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STRENGTHENING EARLY CHILDHOOD CARE AND DEVELOPMENT (ECCD);

SERVICE DELIVERY; PRWECT MANAGEMENT AND

SUPEWISION IN INTEGRATED CHILD DEVELOPMENT

SERWCES (ICDS)

Foreword The need for providing children with improved childhood necessities through a holistic approach, involving cooperation and liaison between disciplines and agencies, are well recognised in India. The National Policy on Education placed high prioriiy on early childhood care and development (ECCD). The policy suggested integration with the Integrated Child Development Sewices (ICDS), programme which is the largest child development service in the country.

While ICDS has placed itself as the pivotal' programms for integrating all mother and child care services, the skills of the functionaries in coordinating and tapping all existing potentialities is very crucial. Therefore, the need to strengthen management skills carries far reaching implications. Efficient management of resources and service delivery has always been a priority area for World Food Programme (WFP). Although, ECCD has not been a major focus area for WFP, the successive appraisal missions during the last decade have reviewed this component in collaboration with special- ized agencies such as UNESCO, USAlD and SCF(USA). The need to strengthen this component in partnership was placed on the agenda of the 1994 WFP appraisal mission.

UNESCO, came forward to collaborate with WFP on an action research. W F P designed a project to' Strengthen ECCD, service delivery, project management and supenilson in ICDS', which was cofinanced by UNESCO. The project was innovatively designed to faciliate and bring out the potentialities of the middle level functionaries, to harness all favourable opportunities. The project was implemented in Dhar district, Madhya Pradesh, with the help of a leading NGO, Bal Niketan Sangh. The project outcome far out- weighed the input costs. This sustainable model can easily be institutionalised through the large ICDS training network available in the country.

Page No . Foreword ................................................................................... iiT I

..................................................................... vii

Abstraci .................................................................................... 3 lntrodudion ............................................................................... 5

Ongoing Interventions ............................................................... 6 Early Childhood Care and .Development-- Some Experiences ... 1 1

Proid Objectiies ................................................................... 15 Project Area ........................................................................... 16

PION Design ......................................................................... 17 Prepro$ct Phase ................................................................... 18 One Day Orientation for Anganwadi Workers .......................... 26

Action Phase ............ .. .............................................................. 31

Postghase workshop .............................................................. 34

R- ................................................................... 43

Glossary of Terms ............................... .................................. 47

Abbreviations .......................................................................... 48

Strengthening Early Childhood Educatbn ................................ 27

Conclusions ........................................................................... . 41

Rderences .............................................................................. 45

Acknowledgements In keeping with their interest in early childhood education, UNESCO's financial support made this project a possibility. Our special thanks to Dr. Warren Mellor for his continued support.

W e are particularly thankful to USAID for extending financial support to meet the cost of early childhood learning materials.

Our special thanks to the Government of India and Govern- ment of Madhya Pradesh for the cooperation extended in the imple mentation of the project.

The enthusiasm with which the Supervisors, Child Develop- ment Project Officers and Assistant Project Officers of ICDS Sardarpur, Nalchha, Gandhwani and Tk participated in this project was remarkable. They would be trend setters in their own state for improved supportive supervision, project management and providing on-the-job training to AWWs.

This prqect was completed successfully due to the encourage- ment received from Mr. Michael Ellis, the WFP Country Director.

The technical and moral support received from Ms. Angela Van Rynbach, WFP Deputy Country Director, was invaluable to the

Dr. Minnie Mathew, National Officer, WFP, was the key per- son for designing, participating and overseeing the project. Her technical inputs and innovations were crucial for the success of the project. She took upon herself the task of redrafting and ediiing this report.

Bal Niketan Sangh (BNS), a training institute for middle level functionaries reputed for its strength in early childhood education was responsible for implementation of this project. The pillar of the project was Padamshri Shalini Moghe, the Director of BNS.

Dr. lndu Karanpuria, the Project Consultant, was responsible for implementing the early childhood component of the pject. She not only designed the early childhood education materials, but acquainted all the A W s of the project area on the use of the kit. The devotion with which she followed up the action phase of the project was remarkably impressive.

proid.

