Industries like treatment borderline personality disorder oxytrol 5mg discount, petrochemical symptoms bone cancer trusted oxytrol 2.5 mg, medicinal medications post mi buy oxytrol 2.5 mg amex, wooden and mining are discharging their effluents in the river through various drain/channels symptoms west nile virus buy 2.5mg oxytrol mastercard. The industrial waste water of the study area contain nickel (Ni), mercury (Hg), cadmium (Cd), zinc (Zn), chromium (Cr), lead (Pb) and copper (Cu) [5]. Therefore, the study was done with a view to identify the behavior of the water quality parameters and to disclose the spatial variation of the pollution status of the surface water. Study Area and Selection of Station the Tunggak River is situated in between 3 05606 to 3059 44 N and 10302242 to 10302447 E adjacent to the Gebeng industrial town holding several types of industries. Station selection was done considering the land use-pattern, point-sources of pollution, vegetation and river network. Sampling, Data Collection and Analysis Water samples were collected monthly from pre-selected 10 23 stations. Three (3) samples were collected from identical 3 positions in every station for replication. Data Analysis the main aim of environmental research is to identify for underlying factors which are not observable directly in database, for this factor analysis technique is suitable [8]. In-situ Parameters River water temperature in Malaysia usually ranges from 240C to 31. In most of the stations temperature was within the normal limit of Malaysian standard but the temperature of station 6 to 8 were beyond the standard limit [11] (Table 2). These three stations received most of the effluents of the industrial estate consist of polymer, chemical, metal, gas & power industries. It was might be because of the industrial effluents at the area of station 8 and 10 contained acidic substances and due to submerge condition at station 9 pH was also low (Table 2). Only the value of pH in station 1 was within the permissible range [11]; perhaps it was due to the tidal interference from South China Sea (Table 1). This was because of entering the saline water in these stations during tide from the South China Sea. Results showed that the amount of sulphate was highest in station 1 followed by 2 and 7. Status of chemical parameters nitrate-nitrogen, ammonia- nitrogen and phosphorus among the stations. Due to the addition of industrial effluents with the river water the quality of water deteriorated and based on the types of industry pollution level of the river differ from station to station. Result showed that water of the river bearing especially the middle stations containing Co, Cd, Cu, Pb and Cr beyond the permissible level [11]. Adjacent to the river the major industries are chemical, polymer, metal, petrochemical and gas & energy; those effluents bear the toxic heavy metal as a result polluting the surface water of the river. Regarding those three stations, they were categorized as 25 polluted and slightly polluted respectively. That was perhaps at station 1 there was tidal interference and forested areas; and at station 9 & 10 there was less industrial activities generating comparatively lesser effluents. However, according to the Interim National Water Quality Standards of Malaysia, water of the river was found to be unusable without irrigation [11]. On the other hand due to tidal interference at lower stream and less industrial activities at the upper stream caused less pollution in lower and upper stream stations. Considering the analytical results and data analysis it is clear that the major source of pollutant was the industrial activities. To reduce the water pollution level close monitoring of industrial activities should be ensured and emphasis should also be given on recycling of industrial wastes of their own before discharging to the river flow. We are also grateful to the laboratory personals for their cooperation during sample analysis. Assessment of spatial variation of water quality parameters in the most polluted branch of the Anzali wetland, northern Iran. Project Report: Identification of Pollution Sources within the Sungai Pinang River Basin. The non-woven fabric membranes are applied in the novel separation technologies that are the pore diffusion separation and the flow fractional separation. The compression ratio, surface roughness and pore size of the membrane were evaluated in the correlation of their filtration performance. It was able to reduce the membrane thickness, the surface roughness and the average pore size of the non-woven fabric membrane by pressing in wet state. It was confirmed the particles with more than 10 m could be removed completely and it was maintained almost stable between two days (3000 minutes) and almost no clogging was observed. To solve the water shortage, many technologies of water treatment have been developed. The water treatment required for developing countries must be small size, easy to handle and low cost, since it is not easy to build large-scale infrastructure. Due to old facilities of domestic infrastructure, it will be good chance to convert them to such small-scale equipment. In the case of installing small devices, the operation system must be simple, because the local people have to operate them. The authors think the non-woven fabric membrane can be applied for water treatment and it is possible to develop a novel separation membrane having a micron pore size. The pore diffusion, defined as the diffusion of a substance in a pore of a membrane, is the technique to separate the large particles and water [1]. Water molecule passes through the inside of the membrane with a multilayer structure by diffusion