INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME
Children in the age group 0-6 years constitute around 158 million of the population of India (2011 census). These Children are the future human resource of the country. Ministry of Women and Child Development is implementing various schemes for welfare, development and protection of children.
Launched on 2nd October, 1975, the Integrated Child Development Services (ICDS) Scheme is one of the flagship programmes of the Government of India and represents one of the world’s largest and unique programmes for early childhood care and development. It is the foremost symbol of country’s commitment to its children and nursing mothers, as a response to the challenge of providing pre-school non-formal education on one hand and breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality on the other. The beneficiaries under the Scheme are children in the age group of 0-6 years, pregnant women and lactating mothers. Objectives of the Scheme are:
- to improve the nutritional and health status of children in the age-group 0-6 years;
- to lay the foundation for proper psychological, physical and social development of the child;
- to reduce the incidence of mortality, morbidity, malnutrition and school dropout;
- to achieve effective co-ordination of policy and implementation amongst the various departments to promote child development; and
- to enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education.
Services under ICDS
The ICDS Scheme offers a package of six services, viz.
- Supplementary Nutrition
- Pre-school non-formal education
- Nutrition & health education
- Health check-up and
- Referral services
The last three services are related to health and are provided by Ministry/Department of Health and Family Welfare through NRHM & Health system. The perception of providing a package of services is based primarily on the consideration that the overall impact will be much larger if the different services develop in an integrated manner as the efficacy of a particular service depends upon the support it receives from the related services.
For better governance in the delivery of the Scheme, convergence is, therefore, one of the key features of the ICDS Scheme. This convergence is in-built in the Scheme which provides a platform in the form of Anganwadi Centres for providing all services under the Scheme.
Prior to 2005-06, providing of supplementary nutrition was the responsibility of the States and administrative cost was provided by the Government of India as 100% central assistance. The nutrition costs were meagre and coverage of the programme in all villages/habitations was also limited and not universal. Since many States were not providing adequate supplementary nutrition in view of resource constraints, it was decided in 2005-06 to support the States/UTs up to 50% of the financial norms or to support 50% of expenditure incurred by them on supplementary nutrition, whichever is less. Since 2009-10, Government of India has modified the sharing pattern of the ICDS Scheme between the Centre and States. The sharing pattern of supplementary nutrition in respect of North-Eastern States between Centre and States has been changed from 50:50 to 90:10 ratios. In respect of other States/UTs, the existing sharing pattern in respect of supplementary nutrition is 50:50. The existing cost sharing ratio for other components is 90:10 except the new components approved under Strengthening & Restructuring for which it is 75:25 (90:10 for NER).
Population Norms for Setting up of AWCs/Mini-AWCs
The revised population norms for setting up of AWCs and Mini-AWCs are as under:
Population Norms under ICDS
For AWCs in Rural/Urban Projects
- 1 AWc
- 2 AWCs
- 3 AWCs
Thereafter in multiples of 800 1 AWC
- 1 Mini-AWC
For Tribal/Riverine/Desert, Hilly and other difficult areas/ Projects
- 1 AWC
150-300 1 Mini-AWC
Anganwadi on Demand (AOD)
Where a settlement has at least 40 children under 6 years of age but no AWC
Revised Nutrition and Feeding Norms under Supplemtary Nutrition Component of ICDS (revised w.e.f 24 February 2009)
Provision of supplementary nutrition under the ICDS Scheme is primarily made to bridge the gap between the Recommended Dietary Allowance (RDA) and the Average Daily Intake (ADI) of children and pregnant and lactating women. Under the revised Nutritional and Feeding norms which have been made effective from February 2009, State Governments/UTs have been requested to provide 300 days of supplementary food to the beneficiaries in a year which would entail giving more than one meal to the children from 3-6 years who visit AWCs. This includes morning snacks in the form of milk/banana/egg/seasonal fruits/micro-nutrient fortified food followed by a hot cooked meal (HCM). For children below 3 years of age, pregnant and lactating mothers, Take Home Rations (THRs) in the form of pre-mixes/ready-to-eat food are provided. Besides, for severely underweight children in the age group of 6 months to 6 years, additional food items in the form of micronutrient fortified food and/or energy dense food as THR is provided. These norms have also been endorsed by the Supreme Court in order dated 22.04.2009. The extent of nutritional supplements to different types of beneficiaries is indicated below:
Registration of Beneficiaries
All children below 6 years of age, pregnant women and lactating mothers are eligible for availing of services under the ICDS Scheme. BPL is not a criterion for registration of beneficiaries under ICDS. The Scheme is universal for all categories of beneficiaries and in coverage.