STRENGTHENING EARLY CHILDHOOD CARE AND DEVELOPMENT (ECCD);

SERVICE DELIVERY; PRWECT MANAGEMENT AND

SUPEWEION IN INTEGRATED CHILD DEVELOPMENT

SERWCES (ICDS)

Abstract The Integrated Child Development Services (ICDS), the nationwide programme of the Government of India offers the most important interventions for addressing the nutrition and health problems and promoting early childhood edmtbn among the disaclvantagedpqulatbn of the coun- tv. The programme haspositively influenced the nutrition and health indicators and school enrolment and retention rates. It is a unique programme meant for the prest communities in the country for the most vulnerable segments namely, women and children. While this promise exists, the programme suffers from implementation bottle- necks such as pr delivery of services, ineffective ctwrdi- nation, inadequate supervision, lack of skills among func- tbnaries and low community involvement. Ineffective COOT- dinatbn, inadequate staffing and sqpleS mnpunded with low awareness and demahd among the community are responsible for p r delivery of heatth services. Poor performance of growth monitoring, nutrition and health edm- tion and early childhood education can be attributed to inadequate sWlls among grassroots functionaries and stp w i v e supervision by the slrpervisory staff Training whbh is central to effective functbning is unfortunately top-down with a high focus on ideal situations and weak in skill buiMng inputs. Programme management is again tpdown with the result the middle-level functionaries are tuned to merely folbwing instructkm and guideha without exercis- ing much of their own problem solving capability. Suprvi- sots fail to see their role as trainers and do not play active roles in strengthening the role of grassroots functionaries.

This U N E S C O M F P collaborative project was a modest attempt to improve the programme management and supervisory skills of ICDS Suprvisors and ChiM Development Project Officers (CDPOs), strengthen their capability for providing on-the-job training and evolve a pattern for the same. Strengthening early chikihd care and development was a crucial element of the project. The project was imple mented in four ICDS projects, Sardatpur, Nakhha, Gandh- wani and Tirla of Dhar district, Madhya Pradesh.

4 STRENGTHENING PROJECT MANAGEMENT IN ICDS

The new approach which was developed to improve the management skills of middle level ICDS functionaries had three distinct phases which included field observations of Supervisors and CDPOs, complemented by independent observations by WFF, Bal Niketan Sangh (BNS), the NGO responsible for the project implementation. Through a pre- phase workshop, individual action plans Were developed by the Suprvisors and CDPOs. The action plans included (i) the performance of each of the components with detailed problem analysis quantifying current performance level for individual Anganwadi centres (A WCs), (ii) the reasons wn- tributing to the problems, (iii) problem specific solutions, (iv) actbn to be undettaken (v) epected obicome in quantifiable terms and (vi) the time frame within which the results could be achieved. These action plans were nego- tiated with the Andanwadi Workers (A WWs) through oneday orientation meetings. This forum was also used to demonstrate an early chiMhood education kit developed by BNS with financial support from USAID. Each A WG was provided with a kit which can be used in a variety of ways for cognitive, social, emotional, motor and fine muscle development.

The second stage was an action phase when the Supervi- sots implemented their action plans which included improving (i) the service delivery, (io coordination with the health depattment, (iii) providing on-the-job training to A WWs. (iv) creating community awareness etc., depending on individual situations. All opportunities were utilised by them to improve the functioning of the A WCs.

During the post-phase workshop, which was the third phase of the project, the Supervisors came back with measurable achievements in each of ‘the components. The outcome was the realisation among the middle level functionaries that they were managers in their own capacity and are responsible for the A WCs within their own jurisdiction. They also understood that they had a substantive influence on the success or failure of the A WCs. The model that was demonstrated was do-able and can be a pattern for supjwr- five supervision.

STRENGTHENING PROJECT MANAGEMENT IN ICDS 5

Introduction Millions of young children today in the developing world live in conditions of poverty. From the perspecthe of overall development, they are born and brought up in an environment which is hostile. Since independence, the Government of India’s determination to bring essential services to all these young children has been impressive indeed. Human development programmes focused on care and wetfare of children occupied an important place. Despite significant improvements in the health and education sectors in recent decades, 80 of every thousand children still do not live to see their first birthday. However, the incidence of severe malnutrition has declined significantly from 15 to 8.7, but the moderate and mild malnutrition, vaccine preventable disorders such as tuberculosis, diphtheria, pertussis, and polio are still common. Apart from these, 30 percent children are born under-weight, and are more vulnerable to illness and death.

