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Background: The integrated childhood development services (ICDS) scheme, launched on 2nd November 1975 is India’s foremost program imparting comprehensive and cost-effective services for children and maternal health through designated anganwadi centers (AWCs). AWCs deliver services right at the doorsteps of the beneficiaries to ensure their maximum participation.Methods: This was a cross sectional descriptive study conducted in 37 AWCs of the urban area in Kathua district from March to May 2019. A checklist was used to assess the physical infrastructure of AWC and logistics available.Results: A total of 37 AWCs were visited. Majority of the AWCs (94.5%) were running in a rented building and had only room. and 86.4% have pucca type of center. Almost half (51.3%) of the anganwadi workers had >10 years of experience. 32.4% of the AWWs received education up to 12th standard. Weighing machines were available in 89.1% of the centers whereas Salter weighing machine was present only in 23 centers.Conclusions: Present case study unveils deficiencies in infrastructure and logistics at the centers. Emphasis should be given to strengthen the basic infrastructure of AWCs which would further help in delivering quality services to the beneficiaries
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Background: Anganwadi centres under integrated child development services is the largest Project in India to improve not only child health but reproductive, maternal and adolescent health. The aim of the present study is to compare the infrastructure of urban and rural anganwadi which is one of the basic need to provide quality services.Methods: A total of 30 anganwadi centres are involved in our study in which 20 are from rural and 10 are from urban field practice area of Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore. This study employed interview method with anganwadi worker’s and observation of anganwadi centre using pre-designed, semi structured questionnaire and checklist.Results: 85% of rural and 60% urban anganwadi centres have their own buildings to carry out the services. 20% of rural anganwadi centres lack fixed name boards compared to urban anganwadi centres. 55% of rural anganwadi centres and 90% of urban anganwadi centres lack separate storage for raw food materials. 15% of rural anganwadi centres lack functional toilet facility. 40% of rural anganwadi centres lack functional weighing machine.Conclusions: Anganwadi centres are remote contact point of health care system within the community. The infrastructure of anganwadi centre such as type of building, space for cooking and activities, availability of functional equipments ensure the quality service deliveries which in turn are enhanced by timely supervision from higher authorities.
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Background: The beneficiaries under the scheme are children in the age group of 0-6 years, pregnant women and lactating mothers, women in the age group of 15-44 years and adolescent girls in selected blocks. Irrespective of caste, religion, socioeconomic status all beneficiaries are eligible for availing of services under the Integrated Child Development Services (ICDS) scheme. BPL is not a criterion for registration of beneficiaries under ICDS2. Present study is to recognize whether all categories of people are utilizing the services or not irrespective of economic status, religion etc.Methods: Descriptive observational study done for period of one year, sampling done by multi stage (random) method. Study conducted in ICDS centers in the field practicing area of Kakatiya medical college Warangal, Telangana, India. 622 children from 31 anganwadi centres of 0 to 6 year age were included.Results: Majority (71.7%) were belongs to ‘0 to 3’ years of age group, male (50%) and female (50%) were equally in distribution. majority (78.3%) were Hindus. Majority parents (father-84.9, mother 84.2) were literates and mothers were unemployed/housewives, fathers were skilled workers (28%) followed by farmers (22%). Majority were (35.4%) belonged to middle, followed by lower middle (30.2%) level of socio economic status.Conclusions: There were less number of 3 to 6 years age category population in the study, means that age group is not getting covered properly by ICDS. Two extremes (higher and lower categories) of education, occupation, socio economic status parents were not properly utilising the ICDS services for their children.
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Background: Integrated Child Development Services (ICDS) today represents one of the world’s largest programmes for early childhood development. The Anganwadi workers and Anganwadi Helpers are the grass root level functionaries responsible for delivery of services.Methods: A field based cross sectional observational study was conducted in Mangalagiri rural ICDS project to assess the knowledge levels and the socio-demographic profile of the Anganwadi workers, all the Anganwadi workers who are working in Mangalagiri rural ICDS project area have been included in the study.Results: Out of 212 AWWs, majority of AWWs were from the age group of between 30-49 years; 123 (58%) AWWs have education qualification from 6th class to 10th class standard and 135 (63.7%) workers had an experience of more than 10 years. About 142 (67%) AWWs had a good knowledge assessment score. They had best knowledge about immunization (96.7%), referral services (93.4%), growth monitoring (82.5%), health check-ups (75.1%) and nutrition and health education (70%). AWWs complained problems like infrastructure related, excessive work overload and record maintenance.Conclusions: The majority of the AWWs are in the age group of 30 to 49 years. More than half of them belong to lower middle socio-economic class. Maximum number of workers has experience of 10 years or more. All the AWWs in our study had 50% and above knowledge about Anganwadi services. Best knowledge is seen regarding immunization followed by referral services. Least knowledge is seen regarding supplementary nutrition. Major problems reported were excess work and record maintenance.
