Aradhna, a six-year-old girl, living in a Kechhodadar village, refuses to believe that the Anganwadi Centre is the only means to a healthy childhood for her brother and herself. The reason is simple; she says the Anganwadi Centre located in her village does not provide for even the most necessary services that they require. Indeed, Aradhna’s younger brother is undernourished and underweight.
The village does have an operational Anganwadi Centre, but there is no visible impact of its services in changing the nutritional status of children like Aradhna.
The problem lies not only in the irregularity of services and a lack of access to them. It also lies in the ignorance of parents, who often fail to understand the effects of undernutrition on a child’s development.
It’s the children who bear the brunt of deprivation as families struggle for sustenance, and providing nutritious food to them becomes a distant reality. India constitutes the largest number of malnourished children in the world and performs dismally on all child nutrition indicators.
Poor nutrition in infants and young children results in growth failure, lowered resistance to infections, increased rates of morbidity, and increased risks to survival, impaired growth and poor school performance.
Though the Government of India has recognized the essential components for initiating a turnaround, an alarming growth in the undernourished population has been recorded. As corroborated by a report given by Global Hunger Index (GHI, 2017), India stands on the 100th position out of 119 nations, with a score of 31.4, at the high end of the ‘serious’ category.
This article highlights the challenges related to Integrated Child Development Services (ICDS) programme in urban areas with a more specific reference to urban poor and slum population in India.
Recognising the crucial importance of a holistic emphasis on the age group 0-6, the Integrated Child Development Services (ICDS) Scheme, a centrally sponsored national flagship scheme of the Government of India, aims at addressing health, nutrition and the development needs of young children (0-6 years), pregnant women and nursing mothers.
The ICDS scheme covers 14 lakh habitations and about 3.50 crore children (3-6 years) are attending pre-school education at 13.50 lakh Anganwadi Centres (AWCs) as on March 31, 2016.
Only 38% of children in the age group of 3-5 years are enrolled in pre-school education in government Anganwadi centres, while 27% of the children are not attending any (either government or private) pre-school (Rapid Survey on Children, 2013-14).
It is an influential instrument to guarantee equal opportunities to the present and future generations of the socially deprived by breaking an intergenerational cycle of multiple deficits: under-nutrition, illiteracy, gender and other forms of discrimination and poverty.
ICDS serves the target groups through a network of Anganwadi Centers (AWCs) which are mostly courtyards and/or play centres that are the focal point for the delivery of services at the community level.
ICDS and Urban Areas:
The reach of ICDS in Urban areas is peculiar. In a city like Mumbai, generally in a ground floor of the building, a living room is converted into an Anganwadi. The area is usually dingy, not very clean and seldom has play material which stimulates child’s interest in playing or learning.
It is usually assumed that the percentage of undernourishment is lower in urban areas. However, that is not what statistics show.
The percentage of underweight children under 5 is 29% in urban areas against 38.3 in Rural Areas. In cities like Delhi and Mumbai, the percentage of underweight children is 27.3% and 22.7%.
After a dip of 9% over the previous year in 2016-17, ICDS budget saw a small increase of about Rs 900 crore – with the total reaching to Rs 15,645 crore in the 2017-18 Union Budget. For a population of 165 million between the age group of 0-6 years, this is a small increase.
Consistent underfunding puts pressure on staff, especially frontline workers (Anganwadi workers and helpers). Softer agendas like nutrition counselling, group meeting and door-to-door visits, meeting with adolescents and mentoring of parents in infant and young children feeding (IYCF) often take low priority under accentuating circumstances.
What needs to be done?
To reach out to such children effectively, we need a well-defined system for management of malnutrition, which would involve the convergence of all stakeholders, with not just the Aanganwadis, but the health care centres, hospitals and MTCs as well.
While ICDS is a well-designed programme, and we have functional Aanganwadis running in most places, bottlenecks in service delivery and community outreach pose a challenge in its proper implementation.
The quality of services needs to improve, with strict emphasis on child growth monitoring and alerting to possible cases of malnutrition.
With improved service delivery of ICDS, and a preventive, rather than reactive, approach to tackle malnutrition with better community outreach, the nutrition status of children in the country will surely witness a significant change.
Investing in our children in the age group of 0-6 will translate itself into long-term positive returns, and pave the way for a healthier and happier nation.
Take Action: Are we really expecting India’s children to fit in just 3.32 % of the Union Budget? If you agree that the Budget for children is not enough (or must increase), share this post and talk about it. If you add your voice, children might be finally heard.