Expansion of ICDS
- Launched in 1975 in 33 Blocks (Projects) with 4891 AWCs.
- Gradually expanded to 5652 Projects with nearly 6 lakh AWCs by the end of 9th Plan.
- Cureently 7076 Projects and 14 lakh AWCs have been apporved. This includes a provision of 20,000 AWCs 'on demand'.
- All 14 lakh AWCs have been sanctioned to the States/UTs
- As on 31.03.2015 13.46 lakh AWCs are Operational.
Revised Financial Norms (w.e.f 22.10.2012)
Financial Norms of Supplementary Nutrition were revised w.e.f. 22.10.2012 to be rolled out in phased manner under the Restructured ICDS.
Financial progress during the XI and XII Plan Period
With wider spread of the Scheme, Plan Allocation, which stood at Rs. 44,400 crore for the Eleventh Plan has been increased to Rs.1,03,003 crores for the Twelfth Plan. For the 3rd year of the Twelfth Plan i.e. for 2014-15, an amount of Rs.16581.82 crores has been released to States/UTs as on 31.03.2015 against Originally Budget allocation (BE) of Rs.18195.00 crore. However, the allocation for ICDS at Revised Estimate (RE) stage has been pegged at Rs.16312.00 crores. Thus, the utilization as on 31.03.2015 under ICDS against RE is 100.12. This includes an amount of Rs. 9869.91 crore for ICDS (General & Training) and Rs. 6711.91 crore for Supplementary Nutrition component under ICDS Scheme released during 2014-15. An amount of Rs.5001.73 crore has been released to various States/UTs during 2015-16 as on 31.07.2015.
Approval of Strengthening and Restructuring of ICDS in the 12th Five Year Plan
In order to address various programmatic, management and institutional gaps and to meet administrative and operational challenges, Government has approved the Strengthening and Restructuring of ICDS Scheme with an allocation of Rs. 1,23,580 crore during 12th Five Year Plan. Administrative approval in this regard was issued to the States/UTs on 22 October 2012.
Restructured and Strengthened ICDS has been rolled out in 200 high burden districts in the first year (2012-13); in additional 200 districts in second year (2013-14) (i.e. w.e.f. 1.4.2013) including districts from special category States and NER; and in remaining districts in third year (2014-15) (i.e. w.e.f. 1.4.2014).
Key features of Strengthened and Restructured ICDS, inter-alia, include addressing the gaps and challenges with :
- Repositioning the AWC as a “vibrant ECD centre” to become the first village outpost for health, nutrition and early learning – minimum of six hours of working, etc.
- Construction of AWC Building and revision of rent including up-gradation, maintenance, improvement and repair.
- Strengthening Package of Services – strengthening ECCE, focus on under-3s, Care and Nutrition Counselling service for mothers of under-3s and Management of severe and moderate underweight.
- Improving Supplementary Nutrition Programme with revision of cost norms
- Management of severe and moderate underweight – identification and management of severe and moderate underweight through community based interventions, Sneha Shivirs, etc.
- Strengthening training and capacity as well as technical human resource, etc.
B. Management Reforms
- Decentralized planning, management and flexible architecture introduction of Annual Programme of Implementation Plan (APIP) and flexibility to States for innovations.
- Ensuring convergence at all the levels including the grassroot level.
- Strengthening governance – including PRIs, Civil Society & institutional partnerships with norm of up to 10% projects to be implemented in collaboration with such agencies.
- Strengthening of ICDS Management Information System (MIS).
- Using Information, Communication Technology (ICT) – web enabled MIS and use of mobile telephoney and others.
- Deploying adequate human and Financial Resources with revision of some of the existing norms in components, training, etc. introducing new items,– pool of untied/flexi fund (for promoting voluntay action, local innovations, Anganwadi-cum-creche, addl worker and link worker, provision for children in special needs etc)
C. Institutional Reforms
- ICDS in Mission Mode with missions at National, State and District levels.
- Introducing APIPs and MoUs with States/UTs.
- Technical and management support for ICDS at various levels hitherto not available.
