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close this bookAdvising Mothers on Management of Diarrhoea in the Home - Instructions for Facilitators (WHO; 1993; 11 pages)
View the documentIntroduction
View the documentHow should Advising Mothers be used?
View the documentSample agendas
View the documentSupervise and monitor activities from Advising Mothers
View the documentSuggested methodology
View the documentSuggested answers to exercises
View the documentSample situations for APAC role-play
 

Suggested answers to exercises

Exercise: Praise and encourage helpful behaviours

 

1.

The mother says, “Yes, my child is drinking. I give him two spoonfuls of ORS, three times each day.”

 
 

What has this mother done that is helpful? What could you say to praise and encourage her?

 
 

The mother has used ORS. You could say, “It is good that you have tried using ORS, and you should keep doing this.”

 

2.

The mother says, “I offer food to my child, but she doesn’t want anything but breastmilk.”

 
 

What has this mother done that is helpful? What could you say to praise and encourage her?

 
 

The mother has been breastfeeding her child, and has tried to get her child to eat. You could say, “Good. Keep breastfeeding; that will help your child. I know it may be difficult to get her to eat, but as you know, food is important, so keep offering her little bits of food at a time.”

 

3.

The mother says, “I have given my child two of the pills that the pharmacist sold to me.”

 
 

What has this mother done that is helpful? What could you say to praise and encourage her?

 
 

In this situation, the mother has not done anything that is helpful. However, she has shown concern for her child, and she has come to you for help. You could say, “I am glad you have come to me for help. It is good that you are concerned and want to do something to help your child get well.”

 

4.

The mother says, “My child hasn’t taken any medications or other treatments.”

 
 

What has this mother done that is helpful? What could you say to praise and encourage her?

 

The mother has given no inappropriate medications, nor any treatments which may be harmful to her child. You could say, “You have done well by bringing your child to me before giving any medicines or treatments.”

 

Exercise: Advise the mother what else to do

 

1.

The mother says, “Yes, my child is drinking. I give him two spoonfuls of ORS, three times each day.”

 
 

(a)

Has the mother done anything that is harmful, or not helpful? What?

 
   

Yes. She has given her child too little ORS to be effective.

 
 

(b)

How would you advise this mother on what she is doing?

 
   

You could say, “It is good that you have used ORS to treat you child. But the amount of ORS you have given to your child is not enough. In order for the ORS to help your child, you need to give him as much as he can drink. Try to give him about half a cupful each time he has diarrhoea.”

 
 

(c)

What else do you need to advise her about giving fluids?

 
   

You should tell her that she can also give her child other things to drink, such as fruit juice or water (or other fluids available in her area).

 

2.

The mother says, “I offer my child food, but she doesn’t want anything but breastmilk.”

 
 

(a)

Has the mother done anything that is harmful, or not helpful? What?

 
   

She seems to have accepted her child’s lack of appetite, and has not encouraged him to eat.

 
 

(b)

How would you advise this mother on what she is doing?

 
   

You could say, “It is very good that you are breastfeeding, and that you offer food to your child. He needs to eat to stay strong during the diarrhoea. If he at first refuses food, don’t force him, but don’t give up. Try to encourage him to eat little bits at a time.”

 
 

(c)

What else do you need to advise her about giving her child food?

 
   

You could tell her that it is very important for the child to eat, and that foods that are soft and mashed may be easier for the child to eat. She should offer him small amounts of food several times a day.

 

3.

The mother says, “I have given my child two of the pills that the pharmacist sold to me.”

 
 

(a)

Has the mother done anything that is harmful, or not helpful? What?

 
   

Yes, she has given her child medicine that is probably not needed. Also, she has given it without consulting a health worker first.

 
 

(b)

How would you advise this mother on what she is doing?

 
   

You could tell her, “It is good that you brought your child in for treatment. You see, for most diarrhoea, medicine like the one you bought is not needed and will not be helpful. It should be used only for diarrhoea with blood in it. If this ever happens, come to see me or someone else here at the clinic and we can discuss what is the best medication.”

 
 

(c)

What other advice do you need to give her on using medications?

 
   

In most cases of diarrhoea, medications are not needed. The best thing the mother can do is to keep encouraging the child to eat and to drink.

 

4.

The mother says, “My child hasn’t taken any medications or other treatments.”

 
 

(a)

Has the mother done anything that is harmful, or not helpful? What?

 
   

In this case, the mother has not done anything harmful.

 
 

(b) and (c) are not necessary in this case.

Exercise: Checking questions

First checking question

Mother’s response

Follow-on checking question

What will you do for the child’s diarrhoea when you get home?

I will give him something to drink.

What will you give him to drink?
How much will you give him?
How often will you give it to him?

What will you give your child to eat?

Soft, mashed foods.

Which foods will you give him?
How can you encourage him to eat?
How often will you give him food?

How will you make the ORS solution at home?

I will mix the packet with water.

How much of the packet will you use?
How much water will you use?
How will you measure the water?

How much ORS or other drinks will you give to your child?

One small cup.

How often will you give him one small cup?
What will you do if he wants more?

How will you know if your child needs to come back to the health centre?

If he’s not getting better.

How will you know he’s not getting better?
What other signs can you look for?

Exercise: Sample conversation

Did the health worker follow the process: “Ask-Praise-Advise-Check”?

Yes, he followed the process. Even though he did not “Check eating and drinking” before moving on to questions about other medications and treatments, he asked all the necessary questions, praised, encouraged, and checked the mother’s understanding.

Give an example of how he praised and encouraged the mother to continue to do something that she had been doing.

After the mother answered the questions about the child’s drinking, the health worker said, “It is very good that you give him water and rice water.”

Give an example of an open question that he asked to check the mother’s understanding.

He asked the mother, “How much should he drink?”

Why did he refer the mother to a group session?

Because she needed to learn and practice how to mix ORS solution. (Note: he should have verified whether she already knew how to mix ORS before he referred her to a group session).

In general, did the health worker advise the mother correctly? Why or why not?

Yes, this health worker did a very good job in advising the mother.

 

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