and also is filtered through a bulk flow. The particles cannot be entered to the internal pores of the membrane, and then, is separated from water. One of the features of the pore diffusion is high level of particle removal ability. Non-woven fabric membrane can be satisfied for the demand of low cost in membrane technology. The separation mechanism is based on the flow fractionation effect (or the collection axis effect) that occurs by quickened flow rate [3]. The flow fractionation effect is observed in blood flow within the human body [4]. By the use of this effect we may maintain a stable long-term filtration performance. For example, red blood cells move to the center of the blood vessel by the effect resulting the stable filtration [5, 6]. When we use this effect in the filtration proses of aqueous solution, it is possible to separate particles and water by low pressure filtration. The flow fractionation effect is observed only in the case of the shear stress to the particles exceed over the critical value that originates the rotational motion of the particles in a flow stream. This indicates that the flow stream of a given aqueous solution must be the laminar flow and the flow should give the shear rate to the particles. When the particles size is a sub-micron, more than 20 sec-1 shear rate works effectively on the rotational motion of the particles. Even in the case of the non-woven fabric membrane, the flow fractionation is available and also the pore diffusion is applicable. We can expect the development of the novel low cost and small scale equipment for water treatment. In this paper, we will prepare a prototype non-woven fabric membrane by pressing a commercial available non-woven fabric. The pressed non-woven fabric may be evaluated compression ratio, surface roughness and an average pore size. The wastewater containing particles of a certain particle size may be employed and the separation performances including particle removal ability and filtration speed may be evaluated. We intend to evaluate the potential application for the novel separation technology. The average pore size of the original regenerated cellulose filament non-woven fabric was about 100 m including support mesh pore size. Compression Ratio the compression ratio was calculated with the thickness of the membrane before and after pressing. Surface Roughness the surface roughness of the pressed non-woven fabric by the roller press was measured. When the highly of the surface of the fabric is expressed in y = f, in micrometers (m), Ra value was determined by the equation shown in the.
The diseases prevented have been classified under headings such as water-borne or water-wash infections treatment 02 generic 2.5mg oxytrol amex, which include many more than the diarrheal diseases that continue to be the first cause of death in many countries medications 222 order 2.5 mg oxytrol with amex. Perhaps even more important are the general improvements in hygiene and health habits that result from the availability of water and sanitary facilities symptoms cervical cancer discount oxytrol 2.5 mg amex. Such improvements are given high priority in local decisions primarily because of the time saved and convenience k-9 medications discount oxytrol 5 mg without prescription, especially for women (Leslie 1986; Agarwal 1990). Partnership Between Community and Health Services Community participation is best facilitated by two parallel components. The first is some kind of community committee to promote nutrition and health and mobilize community interest and resources. Many special projects have used peripheral health centre staff rather than volunteers to do nutrition surveillance and promotion. This can be justified for research precision, but is usually tao expensive for sustainable mass programs. Training local people who have major responsibility for implementation also helps greatly in community empowerment. Volunteers tend to be selfselected and have more service motivation than community health workers who are paid by health services. There is usually a high turnover of volunteers, but that bas the advantage that community values and norms change as more community members receive training and experience. Local priorities should be met first and as information is gathered about the distribution and causes of nutrition prablems, discussion can tum to new interventions and patterns of behaviour pramoted by the health services. It is generally agreed that the malnutrition and infection complex remains the most prevalent public health prablem in the world today (Tomkins and Watson 1989). In many places, infections are responsible for most of the malnutrition (Mata 1984, 1987). Much bas been leamed about mechanisms that contrai the two-way interactions, which vary greatly with particular pairs of nutrient deficit and infectious agent. These range from permitting initial entry of organisms because of changes in mucosal integrity with altered capacity to resist colonization by pathogens, to basic changes in hast immunity. In general, malnutrition increases the duration and severity of infections more than incidence (Kielmann et al. Infections have multiple effects on absorption and intake of nutrients, which include anorexia and decreased transit time in the gut. Fever and associated metabolic changes drastically alter the utilization of nutrients. Dietary support during and after infections bas been shown to be critical in recovery, especially for children who need to achieve catch-up grawth. In sum, the interactions of malnutrition and infections lead to a descending spiral in health and whereas no one event would cause death or permanent disability, the concatenation of synergistic