one year indicating that the indirect effect of improvement
in psychosocial factors on nutrition is evident even at an
early stage. Though there was improvement even in the control
areas, the degree of change was significantly more in the
experimental areas emphasizing the efficiency of intervention.
In Lucknow centre, the absence of improvement in the experimental
area as opposed to the control area (where nutritional status
deteriorated) indicates the protective effect of intervention.
The development quotient which was used as a measure of cognitive
development also showed significant improvement in all centres
in the experimental areas. At the Bangalore centre, this change
was evident only at one year which might be because of the
D.Q. at initial evaluation (being much higher in the Bangalore
centre) and hence improving only after a period of one year.
In fact, wide variations on baseline HRC factors across centres
might account for variations after intervention.
A number of earlier studies (McGregor, 1991; Powell, 1989)
have shown the efficacy of home and family intervention on
childhood development and mental health of mothers in an independent
manner. The current study is important in assessing both parameters
and looking at the effect of intervention on both areas. There
is reason to believe that well being of mothers, psychosocial
factors in the home environment and child development are
intimately related to each other and our study proves this
point. In order to sustain the effect of this intervention
and to improve some areas of well being and home environment
that did not change, a longer duration of intervention may
be necessary. It is also important to evaluate how long the
effect of intervention lasts and whether a booster programme
is necessary to sustain the gains achieved by the intervention.
Some of the variables which might have influenced the results
relate to the selection of control areas in various centres.
In Bangalore centre both the control and experimental groups
were managed by the same Anganwadi workers who performed interventions
in one group and not in the other. In the Lucknow centre,
the four groups were managed by different Anganwadi workers,
however both the workers were trained in HRC. These changes
might have to some extent influenced the results as some intervention
might have inadvertantly been carried out in the control patients
too. The wide variations in home risk factors across the three
centres might also account for some of the variations in the