Integrated Child Development Scheme Research Articles

Regional patterns in minimum diet diversity failure and associated factors among children aged 6-23 months in India.

Background About 35% of the global child deaths and 11% of the total disease burden are due to inadequate nutrition. While in India, 1 in 3 children are underweight and stunted, and 1 in 5 children are wasted. Methods Using multivariate and descriptive statistical analysis, we examined the prevalence, determinants of minimum diet diversity failure (MDDF) and trends of MDDF across different regions of India among children aged 6-23 months. Dietary pattern in 8 food groups was also examined using the National Family and Health Survey (NFHS) data from 2005-06 to 2019-21. Results Overall, MDDF in India has decreased from 87.4% (2005-06) to 77.1% (2019-21). The central region (84.6%) reported the highest prevalence of MDDF in 2019-21. Children of illiterate and rural residing mothers with no mass media exposure, children of the first birth order and children not exposed to counselling and health check-ups at Anganwadi/Integrated Child Development Services (ICDS) centres, children with low birth weight and anaemic, and who belonged to a large family had greater likelihood for MDDF. Conclusion To tackle the high prevalence of MDDF, a holistic action is needed from the government, i.e. improved public distribution system (PDS), intensified Integrated Child Development Scheme (ICDS) programme, use of social media, and nutrition counselling through local self-governance.

Impact of integrated child development scheme on nutritional and health status of children

The Indian government’s centerpiece initiative, the Integrated Child Development Scheme (ICDS) project, aims to improve the overall growth, wellness, and nutrition of children under six years old and pregnant and breastfeeding mothers’ nutritional and physical well-being. KanyaKumari (KK) district, located in the southern state of Tamil Nadu, has also benefited from this program. Using a questionnaire survey method, valid data were collected from 120 participants, and interviews were subsequently conducted with 52 individuals to gain deeper insights into the research topic. SPSS statistical software was utilized. The program under assessment, the ICDS, targets children under six and pregnant and lactating mothers, offering services like nutrition, healthcare, and early childhood education to improve their health and Nutritional Status (NS). The indicators being assessed include nutritional and Health Status (HS) (e.g., malnutrition, immunization rates) to decrease malnutrition and improve overall health outcomes. The findings of this study indicate that the prevalence of child malnutrition has decreased, suggesting that the ICDS has been effective in improving the NHC. The novelty of this research lies in its specific focus on the KK district, its evaluation of a government program’s impact, and its emphasis on child welfare and development. The study’s insights on integrated child development programs can inform policymakers, healthcare providers, and community groups globally, aiding efforts to improve child health and nutrition implications. The ICDS has had a positive impact on the NHC in the KK district. However, continuous efforts are required to overcome challenges and ensure the sustained success of the program in the district.

Lived Experiences of Children in the Child Protection System in New Delhi

Ever since the ratification of the United Nations Convention on Rights of the Child in 1992, India has come a long way in drafting and re-drafting schemes, policies and laws to protect children from abuse, neglect and exploitation. While a lot of thought is put into drafting these legislations and policies, their implementation varies substantially across states, limiting the fulfilment of their objectives. The two prevalent schemes for children are the Integrated Child Development Scheme and the Integrated Child Protection Scheme. Substantial literature is available on the former, limited research and data are available on the latter. Most studies falling under this domain focus on analysing and criticising the legislations, but not on their impact. Children have always been considered as a sensitive and vulnerable group to work with and due to limited access to these sensitive spaces, scholars and researchers have been hesitant to record and document the voices and perspectives of children towards a scheme that focuses and works for their holistic development. Through this study, the researcher has tried to view the Child Protection System from the lived experiences of 10 children who are/have been part of the Child Protection System in Delhi.

Geospatial Analysis of Parental Healthcare-Seeking Behavior in the Vicinity of Multispecialty Hospital in India.

