Universalizing Quality Child Care and Development Services in India
by Savita Varde-Naqvi
The event brought together Ministers and Secretaries of the Department of Women and Child Development (DWCD) from various States and Union Territories of India in a significant bid to hammer out a roadmap for young child survival and development. Senior officials of the Ministry of Health and Family Welfare and the Department of Elementary Education were present to ensure convergence in service delivery to children.
The theme of the National Consultation was universalisation of the Integrated Childhood Development Services (ICDS) with quality. For thirty years now the ICDS centres called the ‘anganwadis’ have delivered care and nutrition to pregnant and lactating mothers, adolescent girls and children below the age of six years across India. In spite of being one of the largest development schemes of the Government of India, the ‘anganwadis’ are not able to reach every child in every one of the 600,000-odd villages of India – a tall order by any standards.
Considering that 30% of the babies born in India have a low birth weight, 47% of Under-3s continue to be underweight and 74% of them are anaemic, it is critical that the services reach all needy children, especially the excluded and the underserved. Out of the 160 million children under the age of 6 years, approximately 98 million are registered by the Scheme but data shows that only 40 million of them actually benefit from the services on a regular basis.
Mr Adorna recommended empowerment of communities as a critical strategy for creating demand for the large number of development schemes targeted towards health and nutrition of young children and mothers. He also underscored the importance of building new partnerships to strengthen ICDS with a quality component focusing on feeding practices rather than mere provision of food for the Under-3 cohort.
The National Consultation identified early initiation of breastfeeding, continuing to exclusively breastfeed for six months, introducing complementary foods thereafter in addition to breast milk as key feeding practices that could cut infant mortality by 17% in India. Micronutrient supplementation was unanimously accepted as another component of the quality package for increased immunity, reduction in morbidity and improvement in the quality of life of young children.
Ms Reva Nayyar, Secretary, Department of Women and Child Development, Government of India announced the Cabinet decision to open additional 188,000 ‘anganwadis’ with a staff increase of 400,000 persons. This has been planned against an increased budgetary allocation of Rs 150 million to implement a population norm of one ‘anganwadi’ for a population of 500 to 700 people.
Dr M K Bhan, Secretary of Department of Biotechnology and an expert on public health urged the Ministers and senior officials present to make a paradigm shift in their thinking. “The answer lies at the household level since 40 – 50% of children die at home,” Also, since a third of the infant deaths are among neonates, “there is no option than zeroing in on the survival and development of newborns through home visitations by the ‘anganwadi’ worker,” he added.
Integrated Management of Newborn and Childhood Illnesses (IMNCI) coupled with quality childcare services through the ‘anganwadis’ was identified as a make or break strategy for young child survival and development by the National Consultation.