effects is the major cause of mortality and morbidity in poor communities. Even today, few field reports are available on the impact of deliberate pragrams to demonstrate synergism between interventions, rather than between particular pairs of nutrients and infectious agents (Scrimshaw et al. Sorne practical principles can be defined about how synergistic pragrams for nutrition and infection contrai can be most cost-effectively implemented. First, is the basic need to fit activities into a general infrastructure for primary health care. Second, is to recognize that the balance 80 between the effects of malnutrition and infections varies at different ages. At Narangwal, nutrition was most important prenatally, infection contrai during infancy, and (between 1 and 3 years of age) the two were equally balanced (Kielmann et al. Third is to focus on family empowerment to improve child care through community-based learning. It has been demonstrated that general nutritional interventions that include food supplements tend to cost about twice as much as infection contrai, when applied at the community level (Kielmann et al. Micronutrients and Specific Components of the Diet Mass public health interventions can have significant impact by preventing micronutrient deficiencies (Latham 1990). Most serious is the hidden hunger of massive, borderline deficiency in specific nutrients that can be corrected by better balanced nutriture. Many of these cases of iron-deficiency anaemia are due to iron loss from infections such as malaria or hookworm. Women are particularly prone to low hemoglobin, and their deficient iron stores may influence the common anaemia of young children. Anaemia produces serious loss of work output and interferes with immune responses. A major consideration is to facilitate the absorption of iron by nutrients such as vitamin C and to prevent blocking of absorption by phytates and other organic chemicals in some vegetables or by tea. Goitre, cretinism, and mental retardation resulting from iodine deficiency are among the most easily and economically applied preventive interventions available. The usual practice of iodinization of sait can be supplemented by the use of iodized oil either by injection or capsules. Innovative alternatives include fortification of other foods such as tea in Tibet. Vitamin A is currently recei-ving special attention because the periodic use of a high potency capsule may justify its old label of an anti-infective vitamin. The main benefit is prevention of blindness from xerophthalmia in children (Gadomski and Kjolhede 1988). Vitamin A has been shown to improve hast resistance in measles dramatically and may have a general impact on infant mortality. There is increasing evidence that diet early in life directly influences multiple, chronic diseases. Quality of Home Care Sociocultural and Behavioural Factors Culturally determined feeding practices contrai decisions about what families do with whatever food they have available (Bolton 1990). Detailed ethnographie study may be required to find out why certain foods are eaten at specified times and circumstances, and why other nutritious foods are ignored. The origins of such traditions have usually been lost in ethnie history, but few cultural characteristics are protected with as much fervour as practices related to food. The distribution of food usually follows cultural rules that often include patterns of overt discrimination against women, such as requiring them to eat only after men. This discrimination is particularly severe in some cultures when girl babies are permitted to slip into malnutrition because of son preference. New approaches are needed for the systematic behaviour change required to alter practices related to food. The caring capacity of families and communities can be directly improved by specific education. To meet the particular needs of poor children and their mothers, special provisions should be made to enhance the "coping skills" of women. Studies have been made of "deviant" mothers who achieve good nutritional status in their children even when very poor (Zeitlin 1990). Appropriate practices can be promoted by ensuring education of women, training in home skills relating to preservation and preparation of food, freeing up more time by technical innovations, breast feeding, improved maternai health care especially related to pregnancy, and general societal support. Numerous studies have shown that women in traditional societies often work much harder than their men (Agarwal 1990; Bolton 1990). In addition to major responsibility for agricultural production, they bear the primary responsibility for child care and nurture. Sorne practical options will help families, and especially women, to increase their caring capacity. Most obvious is direct transmission of knowledge through forma] and informai education and visits to homes by extension and health workers. With population growth, the availability of fuel and water bas become a crisis in many communities around the world. In countries such as Nepal, one persan in a family of six works full time getting fuel and water. Labour-saving technologies are available for most domestic activities, including smokeless stoves to conserve fuel, arrangements for storage of food, and provision for better hygiene and cleanliness around the home. Breast feeding, preparation of appropriate weaning foods, and increased feeding frequency for children all require time investment by family members, as does getting children to weighing days or immunization posts. Women could be given more time for household and child care responsibilities if their children were spaced, if they had maternity leave, and if there were child-care arrangements for working women. A change in roles to persuade men to assume greater responsibility can sometimes be made part of introducing new technical innovations.
