Anganwadi Workers Research Articles

Knowledge, attitude, and practices toward tobacco control among rural community health care workers of primary subcenters in Belagavi district, Karnataka.

ABSTRACTContext:Tobacco is the common cause to a number of illnesses affecting millions of individuals all over the world. Primary care physicians are the initial point of contact for tobacco users, yet reaching everyone is impossible. Therefore, it is important to understand community health workers attitude to render community services in tobacco cessation counseling.Aim:To assess knowledge, attitude, practices, and occupational barriers toward tobacco control among community health care workers in Belagavi district, Karnataka.Settings and Design:This cross-sectional study was conducted in various subcenters of Belagavi district, Karnataka.Methods and Material:Simple random sampling technique was employed and 220 participants were interviewed using an interviewer administered questionnaire comprising of 22 close ended questions. Reliability of the questionnaire assessed with Cronbach’s a value of 0.85, face validity 84%, and content validity ratio 0.78.Statistical Analysis Used:The data were analyzed using descriptive analysis, chi square analysis, correlation, and regression.Results:The mean knowledge score among Accredited Social Health Activist (ASHA) workers was 4.77 ± 2.11 and it was lower in Anganwadi workers 2.93 ± 2.55. There was a statistically significant difference in the attitude scores (P < 0.05) between the community health workers. The majority of the ASHA workers would spread awareness, on the other hand, Anganwadi workers did not take any specific step which showed statistically significant difference with a P value of 0.018.Conclusion:ASHA workers had been superior to Anganwadi workers with regard to knowledge and attitude toward tobacco control. However, knowledge regarding tobacco and its ill effects was below optimal level among community health workers which desires to thoroughly educate in the aspects of oral health and disorders as part of their training.

Knowledge Level of Anganwadi Workers about Non-Formal Preschool Education of Integrated Child Development Services

The present study was carried out the knowledge level of 59 anganwadi workers (AWWs)about nonformal preschool education of ICDS Urban anganwadis of Ludhiana district, Punjab. Almost all anganwadi workers were between the ages of 36-45yr, married, and had attended school up to high school. It was interesting to see that 20% of them had postgraduate degrees, and most of them were between 11–15 yr old and had attended 1–3 trainings, while only 5% had attended more than seven trainings. Most of the participants had average level of knowledge about ICDS. For knowledge level, significant difference (F=10.06; p<0.01), was found in knowledge level of the AWWs. Therefore, need-based training programmes should be designed for anganwadi workers in the future to enable them to update their knowledge and provide quality preschool education for anganwadi children.

Assessment of growth monitoring activities conducted in anganwadi centers: A qualitative study in urban field practice area of a medical college in West Bengal

Background: Growth monitoring under Integrated Child Development Services (ICDS) program is an essential strategy for the prevention and control of malnutrition. Objective: To assess growth monitoring activities done by Anganwadi workers (AWWs), the influencing factors related to it and perception of mothers about growth monitoring service. Materials and Methods: A cross-sectional study was conducted in all the Anganwadi canters of urban field practice area of Community Medicine Department of Bankura Sammilani Medical College. Qualitative data collection methods were employed which comprised of nonparticipant observation of growth monitoring activities, in depth interview (IDI) of AWWs, and focus group discussion (FGD) with mothers of enrolled children. While the checklists had been compiled in Microsoft Excel, transcripts of IDIs and FGDs were analyzed based on the thematic analysis. Results: Growth chart plotting, interpretation of growth curve, and discussion regarding child's growth had been carried out diligently, but preparation for weighing, putting child in the pants and actual weighing of the child were not properly done in all cases. AWWs mentioned logistic issues such as nonavailability of Taring scale and short supply of growth registers, perceived pressure of register maintenance, inadequate infrastructure, lack of periodic training, and supervision among the difficulties. Most of them were satisfied about community participation in growth monitoring process. Many mothers knew about weighing process, but the use of a growth chart had been reiterated by only a few. Conclusion: Logistic and infrastructural issues needed redressal while supportive supervision was essential to ensure the quality of the growth monitoring process. Mothers should also be made more involved in this key activity of ICDS.

Sub-optimal knowledge with positive attitude and belief of frontline health workers toward the use of information technologies: A mixed-method study from rural Haryana, India.

