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CHAPTER 1

INTRODUCTION

The current phase of the project was taken up as a consequence of the findings related to assessment of risk factors in the home environment of a child. It was found in phase I that risk factors in home environment (of which the family forms an integral part) and subjective well being of the mother were intricately related to the normal psychosocial development of the child. The risk factors assessed were also closely related to the ,veIl being and life satisfaction of the mothers.Fortunately, coping skills can be imparted or acquired, to help individuals realise and utilise the inherent strength within, through proper counselling. It is necessary, however, to first identify the individuals who are under stress and to estimate the degree of stress, and amenability to counselling.

Till date the existing child health programmes had overlooked this aspect of  a child's development and had not incorporated the family intervention model into the existing programmes. It was also recognised that these interventions could be effectively utilized ,within primary care only if it was incorporated into the tasks of basic health workers and into maternal and child health programmes already being performed by them. The mental health skills. would be utilized by workers of primary care with the prime responsibility for maternal and child health rather than the more specialized workers. The aim of this phase was to develop a family intervention programme which could be delivered by health workers. The efficacy would be assessed by using home risk factors, well being of mothers and in children, the nutritional status and cognitive development.

In order to satisfy these aims it was agreed that a core module of family intervention be developed based on identification of home risk factors. The cadre of workers who were to be trained were those who were home visitors and were responsible for the maternal and child health services, the principle being that of incorporation of the intervention into primary care. Based on the earlier study of mental health in young women and factors at home which would adversely affect development of a child, a list of risk factors was selected, which included risks in the family and home environment.

The family intervention model proposed and carried out in the project had several assumptions. Firstly, to facilitate any change in the child or his


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