Lesson 3: Maternal Nutrition - Care Group Infocaregroupinfo.org/.../10/2013-DFAP-Mod-3-Hygien-ENG … · Web viewDiarrhea causes the body to lose water. Every time a child has diarrhea

Essential Hygiene ActionsLeader Mother Flipchart

Module 3 of 6

Table of Contents:

Lesson 1: Diarrhea Transmission, Care and Treatment..............3Lesson 2: Hand Washing and Tippy Taps to prevent diarrhea. . .7Lesson 3: Feces Disposal, Good latrines and Deworming........12Lesson 4: Improved Water Sources and Water Purification......16Lesson 5: Proper Feeding of Sick Children...............................22Lesson 6: Dish Drying Racks and Proper Storage of Food........26

Lessons, stories, and activities in the Essential Hygiene Actions Lesson Plan are meant to complement the information provided in Essential Hygiene Actions Leader Mother Flipchart.

Acknowledgements

Hanold, Mitzi J. and Wetzel, Carolyn (2013) Essential Hygiene Actions (Rev. Ed.). Washington DC. Food for the Hungry (FH), made possible through support provided by the Office of Food for Peace, Bureau of Democracy, Conflict, and Humanitarian Assistances, and the U.S. Agency for International Development under the terms AID FFP A 11 00007. The opinions expressed herein are those of the authors and do not necessarily reflect the view of the U.S. Agency for International Development. The original lesson plan and flipchart were developed in 2010.

Many thanks to our illustrator Ir Leonidas Nisabwe.

1

Lesson 1: Diarrhea Transmission, Care and Treatment

Materials for Lesson 1:1. Attendance Registers 2. Blindfold or piece of cloth. 3. A plastic bag without holes and a container of water to fill the bag*

1. Game: Germ in the Circle

2. Attendance and Troubleshooting

3. Story: Mateso has Diarrhea (Picture 1.1)

Mateso has diarrhea again. Yesterday he had watery feces three times. Today the diarrhea continues. Mama Mubaya doesn’t feed him very much, because she wants the diarrhea to stop. Mateso has become weaker and weaker. His diarrhea is less each time, but now he doesn’t even urinate. She and her mother are trying to decide what they should do next. “Mateso has become much worse,” Mama Mubaya says. “How can I help him recover from diarrhea? What should I do? The diarrhea is killing him!”

4. Ask about Current Practices

? Why is the child so weak?? What do you do to help your child

overcome diarrhea?

Let’s compare your thoughts with the practices of Mama Muzuri.

* Materials with an asterisk should be organized by theActivity Leader.

2

Diarrhea Defined and Transmission (Picture 1.2)

5. Share the Meaning of Each Picture

? What do you think these pictures mean?? What is diarrhea? What causes diarrhea?

Diarrhea is three or more water feces in one day.

Diarrhea causes the body to lose water. Every time a child has diarrhea water is drained from the

body.

Germs are passed into our body by drinking contaminated fluids, eating contaminated foods and by eating off fingers contaminated by feces or flies.

Feces have germs which cause sickness. Eating and drinking feces causes diarrhea. Open defecation mixes feces with the soil and puts feces

into our water sources. Flies carry feces on their legs and carry it to our food and

fingers. Preparing food or eating foods without washing our hands

puts feces in our body.

3

Treating Diarrhea (Picture 1.3)


? What do you think these pictures mean?

Every time the child has diarrhea, offer ORS to replace the water that the child has lost.

Prepare Oral Rehydration Solution. Mix one sachet of ORS with one liter of boiled or treated

water. Mix the water until the powder is dissolved. After each liquid feces, give ½ cup of ORS to the child. If the child is vomiting, wait 10 minutes, then give ORS

again, slowly.

? What do we offer children younger than 6 months?

oDo not give water, herbal teas or any other liquids or food to infants. Breast milk is the best medicine.

4

Feeding during Diarrhea (Picture 1.4)



Breastfeed children with diarrhea more often than normal.

Breast milk helps heal the child’s stomach. Additional milk prevents dehydration. If you don’t have a packet of ORS, offer breast milk

frequently until you can get a packet.

Offer additional fluids such as soup, coconut water, rice water, yogurt drinks and boiled or purified water.

Offer these fluids in addition to ORS. Offer fluids more frequently to infants and children while

they have diarrhea and for two weeks after the diarrhea has stopped to replace the weight and strength lost during illness.

