His name is ‘Today’
We are guilty of many errors and many faults,
but our worst crime is abandoning the children,
neglecting the fountain of life.
Many of the things we need can wait.
The child cannot.
Right now is the time his bones are being formed,
his blood is being made,
and his senses are being developed.
To him we cannot answer ‘Tomorrow,’
his name is today.
- Gabriela Mistral
INTEGRATED
CHILD
DEVELOPMENT
SERVICES
Dr Subodh S Gupta
Integrated Child Development Services

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

Objectives of ICDS





Lay the foundation for proper psychological
development of the child
Improve nutritional & health status of children 0-6 years
Reduce incidence of mortality, morbidity, malnutrition
and school drop-outs
Enhance the capability of the mother and family to look
after the health, nutritional and development needs of
the child
Achieve effective coordination of policy and
implementation among various departments to promote
child development
Beneficiaries




Children in age-group 0-6 years
Pregnant and lactating women
Women in the reproductive age-group
Adolescent girls
Intergenerational cycle of malnutrition
Intergenerational transmission of poverty
Child
poor early development
poor stimulation,
nutrition & health
national
economy
7
poor school achievement
behavioural problems
adult
low educational attainment
low skilled job / no work
high fertility
depressed/stressed
Services provided

Nutrition
 Supplementary
nutrition
 Growth monitoring and promotion
 Micronutrient supplementation/ promotion


Pre-school non-formal
education
Health
 Immunization
 Periodic
health check-up
 Referral services
 Nutrition and health education
Target Group & Services under ICDS
Services
Pre-School Education
Target Group
Children 3-6 years
Accountability
AWW
Growth monitoring
Children below 6 years
AWW
Supplementary
Nutrition
Micronutrient
supplementation/
promotion
Immunization*
Children below 6 years;
Preg & Lact Mother
Children below 6 years;
Preg & Lact Mother
AWW & AWH
Children below 6 years;
Preg & Lact Mother
Children below 6 years;
Preg & Lact Mother
Children below 6 years;
Preg & Lact Mother
ANM /MO
Women (15-45 years)
AWW/ ANM/ MO
Health Check-up*
Referral Services
Nutrition & Health
Education
ANM /MO
ANM / MO/ AWW
AWW /ANM /MO
Supplementary Nutrition
Beneficiaries
Calories
(cal)
Protein (g)
Children 6 month – 6 years
500
12-15
Severely malnourished
800
children (6 months – 6 years)
20-25
Pregnant & Lactating
Mothers
18-20
600
Mother and Child Protection Card
Mother and Child Protection Card
Why focus on early child development?
13
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

Pathways to poor development
14
Child
development
Sociocultural
risk factors
Psychosocial
risk factors
Sensorimotor
CNS
development
and function
Poverty
Biological
risk factors
Socioemotional
Cognitive
language
Child growth
Nutrition
16
Child
development
Maternal
competence
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
Coverage with ICDS
ICDS Projects
Operational AWC
Approx 7073
Approx 14 Lakhs
Other approaches


Rajiv Gandhi National Crèche Scheme for Working
Mothers
Initiatives by Non-government
 Ruchika,


SEWA, Nutan Bal Sangh
ECE Centers in Private Sector
Courses in Early Childhood Care and Development
Three Mismatches in ICDS



Service Mismatch
Beneficiary mismatch
Need mismatch
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 in ECCD





Poor attention to age-group 0-3 years
Involvement of the family and community
Minimum standards and regulatory mechanisms
No viable information on indicators of ECCD
Poor documentation of efforts in Voluntary sector
Restructuring of ICDS Scheme
(Programmatic reforms)

Repositioning AWC as a vibrant child friendly ECD
center (Bal Vikas Kendra)
 Extended
duration of functioning
 Additional AWW in 200 high burden
 Piloting of crèche service in 5% AWC
 Greater ownership of women and communities
 Provision of adequate infrastructure
 Facilities; e.g. safe drinking water, toilets, hygienic SNP
arrangements, wall painting, play space & a joyful
learning environment
 Other services for adolescent girls (SABLA Yojana)
Restructuring of ICDS Scheme

Redesigning & reinforcing of the package of ICDS
services, including a new component
 New
component of child care & nutrition counseling by
regular and prioritized visiting at critical contact points
for improving maternal care & nutrition, IYCF

Enhancing nutritional impacts with revised nutrition
and feeding norms
 Joint
kitchens with mid-day meal
 Continuum of care

Community-based prevention and care of Severely
underweight children
Restructuring of ICDS Scheme
(Management reforms)







Community mobilization and monitoring
Improved human resources
Training and capacity building
Strengthening civil society partnerships
Increased public accountability by strengthening
role of PRIs, VHNSCs
Convergence with related sectors
Strengthened monitoring system
Restructuring of ICDS Scheme
(Institutional reforms)








ICDS missions at different levels
Setting up of national/ State ICDS Mission resource
centers
Living Universities
Community ownership
Accreditation system
Focused attention
Increased NGO participation
Service standards