•
•
.•
•
•
While breast feeding:
Eat plenty of foods that give energy (jaggery, ghee, sugar, cereals etc.)
Drink plenty of fluids (10-12 glasses of water, buttermilk, milk, herbal decoctions
etc.)
Special herbs and foods promote breast milk, consume them, (bajri, coconut, poppy
seeds, Shatavari etc.)
Sleep adequately.
Relax and do not worry.
•
•
•
•
•
❖ Care of the infant
Feed the baby frequently, when it demands.
Keep the baby warm.
Keep the baby near the mother. This provides warmth and strengthens the
emotional bond.
• Family members should help with housework.
• Keep the baby dry and clean.
• For the first seven days, wipe the baby clean, keep the stump dry.
• Give the baby massage and fumigation (shek) depending on the season.
• Immunise the child as per the national schedule. Complete the schedule.
• Talk, sing songs and play with the baby.
• Consult a health worker as soon as you see any risk/changes in the baby.
•
•
•
❖ Complications during labour and after childbirth.
Child Birth and Care after Birth
Village Level Training Module
4
rXnTP,OmS 31 'he ear'iest and Shifl ,h9 w°ma" *° <«« level hospKa!
During Labour
‘ 0^ iS "0 Pr°Or?SS eVen af,9r 12 ho,JrS of pain or lh9 W9m»'s mouth does not
thew “b. C°meS °Ul bef°re lhe head of lhe
•
•
•
•
the baby may suffocate inside
If the hand comes out first.
Baby is upside down.
Absence or reduction in foetal movements and heartbeats
Convulsions.
Excessive bleeding.
After Childbirth
•
ExcSve NeXCOme
30 minU‘eS
• Convulsions.
’ andp* in S™”"' Sme"'
'he baby * b°m'
°'the diS9har". accompanied by fever
Our Role in Spreading Awareness about Contraception
As a Family Member
•
•
Do not insist on early pregnancy for a newly wed bride
Keep the pregnant woman happy and share the housework.
Ensure that she takes proper rest and food
’ S'mXXd i&ns.^ ,0°d a’'ailable frOm to9anwadi a"d 99ts
As Men of the House
‘ proST 'S 3 mai°r e''en‘in "’e li,e 01 a woman' ensu’re her ^alth throu0hout the
* enSUle tP^Per d'et and enou9h rest for her- KeeP her happy
’ heT “ter food'8
available from Anganwadi over and above
•
Ensure she gets proper care before delivery, including TT injections and iron tablets.
Child Birth and Care after Birth
Village Level Training Module
5
•
Save money for emergencies during delivery. Be available for her during childbirth.
As a Women's Group Member
Educate villagers about the care necessary of women during pregnancy.
Encourage women and men to avoid repeated pregnancies.
Support woman who wants to get contraceptives and accompany her to the health
center if necessary.
Counsel the family of a pregnant woman to support her during pregnancy.
Ensure that you have a trained dai in your village.
Encourage pregnant women to eat supplementary nutrition from Anaganwadi and
get proper ante natal care including TT injections and iron tablets.
Monitor working of Anganwadi and ANM.
Work with panchayat members to regularize visit of the ANM and availability of the
delivery kits with pregnant women.
•
•
•
•
•
•
•
•
As a Panchayat Member
•
•
•
•
•
•
•
Ensure that your village has a trained dai.
Ensure regular visits of ANM and monitor her working.
Ensure proper running of Anganwadi.
Ensure all the pregnant women get proper care.
Arrange for transportation facilities for women in emergency.
Encourage people to go to district hospital in case of difficult delivery.
Ensure health education and availability of condoms and other contraceptive at
health center or village distribution centres.
Child Birth and Care after Birth
Viliage Level Training Module
6
(
Activity 1 Ramila's Story
Objective
To ensure the care of woman and infant after childbirth.
Material required
Copy of the story given below.
Method
•
•
•
•
•
Divide the participants in small groups of five to six each.
Read out the following story to them.
Ask them to discuss what advice did the dai give to Ramila.
Let the small groups make presentations in large groups.
Make a final list of points of care of woman and infant after childbirth, add points if
necessary.
Story
Ramila lives in Radhanpur village. After two years of marriage, she has given birth to a
beautiful daughter. Radhabai, the local Dai, assisted her. She gave the following
advice to Radha.
“After giving birth, a woman requires a lot of energy to regain her strength, to prepare
for breast feeding and look after the new born. If you will follow my advice you and your
baby will become healthy soon.” Ramila promised to do as Radhabai said. Radhabai
advised her.
Ramila followed Radhabai’s suggestion. Today her daughter Roma is celebrating her
fourth birthday. Ramila feels strong and sturdy like she was before Roma came in her
life.
What advise did Radhabai give to Ramila?
Child Birth and Care after Birth
Village Level Training Module
7
1
REPRODUCTIVE AND CHILD HEALTH
ABORTION
Village Level Training Module
1 hour 30 minutes.
Learning Objectives
At the end of the session the participants will learn about
♦
♦
♦
♦
factors to be considered to decide about abortion.
aspects of safe abortion and difference between safe and unsafe abortion
danger signs after abortion.
care to be taken after abortion.
Design
i
Time in
minutes
30
30
30
Topic
Factors to be considered while deciding for
an abortion__________
Difference between safe and unsafe abortion
Danger signs after abortion and care to be
taken after abort!on
Method/material
Discussion with help of
activity 1____________
Discussion with illustrations
1 to 4________
Discussions
Material required
hoT m sJuations 9iv®fl.in activi‘y 1 • The illustrations 1 to 4 can be photocopied from
here. Marker pens and flip-charts or black board and chalk.
P
Note to the trainer
Welcome the participants and start the session by saying,
i^r,?SterS’ a^,iOn ,S a topic that women need to have information about and is
n5ed technical information about it and we also need to develop
more strength to decide when and where to seek abortion, if required. ”
P
Abortion is not a method of contraception
Abortion
Village Level Training Module
1
duri"8 lakinS a
‘
deS“taan'LVoXiS<:USS
‘
eabor,ion *he,p °f1 to 4
’
^SCh I5
r'Sk S'9nS after abortion and need t0 seek medical advice
Lead the discussions to importance of care, rest, diet and use of appropriate
method <5^rtrace^on.'0^ EmPhaS'2e abOr,i°n
n0'bS USed aS a
aSPeC'S 10 be
Important Messages for the Village Women
❖ Abortion is legal in India
1. by untrained people
2. using unsterilized instruments
3. in a dirty room
4
after more than 20 weeks of pregnancy
v Always get an abortion done by trained personnel
' oaTinl^
heav* b'eedin9. hi9h fever, severe
P
he abdomen, or you have attacks of unconsciousness or feel confused or
foul smelling discharge from vagina after abortion.
confused or
‘ nt!neICopper,T •nserted within a week after the abortion, it may rupture the
Take r? T Se !Ct ^SthOd °f contracePtion of your choice after abortion
❖ Take care of your health after abortion in terms of:
1. Do not have a sexual intercourse for two weeks after
2. Follow up check up in two to three weeks without fail’
3. You will get the next period probably four to six weeks after your
a ortion. If you do not get periods within six weeks, contact the doctor
You can get pregnant immediately after an abortion, even before the '
next period.
4. Use a reliable contraceptive method if you have sexual intercourse and
do not want another pregnancy.
5. Drink plenty of water and eat green vegetables and food like lemon
fresh buttermilk, etc which are sour.
6. To reduce the pain and bleeding rub or massage the lower abdomen
gently, and often.
7. If there is a pain, keep a hot water bottle on the abdomen.
Abortion
V:^ce Leve! Training Module
2
)
Our role in Creating Social Awareness about Abortion
As a Member of Family
•
•
•
Take a joint decision for abortion, rather than alone.