The healthcare-seeking behavior of vulnerable groups, such as children under five, depends on a multitude of factors, including the caregiver's decision making. Approximately 60% of Indians seek care from private hospitals. Recent health policy in India has favored the establishment of multispecialty hospitals. However, it remains unclear to what extent this policy has changed the number of Indians seeking healthcare from these government-established multispecialty hospitals. The study aims to assess the health-seeking behavior of parents of children under five in the vicinity of a public multispecialty tertiary care hospital. This was a community-based cross-sectional survey with geospatial mapping conducted among the parents of children under five using a semi-structured questionnaire in Epi-collect mobile app. The study site was an urban slum in a catchment area [within five kilometers (km)] of a multispecialty tertiary care public hospital in the central Indian state of Chhattisgarh. The study was conducted for one year duration from February 2019 to January 2020. A questionnaire was administered to the parents of the children under five (N = 353) after their household confirmation from the nearby Anganwadi center, the community level service providing center under the Integrated Child Development Scheme by the Ministry of Women and Child Development (WCD). The questionnaire included sections for demographic characteristics, the illness pattern among their children, health-seeking decision-making, and more. Descriptive analysis was presented with numbers and percentages. Univariate analysis was used to assess the association between sociodemographic variables and health-seeking characteristics. Statistical significance was considered at p value less than 0.05. We used geospatial mapping using coordinates collected and compiled using the Microsoft Excel version 2021 and analyzed using QGIS (Quantum Geographic Information System) software. Among the parents interviewed patients (N = 353), maternal literacy rates were over 85%. Approximately 54% of the families were below poverty line. Among 95.2% of the families, mothers were part of decision-making regarding their children's health-seeking. Over 92% of the families opted for consultation in a nearby private hospital or dispensary. Geospatial mapping of private hospitals was a favored place for healthcare-seeking by mothers, irrespective of their socioeconomic status or education rather than multispecialty hospital. The majority of the parents in the vicinity of public multispecialty hospitals seek care from private clinics for ailments for children under five. The establishment of public multispecialty tertiary care hospitals, which are mandated for tertiary level of care and research, cannot replace primary-level healthcare institutions, showed that private hospitals were the favored places healthcare seeking by mothers. These primary-level institutions are critical for the management of common ailments for children under five near home and reducing the financial burden on the family, even in the vicinity of a multispecialty hospital.

A Study of the Role Performance of the Anganwadi Supervisors

The success of any developmental programme depends on the performance of its functionaries. It is also so in case of Integrated Child Development Scheme, which is operated by Anganwadi Centers through where the Anganwadi worker is the actual doer of the programme at the grassroot level and the supervisor who guide them in all their activities plays a key role in attaining the objectives of the programme. Supervisor acts as a link between administrators and field level functionaries in transmitting the directions to the ground level and feed back to the higher-ups. The knowledge of the performance of the supervisors will go a long way in formulating the training curriculum of the Anganwadi workers and also the supervisors, to identify the strengths and weaknesses of the progranmme and to replicate and rectification respectively. The present study is aimed to identify the profile of the serving supervisors, assess their performance in selected areas and to study the relationship between the personal characteristics and their performance.

Assessment of knowledge and practices of Anganwadi workers about integrated child development scheme services in rural Assam

Assessment of knowledge and practices of Anganwadi workers about integrated child development scheme services in rural Assam

A Study to Assess the Awareness and Utilization of Integrated Child Development Scheme (ICDS) Services among the Mothers of Children under 6 Years of Age in a Selected Rural Community of Lakhimpur District, Assam

A Study to Assess the Awareness and Utilization of Integrated Child Development Scheme (ICDS) Services among the Mothers of Children under 6 Years of Age in a Selected Rural Community of Lakhimpur District, Assam

Centrally-sponsored Schemes and Cooperative Federalism in India: A Case Study of Integrated Child Development Scheme

This article attempts to explore the dynamics of cooperative federalism in India through a case study of the Integrated Child Development Scheme (ICDS), a Centrally Sponsored Scheme initiated by the Government of India in 1975 for the health and nutrition of pregnant and lactating women and children of below six years of age. The study of ICDS provides an interesting case to study vertical and horizontal federalism and its interlinkages and the spirit and working of cooperative federalism in India. The article analyses the performance of ICDS in different states by emphasizing factors, such as party congruence, the commitment of the Chief Minister, awareness of the community, functioning of the NGOs and so on. The study has involved fieldwork in some districts of Gujarat and Punjab and relied on government reports and some secondary literature to understand the functioning of ICDS in other states, such as Odisha, Tamil Nadu, and Jammu and Kashmir. Our fieldwork brought to light the fact that there were variations not only in the success rate but also in the number of actors involved in the implementation of the scheme in different states and the adoption of some innovations by particular states. There were pilot initiatives introduced in some districts, such as the toy bank initiative, School Enrolment Drive, Mobile Anganwadi vans, Insurance scheme for Anganwadi workers and felicitation of Anganwadi workers (Mata Yashoda Awards). The study of multi-level federal structure in India is crucial for a holistic understanding of the implementation of the centrally-sponsored schemes in India including ICDS.

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

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.

