by Manju Panwar
Introduction
It is said that the future of tomorrow is in the hands of children. But this is only possible if they are strong enough physically and mentally. They must be given adequate nutrition and health care facilities for making them strong. It is now acknowledged worldwide that the economic development of any nation depends upon the investment in human resources development. Children are the most important component of development not only because they are vulnerable but also because they are the basis for human development. The first six years of a child's life are most crucial because the basics for cognitive, social, emotional, physical, motor and psychological development are laid at this stage.
It is disheartening to know that after more than six decades of independence and despite of various initiatives taken by both the Central and State governments, the condition of children remains a cause of concern in the country. As per the Census of India 2011, there are 157.79 million children below six years of age, and many of them have inadequate access to health care, nutrition, sanitation, child care, early stimulation, etc. (Census 2011) Eradicating child malnutrition is an important component of MDGs (Millennium Development Goals) and Sustainable Development Goals (SDGs).
The problem of malnutrition is so acute that the UNICEF's latest report on the “State of the World's Children 2012” says that India is ranked among the 50 nations with highest under-five child mortality rate. Not only this, a joint study conducted by Assocham and EY revealed that “Over the decade (2005-15), there has been an overall reduction in the infant mortality rate and under-five mortality rate in India, yet the country is housing about 50 per cent of undernourished children of the world.”
Status of Children in Haryana
It is unpleasant to know that in Haryana, which is known for “Desho mein desh Haryana, jaha doodh dahi ka khana”(land of milk and yogurt), children are malnourished. A study conducted by the Post-Graduate Institute of Medical Education and Research, Chandigarh, stated that the four districts, namely, Karnal, Yamuna Nagar, Panchukula and Ambala in Haryana had an “alarming situation” where there was severe malnutrition among children.
The report further stated that 37.4 per cent of children were found to be underweight, 42.8 per cent suffered from stunted growth and 17.5 per cent from wasting. Ninetyfive per cent of the children in Karnal were found to be anaemic. It is alarming to know that in Haryana, 53 per cent of deaths under the age of five were due to malnutrition. It is a humanitarian issue where there is an extensive prevalence of nutritional deprivation among children; this needs immediate attention.
Action taken to Reduce Malnutrition among Children
Eradicating child malnutrition is an important component of the Sustainable Development Goals (SDGs). Apart from the initiatives taken by both Central and State governments, international organisations like the World Bank, UNICEF, Care India, USAID and others have been roped in to improve the condition of the children. Keeping in view the acute malnutrition among children in Haryana, Chief Minister Manohar Lal Khattar opined that for achieving the aim of “healthy child, healthy teenage, healthy mother and healthy Haryana”, there is a need to set up a Nutrition Commission in the Haryana State and create a State nutrition policy to redress the issue of malnutrition among children that will be prepared according to the guidelines of UNICEF and WHO.
Integrated Child Development Scheme (ICDS)
The ICDS is one of the flagship programmes of the Government of India and represents one of the world's largest and unique programmes for early childhood care and development. It reaches more than 34 million children of 0—6 years and seven million pregnant and lactating mothers. The ICDS started in 1976 and has been instrumental in improving the health of mothers and children under the age of six by providing health and nutrition education, health services, supplementary food and pre-school education. The ICDS is the most significant government intervention programme for reducing the maternal and childhood nutrition.
Purpose of the Study
The present study was carried out in four districts of Haryana, namely, Ambala, Mewat, Sonipat and Rothak to find out the major reasons for ineffective implementation of ICDS. In addition to the field visits made to the anganwadi centres, focused group discussions were conducted with the aganwadi workers and mother groups to understand the grassroots realities and how the ICDS is being implemented on the ground.
Concrete Observations
The following observations were made to understand the deficiencies in the implementation of the ICDS.
(1) Irregularity of Food Supply
One of the services of the ICDS is to provide supplementary nutritious food to the children between six months old and six years old and to pregnant and breastfeeding women for improving their health. It was observed during field visits in the sampled districts that a chart is displayed mentioning the food to be distributed everyday but due to the irregularity of the food supply that is not the case as mentioned in the chart. For instance, as per the menu, two days in a week, puri allu and sweet rice is to be prepared and distributed among the beneficiaries. But after conducting observation visits to the anganwadi centres and focused group discussions with the anganwadi workers on the field, it was found that due to the irregularity of the supply of sugar and cooking oil from the distributing agency, they have to distribute cooked dalia mixed with salt to the beneficiaries daily.
This was also cross-checked with the group of pregnant and lactating mothers on the field and they were of the opinion that “getting dalia everyday from anganwadi centres becomes monotonous and sometimes it is not eatable too.” In addition to the irregularity of food supply, lack of delivery to target individuals, lack of awareness among mothers about their children's eligibility for food are some of the other major reasons for not getting the expected results of the ICDS.
