Integrated Child Development Services Research Articles

Job Involvement among ICDS Scheme Functionaries in India: Assessing Extension Needs for Enhanced Performance

Job involvement is psychological identification with one’s work as well as degree to which the job situation is central to person and his identity. Human behavior plays a pivotal role in maximizing organizational effectiveness irrespective of the technological support and their involvement in their job is critical for successful achievement of its objectives. ICDS (Integrated Child Development Services) is a comprehensive scheme of Govt. of India enriches human resource and tackles malnutrition and health problems in children below six years of age and their mothers. The services to the beneficiaries, who are pregnant women, Lactating Mothers, children under 5 years, adolescents and adult women, are provided at Centre called as Anganwadi. The grass-root level functionaries at the center are called Anganwadi workers (AWW) who executes ICDS scheme as per the Government guidelines to raise the level of health and nutrition, create proper mental, physical and social development of children below six years; to reduce mortality and malnutrition and dropouts. Since job involvement contributes to overall availability of human resource, the success of the ICDS programme extents to effective and successful working of AWWs. The study was conducted to know the job- involvement of AWWs and AWHs – the grass-root functionaries of ICDS scheme. The conducted in one of the blocks of Faizabad District situated in Eastern part of Uttar Pradesh state. One hundred AWWs were randomly selected from 182 AWWs in the block and administered interview schedule and standardized Job Involvement scale by Dr. A.P Singh. The data collected revealed that AWWs were highly involved (47%), moderately involved (37%) and rest (16%) had low involvement. Analysis further found that job involvement and income of the workers; educational qualification and work experience are significantly dependent.

National Programmes Related to Child Health

There are many national health programmes which are been designed for new borns as well as childrens also in India, namely, PROMOTION OF ZINC AND ORS NSSK- NAVAJAAT SHISHU SURAKSHA KARYAKRAMA ICDS - INTEGRATED CHILD DEVELOPMENT SERVICES UPI - UNIVERSAL IMMUNIZATION PROGAMME JANANI SHISHU SURAKSHA KARYAKRAMA RBSK – RASHTRIYA BALA SWASTHYA KARYAKRAMA RKSK - RASHTRIYA KISHOR SWASTHYA KARYAKRAMA MISSION INDRADHANUSH JANANI SURAKSHA YOJANA NATIONAL DEWORMING DAY, These schemes helps in promotion and safe guard the health of newborns, neonates, infants, toddlers, childrens and adolescents. These programmes also helps in uplifment of health of pregnant women and feeding mothers. If the nutrition level of the pregnant women is uplifted then there will be no severe acute malnutrition in the children. If there is no severe acute malnutrition in the children then the immunity of the children will be stable. If the immunity level is under stable then no diseases in children thus the nation will be healthy.

Exploring factors affecting Anganwadi workers’ performance motivation: a mixed-methods study in a tertiary care center of central India

Background: The integrated child development services (ICDS) scheme in India employs Anganwadi workers (AWWs) to improve child well-being, reduce health risks, and support maternal education. Despite their crucial role, factors influencing AWWs’ motivation and performance are not well understood. This study examined how individual, program, community, and organizational factors impact AWWs’ motivation in a tertiary care center in central India. Methods: A mixed-methods study was conducted in a tertiary care center in central India, involving 105 AWWs surveyed with a validated questionnaire and 40 AWWs participating in focus group discussions. The study explored individual, community, and health system factors influencing AWWs’ motivation. Results: Results showed that motivation levels were high among 42.85% of AWWs, moderate among 40%, and low among 17.14%. Key motivators included social responsibility, job satisfaction, supportive supervision, and adequate training. However, demotivating factors included inadequate incentives, high workload, insufficient family support, and lack of essential tools and supplies. Conclusions: AWWs’ performance motivation is influenced by a combination of individual, community, and health system factors. Enhancing their motivation requires addressing these factors through targeted interventions such as improved incentives, workload management, better family support, and ensuring the availability of essential tools and supplies. Understanding and addressing these factors can significantly enhance the effectiveness of the ICDS scheme.

