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

INTEGRATEDCHILDDEVELOPMENTSERVICES

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

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Childpoor early development

poor school achievementbehavioural problemspoor stimulation,

nutrition & health

Intergenerational transmission of poverty

adultlow educational attainment

low skilled job / no work high fertility

depressed/stressed

nationaleconomy

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 Target Group AccountabilityPre-School Education Children 3-6 years AWW

Growth monitoring Children below 6 years AWW

Supplementary Nutrition

Children below 6 years; Preg & Lact Mother

AWW & AWH

Micronutrient supplementation/ promotion

Children below 6 years; Preg & Lact Mother

ANM /MO

Immunization* Children below 6 years; Preg & Lact Mother

ANM /MO

Health Check-up* Children below 6 years; Preg & Lact Mother

ANM / MO/ AWW

Referral Services Children below 6 years; Preg & Lact Mother

AWW /ANM /MO

Nutrition & Health Education

Women (15-45 years) AWW/ ANM/ MO

Supplementary Nutrition

Beneficiaries Calories (cal)

Protein (g)

Children 6 month – 6 years

500 12-15

Severely malnourished children (6 months – 6 years)

800 20-25

Pregnant & Lactating Mothers

600 18-20

Mother and Child Protection Card

Mother and Child Protection Card

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Why focus on early child development?

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

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Pathways to poor development

Psychosocial risk factors

Biological risk factors

CNS development and function

Socio-emotional

Sensori-motor

Cognitivelanguage

Child development

Socio-cultural

risk factors

Poverty

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Child growth Child development

Nutrition 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 Approx 7073Operational AWC 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