11 Meeting with State Secretaries Review of Integrated Child Development Services (ICDS) Scheme 28 th October 2010 Ministry of Women and Child Development Government of India

2 PART - I ICDS : Universalization

3 Operationalization : –Delay in operationalization ( against 14.0 lakh, operational lakh Target date for operationalisation was September Firm date of operationalisation may be given & ensured ! –‘Operationalisation’ per se States/UTs to ensure Adherence to the revised population norm in total- ground verification Certification that all habitations are covered Upload a list of AWC locations on web sites of States/ UTs Full coverage of urban slums/ areas with local innovations Address issues of social exclusion Optimise coverage of all eligible beneficiaries

4 ICDS: Operationalisation of Projects Sl. No. Month of report State/UT ICDS Projects Commitment of State Govt. In Dec Sanctioned as on Opera- tional* Pending (1)(2)(3)(4)(5)(6)(7) 108/10West Bengal /10 2 Kerala /10 307/10Chhattisgarh /10 408/10Delhi /09 508/10Rajasthan /10 608/10Orissa /10 708/10Haryana /09Lakshadweep /10Uttrakhand / /10Punjab / /10Arunachal Pradesh /10Mizoram /10Assam / /10Andhra Pradesh / /10Himachal Pradesh / /10Sikkim / /10Bihar /10

5 ICDS: Operationalisation of AWCs/ mini-AWC Sl. No.Month of report State/UT No. of Anganwadis/ mini-AWCs Commitment of State Govt. In Dec Sanctioned as on Opera- tional* Pending (1)(2)(3)(4)(5)(6)(7) 108/10Uttar Pradesh /10 207/10Chhattisgarh /10 305/10Maharashtra /10 408/10Orissa /10 507/10Uttrakhand /10 603/10Bihar /10 707/10Andhra Pradesh /10 808/10Haryana /10Madhya Pradesh / /10West Bengal / /10Assam / /10Rajasthan / /10Delhi / /09Jammu & Kashmir /10

6 ICDS: Operationalisation of AWCs/ mini-AWC Sl. No.Month of report State/UT No. of Anganwadis/ mini-AWCs Commitment of State Govt. In Dec Sanctioned as on Opera- tional* Pending (1)(2)(3)(4)(5)(6)(7) 1509/10Gujarat / /09Manipur / /10Kerala / /10Himachal Pradesh / /10Karnataka / /10Arunachal Pradesh /10Sikkim / /10Puducherry / /10Chandigarh / /10Goa / /10A & N Islands / /09Lakshadweep /10Meghalaya /09Daman & Diu

7 ICDS: Location of AWCs 10 States namely Andhra Pradesh, Arunachal Pradesh, Assam, Madhya Pradesh, Maharashtra, Orissa, Delhi, Punjab, Tripura and Uttar Pradesh have uploaded information onto their website. They may also ensure that cen per cent information of all AWCs are uploaded. Remaining 25 States/UTs may upload the information onto their website and inform the website address by 30 th November positively.

8 ICDS : Services Supplementary Nutrition Programme (SNP): Adoption of norms Implement Revised calorific and cost norms in letter & spirit. Morning snack & hot cooked meal for children 3-6 years Quantity/ weight of SN per bene. actually given, THR for children below 3 yrs and P&L mothers Calorific and nutritional norms Optimization of coverage: 729 lakh children receiving SN as against 1195 lakh child (6 – 72 months) population as per AW survey register Quality Age appropriate and palatable Local nutritious and varied recipes Micronutrients !