Dr. Coluthur Gopalan: Father of Indian Nutrition Science.

Dr. Coluthur Gopalan, a towering figure in nutrition science in India, made seminal contributions that transformed public health and nutrition policy in the country. Born in Salem, Tamil Nadu, in 1918, Dr. Gopalan's illustrious academic journey began at the Christian College High School and Madras Medical College, where he earned his M.D. in General Medicine in 1943. The Bengal Famine of 1942 profoundly influenced his career, steering him towards nutrition research. Awarded the Nuffield Foundation Scholarship, he earned a Ph.D. in nutrition from the University of London in just 30 months. Upon his return to India, he joined the Nutrition Research Laboratories (NRL) in Coonoor in 1949, which later became the National Institute of Nutrition (NIN), where he significantly broadened the scope of nutrition research. Dr. Gopalan's work laid the foundation for pivotal national nutrition programs, such as the Integrated Child Development Services (ICDS) and the midday meal scheme for schoolchildren. His tenure as Director of NIN (1960-1974) and later as Director General of the Indian Council of Medical Research (ICMR) from 1974 to 1979 saw major advancements in addressing malnutrition and emerging issues like overnutrition. His dedication to improving women's and children's nutritional status left a lasting impact on public health in India. Dr. Gopalan's pioneering research on protein-calorie malnutrition, micronutrient deficiencies, and holistic approaches to nutritional problems provided critical insights and guided thenational policies. As an institution builder, he transformed NIN into a premier research center and during his tenure established new research institutes at ICMR, fostering a robust framework for future research. His advocacy ensured that nutrition was prioritized in national development plans, leading to significant health improvements. Internationally recognized, Dr. Gopalan's contributions included efforts to improve global nutrition, earning him numerous accolades. His legacy, encapsulated in the Nutrition Foundation of India, and his several contributionscontinueto be a vital resource for nutritionists and policymakers, ensuring lasting benefits for future generations. Dr. Gopalan's compassionate personality, visionary leadership, and holistic approach have indelibly advanced the nutritional status and health of millions globally.

Satisfaction of mothers with supplementary nutritional services through Anganwadi centres in an urban area of Meerut, India.

Undernutrition in children under 5 years of age is still a great public health burden. Integrated child development services (ICDS) were launched with an idea of making a dent on this age-old issue. Various studies in the past have been done to identify lacunae in the programme, but very few studies are done focussing on the satisfaction of mothers with the supplementary nutrition provided through ICDS programme. The utilisation of the programme depends on various factors, one of which is client satisfaction. The Anganwadi centres of urban areas of Meerut were line-listed after taking a list of Anganwadis from the Child Development Office. There are 297 Anganwadis in urban areas of Meerut. With help of random number tables, three Anganwadis were selected, and to complete the sample of 152, 51 children from two Anganwadis and 50 from one Anganwadi centre were selected with help of simple random tables. The data thus collected were analysed using Epiinfo version 7.2.3.1. The prevalence of underweight was found to be 34.2%, wasted 19.7%, and stunted 11.2%. Among the characteristics assessed, a majority of mothers, 58.5%, were dissatisfied with the frequency at which supplementary nutrition was provided from the Anganwadis. All children were provided Take Home Ration, and 100.0% of mothers reported using it for all family members. Still 63.2% of mothers were unaware about the iron supplementation in childhood and only 65.8% of mothers had satisfactory handwashing practices. In this study, a majority of mothers were dissatisfied with the frequency at which supplementary nutrition was provided to their children. Also, the prevalence of underweight children was significantly higher when mothers were not aware about the factors affecting nutrition in children. The Take Home Ration given for children was shared among family members in 100.0% families.