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Background: Malnutrition is a major public health problem. It continues to be a primary cause of ill health and mortality among children in developing countries. Preschool age is an important stage of life where the nutrition plays an important role and has long lasting effects in the later years of life. Hence the objective of the present study was to assess the nutritional and health status of under-five children covered under the ICDS project.Methods: A cross-sectional study was conducted during March 2013-February 2014 among 846 children attending the rural and urban anganwadi centers of Karimnagar ICDS project. A semi-structured questionnaire was used to collect data and was analyzed using Epi info version 7 and valid inferences were drawn.Results: It was observed in the present study that females (53.5%) were more compared to boys (46.5%), out of the total sample surveyed. In this study 87.6% were completely immunized and 12.4% were partially immunized. According to IAP classification of malnutrition, 27.7% children were mildly malnourished, 16.5% were moderately malnourished, 3.9 % were severely malnourished and 0.9 % was very severely malnourished.Conclusions: High prevalence of malnutrition was observed among children in both urban and rural area warrants urgent attention. ICDS projects should be periodically studied to evaluate the impact of interventions. Further exploratory studies are required to find of several risk factors of malnutrition.
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occurrences ofCandidasp. isolated were C. albicans which was thepredominant species 10(21.5%),C. tropicals 5(5.4%),C. krusei 4(4.3%) andC. Parapsilosis3(3.2%) respectively.Conclusion:Candida albicansremains the most predominant species of Candidain patients suffering from pulmonary tuberculosis and colonizationby Candidaspshould not be ignored.The presence of Candida sp.might contribute to in one way totheprogression of the disease under supplementary nutrition. Immunization and health check-ups were not available for pregnant and lactating women, however, 53.3% received iron and folic acid (IFA) tablets and 4.17% were provided with referral services. 71.53% of adolescent girls received IFA tablets. Health check-ups and basic skills programmes were not conducted foradolescent girls, however, 5.56% were provided with referral services.Conclusion:The performance of ICDS in Kashmir in terms of coverage is very low and almost all the services except supplementary nutrition are not delivered properly. There are many reasons for the underperformance of the scheme including socio-economic and other aspects of the grassroot workers including anganwadi workers (AWWs) and anganwadi helpers (AWHs), inadequacy of equipment for proper implementation, undesirable condition of AWCs, lack of professionalism in implementing staff, lack of co-ordination between AWCs and other associated personals like Lady Health Visitor (LHV)/Auxiliary Nurse Midwife (ANM). In Kashmir the political environment makes the implementation of ICDS scheme even more complicated and difficult. A realignment is the need of hour and the state government must identify the specific problems faced by the scheme and convey them to all the stake holders so that a better and modified version of the scheme is implemented.
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Background: The Integrated Child Development Services (ICDS) scheme has been operational for more than three decades in India. Objective: To evaluate the various aspects of the ICDS program in terms of inputs, process and outcome (coverage), utilization, and issues related to the ICDS program. Methods: A total of 130 Anganwadi centers (AWCs) were selected including 95 AWCs from rural areas and 35 AWCs from urban areas from April 2012 to March 2015, from 12 districts of Gujarat and the union territory of Diu. Information was collected for infrastructure, baseline characteristics of AWWs, provision, coverage and utilization of various ICDS services, and various issues related to program operation. Results: A majority of pregnant (94.7%) and lactating (74.4%) mothers, and adolescent girls (86.6%) were availing ICDS services. In 96.9% of the AWCs, a growth chart was available and 92.3% AWWs were using it accurately. A total of 14.9% children were underweight including 13.5% moderately and 1.4% severely malnourished children. Two-third (66.2%) children were covered by supplementary nutrition (SN). Only 14.6% of the AWCs reported 100% preschool education (PSE) coverage among children. More than half (55.4%) of the AWCs reported an interruption in supply during the last 6 months. Various issues were reported by AWWs related to the ICDS. Conclusion: The study has reported gaps in terms of infrastructure facility, different trainings, coverage, supply, and provision of SN, status of PSE activities in AWCs, and provision of different services to the beneficiaries.
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Background: The two major deficiency syndromes affecting the preschool children in developing countries are protein energy malnutrition and nutritional anemia. Both these conditions have considerable impact on child’s physical and mental development. The objective of the study is to study and compare the prevalence of anemia among children in ICDS and non ICDS areas. Methods: A cross – sectional study with comparison group was carried out in urban slums of Nagpur city in the ICDS and Non-ICDS areas. In all 115 children were examined from each area and the prevalence of anaemia was estimated in both the areas separately. Results: prevalence of anaemia among 0-6 years children in ICDS and Non- ICDS areas was 47.9% (44.1% in male and 51% in female) and 56.1% (47.8% in male and 63.7% in female) respectively. Majority of the anaemia male children were having moderate grade of anaemia in both the groups i.e. 24.4% in ICDS and 29.9% in Non-ICDS area. Cases of severe grade of anaemia were seen in 1-3 years children in ICDS whereas in Non- ICDS group they were from 1-4 years age group. Majority of the anaemia female children were having moderate anaemia in both the groups (30.7% and 45.2%). Conclusion: Prevalence of anemia was found as in ICDS area was 47.9% compared to 56.1% in the non ICDS area. Statistically this difference was not significant. Infants showed least prevalence of anemia in both the groups.