Information technology (IT) can be used by frontline health workers (FLWs) to connect and deliver care to the community. Various studies in India have assessed the beneficial impact of IT usage by FLWs, but for the long-term sustainability, the attitude and belief toward IT usage have not been adequately studied. We conducted this study to assess the knowledge and attitude and to explore the beliefs of FLWs toward the use of IT in a rural area of Haryana. We conducted a mixed-method study (qualitative and quantitative approach) in a rural setting of Haryana, India. We included FLWs of two primary health centers (PHCs). Data were collected from October 19, 2020 to December 31, 2020. We collected data from 75 accredited social health activists (ASHAs), 37 Anganwadi workers (AWWs), 28 multi-purpose workers (MPWs), two information assistants, and two medical officers using a semi-structured interview schedule. Their knowledge about the benefits of IT use, past use of IT applications and devices, and self-rating of knowledge regarding computers or laptops were collected. We used 14 attitude statements, each with a five-point Likert scale to assess the attitude; a total score ≥35 was considered a positive attitude. We conducted eight focus group discussions (FGDs) to explore the beliefs regarding IT usage (four FGDs with ASHAs, two FGDs with AWWs, and two FGDs with MPWs). A descriptive analysis was performed for the quantitative data, and a thematic analysis was performed for qualitative data. Knowledge about the benefits of IT use was present among 77.8% of FLWs. Among the FLWs, 79.2% self-rated their knowledge of computers/laptops as 'do not have knowledge', 16% self-rated as 'low knowledge', and 4.8% self-rated as 'good knowledge'. The median total score for attitude statements among all the FLWs (n = 144) was 54 [inter-quartile range - 48-59]. Four themes emerged for beliefs toward IT usage, namely, positive beliefs, negative beliefs, challenges anticipated in adopting IT use, and facilitation factors. The positive beliefs were related to improvement in work efficiency and social status, less paperwork, timely report generation, and better learning. The negative beliefs were related to an increase in working hours, close monitoring, and feeling over-burdened. We found that FLWs had knowledge regarding the benefits of IT use, but they lacked knowledge regarding laptop/computer use. They had a satisfactory level of confidence in using smartphones, and most of them were using mobile applications. The majority of the FLWs had a positive attitude and beliefs toward IT use and wanted to use it in the future.

Perceptions about nonpharmacological interventions in the prevention of COVID-19 in the field practice area of jawaharlal nehru medical college

Introduction: COVID-19 pandemic is a major global public health threat. Coronavirus includes a large group of viruses, which infects both humans and animals. China reported the outbreak on December 31, 2019, to World Health Organization. Center for Disease Control and Prevention, USA, has published nonpharmacological interventions such as social distancing, zonal lockdown, rolling lockdown, wearing masks, and washing hands to combat the spread of COVID-19. The present study was conducted to assess the perceptions of people about nonpharmacological interventions in the prevention of COVID-19. Materials and Methods: A facility-based study was conducted among 220 participants from December 01, 2020, to February 28, 2021, among outpatients in the field practice area of urban primary health care Rukmini Nagar, under the administrative control of J. N. Medical College in Belagavi district, Karnataka. Results: A total of 220 participants were interviewed and analyzed for the study. Out of which, 36 (16.4%) were male and 184 (83.6%) were female. One hundred and seventy (77.2%) of the participants practiced good hand hygiene and personal hygiene. One hundred and forty-five (65.9%) of the participants always wore a face mask, when they were going outside. One hundred and eighty-one (82.2%) of the participants started drinking more fluids in the form of water compared with normal days. Conclusion: There was a lack of awareness about face protection and the use of hand sanitizer among the common public. Grassroots level health-care workers such as Accredited Social Health Activist, Anganwadi workers, and community volunteers should be trained for giving health education about nonpharmacological interventions to the public for COVID-19 prevention.

Awareness about role of health literacy and self efficacy in tobacco cessation among primary health care workers: A quantitative questionnaire study.

