A people's perspective in nutrition education

Abstract

The Thai Ministries of Public Health and Interior and the Institute for Population and Social Research at Mahidol University in Nakhon Pathom, Thailand, operated the 1990-92 home-based approach, integrated child development services project which aimed to develop a plan to provide age=appropriate care and education for children living in rural areas. The project included nutrition, health, and educational services designed to correspond to the community's life style. Project staff first conducted a survey of 240 mothers of 0-6 year old malnourished or healthy children and of other community members in northern and northeastern Thailand to determine household and community behaviors, perceived needs, and overt and covert cognitive processes influencing the prevalence of malnutrition at home and in the community. Staff used the explanatory model framework which considers the ideas and beliefs of individuals, families, and communities regarding foods, illness and its causes, and the needed treatment. They used interview data on well-nourished children to develop the stages of the culturally based model for child growth and development. Stage 1 comprised children under 2 years old who were totally dependent on their mothers for breast feeding and weaning. Semidependence made up the second stage when children ranged from 2 to 4 years old. Mothers or caretakers spent less time supervising these children than when they were under 2 years old. The third stage included almost total independence for =or 4 year olds. The community used these stages to gauge child growth and development by comparing children with their peers. If a child was small for its age but whose personality and development seemed fine, they tended to believe the small size was due to genetics and not malnutrition. This model allowed project staff to conduct bottom-up planning and development of nutrition education programs.