Snakes and Ladders - ERU Consultants Pvt. Ltd.

Social attitudes and practices:
Observers have repeatedly pointed out that there is a gap in the community and what are
considered objective perceptions of health / nutrition and well-being (put forth by experts / policy
makers / service providers). The latter seems unable to look at issue of nutrition and child
development from the viewpoint of the mothers and the community. Our field experiences reveal
that appropriate nutrition for the community is framed in the alternative discourse of cold and hot
food, energy giving and ‘strong’ foods as opposed to mainstream understanding in terms of
vitamins, micronutrients, iron etc. The indigenous concepts for well-being also differ and this may
(see table below) possibly explain the persistent gap in communication between the experts /
system and the community.
Table 26: Exploring alternative perspectives
EXPERTS / POLICY MAKERS PARENTS AND COMMUNITY
- Healthy mother essential for healthy
child.
- Pregnant women should eat well and
gain weight.
- Keep count of month of pregnancy.
- Antenatal care important, at least three
or four check-ups, measure blood
pressure, check for anaemia and / other
danger signs.
- Anti tetanus injection and IFA tablets.
- Mother to eat well and balanced diet, to
produce sufficient milk for child. Breastfeeding
up to one year. Demand feeding.
(Child knows best when it needs a feed)
Weaning food / solids from 3 months on.
If supplementary milk is unavoidable –
emphasis on keeping bottle clean
(sterilise)
- Immunizations absolutely essential:
- Triple antigen (DPT)
- Polio – at least three doses
- Measles.
- Vitamin A.
- Approach to illness is preventive.
- Proper nutrition and safe water
important.
From conception to birth
Eat normally, not too much. Small child for easy
delivery. No extra eating when pregnant – so that
child stays small. Do not go to a doctor unless
there is a ‘problem’ – pregnancy a part of life, it is
not an ‘illness’. Not really aware of exact weeks
of pregnancy, have rough idea. Not serious about
anti tetanus injection, not sure why it is necessary.
Iron pills given by AHW thrown away or eaten
irregularly.
From birth to 18 months
Mother to eat well but only ‘hot’ foods and foods
for healing the wound’. Breast-feeding till next
child is on the way, feed up to 2 years. Demand
feeding and comfort feeding and to keep the child
quiet, even when the mother has little milk. No
concept of special weaning food among the very
poor; child eats whatever is cooked for others.
Biscuits are a great favourite. Supplementary
feeding irregular, mostly with spoon or glass. If
bottle used, it is just washed
Early childhood care, immunisation and illness
No much motivation for immunizations, all 3
doses not given. Polio drops given if available at
doorstep and because of sustained campaign.
Little knowledge of triple antigen and measles
vaccines. Not serious about Vitamin A. Educated
parents more serious about immunizations.
Approach to illness is curative. Cold, cough, skin
irritations, moderate fever not considered serious.
Educational Resource Unit Page 80 April 2003