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Utilization of ICDS:
Does it make a
difference to child
weight?
CONFERENCE ON CHILD
HEIGHT, STUNTING, EARLY-
LIFE DISEASE ...
Introduction
□ ICDS was one of the programmes launched by the
Indian government for holistic development of
children
□ Uni...
Objectives
□ Analyze the factors that determine demand for
utilization of ICDS services.
□ Measure the impact of ICDS on h...
Literature Review
□ Selected literature review
□ Lokshin (2005) and Bredankamp and Akin (2004) – no impact of ICDS
on stun...
Theoretical Model - I
□ Assume a three member household, with a mother (m), father
(f) and child (c). Its welfare function...
Theoretical Model - II
□ The household maximization can be divided in two cases
□ Case 1
Maximize
s.t.
□ Case 2
Maximize
s...
Theoretical Model - III
□ Let W1
* and W0
* be the maximum welfare for case 1 and
case 2 respectively.
□ The household wil...
Data
□ Study Area – East India, VDSA villages
□ Age group – 6 months – 6 years
□ Sample size – 278 children in 11 VDSA vil...
Summary Statistics - I
□ Difference between de-juro and de-facto availability, and
actual utilization.
□ The actual utiliz...
Summary Statistics
Variables Bihar Jharkhand Orissa Total
Sample size (N) 104 118 56 278
ICDS utilization (%) 42 84 87 69
...
Summary Statistics - III
Yes No Significant
differenceVariables Utilized ICDS services
Underweight (%) 49 44 No
Distance (...
Empirical Estimation - I
□ System of recursive equations
□ Systems estimation with one discrete and one
continuous depende...
Empirical Estimation - II
□ Determinants of Utilization of ICDS services
□ Individual specific covariates – Age, gender
□ ...
Utilization of ICDS services LPM Probit
Age (months) -0.004** -0.020***
(0.001) (0.005)
Gender (1=Male) 0.029 0.124
(0.046...
Empirical Estimation - III
□ Health outcomes – standardized weight
□ Individual specific covariates – ICDS utilization, Di...
Weight-Standardized LPM 2 stage
ICDS utilization 1.289** 0.980
(0.733) (0.554)
Dietary Diversity 0.044 0.030
(0.019) (0.01...
Conclusion
□ Proximity to ICDS center is crucial to utilization of ICDS services.
□ Low economic status correlated with hi...
Way Forward
□ Examining if utilization of each individual service is
demand driven or supply constrained.
□ Examine impact...
Acknowledgements
□ Funding – PhD Research Fellowship under VDSA, ICRISAT
□ Institutional Support - ICRISAT, NCAP, ICAR – P...
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4 nitya mittal - icds

