The Integrated Child Development Services (ICDS) program is India's largest public health program for children under 6 years old and pregnant/nursing women. It aims to improve nutritional and health status through Anganwadi centers that provide nutrition, immunizations, health checkups, and preschool education. Over 34 million children and 7 million women are served by nearly 1.4 million centers run by Anganwadi workers. The program faces challenges with quality of care, capacity of workers, and community involvement.

1. Integrated Child
Development Services
Dr. Shamshuddin Sr Patel
Intern
Mandya Institute Of Medical Sciences
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2. Introduction
• India’s response to the challenge of meeting the needs of its children
• To break vicious cycle of malnutrition
• To promote child development
• Largest public initiative in the world (1975)
• One of the eight flagship programs of GOI
• It reaches more than 34 million children aged 0-6 years and 7 million
pregnant & lactating mothers
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3. Objectives
1. To improve the nutritional status of preschool children 0-6 years of age
group.
2. To lay the foundation of proper psychological development of the child
3. To reduce the incidence of mortality, morbidity, malnutrition and school
drop out
4. To achieve effective coordination of policy and implementation in various
departments to promote child development
5. 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.
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4. Services Provided
• Nutrition
• Supplementary nutrition
• Growth monitoring and promotion
• Micronutrient supplementation/ promotion
• Pre-school non-formal education
• Health
• Immunization
• Periodic health check-ups
• Referral services
• Nutrition and health education
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5. Target Groups
Beneficiaries Services Provided
Pregnant women Health check-ups,
TT Vaccination,
Supplementary nutrition,
Health education.
Nursing Mothers Health check-ups,
Supplementary nutrition,
Health education
Children less than 3 years Supplementary nutrition,
Health check-ups,
Immunization,
Referral services
Children between 3-6 years Supplementary nutrition,
Health check-ups,
Immunization,
referral services,
Non formal education
Adolescent girls 11-18 years Supplementary nutrition,
Health education
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6. Supplementary Nutrition
• Each child up to 6 years of age to get 300 calories and 8-10 grams of
protein
• Each adolescent girl to get 500 calories and 20-25grams of protein
• Each pregnant women and lactating mother to get 500 calories and
20-25 gms of protein
• Each malnourished child to get 600 calories and 16-20 grams of
protein
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7. Immunization Services
• Immunization of pregnant women and infants protects children from
six vaccine preventable diseases-poliomyelitis, diphtheria, pertussis,
tetanus, tuberculosis and measles.
• These are major preventable causes of child mortality, disability,
morbidity and related malnutrition. Immunization of pregnant
women against tetanus also reduces maternal and neonatal mortality.
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8. Referral Services
• During health check-ups and growth monitoring, sick or malnourished
children, in need of prompt medical attention, are referred to the
Primary Health Centre or its sub-centre.
• The anganwadi worker has also been oriented to detect disabilities in
young children. She enlists all such cases in a special register and
refers them to the medical officer of the Primary Health Centre/ Sub-centre
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9. Non-formal Pre-School Education (PSE)
• Non-formal Pre-school Education (PSE) component of the ICDS may
well be considered the backbone of the ICDS program.
• These AWCs have been set up in every village in the country. As a
result, total number of AWC would go up to almost 1.4 million.
• This is also the most joyful play-way daily activity, visibly sustained for
three hours a day. It brings and keeps young children at the
anganwadi centre.
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10. Non-formal Pre-School Education (PSE)
• Its program for the three-to six years old children in the Anganwadi is
directed towards providing and ensuring a natural, joyful and
stimulating environment, with emphasis on necessary inputs for
optimal growth and development.
• The early learning component of the ICDS is a significant input for
providing a sound foundation for cumulative lifelong learning and
development.
• It also contributes to the universalization of primary education, by
providing to the child the necessary preparation for primary schooling
and offering substitute care to younger siblings, thus freeing the older
ones – especially girls – to attend school.
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11. Health check-ups
• Record of weight and height of children at periodical intervals
• Watch over milestones
• Immunization
• General check up for detection of disease
• Treatment of diseases like diarrhea, ARI
• Deworming
• Prophylaxis against vitamin A deficiency and anemia
• Referral of serious cases
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12. Mother and Child Protection Card
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13. Why focus on early child development?
• Brain development is most rapid and vulnerable from conception to
five years.
• The factors known to affect child development are common,
especially in low/middle income countries
• Impaired child development has life-long effects
• Interventions in early childhood are more cost effective than at other
ages.
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14. Anganwadi Centre
• Anganwadi is the Focal Point for Delivery of ICDS Services.
• Located in a Village/Slum.