8. Activity: Dehydration

Demonstration

9. Discuss Ways to Overcome

Barriers

10. Practice and Coaching

11. Discuss Commitment

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5

Lesson 2: Hand Washing and Tippy Taps to prevent diarrhea

Materials:1. Water and a Tippy Tap to demonstrate how a hand washing station is

used.* 2. The materials used to make a Tippy Tap: string, a plastic container, a

nail, a candle, a tin, some small rocks and a bar of soap.*

1. Game: Rainstorm


3. Story: The Family Has Diarrhea (Picture 2.1)

Mama Mubaya’s oldest son did not wash his hands after he left the latrine. While his mother wasn’t looking, he grabbed some of the food from the table. When they all sat down, Mama Mubaya asked, “Did you wash your hands?” “No,” they replied. They dipped their hands into a bucket one by one to wash. Mama Mubaya stirred the food and then served it to everyone. That night the family began to get stomach aches. Soon they were all running to the latrine.


? Why does everyone have diarrhea?? When do you wash your hands?


* Materials with an asterisk should be organized by theActivity Leader.

6

When to Wash Hands (Picture 2.2)



Help young children to wash their hands with soap and water after using the latrine and before eating.

Washing with soap and water is the only way to kill the tiny germs.

Washing with water only will not kill diarrhea-causing germs on hands.

Keep your children healthy, wash their hands with soap. ? What other times should we (and our children) wash our

hands? ? If we don’t have soap, what can we use to clean our hands?

oScrub your hands with ash, and then rinse with water.

7

How to Wash Hands (Picture 2.3)



Wet your hands and the soap with water.

Washing with soap and water is the only way to kill the tiny germs.

Rub your hands and fingers together so that the soap lathers.

Rub between your fingers. Rub under your fingernails. Continue rubbing your hands together until the Hand

Washing Song is finished.

Pour clean water over your hands to rinse off the soap.

NEVER wash and rinse your hands in one basin. The water will hold the germs and spread them to

everyone else who dips their hands in the water. Shake the water off your hands.

8

Making a Tippy Tap (Picture 2.4)



With a hot nail, make holes in the two containers and the lid.

Make a hole in the center of the water container’s lid. Cut the water bottle in half. Make one hole to hang the

container with string. Make one hole 12 cm down and off center for the

container's spout.

9

Making a Tippy Tap (Picture 2.5)



Make a frame for the water container near the latrine.

Add rocks underneath the frame so puddles do not form.

Hang the soap container and foot pedal with string.

Push string through the hole in the lid. Tie a knot on the inside of the lid.

Screw the lid onto the water container. On the other end of the string, tie a stick for a foot pedal. When you step on the foot pedal, the water container

should lean over onto its side. The water container should be upright when you release

the foot pedal.

9. Activity: Washing Hands with the Hand washing song

10. Discuss Ways to

Overcome Barriers



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10

Lesson 3: Feces Disposal, Good latrines and Deworming

Materials1. Attendance Registers

1. Game: Catch the Fly


3. Story: Reading from the Holy Book (Picture 3.1)

Mama Mubaya’s family visits a religious service. The teacher begins with this question, “What does God say about feces?” Everyone in the audience laughs. Then, the teacher explains that God taught his people about disposing of feces when they were camping or traveling through the wilderness. 1 God said,

“Mark out an area outside of your compound to relieve yourselves… After you relieve yourself, dig a hole with the stick and cover your feces. God walks through your compound. Keep your compound clean. »


? What does your faith say about feces?

? Where do people in your house go to relieve themselves?


1 Bible reference is Deuteronomy 23:12.

11

A Good Latrine (Picture 3.2)



Latrines should have walls for privacy, a roof to keep out the rain, and a fitted lid to keep out flies.

The lid keeps flies out and reduces insect breeding in the pit.

Always replace the lid after you use the pit latrine.After using the latrine, throw a handful of ash or sawdust into the pit to reduce smell and the number of flies.

If you don’t have ash, a handful of dirt or dry leaves after each use will reduce the smell.

Build your latrine more than 20 meters away from wells, lakes, streams, or springs.

If the latrine is too close, the feces may seep into the ground water.

Feces in your drinking water will bring sickness.