- Delivery of quality services with measured inputs, processes, outputs and outcomes.
- Mission to report to the Prime Minister’s Council at National leveland to the CM’s council at the State level on Nutrition, Child Development including early learning, etc. State Child Development Society will be set up at the State level with powers to set up its District Units. Fund transfer of the ICDS Mission will be channeled through the Consolidated Fund of the State. However, in the event the State fails to transfer the funds within 15 days, it will be liable to pay interest on the amount on the pattern of releases for the Finance Commission funds;
- Nutrition Counsellor cum Additional Worker in 200 high burden districts and link workers in others district will be on demand by State Government approved through APIPs by EPC.
- District Mission Unit would be set up as per the phasing plan of the ICDS Mission. Besides, District ICDS Cells to continue to operate as per existing norms and District Cells to be set up in those districts where the Cell is not existing;
- Constitution of a Mission Steering Group (NMSG) and Empowered Programme Committee (EPC) at National and State levels for effective planning, implementation, monitoring and supervision of ICDS Mission;
- Creation of a separate ICDS Mission Budget head to allow flexibility and integration within the child development and nutrition sectors and for convergent action with wider determinants of maternal and child under-nutrition.
- The ICDS Mission targets would be to attain three main outcomes namely; i) Prevent and reduce young child under-nutrition (% underweight children 0-3 years) by 10 percentage point; (ii) Enhance early development and learning outcomes in all children 0-6 years of age; and (iii) Improve care and nutrition of girls and women and reduce anaemia prevalence in young children, girls and women by one fifth. Annual Health Survey (AHS) and District Level Household Survey (DLHS) to be used as baseline for measuring the outcomes of ICDS mission.
- To strengthen training and capacity building.
- Revision of rent for AWC building up to Rs.750, Rs.3000 and Rs.5000 per month per unit for Rural/Tribal, Urban and Metropolitan cities respectively, revised norms for pre-school education (PSE) kits @ Rs.3000 per AWC p.a and Rs.1500 per mini-AWC p.a.; revised cost norms for two uniforms @ Rs.300 each per annum per worker subject to overall budgetary allocations and piloting of Crèche services in 5% of the AWCs.
THE ICDS TEAM:
The ICDS team comprises the Anganwadi Workers, Anganwadi Helpers, Supervisors, Child Development Project Officers (CDPOs) and District Programme Officers (DPOs). Anganwadi Worker, a lady selected from the local community, is a community based frontline honorary worker of the ICDS Programme . She is also an agent of social change, mobilizing community support for better care of young children, girls and women. Besides, the medical officers, Auxiliary Nurse Midwife (ANM) and Accredited Social Health Activist (ASHA) form a team with the ICDS functionaries to achieve convergence of different services.
Role & responsibilities of AWW, ANM and ASHA:
Role and responsibilities of AWW, ANM & ASHA have been clearly delineated and circulated to States/UTs under the joint signature of Secretary, MWCD and Secretary, MHFW, vide D.O. No. R. 14011/9/2005-NRHM –I (Pt) dated 20 January 2006.
STATUS of ANGANWADI WORKERS AND HELPERS:
Anganwadi Workers (AWWs) & Anganwadi Helpers (AWHs), being honorary workers, are paid a monthly honoraria as decided by the Government from time to time.
In addition to the honoraria paid by the Government of India, many States/UTs are also giving monetary incentives to these workers out of their own resources for additional functions assigned under other Schemes.
FACILITIES/ BENEITS EXTENDED TO AWWs & AWHs:-
By the Govt. of India
- Honorarium: At the beginning of the Scheme in 1975, the Anganwadi Worker was paid honorarium of Rs.100/- per month (Non-Matriculate) and Rs.150/- per month (Matriculate) and Helper was paid Rs.35/- per month. Govt. has increased their honorarium from time to time, as indicated below:
- Leave: Paid absence of 180 days of maternity leave.
Insurance cover: Govt. of India introduced `Anganwadi Karyakartri Bima Yojana’ to Anganwadi Workers/Anganwadi Helpers w.e.f.1.4.2004 under Life Insurance Corporation’s Social Security Scheme. The amount of premium of Rs. 80/- payable by AWWs and AWHs has also been waived of w.e.f. 1.4.2007 to 31.3.2017.
