Snakes and Ladders - ERU Consultants Pvt. Ltd.

- Height and weight for age an important
indicator of health.
- Also age specific milestones for
assessing physical and mental
development. Immunizations and proper
nutrition are for achieving these ends. If
milestones are inordinately delayed, a
doctor should be contacted.
- Good health is also dependent on
cleanliness - of the self and of the
surroundings.
- Bathe every day, wash hands before
eating.
- Keep surrounding free of household
waste, urine, defection, cow dung, etc.
It is too common to be taken as an abnormal state
of health. Nutrition not directly connected with
health - the special diet (not necessarily
nutritious.) after an illness, is important. ‘Filling
the stomach’ is of primary importance. ‘Hot and
cold’ are key concepts, not nutrition or balanced
diet.
Growth-
Height and weight have little meaning - unless
very noticeably different from other children.
Children not tracked accurately after 2 or 3 years.
As a result, the height/weight/age charts don’t
mean much, not even to the AWWs. There is a
different awareness of milestones (not the result
of awareness-building efforts). But the timeperiod
when milestones should take place is
understood more liberally. No action is taken if a
milestone is not reached. ‘If it is to happen it will’
is the attitude.
Environmental hygiene
Poor personal hygiene and unclean surroundings
not necessarily connected with illness. It is linked
with socio-economic status. Daily bath for upper
castes only. The need to imitate upper castes is
there, but you can be made to feel that you think
you are aspiring beyond your station.
The irony is that children are made aware of their own untidiness / unwashed state -
not in relation to health but in relation to social status / community identity,
especially when commented upon by the teacher
There is a clear need to bridge the gap in concepts as well as language. Discussion with service
providers (ANM, AWW and even some school teachers) revealed that though their belief systems
are not very different from the community, they often convey messages that they themselves are
not convinced about. They are expected to repeat these messages even when they are not getting
through. In some cases, if the messages do get through, they do so in a negative manner – viz.
children are made aware at their own untidiness, not in relation to health but in relation to social
status, especially when commented upon by a teacher who is of a higher economic status.
Further, if we assess the children against existing standards of height and weight, most children
profiled would fall in the moderately to severely malnourished category. Yet this was not our
feeling we got when we interacted with the children or the parents or even the teachers. Children
were active, running around and having a good time. There did not appear any significant
association (save the severely malnourished and sick children who were listless) between
Educational Resource Unit Page 81 April 2003