Among the poor in tribal and rural areas the status of children is often worse than the national figures. Madhya Pradesh (M.P.) which has the largest tribal population in the country (23.3 percent) reflects poor development indicators: for example, the Infant Mor- tality Rate (IMR) is still 104 per thousand which is the second highest in the country (Sample Registration System 1994). This state has a large proportion i.e., 80 percent of malnourished children below -3 SD and -2 SD (National Family Health Survey, 1 995).

In M. P. the literacy level is as low as 50 percent. The gender difference in literacy is glaring with 64 percent for males and 34 percent for women. Around 45 percent of girls (6 to 14 years) are out of school. Again there is a striking difference between the urban and rwal situation with 54 percent rural girls being out of school (National Family Health Survey 1995).Compounded with the problems of poverty and illiteracy is the practice of child marriage in the country i.e.73 percent are married before the age of 18. The mean age of marriage for girls is 15.3 in rural M. P. as compared to 16.5 years in India. These and other critical features adversely affect their own lives and that of the future generation.


Ongoing Interventions

The Government of India (GOI) has remained committed towards care and welfare of deprived children. Many programmes have been staved and many policies and plans were adopted to ensure the maximum benefit of basic services to children. In 1975, the most important, multifaceted Integrated ChiM Development Scheme (ICDS) was launched by GOI. ICDS has been India’s chief vehicle for improving the prospects for healthy physical, psychological and social growth of it’s children. From a base of 33 pilot projects in 1975, the programme has expanded rapidly. As of March 1995, 3907 projects have been launched covering three quarters of the Country.

ICDS is designed to provide a comprehensive package of services for early childhood care and development, targeted to the poorest areas of the country. It consists of six basic components:

D Supplementary nutrition (children up to 6 years of age, ex-

c> Pre-school education (3 to 6 years of age),

D Immunisation, health check-up, referral services (chikiren, ex- pectant and nursing mothers).

Nutrition and health education (NHED) for women 15 to 45 Y-. The Government of India has assumed most of the responsi-

bility for financing the scheme, except for providing food supplements which is a state responsibility. The scheme receives support from international agencies such as the World Bank, UNICEF, World Food Programme (WFP), CARE, UNESCO and USAlD which are actively involved in bringing about qualitative improvements in ICDS. By the end of the Eighth Five Year Plan in 1977, India hopes that ICDS will reach all the 5,153 developmental blocks, reaching every needy child in the country under the age of six.

The philosophy of the ICDS programme is to address children’s needs holistically, to make an overall impact. In principle, each service rendered would be complemented by related services and

pectant and nursing women),

‘


therefore efficiency m the delivery of all the ICDS services is the key to the success of the programme.

The Cutting Edge of ICE: Anganwadis The basic unit of the ICDS system is the network of Anganwadi Centres (AWCs ). These centres provide a powerful mechanism for reaching mothers and theii children. Anganwadis are focal points of delivery of all basic services to women and children. Each centre serves about 1 OOO people in rural and urban areas and 700 in less populated tribal areas. In order to improve outreach in less sparsely populated areas, AWCs can be set up for population less than what is stipulated as the norms.

The AWCs are run by village volunteers, the An- Workers (AWWs) and the Helpers (usually local village women) The A W W s are supported by a cadre of supervisory staff beginning with the Supervisor. The Supewisors are responsible for 17 to 20 AWCs. At the block level, the ICDS project is managed by Child Development Project Officers (CDPOs) and Assistant Project Officers (APOs). They are mainly responsible for selecting AWWs, securing local facilities, ensuring food stqplies, flow of health sentjces and report- ing to higher authorities. At the district level, the District Women and Child Development Officers (DWCDOs) are responsible for all the ICDS projects of the district. At the state level, the Directorate of Women and Child Development exercises overall control through- out the state.

ICDS in Madhya Pradesh ICDS in Madhya Pradesh was started in 1975-76 in two blocks. Now 230 projes are operational which s e d 4.25 million women and children. World Bank, UNICEF, WFP, CARE and USAID are actively supporting ICDS in Madhya Pradesh.