Abortion is legal and there is nothing immoral about it, support the decision of
abortion, if it is safe and appropriate.
Take good care of woman who has undergone abortion.
As Men of the House
•
•
•
’
Abortion is not a method of contraception, resort to it only if necessary
Contraception is a joint decision, take responsibility for it
tomoS aboutT"' "
“linkS abOrti°n iS the besl °ption’there is nothina
SerSnr^ °f WOman wh° has 9°ne lhrough abortion. Ensure proper diet
qi iu I uol lur ner.
As a Women's Group Member
*
and±e"nlheX"'diSSemina'e“am°n9
•
Support woman who decides to abort a child.
Ensure that not a single illegal or unsafe abortion occurs in your village.
thin0316
,ab0Ut the dan9ers of abortion and its use as last option rather
than a method of contraception.
’
As a Panchayat Member
on abortion wi,h he,p ofanm-
:
'
Encourage the community to go only for safe abortions.
abortions^6 V'lla9e
t0 001 promote or 9et involved in unsafe and illegal
•
Arrange for transportation in case of medical emergencies for women.
Remember
The decision for abortion needs to be yours.
You need not take permission of any one for abortion.
Pnvacy and confidentia/ity about abortion is your right.
Abortion
Village Level Training Module
3
IG(
Activity 1 Question sheet
Objective
an abortiorh 1,16
8b°Ut ,he faC,°rS 10 be “nsidered
deciding about
Material Required
Copy of situation sheet. Marker pens and flip charts.
Method
Invite participants to divide themselves in small groups of five to six members
•
Read out one situation with questions to each group separately If there are anv
literate group members give them a copy of the situation sheet
V
ikt J" 9/OUPs dlscuss (he questions and the answers of come to a common
ist of factors to be considered in deciding about abortions. Ask them to specify
who, according to them should decide about the abortion.
P
Ask the group to make presentations in large group.
abortion 'nC'US'Ve ''St °f faCl°rS' emf>hasisin9 "omen's right to decide about
Situation sheet
1' waoeeam^'daU9hterS ar,d ‘hiS 'S hef mh Pree"ancy. Her husband is a daily
vvayc Cal I lei .
J
Does she really want this child? Why?
2. Ramji’s wife is pregnant for the third time
ime. Ramji also takes care of his elder
brother’s widow and his four kids. Ramji’
.’s parents live with him too. Ramji’s wife
does not want to have a child.
Should they have this child? Why?
3'
'a? 5USuand m'9rates 10 a nearby city every year. This year after he came
back he had a burning sensation when he urinated. Shyamla has back pain since
suffe^mToT^Tn^ ShS 'S Pr69nant with her second child- She fears she is
OUIIdlllCJ 11 (Jl 11 o I U.
What should they do? Give details.
Abortion
Village Level Training Module
4
4. Ramila is four months pregnant since last few months. She is not married. She
was abie to hide it from her parents for so long, but now her mother has found
out. The local dai said she was pregnant for five months now
What should they do?
)
Abortion
Village Level Training Module
5
IO
Illustration 1
Safe abortion is performed
By trained and experienced health
personnel
With proper aseptic instruments
Under a clean hygienic conditions and
environment
Upto three months after the last months
bleeding
Upto 20 weeks in consultation with two
medical doctors and special equipment
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Abortion
Village Level Training Module
’6
Illustration 2
Unsafe abortion is performed
By untrained person including a medical
personnel without license
With rusted or wrong instruments
Under a unhygienic.conditions and
environment
After three months of pregnancy
Note: r
‘
Enlarge
this illustration cut it and paste it
on a transparency for use dunng training.
Abortion
Village Level Training Module
on the cardboard or transfer it
7
Illustration 3
How to tell if an abortion will be safe?
This room looks safe for abortion
c>
The room looks clean and airy.
There is a space for washing hands.
he instruments look scientific, properly organized and look like they are in use
I here is a stove in working condition to boil the instruments
An Auxiliary Nurse Midwife (ANM) is present along with the doctor to assist to
perform abortion.
There is dustbin to throw the waste material.
Please Note: Abortion service is free of cost at the Primary Health Centre
on a tran'sparency KZ'dXg 2^’ “ O" ‘b' Cardb°ard "
“
Abortion
Village Level Training Module
'8
Illustration 4
How to tell if an abortion will be unsafe?
This room is not safe for abortion
The room looks dusty and unclean.
There is no space for washing hands
The instruments look dusty and rusty. It looks like they are not in use.
There is no stove to boil the instruments
There ,s no ANM present along with the doctor to assist to perform abortion
The waste material is lying here and there.
Note: r
Enlarge this illustration cut it and paste it
on the cardboard or transfer it
on a transparency for’ use during training.
I*
i
Abortion
Village Level Training Module
a
9
Itf?
Abortion
Village Level Training Module
J
10
H
1
REPRODUCTIVE AND CHILD HEALTH
iNFERTiLrry
Village Level Training Module
o
1 hour 30 minutes.
Learning Objectives
At the end of the session the participants will learn about:
•
•
•
•
what is infertility
reasons for infertility
what is fertile period
what can be done during infertility
Design
Time in minutes
10____________
20
30
30
Topic____________
What is infertility
Reasons for infertility
What is the fertile period and
how to know about it_____
Some ways to overcome the
problem of infertility
Method/materials_____
Discussion___________
Discussion with help of
counseling card 1______
Discussion with help of a
counseling card 2_____
Discussion with help of
illustrations 1 and 2 and
activity 1
Material required
Photocopy counseling cards 1 and 2, and illustrations 1 and 2, along with the
story given in activity land illustrations from here and stick them on cardboard
separately. You may also copy the story on a big flip chart in big letters.
Note to the trainer
Infertility is a very sensitive topic. It can disturb any person who is not able to have
children. Provide space for the person to cry or share her grief if need be.
Infertility
Village Level Training Module
i
1
IU9
Welcome the group by saying,
' ^=2===
to slSE~pa^pants
’ »waa|ly diSCUSS lh?roles of different Mviduals and groups in creating social
awareness regarding infertility.
H
9 social
Important Messages for the Village Women
v A couple who cannot get conceive after having sex together a few times a
™nsyeAar'wf.out using a family plannin9 method maybe
. S^^“So™^gnSy,ertili,y prob'™
hav Jraem^ni;Th:f™X“n be in ei,her man °r “man °r in b°,h- d°
Distribution of Causes of Infertility
20%no reason
10% in bot
40%in wo en
30%in me
Infertility
Village Level Training Module
2
❖
There are different causes for infertility. Some of them are:
Defective or less sperms in men
Too fat or too thin woman
STD infection in one or both the partners
Defective reproductive tract or uterus in woman
Tobacco or alcohol use
X clSf hn!het?SSary tha^ a" women 3ive birth- You can adopt children too
♦ Get both, the man and woman’s examined in case of infertility, other wise the
real reason may not be assessed found out.
❖ Get both the partners examined for reproductive tract infections even if there
S^n' 10 S°me kinds °f infecti°ns there might not be obvious
signs. Even if any one of the partners is suffering from infections it is
eachoSthPr 9et Oth CheCked and treated'to avoid rePeated infections from
V YJ0 hh ve s®x durin9 your fertile time. For most women their fertile time
starts about 10 days after the first day of the monthly bleeding and lasts about
O (Jays.
' tH0Slti°n °f man and woman- whi'e sexual intercourse also helps to increase
the chances of getting pregnant.
increase
If woman does not get pregnant even after one year of sexual relations without
the use of any family planning methods, it is important to consult the doctor.
