Gary Darmstadt
India
Bloomberg School of Public Health, MHS program
Each year, four million newborns die within the first 28 days of life, and 60-80 percent of these deaths can be attributed to low birth weight (Lawn et al. 2005). In an attempt to address the magnitude of neonatal mortality in the developing world, many interventions are targeted directly to low birth weight newborns, or are modified according to weight. However, little is known about how families and local caregivers perceive newborn weight, and whether it is viewed locally as a determinant of health.
This study used qualitative interview techniques in a rural Indian community to discern local knowledge and perceptions surrounding newborn weight. In-depth interviews and focus group discussions were carried out among recently delivered women and their families. It was found that respondents did not conceptualize newborns to have a “weight” per se, but instead classified them according to “type”: theek (healthy), kamjor (weak), or bahut kamjor (very weak). Further, infant weight was not considered to be a determinant of health, and caregivers considered instead the perceived vigor and physical appearance of an infant. Care was provided, and care-seeking was sought based on these characteristics, and rarely by weight. In order to improve targeting of interventions according to weight, programs must incorporate local terms for weight or reframe weight in a manner that is locally relevant.
The only way to learn about working in a developing country is to actually be there. While frustrating or slow at times, my experience in Lucknow, India provided me with the context and insight for future work in global health. I learned so much about the local work culture, communication, and about public health generally. Aside from my internship work with the Hopkins neonatal study, I had the opportunity to visit urban and village health projects, work on a WHO polio campaign, and help a local women's union determine their health needs. There are no better Hindi teachers than rickshaw drivers, and no better way to forge partnerships than by sharing a dinner of rice and green chilies. Shukriya!
Photos © Jessica Shearer >> See all Spring 2006 Framework Award winners | 
Project Abstract:
