Cover Image
close this bookOral Rehydration Therapy and the Control of Diarrheal Diseases (Peace Corps, 1985, 566 p.)
close this folderModule Four: Working with the health system
close this folderSession 12 - Monitoring and follow up for controlling diarrheal diseases
View the document(introduction...)
View the documentHandout 12B: Monitoring worksheet
View the documentHandout 12C: Ways to do monitoring
View the documentHandout 12D: Steps in problem solving
View the documentHandout 12E: Problem situations
View the documentTrainer Attachment 12A: Examples of items to monitor
View the documentTrainer Attachment 12B: Home visits
View the documentTrainer Attachment 12C: Useful tool: diary
View the documentTrainer Attachment 12D: Suggestions for a diary on ORT/CDD
View the documentTrainer Attachment 12E: Sample problem solution

Trainer Attachment 12E: Sample problem solution


When monitoring the community health loader, the health worker in Bornu Health Area found that the community health worker had been referring children with some dehydration to a clinic, without giving the child's other complete follow-up instruction on what to do at home.

1. Importance of Solving the Problem

To help determine the importance of solving the problem, the health worker asked the questions in Section 1 of the Problem-Solving Checklist. Conclusions are summarized below.

• The problem is a serious one which should be resolved soon. If mothers are not given complete instructions on what to do at home, their children may become dehydrated again Also, the next time their children get diarrhea, mothers may not be able to prevent them, from becoming dehydrated by providing early treatment at home.

• If mothers are not shown how to use the ORS packets the community health leader gives them, they may not use them at all or may use them improperly. As a result, their children will not get the best care. Mothers may soon distrust the health leader or her treatment methods and may decide not to seek health care from her at all.

2. Describe the Problem

To help him describe the problem, the health worker asked the questions in Section 2 of the Problem-Solving Checklist. The conclusions were the following:

• The problem is occurring with this community health leader only.

• The problem affects children, mothers, and health leader.

• The problem occurs every time the community health leader treats children with moderate or no dehydration (Treatment Plans A and B).

• The community health leader volunteered and was trained two months earlier. The health worker was not sure, but believes the problems have been occurring since that time.

3. Identify Possible Causes and Reasonable Solutions to the Problem

The health worker investigate to determine possible causes. For each cause he found, he identified a solution.

• Lack of Skill and Knowledge

The community health leader may not know all the follow-up instructions to give to mothers. The emphasis in her training was on Preparing and giving ORT.

The health worker should praise the health leader for correctly assessing the dehydration status of patients, and for correctly preparing and giving treatment with ORS solution. He could also explain to the health leader that it is necessary to teach these things to mothers.

The health worker could provide training on the Job. He or she could demonstrate for the community health leader how to explain to mothers the importance of increased fluids and continued feeding during and after diarrhea, ho. to explain to mothers other ways to prevent diarrhea, how to teach others to prepare ORS solution at hone, and hoe to show mothers the amount of ORS solution to give after each stool.

After observing the health worker the health leader could practice giving these instructions herself, the supervisor could encourage and praise the instructions the health leader gives well and help her improve any that she lives incorrectly.

• Lack of motivation
The cause of the problem is not a lack of motivation

• Obstacles
The cause of the problem is not an obstacle