Utilisation of Supplementary Nutritional Services of ICDS by Paediatric Beneficiaries of Central Kerala, India: A Cross-sectional Study

Abstract

Introduction: Integrated Child Development Scheme (ICDS) is a unique programme for childhood care and development. ICDS had expanded progressively over the past four decades, also the budget allotment for the programme has been increasing over the years. However, the expansion in coverage has not been translated into a proportionate increase in utilisation. Aim: To evaluate the utilisation of supplementary nutritional services of ICDS and also to assess the reasons for not utilising the same by paediatric beneficiaries. Materials and Methods: This community based cross-sectional study was conducted in the Department of Community Medicine, Government Medical College (selected Rural Community Health Centre), Thrissur district, Kerala, India, during January 2019 to August 2019. A total of 290 children, aged between six months to six years, were permanent residents were selected to participate in the study. Data were collected using pre-tested structured proforma by interviewing all the study subjects. Univariate analysis and logistic regression were used for statistical analysis to find the factors affecting the non utilisation of ICDS services. Results: Among the 290 participants, 141 (48.6%) were in the age group of six months to three years while 149 (51.4%) were in the age group 3-6 years, and 154 (53.1%) were boys and 136 (46.9%) were girls. The regular utilisation of supplementary nutrition was 67 (47.5%, 95% CI- 39.1, 56.1) in the age group six months to three years and 83 (55.7%) in 3-6 years. The main reasons for non utilisation were that children attended playschool and a lack of perceived benefits. Those who lived near Anganwadi Centres (AWC) had significantly higher utilisation. Utilisation among children between 3-6 years of age was significantly lower in those with higher maternal education (p-value<0.001), and who reach Anganwadi by vehicle (p-value<0.001). Conclusion: The study found that regular utilisation of supplementary nutrition was poor. Those who were staying away from Anganwadi and who had higher maternal education had lower utilisation of ICDS nutritional services. Public-private partnerships in providing hot cooked meals from Anganwadi in playschools can be explored to increase utilisation.