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categories. In this study we attempt to capture the various processes and their shifting
significance across the age groups through the research tools elaborated in the matrix below:
From Conception to Birth:
Children in this stage of development have been the focus of a large number of health and family
welfare programmes of the government, for example the Maternal and Child Health (MCH) and
Family Planning (FP) programme of the 1980s, Child Survival and Safe Motherhood (CSSM)
programme in the 1990s, and more recently the Reproductive and Child Health (RCH)
programme. Similarly the ICDS programme, operational since the mid-1970s, focuses on
nutrition of mothers during pregnancy and lactation (see Table 13).
− Across the three states, a disturbing finding was that few women took any special nutrition
during pregnancy; if anything most women reported that they consciously ate less in order to
ensure a smooth delivery. Few women were aware that pregnancy requires extra nutrition.
Most believed that it was not an important matter and that it was all right to eat less and have
smaller babies as it is easier to deliver them. Many women interviewed said that they ‘fatten
them (children) up’ after they are born.
− Nearly all deliveries across the three states took place at home assisted by the Dai
(traditional birth attendant or TBA) or a relative/neighbour. Trained midwives were either not
within their reach or families did not think it important to access one. Even though macro
data indicates a higher incidence of institutional and trained midwife assisted deliveries in
Karnataka and Andhra Pradesh, our research shows no significant difference across the
states. 5 It is likely that as we go down the socio-economic ladder, inter-state variations on key
indicators of maternal and child health is minimal and the ANM is rarely called upon at
birthing. The community primarily relies on a local Dai or a relative to assist, while
institutional delivery still remains uncommon or rare (See Table 13).
− Most women continue to breast-feed their children till the next child is on its way. Often in
the case of the latest child, breastfeeding continues as long as mothers have milk, which often
means almost 24 months. Special nutrition during lactation was clearly a novelty for most
5 Interestingly, the official statistics compiled by the Registrar General of India from the records of ANMs
or other sources and those collected by the NFHS from responses of women are at variance as evident in
Table 2. The households consistently report a much higher proportion of deliveries taking place at home.
Educational Resource Unit Page 30 April 2003