Association of Socioeconomic Factors with Nutritional Status of 3–6-Year-Old Preschool Children in Urban Slum Areas of Karad

Background: Children are the most important foundation and future of country. Malnutrition is an indirect cause of death in preschool children living in urban slum and they belong to lower socioeconomic condition with inadequate basic facilities such as food, housing, and sanitation, as these cause malnutrition, morbidity and mortality in children. Objective: The objective is to determine the association of socioeconomic factors with nutritional status of 3–6-year-old Preschool Children. Materials and Methods: A community-based cross-sectional study was conducted in six urban slum areas of Karad, Maharashtra. Data were collected from 137 mothers and their preschool children selected by convenient sampling technique. Data were collected by self-structured questionnaire on demographic variables and anthropometric measurements (height and weight) of preschool children. Malnutrition was classified based World Health Organization classification by calculation of Z score for weight-for-age, height-for-age, and weight-for-height. Data were analyzed by descriptive and inferential statistics. Results: Results show that the prevalence of underweight, stunting, and wasting was 43%, 36.5%, and 28.41%, respectively. There was a significant association between the age of child in months and stunting of children (χ2 = 15.868, P = 0.003). A significant association between height for the age of preschool children and demographic variables of mother such as monthly income of the family (χ2 = 15.944, P = 0.014) and weight-for-height of preschool children and occupation of mother (χ2 = 10.218, P = 0.037). Conclusion: The prevalence of malnutrition was high in urban slum areas in spite nutrition supplements provided by Anganwadis under integrated child development scheme (ICDS) Scheme so there is a need for improvement of living conditions and sanitation in these areas and empowerment of women through education and occupation so mothers can afford good healthy nutritious diet and health care facility for their children.

Impact on Public Health Nutrition Services Due to COVID-19 Pandemic in India: A Scoping Review of Primary Studies on Health and Social Security Determinants Affecting the First 1000 Days of Life.

COVID-19 was declared 'a global pandemic' by the World Health Organization in March 2020. India's lockdown, one of the harshest in the world, came with additional challenges for women. This paper aims to assess the impact of COVID-19 pandemic-related pathways on the first thousand days of life in the Integrated Child Development Scheme and the public distribution ecosystem in India. Using Cochrane guidelines, electronic databases, namely Google Scholar and PubMed-NCBI, were searched for evidence between 1 March 2020 and 1 May 2022. A total of 73 studies were identified in initial search; 20 met the inclusion criteria and, thus, were included in the research analysis. Primary studies were conducted throughout pan-India in rural, urban, and semi-urban areas to study the impact of COVID-19 pandemic-related pathways on the first 1000 days of life. The impact of social security, food insecurity, service delivery, nutrition of pregnant and nursing mothers (P&NMs), and infant and young child feeding (IYCF) varied between geographies and within geographies. Most of the primary studies were conducted at small scale, while only three studies were pan-Indian. The majority of studies were conducted on the mental health of P&NMs and pre-natal and post-natal service delivery disruption. The paucity of the available literature highlights the need to undertake research on the impact of the COVID-19 pandemic-related pathways on 1000 days of life in India and worldwide. The best implementation practices were observed where cross-sectional programs were carried out in relation to health services and social security for P&NMs and children.

Systematic Review of Literature on Quality of Preschool Services in Aganwadis

The paper highlights the implementation and execution of the Early Childhood Education (ECE) program under Integrated Child Development Scheme (ICDS) which was started in 1975. The scheme has been popularized with its need based programs for the larger benefit of millions of children across the country, who is the real assets of the country. The study focus the various aspects of ECE like organizational structure, learning climate, health and hygiene, monitoring and supervision mechanism as well as the infrastructure of the Anganwadi Centers. Pre-school education shoulders the responsibility of making children able to enter into formal schooling. It needs to be recognized as a precondition for the healthy mental and emotional development of children. Rapid growth during the early childhood stages requires the provision of a suitable environment to catalyze the multifaceted development of young children.

Life and Work of Anganwadi Workers: A Literature Survey

The Integrated Child Development Scheme (ICDS) is a welfare scheme of the government of India. The Anganwadi workers are primarily responsible for delivering the services of the ICDS scheme. This study will enable us to gain an insight into the lives of Anganwadi workers. The past literatures are critically analyzed to understand the role, responsibilities, and problems pertaining to job satisfaction of such workers. From the detailed analysis it is found that Anganwadi workers are highly dedicated group of workers and has a potential to play a vital role in transforming the state of the society, but there are certain problems which needs to be addressed so that the job satisfaction and motivation level of such workers can be enhanced. They play a nation building role yet no heed has been paid to improve the job condition and general wellbeing of the workers even after almost two decades of dedicated services. The problem and causes of job satisfaction and job dissatisfaction of the Anganwadi workers are identified.

