Abstract

PIP: Paraprofessionals or medical auxiliaries require in-service training as well as continual analysis of program effectiveness. In a project in Punjab, India death surveys showed that diarrhea and pneumonia caused 66% of the deaths for children 3 years old and younger; therefore, in-service training programs were implemented to develop criteria for recognizing serious cases. Procedures were set up for field health workers to follow in the event of life-threatening illness and responsibility for patient care was left to the medical auxiliaries whenever possible. In diarrhea cases, mothers were taught how to properly care for their ill children since there were too many cases for field workers to handle adequately. To accomplish this, children were visited by paramedicals in their homes so that signs of dehydration could be pointed out. In pneumonia cases, single penicillin injections replaced daily procaine penicillin since mothers rarely returned their children for treatment. Since in-service training began there has been a 50% reduction in deaths due to diarrhea and a 45% reduction in pneumonia deaths despite a rise in both of the diseases.