No claim for originality of the programmes is made by HETV.
We acknowledge our gratitude to the many people and sources whose work has been
drawn freely upon. We thank them all.
Programmes will be supplemented and supported by booklets,
leaflets, posters and informational guides in Marathi and English, and made
freely available at health worker stations, hospitals, schools, and more.
Protect against diseases through the promotion of
clear guidelines about proper feeding practices and the benefits of
immunity. Promote the practice of providing colostrum to the child within
the first half hour after birth, exclusive breastfeeding during the first
six months of a child’s life, with appropriate complementary feeding from
six months and continued breastfeeding for two years or beyond, with
supplementation of vitamin A and other micronutrients as needed.
Oral rehydration therapy, if properly practiced, can
cut infant and child mortality rates by at least half and obviate the need for
countless millions of costly visits to hospitals, health centres, and clinics in
all countries. But is this feasible? Packets of oral rehydration salts
(ORS) are not universally available and the simpler sugar-salt solution can have
dangerous effects if it is improperly mixed or administered. Cereal-based
ORT can overcome both of these disadvantages by providing yet another option for
oral rehydration therapy.
40% of both mothers and children in Maharashtra, India
are chronically undernourished, and under-five mortality occurs at 58
deaths per 1000 live births, or 1 in every 17 children. A very large
number of these deaths are caused by dehydration from diarrhoea, the most
easily preventable cause of childhood mortality.
Health workers will inform mothers, especially those
with limited education or who cannot read, using this series of washable,
easily transportable, and simple-to-use health guides. These
handkerchiefs with drawings, diagrams, and graphs, contain useful health
information, and will be distributed to health care providers throughout
Experience shows that food should not be withheld from
infants and children with acute diarrhoea. Depending on their feeding
status, children should receive breast-milk or diluted milk feeds; in
cases of dehydration, these should be offered as soon as initial
rehydration therapy has been completed. Appropriate locally available
foods (cereals) should be offered as soon as the appetite returns. After
the diarrhoea ceases, more than the usual amount of food should b given
for a short period. The routine use of any special infant formula
(lactose-free products) for diarrhoea cases should be strongly
discouraged as they are only rarely necessary and are costly.
Define and Promote Home-Made Solutions--define clear definitions for
home-made solutions (tea, rice water with extra rice, etc.)
The first-level health worker, a community health worker who has a crucial
role to play in disseminating knowledge and skills for the management of
diarrhoea, as regards the use of both home remedies and ORS. ORS packets
should be available in adequate supply at this level and throughout the
entire health system. If this is not possible, maximum efforts should
continue towards this end and, in the meantime, as complete a formulation as
possibly should be used, recognizing its limitations. When potassium is a
missing ingredient, patients should be encouraged to drink fluids that are
rich in potassium (fruit juices). For the preparation of ORS solution the
safest water should be used.
Focus on increased fluids, preparation and use of home-made and packaged
solutions and dangers of anti-diarrhoeal drugs.
Intended to target mothers’ confusion and lack of
understanding about how to recognize, assess the degree of, and treat
diarrhoeal dehydration. Mothers will be taught the crucial need for
immediate fluid replacement, increased fluids and food, how to correctly
prepare home-made and packaged ORS, cereal-based ORS, when and why to use
it, and continuous feeding, including breastfeeding.
Enhance the current knowledge of diarrhoea management
by facilitating lectures and training courses which will allow for
dialogue and interaction of hundreds of people simultaneously. Key health
issues will be taught and discussed by doctors, medical specialists,
medical students, and health care providers at the existing 100 virtual
learning centres in Maharashtra with video conferencing facilities linked
This 13-month calendar, corresponding to the 13 Facts
for Life messages, makes life-saving information easily available to
everyone. It presents important health information about an issue or
concern that every family has a right to know. The messages are simple,
and people in Maharashtra can act on them. The calendar will also
indicate state health days, and health educational mass media events.
For those without Internet access, all these resources
will be available on a CD which will be freely distributed to health care
providers, educators, reference libraries, doctors, schools,
universities, and hospitals in Maharashtra.
Correct the confusion created by years of mixed
messages regarding measurement of the ingredients in rehydration
solutions. Mothers will receive a plastic one-litre bottle, with a label
about how to recognize signs and degrees of dehydration, how to prepare
home fluids for rehydration, and how to mix and prepare home-made and
packaged ORS. Additionally, they will receive a 2-sided spoon to
correctly measure salt and sugar.
