HEALTHY HOMES PROJECT: Ed Session #2: Respiratory Infections and Tracking Development Milestones

The first step in promoting healthy development of a child is understanding and tracking the stages of development and identifying milestones.  The Ministry of Health has a cleverly designed card that each child receives after birth that allows the parents to record vaccinations, height, weight, and achievements in development.  During each visit to the health center, the nurse reviews the card, marks the height and weight of the child on the graph that shows whether the child’s measurements fall in the normal range (green), at-risk range (yellow), or below normal range (red), indicating risk of malnutrition and potential permanent stunting.  The nurse runs through a series of physical and cognitive tests of the child to determine if the child has met the pre-determined development milestones according to age, and marks the card accordingly.  In addition to the colors, the card is illustrated with pictorial representations so that mothers who are lacking the ability to read will be able to utilize the information.

The challenge is to convince mothers that their actions and daily decisions have a lasting impact on their child, and can greatly influence the outcome of their child’s lives with respect to health and productivity.   Many mothers experience a locus-of-control barrier, believing that they do not have the power to influence the development of their child, and/or they believe the outcome is in God’s hands (barrier of divine influence).

During the first part of the educational session, we walked through several examples of children who had health issues that slowed their growth in terms of height and weight.  The graphs from the development card were projected onto the wall, noting that each point is a record of an age and its corresponding weight or height measurement. Each point falls into a category of red (indicating malnutrition), yellow (risk of malnutrition) or green (normal). 

Our examples showed that even one common and treatable illness, such as parasite infection, can impact the health of child to a degree that takes months or years to recover, emphasizing that it is critical to take all measures necessary to avoid suffering from preventable illnesses that could a have long-lasting impact.

In case the examples weren’t memorable enough, we showed an impactful video “Mi futuro en mis primeros centimetros,” produced by the World Bank, that vividly depicts a comparison between to pueblos in Peru, one that had a public health intervention by the health center staff to reduce the rate of malnutrition, and the other pueblo, sadly, did not have any intervention.  Showing real examples of mothers who successfully raised healthy children was intended to inspire program participants to make necessary changes and follow the advice of the health center staff.

Watch the video here: 

The second part of the educational session covered the prevention, detection and treatment of respiratory infections, the most common illness suffered by all age groups, but particularly impacting children.  It is common to find children in my village who have hacking coughs reminiscent of a chain smoker because of toxic smoke that is trapped in homes by mothers cooking over a campfire indoors.  Cooking indoors is a practice perceived as having benefits to the chef, who otherwise would be cooking outdoors under the intensely hot sun.  The downsides of breathing in toxic smoke are accepted as part of the process of preparing meals, including exposing children who are often playing nearby or napping in a hammock, are not perceived as being severe enough to take action.

An illness that few mothers have heard of is pneumonia, which is commonly known (among health workers) as a life-threatening illness.  It is often mistaken it for bronchitis, and left untreated until the child is in danger of dying.   We reviewed the symptoms of pneumonia and signs of danger.  We discussed the importance of avoiding exposing children to smoke and that it can lead to serious illness, including lung cancer.

Eventually the mothers seemed content that their choice to remain in the program and make the required changes in the home that would allow them to receive an improved cook stove would be a good thing for their families, whether or not they understood that one of the key benefits of the cook stove is dramatically reducing the risk of serious illness due to smoke inhalation.

Please click here to read about Educational Session #3: Nutrition.