Our Role in Creating Social Awareness about Infertility
As a family members
" S^tnS f°nly
tJe 7700130 for not 9ivin9 birth t0 3 child- Encourage the
couple to go through the medical check up.
> inSiff UP'e “[V101 conceive a child. encourage them to adopt a child
h ouoh itTmav h Srt°h Gd
re'i9i0US ritUa'S- D° 001 f0rC3 woman to g 0
inrough it. It may hurt her self esteem.
^m!rfia9H m nOt lhS answer of infertility. It is an insult to woman and
womankind. Never encouranp
Qfomiiw
encourage vnnr
your moi
male
family member to do that..
As a man of the family
> ^i“nyou may
of ^man for n0‘ faring a child (or '
In your family if another couple is having the problem of childlessness explain
to them about the medical check up and adoption of child
P
other
'S
10 aChie''e"fe' Exp'ain ,his
Infertility
Village Level Training Module
3
<r
Tav no
yj
ZJ
0623S
\sl
V *
As a Women's Group
Wh0 is
”
lbra^b *ba ^nts and
encoura9e the members of the family facing the problem of
childlessness, to adopt a child.
" sto^^
lha reas°" chi,dlessness.
to
" Sal "“XSdX'00' in,erti'i,y- AWar6neSS ™'" he'P 10 rem°V6
> Educate the community that though motherhood is important in woman’s life
it is not the only ultimate goal of her life.
’
As a Panchayat member
> Organise medical camps and education sessions for you village on “infertility”
W
™etin9 °f Vi"age hea,lh co^miSee and 7 ’
discuss the problem of fertility and get information from your village nurse
couptoSodothat36peop'6,0adOptCh"dren- Honourand aPPreciate
>
'ame 7?man for no1 bain9 able ,0 co"“i-e ^d provide support to
thl rn n?
b® counsel.her husband and family about medical check of
the couple to combat infertility and about adoption.
Infertility
Village Level Training Module
4
(
Counseling Card 1
Reasons for Infertility
Defective or less sperms in men
1 P
STD infectiorT in orieorbothlhe
partners
Defective reproductive tract or
uterus in woman
T°baccooralcohoTuse
Infertility
Village Level Training Module
5
|1
1 S
Counseling Card 2
How to know the fertile period
Every day during the bath after cleaning the hand with soap insert one or two
finger inside the vagina up to the cervix (mouth of uterus) and remove some
mucus (sticky secretion). This mucus has to be examined between the finger and
the thumb as shown in the diagram.
Dry(no mucus) nothing comes on the finger
Non stretchy, crumbly or like cream on the
fingers(not fertile)
The consistency is like a curd
Stretches a little but breaks(slightly Fertile)
The consistency is like sugar syrup
Wet, very stretchy, slippery(extremely fertile)
The consistency is like a raw egg white
Infertility
Village Level Training Module
6
! )
Illustration 1
Addressing infertility
The best positions for enabling pregnancy during sex are
The woman lies on her back with theman on top-------------------------
Both man and woman have a sex lying on sides
-3
Infertility
Village Level Training Module
’1
7
ISS'
[131e_lEnl.ar9e this il,ustration cut it and paste it on the cardboard or
transfer it on transparency. for’ use during training.
Illustration 2
Addressing infertility
Other things to keep in mind
If any partner is suffering from any kind of STD, get it treated. Even if only
one person is suffering from STD it is important to get the treatment for
both of them
The couple should eat good, healthy food. If you do not have regular
monthly bleeding and you are very thin or fat, try to gain or lose weight
The couple should avoid smoking or chewing tobacco, using drugs , or
drinking alcohol. Avoid caffeine in drinks like coffee, black tea, and cola
drinks
Infertility
Village Level Training Module
8
) .
'I
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on transparency for use during training.
Activity 1 Zarina's daughter
Objective
To sensitize participants and generate discussion on the advantages of adoption.
Material required
lasle «
°f Zar'na 9iVen bel°W Wrile
S,Or>'in biS lelters °n a "iP dart and ■
pdoic IL.
Method
•
•
•
Read the story to the entire group.
Invite participants to share their ideas about adoption
Invite participants to share experiences.
Zarinas daughter
ai i cvLivJI IdltJ.
J
....... ..
She talked to her parents. Her parents also mentioned that vrhat herTusband Is
stoty’to the toaderTtoeXp RamT96 '”men'S 9r°UP and “ed aboul her
Scan "b*
nproc 00d the Sltuatl0n- He a9reed to go for the medical test After rnakina
informed I am sorry to state that Ramji and Zarina cannot have children
Infertility
Village Level Training Module
11
9
a baby iXirto™?"™
Ms dePre^d How they craved for the err _
cries of
foranT"19 °PP0Sed the idea- Bu‘
Ihe cNId
forgot every thing. They fell in love with the child
Infertility
Village Level Training Module
Wants 10 adop',he «W. With
'n 'aW in the
6' l0°kin9 at her they
io
n
REPRODUCTIVE AND CHILD HEALTH
CONTRACEPTION
Village Level Training Module
1 hour.
Learning Objectives
At the end of the session the participants will learn about;
’ "nl?aiXebse
SUPP°rted ,empOra,y and™thods of
How to choose the best contraceptive for self.
Design
Time in minutes
30
---------
30
Topic
What is contraception, different
methods of contraception and
how to use them
Making a right choice of
contraceptive
Method/materials
Samples of contraception.
Activity 1/discussions
Activity 2/discussions
Material required
Contraception
Village Level Training Manual
f
1
Note to the trainer
You may start the session by saying,
'
T am°n9 ,he
JvenTn A°c£«y
•
Discuss effecliveness,- safety and side effects of each method Encourano
diffoemenCe Shann9 Wh'le d'scuss'n9 side effects. Highlight the individual
differences ,n acceptance of appropriate choice of contracepXe Emohasize
factors of safety and effectiveness along with personal chotaT EmphaSlze
’
eZragTX"^^
‘
cwIaceZl reSP°nSibi'i,ies 0'rartous SWS i" encouraging use of
appropria'9 me,hod- '"troto activity 2 and
Important Messages for the Village Women
* se^life^P1'76 me,h°d 'S 3 t00110 PreVenl °r P°stPone Pregnancy while enjoying
* -n^XZZcZnl^ostpVneX^cy 0^’
““
" y^ZsZbesjbX^n yru'he ",e,h°d ''0U chpps^Pending upon what
X CnnHdeal a^e for motherhood for a woman is between 20 and 30 years
. Condom is the most widely known and used barrier device by males around the
Uansm tededentS pre9na™y and Protecfs b°‘h men and women from sexually
transmitted diseases, including HIV/AIDS.
y
* Condoms, pills and IUDs are available at Public Health Centre (PHC) and other
government clinics free of cost under family planning programme
❖ btenhzation operations for men and women are also done free of cost at PHC or
other government hospitals.
Our Role in Spreading Awareness about Contraception
As a Family Member
early pregnancies S
•
•
•
COndOms or other contraception to avoid repeated or
Do not insist on early pregnancy for newly wed bride.
Get information on contraceptives and provide it to couples.
Accompany woman to health center to get contraceptives if necessary.
As Men of the House
Contraception
Village Level Training Manual
2
)
(
*
no ™^lPti°n iS jo;ntJesponsibility- be responsible and use condoms
Do not allow repeated and early pregnancy.
qunnnH
t0 USe contraceP‘ion to avoid unwanted pregnancies
Support the member who wants information about contraception.