A comparative analysis among three world health organization growth charts

Background: India is in a phase of nutrition transition. Child nutrition and growth monitoring services are provided under the state-run Integrated Child Development Scheme program. Classically, only one kind of growth chart is used to quantify nutrition status and categorize the children. Materials and Methods: This cross-sectional study involving 222 children was done to compare the outcome of nutritional status evaluated using three World Health Organization growth charts: weight-for-age, height-for-age, and weight-for-height. The results obtained by the use of these three charts were further compared and analyzed for concordance. Results: The three growth charts showed that 58% of children were underweight, 53% had stunting, and 35% were wasted among the study population. The comparisons using sensitivity/specificity, Kappa statistics, and ANOVA showed bidirectional disagreements between the three charts. Similar results could be deduced from large surveys done previously in Iraq and Congo. Conclusion: Hence, simultaneous use of three growth charts to categorize nutrition status is essential. This will help in preventing missing out cases of malnutrition and perhaps may aid in detecting child malnutrition at a relatively earlier stage.

Editorial

Editorial

Coluthur Gopalan. 28 November 1918—3 October 2019

Gopalan was a brilliant medical student. The Bengal famine of 1942 made him decide to devote his career to ‘the investigation and mitigation of the nutrition-related problems of Indians, especially those of the disadvantaged sections’. He was the first Indian to win a Nuffield Foundation research scholarship to study in England in 1946. In less than three years he had earned a PhD as well as a DSc in nutrition. He returned to India and joined the Nutrition Research Laboratory in Coonoor. His studies over the next decade showed that, contrary to the global belief, both kwashiorkor and marasmus were manifestations of protein energy malnutrition. His research studies on improving the nutritional status of pregnant women and children with food supplementation led to the initiation of India's Integrated Child Development Scheme and Mid-day Meal programmes. India's National Anaemia Prophylaxis Programme and Massive Dose Vitamin A Supplementation Programme were also initiated on the basis of the studies he led. As Director General of the Indian Council of Medical Research he created institutions to undertake research in the areas of neglected tropical diseases and medical statistics. He initiated the National Talent Search Scheme to ensure adequate human resources for medical research. After he retired, he set up the Nutrition Foundation of India, to continue with policy and operational research studies on the triple burden of malnutrition. He initiated the setting up of the Nutrition Society of India and the Federation of Asian Nutrition Societies to improve networking among nutrition scientists. In reply to a query on his major contributions, he said: ‘I helped to get Nutrition Science in India the recognition it deserved, and I built institutions that will serve the people of India long after my lifetime.’

Prevalence and detecting spatial clustering of anaemia among children 6–59 months in the districts of India

BackgroundAmong the developing countries, India was the largest contributor to child anaemia in the last decade. It has many harmful effects on children's lifestyle as it reduces learning capacity, attentiveness and intelligence. The study attempts to identify the spatial prevalence and detect the clustering of anaemia in India based on National Family Heath Survey-IV, 2015–16 and also tries to identify the determinants of anaemia among children (6–59 months). MethodsThe study uses spatial analysis software ArcGIS 10.8 and GeoDa1.18 including Moran's index. Logistic regression model is applied by using STATA-14, to assess the effects of socio-economic and demographic, maternal and child characteristic predictors of prevalence of anaemia among children. ResultsThe anaemia prevalence is highest in Dadra & Nagar Haveli and lowest in Meghalaya. A total of 321 districts are having more than the national level average (58.65 %) of anaemia. Study also finds 110 districts as the hot-spot areas (Moran's I = 0.63) mostly from central, western, south-western, northern and eastern parts of India. Increase of mother's age, education, receipt of full ANC and richer wealth quantile reduce the risk of childhood anaemia. On the other hand, underweight mothers, children in the age group 12–23 months, underweight children and higher birth order increase the risk of childhood anaemia. ConclusionThe study suggests targeting the hot-spot districts with a high prevalence of anaemia and policy-level interventions addressing micronutrient deficiency like the Integrated Child Development Scheme, to reduce the risk of childhood anaemia.