Knowledge and utilization of Integrated Child Development Services among antenatal women during COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare delivery system in both developed and developing countries. Many antenatal women skipped their regular antenatal check-ups due to fear of viral contamination and lack of transport facilities. Integrated Child Development Services (ICDS), which plays a major role in antenatal care, also suffered a great deal during the pandemic. 1. To assess knowledge and utilization of ICDS services by antenatal women during the COVID-19 pandemic. 2. To determine factors influencing the knowledge and utilization of ICDS services by antenatal women. 3. To determine the barriers to utilization of ICDS services during the pandemic. This study was conducted as a descriptive study in a tertiary care center. Antenatal women whose pregnancy period coincided with the second wave of the COVID-19 pandemic were interviewed using a structured questionnaire. The sample size was calculated as 198. Data were entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS). Around 61% of the study population had adequate knowledge about ICDS services. The proportion of antenatal women utilizing ICDS services reduced from 87.8% to 69.6% during the pandemic. Only a few of the mothers were followed up by the Anganwadi workers during the pandemic. The main barriers to not utilizing ICDS services were fear of the spread of the pathogen and lack of awareness about the availability of services during the pandemic. There has been a reduction in the utilization of ICDS services by antenatal women during the COVID-19 pandemic. Measures should be taken by the government to ensure undisrupted care for antenatal women during such hard times.

TIME TO CHANGE THE OUTLOOK OF ICDS SCHEME (AWCS): COMPREHENSIVE FACTS

India is one of the countries with malnutrition and associated health problems. It is also the country with high-level of regional disparity, social hierarchy and inclusive society and is recounted with highest mortality of children of less than 5 years of age with nearly 74 deaths per 1000 live births. As per the reports the hunger and malnutrition among children prevails in large pockets in India. Perusal of literature depicts that 38% of children younger than five years of age in India are stunted. The problem of undernourishment costs India at least $10 billion annually in terms of loss of productivity, illness and death and improvement in human development. ICDS represents the notable symbols of commitment and retort to the above mentioned challenges by providing pre-school education on one hand and simultaneously breaks the nasty cycle of starvation, morbidity, abridged learning capacity and mortality. ICDS hence is believed to be the most imperative and focal progamme with positive role in tackling India’s health and nutrition problems. All the blocks of Jammu and Kashmir are also covered under the Integrated Child Development Services Scheme. The programme is implemented through a network of community-level “Anganwadi Centers”. Despite huge allocations by the Central Government through Centrally Sponsored Programme of ICDS in India (especially in rural areas of the state), and under the flagship of this scheme in Jammu and Kashmir, still the growth in basic infrastructure and perfections in amenities/facilities remained unsatisfactory. The National Educational Policy 2020 guarantee to meet UN Sustainable Development Goal Target 4.2 by 2030 and ensure that all girls and boys have access to quality pre-primary education provide opportunities to safeguard impartial access to quality pre-school education. The main theme of this review is to attract the attention with the fact that there must be emphasis more on the significance of the scheme at various platforms. It is the time to evaluate the actual position of the scheme with respect to its execution at the ground level with specified objectives. Also our focus here is to inform concerned Govt. authorities that new insights and tactics cum methodologies need to be developed with respect to inclusive facts to broaden its implementation along with remedial steps to remove the imperfection.

An Assessment of Facilities and Services at Anganwadi Centres under the Integrated Child Development Service Scheme in Hanur, Chamrajnagar District, India

An Assessment of Facilities and Services at Anganwadi Centres under the Integrated Child Development Service Scheme in Hanur, Chamrajnagar District, India

The role of ICDS services on early childhood development: A cross-sectional study in Hyderabad, Telangana.

