Integrated Child Development Services Scheme Research Articles

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

Maternal and child nutrition services associated with nutritional knowledge and practices, India.

To evaluate whether maternal and child nutrition activities provided through the Indian Integrated Child Development Services scheme in India were associated with improved nutritional knowledge and practices among beneficiary women. We used a multistage sampling design to randomly select 4400 pregnant women or mothers of children younger than 2years for a cross-sectional telephone survey. The respondents were beneficiaries of the scheme from across 11 Indian states. We used multivariate regression models controlling for sociodemographic factors to estimate the association between: scheme activities and nutrition messages heard; and scheme activities and nutrition practices. We also estimated the proportion of the total association with nutrition practices which was mediated by nutrition messages. Among 110 regression models testing unique pairs of seven activities and 18 nutrition messages, 103 showed a statistically significant positive relationship (median risk ratio, RR: 1.14). For activities and nine nutrition practices, 39 out of 54 tested pairs were significantly associated (median RR: 1.16). We observed statistically significant mediation through nutrition messages for 28 out of 42 tested pairs of activities and nutrition practices. Receipt of the scheme's activities was associated with improved nutrition knowledge and practices. Improvements in practices were statistically mediated by improvements in knowledge. These findings suggest that a large-scale nutrition scheme with a strong counselling component could successfully change beneficiary behaviours.

Utilization and Satisfaction of Services Provided for Children under the Integrated Child Development Services Scheme in a Block of West Bengal, India

Background: The Integrated Child Development Services (ICDS) scheme is a community-based program in India for the betterment of health and nutrition of children aged 0-6, pregnant and lactating mothers, and women aged 15-44 years. This study aimed to investigate the pattern of the utilization of services and the level of satisfaction of mothers regarding the services provided to their children in a block of West Bengal, India.
 Methods: This descriptive cross-sectional study was conducted from August 2016 to November 2018, and simple random sampling was used to select ICDS centres. The centres’ were evaluated for determining the rate of utilization of the services. For evaluating satisfaction, a face and content-validated, pre-tested questionnaire was used. The first part of questionnaire was for collecting the socio-demographic profile of mothers. The second part was concerned about determining satisfaction regarding various services provided by centers to children below 6 years of age on a 5-point Likert scale. About 10% of children enrolled in each ICDS centre were selected, and their mothers were surveyed for satisfaction regarding supplementary nutrition services, informal education, immunization, and other health-related services and infrastructures. The data were expressed in number and percentages and the test of association between categorical variables was done using a chi-square test. The GraphPad Prism 6.01 (GraphPad Software, USA) was used for statistical test.
 Results: Among the surveyed 62 ICDS centres, service utilization rates were 98.04% for immunization, 90.56% for supplementary nutrition, 82.52% for informal education, 40.27% for health check-ups, and 13.32% for referral services regarding different health problems. A total of 89.63% of the mothers were satisfied with the supplementary nutrition, 83.46% with immunization and health-related services, 77.42% with informal education, and 56.5% with infrastructures.
 Conclusion: Using supplementary nutrition and informal education exceeded expectations, but immunization, other health-related services, and referral services need improvement to achieve the program's goal. ICDS center infrastructure needs improvement, and a holistic approach is necessary to meet the satisfaction of mothers regarding different services.

Evaluation of the Performance of Anganwadi Workers in Delivering Integrated Child Development Services in the Rural Field Practice Area of a Tertiary Medical College in South India.

