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Learning ObjectivesBy the end of this session, the student will be ableto:

(1) describe the basic principles in counseling;

(2) explain the different steps or approaches in

counseling;

(3) enumerate the guide or tips for effectivecounseling;

(4) describe the elements of follow-up care; and

(5) explain how to provide follow-up care

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Counseling

Session 9-a

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Good Communication

l reassure mother that the child will receivegood care

l success of home treatment depends on howwell you communicate with the child’s mother 

 – needs to know how to give treatment andunderstand the importance of treatment

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Use Good Communication Skills

♥ ASK and Listen to find out what the child’s

problems are and what the mother is alreadydoing

♥ PRAISE the mother for what she has donewell

♥ ADVISE her how to care for her child at home♥ CHECK the mother’s understanding

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Advise mother how to care for her child at home

When Teaching:

l

use words s/he understandsl use teaching aids that are familiar 

l give feedback when s/he practices, praisewhat was done well and make corrections

l allow more practice, if neededl encourage the mother/caretaker to ask

questions and then answer all questions

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3 Basic Teaching Steps

1. Give information

3. Show an example

5. Let her practice

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Give information

l Explain to the mother how to do the task.

For example:

 – How to apply eyeointment

 – Prepare ORS – Soothe the throat

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Show an Example

l Show how to do the task.

For example: – How to hold a child still

and apply eye ointment

 – Mix ORS solution, or 

 – Describe how she willprepare a safe remedy tosoothe the throat

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Good Communication Skills

Check the mother’s understanding♥avoid asking leading questions and questions

answerable with a simple yes or no♥good checking questions describe WHY,

HOW or WHEN she will give treatment

♥

give the mother time to think and then answer ♥praise the mother for correct answers

♥if she needs it , give more information,

examples, or practice

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Good Communication Skills

Teaching to treat local infections at home: ♥explain what the treatment is and why it should be

given♥ describe the treatment steps listed on the TREAT

charts

♥watch the mother do the first treatment

♥tell her how often to do the treatment at home♥ if needed, give the mother the tube of tetracycline

ointment or a small bottle of gentian violet

♥check the mother’s understanding before she leaves 

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Good Communication Skills and

Counseling Teach the caretaker to give oral drugs at home:

♥

determine the appropriate drugs and dosagefor the child’s age or weight

♥ tell the mother the reason for giving the drugincluding: why you are giving the drug and

what problem is it treating♥ demonstrate how to measure a dose

♥ ask the mother to give the first dose to her child

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Good Communication Skills and

Counseling Teach the caretaker to give oral drugs at home:

l

ask the mother to give the first dose to her child.l explain carefully how to give the drug, then label and

package the drug.

l if more than one drug will be given, collect, count andpackage each drug separately.

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Good Communication Skills and

Counseling Teach the caretaker to give oral drugs at home:

l explain that all the oral drug tablets or syrups must beused to finish the course of treatment, even if thechild gets better;

l check the mother’s understanding before she leaves

the clinic.

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Follow-up Care

 

Session 9-b

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A. Immediately

Advise to return immediately if the child has any of theseAdvise to return immediately if the child has any of these

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B. Follow-up visit table

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Follow-up care

l If the child does not have a new problem, usethe IMCI follow-up instructions for eachspecific problem:

 – assess the child according to theinstructions

 –

use the information about the child’ssigns to select the appropriatetreatment

 –  

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Follow-up care

l see if the child is improving on the drug or other 

treatment that was prescribed

l may need to try a second-line drug

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For follow-up visit

If the child has:

l Pneumonial Dysenteryl Malaria, if fever persistsl Fever malaria unlikely or 

uncomplicated fever, if fever persists

l Measles with eye or  mouthcomplications

Return for follow up not later 

than:

2 days

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If the child has:

l Persistent diarrhea

l Acute ear infection

l Chronic ear infection

l

Feeding probleml Any other illness, if not

improving

Return for follow-up:

5 days

For follow-up visit

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  If the child has:

Pallor 

Low (very low) weight

for age

  Return for follow-up:

14 days

30 days

 

For follow-up visit

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When to Return Immediately

For young infants age 1 week up to 2months:

lbreastfeeding or drinking poorly

lbecomes sicker 

ldevelops fever 

lfast breathingldifficult breathing

lblood in the stool

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When to Return Immediately

For children age 2 months to 5 years:

If the difficult breathing child has NO PNEUMONIA(COUGH or COLD), ask them to return, if there is:

l fast breathing

If the child has diarrhea, also return if:lblood in stool

ldrinking poorly