States not conforming to the revised nutritional norms: deficiencies Andhra Pradesh (50 Kcal) Himachal Pradesh (80 Kcal) Punjab (200 Kcal; 6 gm Pr) Jammu (200 Kcal; 3 gm Pr) Puducherry (200 Kcal; 3 gm Pr) Jharkhand (50 Kcal) Orissa (100 Kcal) Karnataka (150 Kcal; 3 gm Pr) West Bengal (100 Kcal) Assam ( 500 Kcal; 12 gm Pr) A & N Islands (4 gm Pr) Uttar Pradesh (50 Kcal) Kerala (100 Kcal) Chandigarh (200 Kcal; 3 gm Pr) Source: MPR, FNB Deficiencies:

Recent Disruption in SNP Assam : No food supplies since Nov 2009 Punjab : Insufficient ingredients Uttar Pradesh : disruption in HCM; Reduced ingredients due to price rise leading to low nutritive values Manipur: No feeding provided in 3 centres out of 7 centres visited (June 2010) Bihar : Out of 11 units visited in May 2010 only one provided SNP. In the month of September 14 centres did not provide any SNP.

SNP : Not as ICDS norms  THR (Hot cooked meal): Chandigarh Haryana Himachal Pradesh A & N Islands West Bengal Puducherry  THR (Dry food grains): Goa Bihar [target 40 children (6m-3yrs) for SN, 8 pregnant & 8 lactating women] Jharkhand  States not providing morning snacks : Puducherry West Bengal Bihar A & N Islands Chandigarh

12 ICDS : Services Supplementary Nutrition Programme (SNP): Micronutrient fortification : The supplementary food may be fortified with essential micronutrients (energy and protein excluded) with 50% of RDA level per beneficiary per day RECOMMENDED DIETARY ALLOWANCES, NUTRIENT INTAKES AND GAPS Age group 1-3 yearsAge Group 4-6 yearsPregnant WomenLactating Mothers RDAIntakeGapRDAIntakeGapRDAIntakeGapRDAIntakeGap Energy(Kcal) Protein (g) Iron (mg) Vitamin A (mcg) Calcium (mg) Thiamin (mg) Riboflavin (mg) Niacin (mg) Vitamin C (mg) Free Folic Acid (mg) HCM: leafy veg; THR: through GMP( manufacturers); Fruits. Sprinkler: NO; Sachet: ? ( only in centralised and monitored kitchens !)

13 ICDS : Services Supplementary Nutrition Programme (SNP): Management Supply chain - commodity management - uninterrupted distribution at AWC Regularity and timelines Adopt normative approach and reduce wastage WBNP: States/ UTs to give basis and details of requirements of food grains urgently Rationale for not availing food grains Regular lifting position to be provided; Previous quarter lifting by 70% for future allocation

14 ICDS : Weighment & Growth monitoring 8 th & 9 th December, 2009 States given commitment to roll out the new WHO Growth Standards by June RFD target 5000 projects for the WHO Growth Standards and Joint MCP Cards: 1536 Projects achieved. Most of the states have indicated printing stage and committed to roll out by December 2010 in all projects and AWCs. Must be ensured ; failing which constrained not to release funds; fortnightly monitoring by secretaries and reporting.

15 ICDS : Vacancies of Supervisors Sl. No.State/UTSUPERVISORS% Vacant Sanctione d by GOI In-positionVacant 1Bihar % 2Uttrakhand % 3Puducherry % 4Himachal Pradesh % 5West Bengal % 6Jharkhand % 7Haryana % 8Assam % 9Chhattisgarh % 10Chandigarh % 11Orissa % 12Sikkim % 13Uttar Pradesh % 14Daman & Diu % 15Karnataka % 16Punjab % 17Jammu & Kashmir %

16 ICDS : Vacancies of Supervisors Sl. No.State/UT SUPERVISORS % Vacant Sanctione d by GOI In-positionVacant 18Rajasthan % 19Mizoram % 20Manipur % 21Tripura % 22Kerala % 23Madhya Pradesh % 24Maharashtra % 25Tamil Nadu % 26Delhi % 27Gujarat % 28Goa % 29Dadra & N Haveli % 30Meghalaya % 31A & N Islands % 32Arunachal Pradesh % 33Nagaland %