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4 nitya mittal - icds

  1. 1. Utilization of ICDS: Does it make a difference to child weight? CONFERENCE ON CHILD HEIGHT, STUNTING, EARLY- LIFE DISEASE & SANITATION Nitya Mittal (PhD Scholar, DSE)
  2. 2. Introduction □ ICDS was one of the programmes launched by the Indian government for holistic development of children □ Universalized in 11th five year plan with huge budgetary allocation □ Poor uptake of ICDS(only 35% as per NFHS 3) □ Mixed evidence of impact on health outcome □ Need to evaluate performance and investigate reasons for underperformance
  3. 3. Objectives □ Analyze the factors that determine demand for utilization of ICDS services. □ Measure the impact of ICDS on health outcomes.
  4. 4. Literature Review □ Selected literature review □ Lokshin (2005) and Bredankamp and Akin (2004) – no impact of ICDS on stunting □ Deolalikar (2004) and Kandpal (2009) – negative impact on probability of underweight and stunting respectively. □ Saiyed and Seshadri (2000) find lower impact of partial utilization of ICDS services. □ Monika Jain – (2011) accounts for selective placement and utilization. She finds no impact of availability but a positive effect of utilization on health care outcomes. But she considers only one service of ICDS – supplementary nutrition.
  5. 5. Theoretical Model - I □ Assume a three member household, with a mother (m), father (f) and child (c). Its welfare function is given by- where F is food consumption, G is non-food consumption and H is health status □ The household maximizes its welfare function subject to health production function and budget constraint.
  6. 6. Theoretical Model - II □ The household maximization can be divided in two cases □ Case 1 Maximize s.t. □ Case 2 Maximize s.t.
  7. 7. Theoretical Model - III □ Let W1 * and W0 * be the maximum welfare for case 1 and case 2 respectively. □ The household will choose to utilize ICDS services if and only if: □ The underlying demand for ICDS services is given by □ The reduced form for health outcome is or
  8. 8. Data □ Study Area – East India, VDSA villages □ Age group – 6 months – 6 years □ Sample size – 278 children in 11 VDSA villages, 34 ICDS centers □ Study funded by VDSA, ICRISAT □ Two Questionnaires – household and anganwadi □ Household Questionnaire □ Availability and utilization of each ICDS service, anthropometric outcomes, demographics, assets, monthly expenditure, prices □ Anganwadi Questionnaire □ Availability of equipments, facilities and services
  9. 9. Summary Statistics - I □ Difference between de-juro and de-facto availability, and actual utilization. □ The actual utilization of services is much lower than availability, indicating that households do not choose to utilize all the services available at the ICDS center. Number of services that ICDS center says are available 3.5 Number of services household perceive to be available 3.2 Number of services utilized 1.7
  10. 10. Summary Statistics Variables Bihar Jharkhand Orissa Total Sample size (N) 104 118 56 278 ICDS utilization (%) 42 84 87 69 ICDS utilization NFHS-3(%) 8.8 38.6 60.5 Underweight (%) 50 56 33 49 Underweight NFHS-3 (%) 55 56 41 Age (months) 40 39 43 40 Male (%) 49 51 50 50 Mother - working (%) 12 10 6 10 Mother Education (years) 5 3 7 5 Father Education (years) 9 6 7 7 Schedule Caste (%) 22 10 10 15 Schedule Tribe (%) 0 64 9 29 Backward Class (%) 55 24 56 41 Non-Hindu (%) 2 27 2 13 Open defecation (%) 63 97 89 83
  11. 11. Summary Statistics - III Yes No Significant differenceVariables Utilized ICDS services Underweight (%) 49 44 No Distance (meter) 225 583 Yes Schedule Tribe (%) 34 17 Yes Underweight Mother - working (%) 12 6 Yes Schedule Tribe (%) 37 25 Yes Open defecation (%) 90 80 Yes Underweight (%) Utilized ICDS service (%) Yes No Yes 35 14 No 36 15
  12. 12. Empirical Estimation - I □ System of recursive equations □ Systems estimation with one discrete and one continuous dependent variable □ Simultaneous estimation – LPM □ Maddala (1976)
  13. 13. Empirical Estimation - II □ Determinants of Utilization of ICDS services □ Individual specific covariates – Age, gender □ Household specific covariates - Distance to ICDS center, Mother’s education, Mother’s occupational status, Economic status, Caste category, Religion □ State fixed effects
  14. 14. Utilization of ICDS services LPM Probit Age (months) -0.004** -0.020*** (0.001) (0.005) Gender (1=Male) 0.029 0.124 (0.046) (0.197) Distance (meter) -0.299*** -1.454*** (0.070) (0.340) Assets -0.042*** -0.190*** (0.013) (0.055) Jharkhand 0.398*** 1.242*** (0.074) (0.323) Orissa 0.380*** 1.113*** (0.073) (0.291) Observations 227 259 Log-likelihood -6300 -107 Standard Error in parenthesis. ***p<0.01, **p<0.05, *p<0.10
  15. 15. Empirical Estimation - III □ Health outcomes – standardized weight □ Individual specific covariates – ICDS utilization, Dietary diversification, Vaccination (number of vaccines received out of 9 government mandated vaccines), Dummy for morbidity (fell sick in last one month), Size at birth □ Household specific covariates – Sanitation, Source of water supply, Economic status, Mother’s education, Father’s education, Mother’s occupational status, Household size, Caste category, Religion □ State fixed effects
  16. 16. Weight-Standardized LPM 2 stage ICDS utilization 1.289** 0.980 (0.733) (0.554) Dietary Diversity 0.044 0.030 (0.019) (0.018) Vaccination 0.089 0.082 (0.049) (0.052) Morbidity (Dummy) -0.532 -0.646 (0.204) (0.230) Open Defecation -0.606 -0.723 (0.323) (0.335) Log(Monthly per capita expenditure) 0.610 0.635 (0.297) (0.308) Household size 0.084 0.077 (0.034) (0.035) Jharkhand -1.106** -0.847 (0.536) (0.425) Orissa -0.447 -0.156 (0.482) (0.381) Observations 227 227 LL / R-squared -6300 24.34
  17. 17. Conclusion □ Proximity to ICDS center is crucial to utilization of ICDS services. □ Low economic status correlated with higher utilization. There are no gender, caste or religion differences in utilization of ICDS services, but there are regional differences. □ ICDS utilization has a positive impact on weight but magnitude appears large. □ Economic status, hygienic sanitation facility, vaccinations, better diet quality all affect weight.
  18. 18. Way Forward □ Examining if utilization of each individual service is demand driven or supply constrained. □ Examine impact of individual service utilization on anthropometric outcome.
  19. 19. Acknowledgements □ Funding – PhD Research Fellowship under VDSA, ICRISAT □ Institutional Support - ICRISAT, NCAP, ICAR – Patna □ Enumerators – Amit Kumar, Chittaranjan Sharma, Dayanand Tripurari, Ganesh Prasad Behura, Harendra Kumar Chaubey, Nalini Ranjan Sahoo, Prakash Kumar , Rajesh Kumar, Sanjay Kumar, Sant Kumar Rai, Saroj Kumar Majhi

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