8-11
TREATMENT AND MANAGEMENT
Sensible use of medicines or alternatives:
Did you . . .
——use no medicines if they were not needed?
At least 50% of health problems are best
managed without medicines.
——if medicines were not needed, help the person
understand why the problem is best managed
without them?
——use appropriate non-medicinal treatments?
——use only medicines that were needed?
Use only 1, or at most 2, medicines. If 3 or
more medicines are given at one time, people
often cannot remember how to use all of
them properly.
HEALTH EDUCATION AND PREVENTION
Communication about the health problem: Did
you . . .
——discuss with the sick person and his family: the
illness, its causes, and its prevention?
——use simple, clear language, and local words?
——include the child, as well as the mother when
discussing the health problem and its prevention?
——use books, teaching aids, examples, or stories to
make points clearer?
Prevention:
——Did you place enough emphasis on prevention?
——Were the preventive measures you suggested
clearly related to the problem in question?
——Did you consider the feelings and concerns of the
sick person and his family?
——ask if the person is allergic to any medicines?
——before giving a woman medicine, ask if she was
pregnant? Give only medicines that are safe
for the child
in the womb.
For example, did you talk about prevention
only after providing for treatment?
——Did you try to make sure that the preventive
measures you suggested would be followed?
——use the correct dosage of medicines?
——measure or count the medication (pills)?
F•o rOefxfeamr tpolev,isinit
case of typhoid, did you:
the home and plan with
neighbors to help construct a latrine?
• Help the family make a water filter or a rain
water collecting system.
——write for the person the name of the medicine,
its use, the dosage and the person’s name, in
clear simple form (or in picture code if illiterate)?
——explain the medicine and dosage clearly and
simply, and have the person repeat it?
——do your best to make sure the person will take
the medicine correctly?
——Did you do your best to share your knowledge
and show there is nothing magic or secret about
your medical abilities? Or did you look things
up secretly (or not at all) in order to give the
impression that you ‘know it all’?
USE OF BOOKS Did you . . .
For example, have him take the first dose
at once, especially if it is a single-dose
medication (like some worm medicines).
——make good use of your reference book(s) during
the consultation?
——openly look things up in the book while with the
sick person and his family?
——avoid injections, except when absolutely
necessary?
——show the sick person or a parent the sections or
pictures in the book that explain the problem?
——consider the cost of different possible
medications, and choose the cheapest one likely
to do the job adequately?
——double check dosage or other information by
looking it up, even if you were fairly sure?
——emphasize the importance of taking the medicine RECORDS Did you . . .
as directed and for the time necessary?
——write a record of the consultation?
——give advice about risks and precautions?
Traditional medicines and beliefs: Did you . . .
——use traditional medicines or healing methods, if
appropriate?
• Name, age, date, etc.
• Health history and what you found in
physical exam—in enough detail for another
health worker to understand.
——explain about diet and other traditional concerns
people have when taking medicines?
——explain things in such a way as to respect and
build upon people’s traditions and beliefs, rather
than reject them?
——Follow-up Did you make arrangements for follow-
up, if necessary?
• Possible alternatives for diagnosis.
• Tests and information in order to rule out or
confirm possible causes.
• Conclusion (most probable diagnosis).
• Care and treatment (or decision to refer).
• Preventive advice given.
Referral: Did you . . .
——recognize your limitations, if the problem was
——record the information so that it is clear and well
organized?
beyond your ability to diagnose and treat?
——record the information in a way that did not disturb
——openly explain your limits and help arrange for
your conversation with the sick person?
the person to receive care elsewhere (hospital or ——fill out any other necessary forms?
clinic)?