17 ICDS : Vacancies of AWWs Sl. No.State/UT No. of AWWs Sanctioned by GOI as on Sanctioned by State Govt. as on In-positionVacant w.r.t. sanction by SG 1West Bengal Maharashtra Tamil Nadu Madhya Pradesh Andhra Pradesh Karnataka Gujarat Rajasthan Orissa Uttar Pradesh Manipur Uttrakhand Jharkhand Tripura Meghalaya Punjab Chhattisgarh Himachal Pradesh

18 ICDS : Vacancies of Helpers Sl. No. State/UT ANGANWADI HELPERS Sanctioned by GOI as on Sanctioned by State Govt. as on In-positionVacant w.r.t. sanction by SG 1West Bengal Chhattisgarh Uttar Pradesh Maharashtra Uttrakhand Andhra Pradesh Tamil Nadu Haryana Orissa Bihar Madhya Pradesh Delhi Gujarat Karnataka

19 ICDS : Vacancies of Helpers (Contd..) Sl. No.State/UT ANGANWADI HELPERS Sanctioned by GOI as on Sanctioned by State Govt. as on In-positionVacant w.r.t. sanction by SG 15Rajasthan Jammu & Kashmir Assam Manipur Jharkhand Tripura Kerala Punjab Himachal Pradesh Arunachal Pradesh Sikkim Puducherry Goa Chandigarh

20 ICDS: Management Manpower Vacancies: –Large vacancies at all levels in almost all States –Timeliness to fill up vacancies at all levels [10% deduction from grant if vacancies of Supervisors, AWW s & AWHs 40% or more; 20% deduction if 50+%? ] Promotion: –AWW to Supervisor –AWH to AWW Dedicated cadre Tenure stability Disengagement of ICDS functionaries from non- ICDS related activities [10% deduction from grant if? ]

21 ICDS: Management Issues Fund flow mechanism Timely payment of honoraria: mechanism to be put in place Motivation –Additional honoraria by state –Insurance coverage of LIC & other benefits –Proposed Rastriya Swasthya Bima Yojana (possible sharing 75:25) –Proposed pension scheme (Quantum of State share say 1000 per anum / per benef.)

22 ICDS: Management Issues Pending Construction of AWCs building sanctioned for NE States since till : S.No Name of the States AWCs sanctioned for Construction since AWCs actually Constructed Construction AWCs yet to be completed 1Assam Manipur Meghalaya Nagaland Tripura Sikkim No fund for ICDS general would be provided unless UCs and progress report is given along with any undertaking by the Secretary

23 ICDS : Services Pre-School Non-formal Education: Pre-School Education Kits: 10 States/UTS viz. Andhra Pradesh, Bihar, Haryana, J&K, Jharkhand, Kerala, Chandigarh, Lakshadweep, Puducherry and Mizoram have not made any procurement during and on the PSE kits Ensure availability of PSE kits Usage of Local materials & effective communication Methods used for joyful learning and improve Quality Optimize coverage of children (3-6 years) for PSE Ensure PSE activities on regular basis at all AWCs Assess and ensure school readiness (Section 11 of RTE) & Leverage resources for strengthening ECE; Linkage and leverage with RTE

24 ICDS : Services Health and Nutrition Education: Joint home visits Training IEC and campaign – Observation

25 ICDS : Services Coordination & Convergence: Health: - Effective arrangement for health related services at AWCs Immunization Supply of IFA tablets and Vitamin “A” Health check ups and referrals Management of severally undernourished - Reflect ICDS related services separately and categorically in NRHM PIPs at all levels - Holding of VHND - Institutional arrangements for effective engagement of health sector DDWS: - Provision of safe drinking water -Provision of child friendly toilet - Awareness on sanitation and safe drinking water

26 ICDS – Infrastructure Construction of AWCs Buildings Tap MPLADS, MLALADS, BRGF, RIDF, PRI, State Plan including ACA, MSDP, BADP, etc for AWCs buildings (13% of total constructed ) Construct good model buildings with full amenities Provide adequate space, other facilities and equipments State/UTS were requested to submit Action plans for strengthening quality of infrastructure at AWCs by September  No State has sent so far.