The purpose of this study was to measure primary health care providers' understanding of the significance of health literacy and self-efficacy in cigarette quitting. The current study used a quantitative descriptive questionnaire to collect data. The research was carried out among primary health care providers in a rural location near the Azamgarh Dental College in Uttar Pradesh. Medical officials, nursing personnel, and dental practitioners, if existent, are examples of primary health professionals. Azamgarh district is divided into 22 blocks. 22 primary health facilities were selected from these 22 blocks. 54 medical officers and 98 other primary health workers (ANMs, GNMs, and Asha workers) were questioned at these primary health facilities. The majority of study participants {132 (86.84%)} were aware of the bad effects of tobacco consumption. Most of the study participants don't know about health literacy {115 (75.65%)} and self-efficacy {78 (51.32%)}. The majority of them did not know the questionnaire to test health literacy {114 (75.02%)} and self-efficacy {150 (98.68%)}. poor mean awareness score (20.77 ± 3.33) was significant (p = 0.001) in the age group 25-35 years. Anganwadi workers were having significantly (p = 0.002) highest poor awareness score (22.67 ± 2.34). From the above results, it was concluded that awareness of the role of health literacy and self-efficacy in tobacco cessation among primary health workers was poor. Almost all study participants had not attended any training programs on tobacco cessation.

Community perception of accessibility and barriers to utilizing mental health services.

BACKGROUND:The Government of India and State Government authorities are trying their best to provide adequate mental health services through various mental health policies and programs. To reduce the burden in psychiatric hospitals, Government has decentralized mental health services. Although Government has provided mental health services, the utilization has always been low due to many reasons. In the present study, an attempt was made to assess the accessibility and the barriers to utilizing mental health services with various community stakeholders.MATERIALS AND METHODS:This is a qualitative study wherein data was collected from youth, women, geriatric groups, community key leaders, and Anganwadi workers. The primary data were collected through focused group discussions and interview methods. The collected data were analyzed using thematic coding.RESULTS:A total of twenty-five factors have been identified in the study, which were categorized under eight themes. (a) Lack of awareness and misinformation on mental health, illness, and available services, (b) Perceived causes for mental illness, (c) Reasons for not approaching health professionals, (d) Treatment adherence-related issues, (e) No multidisciplinary team in private hospitals and lack of involvement in government sector (f) Manpower issues, (g) Quality of service issues and building confidence among community people, and (h) Belief system and stigma.CONCLUSIONS:Inadequate mental health services, lack of awareness of mental health, and illness are still persist. The District Mental Health Program and other service providers need to reach communities, especially in remote areas. Periodical evaluation should be carried out to improve the utilization of mental health services.

The Efficiency of Anganwadi Centers Located in Rural Field Practice Area of a Medical College in North India: Data Envelopment Analysis.

The Integrated Child Development Services (ICDS) scheme was launched in 1975 for the improvement in maternal and child health and nutrition. The services under ICDS are implemented through Anganwadi centers (AWCs) and are delivered by Anganwadi workers (AWWs) at grassroots level. To evaluate the efficiency of all AWCs located in the field practice area of the medical college in North India, using data envelopment analysis (DEA) technique. A cross-sectional study was conducted in the catchment area of rural health training center. Each of the 15 AWCs was considered a decision-making unit (DMU), and physical structure and logistics were included as input variables; and percentage of beneficiaries receiving supplementary nutrition and health checkups were included as output variables. DEA technique was used to calculate the efficiency score for each DMU with the help of DEAOS free online software. DMU 14th was found to be most efficient (100%) and DMU second was the least efficient (45%). DMU 13 and 14 demonstrated a level of performance that is superior to all other DMUs. DMU 13th and 14th were, therefore, considered 100% efficient. DEA analysis showed that total output increases and/or input reductions were required for making the inefficient DMUs efficient. Most of the AWCs were inefficient and an improvement in the infrastructure and logistics is likely to improve the efficiency of AWCs.

