Advising Mothers on Management of Diarrhoea in the Home - A Guide for Health Workers (WHO, 1993, 18 p.): Practising the steps: Step 1: Ask the questions

Advising Mothers on Management of Diarrhoea in the Home - A Guide for Health Workers (WHO, 1993, 18 p.)

Practising the steps

		(introduction...)
		Step 1: Ask the questions
		Step 2: Praise and encourage helpful behaviours
		Step 3: Advise the mother what else to do
		Step 4: Check the mother's understanding

Step 1: Ask the questions

The process for advising mothers is based on a series of simple key questions. These key questions, found in the following table, concern the main activities of home case management: increasing fluids, continued feeding, and appropriate use of medication. The things you praise and encourage, and the specific advice you give to each mother, will depend on the information you learn from her by asking these questions.

Home care activity	Key Questions
Increase fluids	Has the child been drinking? How much? or Why not?
Continue feeding/breastfeeding	Has the child been eating? What? or Why not?
Appropriate use of medication	Has the child taken other medication or treatments?

You will need to ask the mother both open and closed questions to get the required information. Sometimes it is useful to combine open and closed questions, that is, to ask for the information in two parts. The first part should be a closed question, to orient you to how the child has been treated at home. This can be followed by an open question to help you get more information. In the following exercise, you will find a series of questions that you can use. Each question is first presented as a closed question. It is followed by a "Yes" or "No" answer; there is then a space for a follow-on open question to help you to obtain more information. As an example, the first question has been filled out. Read it, then complete the other questions.

Exercise

Closed question	Mother's answer	Follow-on, open questions
Has your child been drinking?	Yes	What has he had to drink? More, less, or the same amount as usual?
Has your child been drinking?	No	What seems to be the problem?
Has your child been eating? or breastfeeding?	Yes
Has your child been eating? or breastfeeding?	No
Has your child taken any medication or other treatment for the diarrhoea?	Yes
Has your child taken any medication or other treatment for the diarrhoea?	No	(No follow-on questions needed)

Suggested answers to exercise

Closed question	Mother's answer	Follow-on, open questions
Has your child been drinking?	Yes	What has he had to drink? More, less, or the same amount as usual?
Has your child been drinking?	No	What seems to be the problem?
Has your child been eating? or breastfeeding?	Yes	What kinds of foods has he been eating? Does he eat (or breastfeed) more, or less than usual, or about the same?
Has your child been eating? or breastfeeding?	No	Why do you think not?
Has your child taken any medication or other treatments for the diarrhoea?	Yes	What kinds of medication or treatment has he taken? Who advised you to give these treatments?
Has your child taken any medication or other treatments for the diarrhoea?	No	(No follow-on questions needed)