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Elisabeth SommerauerMOM, module 2 week 10Tow Ears of Corn1. According to the book, list the seven reasons we are careful about what technologies we introduce and briefly explain each.To start slowly and smallThe more techniques are introduces the more complex the program becomes, that which means more aids must be purchased, more plots, more follow ups. The more techniques are introduced the more steps need to be taken in consideration.To achieve a high rate of successThe less practices we apply the less we waste and the higher the success is. To reach hundreds of peopleTeaching one practice to one hundred people is better than one hundred practices to one person. Projects have failed due to peer pressure, every one in the village would start one innovation yet within two years dropped it due to peer pressure.To reach the critical massIt is important that the critical mass is reached and adopts the program/ the innovation for it to succeed. Which means 25- 45% of a community.And again for this to be successful it is important for only one or two practices to be introduced at the same time. A limited technology program must move on to a new group of farmers (midwives) when successfully adopted by the first group.To develop leadershipRather teach fewer techniques to the leaders in the village that you gather.It has been shown, that the less you teach the better it will be adopted and then those leaders can teach the new group. Also those who have had experience on the field rather than being educated outside the village might have more enthusiasm to adopt things.To avoid excessive increase in incomeIf the income increases by more than 150% it has been shown that this can cause jealousy, resentment and group tension.When money came to easy people often rather waste it.But when income rises gradually they can use it and look towards the future and start to plan in how to use it.To avoid making needless effortsIt has been shown that villagers only adopt one or two techniques anyways, if many have been taught.2. Stethoscopes, Doppler’s, and IV’s are all examples of technologies used in the realm of birth. How do we know which ones to introduce and which to leave out? The book is very specific about how to make these determinations. Using the criteria in the book, explain how each of the following pieces of midwifery equipment should be examined as far as introducing it to a developing community: stethoscope, fetal doppler, pinard horn, ultrasound, and fetoscope. Be sure to walk through each step with each piece of equipment1. Establish general priorities in the area.First ask what are the problems why mothers die in childbirth? Or why children die after birth?Pre-Eclempsia, IGUR, Hemorrhage2.Look for and list the potential innovations.Stethoscopes, Doppler’s, IV, Ultrasound, Fetoscope, Pinard Horn…3.Choose three to six innovations according to the criteria from chapter eight.IV’s, Doppler and Stethoscope4.Test the innovations.To know whether a technology can or should be used ask the following questions.1.Is the technology recognized by the poorest farmers (midwifes) as being successful?Does the technology meet a felt need?Is the technology financially advantageous?Does it bring recognizable success quickly?Does the technology meet local farming patterns?Stethoscopes: The technology definitely does meet a felt need, in an area where only by hands or visualizations you are able to diagnose.Dopplers: A Doppler would also meet a felt need, to listen to a baby’s heart beat, I think when appropriately taught, there will a recognizable success quickly. It will most likely not meet the known midwifery patterns if until then there hasn’t been a technique like this, but I can imagine the fast sucess rate will motivate the use of this device.IV’s: Definitely meet a felt need. It is only advantageous to safe lives in case of hemorrhages, yet is needs a lot of training and practice and more equipment (fluids, alcohol swabs, IV lines etc.) for it to be useful and it can only be used one time.2.Does the technology deal with those factors, that most limit production?Stethoscopes: The technology will be useful in terms of midwifery to listen to baby’s heart tones, listen to mother’s heart tones, listen to the lungs and if blood pressure cuff available to measure mothers blood pressure. In this case we don’t speak about limit production, but the maternal death and fetal death as well as newborn complications. This definitely can help assess the mother and baby correctly to help prevent and further treatment.Doppler’s: This method will definitely help examine a fetus, placing of placenta. And in terms of maternal mortality, might help diagnose and send to mother to a higher level of care and might save the mothers and babies life.IVs: Will definitely safe mothers lives, but if applied inappropriately can be a risk factor in itself.3.Will the technology benefit the poor?Does the technology utilize the resources the people have already?Is the technology relatively free of risk?Is the technology culturally acceptable to the poor?Is it labor intensive rather than capital intensive?Is the technology simple to understand?Stethoscopes: It definitely can benefit the poor but is pricey, also though a one time investment. It is free of risk and beneficial.Doppler’s: This technique is relatively pricey and pricey to maintain. It needs power and or batteries, which are a high cost factor. When appropriately taught it can be very beneficial. It is free of risk to my understanding.IVs: This technology would be the least for me to think it would benefit the poor, it will definitely safe life’s, yet is very cost intensive, it is of high risk, not for necessarily easy to understand and needs to be applied under certain regulations. (The material must be sterile, available, appropriately applied) 4.Is the technology aimed to adequate markets?Are market prices both adequate and