V.JAGDISH
Child Care in India — The Integrated Child Development Services Scheme by V. JAGDISH, M.B., B.S. Johns Hopkins University School of Hygiene and Public Health, Department of International Health, 615 North Wolfe Street, Baltimore, Maryland 21205
The Integrated Child Development Services Scheme1 (ICDS) has been introduced initially on an 94
experimental basis in thirty community development blocks in different parts of the country. These include 16 rural, 10 tribal and 4 urban areas. For the purposes of the ICDS scheme each rural area in the project comprises of about 100 villages having a total population of 100,000 of whom 17% i.e. 17,000 are less than 6 years of age. The number of women in the age group 15-44 years is estimated to be 20,000 and of this 7,000 are estimated to be nursing and expectant mothers. The urban area in the project is expected to have similar demographic characteristics. In the tribal area there are about 50 villages with an estimated population of 35,000 of whom 17% i.e. 5,950 are less than 6 years of age. The number of women in the age group 15-44 is estimated to be 7,000 and of this 2,450 are estimated to be nursing and expectant mothers. The objectives of the Integrated Child Development Services Scheme are: 1. to improve the nutritional and health status of children in the age group 0-6 years. 2. to lay the foundations for proper psychological, physical and social development of the child. 3. to reduce the incidence of mortality, morbidity, malnutrition and school dropouts. 4. to achieve effectively coordination of policy and implementation amongst the various departments to promote child development; and 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. Services in the ICDS scheme are provided through a unit called the Anganwadi, set up at each village and urban center in the project. The worker at the Anganwadi is called the Anganwadi worker and is as far as possible from the same area and is acceptable to the local community. Thus each rural project would have 100 Anganwadi workers. The Anganwadi is the focal point for delivery of child development services. The Anganwadis will coordinate closely with other schemes of the Department of Social Welfare, the Bal Kendra Schemes, the health staff and other department schemes in the project area. Table I describes the Administrative control and coordination with other departments and voluntary agencies of the ICDS projects in the rural areas. ^ The Anganwadi worker is responsible for Environmental Child Health, April 1977
Downloaded from http://tropej.oxfordjournals.org/ at TULB Jena on May 22, 2015
There have been considerable improvements in health conditions in India since Independence in 1947. These improvements have been accompanied by all round socioeconomic development. However, there are many major problems in the areas of child welfare and development. At the time of the 1971 Census of India, there were two hundred and twenty-eight million children up to 14 years of age. One hundred and eighty-six million of these children lived in rural areas while 42 million children lived in urban areas. One hundred and fifteen million children were below 6 years of age. Undoubtedly these figures have increased quite considerably during the past few years. Infant mortality rates in most parts of India continues to be more than 100 per thousand. There is high incidence of malnutrition." Subsequently physical growth and. mental capacity of children is affected. Infectious diseases and parasitic diseases are very common. All this is despite the fact that there are many programmes to improve child health and welfare. These programmes have been run independent of each other and consequently have not proved effective. Recognizing the problems faced by children the Government of India adopted a Resolution on National Policy for Children in 1974. Later on, the same year, the National Children's Board was set up with the Prime Minister as its head emphasizing the priority Government gave to the children's welfare. The National Policy for children has placed considerable stress on child health and nutrition and has recognised the importance of children's programmes as vital for socioeconomic progress. The Planning Commission of India conducted eight interministerial studies and subsequently proposed integrated child care services for pre-school children. The proposals covered supplementary nutrition feeding, immunizations, health care including refferal services, nutrition education of mothers, pre-school education and recreation, family planning and the provision of safe drinking water. The Government of India accepted these recommendations and the Department of Social Welfare introduced the Integrated Child Development Service Scheme toward the end of 1975.