1000 Versus 635 Days Approach for Prevention of Undernutrition in Children

Since the pre-independence era, India is dealing with a variety of health problems that have been eliminated in developed nations. As we prepare to enter post covid era, a problem which we are dealing since ages is child promotion and child survival. India is a nuclear weapon-affiliated country now but it still has a long way to go as far as child malnutrition is concerned. It is a surprising fact to know that the prevalence of malnutrition in India is double that of sub-Saharan country.[1] It has been 45 years since the launch of the Integrated Child Development Scheme (ICDS) and we still have 35.8% of undernourished children in our country makes one think about the drawbacks in our current approach. [2] There are a wide variety of reasons for decreased weight inchildren under the age of 5. Interestingly inadequate food security is considered as one of the primary reasons, however,it does not justify the 20.1% of underweight children belonging to high socioeconomic status.[2] Other reasons include infections i.e. diarrhea and acute respiratory infections in children and it could be attributed to a moderate rate (approximately 62%) of immunization in the under 5 age group.[2]

Assess the knowledge, utilization, level of satisfaction of utilization and barriers of non-utilization regarding Integrated Child Development Services (ICDS) among women of Ernakulam District, Kerala, India

IntroductionThe integrated child development scheme (ICDS) was launched in 1975 to provide an integrated package of services to aid the holistic development of the child. The beneficiaries of this scheme are children below the age of six, pregnant and lactating women in the age group of 15–45 years. ObjectivesThe objectives of the present study were to assess the knowledge, utilization, level of satisfaction of utilization and barriers of non-utilization regarding Integrated Child Development Services (ICDS) among women. MethodsThis study adopted a quantitative approach using a descriptive survey design. Convenience sampling technique was used to collect data from 553 women between the age group of 18–45 years residing in Ernakulam district, Kerala, India. Five tools were used to collect the data. The obtained data from 553 women entered in data sheet using SPSS version 20 and was analyzed by using descriptive statistics. ResultsMajority women (68.5%) had average knowledge regarding ICDS services. Mothers who had under five children utilized more ICDS services (90.5%) compared to pregnant women (48.7%) and lactating mothers (27.2%). Majority women (75%) were highly satisfied with utilization of ICDS services. The first and foremost barrier for non-utilization of ICDS services among women was lack of time due to work (60%). ConclusionThe ICDS programme is a globally recognized community based programme, which addresses the basic interrelated needs of young children and mothers, in a holistic manner.

Gut bacterial profile in Indian children of varying nutritional status: a comparative pilot study.

PurposeChildhood malnutrition is a multifactorial disease, responsible for nearly half of all deaths in children under five. Lately, the probable association of a dysbiotic gut to malnutrition is also being eagerly investigated. The current study is an attempt to investigate this purported association through assessing the abundance of major gut bacterial phyla (Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria), probionts (Bifidobacteria and Lactobacillus), butyrogens (Faecalibacterium and Roseburia) and pathogens (Escherichia and Klebsiella).MethodsThe study was conducted in the suburbs of Chandigarh, India in the year 2017. The children enrolled in the study were part of Anganwadis (Rural Child Care Centres) set up under Integrated Child Development Scheme (ICDS) of Government of India where community-based management approach is being widely used for treatment of malnutrition. We used qPCR based absolute quantification as well as the 16S rRNA amplicon sequencing approach for our study. The study population included 30 children in the age group of 2–5 years who were categorized into three groups Healthy, Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM), with 10 children in each group. The selection of participants was made based on Z scores. Further, statistical tools like the One-way ANOVA, PCA and PLSDA were employed to analyze and compare the gut bacterial profile.ResultsOur investigation through the qPCR (Absolute quantification) approach revealed a significantly higher abundance of Actinobacteria in healthy, in comparison to children suffering from Severe Acute Malnutrition (SAM). Consequently, the same trend was also reflected with respect to Bifidobacterium, a prominent member of the Actinobacteria phylum. Conversely, a significant higher abundance of Lactobacillus with the diminishing nutritional status was recorded. Escherichia showed a significant higher abundance in healthy subjects compared to the malnourished; however, no such difference in abundance of Klebsiella was observed. The other target phyla [Bacteroidetes, Firmicutes and Proteobacteria] and genera (Faecalibacterium and Roseburia) showed differences in abundance; however, these were non-significant. Similarly, the bacterial taxonomy analysis of 16S rRNA gene amplicon sequencing data revealed the higher abundance of phylum Actinobacteria and its member Bifidobacterium with lower prevalence of Lactobacillus in healthy children.ConclusionThe pattern of gut microbiota profile in malnourished subjects suggests a dysbiotic gut depleted in Bifidobacteria, a core member of the consortia of beneficial anaerobes of the healthy child gut.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00394-021-02571-7.