As a Women's Group Member
WantS ,0 961
■
Stif
’
’
^U2Se!lher fam'ly t0 Support her in delaying pregnancy
cenireTfroXT member 10 9et reSo'ar stook of free oontraceptivee in health
and ^-pany her to heatth
-As a Panchayat Member
’ ornwcsn,O™a,i°n and re9Ular stocl' °f frea contraceptives at the health center
You can get condoms from ANAA
Our Roles in Promoting Contraceptives
Role of men
Wma" a"d ™ -e
X°ns“?XTen!CnXTeS
other protected from diseases. In ourCy 3nd ke®pin9 themselves and each
be falling on women only, men should be eauaTnarfH81^11^^ birth contro1 seem to
Some specific actions they can take are- q
P rtner IS shann9 this responsibility.
•
’
r>
Use condom as a method of contraception
?he^OreHnf°rmatiOn ab0Ut available contraceptives.
contra JpHon.55
VaSeCt°my when time comes
permanent method of
'
hospital ‘he effeCt °f OT'ra“=P>'« »n <he woman and if need be take her to the
.■
XToLTmTn^eTXo;'
Contraception
Village Level Training Manual
3
Role of Women’s group
’ Zmeennin™aPgCen
'h'0""3"0'’ ab°U' “rtra“P««*
educate other
‘ cTohnXnpPveTPa'e ‘n Vi"a3e Hea"h C°mn,iltee a"d '5et — -'o-ation about
’ InXe herXZr
•
V"°
°f “"—pHves
They can talk to men of the village and educate them about contraceptives
'°
oSra^teS SgX
•
Sm00,h "Ow
They can accompany women going for tubectomy.
Role of Ponchoyat
•
Panchayat members can set example to the village by accepting contraceptives
for spacing and preventing childbirth and talk about it.
P
anchayat can ensure smooth flow of contraceptives in the villaqe
‘ ™e\yi|Sg;Xnmu„«ya',h edUCa,i°n SeSSi°"
he'P “ DePartment f°r
’
in“
: Sszsxs'zzsiz**
Contraception
Village Level Training Manual
4
n
Activity 1 Knowing Contraceptives
Objective:
To familiarize participants with contraceptives and prepare them for discussion.
Material required:
You will need samples of different contraceptives mainly, pills, condom and copper T
pictures of vasectomy and tubectomy operations.
Method:
•
•
•
Distribute the contraceptives and pictures randomly in the group.
Do not talk about anything for some time. Let the pictures and contraceptives
change hands and participants giggle.
Once most people finish touching and looking at them ask them the questions
given below and encourage informal discussions.
Encourage sharing of experiences.
Questions:
• What is that?
• Have you used that contraceptive any time?
• Do you know of anyone who uses that contraceptive?
• What happened to you (or anyone who used it) when you used it?
• From where can we get that? How much does it cost?
• Were you afraid to use it for the first time?
Demonstrate use of condom and IUDs
Demonstration of condom use
•
’
Get a pack of condom, a model of penis or banana or carrot
So not XtZdom bXXPgeS on
S° ‘"a* C°ndOm d°eS n0‘
•
J61.1 Partlc|Pants tha* Penis is not circumcised, pull foreskin back. Squeeze the
tip if the condom and put it on the end of the hard penis.
?0|?lnUe squeezin9 liP ^i'® unrolling the condom till it covers the entire penis.
Te l them that condom should be removed after the man ejaculates (comes)
holding rim of condom before penis gets soft.
Be careful to slide condom off without spilling liquid (semen) inside
Throw away or bury the condom.
•
•
•
Remember
Do not use grease, oils, lotions or petroleum jelly to make condoms slippery.
ese make condoms break. Only use a jelly or cream that does not have oil in it
and it is always advisable to use water-based lubricants like KY jelly.
Contraception
5
Village Level Training Manual
•
*
Do not open the condom to check if it is broken, they are already checked.
use a new condom each time you have sex.
Use a condom once only (single use).
Store condoms in a cool and dry place.
Learn to wear condom properly. Loose fitting
or angled wearing can lead to
leakage or breaking of condom.
(illustrations)
oilk°^XXeXkldUrSg interc°urse' contact you doctor or nurse and take oral
pills as early as possible according to their advice.
«
•
•
•
•
Demonstration of IUD insertion
the^Tems
•
’
USUa"y °Pen
t0P’ showthe PartlciPants how the IUD fits inside
Show where women can feel the thread with their index finger
in the 'T!?006 °f sterilization of instrument, cleanliness of the place
So is inserts theewa C'ean a"" S'e"'i2ed 9loves °n lhe hands °f
(illustrations)
insertion of0|ifnS
available use the ''lustrations given herewith to explain the
ii loui IIUII Ul IUD.
Contraception
Village Level Training Manual
6
)
Activity 2 Deciding the right contraceptive
Objective:
To sensitize participants about the factors influencing choice of contraceptives.
Material required:
You will need a copy of the of the story given below, or you may write it in big letter
on a flip chart and put it on if some participants can read.
Method:
•
•
•
•
Divide the participants in small groups.
Read out the story of Govind and Godavari.
Ask the groups to discuss the questions at the end of the situations and come up
with a collective answer. Ask the small groups to make a presentation.
Encourage the other participants to argue about their choice. You may
summarize by emphasizing on need for information, counseling and how one’s
values reflects on choice of contraception.
t Story of Govind and Godavari
Govind and Godavari have three children. Govind is a casual labour in the near by
town doing small jobs and Godavari works as agriculture labour on the landlord’s
land. Both of them realize that having more children is not good for them. The villaoe
nurse is pressurizing Godavari to go for tubectomy or Govind for vasectomy for a
long time now. But Godavari is not sure if she wants to do it. She thinks her children
are too young. Many children die before ten years in her village. Besides she is
afraid of the operation. Govind might also not agree to this, because this will mean
loss of wages for both of them for at least two days and what if she ends up sick? So
many women get sick after the operation.
Govind on the other hand, does not want children but is afraid of going for the
operation. What if his sex desire die after that and so many men cannot do hard
work after that. Besides his children are too young. The village nurse explained
about the use of contraception to both of them. Govind suggested Godavari to take
pills. Godavari started taking pills. But in between forgets and then she gets tensed
about pregnancy, all this leaves her very uneasy.
She asked Govind to avoid sex to avoid pregnancy. Govind is very angry with that
He wants Godavari to go to hospital with him and insert a copper T even the villaoe
nurse says^t's very safe. But Godavari is afraid. All this makes Govind very angry9
h JHidncknm Godava.r' w" not'co-operate, he will end up going to other women (which
he did sometime in the town, when Godavari was pregnant!)
Do you think Govind is right in his thinking? Why?
Do you think Godavari is right in her thinking? Why?
What contraceptive would you suggest them to use? Why?
H
Contraception
Village Level Training Manual
7
CANCERS
CERVICAL CANCER
Village Level Training Module
1 hour 30 minutes.
Learning Objectives
At the end of the session the participants will learn about
♦ probable causes of cervical cancer.
♦ signs of the cancer of cervix.
. importance and procedure of Pap test for early diagnosis of cancer of cervix.
Design
Time in
minutes
30
30
30
Topic
Method/materia!
Causes of cervical cancer
Signs of cancer of cervix
'
Pap test for early diagnosis of cervical
cancer
Discussion with help of
illustrations 1 to 8
Discussion
Discussions
Material required
cardboard separate'ly1
“h b6 photoPied
here and stuck on the
Note to the trainer
Tell the group of village women that,
Cervical Cancer
Village Level Training Module
n
i
14-C
-
With the help of illustrations discuss the probable causes of cancer of cervix.
Discuss signs and symptoms of cervical cancer. Encourage sharing of
personal experiences, if available or experiences heard from others.
Give information of Pap test and encourage women to go for the test as
action plan at the end of the session.
The mouth of uterus is known as Cervix
Important Messages for the Village Women
v General causes of cervical cancer:
Smoking or chewing tobacco.