Background and objective To meet the overall developmental needs of children below six years, adolescent girls, and expectant and nursing mothers, the Integrated Child Development Services (ICDS) waslaunched on 2nd October1975via the network of Anganwadis. It included a range of services like supplementary nutrition, preschool education, immunization, health check-up, referral services, and nutrition and health education. The majority of Karnataka's population resides in rural areas (61.3%) and among them, children (aged zero to sixyears) constitute around 12.05%. The incidence of mortality and morbidity among vulnerable groups is quite high. A total of 204 ICDS project areas have been sanctioned in Karnataka till 2012, out of which 63,377 Anganwadi centers (AWCs) from 185 projects have been functional. Findings showan alarming gap of 12 million beneficiaries for the required services.Mere 44% of children between 12 and 23 months have received complete immunization. The scheme has reached a stage where enriching its contents is more crucial than concentrating on universalization. Our study has tried to recognize the hindrances in the delivery of ICDS services by evaluating the performance ofAnganwadi workers (AWWs), which in turn willoptimize the benefit for the beneficiaries. Materials and methods This was a community-based, cross-sectional, descriptive study conducted over a period of six months. The tertiary medical college covers a population of 16,231 in its rural catchment area, whose health needs are served by 21 AWCs. All 21 centers were included in the study through the universal sampling method. Data collection commenced after obtaining clearance from the Institutional Ethics Committee and permission from the Program Officer and Child Development Project Officer (CDPO) of the concerned ICDS block. Informed consent was taken from all the AWWs. Data to evaluate the performance of AWWs were collected using a pre-validated and pre-structured questionnaire. Performance was evaluated by allotting scores to each question. Results Among the 21 AWWs interviewed, 38.1% belonged to the age group of 41-50 years. Of them, 76.2% achieved the correct number of target home visits per day. Growth charts were plotted correctly by the workers in only 60% of centers. Only 57.1% of centers stored raw food materials safely, away from infestation. In 71.4% of centers, the health staff had immunized the children appropriately. Only 38.1% of AWWs had the knowledge of giving paracetamol tablets to the mothers in case of fever and were also giving vitamin syrup to the children. Only 19% of AWWs responded correctly regarding the importance of Village Health and Nutrition Days (VHND). In our study, 11 (52.4%) workers had "good" knowledge about delivering different services under the ICDS scheme,eight (38.1%) had "poor" knowledge while two (9.5%) workers had "satisfactory" knowledge. Conclusion The present study gives some insight into the existing situation in rural AWCs. Although the majority of AWWs had good knowledge about delivering different services under the ICDS scheme, further improvement is needed for optimizing the outcome.

Utilization of Nutritional Supplementation Services and Their Predictors in Pregnant and Lactating Women Living in an Urban Resettlement Colony of Delhi, India: A Cross-Sectional Study.

Introduction Maternal undernutrition during pregnancy and lactating has adverse health consequences for the mother and her child. The Integrated Child Development Services (ICDS) scheme by the Government of India provides supplementary nutrition services to all pregnant and lactating women but its utilization is suboptimal due to inefficient distribution through the health system and beneficiary concerns regarding its usefulness. This study was conducted with the objective of assessing the utilization of nutrition-related ICDS services by pregnant and lactating women in urban poor settlements of Delhi and the sociodemographic factors associated with non-utilization. Materials and methods This was a community-based cross-sectional survey in an urban resettlement colony and slum area located in the northeast district of Delhi. The data collection was conducted from January to May 2022. Eligible participants included pregnant women in their second or third trimester of pregnancy and lactating mothers in their first six months of the postpartum period who were residents of the study setting.Data were collected using face-to-face interviews using a pre-tested and self-designed questionnaire. The primary outcome was the proportion of women utilizing ICDS take-home rations (THR) in the previous month. Results A total of 365 participants were recruited in this study including 208 pregnant and 157 lactating women having a median (IQR) age of 25 (22-28) years.A total of 211 (57.8%) participants reported a history of utilization of ICDS supplementary nutrition services during their current pregnancy or postpartumwith 154 (42.2%) having received THR in the previous month. Among the currently pregnant women, 84 (40.4%) had utilized ICDS THR while in the currently lactating women, 70 (44.6%) had utilized THR in the previous month.On adjusted analysis, multigravid women were less likely to have utilized ICDS compared to primigravida women. Reasons for non-utilization of the ICDS supplementary nutrition services by the mothers were temporary disruption due to cessation of ICDS services by protesting Anganwadi workers (over demand for increased honorarium), difficult access to Anganwadi center, the poor perceived taste of the food provided as THR, and perception by the mothers that they did not require THR. Most women reported sharing the THR with their family members. All pregnant and lactating women were found to be calorie and protein deficient in this study when applying the recommended intake values. No association was observed between the utilization of ICDS in the previous month and the presence of calorie deficiency in both pregnant (p=0.35) and lactating (p=0.24) women. Conclusions More than four in ten eligible pregnant and lactating women in an urban resettlement colony in Delhidid not utilize ICDS supplementary nutrition services with similar rates of utilization in both pregnant and lactating women. Women living in joint families and consequently larger households were less likely to utilize ICDS services. A majority of pregnant and lactating women were calorie and protein deficient even on applying non-pregnant cut-off requirements. The ICDS scheme needs to strengthen information, education, and communication (IEC) strategies and interventions to improve its acceptability and utilization by this vulnerable population.