Facility Based Management of Child Malnutrition- Lesson Learnt from a North Gujarat Study

Introduction: Malnutrition is a key health problem in India and Gujarat. Mission BalamSukham was launched to overcome malnutrition. Facility-based management of malnutrition is one of two components of this program. Objectives: 1. To evaluate Strengths, Weaknesses, Opportunities and Challenges (or Threats) of Child Malnutrition Treatment Centre (CMTC) and Nutrition Rehabilitation Centre (NRC). 2. To project into areas that needs improvement to overcome the centres’ weaknesses and challenges. Method: In-depth interviews were taken for health workers and beneficiaries of NRC and CMTC of Patan district till saturation of responses. Transcripts were made and themes were analysed based on the SWOC matrix. Results: Major issues identified by the study were absence of continuous financial support to operationalize CMTCs selected under Gatishil Gujarat program, Absence of Paediatrician, lack of awareness regarding child nutrition over night stay at centre and quality of training. Conclusion: Some internal weaknesses and strengths were acknowledged. Only facility-based management of SAM children did not make a difference in community. Training of ASHA and Anganwadi worker about nutritional counselling, screening and monitoring of SAM child is needed to strengthen the community-based management of SAM children.

Depression, anxiety, stress among ASHA workers, in selected primary health centres in Southern Bengaluru

Background: The COVID-19 pandemic was caused by a novel corona virus first discovered in Wuhan, December 2019. The healthcare system in India was quickly overwhelmed as tens of thousands of people with flu-like symptoms swarmed the hospitals.Methods: The present community based cross-sectional study was conducted among the accredited social health activist (ASHA) workers working under the selected primary health centres from August 2020 to November 2020. Primary health centres were selected by using simple random sampling technique. Three primary health centres were selected from the southern region of Bengaluru. The data was collected, compiled and entered into a Microsoft excel worksheet and analyzed using statistical package for social sciences (SPSS) software v.22.0. Descriptive statistics and suitable tests of significance like Chi-square test were applied as required.Results: A total of 78 ASHA workers participated in the present study. Majority of them belonged to the age group of 33-44 years. The mean age of the participants was 34 (+1.390) years. The present study showed that, 56.5% of the study participants experienced depression, anxiety or stress during the time of COVID-19 pandemic. Around 65% of the ASHA and Anganwadi workers were aware of the personal prophylactic measures to be used to prevent COVID-19 disease according to the present study.Conclusions: A significant proportion (56.5%) of the ASHA workers experienced depression, anxiety and stress during this pandemic. Measures should be undertaken to address the same.

Data-Driven Monitoring in Community Based Management of Children With Severely Acute Malnutrition (SAM) Using Psychometric Techniques: An Operational Framework.

BackgroundThe success of the Community Based Management of Severe Malnutrition (CSAM) programme largely depends on the knowledge and skills of Front-Line Workers (FLWs). A robust supportive supervision system in CSAM should be tailored to individualistic learning needs by distinguishing the FLWs as per their ability and simultaneously identifying the task domains to be emphasized more in supervisory visits. This paper details the ability assessment strategy developed and employed in the selected geographical locations in Madhya Pradesh (Central India) among the 197 Anganwadi workers (FLWs involved in CSAM implementation).MethodologyA 25 items tool was developed based on an analytical construct for ability estimation through Rasch Analysis (RA). RA models the probability of right/wrong answers as a function of a person (participants) and item (questions) parameters and calculates the item difficulty in relation to personability on the same unidimensional linear scale. Suitable visualization like item characteristic curve (ICC), person item map (PIM) and quadratic allocation were plotted in RA. The data fitting to the Rasch model (Rasch diagnostic) was tested by numeric (Anderson LR and Wald test) and graphical methods.ResultsThe item easiness parameter (β) value related to Diarrhoeal assessment was lowest (-2.32, -2.91 to -1.73) and related to peer assessment meaningful action (2.009, 1.669- 2.348)) was highest (most difficult). Anderson LR test (LR=31.32, df=24, p=0.079) showed the absence of global outliers. Quadrant analysis using the permutations of ability score and adjusted burden of malnutrition further mapped 41/197 (20.8%) FLWs to low ability -high burden quadrant and 44/197(25%) as low ability low burden quadrant.ConclusionRasch assessment may address the innate challenges to maintain homogeneity, discrimination capacity and linearity in a raw score-based measurement construct. The monitoring strategy developed on this thus may offer a judicious, pragmatic and thematic approach to supportive supervision in the CSAM program.