V.JAGDISH
Anganwadi worker has additionally to maintain routine records. Another very important role for the Anganwadi workers is to try to involve the community ,in the ICDS scheme by eliciting their support in participation and nursing of the programmes. Funds for the ICDS scheme are being provided by the Central Government. Selection of Anganwadi workers is done locally and a minimal educational limit has been set which is relaxable in exceptional circumstances. Training of the Anganwadi workers is of extreme importance. The National Institute of Public Cooperation and Child Develpment have developed syllabi to be used for training the different functionaries.2 UNICEF, WFP and CARE have shown interest in the ICDS scheme since it envisages the implementation of a coordinated strategy for development of the child. If the present scheme is successful it is the intention of the Government of India to gradually phase it into other blocks throughout the country. Evaluation of the ICDS projects will therefore be done independently by the Programme Evaluation Organization of the Planning Commission of India after the ICDS projects have been in operation for a year or two. Summary
Despite progress in all spheres of development, child care services in India are still not satisfactory. High infant mortality rates, high incidences of malnutrition and high morbidity rates particularly with infectious
Table I Administrative Control of ICDS Projects in Rural Areas Central Government
Department of Social Welfare
• • Coordinates with Ministry of Health, Department of Rural Development Planning Commission
State Government
Department of Social Welfare • (will administer projects in its state)
- • Coordinates with State Social Welfare Advisory Board Departments of Helath, Rural Development, Voluntary Organizations, State Council and Child Welfare
District
District Social Welfare Officer in charge. If not in position Dist. Dev. Officer or Planning Officer in charge
-•Coordinates with District Collector and other officers interested in in child welfare and voluntary organizations
Block
Child Development Project Officerin charge
- •Coordinates with PHC doctor, block level officers of departments interested, voluntary agencies, Panchavat representatives
Village
Anganwadi worker -
- >- Coordinates with local prominent women, school teachers, social workers, officials of other departments «
Environmental Child Health, April 1977
95
Downloaded from http://tropej.oxfordjournals.org/ at TULB Jena on May 22, 2015
organizing non formal education and preschool activities for children aged 3-5 years, using materials of indigenous origin made by local artisans. The Anganwadi units links with the elementary school should make it possible for a child to move from there to school adequately prepared emotionally and mentally. Health and nutrition education to women aged 15-44 years is carried out by: 1) mass media publicity; 2) special campaigns in the project areas; 3) individual home visits by the Anganwadi workers; 4) demonstration of cooking and feeding, etc. There will also be extensive utilization of helath and nutrition education programmes of other ministries, especially the Mobile Food and Extension Units of the Department of Food. Supplementary nutrition services are provided for children aged 0-6 years and expectant and nursing mothers. The ICDS scheme stresses heavily on the best possible use of locally available foods and recipes. Children found to suffer from various degrees of malnutrition are to be given more food and the Anganwadi workers have special responsiblitiy for them. Programmes of immunization including immunization against tetanus for all expectant mothers are provided in close collaboration with health staff. Helath services in the ICDS project areas are being" strengthened by employment of additional staff (1 extra doctor with a diploma in paediatrics and 10 auxiliary workers) to provide better facilities for expectant and nursing mothers and for children. Health staff remain under the administrative control -of the State Health Department. The
V.JAGDISH
and parasitic diseases are some of the problems faced. The Government of India have recognized these problems and taken steps to rectify them. The Integrated Child Services Development Scheme has been introduced on an experimental basis in selected number of rural, urban and tribal areas. Services in the scheme, are provided through a unit called the Anganwadi which is to be the focal point for delivery of Child development services. A new type of functionary — the Anganwadi worker is responsible in each village or urban unit for the effective
implementation of the target and for coordinating programmes of other departments and voluntary agencies with regard to child welfare. References 1. Integrated Child Development Services Scheme. Department of Social Welfare, Ministry of Education and Social Welfare, New Delhi, 1971. 2. Integrated Child Development Services Scheme. Syllabi for Training of Functionaries. National Institute of Public Cooperation and Child Development, New Delhi, 1975.