Evaluation of the Integrated Child Development Services Scheme in a Hilly Tribal District of Manipur: A Cross-Sectional Study

Introduction: The Integrated Child Development Services (ICDS) Scheme, the largest program for promotion of maternal and child health nutrition in India, is operational for more than four decades. Objective: To evaluate Integrated Child Development Services Scheme in Kangpokpi District of Manipur in terms of input, process and outcome indicators. Method: A community-based cross-sectional study was conducted at a tribal hilly district of Kangpokpi in Manipur. The study included ICDS staff and beneficiaries of 35 randomly selected Anganwadi Centres (AWCs). Data related to ICDS was collected by using interview schedules and checklists. The descriptive data were expressed in terms of mean, standard deviation and percentage. Association between important background characteristics and Anganwadi centre attendance was analysed using chi-square test. Ethical clearance was obtained from the institutional Ethic Committee of JNIMS, Imphal before conducting the study (study period: May 2018 to April 2021) Results: Input indicators: The study found that86% anganwadi centres were run in anganwadi worker’s own house. Two-thirds of the anganwadi workers (65.7%) were found to have separate toilet and 22.9% had separate kitchen. Process indicators: Even though the proportions of beneficiaries accessing services from anganwadi centres were high, the number of days Supplementary Nutrition (SN) was provided in a month was comparatively low (mean: 2.97 and SD: 0.618 for under-6 children and mean: 1 and SD: 0.000 days for adolescent girls, pregnant women and lactating mother in a month) due to frequent interruption of supplementary nutrition supply. There was no supplementary nutrition stock in 74.3% of the anganwadi centres on the day of visit. Outcome indicators: Regarding the nutritional status 90% of Under-6 children were found to be normal, 9% underweight and 0.6% severely underweight. Conclusion: The Integrated Child Development Services Programme in the study area was found to have several short-comings both in terms of inputs and process. There were not only inadequate facilities and infrastructure, but the anganwadi centres also lacked essential equipment like weighing machines and medicine kits, rendering a vital activity like growth monitoring to be almost completely absent. Supervisory visits were far below satisfactory.

Awareness and perception of mothers regarding Integrated child development services scheme for children in an urban area of Kerala

Background: Integrated child development services (ICDS) scheme was launched in India to improve the nutritional and health status of children. Perception of beneficiaries about ICDS services provided by Anganwadi centres had not being sufficiently explored. Hence the objective of this study was to assess the awareness and perception of mothers regarding Anganwadi services for children in an urban area of Kerala. Methods: A cross-sectional study was conducted in an urban area of central Kerala. Study participants were mothers having pediatric children, who were residing in the urban areas of central Kerala for at least the past one year. A total of 70 mothers were interviewed using a pre-designed semi-structured questionnaire after obtaining informed consent. Data were analyzed by SPSS software version 18.Results: Mean age of the study participants was 31.7±5.8 years. But 24.3% of children of the study participant never attended Anganwadi. The majority of study participants were aware of supplementary nutrition services (97%) provided by ICDS. Immunization services (58.6%) were the least aware service in ICDS. The perception of participants regarding adequate quantity and quality of supplementary nutrition from Anganwadi was only 58.6% and 62.9%. Only 57.1% felt that preschool non-formal education was beneficial, even though 90% were aware of this service from the Anganwadi centre.Conclusions: The participants were aware of ICDS services, but their perception regarding Anganwadi services was poor. Reasons for poor perception regarding ICDS services need to be assessed by focus group discussions and in-depth interviews with beneficiaries.

Perception, awareness and utilization of integrated child development services scheme by mothers in coastal Karnataka, India

