TEACHING DAIS AT HOME – Importance of Dais Training, Considerations in Dais Training, Objectives of Dais Training Program, Selection of Dais, Training of Dais, Procedure to Teach Care, Stipend, Certification, Hygiene Practices of Dai During Nursing Care, Supervision of Healthcare Workers, Principal Duties of a Supervisor (According to H. Nisson), Types of Supervison, Objectives of Supervision, Principles of Supervision and Supervision of Healthcare Workers (COMMUNITY HEALTH NURSING)
The dais or traditional birth attendants (TBA) are an integral part in providing maternal care services especially in the rural areas and urban slums
Dai not only assist at the time of child birth but she is also a counselor to the village women during pregnancy and after delivery and in the times of illness
IMPORTANCE OF DAIS TRAINING
- Training of dais on correct practices can bring about a radical change in improving the health of mothers and newborns
- The trained dais can be utilized for spreading in their work may reduce the morbidity and mortality
- Teaching of proper skills and sterile technique in their work may reduce the morbidity and mortality
CONSIDERATIONS IN DAIS TRAINING
- Some dais will grasp the subject very rapidly while others will be slow. The teaching must be in a very simple language and should be repeated many times
- Dais learns best in small groups
- Dais learn best when they participate in the learning process
- The dais vocabulary is small and simple. She learns new terms slowly
- Discuss, ask questions and learn how they do things before each class and demonstration
- Evaluate you are teaching, observe and supervise five or more deliveries in each year
OBJECTIVES OF DAIS TRAINING PROGRAM
- Antenatal care: the dais in the community should motivate for antenatal pregnancy advice to take balanced diet and adequate rest during antenatal period
- The dais should able to identify the high risk women and maternal complications. The dai should prepare the antenatal mother mentally and physically for normal delivery
- Delivery practices: clean practices such as clean hands, clean surface, clean razor blade, and clean cord tie and clean cord stump
- Postnatal: the dai should have basic knowledge to provide newborn care such as warmth, infection control, advice on immunization and birth spacing
SELECTION OF DAIS
- The traditional birth attender are actually practicing the profession are to be invited
- Preferably some elderly ladies in the community
TRAINING OF DAIS
- The training will be residential for 6 working days at the postpartum centers or the rural family welfare and health centers where at least 50-60 deliveries are conducted per month
- The trainers would be the lady health visitors or public health nurse who is in charge of the labor room of the center under the overall guidance and supervision of the medical officer in charge
- The topic of the day would be covered using a flip chart in the morning for not more than 30 to 40 minutes. The dais should be given the opportunity to ask questions, clear doubts and interact with each other
- The rest of the day there should be an agent in the antenatal clinics, labor room and in the maternity wards
- The dais should also be exposed to antenatal check up and counseling of pregnant women
- At each training session, there should be only 5 to 6 dias so that they can give individuals attention
- During the training session, each dai should be allowed to conduct to five deliveries under supervision
PROCEDURE TO TEACH CARE
- Measurement of weight
- Blood pressure measurement
- Detection of edema, anemia, etc
- Antenatal checkup
- Referral of cases
- Taking precautions during pregnancy and delivery
- Postnatal care of the mother
- Care of newborn and inspection of the newborn
- Birth registration
STIPEND
During training 300 INR will be paid for each dai for the entire training period (1 month). During the training a picture manual is given to each dai for their references
CERTIFICATION
The entire dais that have attended twelve month training sessions and have conducted at least 10 deliveries under clean safe conditions and the health of the mother and the child have been safe up to 42 days after delivery will receive a certificate at a specially organized function on 11th May World Population Day every year at the PHC by the PHC medical officer
- Dias is the important messengers they carry information to the community. They motivate community people or immunization, sterilization and birth spacing, etc
- Dais will be able to give information or vital events that may have taken place after your last visit to the village
HYGIENE PRACTICES OF DAI DURING NURSING CARE
- Remove bangles and ring before delivery and when caring for the mother
- Keep the mails clean and short
- Wash hands with soap before and during the labor and delivery
- Boil scissors and cord ties before cutting the cord
