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Oral Rehydration Therapy and the Control of Diarrheal Diseases

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Oral Rehydration Therapy and the Control of Diarrheal Diseases DOCUMENT RESUME ED 289 005 CE 049 002 AUTHOR Clark, Mari; And Others TITLE Oral Rehydration Therapy and the Control of Diarrheal Diseases. Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-34. INSTITUTION CHP International, Inc., Oak Park, IL. SPONS AGENCY Peace Corps, Washington, DC. Information Collection and Exchange Div. PUB DATE liar 85 CONTRACT PC-284-1011 NOTE 514p.; Some illustrations will not reproduce clearly. PUB TYPE Guides Classroom Use Guides (For Teachers) (052) EDRS PRICE MF02/PC21 Plus Postage. DESCRIPTORS Communicable Diseases; Competence; Competency Based Education; Course Content; Course Organization; *Developing Nations; *Disease Control; Disease Incidence; Drinking Water; Epidemiology; Foreign Countries; *Health Education; Health Personnel; Hygiene; Lesson Plans; *Nutrition; Postsecondary Education; Public Health; Sanitation; Teaching Methods; Volunteers; *Volunteer Training IDENTIFIERS *Diarrhea; *Oral Rehydration Therapy; Peace Corps ABSTRACT This manual was developed to train Peace Corps volunteers and other community health workers in oral rehydration therapy (ORT) and the control of diarrheal diseases. Using a competency-based format, the manual contains six training modules (organized in 22 sessions) that focus on interrelated health education and technical content areas. Each module begins with a set of behavioral objectives and contains a sequence of sessions that address the specific content area. Session formats include targeted time frame, overview, objectives, resources, materials, procedures, and trainer notes. The modules cover the following topics: climate setting and assessment; diarrhea, dehydration, and rehydration; nutrition and diarrhea; working with the health system; working with the community; and community health education. Extensive examples, sample forms, schedules, and handouts are provided. Materials are illustrated with photographs and line drawings. Suggestions to the trainer for adapting the materials for different countries and different learners are included in the training packet. (KC) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** t' a71w zc9LU 8g 232-SCCC27% o158K510P2'6 E0 ° fs,a3 wsl INFOR4ATICts1 CiaLIECTICN & OCCHANGE Peace Corps' Information Collection & Exchange (ICE) was established so that the strategies and techrc'ogies devel- oped by Peace Cbrps Vblunteers, their co-morkers, and their counterparts could be nede.available to the wide range of development organizations and individual workers who might find than useful. Training guides, curricula, lesson plans, project reports, manuals and other Peaces COrps-generated materials developed in the field are collected and reviewed. Sane are reprinted "as is"; others provide a source of field Lased information for the production Of nenuals or for re- search in particular program areas.Materials that you sub- mit to the Information Collection & Exchange thus became part of the Peace Cbrps' larger contribution to development. Information about ICE publications and services is available through: Peace Corps Information Collection & Exchange Office of Training and Program Support 806 Connecticut Avenue, N.W. Washington, D.C. 20526 Add your experience to t-ICE Resource Center. Send ma- terials that you've prepared so that we can share than with others working in the development field. Your tech- nical insights serve as the basis for the generation of ICE nenuals, reprints and resource packets, and also ensure that ICE is providing the most updated, innovative problem-solving techniques and information available to you and your feller &veldt:nerd: workers. Peace Corps 3 A Training Manual on ORAL REHYDRATION THERAPY AND THE CONTROL OF DIARRHEA! DISEASES Prepared for Peace Corps by CHP INTERNATIONAL Marl Clark Mary Harvey Kathleen West Marsha Wilburn Oak Park, Illinois March, 1985 A Training Manual on ORAL REHYDRATION THERAPY AND THE CONTROL OF DIARRHEAL DISEASES March 1985 Prepared for the Peace Corps by CHP laternational Inc. Contract No. PC-284-1011 Funded by the Office of Health Agency For International Development PASA No. BST-539-P-PC-4042-00 This manual may be reproduced and/or translated in part or in full without payment or royalty. Please give Standard acknowledgement. Available through: Peace Corps Information Collection and Exchange (ICE) 806 Connecticut Avenue NW Washington D.C. 20526 5 ACKNOWLEDGEMENTS It is only with the help and support of many people that we have been able toobtain themostcurrent informationon Diarrheal Disease Control programs, in particular Oral Rehydration Therapy. The