Under this Bima Yojana, a free add on scholarship is available for the children of the members who are covered under the scheme. Scholarship of Rs.300/- per quarter for students of 9th to 12th standard [including ITI courses] would be provided. Scholarship is limited to two children per family.
- Award: In order to motivate the Anganwadi Workers and give recognition to good voluntary work, a Scheme of Award for Anganwadi Workers has been introduced, both at the National and State Level. The Award comprises Rs.25,000/- cash and a Citation at Central level and Rs.5000/- cash and a Citation at State level.
Selection process for conferment of Awards to Anganwadi Workers for the years 2011-12, 2012-13 & 2013-14 have been completed. The Award conferment function is schedules to be held on 10.11.2015 at Vigyan Bhawan, New Delhi.
- Uniform: Government has made a provision for a Uniform (saree/suit @ Rs. 300/- per saree per annum) and a name badge to Anganwadi Workers and Helpers;
By State Governments/ UT Administrations:-
- To recruit at least 25% of Supervisors under ICDS Scheme from AWWs with 10 years’ experience of satisfactory service;
- To Engage 25% of AWWs from amongst the Anganwadi Helpers who have put in minimum 10 years of satisfactory service and also possess the requisite qualifications (age, education etc.) as laid down by the concerned States for selection of AWWs.
- To set up Anganwadi Workers and Helpers Welfare Fund at the State/UT level out of the contribution from Workers/Helpers and State/ UT Governments;
- To set up Grievances Redressal Machinery at the State/UT and Districts level for prompt redressal of their grievances.
Existing Monitoring System under ICDS Scheme:
Ministry of Women and Child Development (MWCD) has the overall responsibility of monitoring the ICDS Scheme. There exists a Central Level ICDS Monitoring Unit in the Ministry which is responsible for collection and analysis of the periodic work reports received from the States in the prescribed formats. Records and registers at AWC level and monthly/ half yearly progress reports at Block and Anganwadi levels have been prescribed. States/ UTs are required to compile the information and send the State level consolidated reports to MWCD on number of operational projects, AWCs, number of beneficiaries of supplementary nutrition and pre-school education and nutritional status of children. The information received in the prescribed formats is compiled, processed and analysed at the Central level on quarterly basis. The progress and shortfalls indicated in the reports on ICDS are reviewed by the Ministry with the State Governments regularly by review meetings and field visits.
Wheat Based Nutrition Programme (WBNP)
Under the Wheat Based Nutrition Programme (WBNP), food grains viz., wheat, rice and other coarse grains are allocated at Below Poverty Line (BPL) rates to the States/UTs through the Department of Food & Public Distribution (D/o Food & Public Distribution), for preparation of supplementary food in ICDS. The Ministry is responsible for processing and approval of the proposals from the States/UTs for allocation of food grains in coordination with the D/o F& PD. During 2014-15, allocation of 9,70,653 MTs of wheat; 7,10,406 MTs of rice and 12,075 MTs of maize was made to 31 States/UTs. An allocation of 4,74,782 MTs of Wheat, 4,40,534 MTs of Rice, 11,036 MTs of Maize and 9418 MTs of Ragi has been made to 30 States/UTs for the 1st and 2nd quarter of 2015-16.
Supplementary Nutrition (under the Integrated Child Development Services Scheme) Rules, 2015 under NFSA, 2013
National Food Security Act (NFSA) was promulgated by the Government of India vide Gazette Notification dated 10.09.2013. In view of this, Supplementary Nutrition Programme (SNP), which is one of six services under ICDS has been made as an entitlement under the NFSA. Sections 4,5,6 & 7 of the NFSA pertain to ICDS and IGMSY schemes of the Ministry. As per clause 22 (3) of the said Act, the Central Government shall provide foodgrains in respect of the entitlements, under Section 4,5 & 6 to the State Governments, at prices specified in Schedule I of the Act.
Section 39 of the NFSA provides that the Central Government may in consultation with the State Governments and by notification make rules to carry out the provisions of this Act. Accordingly, the Supplementary Nutrition (under the Integrated Child Development Services Scheme) Rules, 2015 were notified in the Gazette of India on 01.06.2015 in consultation with State Governments and other stake holders.