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This is a case study from a village in Haryana. A migrant family from another state was working in poultry farm. Family had six children. Youngest was girl infant with grade IV malnutrition and unimmunised. This family was denied immunisation, registration to Anganwari centre, and there were issues of child labour. With public health activism, all these problems were solved. This case study demonstrates that if there is strong commitment and confidence among public health practitioners, they can overcome most of the barriers. Such Public Health Activism should be promoted.
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Background: Although more than one-third of under six year children in Delhi slums are undernourished; but what is the situation in rural areas of Delhi - a capital of India, it is not very clear. Moreover the research in rural area on topic has also not received much focus in past. Methods: The study was done in the Narela area (a Rural ICDS project in Delhi). All the eligible 450 children between the age group 0-5 years as found in the survey register of ICDS project for 2 Anaganwadi Centre’s (AWC-A & AWC-B) at the time of data collection, were included in the study. The prevalence of undernutrition in 2 AWCs was determined and it was compared with records of 2 AWCs. The primary and secondary data was triangulated to confirm pattern scenario of undernutrition. Results: In Rural ICDS Block, the prevalence of underutrition came out 57.8%.The difference in nutritional grades of undernutrition in the study were not statistically significant (P >0.05) as per their the registration status at AWCs in ICDS scheme. The type of family and family income of household however were statistically significantly associated with the nutritional status of child (P <0.01). Conclusions: The undernutrition is prevailing in rural area of Delhi (India), despite the presence of ICDS scheme; suggesting that other host factors in family are also important and service delivery factors in nutrition and health programmes also needs radical relook for tackling undernourished children in Delhi.
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Objective: To evaluate Integrated Child Development Services (ICDS) program in terms of infrastructure of Anganwadi centers, inputs, process, coverage and utilization of services, and issues related to program operation in twelve districts of Gujarat, India. Design: Facility (Anganwadi) based study. Setting: Twelve districts of Gujarat, India (April 1, 2012 to March 31, 2013). Participants: ICDS service providers (60 Anganwadi workers from 46 rural and 14 urban Anganwadi centers) and their beneficiaries. Main Outcome measures: Coverage of supplementary nutrition, pre-school education, immunization and referral services. Results: Supplementary nutrition coverage was reported in 48.3% in children. Interruption in supply of supplementary nutrition during last six months was reported in 61.7% Anganwadi centers. Only 20% centers reported 100% pre-school education coverage among children. Immunization of all children was recorded in only 10% Anganwadi centers, while in 76.7% centers, no such records were available. Regular health checkup of beneficiaries was done in 30% centers. Referral slips were available in 18.3% Anganwadi centers and referral of sick children was done from only 8.3% centers. Conclusion: There are program gaps in coverage of supplementary nutrition in children, its regular supply to the beneficiaries, in pre-school activities coverage, recording of immunization, and regular health check-up of beneficiaries and referral of sick children.
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Background: Malnutrition is serious problem in India. ICDS provides supplementary nutrition through anganwadis to its beneficiaries. Aims & Objective: (1) To study quantitative effect of supplementary nutrition on physical growth of children beneficiaries of ICDS. (2) To understand determinants of physical growth among children registered with ICDS anganwadis. Material and Methods: It was a prospective cohort study done during September 2010 to August 2011. All children of three to five years of 6 randomly selected anganwadis of Jhagadia block of Bharuch district were selected for study. The pretested and predesigned questionnaire was used for collection of data from the mother of the children at their home. Anthropometric measurements were done at anganwadi. Data for availing of supplementary nutrition by child and was obtained from anganwadis. Follow up anthropometric measurements were done another two times over the period of one year. Results: Out of 104 children, 70 (67.3%) received adequate and 34 (32.7%) did not receive adequate supplementary nutrition. Both weight and height gain were more in the children who received adequate supplementary nutrition as compared to the children who did not receive adequate supplementary nutrition. Multivariate analysis indicated that, out of so many factors, supplementary nutrition and caste were the one which had significant effect on weight gain of children. Conclusion: Supplementary nutrition provided at anganwadi has significant impact on physical growth of its beneficiaries
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Decline in malnutrition levels has been dismal since the 1990s. We ascertained decadal trend in childhood nutritional status between 1997 and 2007 in Chandigarh, India and assessed impact of Integrated Child Development Services (ICDS) on childhood undernutrition. A total of 803 under-five children, 547 children between 12-23 months age, and 218 women with an infant child were recruited for the study. Findings of present study were compared with another methodologically similar study (1997) from Chandigarh and Reproductive and Child Health Rapid Household Survey (1998) to draw decadal trends. Prevalence of underweight among under-five children remained almost stagnant in the last one decade from 51.6% (1997) to 50.4% (2007). There was insignificant difference (P=0.3) in prevalence of underweight among children registered under ICDS program (52.1%) and those not registered (48.4%) in 2007. Other health and service provision indicators had mixed results in the past decade. Health services utilization was poorest in urban slums.