authors gratefully acknowledgethe following individuals who provided invaluable information, suggestions and critical comments: Claudette Kaba- Health Specialist, Office of Trainingand Program Support (OTAPS), Peace Corps Washington Colleen Conroy CCCD Project Director, OTAPS, Peace Corps Washington Robert Clay - Health Advisor, AID Office of Health Carl Kendall - Health Advisor, AID Office of Health Robert Hogan - ProgramManagement Officer, WHODiarrhea! Disease Control Program Eugenia Eng - Assistant Professor, University of North Carolina, School of Public Health at Chapel Hill Kathy Parker - Health Education Specialist, International Health ProgramOffice (IHPO), Centers for Disease Control (CDC) Melinda Moore- Medical Epidemiologist, IHPO, CDC CHP international Staff Special thanks areextended to the individuals at the following agencies that provided information, references, materials and visual aids: Agency for International Development (AID), Office of Health Academy for Educational Development (AED) Program for International Training in Health (INTRAH) Pan American Health Organization (PAHO) Program for the Introduction of Contraceptive Technology (PIACT) Technologies for Primary Health Care (PRITECH) United Nations International Children's Education Fund (UNICEF) Water and Sanitation for Health Project (WASH) World Health Organization (WHO) Finally, and perhaps most importantly, we extend our sincere thanks to the Peace Corps Washington and APCD Staff, the trainers, and Volunteers in the Philippines, Nepal, Gabon, and Senegal who planned and participated in the fieldtesting of the ORT Training Manual and whoprovided relevant feedback that we incorporated in the final writing of this manual: Paulette Chapponiere -Consultant Trainer, Peace Corps, Mal Collantes ORT and Health Project Director, Peace Corps, Philippines Pape Gaye - Consultant Trainer, Peace Corps Tom Leonhardt - Consultant Trainer, Peace Corps, Suzanne Plopper - Consultant Trainer, Peace Corps Acknowledgements, Page 2 Sanu Kessari Senior Administrator, Nursing Division, Ministry of Health, Nepal Hari Pradan Lecturer in Health Education, Institute of Medicine, Nepal Padma Raj Rajmandarl Chief, Training Section, integrated Community Health Services Development Project, Ministry of Health, Nepal Chiz Shrestha Trainer/Consultant, Peace Corps, Nepal ChiranJvl Thapa Chief, Health Education Section Department Ministry of Health, Nepal Phyllis Jones ORT Program Technician, OTAPS, Washington Wehope that the efforts of everyone who participated in the development and testingof this manual and to those who will use it in the future, will lead toward the goal, as stated by Mr. M. Peter McPherson at the International Conference onOral Rehydration Therapy, "of applying a simpleand effective technology to one of the scourges of mankind which is holding tenaciously tosocieties in the developingcountriesof the world". TABLE OF CONTENTS ACKNOWLEDGEMENTS INTRODUCTION 1 TRAINER GUIDE 3 MODULE ONE: CLIMATE SETTING AND ASSESSMENT Session 1 Diarrhea Dialogue: Assessing Our Knowledge, Needs and Skills 19 Handouts: 1A Pretest 25 1B Training Objectives 29 Trainer Attachments: 1A Pretraining Questionnaire for Volunteers 31 1B Pretraining Questionnaire for Counterparts 35 1C Trainer Pretest Guide 39 10 Pretest Answers 41 Session zTraining Program Evaluation 45 Handouts: 2ATraining Program Evaluation 49 MODULE 7110: DIARRHEA, DEHYDRATION AND REHYDRATION Objectives 51 Session 3 Prevention and Control cf Diarrhea 53 Handouts: 3A Sanitation, Water Quality and the Spread of Disease 61 3BCommon Causes of Diarrhea 63 3CMethods of Controlling Enteric Diseases 65 30Water Excreta Behavior and Diarrhea 71 3E Primary Health Care 73 Trainer Attachments: 3AThe Global Impact of Diarrhea 75 3BA Story About Diarrhea 81 3C Suggestions for Using the Picture Story 99 Table of Contents, Page 2 Session 4Dehydration Assessment 101 TrainerAttachments: 4APictures of Children with Signs of Dehydration 109 4BGuidelines for Presentation of the WHO Treatment Chart 119 4CAnswers for Exercises 121 4DCreating a Case Study 123 4EAdaptation of the WHO Treatment Chart 125 Session 5Rehydration Therapy 127 Handout: 5A ORT Preparation Worksheet 137 Trainer Attachments: 5A Materials and Equipment Needed for ORT Stations .. 139 5B Using Models to Show Why Rehydration is important 141 5C Suggestions for a Lecturette on the Hows and Whys of ORS 143 5DOral Rehydration Therapy: TheScientific and Technical Basis 147 5E Storing and Maintaining Supplies of Oral Rehydration Salts 151 5FOral Rehydration With Dirty Water? 153 5G A Pinch of Salt, A Handful of Molasses 155 5H Cautious Prescription 157 Session 6Practicing ORT In The Village 159 Trainer Attachment: 6A Problem Situations:ORT in the Home
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