Provide a monitored, consistent, and expedited health
worker training process, including a certification program, for the
Mother Child Protection Card. The CBT will accelerate the current pace of
training to health workers by using over 1,000 computer literacy centres
throughout Maharashtra. This will provide a better learning experience
through interactive computer exercises, and, when necessary, give the
option to complete an individual training module at a modified pace.
Skilled attendance during pregnancy, childbirth and
the immediate postpartum period. Mothers will be provided with training
for breastfeeding from the nurse or midwife, encouraged about the
importance of providing colostrum within the first half hour after birth,
and advised about other questions they may have about their newborn or
Educate all school children, especially young girls
before child-bearing age, about important health information. A
partnership between the Ministries of Health and Education in Maharashtra
will include the teaching of proper health practices within the
Educate the general public and mothers about health
issues through an informal dialogue in various radio formats (interviews,
documentaries, quiz shows). The radio programmes will educate with the
same messages as the TV broadcasts, but will reach a wider audience.
If mothers could recognize and treat dehydration early
on at home, the great majority of children would not need additional medical
care. While only 41% of mothers in Maharashtra can correctly identify
symptoms suggesting a child needs medical treatment for dehydration, 77% take
a child with diarrhoea to a health facility. In this way, better practice and
education would save mothers the trouble and expense of traveling to the
health centre (and also prevent them from spending money on unnecessary
drugs), and it would release some of the burden on health facilities,
allowing better treatment for children who are severely ill.
Water quality interventions that employ simple, inexpensive and robust
technologies appropriate for the developing world. The objective is to make
water safe through disinfection and safe storage at the point of use. The
basis of the intervention is:
Point-of-use treatment of contaminated water using sodium hypochlorite
solution purchased locally and produced in the community from water and salt
using an electrolytic cell;
Safe water storage in plastic containers with a narrow mouth, lid, and
a spigot to prevent recontamination;
Behaviour change techniques, including social marketing, community
mobilization, motivational interviewing, communication, and education, to
increase awareness of the link between contaminated water and disease and the
benefits of safe water, and to influence hygiene behaviours including the
purchase and proper use of the water storage vessel and disinfectant.
Educate school children about health issues in
descriptive messages, cartoons, and animation printed on their notebooks.
Young school-children will see these key health messages almost every day
to encourage them to become health conscious members of society, and to
convey important information to their families and the community.
Promote the habit of Hand Washing with Soap and Water
to decrease episodes of diarrhoea. To ensure the sufficient availability
of soap, partnerships with local manufacturers will be used to promote
Educate and encourage young boys to be health
conscious members of society, and to convey important health messages to
their families and the community. The Boy Scouts will partner with the
government of Maharashtra, attend school events and public fairs,
organize rallies and fundraisers, create and distribute handouts.
Disinfect soiled water with this free and easy
technique using solar radiation. This simple process of filling
transparent containers with water, and exposing them to full sunlight for
about five hours, destroys pathogens in the water.
Educate the entire community about health issues
through documentaries, commercials, news programs, public service
announcements, and other TV programs. The broadcasts, linked to the Facts
for Life Calendar, will advertise health days and other monthly TV health
Encourage the culture of having children later in life
and having a child at least 24 months after a previous birth. Reduce
health risks for children born to mothers under the age of 18 by
educating about the importance of timing births as it relates to the
dangers of diarrhoea.
Encourage and contribute to developing the necessary
partnership between the state of Maharashtra and the Government of
India’s programmes to establish toilet facilities in all schools. The
Indian government has launched a focused campaign to increase the
households in the country that have toilets by 2010. Additionally, we
will target the urgent need for separate toilets for boys and girls,
together with a hand-washing facility in every school in Maharashtra.
Treat soiled water and prevent the spread of disease
by promoting the practice of boiling water and the usage of chlorine,
iodine, or even household bleach, to conduct home water disinfection.
Health workers will be trained to use these practices, and will convey
the techniques to mothers.
ORS and Zinc : Treatment of diarrhoea is now more
Prevent deaths from diarrhoea and decrease child
susceptibility to diarrhoea after episodes by educating all health-care
providers and mothers about zinc supplementation. Through focused and
integrated campaigns, and through partnerships with local manufacturers,
we will increase availability of zinc supplements.