Background: Integrated Child Development Services (ICDS) scheme is the leading outreach program aimed at promoting maternal and child health care and help in strengthening the implementation of MCH activities like immunization, growth monitoring, supplementation of vitamin A and iron folic acid tablets. Hence, ICDS takes holistic approach in development of children and attempts to improve their prenatal and post-natal environment. Hence the present study was undertaken to study the awareness and utilization of ICDS scheme by expectant mothers and nursing mothers in coastal Karnataka. Objectives of current study were to study the awareness and utilization of services offered to mothers under ICDS 2 and to assess the perception about the services.Methods: A community based cross sectional study was done among 141 mothers registered in anganwadis.Results: Majority were aware of SN (96.5%) followed by TT immunization (89.4%) and NHED (22%). The most common service utilized by the study subjects was supplementary nutrition (94.3%) followed by NHED (24.1%) and home visit (23.4%). Larger proportion of the study subjects were of opinion that SN food of good quality (57.1%) and almost 96.2% mothers said food was of adequate quantity.Conclusions: Among the eligible expectant and nursing mothers, majority of them utilized supplementary nutrition. Nearly 40% of expectant and nursing mothers were not happy about the quality of food offered to them. Nutrition and health education sessions were attended by only 40% of the eligible mothers.

Knowledge and practice pattern of integrated child development services scheme supervisors (AWS) following capacity building and remote supportive supervision

Nutritional status of under-5 children in India is not promising and lags far behind the WHO Global Nutrition Targets. Although the Integrated Child Development Services has been continuously delivered through Anganwadi centers since 1975, the burden of malnutrition still persists. This study was conducted to estimate the knowledge and practice pattern of Anganwadi supervisors and the effect of capacity building through remote supportive supervision during the COVID-19 pandemic in Assam, India. A cross-sectional before-after study using a mixed methods approach was used to evaluate the knowledge pattern and service delivery of supervisors from each district of Assam. For qualitative assessment, telephone depth interviews were conducted. Knowledge of supervisors in the beginning was 83.43% which improved by 7.97% at the end of the study. The highest burden of SAM children was in Tinsukia and Barpeta districts. On mapping, most districts with lower burden of SAM had supervisors with higher knowledge levels on Infant and Young Child Feeding practices. Qualitative assessment revealed house-to-house visit for ensuring service delivery and use of online platforms and phone calls for counseling. However, community resistance and lack of transport stood as a main challenge. Supportive supervision done remotely during the pandemic to enhance the performance of health workforce was found effective.

Effectiveness of weekly local mothers' kitchen recipe talks to improve dietary iron intake among tribes of Andhra Pradesh, India: A prospective cohort study.

Anemia is a major public health problem in India, especially among tribal women. The study was done to estimate the prevalence of iron intake below the estimated average requirement in the diet and to study the effectiveness of weekly local mothers' kitchen recipe talks. A total of 340 women from scheduled tribes participated in a prospective cohort study over 10 months in 10 clusters in the Guntur district of Andhra Pradesh, India. A questionnaire, a 24-hour dietary recall, and an assessment of hemoglobin were done to gather information at baseline and after three months of weekly local recipe talks in mothers' kitchens. A total of 340 women were studied. The mean age of the mothers was 23.5 ± 3.6 years. At baseline prevalence, the mean intake of daily iron in diet among mothers was 9.04 ± 3.18 (SD) mg/day. The prevalence of anemia among mothers at the baseline was 63.8%. The mean intake of daily iron in the diet at the end line was significantly higher with a P value of 0.019 among mothers who attended 10 or more weekly local mothers' kitchen recipe talks and did not take iron folic acid (IFA). Mothers who attended 10 or more weekly local mothers' kitchen recipe talks without IFA intake have a significant drop in the prevalence of severe anemia. The integration of weekly local mothers' kitchen recipe talks in the ongoing Integrated Child Development Service Scheme can be a boon for early-aged, less-literate, inexperienced, and financially poor mothers.

An appraisal of knowledge, attitude and practices of anganwadi workers under integrated child development services scheme on infection prevention and control in the initial months of COVID-19 pandemic in District Lucknow, UP, India

Background: During the COVID-19 pandemic, Anganwadi workers (AWWs) were repositioned for community support, community surveillance, community awareness on infection prevention and mitigating stigma/discrimination entailing infection, going door to door. The job entailed good knowledge, attitude and practices (KAP) with regard to infection prevention and control (IPC). Aims: To assess the KAP of AWW with regard to IPC in context of COVID-19 in Lucknow district. Methods: A cross-sectional survey was conducted using Google form between 30 June and 28 July 2020. AWWs were recruited from Lucknow district irrespective of their training status; data analysis was done on 137 participants. The mean KAP score was calculated and student t-test was applied. Chi-square test was performed between categorical variables and KAP. Univariate and multivariate logistic regression was applied between independent and dependent variables. Results: The mean score of knowledge was 7.22 ± 2.64, attitude was 4.34 ± 1.14 and practice was 4.44 ± 1.11. There was a significant difference between good and poor score for KAP. Participants with older age, good knowledge and attitude scores were more likely to have good practices. Conclusion: AWWs had good attitude and practices, but lacked adequate knowledge on IPC measures. Ensuring training for AWW on IPC is important.

