[Social forces and the communicative scenario in health education: the case of the growth and development program]

to understand how the significance of child rearing is construed in the Growth and Development Monitoring Program as a way of studying health education and enhancing its theoretical and pedagogical framework.

an ethnographic study in four health institutions in Medellín, Colombia, developed through observation of sessions and interviews with actors, namely significant adults and health team members.

a communicative process based on a behavioral education model is established to modify behavior and to impose cultural values.

the pedagogical setting or micro-context is influenced by powerful macro-contextual forces, which are a product of uneven distribution of social, cultural and economic capital. Consequently, significant adults and health team members are situated at two different communicative levels for the construction of significance, which affects communication between them. Understanding this social process from a wider theoretical perspective strengthens critical positions, which is required for achieving more pertinent health education from a socio-cultural dimension.