|Oral Rehydration Therapy and the Control of Diarrheal Diseases (Peace Corps, 1985, 566 pages)|
|Module Four: Working with the health system|
|Session 12 - Monitoring and follow up for controlling diarrheal diseases|
How you monitor an item to determine if it is being done correctly will depend on the availability of time, records, and your role in a CDD project or program. There are several monitoring methods to choose from. Some of these methods are described below.
1. Talk. with Mothers at Time of Treatment.
Talking with mothers at the time of treatment (or listening to health
workers as they talk with mothers) will help you determine if mothers understand
the instructions given to them. For example, to determine if mothers uncle stand
the information about feeding, you can ask a few of them how they will feed
their children during and after diarrhea.
2. Make Home Visits. Visiting the homes of patients who have received services to observe them and to talk with their mothers will help you determine if the patients were treated correctly, whether instructions given at the time of treatment are being followed, and what the mother plans to do the next time her child suffers from the disease. You can also observe conditions of the children and the surroundings of the home.
3. Observe Mothers and Health Workers. An effective monitoring method is to observe mothers and health workers as they actually DO their task in the setting in which the task is done. For example, you can observe a health worker treating a child who has diarrhea to see if the child is being treated properly. You can observe another mixing ORS to see if he or she mixes it properly. It is important the people know you are not observing them to criticize their skill but to help them improve it.
4. Talk with Mothers and Health Workers. Talking with mothers and health workers will help you identify what they know and what they think about preventing and treating diarrhea. If you have identified problems' talk to them to find out causes of these problems and to get ideas on how to solve them. Talking with health workers will also allow you to compliment them on tasks being done especially well.
5. Review Records. This monitoring method is often used because the records kept by community health workers and health facilities are usually available it generally does not take a lot of time to review records. To obtain the necessary information from records, however, the records must be properly designed and completed. Some types of information that can be obtained from record review are whether patients are befog sent to the appropriate referral facility or whether the medicines being administered to patients are appropriate for their conditions. Some types of information that cannot be obtained from record review are how well certain treatment procedures are befog done, or what mothers are being told.
(Adapted from: WHO Monitoring Performance, pp. 5-6)