? What should you do if you don’t have a latrine?oDesignate an area away from your household to use for

feces and urine.oDig a hole and relieve yourself there. Fill the hole with dirt

using a designated shovel or stick.

12

Disposing Child Feces (Picture 3.3)



Dispose of feces in a latrine to protect your child and family from germs.

If the child uses a pot, empty the feces into a latrine immediately.

Feces contain germs that have been excreted from the body.

Even tiny bits that are left on a child’s hands or fingers can bring sickness if it gets into the mouth.

? What should you do if you don’t have a latrine?

oDig a hole for the child’s feces. oCover the feces with dirt.

13

Deworming (Picture 3.4)



Beginning at 12 months, all children should receive deworming medication every six months.

When a child has worms, it can cause anemia. Anemia reduces a child’s ability to overcome illness. Anemia reduces a child’s ability to do well in school.

? When was the last time your child received deworming medication?

? What changes did you see in your child’s health after they received the medication?

8. Activity: Village Feces

Walk


Barriers



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Lesson 4: Improved Water Sources and Water Purification

Materials1. Attendance Registers 2. A ball of string or yarn3. Bring supplies for the two types of water purification that you are

promoting as well as several liters of unpurified water * 4. Ask each mother to bring a clean, drinking cup with them to the

lesson*

1. Game: Spider’s Web


3. Story: Selling Chlorine (Picture 4.1)

At the market, Mama Mubaya meets someone trying to sell her chlorine. The salesperson says. “Do you purify your water? If you add chlorine drops to the household drinking water; it will clean away the germs that cause diarrhea!” Mama Mubaya shakes her head and smiles, “No one adds chlorine to the water in my community. Our water comes from a well (or stream). It’s already clean!”


? Why doesn’t Mama Mubaya clean her drinking water?

? Do you purify your water?


15

Protected Water Source (Picture 4.2)



Always take water for drinking, cooking, washing dishes, hands and bodies from a protected source.

A protected source has a cover or an enclosed tank like a well with a cover, or water that comes from a pipe. Protected sources keep out rain, animals, insects and other insects.

Avoid rivers and open wells and streams. Germs easily fall into the water and contaminate it. Keep the area clean. Keep buckets and ropes used for

drawing water off the ground. Keep animals away so they do not contaminate the area

with feces.

? If you don’t have a protected water source in your area, what should you do?

Talk with community leaders about improving the sources. Ask the Food for the Hungry staff to help you educate

community leaders on ways to improve the source that you have.

16

Water Purification with Boiling (Picture 4.3)



Always purify water before drinking.

Even if you draw water from a protected source, germs can still get into the water.

Purifying your water removes bacteria, germs, worms, and cysts.

This will reduce diarrhea and sickness in your family.

1. Put water in a pot with lid. Bring water to a rolling boil that does not stop or slow when stired. Let it simmer for 10 minutes.

2. Let the water cool.3. After cooling the water is ready to drink.

17

Water Purification with Chlorine (Picture 4.3)



1. Add one tablet of chlorine to 20 liters of water. 2. Shake the container letting the tablet dissolve. Let

the water sit for five minutes.3. The water is now ready to drink.4. Seal the container after you are done drinking.

18

Water Purification with PUR (Picture 4.4)



1. Cut open the PUR packet. Add the contents of the packet to a clean container holding 10 liters of water.

2. Stir the water vigorously for 5 minutes until the water become clear.

3. Once the water is clear and the particles have sunk to the bottom of the container, filter the water through a clean filter into a clean storage container. Let the water stand for 20 more minutes.

4. The water is now ready to drink.

19

Water Storage (Picture 4.5)



Store purified drinking water in a clean covered container with a small opening and fitted lid.

o This keeps children’s hands and other contaminants from getting into the water.

Serve the purified water with a designated cup or ladle. Keep it covered in a clean place.

o Do not let it fall to the ground.o Do not let anyone drink directly from the stored

water container. It will contaminate all of the water in the container.

? How often should you clean the storage container? ? How do you store your water at home?

10. Activity: Water Taste

Test


Barriers



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20

Lesson 5: Proper Feeding of Sick Children

Materials1. Attendance Registers

1. Game: The Scream Game


3. Story: Mama Mubaya Helps Her Neighbor (Picture 5.1)

Mama Mubaya’s neighbor, comes to visit Mama Mubaya. She says, “My son has been sick for two weeks. First, he was sick with fever. I took him to the clinic for malaria treatment. But even now, he doesn’t eat very much and is not interested in playing. I see that Mateso recovers from illness much faster than the other children. How do I help my child recover too?”