The family context of ASHA and Anganwadi work in rural Rajasthan: Gender and labour in CHW programmes

ABSTRACT Across the literature on CHWs globally, the role of CHWs’ families remains largely unexplored. This article focuses on ASHAs and Anganwadi Workers in a town in rural Rajasthan, India. We interviewed all twenty ASHAs and Anganwadi Workers in this town, and ten of their families; we also conducted participant observation in Anganwadi Centers, health centres, and family settings. ASHA and Anganwadi work was in high demand, despite being low paying, because of an overall lack of jobs for educated women. Every aspect of CHW work, from recruitment to selection to training to the number of hours spent on the job, was heavily determined by families. Women’s mobility, income, and workload was tied up in family structures. ASHA and Anganwadi Work increased the mobility and autonomy of the women who held those jobs in significant ways. But mostly, women stayed in these extremely low paying jobs because they and their families hoped that one day they would become permanent jobs with salaries and benefits. By providing honourable work, and keeping the idea of permanent employment in view but always just out of reach, the ASHA and Anganwadi programmes both exploited and strengthened gendered inequalities in the rural Rajasthani labour market.

A brief about autism spectrum disorders for nurses and other peripheral health workers

Autism spectrum disorder encompasses a wide range of neurodevelopment disabilities which affect children and their families across all sections of the society both in rural and urban settings. The prevalence of autism is rising irrespective of the socioeconomic background of the children. Hence every health worker has to be aware of ways to suspect and diagnose this condition and decide the appropriate treatment. Earliest intervention in autism spectrum disorder gives better results due to neuroplasticity. This article is targeted to help Medical officers, auxiliary nurse midwifes, anganwadi workers and other peripheral health workers by providing information on basics of ASD, normal speech development, simple ways for diagnosis and treatment for the same.

The impact of community health workers on antenatal and infant health in India: A cross-sectional study

BackgroundCommunity health workers (CHWs) are central to India's strategy for reaching the Sustainable Development Goals around maternal and child health. Despite India's significant investment in these programs, few studies have analyzed the effect of CHWs across India. ObjectiveThis study aims to analyze multiple types of CHWs and their impact on a broad range of antenatal and infant health outcomes across India. MethodsIn this population-based cross-sectional study, we analyzed data of women interviewed by the most recent 2015–2016 National Family Health Survey-4 (NFHS-4) in India. This study performed multiple variable regressions to examine the effect of receiving ANC during pregnancy from 1) any CHW and 2) by specific type of CHW - Accredited Social Health Activist (ASHA), Anganwadi Worker (AWW), and Community/Village Health Worker (defined in Table 1) on antenatal and infant health outcomes. ResultsOf 166,498 women, 14.2% received ANC from any CHW with specifically 5.9% receiving from ASHAs, 10.2% receiving from AWWs, and 0.5% receiving from Community/Village Health Workers. Women who received ANC from an ASHA had increased ANC utilization (OR 1.77; 95% CI 1.65, 1.91) as well as quality (IRR 1.06; 95% CI 1.05, 1.08), increased early initiation of breast feeding (OR 1.20; 95% CI 1.12, 1.29), and decreased one-year mortality (OR 0.75; 95% CI 0.63, 0.88). Women who received ANC from an AWW had increased ANC utilization (OR 2.24; 95% CI 2.12, 2.37) as well as quality (IRR 1.07, 95% CI 1.06, 1.08) and increased early initiation of breast feeding (OR 1.30; 95% CI 1.26, 1.40). ConclusionReceiving ANC from ASHAs and AWWs is associated with improved ANC utilization, ANC quality, early initiation of breastfeeding and the key outcome of reduced infant mortality.

Integrated approach for survival and development during first 1000 day of life

Introduction: With increased evidence of the association between early child-rearing practices and children's health, growth, and development, the government of India has introduced several policies and strategies, of which the home-based care for young child (HBYC) is the most recent. An assessment was conducted in three aspirational districts in Jharkhand to see system preparedness for implementation of the program. Material &amp; Methods: Eight district key health personnel from 3 districts were interviewed on health systems readiness components. A total of 100 Sahiyas (Accredited Social Health Activists) and 100 mothers were selected across 8 villages in 2 blocks in each of the 3 districts of Lohardaga, Simdega, and West Singhbhum, and interviewed with a structured questionnaire on knowledge and practices. In addition, 24 auxiliary nurse midwifes, Sahiya Sathis, and Anganwadi workers were interviewed. Data collection teams underwent an orientation. Results: Most nodal persons were recruited; however, orientation to HBYC and awareness of key components such as incentives, supervision mechanism, and monitoring indicators was lacking. Supply of prophylactics and equipment was inadequate. Knowledge of community health workers was inadequate for many child care indicators except Oral Rehydration Salt (ORS) preparation (96%) and initiation of complementary feeding (97%). Knowledge of danger signs requiring referrals was particularly low (30%). Mothers' knowledge and practices were low on all the indicators. Conclusion: The HBYC program can build its success on the present health system functioning by tailoring trainings to focus on gaps in knowledge, addressing specific gaps in supplies, improving supervision, and integration efforts

