INTEGRATED CHILD
DEVELOPMENT SERVICES
(ICDS)
DR. KANUPRIYA CHATURVEDI
PROGRAM OUTLINE
Started by the Government of India in 1975, the
Integrated Child Development Scheme (ICDS)
has been instrumental in improving the health
and wellbeing of mothers and children under 6
by providing health and nutrition education,
health services, supplementary food, and preschool education.
The ICDS national development program is one
of the largest in the world. It reaches more than
34 million children aged 0-6 years and 7 million
pregnant and lactating mothers.
Lesson Objectives
• To know the extent of malnutrition
• To know about the goals. objectives target
groups, service components and
coverage of ICDS program
• To know about the impact of the Program
Under nutrition in Children under Age 3
60
50
51
45
43
40
40
30
20
23
20
10
0
Stunted
Underweight
NFHS-2
NFHS-3
SOURCE: NFHS-3 2005-6
Wasted
Anemia among Children Age 6-35
Months
90
80
74
79
70
60
50
40
30
20
4
10
0
Any anaemia
NFHS-2
5
Severe anaemia
NFHS-3
SOURCE; NFHS -3 2005-6
Recommended and Actual
Breastfeeding Practices
• Goal: Initiation of breastfeeding within
1 hour of birth
– Achievement: 25%
• Goal: No prelacteal feeding
– Achievement: 43%
• Goal: Exclusive breastfeeding
•
(6 months)
– Achievement: 46%
SOURCE NFHS-3, 2005-6
Every fifth young child in the
world lives in India
Every second young child in India
is malnourished
Three out of four young
children in India are anaemic
Every second newborn in India is
at risk of reduced learning
capacity
due to iodine deficiency
Malnutrition limits
development potential and
active learning capacity of the
child
ICDS OBJECTIVES
• To improve the nutritional status of preschool
children 0-6 years of age group.
• To lay the foundation of proper psychological
development of the child
• To reduce the incidence of mortality, morbidity
malnutrition and school drop out
• To achieve effective coordination of policy and
implementation in various departments to
promote child development
• To enhance the capability of the mother to
look after the normal health and nutritional
needs of of the child through proper nutrition
and health education.
THE TARGET GROUPS
BENEFICIARY
• Pregnant women
• Nursing Mothers
• Children less than 3 years
• Children between 3-6 years
• Adolescent girls( 11-18 years)
SERVICES
• Health check-ups, TT,
supplementary nutrition,
health education.
• Health check-us
supplementary nutrition,
health education
• supplementary nutrition,
health check-ups,
immunization, referral
services
• supplementary nutrition,
health check-ups,
immunization, referral
services, non formal
education
• supplementary nutrition,
health education
COMPONENTS
• Health Check-ups.
• Immunization.
• Growth Promotion and Supplementary
Feeding.
• Referral Services.
• Early Childhood Care and Pre-school
Education.
• Nutrition and Health Education.
Supplementary nutrition
• Each child upto 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
Immunization
• 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
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
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.
Contd.
• 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.
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
Adolescent girls scheme
( Kishori shakti yojna)
•
•
•
•
•
General health check ups
Immunization
Treatment of minor ailments
Deworming
Prophylactic measures against anemia,
IDD, vitamin deficiency
• Referral
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.
Integrated Child Development Scheme
(ICDS) in India
No. of Blocks
No. of AWW
Children (0 - 6 years)
Sanctioned
Functioning
Gap
5652
4545
19.6%
608,066
546,434
11.2%
:
Expectant and Nursing mothers :
35.39 million
6.38 million
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
Training Infrastructure
There is a countrywide infrastructure for the
training of ICDS functionaries, viz.
– Anganwadi Workers Training Centres
(AWTCs) for the training of Anganwadi
Workers and Helpers.
– Middle Level Training Centres (MLTCs) for the
training of Supervisors and Trainers of
AWTCs;
– National Institute of Public Cooperation and
Child Development (NIPCCD) and its
Regional Centres for training of
CDPOs/ACDPOs and Trainers of MLTCs.