27 ICDS: Management Issues Community Participation Replication of Best practices Effective monitoring Training: Cross sectoral, horizontal and vertical integration of training both in content and participation; circular trg. intrasector/ intra project and inter project Make STRAP a meaningful exercise. Send proposal for by January State level Task Force Peer group

WBNP States/ UTs lifted below 50% allotment ( ): Uttarakhand, Manipur, Maharastra, J & K, DN & Haveli, Arunachal Pradesh For , allocation of foodgrains to States/ Uts will be made who have lifted lifted 70%+ of the foodgrains allotted so far (including revalidated quantities) 28 Statement indicating on Requirement, Allocation & Lifting (in MTs) YearsRequirementAllocationLifting 2008 – 091,018,084729,100666, ,168,831967,584757, ,13,04410,50,734 (till 3 rd quarter) 1,88,261 (till June 2010)

29 ICDS: Review and field visits Review of ICDS Scheme and field visits to AWCs from time to time MOS (I/c), MWCD visited Guwahati (Assam), Jhabua (M.P.), Sikkim and Uttrakhand Secretary, MWCD visited to AWCs in Haryana, Uttrakhand, Punjab, Chandigarh & U.P. And reviewed implementation of ICDS Area Officers are also reviewing the implementation and visiting AWCs

30 ICDS: Review and field visits (Contd..) Major issues emerges: Operationalisation of pending AWCs/ mini- AWCs; Filling up of vacant posts; Compliance of GOI directions on supplementary nutrition as per revised norms; Need to devise a normative approach for reporting attendance; Maintenance of WHO Growth Chart and training to AWWs Convergence with line departments on drinking water, sanitation etc.

31 ICDS: Monitoring State level consolidated MPR in Format I & II to be sent with regularity Officer i/c Monitoring must be held responsible: Late submission cause for withholding the salary of concerned monitoring officer Revised MIS being Field tested in 6 blocks in 6 states. Revised records & registers at AWCs and MPRs/ ASRs being implemented from Web based MIS being developed by NIC on revised MIS..

32 ICDS: Monitoring contd… CMU, NIPCCD in operation since Medical Colleges, Home Science Colleges and School of Social Science involved in monitoring and supervision of ICDS Proposal to revise monitoring committees at all levels Check list for field visit for monitoring and supervision finalised. Proposal to involve National Level Monitors (NLMs) rtd civvil servants and defence personnels.

Draft Findings Evaluation of ICDS by NCAER (2009)

Summary Findings A.Coverage of target groups – Children 49% of the size of the eligible group (vide census) are actually registered for ICDS benefits. At the national level, of those recorded in the delivery register for ICDS benefits: –64% received Supplementary Nutrition (may not be for all 300 days), immunization and other benefits, –12% received other benefits but not supplementary nutrition and –24% have not received any benefits;

The proportion receiving all ICDS benefits varies across States: High Performers: More than 70% of the children receiving supplementary nutrition out of the total children recorded in the delivery register (not necessarily as per norms) are: Andhra Pradesh, Assam, Chhattisgarh, Gujarat, Himachal Pradesh, Jammu & Kashmir, Jharkhand, Karnataka, Kerala, Tamil Nadu, Uttarakhand and West Bengal. Low Performers: Bihar (53%), Haryana (52%), Rajasthan (56%) and Uttar Pradesh (41%), Punjab (59%). Coverage - Continued

A. AWC Buildings: Overall 42.5% of sampled AWCs have their own buildings, 17.4% are in rented buildings, 17.3% are located in primary schools and other 22.9% are running from AWW/AWH house, panchayat and community buildings. More than 60% AWCs run from their own buildings in the states of Tamil Nadu (85.6%), Chhattisgarh (92.6%), Assam (69.6%), Maharashtra (68.5%), Karnataka (65.3%), Kerala (65%) and Gujarat (61.5%). Space for indoor activities was found to be adequate in most AWCs (71.8%). Almost all States had similar dimensions of the AWC buildings. Average room area: 315 sq ft (average length : 20 ft, breadth: 15 ft), lowest being reported in Himachal Pradesh and J&K (160 sq ft). Infrastructure

