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. Launched on 2nd October 1975, on an experimental basis in 33 ICDS blocks, it has been gradually expanded to 6284 projects. Today, ICDS Scheme represents one of the worlds largest and most unique programmes for early childhood development. , it currently reaches around 7.28 crore children and about 1.6 crore pregnant and nursing mothers (March 2010).

ICDS Scheme represents one of the worlds largest and most unique programmes for early childhood development. ICDS is the foremost symbol of Indias commitment to her children Indias response to the challenge of providing pre-school education on one hand and breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality, on the other

60 50 40 30 20 10 0

51 45 43 40

20

23

Stunted

Underweight NFHS-2 NFHS-3

Wasted

SOURCE: NFHS-3 2005-6

90 80 70 60 50 40 30 20 10 0

74

79

Any anaemia NFHS-2

Severe anaemia NFHS-3

SOURCE; NFHS -3 2005-6

Every fifth young child in the world lives in India Every second young child in India is malnourished Three out of four young children in India are anaemic

Every second newborn in India is at risk of reduced learning capacity due to iodine deficiency
Malnutrition limits development potential and active learning capacity of the child

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 Ministry of Women and Child Development (MWCD) is responsible for budgetary control and administration of the Scheme at the Centre. At the State level, Department of Social Welfare, Women & Child Development or the Nodal Department, as may be decided by the State Government, is responsible for the overall direction and implementation of the programme. The Administrative Unit for the location of an ICDS Project is a Community Development Block in the rural areas, a Tribal Development Block in pre-dominantly tribal areas and ward(s) or slums in urban areas. Scheme of ICDS has been classified as a centrally sponsored programme that will be implemented throught the state government with 100 percent financial assistance from the Central Government for inputs other that supplementary nutrition. The Central Social Welfare Board (CSWB), voluntary organizations, local bodies, panchayati raj institutions are to be actively involved in this programmer for implementation, getting community support etc.

BENEFICIARY

SERVICES

Pregnant women Nursing Mothers Children less than 3 years Children between 3-6 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

Adolescent girls( 11-18 years)

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

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 20-25 gms of protein Each malnourished child to get 600 calories and 16-20 grams of protein

Immunization of pregnant women and infants protects children from six vaccine preventable diseases-poliomyelitis, diphtheria, pertussis, tetanus, tuberculosis and measles. These are major preventable causes of child mortality, disability, morbidity and related malnutrition. Immunization of pregnant women against tetanus also reduces maternal and neonatal mortality

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) 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.

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.

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

General health check ups Immunization Treatment of minor ailments Deworming Prophylactic measures against anemia, IDD, vitamin deficiency Referral

Anganwadi is the Focal Point for Delivery of ICDS Services. Located in a Village/Slum. Anganwadi is run by an AWW, supported by a Helper. AWW is the 1st Point of Contact for Families Experiencing Nutrition and Health Problems.

Sanctioned No. of Blocks No. of AWW Children (0 - 6 years) 5652 608,066 :

Functioning 4545 546,434 35.39 million 6.38 million

Gap 19.6% 11.2%

Expectant and Nursing mothers :

There is a countrywide infrastructure for the training of ICDS functionaries, viz.

Anganwadi Workers Training Centres (AWTCs) for the training of Anganwadi Workers and Helpers. Middle Level Training Centres (MLTCs) for the training of Supervisors and Trainers of AWTCs; National Institute of Public Cooperation and Child Development (NIPCCD) and its Regional Centres for training of CDPOs/ACDPOs and Trainers of MLTCs. NIPCCD also conducts several skill development training programmes

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.

State level: Various quantitative inputs captured through CDPOs 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. CDPOs 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

At block level,

Child Development Project Officer (CDPO) is the incharge of an ICDS Project. CDPOs 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.

 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

Government of India partners with the following international agencies to supplement interventions under the ICDS: United Nations International Children Emergency Fund (UNICEF) Cooperative for Assistance and Relief Everywhere (CARE) World Food Programme (WFP)

UNICEF supports the ICDS by providing technical support for the development of training plans, organizing of regional workshops and dissemination of best practices of ICDS. It also assists in service delivery and accreditation system where the capacity of ICDS functionary is strengthened. Impact assessment in selected States on early childhood nutrition and development, micro-nutrient and anemia control through Vit. A supplementations and deworming interventions for children in the age group of 9-59 months is also conducted by UNICEF from time to time.

CARE is primarily implementing some non-food projects in areas of maternal and child health, girl primary education, micro-credit etc. Integrated Nutrition and Health Project (INHP)-III, which is a phaseout programme of INHP series would come to an end on 31.12.2009.
WFP has been extending assistance to enhance the effectiveness and outreach of the ICDS Scheme in selected districts (Tikamgarh & Chhattarpur in Madhya Pradesh, Koraput, Malkangir & Nabrangpur in Orissa, Banswara in Rajasthan and Dantewada in Chhattisgarh), notably, by assisting the State Governments to start and expand production of low cost micronutrient fortified food known as Indiamix. Under this the concerned State Government are required to contribute to the cost of Indiamix by matching the WFP wheat contribution at a 1:1 cost sharing ratio.

More than 40 per cent AWCs (Anganwadi Centres) across the country are neither housed in ICDS building nor in rented buildings. One-third of the Anganwadis are housed in ICDS building and another one-fourth are housed in rented buildings; As regards the status of Anganwadi building, more than 46 per cent of the Anganwadis were running from pucca building, 21 per cent from semi-pucca building, 15 per cent from kutcha building and more than 9% running from open space; It is quite encouraging to observe that average number of children registered at the Anganwadi centre is 52 for boys and 75 for girls;

The survey data reveal that more than 45 per cent Anganwadis have no toilet facility and 40 per cent have reported the availability of only urinal; Of the 39 per cent Anganwadis reporting availability of hand pumps, half of the hand pumps were provided by the Gram Panchayat and 12 per cent provided by the ICDS; More than 90 per cent Centers provided supplementary food, 90 per cent provided preschool education and 76 per cent weighed children for growth monitoring; Only 50 per cent Anganwadis reported providing referral services, 65 per cent health check-up of children, 53 per cent for health check-up of women and more than 75 for nutrition and health education;

Average number of days in a month in which services are provided at the Anganwadi centers are 24 for supplementary food, 28 for pre-school education and 13 for Nutrition and health education; More than 57 per cent of Anganwadi centers reported availability of ready-to-eat food and 46 per cent availability of uncooked food at the Anganwadi centers; Nearly three-fourth of the Anganwadis have reported the availability of medical kits and baby weighing scale. On the other hand adult weighing scale has been reported only by 49 per cent of the Anganwadis

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 46.31 days at Anganwadi level. Major reasons causing disruption was reported as delay in supply of items of supplementary nutrition;

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 nonavailability of materials/aids for Nutrition and Health Education (NHED).

Evaluations in the past have thrown up a number of gaps in the delivery of ICDS. In many states, the ICDS has got reduced to a feeding programme operated through an overburdened and underpaid anganwadi worker (AWW); linkages with the public health system have been weak; the pre-school component is missing; early childhood care has never got the attention it deserves; anganwadi centres (AWCs) have not had the physical space to operate efficiently and effectively; community engagement and participation are virtually non-existent. Falsification of data, poor management information systems (MIS), and delays in release of funds and payments to AWWs are also reported from different states. Little attention has been paid to the needs of working women for whom access to a crche is an urgent priority.