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
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