Integrated child development services (ICDS) include supplementary nutrition, nutrition and health education, health check-ups, immunization, preschool education, and referral services targeted at beneficiaries including pregnant and lactating mothers, children below six years, and women of reproductive age. Specific interventions are implemented to support children for a higher developmental outcome. The aims of this study are (1) to compare the development of ICDS beneficiaries in the age group of 4-6 years with the dropouts, (2) to assess caregiver practices among mothers of beneficiaries and the dropouts, and (3) to understand the perceptions of Anganwadi workers (AWWs) on early child development (ECD) and ICDS services. A cross-sectional study was conducted for two months in select Anganwadi centers (AWCs) of Hyderabad. AWCs were selected through multi-stage sampling. Respondents included 114 mothers and five AWWs. Quantitative data was collected by a questionnaire and qualitative data through an interview guide. Proportions were estimated for description. STATA 14.0 was used to find out correlates of development in children through unpaired t-test, Chi-square test, and logistic regression. Thematic analysis was done for qualitative data. About 68.42% and 33.33% of children from the beneficiary group were found to show normal cognitive and emotional development when compared to the dropout group (59.65% and 21.05%, respectively). KAP assessment revealed no significant difference between the mothers of dropouts and beneficiaries. Lack of infrastructure and poor attention to preschool activities were identified as reasons for dropout. Improving infrastructure, capacity building of AWWs, and reducing their workload will help in focusing on ECD-related activities at ICDS centers.

Early Childhood Care and Education: A Systematic Literature Review in Indian Context

Early Childhood Care and Education (ECCE) is often regarded as A key element of universal education. This study delves into the landscape of Early Childhood Care and Education (ECCE) in India through a systematic review of literature. After extensive attempts, several nations throughout the world are making strides toward securing ECCE. Despite this, the majority of them were unable to reach or compromise on this aim owing to insufficient resources, bad planning, and weak strategies for implementation, particularly in a large and populated nation such as India. The development of quality standards and curriculum frameworks, plans, acts, constitutional amendments, schemes, and flagship programmes like, District Primary Education Programme (DPEP), Integrated Child Development Services (ICDS) and Sarva Shiksha Abhiyan are just a few of the initiatives the Indian government has launched to improve quality. It has resulted in both anticipated and unexpected concerns and obstacles due to India's compromise on the non- negotiable ECCE quality requirements. Consequently, the government's objective of guaranteeing quality in ECCE was not fully achieved. However, recent research indicates significant advancements in quality improvements. Of course, there are unsatisfactory results in certain areas and components, but there has also been progress in other areas, suggesting that maintaining quality is a realistic objective. This research aims to present an overview of the Government of India's operations, assess the situation on the ground, pinpoint the primary hurdles to ECCE quality development and offer workable solutions to overcome those hurdles.

Equity in Access to Nutrition through ICDS

With the recognition of the problem of child malnutrition in India, the government provides supplementary nutrition under the flagship scheme of Integrated Child Development Services. The scheme has a specific focus on children from geographically and socio-economically disadvantaged groups. In the recent past, although several studies have looked into the access of children to supplementary nutrition services, the effectiveness of the services on children’s nutrition status through the lens of equity has however not drawn adequate attention. This article assesses the nutritional status of children across social groups based on the standard of ‘Nutritive Value of Indian Food’. Data collected from a sample of 286 children across social groups registered under the ICDS scheme covering ten villages in two rural districts of one state; reveals that although the supplementary nutrition meets the protein intake as per the Recommended Dietary Allowances norm, deficiencies are observed in the intakes of nutrients like calorie, calcium and iron. There are notable differentials among children across social groups in the intake of nutrients. The article calls for monitoring of adequacy of supplementary nutrition services for children from disadvantaged groups, and raising nutritional awareness among caregivers.

Utilization of Integrated Child Development Services (ICDS) and its linkages with undernutrition in India.

The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6-59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS-4 [2015-2016] and NFHS-5 [2019-2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference-in-differences (DID) approach. Utilization of ICDS increased from 58% in 2015-2016to 71% in 2019-2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%-12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6-59 months in this period.