LADLI BETI SCHEME: SUCCESS OR FAILURE IN JAMMU DISTRICT

Era has transformed. A global attention to various issues in the society has reached an unprecedented level as nations prepare themselves to achieve higher economic growth. The future of India, rests on the foundation being laid today. Children of today are the leaders of tomorrow. If the role of children in the development of the nation is so important, the role of the way they are being brought up is much more important. And here comes the issue of raising a girl in a family as compared to boys. As we know the status of girl child stands very low in Indian society hence there is a low sex ratio in our country. In the process of preparation of the future builders of the nation it has become very important to look towards this issue very seriously. Even after more than seventy years of independence the situation is no more different. Considering these factors in mind the government of Jammu and Kashmiri has started few projects for the benefit of women and girls. Ladli Beti scheme is one of them which is started as a pilot project in few districts of Kashmir and Jammu showing low child sex ratio in April 2015 under the Integrated Child Development Service Scheme. The present study was thus carried to know about the Ladli Beti Scheme and its functioning. Also who are benefitted by the scheme, the problems faced by the beneficiaries in availing this scheme and any change if brought so far. The present study was carried on a total of 24 AWCs. A total of 96 parents were interviewed for the study. The results showed 18.75% of the parents were benefitted by the scheme 76.04% of the parents were not benefitted by the scheme. It was found that the beneficiaries should be provided proper help and guidance time to time by the authorities for proper benefit of the scheme. Some more efforts and focus is required by the authorities towards the scheme.

Factors influencing the performance of community health workers: A qualitative study of Anganwadi Workers from Bihar, India.

Globally, there remain significant knowledge and evidence gaps around how to support Community Health Worker (CHW) programmes to achieve high coverage and quality of interventions. India’s Integrated Child Development Services scheme employs the largest CHW cadre in the world—Anganwadi Workers (AWWs). However, factors influencing the performance of these workers remain under researched. Lessons from it have potential to impact on other large scale global CHW programmes. A qualitative study of AWWs in the Indian state of Bihar was conducted to identify key drivers of performance in 2015. In-depth interviews were conducted with 30 AWWs; data was analysed using both inductive and deductive thematic analysis. The study adapted and contextualised existing frameworks on CHW performance, finding that factors affecting performance occur at the individual, community, programme and organisational levels, including factors not previously identified in the literature. Individual factors include initial financial motives and family support; programme factors include beneficiaries’ and AWWs’ service preferences and work environment; community factors include caste dynamics and community and seasonal migration; and organisational factors include corruption. The initial motives of the worker (the need to retain a job for family financial needs) and community expectations (for product-oriented services) ensure continued efforts even when her motivation is low. The main constraints to performance remain factors outside of her control, including limited availability of programme resources and challenging relationships shaped by caste dynamics, seasonal migration, and corruption. Programme efforts to improve performance (such as incentives, working conditions and supportive management) need to consider these complex, inter-related multiple determinants of performance. Our findings, including new factors, contribute to the global literature on factors affecting the performance of CHWs and have wide application.

A Study to Analyse the Knowledge Level of Women Beneficiaries of Anganwadi Centres (AWC) Regarding Nutrition in District Budgam of Kashmir Region

