Introduction

Why was Advising Mothers produced? Every child that is seen at a health facility with mild diarrhoea, and every dehydrated child that has been successfully treated at the facility, will be sent home to follow Plan A of the WHO/CDD Diarrhoea Management Chart, Case Management in the Home (give increased fluids, continue feeding, and seek medical care when needed). Unlike many other treatments, which are provided by the health worker, case management in the home is entirely the responsibility of the mother or other child caretaker. If correctly carried out, it can have a significant impact on the health of the child. How well the mother carries it out depends partly on how well the health worker advises her.

Advising a mother on home case management is often the last activity carried out during a consultation, and often the least well done. The advice and the manner in which it is given are often not sufficient to enable the mother to understand and have confidence in her ability to care for her child’s diarrhoea. There are many reasons for this: the health facility may be crowded, a health worker may have little time, and it is not always clear just how to advise the mother. When assessing and treating a child with diarrhoea at a health facility, the health worker should follow the same, systematic approach with every child: “Look, Ask, Feel, Decide, Treat.” Advising a mother on how to care for the child at home may seem like a less structured activity; it is definitely one which calls for good judgement and understanding on the part of the health worker.

It was for these reasons that the CDD Programme produced Advising Mothers. This guide teaches a process and skills which will help the health worker to advise mothers on home case management correctly and effectively. The process will help the health worker to communicate all the essential information to the mother in a structured manner, and in a reasonable amount of time. It will also help the health worker to limit the amount of information to give, and it should make it easier for mothers to remember the advice.