Courtesy: Wikimedia
There are 158.8 million children below the age of 6 in India out of which 63 million (nearly 40%) are undernourished. Every year, 3.1 million children die due to under nutrition. 80% of children under the age of 3 are anaemic 45.9% are underweight, and only 44% of children of 12-23 months are fully immunized against the six major preventable diseases (Tetanus, Pertussis, HIB (Haemophilus influenzae type b), Measles, Rotavirus and Pneumococcus), 1 million infants die before reaching their first birthday, only 50% pregnant women receive complete antenatal care, 0.7 million infants die during the first four weeks of their birth.
The statistics speak for themselves yet somewhere it has not completely made us notice that every day somewhere children are dying! More alarming is the fact that that it is in these very first six years that an individual’s physical, mental, psychological and behavioral functions develop. Sadly, most of the issues within under-nutrition go uncorrected since it remains relatively an invisible problem, wherein “unseen becomes equal to unacknowledged”!
In its bid to combat the crisis of undernourishment, under the Indian ministry of women and child development, the ICDS (Integrated Child Development Services) programs were implemented as the state’s primary response to child malnutrition in 1975. The scheme was to provide not only food and preschool education to children but also primary healthcare to both children (less than six years of age) and to their mothers.
Anganwadis was to be the main tool by way of which children and expecting mothers were to be catered to. The initial attention was to increase the coverage of the ICDS program and until quite recently there were some 13.7 lakh sanctioned anganwadi centers out of which 13.31 lakh anganwadis and mini anganwadi centers were set up in the low socio-economical areas.
While the coverage does matter, what is equally important is to observe if the anganwadis are functioning the way they are supposed to. Sadly, there continues to remain a gap between the policy intentions of ICDS and its actual implementation, hence the actual impact of the program has been grossly limited. The ICDS program though well conceived and well placed is lackadaisical towards its focus on improving the quality of its services and distributing food. It also does not help that there are substantial operational challenges prevalent within the program including inadequate worker skills, shortage of equipments, poor supervision and weak monitoring and evaluation methods.
Further challenges are added when community workers are overburdened- imagine being asked to be a teacher as well as nutrition provider and supervisor to 4 and 6 year olds, all at the same time! As a result these community workers are unable to cater to all their responsibilities impacting children in a way that they remain bereft of micronutrient supplements, even as their parents continue to remain ignorant on better feeding and child care practices. To make matters worse there has been an increasing emphasis by the state to increase supplementary feeding provisions at the expense of other crucial components needed to combat undernourishment.
The issue may seem large but the solutions need not be taken from odd places; the solutions can be found within the same programs. There needs to be a willingness to understand and ascertain the full potential of the ICDS program and resolve the ambiguity about the priority of different objectives and interventions. A renewed focus on the determinants of malnutrition, including disease control and prevention activities, creating awareness on enhanced domestic child-care and feeding practices, need to be developed. Activities need to be better targeted towards the most vulnerable age groups (children under three and pregnant women), while funds and new projects need to be redirected towards the states and districts with the highest prevalence of malnutrition.
Involving the community in implementing and monitoring the ICDS programs will ensure in bringing in additional resources to the Anganwadi centers and improve the quality of its services. It is high time for us to step back and relook at the ICDS program with a new lens wherein it needs to be viewed as tools that can truly usher in better health and create inroads towards effective early life intervention. We owe it to ourselves to give a healthy start to our children.
The post We owe the children of our country a healthy start to their lives appeared first on The Alternative.