Mother is a main caretaker of their children particularly during the first three to six years of life when they are at the risk of being undernourished. How well she takes care of her children to keep them healthy will depend upon the level of her knowledge regarding childcare and nutrition and various associated factors. As such this study was planned to assess and enhance the extent of knowledge among women beneficiaries of ICDS (Integrated child development Service Scheme) centers of district Budgam of Kashmir region. With an intension to surpass and facilitate the knowledge of women beneficiaries this study was taken up with a sample of 600 registered women beneficiaries of AWCs (Anganwadi centers) out of which 150 were nursing mothers, (NM) 150 were pregnant women (PW) and 300 were mothers of child beneficiaries (MCB having children in the age group 6 months-3years. The tool used for assessing the knowledge level was a self-devised rating scale designed to measure the nutritional knowledge related to importance of different kinds (variety) of foods for adequate/ optimal growth and development of a child. Further, in order to divide the levels of nutritional knowledge as, low, medium and high, Quartiles were calculated. In this way the mothers having low level of knowledge (Q1) those who scored up to 4, medium (Q2) whereas, sample women who scored between 5-6 and high level of knowledge (Q3) scored as ≥ 7.The statements were so arranged that a positive answer was specified under score of 1, whereas, a negative statement was granted a score of 0 . The scores of positive responses were summed up and the level of knowledge of women beneficiaries was ascertained, a statistically significant variation is observed in levels of nutritional knowledge as per educational qualification and income group among the respondents. It is also seen that respondents from block B.K.Pora and Nagam blocks are having high level of nutritional knowledge in comparison to block Budgam and Chadoora. Among the groups, MCB are having higher level of knowledge in comparison to NM and PW. No significant variation in the levels of nutritional knowledge is seen as per age. It is quite obvious from the study that education of mothers is directly related to knowledge. Educated mother are more knowledgeable than functionally literate mothers.

Assessment of Utilization of Integrated Child Development Services Scheme in Uttarakhand

Background: ICDS scheme has been playing its role effectively since 1975 when it was launched, but still there are some short comings which need to be addressed. Uttarakhand being one of the states with poor health indicators with respect to child and mother there is need to increase research on implementation of programs. Aims & Objectives: The present study was conducted to see utilization of services provided under ICDS scheme in Uttarakhand. Material & Methods: A cross sectional study was conducted in selected areas of Uttarakhand from October 2018 to June 2019. 505 households from 16 Anganwadi centers, from both urban and rural areas of Dehradun and Haridwar districts were included. Assessment of utilization of services was done by household interviews. Data was analyzed using SPSS V 23 software. Results: Availing supplementary nutrition services was the most utilized service (94.5%) followed by health education services (88.3%), health and referral services (83.2%), preschool education services (76.7%) and least utilized service was immunization service (69.3%). Conclusion: Various factors independently affecting utilization of services were identified. Overall utilization of services is highest among pregnant women and least among adolescent girls and women of reproductive age group.

Assessment of Integrated Child Development Services Scheme in Select Districts of Uttarakhand

Introduction: ICDS scheme was launched on October 2nd 1975 to address high infant mortality, malnourishment and poor learning outcomes. Since its inception was playing its role effectively, but still there were some shortcomings which were needed to be addressed. Uttarakhand was one among the states with poor health indicators with respect to child and mother, there is need to search for reasons effecting the implementation of programs intended for woman and child development. The present study aims to asses functioning of ICDS scheme in select Uttarakhand.
 Methodology: A cross sectional study was conducted selected areas of Uttarakhand state during October 2018 to June 2019, among 16 anganwadi centers from urban and rural areas of Dehradun and Haridwar districts. Results were expressed in percentages and proportions with 95% confidence interval. Relevant statistical tested applied wherever necessary.
 Results: Functioning of ICDS scheme in Uttarakhand varied for different services provided under it. Supplementary nutrition service was uninterrupted but medicine kits and referral slips were not supplied to anganwadi centers at the time of study.
 Conclusions: Study identified various insufficiencies regarding the functioning of ICDS scheme. There is a need to improve facilities at anganwadi centers for proper implementation of ICDS scheme.

Differential frequency of obtaining knowledge of icds beneficiaries by AWWs in selected rural and slum areas of Agra District

The women and children of a country are its valuable assets. A nation's efforts towards enhancing women and children's health, nutrition and education and also its commitment to resolve problems to implementation of related policies is relevant in measuring its development. In this direction Gov of India launched integrated child development service scheme. An Anganwari centre through AWWs ICDS program provides all services beneficiary group. AWWs thus, play an important role in spreading knowledge to ICDS beneficiary group. The present study is an attempt to assess the effectiveness of program by assessing the difference in the knowledge of ICDS beneficiaries obtaining by AWWs . The study was conducted on one hundred fifty women of Agra District. The sample was selected by multi stage random sampling technique. Low frequency of imparting knowledge regarding reproductive health was seen in rural areas whereas frequency of imparting knowledge regarding reproductive health was significantly higher in slums (χ2=8.373).

The impact of integration of a dental module into the existing integrated child development services scheme in Chennai, India.

