Soc Sci Med. 1993 Oct; 37(7): 937-52.

Reasoning about childhood nutritional deficiencies by mothers in rural India: a cognitive analysis.

Sivaramakrishnan M, Patel VL.

Centre for Medical Education, McGill University, Montreal, Canada.

This study examines reasoning about the cause and treatment of three types of childhood protein energy malnutrition (PEM) by 108 mothers in rural South India. The mothers were interviewed and their explanations of the childhood nutritional problems were verbally recorded, transcribed and then analyzed using cognitive methods of analysis. The results indicated that knowledge and practices associated with traditional systems of Indian medicine prevalent in rural areas greatly influenced the mothers' reasoning. Their explanations were shown to have story-like structures, with sequences of events linked by strong causal explanations. Mothers with higher levels of formal education showed greater verbal use of concepts related to biomedical theories of nutritional disorders. However, their interpretations of these concepts were still based on the traditional theory. The study revealed both positive and negative aspects of traditional knowledge and beliefs for adequate child nutrition and health. The development of improved instructional strategies for nutrition and health education in relation to knowledge organization is discussed in the context of rural India.