NIPCCD also conducts several skill
development training programmes
PROGRAM MONITORING
• CENTRAL LEVEL
– (i) Supplementary Nutrition : No. of Beneficiaries
(Children 6 months to 6 years and pregnant &
lactating mothers) for supplementary nutrition;
– (ii) Pre-School Education : No. of Beneficiaries
(Children 3-6 years) attending pre-school education;
– (iii) Immunization, Health Check-up and Referral
services : Ministry of Health and Family Welfare is
responsible for monitoring on health indicators
relating to immunization, health check-up and
referrals services under the Scheme.
Monitoring at state level
• State level: Various quantitative inputs captured
through CDPO’s MPR/ HPR are compiled at the
State level for all Projects in the State.
• No technical staff has been sanctioned for the
state for programme monitoring.
• CDPO’s MPR capture information on number of
beneficiaries for supplementary nutrition, preschool education,
• field visit to AWCs by ICDS functionaries like
Supervisors, CDPO/ ACDPO etc.,
• information on number of meeting on nutrition
and health education (NHED) and vacancy
position of ICDS functionaries
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 Halfyearly Progress Report (HPR) to State by 7th
April and 7th October every year.
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’ Incharge 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
Nutrition and Health Education
Nutrition and Health Education
– This service is not monitored at the Central
Level. State Governments are required to
monitor up to State level in the existing MIS
System.
– No. of ICDS Projects and Anganwadi Centres
(AWCs) w.r.t. targeted no. of ICDS Projects
and AWCs are taken into account for review
purpose
Rapid facility Survey
• More than 40 per cent AWCs (Anganwadi Centres)
across the country are neither housed in ICDS building
nor in rented buildings. One-third of the Anganwadis are
housed in ICDS building and another one-fourth are
housed in rented buildings;
• As regards the status of Anganwadi building, more than
46 per cent of the Anganwadis were running from pucca
building, 21 per cent from semi-pucca building, 15 per
cent from kutcha building and more than 9% running
from open space;
• It is quite encouraging to observe that average number
of children registered at the Anganwadi centre is 52 for
boys and 75 for girls;
Contd.
• The survey data reveal that more than 45 per cent
Anganwadis have no toilet facility and 40 per cent have
reported the availability of only urinal;
• Of the 39 per cent Anganwadis reporting availability of
hand pumps, half of the hand pumps were provided by the
Gram Panchayat and 12 per cent provided by the ICDS;
• More than 90 per cent Centers provided supplementary
food, 90 per cent provided pre-school education and 76
per cent weighed children for growth monitoring;
• Only 50 per cent Anganwadis reported providing referral
services, 65 per cent health check-up of children, 53 per
cent for health check-up of women and more than 75 for
nutrition and health education;
Contd.
• Average number of days in a month in which
services are provided at the Anganwadi centers
are 24 for supplementary food, 28 for pre-school
education and 13 for Nutrition and health
education;
• More than 57 per cent of Anganwadi centers
reported availability of ready-to-eat food and 46
per cent availability of uncooked food at the
Anganwadi centers;
• Nearly three-fourth of the Anganwadis have
reported the availability of medical kits and baby
weighing scale. On the other hand adult
weighing scale has been reported only by 49 per
cent of the Anganwadis
Three Decades of ICDS – An appraisal
by NIPCCD (2006)
• i) Around 59 per cent AWCs studied have
no toilet facility and in 17 AWCs this facility
was found to be unsatisfactory.
ii) Around 75% of AWCs have pucca
buildings;
• iii) 44 per cent AWCs covered under the
study were found to be lacking PSE kits;
• iv) Disruption of supplementary nutrition
was noticed on an average of 46.31 days
at Anganwadi level. Major reasons causing
disruption was reported as delay in supply
of items of supplementary nutrition;
Contd.
• v) 36.5 per cent mothers did not report
weighing of new born children;
• vi) 29 per cent children were born with a
low weight which was below normal (less
than 2500 gm);
• vii) 37 per cent AWWs reported nonavailability of materials/aids for Nutrition
and Health Education (NHED).
ICDS and MDG
Govt.
Programs
Contributing to MDG Goal
Concerned
Departments
1- Eradicate Extreme Poverty
NREGS,
and Hunger
PR & RD, WCD,
ICDS,
PDS 2- Promote Gender equity and Food & civil
etc
empower women
supplies Corp.
3- Reduce child mortality