• Anganwadi is run by an AWW, supported by a Helper.
• AWW is the 1st Point of Contact for Families Experiencing Nutrition
and Health Problems.
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15. Population Norms
• One AWC for every 800 population
• For Rural/ Urban Projects
• 400 – 800 – 1 AWC; 800-1600 – 2 AWCs
• 150-400 – 1 Mini AWC
• Tribal/ Desert/ Hilly areas
• 300 – 800 – 1 AWC
• 150-300 – 1 Mini AWC
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16. Anganwadi worker (AWW)
• Monitor growth of children
• Provide non formal pre-school education
• Provide supplementary nutrition
• Give health and nutrition education
• Referral for sick children
• Elicit community participation
• Provide health service in collaboration with ANM/ASHA
• Implement adolescent girls’ scheme
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17. Anganwadi worker (AWW)
• Anganwadi Workers (AWWs) & Anganwadi Helpers (AWHs), being
honorary workers, are paid a monthly honoraria as decided by the
Government from time to time. AWWs are paid a monthly honoraria
depending on their educational qualifications and experience.
Similarly, AWHs being paid monthly honoraria of Rs. 500/-
• In addition to the honoraria paid by the Government, many
States/UTs are also giving monetary incentives to these workers out
of their own resources for additional functions assigned under other
Schemes.
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18. Training Infrastructure
• There is a countrywide infrastructure for the training of ICDS
functionaries, viz.
• Anganwadi Workers Training Centers (AWTCs) for the training of
Anganwadi Workers and Helpers.
• Middle Level Training Centers (MLTCs) for the training of Supervisors
and Trainers of AWTCs;
• National Institute of Public Cooperation and Child Development
(NIPCCD) and its Regional Centers for training of CDPOs/ACDPOs and
Trainers of MLTCs. NIPCCD also conducts several skill development
training programmes
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19. Monitoring at village level
• At the grass-root level, delivery of various services to target groups is
given at the Anganwadi Centre (AWC).
• The Monthly and Half-yearly Progress Reports of Anganwadi Worker
have also been prescribed. AWW is required to send these Monthly
Progress Report (MPR) by 5th day of following month to CDPO’ In-charge
of an ICDS Project.
• Similarly, AWW is required to send Half-yearly Progress Report (HPR)
to CDPO by 5th April and 5th October every year
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20. Monitoring at Block level
• At block level, Child Development Project Officer (CDPO) is the in-charge
of an ICDS Project. CDPO’s MPR and HPR have been prescribed
at block level.
• A supervisor, under the CDPO is required to supervise 25 AWC on an
average.
• CDPO is required to send the Monthly Progress Report (MPR) by 7th
day of the following month to State Government. Similarly, CDPO is
required to send Half-yearly Progress Report (HPR) to State by 7th
April and 7th October every year.
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21. Challenges faced in the present interventions
• Poor quality of child development services.
• Overburden on the ICDS.
• Capacity of Child Care Workers.
• Not recognized as skilled work.
• Unavailability of trained manpower.
• Poor attention to age-group 0-3 years.
• Involvement of the family and community.
• Minimum standards and regulatory mechanisms.
• Poor documentation of efforts in Voluntary sector.
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22. References
• "UNICEF - Respecting the rights of the Indian child". UNICEF. Retrieved 26 July 2014,
www.unicef.org/sowc01/panels/panel7.htm
• "Integrated Child Development Services (ICDS) Scheme". Ministry of Women & Child
Development, Government of India. Retrieved 26 July 2014, www.wcd.nic.in/icds.htm
• Kapil, U. (July 2002). "Integrated Child Development Services (ICDS) scheme: a program for holistic
development of children in India". Indian J Pediatr (Indian Journal of Pediatrics) 69 (7): 597–601.
doi:10.1007/bf02722688. PMID 12173700.
• "The Integrated Child Development Services (ICDS)". UNICEF. Retrieved 26 July 2014,
www.unicef.org/india/media_2640.htm
• "Supreme Court Commissioners". www.sccommissioners.org. Retrieved 26 July 2014.
• "The WHO Child Growth Standards". World Health Organization. Retrieved 26 July 2014,
www.who.int/childgrowth/en/.htm
• "CHAPTER 2 THE INTEGRATED CHILD DEVELOPMENT SERVICES PROGRAM (ICDS) – ARE RESULTS
MEETING EXPECTATIONS?". World Bank. Retrieved 26 July 2014,
siteresources.worldbank.org/SOUTHASIAEXT/resources/223546-
11472668285/undernourished_chapter_2.pdf
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23. Thank You
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