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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 final evaluation.


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