The Functions of Integrated Child Development Services (ICDS): An Assessment of Existing Policy and Practice in Odisha

The Integrated Child Development Services (ICDS) scheme is the world’s biggest and unique programme for nutrition and childcare, launched way back on 2 October 1975 by the Government of India. It is a centrally subsidised scheme implemented by states across the country for the benefit of children, especially for vulnerable groups. The scheme’s main objective is to improve the health and nutritional condition of children below six years of age, along with pregnant women and lactating mothers. The objective of the study is to critically analyse functions of the ICDS Scheme in the state of Odisha about implementation and monitoring. The analysis was done with the help of secondary literature and available data from government documents. The opinion and experience of various stakeholders like Anganwadi workers, supervisors and other government staff have been analysed for this purpose. This article describes existing policies and procedures of food procurement, storing, supply, cooking, production and serving cycle under ICDS Scheme in Odisha. The recommendations of the study may help for future improvement of various thrust areas of the ICDS Scheme. The article brings out critical factors accountable for the efficient implementation of the ICDS programme. Further, the study evaluates the ICDS Scheme based on existing government guidelines to reach out to the masses in Odisha.

Anganwadi centres in society

According to Mahatma Gandhi, “if you educate a man you educate an individual, but if you educate a woman you educate an entire nation.” India, in spite of having the world’s largest youth population, it has been struggling a lot with the lack of efficient implementation of various policies in the health care system. Since majority of India’s population is still residing in the villages, which have a greater say in the overall development of the nation but they are left untouched most of the times either due to improper implementation of the policies or hindrances in the process of development of health care system. Anganwadi’s are India's backbone in delivering the healthcare that everyone in country can access to it, by focussing on nutritional supplementation, women’s health and so on. This paper is an attempt to shine the light on the impact of the Anganwadi centres in improving the health status of people in the rural areas at grassroot level, focusing especially on women and children’s health and the association between the potential contribution of the Anganwadi workers and the child health indicators. Also, current pandemic influences on the centres were quoted.

Integrated Child Development Services (ICDS) Scheme in India - a tired horse or an ignored one. An evaluation in a tribal district of Maharashtra, India

Introduction: The lives of children and women are the true indicators of the strength of communities and nations. UNICEF considers Child Mortality rate as the single best indicator of social development and well-being. Integrated Child Development Services (ICDS) Scheme is one of the largest maternal and child health programs representing a symbol of India’s commitment to its children. The anganwadi centre (AWC) is the grassroot functionary of ICDS and the program is executed through dedicated cadre of female workers named Anganwadi workers (AWWs). Still India records high infant, child and maternal mortality rates. Also, frequent malnutrition related deaths in the state of Maharashtra has raised questions on the implementation of these programmes. This study was conducted to evaluate the functionality of Anganwadi Centres in terms of infrastructure and logistics and assess the satisfaction of Anganwadi workers. Methodology: This was a community based cross-sectional descriptive study in the tribal district of Palghar in Maharashtra. Universal sample of all the Anganwadi centres under the randomly selected PHC was adopted for the study. Data for the study was collected by using personal interview technique with the help of a semi structured questionnaire and by self-observation using a standard checklist. The data collected was analysed using appropriate descriptive statistics with the help of Epi info. Result: Only just about half of the AWCs were functioning in their own building. Among infrastructure and logistics, registers for record keeping was found to be most deficient (88.9%) followed by presence of electricity and baby weighing machine (77.8%). Availability of separate kitchen and storeroom and regularity of supplementary nutrition supply was seen deficient in 69.4% of AWCs. Growth card was the most available amenity (100%) followed by adult weighing machine which was present in 91.7% of AWCs and drinking water facility in 86.1%. Toilet was present in only about half of the AWCs studied. Among the various problems accounting for poor job satisfaction among AWWs, some of the prominent were, lack of own anganwadi building, inadequate space for activities, lack of teaching materials, problems in eliciting the Supplementary Nutrition Programme (SNP) due to inadequacy or irregularity of the supplementary nutrition supply, and absence of separate kitchen. Other problems faced were low government and community involvement, increased workload and a modest honorarium. Conclusion: Studies conducted across the country, has observed that various factors contributed to the efficient service delivery of ICDS. Our study exposes some key factors that affect the effective implementation of the scheme and the felt needs of its implementers at the grass root level.