- Use only clean materials for vulva before, during and after labor
SUPERVISION OF HEALTHCARE WORKERS
- Supervision means overseeing the employees at work. It has been defined as the authoritative direction of the work of one’s subordinates. It is a necessary concomitant of their hierarchical organization in which each level of subordinate to one immediately above it and subject to its order
- Supervision can be defined as a process by which the subordinates are helped according to their needs by their immediate supervisors to make improve their abilities so as to their jobs efficiently to themselves and to the organization in which they function
PRINCIPAL DUTIES OF A SUPERVISOR (ACCORDING TO H. NISSON)
- To understand the duties and responsibilities of his own positions
- To plan the execution of the work
- To divide the work among subordinates and to direct and assist them in doing it
- To improve his own knowledge as technical expert and leader
- To improve his work methods and procedures
- To train the personnel
- To evaluate the performances of the employees
- To correct mistakes, solve employee’s problems and develop discipline
- To keep subordinates informed about policies and procedures of the organization and above the changes to be made
- To cooperate with colleagues and seek advice and assistance when needed
- To deal with employee suggestions and complaints
TYPES OF SUPERVISION
Direct supervision: this can be exercised at the ward or unit level in the hospital or primary health center or sub center of the community setting. This is done through face-to-face talk it to the workers. it provides opportunity to the workers to give reply
Indirect method: it is done with the help of record and reports between the supervisor and supervisee. It ensures that every worker is allotted work in accordance with the plan of operation and with the prescribed methodology in keeping pace with the time as far as possible
OBJECTIVES OF SUPERVISION
- To promote optimum functioning of each worker as well as the functioning of each unit
- To help the staff to do their job skillfully and effectively to give maximum output with minimum resources – cost effectiveness
- To help in formulation of new policies and also to interpret policies and objectives of the organization to the subordinates and suggests ways and means to improve them
- To safeguard the workers from making mistakes and thereby to protect the public
- To improve the attitudes of the member towards the work or program
PRINCIPLES OF SUPERVISION
- Good supervision is based on the need of the individual. The supervisors assess the training needs of the subordinate before delegating the responsibility and authority
- Good supervision is based on the job description of the individual to be supervised
- Good supervision establishes good interpersonal relationships among the members of the organization and the general public
- Good supervision helps the subordinates to set personnel goals in accordance with organizational goals
- Good supervision helps to create a physical, psychological and social climate in which the individual is free to function at his optimum functional level
- Good supervision is employee centered rather than production centered
- Good supervision is a continuous and ongoing process and also respects the individuality of the subordinates
- Good supervision helps the nurse to make a pattern for analysis and to analyze continuously her success in reaching her objectives
- Good supervision is well planned. Objectives, methods of supervision and the criteria for evaluation, etc. are established ahead of time
SUPERVISION OF HEALTHCARE WORKERS
Home visiting with the staff: surprise visits are more effective when they are planned. Surprised visits have very little value in supervision as the main purpose of supervision is to guide and help the staff. Surprised visits may be done on rare occasions and situations, especially when inspecting the work of an unsatisfactory worker
Field visiting: along with the staff should be planned in relation to the total supervisory program. The supervisor should maintain some form of individual record for guiding the staff
Nursing personnel at the clinics: the supervisor observes the clinical setup, sterilization of equipment, maintenance of equipment, clinical records and nursing procedures being carried out by the nursing personnel
Nursing personnel working in PHC: supervisor supervise the staff nurse working in hospitals attached to PHC maternity homes. The supervisor observes bedside care and nursing procedures, storage of drugs, sterilization of articles, maintenance of equipment, health teaching carried out in the hospitals, records and report maintenance
School health activity: the supervisor should help the staff in planning and executing school health programs and other community health work