Under this policy medicine 1950 discount 5 mg oxytrol with visa, all tanneries have to clean their effluents before disposal and install environmentally friendly technologies symptoms 37 weeks pregnant buy oxytrol 5 mg on line. Those who are unable to obey the rules have to close their tanneries and Governments have to support them to switch in other sectors medications zetia order oxytrol 2.5 mg otc. Thus the problems of inadequate waste management and insufficient open space can be solved medications you cant take while breastfeeding 2.5 mg oxytrol sale. The Government has launched a relocation project of Hazaribagh tanneries to a new area, located at Savar near Dhaka to save Buriganga. But this relocation project proves to go in vain because of unwillingness of the tannery owners to move and in terms of the cost effectiveness and potential environmental threat of the new area [13]. Recycling Policy and Practice Recycling is re-using of products, a mean of waste reduction. Government may introduce or innovate new technologies for recycling to reduce or manage solid wastes. It is possible to recycle the solid wastes from tannery industries as poultry and fish feed, hard board, glue etc. So recycling policy and practice may be a fruitful policy for environmental regeneration and developing activities. As the apparel industry and the leather product industry are being shifted from China to Bangladesh for its cheap labor cost, further pollution of the watershed environment is assumed. But as Bangladesh is a developing country, the existing rules of proper industrial waste treatment have always been ignored by the owners of the industries. Lack of implementation of rules by the concerned Government agencies has aggravated the environmental pollution problem. DoE should take the leading role to implement the rules with the help of law enforcing agencies. However, political commitment is necessary to avoid and overcome the socio-political implications, which may curb pollution and regenerate the watershed environment of Buriganga River. Evaluation of aquifer environment under Hazaribagh leather processing zone of Dhaka city. Surface Water Pollution in Three Urban Territories on Nepal, India, and Bangladesh. Feasibility & Mathematical Model Study of Approaching and Investing Strategy for Rehabilitating the Buriganga-Turag-Shitlakhya River System and Augmentation of Dry Season Flow in the Buriganga. Mitigation of River Pollution of Buriganga and linked rivers-Turag, Tongi Khal, Balu, Sitalakhya and Dhaleswari. Country case study on Environmental Requirements for Leather and Footwear export from Bangaldesh. Due to increase of population, road traffic is increasing day by day which causes noise pollution in the environment. The study was carried out from 8:00 am to 8:00 pm to assess the noise level at various intersections in Sylhet city. Traffic noise can interrupt speech communication, sleep and relaxation and reduces the ability to perform complex tasks [1]. Surveys of many countries have shown that traffic noise is the principal environmental nuisance in urban areas [4]. Noise from the motors and exhaust systems of large trucks provides the major portion of highway noise and provides a potential noise hazard to the surrounding people and driver as well [3]. In Sylhet city, the main sources of noise pollution are the motors and exhaust systems of autos, smaller trucks, buses, and motorcycles. This type of noise can be augmented by narrow streets and tall buildings, which produce a "canyon" in which traffic noise reverberates [5]. Throughout dozens of studies, noise has been clearly identified as an important cause of physical and psychological stress [8]. Stress directly influences the activities of our body mechanism and thereby noise can easily be associated with many of the disabilities including heart attack, high blood pressure, headaches, fatigue and irritability [6]. Among the health hazards related to noise, hearing loss is the most commonly treated by health professionals [7]. Noise that causes annoyance and irritability in healthy persons may have serious consequences for those who are already ill in mind or body [2]. The major intersections were Madina Market, Subidbazar, Amberkhana, Chowhatta, Zindabazar, Niorpool, Bondor and Rikabibazar. Noise levels were measured during the period of 8:00 am to 8:00 pm of the workdays. The four time intervals were 8:00 am to11:00 am 11:00 am to 2:00 pm 2:00 pm to 5:00 pm 5:00 pm to 8:00 pm Before the measurement being started, calibration was performed. Noise levels were measured at the road side as well as at distances (near hospital building) away from the road side. The average values of these measurements were recorded as the sound level for the corresponding location and time interval. According to field survey it was found that most of the people feel noise as a hazard but very few of them know about its impact on health. The following table shows the different parameters of noise level at various intersections. Such variations of noise create shock wave which severely affect patients of heart disease. Construction noise control program and mitigation strategy at the central artery/tunnel project. Modeling & measurement of equivalent noise level in Tehran and an overall survey on noise barrier. Measurement and modeling of equivalent noise level and determination of noise pollution critical zone (case study in an automobile manufacturing Co. The 2nd Conference & Exhibition on Environmental Engineering, Tehran