Aim:The aim of this study was to assess the impact of reinforced oral health awareness program to the children, parents and Anganwadi workers on the oral hygiene and oral health status of the children in Anganwadi centers functioning under the Integrated Child Development Scheme (ICDS) services all around Chennai city, Tamil Nadu, India.Materials and Methods:This longitudinal study was conducted among 511 study participants. All the study participants, their parents and Anganwadi workers attended an oral health education program. Oral hygiene and the oral health status of the children were assessed using a debris and WHO Pro forma 2013 at the baseline and after 1 year. Follow-up debris score was collected after 3 weeks, 1, 3, and 6 months in all the 12 zones divided into three groups, i.e., Groups A, B, and C according to the re-intervention schedule.Results:A highly significant reduction in the debris scores of the study participants was observed between each follow-up data collection (P = 0.001) regardless of the groups. A significant reduction (P = 0.001) in terms of the prevalence of dental caries, filled with no caries, missing teeth, gingival bleeding, and oral mucosal lesions were observed in the children between the baseline and final assessment after 1 year.Conclusion:A definite paradigm shift was observed in the present study after incorporation of the dental module, which could be taken up as an example to include oral health education and oral health checkups to the existing ICDS scheme, which was lacking before.

Framework for enhancing maternal nutrition: addressing under nutrition in tribal children inhabiting Central India

AbstractOur world is transitioning into a new generation of governance with much greater emphasis on targeted actions and mission mode programmes to achieve global sustainable goals (SDG). India with its Twenty-point programme which directly maps national and state programmes to global SDGs has been pacing up for 2030 targets. One of the major programmes that has been the prime focus is Integrated Child Development Services Scheme. India ranked 103rd among 119 countries on global hunger index, 2018. Significant reduction in malnutrition was seen among children below 6 years but the pace of reduction has been slow over the past decade. The path of malnutrition reduction of central belt states (tribal population dominant) deviates from rest of the country.Our analysis of National Family Health Survey-4 (NFHS) found that 42% of tribal children are underweight (i.e. 1.5 times higher than non-tribal children), over 50% of prevalence of malnutrition is in tribal population. 100% Mother & Child Protection registration do not reciprocate to 100% all Anti-Natal Care visits showing faults in monitoring system indicating that the investment by government in all fronts, economic development has not translated into desired reduction in malnutrition. Their 8.6% population accounts to 30% cases of malaria translating to 50% malarial deaths indicative of higher disease burden. Malnutrition crisis among tribals begins way early manifesting in higher rates of Low Birth Weight deliveries (LBW) which is 3–4% higher compared to non-tribal population. This is due to low nutrient diet, laborious work during gestational period and high disease burden.The focus of Maternal nutrition enhancement projects by Tribal Welfare Depts in these states should include nutrition sensitive along with nutrition specific interventions targeting the population under risk as well as entering risk. Now with district level data (NFHS) available every 4 years can aid in district level planning, shifting focus from population based to prevalence and exclusive planning for tribals. Our study involves developing a robust framework to enhance maternal nutrition through strong community mobilization and partnership. It also addresses the convergence issue being faced in the current system and paves a way forward for convergence among inter departmental schemes for larger participation by people and greater coverage of the scheme and its benefits.

An assessment of facilities and services at anganwadi centers under the integrated child development service scheme in urban area of Kathua district, Jammu and Kashmir

Background: The integrated childhood development services (ICDS) scheme, launched on 2nd November 1975 is India’s foremost program imparting comprehensive and cost-effective services for children and maternal health through designated anganwadi centers (AWCs). AWCs deliver services right at the doorsteps of the beneficiaries to ensure their maximum participation.Methods: This was a cross sectional descriptive study conducted in 37 AWCs of the urban area in Kathua district from March to May 2019. A checklist was used to assess the physical infrastructure of AWC and logistics available.Results: A total of 37 AWCs were visited. Majority of the AWCs (94.5%) were running in a rented building and had only room. and 86.4% have pucca type of center. Almost half (51.3%) of the anganwadi workers had >10 years of experience. 32.4% of the AWWs received education up to 12th standard. Weighing machines were available in 89.1% of the centers whereas Salter weighing machine was present only in 23 centers.Conclusions: Present case study unveils deficiencies in infrastructure and logistics at the centers. Emphasis should be given to strengthen the basic infrastructure of AWCs which would further help in delivering quality services to the beneficiaries.