Welfare Measures for the AWWs and AWHs
Honorarium of AWWs has been enhanced by Rs.1500/- per month on the last honorarium drawn by them and that of AWHs and AWWs of Mini-Anganwadi Centres by Rs. 750/- per month on the last honorarium drawn by them with effect from 1st April, 2011. The honorarium to AWWs of Mini-AWCs is further enhanced by Rs. 750/- per month, on the last honorarium drawn by them w.e.f. 04.07.2013.
Anganwadi Karyakartri Bima Yojana (AKBY)
The ICDS Scheme envisages Anganwadi Workers (AWWs) and Anganwadi Helpers (AWHs) as honorary workers who are paid a monthly honorarium. AKBY under the LIC’s Social Security Scheme is one of the welfare measures extended to the grassroots functionaries of the ICDS Scheme. The Government of India has introduced the Anganwadi Karyakatri Bima Yojana with effect from 1.4.2004. The premium under the scheme is Rs. 280/- per annum per member out of which Rs.100/- is paid by LIC from Social Security Fund, Rs.100/- by the Government of India and Rs. 80/- by the Anganwadi Worker/Helper (insured member). The premium of Rs. 80/- payable by these workers have been waived off until 31.3.2017. The salient features of this Bima Yojana are as under:-
- Natural death Rs. 30,000
- Accidental benefit Death/ Total permanent disability Rs. 75,000
- Partial permanent disability Rs. 37,500
Female Critical Illness (FCI) Benefits
An amount of Rs. 20,000/- is payable on the diagnosis of invasive cancers (malignant tumour) manifest in the organs (i) Breast, (ii)Cervix Uteri, (iii) Corpus Uteri, (iv) Ovaries, (v) Fallopian Tubes, (vi) Vina/Vulva (subject to proof of affliction satisfactory to Corporation). A malignant tumour characterized by uncontrolled growth and spread of malignant cells and invasion of tissue that originates in one of the above anatomical sites is covered under the Scheme.
Shiksha Sahayog through Anganwadi Karyakartri Bima Yojana(AKBY-LIC)
A free add-on scholarship benefit is available for the children of Anganwadi Workers covered under the AKBY Scheme. Scholarship of Rs. 300/- per quarter for students in 9th to 12th standard (including ITI courses) is provided. Scholarship is limited to two children per family. With the waiver of Rs. 80/- as premium payable towards critical illness by the Anganwadi Workers (AWWs) and Helpers (AWHs) w.e.f. 1.4.2007, all AWWs and AWHs are covered for all the benefits under the Scheme. During the financial year 2015-16 (upto 31.06.2015).
It is necessary that AWC is consolidated as the first village/ habitation post for health, nutrition and early learning centre or platform on which the two new Schemes of SABLA and IGMSY are also implemented. Till Restructured ICDS was approved in 12th Plan, ICDS Scheme did not have provision for construction of AWC buildings except in the North Eastern (NE) states. As part of Strengthening and Restructuring of ICDS Scheme, Government of India has approved provision for construction of 2 lakh AWC buildings @ Rs. 4.50 lakh per AWC building during the XII Plan period in a phased manner with cost sharing ratio of 75:25 between Centre and States other than the NE States, where it will be at the existing ratio of 90:10.
As per the information available as on 31 March 2015 from 12.15 lakh AWCs/ mini-AWCs, about 81.19 % AWCs are running from the pucca buildings and remaining 18.81% from kutcha buildings; 30.62% running from Government owned buildings; 21.62% running from school premises; 4.54% running from Panchayat buildings; 32.56% running from rented including 5.90% from AWWs/ AWHs house; 9.79% running from others; 0.87% running from open space. 65.91% AWCs are having drinking water facilities within the premises and 50.01% AWCs have toilet facilities.
Convergence with other programmes: States/UTs have been requested to tap the funds for construction of AWC buildings from various schemes such as MPLADs, MLALADS, BRGF, RIDF, Panchayati Raj Institutions, MGNREGA and Tribal Affairs, Multi-Sectoral Development Programme of Ministry of Minority Affairs (MoMA), under SSA, Finance Commission, Additional Central Assistance under State Plan, Integrated Action Plan for Left Wing Extremism (LWE) districts, etc. Construction of AWC buildings has also been included in the list of permissible works in Schedule-I under MGNREGA, 2005 vide notification dated 22.11.2012.