Consuming fat rich food.
Certain viral infections like hepatitis B or genital warts
Incorrect use of hormones.
Some cancers to some extent are also hereditary eg. Breast
cancer.
❖ Some women more likely to get cancer of the cervix, are those women who:
b^dinVeXUa,,y aCt,Ve W,th in °nly 3 year °f startin9 their m°nthly
have more than one sex partner
have a partner who has more than one sex partner
have had Sexually Transmitted Disease
have had viral infections such as genital warts <
have a relative who have had cancer
have had several pregnancies
smokes tobacco or breathes tobacco smoke where they live or
work
4
maintain cleanliness of their genital parts
v Common signs for the cancer of cervix
abnormal bleeding from vagina, including bleeding after sex
a pinkish or bad smelling discharge, or a bad smell from vagina
in very advanced cases, signs may include pain when passing
urine, or pain in the legs, lower belly or back.
v It is very important that the diagnosis of cervical cancer is done at an early
stage. This could be done through Pap Test It is a quick and simple
procedure. For this test, doctor needs to scrape some cells from the cervix
(this is not painful) during a pelvic exam and sends them to a laboratory to be
examined with a microscope. The result of the test takes about two weeks.
Woman should be tested at least every 3 years. In places where this is not
possible, woman should try to get tested at least every 5 years, especially
women over 35 years of age.
Cervical Cancer
Village Level Training Module
2
)
(
Pap test is not done during menstrual period
tabled ShOUld "O‘be d°ne WiU“n 4ahours of insenion of v^inal
Paptestshould net be repeated earlier than six months
Our Role in Combating Cervical Cancer
As a Family Member
pp
’ a^3?y9e~ge° °e'S
3
'‘
after 35 years of age.
simdarraymptoms ^mP,°mS
''WOman
*
system ne9'eCI 'he hea'‘h C°mplains of women
•
Do not allow child marriages.
Prevent repeated pregnancies by preventive action or through advice
Support women if she is diagnosed to have cervical cancer.
about any
1°
reproductive
As Men of the House
I
•
Prevent child marriages and early pregnancy
•
pregnS's0" * i0'nt responsibai»'. be responsible and avoid repeated
•
'
Do not neglect or do not allow woman to her own health
Encourage woman to get pap test done after age of 35 years
-mPpXW=enthe " deteCted 33
P°Sil-
ear|y and
As a Women's Group Member
•
•
•
Do not allow child marriages and early pregnancies.
educate villagers about cervical cancer
Encourage women above 35 years of age to go for pap lest every year
. Ssxxx“ suf,erin9^h ce™ca'
Cervical Cancer
Village Level Training Module
3
i ( .P
Xs a Panchayat Member
ANMre ln'orn’alion about cen'ical “"“r in village health meeting with help of
’
•
•
.^iogicat camps, including the facility for Pap test in villaoe at
egular intervals and encourage women to participate in them. ’
9
Spread awareness about cervical cancer.
Do not allow child marriages.
Ensure health education and availability of contraception.
Cervical Cancer
Village Level Training Module
4
Illustration 1
Risk factors for women of cervical cancer
Girls who became sexually active within one year of starting their
monthly bleeding
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
R
5
(7o
Illustration 2
Risk factors for women of cervical
cancer
Women who have more than <—
one sex partner or has a partner who has
more than
—i one sex partner
t?'S i,lustration cut '* and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
6
R
Illustration 3 |
Risk factors for women of cervical
cancer
Persons who have had Sexually Transmitted Disease
Cervical Cancer
Village Level Training Module
7
Illustration 4
Risk factors for women of cervical cancer
Women who have had viral infections such as genital warts
I
Note. Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
8
Illustration 5
Risk factors for women of cervical cancer
Women who have a relative who has had cancer
g~^^^Ls;dX^hecartboardor
Village Level Training Module
VI
9
\7Q
Illustration 6
Risk factors for women of cervical cancer
Women who have had several pregnancies
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
10
IV
REPRODUCTIVE TRACT INFECTIONS AND
WOMEN’S HEALTH
Village Level Training Module
1 hour.
r
Learning Objectives
At the end of the session the participants will learn about
♦ causes and symptoms of RTis.
♦ treatment and prevention of RTis.
design
Time in
minutes
30
Topic
30
Symptoms, treatment and prevention of RTIs
Vvnat are RTis and their common causes
Method/material
Discussion with help of
flash cards
Discussion with help of
flash cards
Material required
Flash cards given below. You may photocopy them and stick each separately.
Note to the trainer
Welcome the participants and start the session by sayinq.
“Dear s/sfers. today we are going to talk about the subject which creates a lot of
anxiety and concern among many women. White discharge (safed pani) is
something, many of us suffer from and many a times we neglect it or try remedies
wtvch may not work Let us spend some time in understanding our bodies and what
we can do to prevent problems like white discharge. ”
Speak up, white discharge should be treated immediately
Reproductive Tract Infections and Women’s Health
Village Level Training Module
n
t
•
Ask the participants if they have heard women share about a smelly and
excessive secretion from their genitals. What do they do? Where do they qo to
seek help? What are some of the difficulties they face when they have such a
ExnlaitTwtwt00 RT?6 thSm t0 SharS b°th physical discomfort and social problem
With the help of flash cards explain the causes, symptoms, treatment and
prevention of RTIs.
For herbal remedies please refer chapter on Traditional Health and
Healing Prac tices
Important Messages for the Village Women
v Thin white milk-like secretion without smell or imitation in vagina. This secretion
increases or decreases during different periods of the menstrual cycle.
Women are very shy of discussing RTIs. Break the culture of silence and speak
up. RTIs should be treated early.
❖ Reasons for problem of RTIs are
1. Poor general health leading to infections.
2. Some medicines can lead to this problem, like antibiotics.
3. Infection due to aberration during intercourse, childbirth or IUD
insertion.
4. Poor personal hygiene, especially during menstruation or
intercourse.
5. Ulcers on mouth of the vagina.
6. Sexual intercourse with person suffering from sexually transmitted
diseases.
❖ Symptoms of problem of secretion
1. Thickness, smelly and excessive
2. Change in colour of discharge.
3. Itching in vagina or around it.
4. Pain in lower back and abdomen.
❖
Some of the problems are transmitted from man to woman and the vice versa, it
is very important to get both the partners treated in those kinds of infections.
Using condoms during sex will prevent such transmission.
❖
Some RTIs do not show obvious symptoms in different human beings. Get
yourself and your partner examined if you doubt an infection in either of you.
Reproductive Tract Infections and Women’s Health
Village Level Training Module
2
n
Illustration 7
Risk factors for women of cervical cancer
Women who smokes tobacco or breathes tobacco smoke where they live
or work
OR
Women who use fire wood or smoked chulla to cook
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
I 1
11
176
Illustration 8
Risk factors for women of cervical cancer
Women who do not keep cleanliness of their genital parts
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
12
M
f-'
KS^urse00" PerS°na' hy9ienS’ eSpeCia"y durin9 menstruation and after sexual
•> Eat enough and nutritive foods to stay healthy and do not over exert yourself.
STD$ increase the chances of HlV/AIbs
Use condoms if there is a doubt of
getting a STD. Get both the partners
treated to avoid repeated infections
Our role ln Creating Social Awareness about RTIs
As a Member of Family
•
Share responsibilities of housework
As Men of the House
•
Ensure props?«SswSan^VSad"^lhem SBri0,Js1''-
• Ensure
uXX
w?f7n t0 90 ,or early ,rea"™«
Irealment ol tab thXriX mi9hl
•
■,or a",he members-
ahance el a STD
As a Women's Group Member
•
and STDs “ P-Wa and disseminate it
S
wffS/ TraZng^MoZ
Women's
3
H
I ,?c-
As a Panchayat Member
‘
ANMor healthworte”"SeSS'°nVi"a9erS°n RT'S
•
Arrange for lady doctor in the nearest PHC.
