Integrated Child Development Service Programme (ICDS)

This is a unique programme under which a package of integrated services consisting of supplementary nutrition, immunization, health check up, referal and education service are provided to the most vulnerable groups even within children and women, i.e. children up 6 years of age and expectant/nursing mother, through a common focal point called Anganwadi (the courtyard centres) in each of the village/urban slums.

The objectives of ICDS (Annual Report, Department of Women and Child Development, 199394) are:

- to improve the nutritional and health status of children in the age group 0-6 years;

- to lay the foundation for proper psychological, physical and social development of the child;

- to reduce the incidence of mortality, morbidity, malnutrition and school drop out;

- to regulate effective coordination of policy and programme implementation amongst various departments to promote child development;

- to enhance the capability of the mother through proper nutrition education for taking care of the normal health and nutritional needs and health of the child

One ICDS project covers either a tribal or a rural Block, the territorial unit at sub-district level or a cluster of urban slums in an urban project. Preference in selection of Blocks is given to those which have comparatively larger proportion of the population of tribal people and other disadvantaged categories. The ICDS programme was launched experimentally and rather modestly, by covering 33 Blocks/slums in 1975-76. The author happened to be the Director incharge of the programme in the then Ministry of Education and Social Welfare immediately thereafter, when programme was internally evaluated and expanded to 66 Blocks. Since then, the programme has been expanded gradually in a phased manner and by the end of March 1993, it consisted of 3066 projects with 19.5 million children and mothers receiving supplementary nutrition under the programme. In addition, 9.34 million children were receiving pre-school stimulation. The entire expenditure of the 2871 centrally sponsored ICDS projects (of the total 3066 projects in place by the end of March 1993) is borne by the Central Government, barring expenditure on supplementary nutrition which concerned State Governments incur. Expenditure on rest of the projects is borne of the state governments. How massive is the programme can be gauged by the fact that "21.4 million women and children are likely to have been covered by one or other aspects of this programme in 1993-94 and an amount of Rs. 4618 millions is likely to have been spent by the Central Government itself. UNICEF and some other international agencies are also assisting the programme. (Annual Report, Min. of Women & Child Dev., 1993-94)

An evaluation of the ICDS programme carried out in 1990-92 has revealed that some of the positive impacts of programme are (i) IMR in ICDS covered areas was significantly lower (66.6/1000) compared to IMR in the non-ICDS areas (86/1000); (ii) immunization coverage in ICDS areas has been much better (iii) there has been better coverage of prophylaxsis programme of Vit. A and iron; (iv) the nutritional status of covered children was going up and (v) the percentage of low birth weight babies was also found to be lower. On the negative side, the report has brought out inadequate community participation and perhaps too much dependence on Government. Another status appraisal of ICDS, carried out in four States by the National Institute of Nutrition, Hyderabad revealed that "Nutritional status of ICDS beneficiaries in Bihar was better than their non-ICDS counterparts and only marginal differences were observed in the remaining three States of Andhra Pradesh, Madhya Pradesh and Orissa". This report, therefore, suggests better training and motivation of ICDS workers to monitor growth properly and continuously identify the children and mothers at risk, arrange for clinical intervention in their cases, increase the quantum of their supplementary nutrition and so on. In fact, NIN is now starting the "nutrition surveillance" in ICDS blocks in Andhra pradesh on pilot basis for achieving the abovementioned purposes.

It is now well recognised that proper and continuous training of ICDS functionaries at all levels and functional monitoring is vital to the success of a programme like ICDS which seeks of deliver a package of services. At the same time, motivation of the village