(2)Overload Anganwadi Worker
The anganwadi worker is the focal point for the delivery of ICDS services to children and mothers. The role of the anganwadi worker is very important for the successful implementation of the ICDS. The major role of the aganwadi worker is to ensure antenatal and postnatal care for pregnant women and immediate diagnosis and care for the new born children and nursing mothers. The Ministry of Women and Child Development has laid down guidelines for the responsibilities of the anganwadi workers (AWW). They administer the immuni-sation of all children below the age of six years. The anganwadi worker often takes on the role of a teacher and aims to provide pre-school education to children between the age of three and five years. These include showing community support and active participation in executing this programme, conducting regular quick surveys of all families, organising pre-school activities, providing health and nutrition education to families, especially pregnant women, on how to breastfeed, etc., motivating families to adopt family planning, educating parents about child growth and development, assisting in the implementation and execution of Kishori Shakti Yojana (KSY) to educate teenage girls and parents by organising social awareness programmes etc., identifying disabilities in children, and so on.
After conducting focused group discussions with the anganwadi workers in all four sampled districts, it was found that they are overburdened. A majority of them were of the opinion that they are not able to fulfil their actual role of anganwadi worker properly as most of the time they are occupied with other activities such as preparation of aadhar card, issuing of birth and death certificate, election duty, preparation of maternity card etc. Some of the anganwadi workers pointed out that due to excessive record maintenance, they have piled up so many registers at their place and the same cannot be sold as the record can be asked anytime.
In addition to this, they also said it was more than ten years, they were working on contract basis and their job were not getting permanent with comprehensive retirement benefits like other government staff.
(3) Lack of Infrastructure Facilities.
After conducting focused group discussion with the mother group and non-beneficiary group, it was found that as there was no reading and writing in the pre-school component under the ICDS, a majority of the parents do not send their children to the anganwadi centres and admit them either in private or government schools. A majority of the Gram Panchayats do not have separate building for running the anganwadi centre. Either they are functioning in the panchayat ghar, schools or sometimes in the house of the anganwadi worker. There is no proper storage of foodgrains in the anganwadi centre. Due to the lack of proper toilet facilities, clean drinking water and other facilities in the anganwadi centre, children belonging to poor families come only when food is distributed in the centre. Relevant teaching and learning aids were not sufficiently used for motivating children to come regularly to the anganwadi centre.
(4) Limited role of Gram Panchayat and community-based organisations
The ICDS being a community-based progra-mme the Gram Panchayat's participation is needed for effective implementation of the ICDS. Gram Panchayat has an important role to play in nurturing the children of the village. Development of women and children is one of the 29 functions listed in the 73rd Constitutional Amendment devolved to the Panchayati Raj Institutions. The Gram Panchayat can keep an eye on the functioning of the anganwadi centres. It is the responsibility of the Gram Panchayat to see whether adequate infrastructure is being provided to the centre and to check the quality of food being served to the children.
Though the Gram Panchayat has a vital role to play but grassroot realities show different picture. After interacting with some of the Presidents of Gram Panchayats, they were found saying that the “ICDS is a women and children related-scheme and the Panchayat has no role in it”. Not only the Gram Panchayat, community based organisations like SHGs, youth Club, Mahila Mandal etc. also have not much awareness nor take interest in the functioning of the ICDS in their village.
Conclusion
In order to make the ICDS successful, it is imperative that adequate nutrition should be provided from early childhood to the adoles-cents. The need of the hour is to give special focus from the bottom up to the top approach. The role of anganwadi worker is one of the critical indicator of better implementation of the ICDS.
The role of the anganwadi worker is to educate, mobilise and organise the community so that they can participate in the ICDS programme actively for the cause of child survival and development. But with many responsibilities on their shoulders, they are not able to perform their actual work.
The role of the anganwadi worker is to act as a bridge between the community and ICDS. There is a need to look into the matter of their remuneration. There is a need to set up close relationship between the Gram Panchayat and anganwadi centre. The success of any programme/scheme depends upon the community participation. The IEC (information education and communication) plays a strong role in creating awareness among the masses. It is essential that different channels of communication must be utilised to ensure that important stakeholders like parents, panchayat members, community leaders and others are roped in to create awareness.
References
1. Census 2011, Office of Registrar General of India, GOI. 2. Annual Report 2011-12, Ministry of women and Child Development.
2. The State of the World's Children 2012, UNICEF.
3. Report of Assocham-EY, 2017.
Dr Manju Panwar is the Chairperson, Department of Social Work, B.P.S. Women's University, Khanpur Kalan, Sonipat, Haryana.