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Year : 1984  |  Volume : 30  |  Issue : 1  |  Page : 13-9

Experience with Under Fives' Clinic in Malavani, a slum area near Bombay.



Correspondence Address:
S S Kowli


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Source of Support: None, Conflict of Interest: None


PMID: 0006716303

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3 models of Under Fives Clinics were tried successively at the Malavani Health Center beginning in 1978. Malavani is a village with a population of abourt 70,000 near the city of Bombay (India). In each model mothers were given a Road to Health Card for each child. Model I was a center-based model. The venue was the same center where outpatient departments were located for the convenience of the mothers. The staff comprised 1 pediatrician from the staff of the K.E.M. Hospital and rotating interns posted for 1 month at a time. Enrollment and follow-up of the children were done in the outpatient department. Model II, a subcenter-based model established in 1980, 5 satellite subcenters located in the community were established. The permanent staff consisted of a medical officer, a medico-social worker, and a records assistan. A detailed record of each child was maintained at the subcenter. The medico-social worker held group discussions with the attending mothers and an attempt was made to understand their views and beliefs about child care before trying to educate them. Model III, a community-based model, was established in April 1983. The staff was partly permanent (a medico-social worker, a student nurse, and local community health volunteer) and partly temporary (rotating interns). The staff visited different areas of Malavani village by rotation. An attempt was made to visit each area at least once in 2 months. Detailed recors were maintained as in Model II. In all models, the children were weighed at each visit. They were given oral polio and triple vaccines. Mothers were advised on foods to feed the children to improve nutrition and were given simple recipes and cooking demonstrations. An attempt was made to evaluate the regularity of attendance, weight gain in children, and immuniation coverage. With Model I 450 babies were registered in 6 months but only 48 of them were brought for further follow-up; only 21 of them completed primary immunization. 2034 babies were registered under Model II over a 2-year period. Of these, 1280 attended the clinic regularly for follow-up and completed the course of primary immunization. A striking feature was the weight gain in 1011 children. The number of family planning users increased significantly from 237 at the time of clinic registration to 384 after a few months. 856 babies were registered in 6 months under Model III and 764 attended regularly for follow-up. 613 of the 764 children gained weight and all 764 completed the primary course of immunization. The deficiencies of the center-based model, Model I, are evident. Models II and III proved effective in improving the care of children under 5.






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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow