Grandmothers: A Learning Institution - Basic Education and Policy ...

in the family and social networks. Saguarograndmothers are involved not only intreatment but also in health promotionwithin the family. McKee (1987) came tosimilar conclusions based on work in theHighlands where “primary medical specialists”at the household level are seniorwomen who, in turn, train younger womento assume this role.Colombia: In urban Bogota, Myers andIndriso (1986) found that in extended familieschildcare was most frequently providedby female relatives, including mothersand mothers-in-law.Mexico: Related to infant feeding, a studyin rural Mexico documented the influenceof female social networks on childcarepractices of younger women. It was foundthat women with young babies more frequentlyconsult their mothers-in-law, mothers,and sisters for advice on infant feeding,than their doctors.EXAMPLES FROM THE PACIFICIn a 1998 study on breastfeeding practicesin urban Suva, in Fiji, it was found that, bothamong Indigenous Fijians and Indo Fijians,women’s infant feeding practices are significantlyinfluenced by the networks ofwomen within and around their families(UNICEF/Fiji 1998).EXAMPLES OF MORESYSTEMIC ANALYSES OF(GRANDMOTHERS’) ROLES INCHILDREN’S DEVELOPMENTMost of the literature discussed abovereports on discrete attitudes and practicesof grandmothers’ practices related to program-specificchild development issues,such as childcare, breastfeeding or femalecircumcision. However, very few of themprovide information on grandmothers’roles within household systems, and theirinfluence and involvement in decision-making.There are some examples of formativeassessments, carried out in the context ofchild development programs, that arebased on a family and community systemsapproach in which there is analysis both ofthe roles and influence of the varioushousehold actors on a child’s development,and of the specific practices of thosehousehold members. While no definitivemethodology exists for applying such anapproach, two other studies have beendescribed here that serve as examples ofhow this approach might be applied and ofthe type of results it could produce: first, astudy on newborn health conducted byHKI in Mali (Aubel et al. 2002), and second,a study on ECD carried out by SaveThe Children in Nepal (2000). The HKIstudy in Mali was a rapid assessment carriedout in one month with HKI andMinistry of Health staff. The Nepal studywas conducted over a one-year period bya team of researchers.SYSTEMS APPROACH TO STUDYINGNEWBORN HEALTH: MALIIn Mali, Helen Keller International (HKI), incollaboration with the Ministry of Healthand Social Affairs, is implementing a communityproject to promote newbornhealth and reduce neonatal deaths. At theoutset of the project, a formative qualitativestudy was carried out in BambaraGRANDMOTHERS:THE LEARNING INSTITUTION67