INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS ) DR. AMRITA KENEI DR. VISHAL

PROGRAM OUTLINE Started by the Government of India in 1975, the Integrated Child Development Scheme (ICDS) has been instrumental in improving the health and wellbeing of mothers and children under 6 by providing health and nutrition education, health services, supplementary food, and pre- school education. Integrated Child Development Scheme (ICDS) The ICDS national development program is one of the largest in the world. It reaches more than 34 million children aged 0-6 years and 7 million pregnant and lactating mothers.

Under nutrition in Children under Age 3 SOURCE: NFHS

Anemia among Children Age 6-35 Months SOURCE; NFHS

1. Every fifth young child in the world lives in India 2. Every second young child in India is malnourished. 3. Three out of four young children in India are anaemic 4. Every second newborn in India is at risk of reduced learning capacity due to iodine deficiency 5. Malnutrition limits development potential and active learning capacity of the child

ICDS OBJECTIVES □To improve the nutritional status of preschool children 0-6 years of age group. □To lay the foundation of proper psychological development of the child □To reduce the incidence of mortality, morbidity malnutrition and school drop out □To achieve effective coordination of policy and implementation in various departments to promote child development □To enhance the capability of the mother to look after the normal health and nutritional needs of of the child through proper nutrition and health education.

THE TARGET GROUPS □Pregnant women □Nursing Mothers □Children less than 3 years □Children between 3-6 years □Adolescent girls( years ) □Health check-ups, TT, supplementary nutrition, health education. □Health check-us supplementary nutrition, health education □supplementary nutrition, health check-ups, immunization, referral services □supplementary nutrition, health check-ups, immunization, referral services, non formal education □supplementary nutrition, health education BENEFICIARY SERVICES

COMPONENTS □Health Check-ups. □Immunization. □Growth Promotion and Supplementary Feeding. □Referral Services. □Early Childhood Care and Pre-school Education. □Nutrition and Health Education.

ICDS INDICATORS Indicators AWCs in Pucca Structure43%75% No. of Children Registered (6-36 months)45.40%57.15% No. of Children availing ICDS services (6-36 months)78%75.25% No. of Children Registered (3-6 Years)56%63.50% Pregnant & Lactating mothers registered77%87% Low Birth Weight Children41%29% Severely malnourished Children (0-3 Years)7%1% Interruption in supply of Supplementary Nutrition63.20%54%

Supplementary nutrition □Each child upto 6 years of age to get 300 calories and 8-10 grams of protein □Each adolescent girl to get 500 calories and 20-25grams of protein □Each pregnant women and lactating mother to get 500 calories and gms of protein □Each malnourished child to get 600 calories and grams of protein

IMR STATUS OF INDIA

Immunization □Immunization of pregnant women and infants protects children from six vaccine preventable diseases-  poliomyelitis  diphtheria  pertussis  tetanus  tuberculosis  measles

Referral Services □During health check-ups and growth monitoring, sick or malnourished children, in need of prompt medical attention, are referred to the Primary Health Centre or its sub-centre. □The anganwadi worker has also been oriented to detect disabilities in young children. She enlists all such cases in a special register and refers them to the medical officer of the Primary Health Centre/ Sub-centre

Non-formal Pre-School Education (PSE) □Non-formal Pre-school Education (PSE) component of the ICDS may well be considered the backbone of the ICDS program. □These AWCs have been set up in every village in the country.. As a result, total number of AWC would go up to almost 1.4 million. □This is also the most joyful play-way daily activity, visibly sustained for three hours a day. It brings and keeps young children at the anganwadi centre.

Contd. □Its program for the three-to six years old children in the anganwadi is directed towards providing and ensuring a natural, joyful and stimulating environment, with emphasis on necessary inputs for optimal growth and development. □The early learning component of the ICDS is a significant input for providing a sound foundation for cumulative lifelong learning and development. □ It also contributes to the universalization of primary education, by providing to the child the necessary preparation for primary schooling and offering substitute care to younger siblings, thus freeing the older ones – especially girls – to attend school.

Health check-ups □Record of weight and height of children at periodical intervals □Watch over milestones □Immunization □General check up for detection of disease □Treatment of diseases like diarrhea, ARI □Deworming □Prophylaxis against vitamin A deficiency and anemia □Referral of serious cases

PROGRAM MONITORING □ CENTRAL LEVEL (i) Supplementary Nutrition : No. of Beneficiaries (Children 6 months to 6 years and pregnant & lactating mothers) for supplementary nutrition (ii) Pre-School Education : No. of Beneficiaries (Children 3-6 years) attending pre-school education (iii) Immunization, Health Check-up and Referral services : Ministry of Health and Family Welfare is responsible for monitoring on health indicators relating to immunization, health check-up and referrals services under the Scheme

Monitoring at state level State level: Various quantitative inputs captured through CDPO’s MPR/ HPR are compiled at the State level for all Projects in the State No technical staff has been sanctioned for the state for programme monitoring CDPO’s MPR capture information on number of beneficiaries for supplementary nutrition, pre-school education field visit to AWCs by ICDS functionaries like Supervisors, CDPO/ ACDPO etc information on number of meeting on nutrition and health education (NHED) and vacancy position of ICDS functionaries

Monitoring at Block level □ At block level □Child Development Project Officer (CDPO) is the in-charge of an ICDS Project. CDPO’s MPR and HPR have been prescribed at block level. □a supervisor, under the CDPO is required to supervise 25 AWC on an average. □CDPO is required to send the Monthly Progress Report (MPR) by 7th day of the following month to State Government. Similarly, CDPO is required to send Half- yearly Progress Report (HPR) to State by 7th April and 7th October every year.

Monitoring at village level □At the grass-root level, delivery of various services to target groups is given at the Anganwadi Centre (AWC). □The Monthly and Half-yearly Progress Reports of Anganwadi Worker have also been prescribed. AWW is required to send these Monthly Progress Report (MPR) by 5th day of following month to CDPO’ In- charge of an ICDS Project. □Similarly, AWW is required to send Half- yearly Progress Report (HPR) to CDPO by 5th April and 5th October every year

Nutrition and Health Education □This service is not monitored at the Central Level. State Governments are required to monitor up to State level in the existing MIS System. □ No. of ICDS Projects and Anganwadi Centres (AWCs) w.r.t. targeted no. of ICDS Projects and AWCs are taken into account for review purpose

Three Decades of ICDS – An appraisal by NIPCCD (2006) i)Around 59 per cent AWCs studied have no toilet facility and in 17 AWCs this facility was found to be unsatisfactory ii.Around 75% of AWCs have pucca buildings iii) 44 per cent AWCs covered under the study were found to be lacking PSE kits

iv.Disruption of supplementary nutrition was noticed on an average of days at Anganwadi level. Major reasons causing disruption was reported as delay in supply of items of supplementary nutrition

Contd. v) 36.5 per cent mothers did not report weighing of new born children; vi) 29 per cent children were born with a low weight which was below normal (less than 2500 gm); vii) 37 per cent AWWs reported non- availability of materials/aids for Nutrition and Health Education (NHED).

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