University, Tehran, Iran. At various time intervals equivalent Noise Levels are the highest in 5:00 pm-8:00 pm (Table 1). The following measures can be adopted to control noise pollution: Tree plantation can be encouraged. Control of noise sources can be adopted; drivers can be trained with proper vehicular maintenance. Traffic can be controlled, geometric and structural design of the roads can be controlled. Noise path can be controlled by using appropriate barriers that can reflect and diffuse noise. Buffer zones can be created between roads and the house holds to provide a distance over which noise can be attenuated. Awareness programs can be carried out to make the people known about the hazards of noise. The study was conducte d with the objective to explore the spatial variation of the water quality of the river due to anthropogenic activities. The study revealed that point sources especially industrial wastes contributing the major pollutants. Pollution was higher in the middle stations due to addition of most of the industrial effluents to those sites. Due to increasing population and rapid growth of industrialization the demand of fresh water rises tremendously in the last few decades [1]. The rate of fresh water deterioration by anthropogenic activities is coupled with the ever- growing demands of water resources [2]. Malaysia is subsidized with bounty of natural water resources which is contributing significantly to the socio- economic development of the country [3]. But the situation is changing day by day with population growth, urbanization and industrialization. According to the Environmental Quality Report 2009, 46% river water of Malaysia is polluted which is higher than previous couple of years [4]. The Tunggak is one of the important rivers in Pahang which is adjacent to Gebeng the main industrial area in Kuantan, Pahang, Malaysia. The town Gebeng is located near Kuantan Port; where industrial development is growing rapidly. These industrial activities are generating effluents which contain high concentrations of conventional and nonconventional pollutants that deteriorating the water quality of the river. In the study area, non-point source associated with runoff from construction sites of newly developing industrial areas and the point source contributing the maximum pollutants especially industrial wastes.
Doing growth monitoring in the context of health sessions medications known to cause seizures buy oxytrol 5 mg without prescription, where illness is treated in an individual and nutrition problems are also treated in an individual treatment bipolar disorder buy oxytrol 5 mg with mastercard, encourages the health system to emphasize the role of the individual mother in child health and nutrition schedule 6 medications generic oxytrol 2.5 mg free shipping. This is logical in view of her primary role as care-giver medicine for pink eye discount 2.5mg oxytrol amex, but not useful in view of the existing stresses on her time and energy, and her relative powerlessness and Jack of access to resources in these societies. Fathers, who control resources in the family, and village males, who control village economic and political life, are not exposed by the program to information about and analysis of nutrition and health problems and are not asked to assist in their resolution. The special role played by the extended family or the neighbours is not brought into the therapy. This emphasis on the individual child and mother is maintained even though the reasons for and solutions to growth faltering may be common to the great majority of the children. Having growth monitoring in the context of health programs also encourages the attitude that the detection of nutrition problems in young children leads to effective action, just as the detection of pneumonia leads to effective action, such as the prescription of an antibiotic. No questions are asked and no measurements are made of the effectiveness of either intervention. Using an algorithm to diagnose and treat an individual child may be logical in pneumonia, but is not so helpful for nutrition problems where causes and solutions lie outside the purview of the simple prescription of drugs and advice. For health personnel doing growth monitoring, the time required to deal with so many individuals precludes all but a superficial analysis of problems at the individual level and a standardized, repetitive response. Growth monitoring provides seemingly neat answers for health workers who are dealing with large numbers of children in time-pressured situations. However, the answers do not respond well to many of the varied situations faced by parents of young children. The evaluation of a program in Thailand found that mothers thought suggested actions by village health volunteers to be simplistic and prescriptive and impossible to implement (Ministry of Public Health, Thailand 1991). The simple technological response leaves the mother to find a more comprehensive answer to why the child has a problem and how to treat it, which may involve using alternative health care systems. This finding from Thailand is striking in that this perception is held of village volunteers. It has been suggested that effective treatment and compliance with treatment depends on the quality of the "therapeutic alliance", the interaction between providers and users of health care. The strength of the alliance depends on the degree to which a social and cultural gap exists between patient and provider; there should be little such gap between village volunteers and mothers. It may be that the symbols used in growth monitoring, and the character of the treatment process itself, mitigate against acceptance of the treatment (Heggenhougen 