STDSWllh he'Pof
Maintain personal hygiene during
menstruation and physical intercourse
Reproductive Tract Infections and Women's Health
Village Level Training Module
4
)
f1
Flash card 1
Let us understand the problem of white discharge
o
^ductive Tract Infections and Women’s Health
Village Level Training Module
I1
5
1^
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 2
Normal secretion from vagina
Reproductive Tract infections and Women’s Heatii
Village Level Training Module
6
fl
(
Note: Enlarge thia illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 3
When does the normal secretion increase?
Reproductive Tract Infections and Women's Health
Village Level Training Module
I1
7
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 4
When is "white discharge" a problem
Reproductive Tract Infections and Women’s Health
Village Level Training Module
8
n
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 5
Types of white discharge
Reproductive Tract Infections and Women's Health
Village Level Training Module
n
9
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 6
I
Types of white dischor
Reproductive Tract Infections and Women’s Health
Village Level Training Module
10
)
f1
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 7
Types of white discharge
Reproductive Tract Infections and Women's Health
Village Level Training Module
11
ii
Note: Enlarge this illustration cut it and paste it on fhe cardboard or transfer it
on a transparency for use during training.
Flash card 8
Types of white discharge
Reproductive Tract Infections and Women’s Health
Village Level Training Module
12
I 1
\ Co?
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 9
Types of white discharge
Reproductive Tract Infections and Women's Health
Village Level Training Module
[ 1
13
Note. Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 10
When is white discharge dangerous
Reproductive Tract Infections and Women's Health
Village Level Training Module
14
Note: Enlarge this illustration cut it and paste it on the cardboard or transfer it
on a transparency for use during training.
Flash card 11
Treatment and prevention of white discharge
Reproductive Tract Infections and Women's Health
Village Level Training Module
15
Note: Enlarge this illustration cut it and paste it
on the cardboard or transfer it
on a transparency for use during training.
Reproductive Tract Infections and Women's Health
Village Level Training Module
16
\<<S
REPRODUCTIVE AND CHILD HEALTH
HIV/AIDS
Village Level Training Module
© 2 hours.
Learning Objectives
At the end of the session the participants will learn about:
•
•
•
•
the spread of HIV and AIDS.
how HIV/AIDS does not transmit.
prevention of HIV/AIDS.
symptoms of AIDS.
Design
Time in minutes
30
30
Topic_____________________
Understanding HIV/AIDS and its
transmission routes__________
How is it not transmitted
30
30
Symptoms of AIDS______
Prevention of HIV infection
Method/materials_____
Discussion with help of
illustrations 1 to 3______
Discussion with help of
illustrations 4_________
Discussion__________
Discussion through cards
Material required
Photocopy illustrations and discussion cards given behind and stick them on
cardboard separately.
Note to the trainer
You may start the session by saying,
Dear sisters, discussions about HIV/AIDS creates fear and apprehension among
all. The disease is very deadly. We can get infection of HIV by various means. It
is very necessary to learn about the disease to keep our partners and us safe
from HIV/AIDS infections. Also if at all one finds oneself or a friend in this
situation, it is necessary to understand that it is possible to lead a normal life, to a
certain extent even after the infection.”
HIV/AIDS
Village Level Training Manual
i
;
Sos
dlscusslon cards’ discuss prevention of HJV/AIDS infection
*
Important Messages for the Village Women
V imm,TnHUmT ln?muno-deficiency Virus, which causes damage to the human
DoteXi3/!601 by attacking the white bl00d cells. Our white blood cells kill
blood ce
an? infections- °ver time HIV kills enough white
oiood cells that our body can no longer fight infection Therefore Acouired
Immuno-Deficiency Syndrome or AIDS is the end stage of HIV infecSon when
❖ HIvTndAIDS arS 'H^1003 that are not common in a normal healthy person
HIV and AIDS are not the same thing although people sometimes use the two’
notrdAIDn erH±n9eably- 11 iS P0SSible for a person t0 have HIV infec,ion dot
cause AIDS
'
A'DS mUS‘have HIV aS il is this virus
o'Y°nly Jansn;itted through bodily fluids: blood, semen and vaginal
secretions. Therefore there are 3 main routes of transmission:
1. Unprotected sex with an infected partner,
2. Transfusion of infected blood or contact V/ith infected
blood through sharing needles, syringes etc.
3 breast? irJJfeCted 7/00130 to her unborn child or during
Unprotected penetrative sex (vaginal/anal), which means sex without the use
chance nTHiV
VirUS' The presence of a STD ^creases the
chance of HIV infection because diseases like syphilis, gonorrhea and
chancro'd cause genital sores which provide breaks in the skin where HIV
can pass.
HIV infection is not contagious and therefore cannot be passed through
sr1ee2|ng- HIV cannot be transmitted through casual contact
such as shaking hands, hugging, toilet seats, or mosquitoes
v For prevention of HIV/AIDS:
1. Abstinence is the best way to stay infection free unless you remain in a
monogamous relationship with a partner who is HIV negative
ofTJ vin"! UrS C°ndOmS iS the °nly °ther
t0 prevent transmission
• a.u f h
Condoms are only effective if used properly.
v Other contraceptives such as Copper-T and birth control pills only prevent
pregnancy, and not the transmission of HIV or other STDs.
HIV/AIDS
Village Level Training Manual
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)
❖ All utensils which come into contact with blood and should be sterilized
before next use. Which includes needles, razors or surgical instruments
If a transfusion is not avoidable, the screening of blood should be insisted
cherkSi HfV
MSe Only HIV negative bl00d- The blood should be
checked at a reliable blood bank. Avoid taking blood of professional donors
V Chance of transmitting HIV from an infected mother to her unborn babv is
10O15o/0h: an.infected molher t0 child through breast feeding is about
mn’f1h5/0»bH TVer’ bfeaS feedin9 is sti"the best oPtion for an HIV positive
X sincTHV^uTin8 |k Sh0Uld bA6 taken °Ut from her breast and fed t0
more’ n”beCaUSe the m°ther'S milk *
❖ illnesses31 813968 °f AIDS haVS symptoms-
are common to many
Major Signs:
Ten percent loss of body weight in a short period of time.
Chronic diarrhoea persisting for more than one month.
Chronic fever for more than one month.
Minor Signs:
Persistent cough for more than one week.
Generalized itchy skin (dermatitis).
A Painful rash with blisters on the face, limbs, or lower body
A white furry coats on the tongue and roof of the mouth or vagina
th? mUCe(t S°reS’ uSUa"y referred t0 as cold sores, on and around
the mouth or on the genitals.
aXteand gro'n'j96"’6'11
'ymPh n°deS ar0U"d lh8ia».
Our Role in Combating HIVMlbS
As a Family Member
•
•
•
•
•
Encourage couples to use condom.
Be aware of the symptoms of HIV/AIDS.
Do not ignore health complains of any family member
creVe?! ™9r,atl0n if P°ssible by Ending alternative employment.
Support the family member if detected HIV positive.
As Men of the House
•
•
Be loyal to one partner and engage in
,
sex with only one uninfected partner.
Health is joint responsibility, be responsible
J and use condoms.
HIV/AIDS
Village Level Training Manual
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3
\Ctt
• Support
EnCSX
en°'±7 Tan'° ne9,“ her
the member s/he ts defeaed HIV0<1 f0.r rela,ives-
•
maintain her/his health.
V P°Sltlve and insist on measures to
Xs a Omen's Group Member
•
Educate villagers'1;aboutHWAIQgSexual exP >O'ta tion of girls and women.
