Urmila’s son is now four years old, they started attending Positive Deviance/Hearth (PD/Hearth) session held by World Vision in 2014. During the first session, Ayush did not gain any weight since he was not eating at that time. However, during the second session, Ayush gained weight gradually as he picked up the habit of eating when he was sitting with other children. Within one year of enrolling in PD/Hearth, Ayush has gone from moderate malnutrition (underweight) to normal weight for his age. Beside obvious weight gain that improved Ayush’s health, Urmila and Ayush have also recognised the importance of personal hygiene practices such as hand washing, and dietary practices such as eating three meals and a light snack a day.

The willingness of the community to participate is one of the major success factors of the project. Unfortunately, not all families could participate in the project. This is true in the case of Shanti. Without her husband’s permission, Shanti, a mother of three children and currently pregnant with the fourth, failed to join the PD/Hearth session. Additionally, she is preoccupied with housework and taking care of her children at home. Also, her economic situation does not allow her to bring any ingredients to join the PD/Hearth session.

How does PD/Hearth help?

PD/Hearth is a community-based rehabilitation and behaviour change intervention for families with underweight preschool children. The ''positive deviance'' approach is used to identify behaviours practised by the mothers or caretakers of well-nourished children from poor families and to transfer such positive practices to others in the community with malnourished children. The ''hearth'' or home is the location for the nutrition education and rehabilitation sessions.

World Vision Hong Kong is working to improve the nutrition of children in India. Considering the project in Bokaro District, 18 slums were covered in total, about 70 to 90 per cent of the women are able to keep the practices they learned during the PD/Hearth session. These practices include hand washing, cooking with clean vessels, washing the vegetables thoroughly for at least three times prior cooking, and incorporating proteins such as eggs into their diet.

Some women say that their children normally would not eat at home, but when they saw other children eating at the PD/Hearth sessions, they too would happily consume the meals. Some positive changes are also happening within the households, husbands are bringing in more vegetables and becoming more responsible and supportive in caring for children’s health. Mothers who meet frequently at the PD/Hearth sessions also form friendships and develop a support network. Most importantly, children who were lethargic before are now more active and energetic.