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Interventions: The entry point being discussions regarding the mothers overwork, would usually lead to ventilation of her emotions to some extent and understanding of the advice and suggestions of the worker. To handle the strain of work and children, the worker may encourage and negotiate among the family members so that the work is distributed equally and is not a burden on the mother alone. The worker may need to see the couple together for this.

Birth control may be advised to this couple since there are already five children and the mother is pregnant for the sixth one. She may explain the adverse effects it will have on the physical and mental health of the mother and thereby making her incapable of looking after her children well.

The father needs to be encouraged to make small changes in sharing of work and initiating birth control which may reduce the discord automatically. This may not be so easy to change but an effort can be made to better the communication pattern. They can be given tasks of spending time together with children or having some family rituals like prayer etc.

The father's drinking habit may be difficult to change and one might face resistance, however discussions regarding the effects of alcohol can be initiated.

As for abject poverty, they may be taught budgetting, low cost nutrition and play material and making effective use of existing resources.

The positive aspects in this family like healthy children, immunization, regular attendance to Anganawadi centre should be appreciated.

Since this family has too many risk factors it would be necessary to deal with each risk factor carefully and bring about change gradually. Since the risk factors are related to one another, intervention with one may cause some change in another.

Outcome: the mother feels relieved with someone sharing her problems. The couple followed the advise and the number of quarrels, specially in front of children has come down. They have agreed for birth control realizing the difficulty over crowding is causing them. The father is trying to help the mother out some times. But has not yet stopped drinking.

Case 4: This family displays abject poverty and disorganization. The mother is employed as servant maid. The mother has five children. Three of them are below six years. All the children are immunized and attend the Anganwadi Centre. The younger child bed- wets. The elder children go to


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