reliable?Is the market available to small famers?Does the market have sufficient depth?Stethoscopes: I think this is an N/A it is a one time investment, would only be used for midwifes and CBA’s. Doppler’s: Another N/A, the market is the midwives, health clinics, and mothers. It is a very reliable market; mothers will always get pregnant and are always in need of care.IVs: N/A the same.5.Is the technology safe to the area of ecology?Stethoscopes: yesDopplers: yesIVs: IV’s are the only group where I would be concerned about safety!6.Can the technology be communicated efficiently?Does the technology require a minimum of on-site supervision?Is it simple to teach?Does it arouse enthusiasm amongst the farmers?Stethoscopes: Simple to teach, needs supervision and more teaching than what you would expect. Especially about what to do with the results of examination and what do the results mean.Dopplers: Simple to teach, I think it would create a lot of enthusiasm, needs some supervision as well. IVs: Needs most supervision out of all the techniques, when possibility of easily obtaining materials, the results can safe lives and create enthusiasm. Yet intensive training and one-site supervision required.7.Is the technology widely applicable?Stethoscopes: Yes, you can easily carry it to places. For every pregnant women in any area applicable.Dopplers: Also easily applicable and widely, yet batteries/power needed more cost intensive.IVs: Widely applicable, yet training intensive, lots of material needed.3. Starting on page 133 you will find the section entitled “Technology Pyramid”. Read this section again and explain how this process works with the following three examples: proper cleaning of instruments, the importance of breastfeeding, and following proper nutrition programs. Your explanations should follow the progress of the technology pyramid for each of the aspects mentioned.Proper cleaning of instrumentsImportance of breastfeedingProper nutrition programStart with one or two innovations:Hygiene: Proper cleaning of instruments, in the 1st yearWait until the innovations are adopted and only then start with the second technique. As they see here fewer infections, less complications and good results they will stay enthusiastic for the second year.Add the importance of breast-feeding in the 2nd yearAnd proper nutrition in the 3rd year.With every year follow the same principal only add the new subject if the community has started to adapt it, only if the enthusiasm is still there.If not you have to start completely over.The ones that have adapted the new concept are the ones that will be learning and adding new subjects or themselves might become teachers for others.The ones that are at the bottom of the pyramid should still start with only one technique. The simplest one. For example what I put on the bottom of the list instrumental cleaning. It might be a simple process within the bigger process of birthing.Depending on the felt needs in the community I would organize the pyramid differently. Starting maybe with breastfeeding (if infant death is not due to infections, but dehydration) or if maternal death is a greater problem due to malnutrition, anemia or pre-eclampsia. The way I would teach it would be by chart No5.Sterilization.First teach “why”.Why is sterilization important? Make germs visible. Through visuals, like flower, sand, dirt that is on hands an instrument and pass them on and spread the germs through the room. Help people understand that those germs go inside the wound and cause infections, sickness and great complications.Second teach how: Use a piece of fabric and put it inside a pot on a fireplace for example. With another pot around that my simple help the inside pot to heat up, but not to burn. Leave them in there for at least an hour.Do not touch the instruments that are rolled up in the fabric until you need them.“Try it out” Have everyone bring their scissors, razor blades etc. that they use for cord cutting. Have them bring a piece of cloth that they would have separate in their home and designated from not on for this procedure. And try it out.Evaluate.Speak with them about the results, if they understood, if it’s easy, what concerns they have, etc.Train and encourage teaching others.Breastfeeding.Again as you start teaching breastfeeding.Start with why it is important.Name some advantages. (also here name the ones that are important for them and not ALL of them) For example, cheap, always accessible, clean, nutritious.Things like laxative, or colostrum has Vit K etc. I think are not as important to many villagers.Teach again How to breastfeed.Teach a proper latch. Since most complications are due to an improper latch.When they understood how to latch then maybe talk about positions.Only if those concepts are understood, start sharing about complications.Try it out.Have them bring their babies. Or bring nursing mothers from the communities, where the women can learn to help latch the baby and see how it works. I believe the more practical the better.Evaluate.Have the women participating give you feedback on how it work for them, what questions and concerns they have.That can take a long time. Have them set up with first times moms or mothers with breastfeeding complications, where they can learn to share what they just learned.Nutrition.The year you start teaching with nutrition you also follow the steps of why, how, practice and evaluate and train them to train others.Also within the topic of nutrition, focus on the one or two topics that are of highest priority. Maybe iron intake and folate intake? Then find out what the reason for the deficiency is. Maybe you need to teach how to grow a certain kind of food, like spinach, moringa. Or if available maybe it will be your job to make this a pregnancy food or emphasize this for a pregnancy.And again, don’t teach the entire topics at ones but keep the pyramid in mind. ................
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