A comprehensive approach to community welfare: growth monitoring and the role of women in Jamkhed.

Abstract

The Comprehensive Rural Health Care Project at Jamkhed services 175 villages with a total population of almost 200000. The program actively encourages community participation self-help and integration of solutions to all types of problems within the community. The project started as a mobile clinic which periodically visited each village. Villagers participated in weighing and nutritionally assessing the children. Drought hit the area in 1972 and the lack of weight gain in children caused communities to establish special feeding programs for the poor children. Growth monitoring has helped villagers to understand growth-development relationships and has been an important tool for diagnosing illnesses in children with no apparent malnourishment problems. A comparison of mean weights between children in 1975 and 1985 was performed. In 1985 less than 6% of the children were moderately or severely malnourished whereas in 1975 30% were considered malnourished. Women villagers were strongly opposed to the cessation of this program. The most difficult problem has been to facilitate the realization among health workers that growth monitoring is an important tool. Also difficult was the introduction of weighing scales into a superstitious community. When given the responsibility of growth monitoring however communities rise to the challenge and participate fully.