Worlds largest and unique early childhood development programme Introduced on 2nd October 1975 has so many positive outcomes till date but yet to achieve its objectives....

1. Dr Rajesh Kumar Ludam
PG Student
Dept of Community Medicine
V.S.S.M.C.H , Odisha

2. Every fifth young child in the
world lives in India
Every second young child in India
is malnourished
Three out of four young
children in India are anaemic
Every second newborn in India is
at risk of reduced learning
capacity
due to iodine deficiency
Malnutrition limits
development potential and
active learning capacity of the
child

3. Introduction-:
 Worlds largest and unique early childhood
development programme of its kind.
 Introduced on an experimental basis on 2nd
October 1975 in 33 project blocks.
 The outreach of ICDS services has increased
enormously.
 Nutritional and developmental needs of
children below six years, pregnant and
lactating mothers.

4.  7025 projects and 13,31,076 AWC’s are
operational in 35 States/UTs
 927.66 lakh beneficiaries under supplementary
nutrition and 346.66 lakh 3-6 yr children under
pre-school education component.
 Cost sharing between the Centre and State-:
- 90:10 for all components including SNP for NE
- 50:50 for SNP and 90:10 for all other
components for states other than NE
 Key functionary is AWW & Overall
responsibilities lies with the CDPO.

5. Objectives-:
 Improve the nutrition and health status of the
children.
 Foundations for proper physical, social and
psychological development.
 Reduce the incidence of
morbidity,mortality,malnutrition and school
dropouts.
 Achieve effective coordination and amongst the
various departments .
 Enhance capability of the mother to look after
normal health and nutritional needs of child.

6. THE TARGET GROUPS
 Pregnant women
 Nursing Mothers
 Children less than 3 years
 Children between 3-6 years
 Adolescent girls( 11-18 years)
 Health check-ups, TT,
supplementary nutrition,
health education.
 Same as pregnant mothers
except TT.
 supplementary nutrition,
health check-ups,
immunization, referral services
 Same as children below 3 years
+ non formal education
 supplementary nutrition,
health education
BENEFICIARY SERVICES

7. Positive Outcomes-:
 Birth rate & IMR has decreased significantly.
 Under-five years mortality has also decreased.
 Percentage of children in severe grades of
malnutrition has declined.
 School enrolment and performance of children is
better.
 School drop out has reduced.
 Immunisation status of the beneficiaries has been
improved.
 Burden of Blindness and Anaemia has also
decreased.

8. :-BOTTLENECKS-:
 Defective Policy Development-
-Incomplete mapping and ground verification.
-Lack of comprehensive program implementation
guidelines
-Inadequate operational efficiency & accountability
-Improper fund transfer mechanism
-Non-revision & indexation of cost to rising prices.
-Low focus on growth monitoring
- Inadequate fund for community mobilization by
IEC.

9. INFRASTRUCTURE AND EQUIPMENT-:
 Failure to sanction of req no. of AWCs & also to
operationalise even the sanctioned ones.
 Delay in construction of AWC building.
 A study by NIPCCD reveals 42.5% of sampled
AWCs had their own building,17.4% were in
rented,17,3% in primary schools.
 Countrywide around 75% of AWCs have Pucca
structure.
 Necessary equipments, furniture, utensils are
lacking

10.  69% of sampled AWCs have functional baby
weighing scale
 87% have drinking water supply with a little
information regarding its hygiene.
 Less than 50% have toilet facility.
 Lack of functional computers, printers and
vehicles.

11. HUMAN RESOURCE-:
• Shortage of nearly 30% of CDPO and 29% of
supervisors
• Those who are present only 70% are trained.
• Almost all AWWs are in position but about 80%
of them are matriculated or above
• One third of them have in-service training.
• A study from AP reported most supervisors have
average job performance
• Posting of AWH is also disappointing.

12.  SUPPLEMENTARY NUTRITION AND
GROWTH MONITORING-:
- The NCAER study reports about 60%
registration.
- Review in Rajasthan found nearly 92% women
getting the benefits but the food served is stale.
- Evaluation in J&K,WB,MP,UP,Bihar reported
children not weighted regularly with about 60%
coverage.
- Per beneficiary per day expenditure remain low
compared to stipulated norms.
- Improper storage of the supplies and unhealthy
cooking environment

13. - Evaluation report of planning commission showed
64% of registered received food 16 days/M.
IMMUNISATION-:
- Study in Chandigarh reports TT Coverage about
70% in pregnant women
- Evaluation in J&K 91% for polio and DPT, 89%
BCG,74% for measles.
- Centre for Child Rights discovered >50% not fully
immunized ,14% were never immunized.
- Poor awareness of people, non co-operation of
staffs, disbeliefs are major hurdles for 100%
immunization.

14. Non formal pre school education-:
 No data of eligible beneficiaries and also
implementation plan.
 Average attendance found on three successive visits
by research team was 14.
 A study in WB reported that majority of parents
send their children for food rather than PSE.
 A report from Odisha in 2007 covering 12 villages
found that pre-school education was present in only
one village.
 Pre school education quality are also compromised as
reported by various studies.

15. Health check-up and referral-:
 As per an evaluation by planning commission in 2011
health check ups are provided by nearly 70% and
referral by around 50% AWCs across country.
 A review by UNICEF and Gram-Sabha stated health
check-ups and distribution of medicines were
irregular in Bihar.
 UNESCO found these to be the weakest link of ICDS
due to lack of community participation and health
staffs.

16. Nutritional Health Education-:
 Not effective because of-:
-Faulty service and providers
-Lack of active participation of women
-Literacy status of women
-Religious constraints
-False Beliefs

17.  Monitoring & Evaluation-:
- Vacancy in supervisory staff resulting in deficient
reporting at field level.
- The M&E unit of Ministry don’t have fully reliable
data.
- The State visits of officers and their corrective
action reports are not properly documented.
- Insufficient action taken by the Ministry to
address the reported shortcomings through
performance audit by C & A G.

18. Summary-:
1. Inadequate emphasis on Nutrition and Health
Education (NHE) activities for behavior change
2. The focus and coverage of children in 0-3 years of
age is inadequate.
3. Lack of effective co-ordination between Health
and ICDS functionaries.
4. Irregular supply of Supplementary Food due to
administrative reasons.
5. Programmatic emphasis on Community
participation is poor.

19. 6.The quality of training of Anganwadi workers needs
improvement.
7. The referral system is weak.
8. Home visits by AWWs are infrequent.
9. There is inadequate decentralization; i.e. the same
guidelines of Government of India are followed all
over the country.
10. AWW has not been accorded the dignity and
prestige as a voluntary worker.
11. Failure to promote effective community leadership
and participation.
12. The role of supervisor is marginal and the CDPO’s
skills require improvement

20. CHALLENGE-:
To harmonize the geographic expansion along
with an improved implementation strategy to
accelerate better & visible programme
outcome….