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Intervention in the second group are for children identified usually at birth with a biological impairment, for example, asphyxiated or low birth weight infants, infants with genetic, metabolic, neurological or anatomic defects. These interventions have been reviewed by Simeonsson et al (1982) and are not in the purview of our present study. Chapman et al (1990) reviewed seven programmes in the United States which studied the effects of home visitors on child health. Most of these programmes had the entry point in the second trimester of pregnancy and exit from six weeks to 1-2 years after birth. Families with one or more risk factors were taken for intervention i.e., low income families, single women and mothers less than seventeen years of age. These families were seen by paraprofessional home visitors (Volunteer/paid, full time or part-time) and each home visitor saw anywhere from two mothers/families to thirty-five in some areas. The frequency of their family visits were every 1-2 weeks (from pregnancy to six months of age), monthly (six months to one year of age) and every six weeks from 1-2 years). Each visit involved training programmes with mother and the families from 1-10 sessions, depending on the programme. Each session lasted approximately 3 hours/half a day.

The objectives of these programmes were both psychosocial and physical viz. improvement in maternal and child health, improvement in maternal health behaviours, prevention of health and developmental problems, improvement of women's own life course development and utilization of health services by mother and infant. The sample sizes varied from 100-500 mothers per programme and research design was a random assignment to treatment or control group.

The outcome measures of these seven programmes showed the following statistically significant effects.

(a) Birth weight: Improved compared to control group especially so when teenaged primis were visited at home compared to non visited controls. There was no difference in birth weight when the programme focussed on maternal-infant interaction. .

(b) Prenatal care: Visited women had more prenatal visits as opposed to controls. There was also inadequate prenatal care in the control group. In programmes where both controls and study groups had visits, there was no change.

(c) Use of health care and community services: In the study group there was increased awareness, greater usage of facilities, increased


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