Prevalence and predictors of minimum acceptable diet (MAD) feeding among tribal children aged 6–23 months in India

ABSTRACT Minimum acceptable diet (MAD) that combines minimum dietary diversity (MDD) and minimum meal frequency (MMF) is one of the eight core indicators for assessing infant and young child feeding (IYCF) practices for children aged 6–23 months. With low MAD, young children and infants are more susceptible to undernutrition. The study assesses the prevalence and predictors of MAD among tribal children aged 6–23 months in India. Descriptive, bivariate, and multivariate analyzes were performed on data from 6326 tribal children of the National Family Health Survey (2019–21). Stata was used for the analyzes, with a 5% significance level. Only 12% of tribal children were fed with a MAD, while 24% had MDD and 34% MMF. Children aged 18–23 months had a three times higher chance of MAD than their 6–8 months counterparts. Children receiving Integrated Child Development Services (ICDS), children of mothers with ten or more years of schooling, children whose mothers were exposed to mass media, and whose mothers had 4+ antenatal care visits in their last pregnancy had a higher likelihood of MAD. The study concludes that MAD among tribal children aged 6–23 months is unsatisfactory and varies significantly by socio-demographic characteristics, suggesting targeted intervention.

IJCM_253A: A cross sectional study to assess the coverage, impact and reasons for non- utilisation of supplementary nutrition among ICDS beneficiaries in the field practice area of a tertiary medical college in Mangalore

Background: Integrated Child Development Services (ICDS) scheme is world’s largest community-based Programme Objective: To assess the coverage, impact, and reasons for non-utilization of supplementary nutrition among ICDS beneficiaries Methodology: To assess the coverage, impact, and reasons for non-utilization of supplementary nutrition among ICDS beneficiaries Results: 66 % of the beneficiaries are aware of the supplementary nutrition availability, while only 52% of them acquire the services. Only 24% of the adolescents are aware of the supplementary nutrition being given in ICDS and none of them are availing it. 28.7 % of the beneficiaries are getting. Conclusion: 52% of the study participants were utilizing the services and the major reason for non-utilization was inferior quality of the grains and unawareness, mainly among adolescent females. Positive impact could be seen with reduction in SAM cases, immunization updation but nutrition education needs to be upgraded.

"The Early Years are Like a Foundation for the Future" Perspectives, Facilitators, and Challenges of Anganwadi Workers in Supporting Early Child Development Interventions in Hyderabad, India: Qualitative Findings from a Scalable Program Incorporating Early Child Development Interventions.

Integrated Child Development Services (ICDS) scheme, a large public health program, addresses the needs of young children with Anganwadi Workers (AWWs) as frontline agents of delivery. A scalable program incorporating early child development interventions (ASPIRE) has been developed to complement the program and address some of its gaps. This paper describes formative work done with AWWs, as part of ASPIRE to assess their understanding of early childhood development (ECD) and acceptability of a novel ECD intervention using digital technology. Six focus group discussions (FGDs) were conducted with 31 AWWs, using a semi-structured guide. Framework analysis of their responses from FGDs led to the identification of three themes: (1) time use, (2) understanding of ECD, and (3) delivering messages using videos. The findings suggest that AWWs tight schedules often leave them feeling overburdened with work. They are aware of factors that can aid as well as hinder child growth and development, but their understanding of play is limited to games played by older children. They expressed acceptability in using a video intervention, specifying features that would increase relevance for families. Integration of novel ECD interventions delivered by frontline workers needs to take into account their existing work schedules and associated challenges. Training on ECD interventions will need to broaden AWWs understanding of the critical foundational experiences which responsive caregiving and early child stimulation can provide.

IJCM_416A: Health Profile of Anganwadi Workers: a camp-based study conducted at a Tertiary Hospital, Mumbai, India

Background: As part of the Integrated Child Development Services program, The Anganwadi system is mainly managed by the Anganwadi worker (AWW). The fundamental tasks performed by Anganwadi workers are crucial and must be completed as effectively as possible. Hence the good health of Anganwadi workers decides how efficiently they can do their allotted work. So, this study was conducted to assess the health profile of Anganwadi workers. Objective: To assess the health profile of Anganwadi workers attending a Health checkup camp at a Tertiary Hospital. Methodology: A cross sectional descriptive study was conducted at a free health camp in a Tertiary Hospital of Mumbai, India, by the staff and interns of the Department of Community medicine. All AWWs who attended the camp were included in the study. AWWs who attended the health checkup camp were assessed for morbidity. Data collected by semi structured questionnaire was entered into Microsoft Excel and analysed using SPSS version-17.0. Results: Most of AWWs were from the age group of between 41-50 years; more than half of them were matriculate and 34(69.38%) workers had an experience of more than 10 years. Around 49% of them were having abnormal BMI and 53% were anaemic. PAP smear findings were abnormal in 4% AWWs. Conclusion: AWWs are considered cornerstone in providing ICDS services, but in this study, we found that most of AWWs themselves were not at their good health. Regular health checkups of healthcare workers of each level should be done to efficiently deliver the healthcare services to people of our country.