Assessment of Integrated Child Development Services (ICDS) at Grass Root Level in an Urban Area, Raigad District, Maharashtra

Background: ICDS is an integrated program intended for Maternal and Child Care which adopts a holistic, lifecycle approach. Its main focus is on health, nutrition and education. Urban ICDS caters to the vulnerable urban slum population. Despite the program running for four decades its impact on its beneficiaries is still slow. The Anganwadi worker and helper are the grass-root functionaries running this program through Anganwadi centre. Hence this study was conducted to assess the functioning of the Anganwadi centre. Methodology: A Descriptive Cross-sectional study was conducted at all 15 urban-ICDS Anganwadi Centres of Khopoli during September-November 2019. The Anganwadi workers and helpers were interviewed regarding their sociodemographic details, knowledge and challenges perceived to run the centre. Observational Checklist designed based on guidelines and standard proforma for monitoring of the ICDS projects was used to assess infrastructure, equipment and registers. Results: Out of 14, 11(78.57%) Anganwadi workers had more than a decade experience. Indoor space of 600 sq.ft was available in 7(46.67%) centres. Toilets with running water were available in 9(60%) Anganwadi Centres and 6(40%) were linked to the school. Functional Salter’s weighing scale was available in 11(73.33%) Anganwadi centres. All 12 registers were available in 9(60%) Anganwadi centres. The utilization of services by pregnant women was the highest. Partially immunized children were present in 2(13.33%) Anganwadi centres. The service gap was highest (100%) with health check-up. Conclusions: There is a gap in the availability of infrastructure and utilization of some services. Keywords: urban ICDS, Maharashtra, Service gap.

Rehabilitation of Special Needs Children at Pre-school Level: A Study of Attitude of Integrated Child Development Services Functionaries and Parents

The Integrated Child Development Services (ICDS) is a significant scheme that works for rehabilitation of different categories of children including special needs children at pre-school level in India. For rehabilitation of special needs children at pre-school level, the ICDS functionaries and parents (of the children) play the vital role. For developing the favorable attitude of ICDS functionaries and parents towards rehabilitation of special needs children at pre-school level, it is important to study the attitude of ICDS functionaries and parents towards rehabilitation of special needs children at pre-school level. Hence, in this study an attempt was made to study the attitudes of ICDS functionaries (Child Development Project Officers, Supervisors and Anganwadi workers) and parents towards rehabilitation of special needs children at pre-school level. The study was a descriptive survey-cum-comparative type research. 36 Child Development Project Officers (CDPOs), 108 Supervisors, 108 Anganwadi workers (AWWs), and 216 parents under thirty six ICDS projects from nine administrative districts of Assam were taken as participants of the study. A self-developed attitude scale was used to collect data from the participants. Mainly quantitative data analysis techniques were used to analyze the data of the study. The major findings of the study indicated that all the ICDS functionaries and parents have shown high attitude towards rehabilitation of special needs children at pre-school level; and CDPOs possess better attitude than the supervisors, and parents possess better attitude than the supervisors towards rehabilitation of special needs children at pre-school level. And from the study, it is also found that the background variable ‘experience’ of the supervisors acts as a determining factor in determining the attitude of the supervisors towards rehabilitation of special needs children at pre-school whereas no other background variable of the supervisors and none of the background variables of the CDPOs, AWWs and parents acts as a determining factor in determining their attitude towards rehabilitation of special needs children at pre-school level.