•
Encourage women and men to use condoms
• Counsel heXnyfoTpparthem.^"""61133 H'VP°Sl"''e'
Work with panchayat member to get basic amanv • u
tu yer oasic amenities in the village.
-As a Panchayat Member
• Ensure Information about HIV/A.OS ln villa3e hea„h mee,jng
professionafblood donor?16 bl°°d ,0 relallves if lhe need be rather than
Spread awareness about HIV/AIDS
XPration.PrO0rammeS ,Or income 9eneration within village to prevent
• Do not allow child marriages.
• Ensure health education and availability of condoms
• Ensure basic amenities in the village. °'condo,ns-
There is no cure for
____
hiv/aids
Village Level Training Manual
. .
~
-----use condom to prevent it
4
fl
Illustration 1
Transmission of HIV/AIDS
Unprotected sex with an infected partner
(physical intercourse without
use of condom)
Note: Enlarge this illustration
cut it and paste it on the cardboard or
transfer it on a transparency f<
or use during training.
HIV/AIDS
Village Level Training Manual
H
5
Illustration 2
Transmission of HlV/AIbS
Transfusion of infected blood
or contact with infected blood through
sharing needles.
syringes etc.
or
*
hiv/aids
Lsvs;
.v.anual
6
cA
H
Illustration 3
Transmission of HIV/AIDS
From an infected woman to her unborn child or via breast feeding
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
HIV/AIDS
Village Level Training Manual
7
Illustration 4
HIV/AIbS is not transmitted by
Casual contacts like shaking hands,
kissing or hugging
Sharing bed, toilet seats or house
Mosquito or insect bites
Coughing and sneezing
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cards: You may photocopy these cards and stick them on
cardboard separately for use during training.
HIV/AIDS
Village Level Training Manual
8
Card 1
Prevention of HIV transmission through unprotected sex with an
infected partner
A' ^stinence IS th® best
t0 s^y infection free unless you remain in a
monogamous relationship with a partner who is know to be HIV negative.
B. Consistent use of condoms is the only other way to prevent transmission of
the virus. Condoms are only effective if used properly.
Note the following guidelines:
expired throw the condom away. Condoms must be put on correctly.
2-
HIV/AIDS
Village Level Training Manual
.
9
Card 2
Prevention of HIV trnnomteion through blood tronofuoion or sharing of
contaminated needles and syringes
A
c-sid-
Ct
B' XTmu^b^XXloXd"'30'With bl0°d inC'Udin9
«
US'n9 °ne °f lhe
methods:
1. Boiling in water
2. Cleaning thoroughly with household bleach (1 part bleach/9 parts water).
C. Other precautions can be taken to avoid infection1.
“r '°W PartiCU'^ P'a^ ^ere
a "iXte'’1”*1"6' '“"S’ b°dy Pie™9
2. Avoid injections if
3. stXdhare ra2°r b'adeS °r needles unless lhey have been properly
hiv/aids
Village Level Training Manual
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7
I
Card 3
Prevention of HIV transmission from infected mother to unborn child
A. Chance of transmitting HIV from an infected
infected mother
to her
baby is
is
mother to
her unborn
unborn baby
about 30%. The only way to prevent this is counsel the couple to avoid
pregnancy and adopt children.
B. An infected mother can transmit HIV infection to child through breast feedinq.
There is about 10-15% of the same. However, breast feeding is still the best
option for an HIV positive mother since mother’s milk is more nutritious and
more accessible and affordable. HIV cannot live in open air, therefore
mother’s milk should be taken out from her breast and fed to child this wav
infection from breast feeding can easily be avoided.
J
HIV/AIDS
Village Level Training Manual
11
CANCERS
CERVICAL CANCER
Village Level Training Module
1 hour 30 minules.
Learning Objectives
At the end of the session the participants will learn about
♦ probable causes of cervical cancer.
♦ signs of the cancer of cervix.
. importance and procedure of Pap test for early diagnosis of cancer of cervix.
Design
Time in
minutes
30
30
rso
IL
Topic
Causes of cervical cancer
Signs of cancer of cervix'
Pap test for early diagnosis of cervical
cancer
Method/materia!
Discussion with help of
. ^illustrations 1 to 8
Discussion
Discussions
Material required
SXn’sX*" be pho,ocopied from here and stuck °n
Note to the trainer
Tell the group of village women that,
^X^d&7ea"e 'S&XSm
Cervical Cancer
Village Level Training Module
1
«»-aLa‘’<
With the helo of illustrations discuss the probable causes of cancer of cervix.
Discuss siqns and symptoms of cervical cancer. Encourage sharing of
personal experiences, if available or experiences heard from others
• Give information of Pap test and encourage women to go for t e es
action plan at the end of the session.
.
.
The mouth of uterus is known as Cervix ~j
Imnor+ant Messages for the Village Women
❖ General causes of cervical cancer.
Smoking or chewing tobacco.
Chronic Infections
Prolonged exposure to UV rays/high temperature
Prolonged trauma/irritation
Certain viral infections like hepatitis B or genital warts.
Incorrect use of hormones.
Some cancers to some extent are also hereditary eg. Breast
bleeding
have had Sexually Transmitted Disease
have had viral infections such as genital warts
have had several pregnancies
' ’
do not maintain cleanliness of their genital parts
common X^Xd^Xoina. induding Weeding after sex
a pinkish or bad smelling discharge, or a bad smell from vagina
in very advanced cases, signs may include pain when passing
urine, or pain in the legs, lower belly or back.
❖ It is very important that the diagnosis of cervical cancer is donei at an e y
stage. This could be done through Pap Test. It is a quick and
p
procedure For this test, doctor needs to scrape some cells fromi the
women over 35 years of age.
2
Cervical Cancer
Vi.iace Level Training Module
<!<?*)#’ tiSKSFiT
s - L" »• <Oa:c,v . = +c, g 2
n
Pap last is not done during menstrual period
Pap test should not be done within 48 hours of insertion of vaginal
tablet
Paptest should not be repeated earlier than six months
Our Role in Combating Cervical Cancer
As a Family Member
Encourage woman to get a pap test done and a regular medical check up
after 35 years of age.
* W°man complains about any
’
simnar^mptoms^P10"15 °f
•
sysf10^ ne®'eC^
•
•
•
Do not allow child marriages.
Prevent repeated pregnancies by preventive action or through advice.
Support women if she is diagnosed to have cervical cancer.
complains of women related to her reproductive
As Men of the House
•
•
•
•
•
Prevent child marriages and early pregnancy.
Contraception is joint responsibility, be responsible and avoid repeated
pregnancies.
Do not neglect or do not allow woman to her own health.
Encourage woman to get pap test done after age of 35 years.
Support woman if she is detected as cancer positive and insist on early and
complete treatment.
As a Women’s Group Member
•
•
•
•
•
Do not allow child marriages and early pregnancies.
Educate villagers about cervical cancer.
Encourage women above 35 years of age to go for pap test every year.
Support woman who has been identified suffering with cervical cancer.
Counsel her family to support her.
Cervical Cancer
Village Level Training Module
3
As q Panchayat Member
ANM.
nf0rmall0n about cerv'cal cancer in village health meeting with help of
regular InSlnd'Tn
'""a98 a‘
j Spread awareness about cervical cancer.
• ,Do not allow child marriages.
• Ensure health education and availability of contraception.
