Child - Centred Approaches to Preventable Disability - the Case of Nutritional Rickets in Bangladesh
Project update - one year on
Rickets is placed in a vicious cycle, being the cause as well as a consequence of poverty. In developing countries, it is mostly caused by nutritional deficiency, a condition mostly associated with poverty.
On the other hand it is also a disease, which if addressed in the early stages of a child's life, can be cured without any long-term effects. But often it is neglected, due to lack of awareness on child care practices among the majority of rural and poor households, and can cause permanent disability, which may subject the individual to lifelong poverty.
This project indirectly aims to contribute to breaking this vicious cycle, by developing increased awareness on rickets, nutritional care for children, early symptoms and early treatment among the families and service providers. Our vision is that by reducing the prevalence of rickets among children and the incidence of permanent disability resulting in poverty will also diminish.
During its first year, the project has already started to generate active responses from CSOs, as well as from the government.
The focus of the initial project period was on understanding the existing status and needs. This was used as the basis for plans to develop the skills of the team to facilitate the orientation process among different target groups. Initiatives such as designing the baseline study; planning the Master Training of family planning health workers; developing links with local government authorities; and institutional internalisation of concepts such as ‘child-centred approach’, ‘gender’ and ‘diversity’ and their relevance to the project, are the significant achievements so far.
During the baseline survey, local CSOs were identified and some have now received orientation on rickets and on the project itself. Orientation for the other CSOs identified will take place in the second year of the project.
The orientation of local authorities and meetings with government officials has helped to develop and strengthen links with local authorities. Officials from the Family Health Department contributed to planning the capacity development of family planning health staff and grassroots level workers. They also committed towards the inclusion of rickets in their staff training module, based on learning from the Master Training and roll outs scheduled for the second year of the project.
Important lessons have been learnt over the past year:
- That the principles of participation are applicable to every step of project implementation;
- That the baseline survey is not only about capturing quantitative data, but also a means to understand and assess the community perceptions regarding child care practices, local needs, identify local customs and existing resources;
- A child-centred approach is not only about caring for children, but rather respecting their voices and giving them space at the centre of all initiatives for their development, and
- Engagement of local government authorities in initial stages of planning can ensure increased ownership and support in sustaining the programme.