Grant in aid for construction of AWC Building under restructured ICDS: Under restructured ICDS Scheme, Grant-in-aid at the rate of Rs. 4.5 lakhs per AWC Building construction in the cost sharing ratio of 75:25 between the Centre and States has also been allowed from the year 2013-14 and first instalment of Rs. 723.59 crore has been released for construction of 44,709 AWC Buildings in 2013-14. During 2014-15, Funds for AWCs construction in the States of Chhatisgarh (3504.00 lakh), Madhya Pradesh (6422.81 lakhs), Tamilnadu (Rs. 3788.82 lakhs), Arunachal Pradesh (Rs. 1570.13 lakhs), Goa (Rs.13.50 lakhs), Rajasthan (3278.82 lakhs) and Uttarakhand (Rs. 128.68 lakhs) were released.
APIP approved 42156 AWC buildings for up-gradation during the previous financial year 2014-15 in the cost sharing ratio of 75:25. The first instalment of Rs.31613.25 lakhs has been released to States/UTs for upgradation of Anganwadi Centre buildings.
Implementation of ICDS Scheme as per State Annual Programme Implementation Plan (APIP)
The Government of India has introduced development of Annual Programme Implementation Plans (APIPs) in ICDS since 2011-12 in a prescribed format. The APIP mode of programme implementation in ICDS Scheme is one of the key aspects of the recently approved strengthened and restructured ICDS Scheme for the 12th Plan whose administrative approval has been issued to the States on 22nd October, 2012.
The States/UTs were also informed that from 2013-14, submission of the APIP by the States/UTs in the prescribed format will be mandatory and the second as well as any subsequent installments of funds from GOI will be released to the States/UTs only after approval of the APIP, according to the demand justified in the APIP.
APIPs from 30 States/UTs have been received during 2015-16. The Administrative approval will be issued after holding a meeting with the States/UTs.
Cooperation with Development Partners
Several international agencies/development partners including UNICEF provide technical assistance to ICDS programme both at the central and State level. Some of them are given below:
GoI-UNICEF Programme of Cooperation
The partnership between UNICEF and the Government of India (GoI) spans over more than 60 years. UNICEF has continued its support to government in enhancing systems and improving delivery of services to women and children especially from the vulnerable and marginalized sections. The Basic Agreement that provides basis of the relationship between the GoI and UNICEF dates from 10 May 1949 and was amended on 5 April 1978. Over the last 65 years, a succession of Country Programmes has been implemented in conformity with the Basic Agreement. Currently the Govt. of India collaborates with UNICEF based on an agreed five year Country Programme Action Plans (CPAP). The current CPAP 2013-17 was signed between the Ministry of Women and Child Development and UNICEF on 21 January 2013 with an estimated budget US$ 750 million.
Besides UNICEF, following Development Partners also support the ICDS Scheme:
- DFID (Department for International Development, Govt. of United Kingdom): Provides technical assistance to ICDS in three States (Odisha, MP and Bihar) and also at the central level to support restructured ICDS. Delloite India is supporting DFID as Technical Support Agency (TSA) by providing field level technical assistance.
- WFP (World Food Programme): Provides technical assistance to the Ministry at the central level and also provides technical support in ICDS implementation.
- CARE India: Supporting the Ministry in strengthening ICDS MIS.
Government has initiated the roll out of a Community based care programme for undernourished children under 6 years across the country through the Integrated Child Development Services (ICDS) scheme. Restructured and strengthened ICDS scheme comprises a number of new components. One of these components is “Sneha Shivir” which is designed to be a community based approach for the prevention and management of moderate and severe under nutrition. Sneha Shivir has been introduced in 200 high burden districts of the country and is to be served through an Additional Anganwadi Worker/Nutrition Counsellor at the Anganwadi Centre.
During the SNEHA SHIVIRs the Anganwadi workers with the help of community volunteers, mothers groups and SHGs facilitate a-learning-by doing technique for mothers and caregivers of moderate and severe underweight children. Nutrition Counselling and Child Care sessions organized at cluster level helps caregivers and mothers practice new cooking, feeding, hygiene, health and caring behaviors shown to be successful for rehabilitating underweight children. The selected practices would come from both public health accepted behaviors and from the positive practices seen in the homes of healthy children living in the same milieu and belong to similar socio economic group. The SNEHA SHIVIRs promotes behavior change and empowers caregivers to take responsibility for nutritional rehabilitation of their children using local knowledge and resources and peer learning at 12 day sessions followed by 18 days home based practices.