Downloaded from http://tropej.oxfordjournals.org/ at TULB Jena on May 22, 2015
96
Environmental Child Health, April 1977
Child Care in India — The Integrated Child Development Services Scheme by V. JAGDISH, M.B., B.S. Johns Hopkins University School of Hygiene and Public Health, Department of International Health, 615 North Wolfe Street, Baltimore, Maryland 21205
The Integrated Child Development Services Scheme1 (ICDS) has been introduced initially on an 94
experimental basis in thirty community development blocks in different parts of the country. These include 16 rural, 10 tribal and 4 urban areas. For the purposes of the ICDS scheme each rural area in the project comprises of about 100 villages having a total population of 100,000 of whom 17% i.e. 17,000 are less than 6 years of age. The number of women in the age group 15-44 years is estimated to be 20,000 and of this 7,000 are estimated to be nursing and expectant mothers. The urban area in the project is expected to have similar demographic characteristics. In the tribal area there are about 50 villages with an estimated population of 35,000 of whom 17% i.e. 5,950 are less than 6 years of age. The number of women in the age group 15-44 is estimated to be 7,000 and of this 2,450 are estimated to be nursing and expectant mothers. The objectives of the Integrated Child Development Services Scheme are: 1. to improve the nutritional and health status of children in the age group 0-6 years. 2. to lay the foundations for proper psychological, physical and social development of the child. 3. to reduce the incidence of mortality, morbidity, malnutrition and school dropouts. 4. to achieve effectively coordination of policy and implementation amongst the various departments to promote child development; and 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. Services in the ICDS scheme are provided through a unit called the Anganwadi, set up at each village and urban center in the project. The worker at the Anganwadi is called the Anganwadi worker and is as far as possible from the same area and is acceptable to the local community. Thus each rural project would have 100 Anganwadi workers. The Anganwadi is the focal point for delivery of child development services. The Anganwadis will coordinate closely with other schemes of the Department of Social Welfare, the Bal Kendra Schemes, the health staff and other department schemes in the project area. Table I describes the Administrative control and coordination with other departments and voluntary agencies of the ICDS projects in the rural areas. ^ The Anganwadi worker is responsible for Environmental Child Health, April 1977
Downloaded from http://tropej.oxfordjournals.org/ at TULB Jena on May 22, 2015
There have been considerable improvements in health conditions in India since Independence in 1947. These improvements have been accompanied by all round socioeconomic development. However, there are many major problems in the areas of child welfare and development. At the time of the 1971 Census of India, there were two hundred and twenty-eight million children up to 14 years of age. One hundred and eighty-six million of these children lived in rural areas while 42 million children lived in urban areas. One hundred and fifteen million children were below 6 years of age. Undoubtedly these figures have increased quite considerably during the past few years. Infant mortality rates in most parts of India continues to be more than 100 per thousand. There is high incidence of malnutrition." Subsequently physical growth and. mental capacity of children is affected. Infectious diseases and parasitic diseases are very common. All this is despite the fact that there are many programmes to improve child health and welfare. These programmes have been run independent of each other and consequently have not proved effective. Recognizing the problems faced by children the Government of India adopted a Resolution on National Policy for Children in 1974. Later on, the same year, the National Children's Board was set up with the Prime Minister as its head emphasizing the priority Government gave to the children's welfare. The National Policy for children has placed considerable stress on child health and nutrition and has recognised the importance of children's programmes as vital for socioeconomic progress. The Planning Commission of India conducted eight interministerial studies and subsequently proposed integrated child care services for pre-school children. The proposals covered supplementary nutrition feeding, immunizations, health care including refferal services, nutrition education of mothers, pre-school education and recreation, family planning and the provision of safe drinking water. The Government of India accepted these recommendations and the Department of Social Welfare introduced the Integrated Child Development Service Scheme toward the end of 1975.