♦
Cervical Cancer
Village Level Training Module
4
xnusrraiion i
Risk factors for women of cervical cancer
Girls who became sexually active within one year of starting their
monthly bleeding
1
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
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Illustration 2
Sisk factors for women of cervical cancer
Persons who have had Sexually Transmitted bisease
i
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
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I
Illustration 3
Risk factors for women of cervical cancer
Women who have had viral infections such as genital warts
Note. Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
7
Illustration 4
Pisk factors for women of cervkal cancer
Women who have had several pregnancies
♦’S ll,UStration cut and Paste it on the cardboard or
transfer it on a transparency for use during training.
.Cervical Cancer
Village Level Training Module
8
■ r
Illustration 5
Risk factors for women of cervical cancer
Women who do not keep cleanliness of their genital parts
Note: Enlarge this illustration cut it and paste it on the cardboard or
transfer it on a transparency for use during training.
Cervical Cancer
Village Level Training Module
9
CANCERS
BREAST CANCER
Village Level Training Module
1 hour.
Learning Objectives
At the end of the session the participants will learn about
• what is breast cancer?
• causes of breast cancer
• who all are more at risk?
• treatment and protection from breast cancer?
Design
Time in
minutes
15____
15____
30
I______
Topic
Method and Material
Causes of breast cancer______
Who are more at risk_________
Protection against breast cancer,
breast self examination
Discussion_________
Discussion_________
Discussion with help of
Activity 1
Material Required
Copy the pages of breast self-examination on paper and stick them separately on
cardboard for use in the session.
Note for the Trainers
You may start the session by saying.
"Dear friends, we already know about cancer and cervical cancer. Today we will
discuss about breast cancer. Do you know that cases of breast cancer are
increasing in our country? Have you seen or heard any one suffering from breast
cancer? Can you tell me what are the symptoms of breast cancer."
Breast Cancer
Village Level Training Module
!I
1
(U
•
You could wait for their answers. Note down their answers. Some may be
incorrect also. You may give the correct answers and enrich the information.
•
Discuss who all are more at risk of breast cancer. It is important to focus that
women witti risk factors may not always develop breast cancer. If you do not
discuss this, it may lead to unnecessary fear among women.
•
Once the participants have clarity on the above mentioned topics lead the
discussion towards the treatment of breast cancer. Very briefly give them the
information and discuss its side effects.
„
•
For protection from breast cancer focus on breast self-examination. You may
organize a demonstration or explain it though the pictures given herewith.
Emphasize the importance of early diagnosis.
•
Discuss our role in spreading awareness regarding breast cancer as members
of different groups.
Important Messages for the Village Women
v There is nothing to get ashamed of in breast cancer. It is a disease like any
other disease. Early diagnosis is its best treatment Speak up and encourage
other to speak up about breast cancer.
❖ Symptoms of breast cancer
1. Hard, painless lump, which sometimes may be soft
2. Change in size or shape of breast
3. Change in colour or feel of the skin of the breast or nipolefdimpled or
puckered)
4. Red secretion from nipple, at times it may be yellow.
❖ The following women are at risk of breast cancer. The women who
1. are more than 50 years old.
2. has had cancer in one breast
3. has more than one close relative (mother or sister) who has breast
cancer.
4. has delivered their first child after the age of 30.
5. has not had any children, or has not breast-fed their children.
6. eat a high fat diet or an unbalanced diet
7. stressful life.
Breast Cancer
Village Level Training Module
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❖ Protection against Breast Cancer
1. Eat a variety of fiber rich seasonal foods like fruits and vegetables
2. Eat more cereals, pulses, raw vegetables and fresh fruits like carrots,
beetroot gooseberries, spinach, fenugreek leaves, etc.
3. Choose a diet that is low in fat
4. Maintain your body weight with regular exercise and a balanced diet
5. Avoid tobacco and alcohol
6. Be alert and keep mentally peaceful with yoga and meditation
7. Ensure breast self examination
r
I
I
!
Contact doctor if you locate a
lump in breast for further
L
Breast Cancer
Village Level Training Module
I 1
3
Our Role in Preventing Breast Cancer
As a Member of Family
•
•
•
•
Encourage friendly and open atmosphere at home where people can share
about their health problems.
Encourage women of the house to share their health problems and take them
seriously
Support the family member if she is detected a patient of breast cancer. Ensure
her complete and early treatment
Spread information about breast cancer and how to self-breast-examination,
especially among girls and women.
As Men of the House
•
•
•
•
Be sensitive to health problems of women and take them seriously.
Ensure proper diet and distribution of workload in the family for all the members.
Get mammography of the women of the house if any one of them have one or
more of the above mentioned risk factors.
Breast cancer can be very stressful for woman, support her if she is detected a
breast cancer patient and reassure her. Ensure her early and complete
treatment If necessary, help her face the side effects of the treatment bravely.
As a Women’s Group Member
•
•
•
•
•
•
Spread information about self-breast examination and encourage women to
practice it
Get as much information about breast cancer as possible and disseminate it
among men and women in village.
Ensure regular visit of ANM in the village and her access to women.
Arrange with the help of panchayat members to get a lady doctor in the nearest
PHC.
Encourage women for early diagnosis of breast cancer and encourage the family
to go for early treatment
Support women who are detected as cancer patients and counsel her husband
to support her.
As a Panchayat Member
Ensure health education session on breast cancer with help of ANM for men and
women.
• Ensure regular visit of ANM in your village and her access to village women.
• Encourage men to be active support to women who are detected breast cancer
patients.
• Arrange for lady doctor in (he nearest PHC.
•
breast Cancer
4
¥
11
j
Activity 1
How to Perform Breast Self-examination
Regular self -examination of breast will help to locate and detect lump in breast at
an early stage.
Observation of the Breast
A mirror is necessary to look at the breast You need a mirror of a size 45 cm. x 45
cm.
Stand in front of a mirror. Let your arms hang by the side of your body. Observe
your breasts from the front and from both the sides.
Has there been any change in size and shape?
Is there any redness or puckery skin on the breast?
Is there any discharge from the nipple?
Now lift your hands above your
head. If there is a lump, the skin
may be puckered, it may look like
the peel of an orange.
Bring your hands to the level of
your nose, as shown in the
figure, and make a gesture like
'namaste'. Squeeze your
palms together.
During both these positions, observe changes in the breast and armpit.
Breast Cancer
Village Level Training Module
5
L
Examination by Hands
It is important to examine both the breasts with
your hand. Use thexight hand to examine the
left breast, and the left hand to examine the
right breast. Hold the thumb and fingers
together. Keep the fingers straight so that the
hand remains flat. Feel for any hard or thick
lump in your breast.
Start examining the breast from the
outer most area. Feel around the
breast in a circular movement.
Make a small circle all the way around
your breast
I
Bend your wrist to check your armpit.
Once you complete checking the outer
circle, shift your hand slightly towards the
nipple and go around the breast again.
Breast Cancer
Village Level Training Module
6
%
Keep moving towards the nipple. Do not
forget to check the nipple. As shown in
trie figure, press your hand against the
nipple and check for hardness.
Press the nipple between your tl iurnb and
finger and look for discharge.
You can examine the breast while
lying down. Before going to sleep,
lie down on a hard surface. Keep
your right hand below your head
and use your left hand to examine
the right breast as explained
above.
Then change hands and examine the left breast.
Remember
•
•
•
•
Always examine both the breasts.
Check every part of the breast while examining. Always keep your hand in
constant contact with breast Do not lift the hand from the breast Give equal
pressure on every part of the breast
Bend your wrist to feel under the armpit
Never conduct breast self-examination while wearing your clothes.
Note:
Uiese P39cs on transparency and show it to participants
with the help of overhead projector. You may prefer to conduct a
demonstration, if you demonstrate breast seif examination wearing clothes
it
is extremely important that you explain to them that in reality they have to '
perform it without clothing. The best time for that is while taking bath.
Breast Cancer
Village Level Training Module
7
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