During the 12 days, children are fed additional high calorie local foods, provided underICDS and from contribution of care givers and community. During 12 days, children regain appetite and visible changes are seen as also indicated by gain in weight, a gain of 200-400 gms is expected. The 12 day session is followed by 18 day home based care during which the practices learnt at the sessions are followed at home. During these 18 days Anganwadi workers closely monitor these children through home visits, a further weight gain is expected if the practices are followed. During this process of rehabilitation the mothers imbibe the practices thoroughly so that they can sustain the rehabilitation and prevent undernutrition in other siblings. There is also a ripple effect which leads to an improvement in care practices in other families.
Key interventions of SNEHA SHIVIRs organized during the 12 day session would largely include
- Selection of moderate and severe undernourished children (preferably not more than 15 per AWC / cluster)
- Orientation of mothers and caregivers of selected children
- Weight monitoring of the selected children
- Deworming of these children
- Ensure IFA and complete immunization for these children
- 12 day hands-on practice sessions for mothers and care givers to promote improved feeding and child care practices.
- Recording of weight on first day, 12th day and after 18 days
Theme based education using IEC on feeding, health, hygiene and psychosocial care on each of the 12 days, using mother child protection card package.
Health check-up and referral services.
- 18 days home based practices.
- Repeat of session for each child till child becomes normal.
- Monitoring progress – child-wise, AWC-wise as well as at the block and district levels.
The session requires the support of Ministry of Health and Family Welfare the ANM / doctor under the NHM carries out health checkup of all the underweight children enrolled for Sneha Shivirs., the ANM or a doctor assigned by the NHM decides on type of referral or treatment facilities required as well as linking the child to the appropriate health care / facility based treatment.
INTRODUCTION OF WHO GROWTH STANDARDS IN ICDS
The World Health Organization (WHO) based on the results of an intensive study initiated in 1997 in six countries including India has developed new International Standards for assessing the physical growth, nutritional status and motor development of children from birth to 5 years age. The Ministry of Women and Child Development and Ministry of Health have adopted the New WHO Child Growth Standard in India on 15th of August, 2008 for monitoring the Growth of Children through ICDS and NRHM.
A common Mother & Child Protection Card (MCPC) to be used under both ICDS & NRHM programme has been sent to all States/UTs with a letter under joint signatures of both the Secretaries of WCD & Health. It is currently under roll out by the States/UTs.
(i) - Change in current estimates
- increase in total of normal weight children
- increase in severely underweight children
- increase in underweight children (mild/moderate and severe)
in age group of 0-6 months.
- The requirement of funds for SNP; Centre and State contribution would be almost double.
- The Anganwadi Worker with the help of New Growth Chart would be able to assess correctly severely underweight children and number of such children would increase in each Anganwadi Centres. The number of normal children would also increase in all the Anganwadi Centres.
- The new charts would now help us in comparing growth of our children within projects, districts, states & also other countries.
According to the recent review under the Secretary, WCD, and the information provided by the States , the new WHO Growth Chart has been implemented in 6666 ICDS Projects and 12,71,889 Anganwadis.
The joint MCPC card has been completed in 6621 Projects and 10,12,153 Anganwadi centres. The States have been impressed upon to ensure compliance of the roll out of New WHO Growth Chart & MCPC card.
- 4.59 lakh new AWCs/mini-AWCs became operational during XI Plan as compared to 2.99 lakh AWCs/ mini-AWCs during X Plan. The number of operational AWCs/ mini-AWCs increased from 13,04,611 in March 2012 to 13,46,186 in March 2015.
- Number of beneficiaries [Children (6 months to 6 years) and pregnant & lactating mothers] for supplementary nutrition increased from 705.43 lakh at the end of X Plan to 972.49 lakh at the end of XI Plan meaning thereby an increase of 37.85% and further increased to 1022.33 lakh in March 2015.
- Number of beneficiaries [Children (3-6 years)] for pre-school education increased from 300.81 lakh at the end of X Plan to 358.22 lakh at the end of XI meaning thereby an increase of 19.09% and further increased to 365.44 lakh in March 2015
As on 31st March 2015, 7072 projects and 13,46,186 AWCs are operational across 36 States/UTs, covering 1022.33 lakh beneficiaries under supplementary nutrition and 365.44 lakh 3-6 years children under pre-school component.