Reflection on counselling a mother on choosing appropriate contraceptive methods:

➢ Family planning refers to practices that help individuals or couples to

i. Avoid unwanted births
ii. Bring about wanted births
iii. Regulate the interval between pregnancies
iv. Control the time at which birth occur in relation to the age of parents
v. Determine the number of children in the family

➢ At the time of counselling, we can follow GATHER approach.

Steps under GATHER approach Family planning counselling:

G- • Greet the client.

Greet • She should feel welcome.
• Build a rapport with client by greeting the client and making her feel
comfortable.
A- • Ask questions effectively in a friendly manner using words that client
Ask understands and listen patiently, without being judgmental.
• Identify client needs by asking relevant questions about personal, social,
family, medical and reproductive health including reproductive tract
infections, sexually-transmitted diseases, family planning goals and past/
current use of family planning methods.
T- • Tell her about different contraceptive choices, which methods interest her and
Tell what she knows about the methods.
• Briefly describe each method of interest and explain how it works, its
advantages, disadvantages and possible side-effects.
H- • Help her reach a decision and make an informed choice regarding method
Help • Ask what the spouse/partner likes and wants to use.
• Ask if there is anything she cannot understand, and repeat information when
necessary.
• When the chosen method is not safe, explain clearly why the method may not
be appropriate and help her choose another method.
E- • Explain and demonstrate how to use the methods.
Explain • Give supplies if appropriate.
• If the method cannot be given immediately, explain how, when and where it
will be provided.
• Describe any possible side-effects and warning signs, and tell them what to do
if they occur.
• Ask them to repeat this information back to you
R- • Tell them when to come back for a follow-up visit and to come back sooner if
Return/Refer they wish, or if side-effects or warning signs occur.
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Reflection on counselling a patient with an infectious disease on prevention of the same:

➢ During community visit, we came across to a diagnosed dengue case. He was undergoing
home treatment for dengue fever from our hospital.

➢ The following advices were given to him regarding prevention of dengue:

1. Encourage intake of oral rehydration solution (ORS), fruit juice and other fluids
containing electrolytes and sugar to replace losses from fever and vomiting.
2. Instruct the care-givers that the patient should be brought to hospital immediately if
any of the following occur; no clinical improvement, deterioration around the time of
defervescence, severe abdominal pain, persistent vomiting, cold and clammy
extremities, lethargy or irritability/ restlessness, bleeding (e.g., black stools or coffee-
ground vomiting), not passing urine for more than 4-6 hours.
3. He should isolate himself under bed net.

➢ Certain general advices were given to him regarding prevention of dengue in future:

1. Use bed nets at night or afternoon.

2. Use insect repellent creams.
3. Aerosol can be used during day time to prevent the bites of mosquitoes.
4. Wear long-sleeved shirts and long pants, treat them with insect repellents.
5. Use screens for windows and doors. Repair holes in screens if any.
6. Once a week, empty and scrub, turn over, cover or throw out items that hold water
such as tires, buckets, flower pots, containers.
4. Change water of aquarium, fridge, air-cooler and cover the water tanks.
5. When cleaning house, use insecticidal sprays.