1991). How then has "growth monitoring and promotion" become such a popular phrase, implying that growth promotion requires growth monitoring Why do health planners propose to funders programs called "growth monitoring and nutrition", when they would not think of proposing a program called, for example, "X-rays and tuberculosis control" or "blood testing and malaria. Used in the same way as these for screening, growth monitoring should not have a life of its own but should be, when screening is necessary, a minor part of larger activities to improve health and nutrition. The attraction perhaps lies more in the perception 147 of literate people, who are also trained to seek scientific measurements of disease, that growth monitoring information is a valid measure of pathology and health, satisfying to care-givers as a means of validating their diagnostic acuity. Growth charts can act to stimulate them to undertake various actions; perhaps there is an unconscious belief that the mother will also be so stimulated. The danger of growth monitoring is that its information provides the illusion of effective action, while the sociocultural, economic, and political factors that are the determinants of health in primary health care philosophy are ignored. Anthropometric assessment of energy-protein malnutrition and subsequent risk of mortality among preschool-aged children. Proceedings of the International Population Conference, Florence, Italy, 5-12 June pp. Paper presented at the Rockefeller Foundation Conference on Good Health at Law Cast, Bellagio, Italy, 29 April-3 May 1985. The raie of maternai and child health clinics in education and prevention: a case study from Papua New Guinea. Nutrition information systems for action at different levels of society with particular reference to Growth monitoring and promotion. Background notes prepared for a meeting on nutrition information systems Nairobi, May 1992. Universiteit Antwerpen, (dissertation) 149 Successfal Growth Monitoring in South Indian Villages S. The original objectives of the growth charts were to motivate the health care worker, who would in tum encourage the mother to provide better child care to avoid faltering of growth. The regular monitoring of weight also enabled the worker to screen for children at risk of malnutrition. Currently, about 300 different charts are being used in over 80 countries (Jelliffe 1990). In Southern India, a large, carefully monitored field study bas recently been completed in villages where over 60% of the mothers were illiterate. Study Population the study was carried out in 10 villages (a population of approximately 11,000) of the North Arcot District. Kuppam Black for over 12 years providing health services on behalf of the govemment. Living in the Kavanur village from September 1986 for 4 years, the principal researcher identified study villages, selected workers, organized training, and ensured the quality of services provided and assessments undertaken. Informed consent was obtained from the parents who were free to refuse any of the services offered while receiving the other services they wanted. For ethical reasons, severely 152 malnourished (Gomez - 3rd Grade) children (Gomez et al. The growth chart was used to facilitate health and nutrition education of the mothers. Immunizations at the village and antenatal services at the peripheral rural clinic. Distribution of vegetable and fruit seeds and saplings twice during the study period. Anthropometry and Assessments of Maternai Comprehension the implementation of interventions and the assessment of outcomes were conducted by independent workers. In these villages, all mothers of children barn between 1 October 1986 and 31 March 1989 were interviewed again between November 1989 and January 1990 by the same interviewer. A household census was followed by a preliminary weighing of children in all 10 villages in April 1987 to ascertain the willingness of the communities to accept weighing. This was to ensure maximal coverage and the best possible understanding of the growth charts. She spent around half an hour with each mother on at least two child visits made per month. The supervisor visited each village twice a week and independently checked about 20% of the weights every month. Every 4 months, all the growth charts were withdrawn from the mothers to check for accuracy and completeness of the weights plotted. If growth (as indicated by weight gain) was inadequate, attempts were made to identify reasons for the inadequacy and corrective steps were discussed, and during the next visit the worker would verify that these actions were implemented by the mother. The mothers were advised on persona} and environmental hygiene, and on avoiding contamination of food and water. The supervisor also visited all children under 6-months of age who were not gaining weight and children under 12 months who were losing weight. If no further improvement was seen the following month, these children were referred to the rural hospital. All aider children who did not gain weight for 3 consecutive months were referred to the rural hospital. At the end of 6 months in January 1988, the supervisor distributed growth charts to all mothers, when over 50% of the charts had at least four weights already plotted. Because of this, from the first month of regular weighing and use of charts (February 1988), most mothers could visualize how their child was growing. Infants under 3 months of age were excluded because some were temporarily absent and prenatal factors have a major influence on their growth. When mothers were specifically shown the growth chart on the yellow card and asked what it was for, over 90% did not know, and only 8.