Estimated effect of age of marriage on utilisation of India’s Integrated Child Development Service programme

BackgroundAge of marriage among women is considered an important indicator of their readiness for familial integration and parenting. This study estimated the effect of age of marriage of young mothers...

Integrated child development service (ICDS) coverage among severe acute malnourished (SAM) children in India: A multilevel analysis based on national family health survey-5.

Severe acute malnutrition (SAM) can be fatal for children, and potentially limit their cognitive and physical growth. The last three National Family Health Survey (NFHS) in India shows an increase in the prevalence of SAM among under-five children. Given the specific mandates under ICDS (Integrated Child Development Service) for SAM children, it is important to validate the coverage efficiency of ICDS on SAM children. This paper examines a possible association between the coverage efficiency of ICDS on SAM children. The study further aims to identify the determinants of ICDS service utilization among SAM children. We used data from the fifth round of the National Family Health Survey. Descriptive statistics was used to estimate the SAM coverage under ICDS. Multilevel Logistic Regression was used to identify the determinants of ICDS service utilization among SAM children. The burden of SAM is higher among older children (3+ age). Coverage of ICDS was more among younger children and the poorest households in the rural areas. Results from multilevel logistic regression showed that age had a significant relationship with the outcome variable. SAM children living in the rural areas had a significantly higher odds of being covered under ICDS service (OR 1.57; CI: (1.35, 1.82)) than their urban counterparts. Pregnant and lactating mothers who received ICDS services were significant determinants of SAM coverage under ICDS. There is no evidence that ICDS is more efficient in identifying and covering SAM children than non-SAM children. Despite special provisioning in place for SAM children, coverage of different ICDS services was similar to that of non-SAM children, and were in fact lower than non-SAM children for some categories. The study suggests that improving coverage of ICDS services among pregnant and lactating mothers would increase the coverage of ICDS services among SAM children.

Malnutrition among children in India: exploring the contribution of the integrated child development service scheme

Malnutrition among children in India: exploring the contribution of the integrated child development service scheme

Effect of Inclusive Early Childhood Development (IECD) on Growth and Development of Children in the Rural Part of the Central India: A Cohort Study.

To compare the difference between the growth and developmental status of the children who were residing in the area where Inclusive Early Childhood Development (IECD) project was being implemented and who had received interventions through trained Anganwadi workers (Frontline workers) under Integrated Child Development Services (ICDS) scheme with the children who had not received the Inclusive ECD project interventions. It was a mixed method cohort study, nested in an ongoing project in a medical college in which Inclusive ECD was used as an intervention through International Guide for Monitoring Child Development (GMCD) which is a tool for both monitoring and assessment with the help of existing government structures and personnel such as Anganwadi workers, Anganwadi supervisors and their contact points with communities. A sample of 200 children was selected; 100 each from intervention group (IECD cohort) and comparison group (Usual care cohort) and were followed till the child became 2 y of age. IECD intervention showed statistically significant effect on weight (p = 0.04) and height (p = 0.03) of the IECD cohort. Overall developmental assessment showed that the identified developmental issues (Concerns + Delays) were approximately half in IECD cohort (9.67%+5.37%=15.04%) as compared to usual care cohort (17.20%+11.82%=29.02%). The results from binomial logistic regression performed for developmental outcomes were statistically significant (p = 0.04) suggesting that children with IECD intervention have lower odds of developing developmental issues. The study indicates that it is possible to implement IECD interventions through frontline workers, which significantlyimproves the growth and development of the children.