B. Drinking Water facility at AWCs: Country-wide, a total of about 87% AWCs (58.8% with hand-pump, 28.4% with pipe water facility) were found to have drinking water supply. C. Sanitation Facility at AWCs: About half the AWCs across the states had toilet facilities in the premises. However, most AWCs (about 80%) in Bihar, UP and Orissa were without toilets. D. Equipments/Kits at AWCs: 69% of sampled AWCs having functional baby weighing scale; 49% of AWCs having utensils; 48% of AWCs having cooking vessels; only 44% of AWCs having PSE kits and 62% of AWCS having medicine kits. E. Overall Infrastructure Index (20 major States): Top 5 States: Tamil Nadu, Kerala, Maharashtra, Andhra Pradesh and Gujarat are ranked as top five states Bottom 5 States: Rajasthan, UP, Punjab, J & K, and Bihar Infrastructure (Contd.)

Service Delivery 82% of AWWs reported to have been involved in other government schemes during the last year with an average no. of days spent as 14 with 6 hrs/day. (Table 6.12 pp-64) Only 41.2% AWCs reported to have updated child growth chart (Table 6.16) 93.6% of sampled AWWs reported to have been adequately trained to conduct PSE (Table 6.17) Average visits made to AWC in six months: By Supervisors - 5 visits; By CDPOs – 1 visit. Their main focus during the AWC visits has been record keeping (pp-76). About 40% of AWWs reported getting some help from Panchayat with about 36% in monitoring and 34% in providing infrastructure (pp-83) 31% AWWs reported getting help from Village leaders/Committee with 41% in monitoring and 26% in providing infrastructure (pp-84)

Service Delivery (Contd.) About 70% of the community leaders felt that the ICDS programme was very useful to the community (pp-102); 51.2% children (12-23 months) were found to be fully immunized (pp-121); 49% of children were observed to be able to write alphabets/ words; Only 24% women reported to have attended NHE meetings; Average attendance of no. of children 3-6 yrs based on three sudden visits by the Research Team was found to be 14 (pp-121);

Programme Outcomes Intended behavioral changes of varied intensity observed in Kerala, Himachal Pradesh, Andhra Pradesh, Tamil Nadu, Maharashtra, West Bengal and Jharkhand; Bihar, Uttar Pradesh, Rajasthan, Haryana and Punjab ranked very low in terms of intended behavioral changes among ICDS beneficiaries. In general, the practice of breast feeding within an hour of birth is found to be more widespread among ICDS beneficiaries; ICDS has positively influenced formal school enrolment and reduction in early discontinuation among beneficiaries; At the national level, ICDS programme has impacted the immunization coverage, specially measles vaccination (Table 8.9). There is no significant difference in the nutritional status among children 7-60 months between ICDS and non-ICDS populations (Table 9.2, pp-146)

41 Changes Required for Better Performance Universalization Vs resources Job security and compensation of AWW AWC infrastructure Convergence of complementary services Monitoring and verification of office records Revision of per capita norms in keeping with inflation

Ranking of States : Overall Performance in ICDS Based on seven indicators: –Ave. no. of days SNP received in last 3 months, –% of children months fully immunized, –% of children who are able to write alphabets/words, –% of women reporting NHE meetings, –% of mothers reporting seeking help from AWW when their child gets sick, –% mothers reporting received deforming tablets from AWC, and –Ave. attendance of 3-6 year old (based on 3 visits by NCAER) Top Six States: Karnataka, Maharashtra, Andhra Pradesh, West Bengal, Jharkhand and Tamil Nadu Bottom Six States: Punjab, Uttarakhand, Rajasthan, UP, Assam and Bihar