V.JAGDISH
Anganwadi worker has additionally to maintain routine records. Another very important role for the Anganwadi workers is to try to involve the community ,in the ICDS scheme by eliciting their support in participation and nursing of the programmes. Funds for the ICDS scheme are being provided by the Central Government. Selection of Anganwadi workers is done locally and a minimal educational limit has been set which is relaxable in exceptional circumstances. Training of the Anganwadi workers is of extreme importance. The National Institute of Public Cooperation and Child Develpment have developed syllabi to be used for training the different functionaries.2 UNICEF, WFP and CARE have shown interest in the ICDS scheme since it envisages the implementation of a coordinated strategy for development of the child. If the present scheme is successful it is the intention of the Government of India to gradually phase it into other blocks throughout the country. Evaluation of the ICDS projects will therefore be done independently by the Programme Evaluation Organization of the Planning Commission of India after the ICDS projects have been in operation for a year or two. Summary
Despite progress in all spheres of development, child care services in India are still not satisfactory. High infant mortality rates, high incidences of malnutrition and high morbidity rates particularly with infectious
Table I Administrative Control of ICDS Projects in Rural Areas Central Government
Department of Social Welfare
• • Coordinates with Ministry of Health, Department of Rural Development Planning Commission
State Government
Department of Social Welfare • (will administer projects in its state)
- • Coordinates with State Social Welfare Advisory Board Departments of Helath, Rural Development, Voluntary Organizations, State Council and Child Welfare
District
District Social Welfare Officer in charge. If not in position Dist. Dev. Officer or Planning Officer in charge
-•Coordinates with District Collector and other officers interested in in child welfare and voluntary organizations
Block
Child Development Project Officerin charge
- •Coordinates with PHC doctor, block level officers of departments interested, voluntary agencies, Panchavat representatives
Village
Anganwadi worker -
- >- Coordinates with local prominent women, school teachers, social workers, officials of other departments «
Environmental Child Health, April 1977
95
Downloaded from http://tropej.oxfordjournals.org/ at TULB Jena on May 22, 2015
organizing non formal education and preschool activities for children aged 3-5 years, using materials of indigenous origin made by local artisans. The Anganwadi units links with the elementary school should make it possible for a child to move from there to school adequately prepared emotionally and mentally. Health and nutrition education to women aged 15-44 years is carried out by: 1) mass media publicity; 2) special campaigns in the project areas; 3) individual home visits by the Anganwadi workers; 4) demonstration of cooking and feeding, etc. There will also be extensive utilization of helath and nutrition education programmes of other ministries, especially the Mobile Food and Extension Units of the Department of Food. Supplementary nutrition services are provided for children aged 0-6 years and expectant and nursing mothers. The ICDS scheme stresses heavily on the best possible use of locally available foods and recipes. Children found to suffer from various degrees of malnutrition are to be given more food and the Anganwadi workers have special responsiblitiy for them. Programmes of immunization including immunization against tetanus for all expectant mothers are provided in close collaboration with health staff. Helath services in the ICDS project areas are being" strengthened by employment of additional staff (1 extra doctor with a diploma in paediatrics and 10 auxiliary workers) to provide better facilities for expectant and nursing mothers and for children. Health staff remain under the administrative control -of the State Health Department. The
V.JAGDISH
and parasitic diseases are some of the problems faced. The Government of India have recognized these problems and taken steps to rectify them. The Integrated Child Services Development Scheme has been introduced on an experimental basis in selected number of rural, urban and tribal areas. Services in the scheme, are provided through a unit called the Anganwadi which is to be the focal point for delivery of Child development services. A new type of functionary — the Anganwadi worker is responsible in each village or urban unit for the effective
implementation of the target and for coordinating programmes of other departments and voluntary agencies with regard to child welfare. References 1. Integrated Child Development Services Scheme. Department of Social Welfare, Ministry of Education and Social Welfare, New Delhi, 1971. 2. Integrated Child Development Services Scheme. Syllabi for Training of Functionaries. National Institute of Public Cooperation and Child Development, New Delhi, 1975.
Downloaded from http://tropej.oxfordjournals.org/ at TULB Jena on May 22, 2015
96
Environmental Child Health, April 1977