? What do you think Mother B will say?? How do you help your child recover?

Let’s see what Mama Mubaya suggests.

21

Encourage Eating (Picture 5.2)



Encourage sick children to eat, even when they don’t seem hungry.

During illness children lose their appetite. Children who are not encourage to eat, will lose weight and

strength. Use songs and games to encourage them to eat. Offer favorite foods to encourage the child to eat. Children who are scolded or beaten for not eating will not

grow well.

? What do parents in this community do if their child refuses

to eat? ? Is this a good practice for the child’s health? Why or why

not?

22

Feeding Guidelines (Picture 5.3)



Breastfeed sick children more often than normal.

Sick children often eat and drink less during illness. Encourage them to breastfeed often. Breast milk helps the child gain strength. During illness and for two weeks after a sick child recovers

breastfeed the child more often than normal. Offer one additional snack each day to a sick child during illness and for two weeks after the child recovers.

Additional foods and liquids prevent malnutrition. Additional foods and liquids help the child grow strong and

gain weight. Encourage the child to eat, but do not force them.

23

Danger Signs (Picture 5.4)



If you see one of these signs, take the child to the clinic immediately.

Child has difficulty breathing or a cough for thirty days or more.

Child has a fever (malaria). 2 Child is unable to suck, swallow or drink. Child vomits every time he eats or drinks. Child has convulsions and doesn’t respond when spoken

to. The child’s arms and legs stiffen with fits and spasms.

8. Activity: The Danger Sign

Song


Barriers



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Lesson 6: Dish Drying Racks and Proper Storage of Food

2 Baseline: [DRC – Not Measured; MOZ – 37%] of caregivers took a child with fever to the health clinic within the first day.

24

Materials1. Attendance Registers 2. Materials needed to build a dish rack or food storage container *

1. Game: Musical Chairs


3. Story: Mama Mubaya’s damaged foods (Picture 6.1)

One day as Mama Mubaya is storing harvested food, she realizes that her foods are at risk of being damaged by mold, insects and rodents. “Our food is in trouble,” Mama Mubaya says. “We need this food to keep the family healthy until the next harvest.” “How can we keep our food from being damaged?” her son asks. “I will show you. I know exactly what we need to do!” says Mama Mubaya.


? Why is Mama Mubaya so confident that she can make improvements?

? How do you keep your food from being damaged?

Let’s see how Mama Mubaya makes improvements.

25

Sweeping and Dish Washing (Picture 6.2)



Wash dishes right after eating. Put wet dishes on a rack in the sun or under a thin cloth.

Wash dishes with soap and water. Dirty dishes attract flies.

The sunlight and heat kills any germs that stay on the wet dishes.

Place the dishes so that flies do not land on the eating surface.

A thin cloth can also be used to cover the dishes to protect them from flies.

Sweep the storage room regularly.

Remove food scraps, animal droppings, and other trash. Keep animals away from the food stores. Animals carry

germs on their feet, in their urine and feces.

26

Drying Grains and Seeds (Picture 6.3)



Make sure grains, legumes and seeds are dry before storing.

Eating the spoiled food will bring sickness. To dry grains, legumes and seeds, spread them on a

screen or cloth in the sun to dry before storing.

Store food off the ground to keep it from being contaminated by children’s hands.

Put collars on the legs (of food storage tables) to keep rodents from climbing up.

As the air moves around and under the food, it will dry up any remaining moisture.

Moisture can damage foods and help germs to grow.

27

Insects and Stored Foods (Picture 6.4)



Add a handful of wood ash or ground Neem seed to a kilo of grain to repel insects.

Protect your stored foods from insects. Insects burrow into stored grain and lay eggs in food

supplies. Mix the ground powder or ash so it is distributed through

the grain. Rinse the grains with water before eating.

Sew bags closed or use containers with fitted lids to keep out flies.

8. Activity: Building a Dish or Food Storage

Rack


Barriers



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Lesson 3: Maternal Nutrition - Care Group Infocaregroupinfo.org/.../10/2013-DFAP-Mod-3-Hygien-ENG … · Web viewDiarrhea causes the body to lose water. Every time a child has diarrhea

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