43 Components of Facility Index (FI) ComponentsMaxAverage AWCs housed in owned buildings (%)92.6 (Chh)43.8 AWCs with adequate space for cooking (%)92.6 (TN)59.9 AWCs with adequate space for storage (%)91.8 (TN)59.8 Mean area of room in AWC (Sq Ft)404.0 (Rajasthan)299.8 AWCs having toilet with flush system (%)60.0 (TN)15.6 AWCs having drinking water facility within premises (%) 88.1 (MP)62.7 AWWs attended training (%)100.0 (AP, Har, Raj, Jha) 82.8 AWCs with functional weighing scale of children (%) 95.5 (TN)73.7 AWCs having adequate toys (%)89.9 (HP)37.1 AWCs having adequate posters (%)94.2 (Uttarakhand)57.0 AWCs having adequate PSE kits (%)90.1 (HP)47.1 AWWs whose education above middle school (%)98.1 (Uttaranchal)80.8

44 Mean SD of the Indicators used for Composite PI IndicatorsMaxAverage Average number of days received food21.0 (Haryana, Karnataka, Maharashtra, Orissa, TN, WB) 16.9 Percentage of children (12-23 months) fully immunized 86.7 (TN)58.9 Percentage of Children able to Write alphabets/words among those attending PSE 82.3 (Assam)53.2 Percentage of women reporting attended NHE meetings 72.1 (Kerala)27.9 Percentage of mother reporting seeking help from AWW when their child gets sick 28.5 (Andhra Pradesh)11.2 Percentage of mother reporting received deworming tablets from AWC 92.8 (Madhya Pradesh)59.9 Average attendance (number of children aged 3-6 years) based on 3 sudden visits by NCAER 20 ( Madhya Pradesh, Maharashtra) 13.6

45 Theory of change issues in ICDS: Program Restructuring HierarchyCausal chain-ICDSObservations-general ImpactReduced mortality, Increased weight for age in children Impact conditional on Effective Coverage, AWC performance, quality spending, convergence of services. OutcomeAwareness, Behavioural changes in: hygienic/dietary habits, health/education seeking behaviour Influenced by infrastructure, human resources, convergence of interrelated services, quality delivery of services. OutputEffective coverage, Quality of delivery of SN, PSE/NHE Influenced by quality of spending, infrastructure, human resources ActivitiesSurveys, Coverage, Organising delivery of food/ration, PSE/NHE, Immunization etc. Affected by infrastructure, overburdened/underpaid AWC; Monitoring weak; more emphasis on Record-keeping, data unrepresentative. InputAWC infrastructure, Funds, Materials, Human resources AWC not equipped, AWW –vulnerable, not trained & motivated, inadequate & untimely input;

46 PART - II ICDS : Restructuring

47 ICDS: Restructuring ICDS Restructuring details provided in the agenda for 16 th /17 th June: States were requested to provide suggestions by August 2010: –Implementation in flexible mode – different models and institutional arrangements for delivery of services –States/ UTs had to submit successful models after stakeholders consultation at various levels & validation –[still pending] State PIPs for ICDS from with accountability for administration/ delivery arrangements; nutrition and early learning outcome. State to confirm constitution of Nutrition Council and State Nutrition Action Plan.

Nutrition Challenges 48 State Nutrition Council Executive Committee District Level Council State and Multisectorial Nutrition Action Plan

49 Mother & Child Protection Card THANK YOU

50 ICDS – Infrastructure S. NoIndicator(s)NCAERCMU Three Decades of ICDS Average 1 Ownership of AWC Buildings - Own building/State Govt Primary school building/ Provided by Community free of Rent Rented building Others Facilities & Infrastructure available at AWCs - Kuccha Buildings Semi-Pucca Buildings Pucca Buildings Open Space AWC's having Separate Space/ Adequate Space - For Cooking For Storage

51 ICDS – Infrastructure (contd..) S. NoIndicator(s)NCAERCMU Three Decades of ICDS Average 4 AWC's having Adequate Space - For Outdoor Activities For Indoor Activities Available with Toilet Facility AWC’s with Water Sources - Tap/ Piped Water Hand Pumps Others Avalability of Utensils - For Cooking For Serving Available of Weighing Scale - Weighing Scale available & Functional