The World Bank is assisting in strengthening 1 13 ICDS projects and expansion of ICDS in 131 new projects covering an estimated population of 7.6 million. This ptoject will seek to enhance the quality and effectiveness of ICDS services and refine further several key areas of ICDS.

8 STRENGTHENING PRQJECT MANAGEMENT IN ICDS

n, ICDS Health Department Distrlct level Dlstrict Level

District W o m n and Child Development Officer

Dlstrlct Health Officer

r h

Organisational Structure of ICDS

‘4

Block level Block level Child Devekpment Project Oflicer Medical Officer

I t

l l ICDSklealth Linkages I

Sector level Sector level Supervisor Lady Health Officer

_. - 1

r

Vlllage level Anganwadi Worker

Heper r

Village level Auxiliary Nurse Midwile Tradilional Blrth Attendant

WFP provides food assistam to 34 ICDS projects, with 330,OOO beneficiaries. These are spread over three tribal districts i.e. Jhabua, Dhar and Khargone. WFP has also undertaken several initiatives to improve the quality of ICDS. For example : The project, “Empow- erment of adolescent girls”, has several components which contribute towards quality improvement and will be described in subsequent sections. CARE supports 916,000 beneficiaries of the ICDS programme. Several health initiatives addressing the problems of diarrhoea and respiratory infections are also attempted by CARE.

UNICEF works with the Government of Madhya Pradesh on a number of programmes guided by the overall priority in the Five Year Plans for supporting development of women and children in rural areas (DWCRA). UNICEF supports training of ICDS function-


aries besides providing equipment such as jeeps, balances and growth cards for growth promotional activities for children. Vaccines and micronutrient supplements are also provided by UNICEF.

Impact of ICDS Since its inception, the ICDS has generated considerable interest among academicians, planners administrators and those who are responsible for implementing the programme. Therefore, large numbers of studies have been conducted to evaluate and assess the impact of the programme. Review of these research studies indicate that ICDS has had a positive impact in terms of infant mortality, reduction in severe malnutrition, coverage of immunisation and utilisation of health services, (National Institute of Public Co- operation and Child, Development, NIPCCD, 1992).

The study also found a greater school retention rate by children exposed to pre- school education in preparing them for formal learning, better adjustment in primary school and promoting retention in elementary school and reducing drop-out rate. While such great potentiality exists in the programme, it is necessary to identify the short-comings and find out ways and means by which the programme can make a better impact.

Research efforts have also contributed considerably to the understanding of the programme and have helped in identifying bottle necks and lacunae in the implementation of the scheme with regard to poor delivery of services, inadequate supervision and poor community participation and limited role of ICDS supervisory staff. Several studies reported that lack of transport facilities, village level politics, ineffective coordination of ICDS staff, lack of supervision, poor interpersonal communication as major difficulties which ham- per the smooth implementation of ICDS (Lakshmi Kumari, 1987, Rane, 1989, CHETNA, 1989, Murthy, 1989).

The main constraint in eliciting community participation has been identified as the lack of skills among functionaries in mobilising the community (Coonar and Mohan, 1985, Nutrition Foundation of India (NFI), 1988, Philips and Kurien, 1986, NIPCCD, 1988). Many studies have reported that NHED is a weak component of the ICDS programme. NHED is rarely conducted and the workers lack the skills to implement it effectively.

.-


The national evaluation of ICDS by NIPCCD (1992) showed that about 36.3 percent A W W s were not able to monitor the growth of children. The main reason that was pointed out was the lack of skills among A W W s in filling up growth charts. Lack of coordination between ICDS and health staff has been shown to affect the delivery of health services in ICDS areas. As reported in the evaluation of ICDS (1992) the percentage of health check-up performed by Medical Officers (MOs) was higher in urban AWCs as compared to tribal and rural areas.

Deulkar et al. (1989) conducted a job analysis of A W W s in selected ICDS blocks. They found that verbal activities were the most frequent and outdoor games were the least. Instead of child- centred activities, rote learning group activities were common. The NIPCCD study (1992) reported that the A W W s focused on formal methods of learning and that the majoriiy of children could count up to five objects. Cognitive and manipulation competencies were found to be weak. A study conducted by Mathew (1992) in the tribal district of Jhabua in Madhya Pradesh also reflected several weakness in the implementation of ICDS. Only 43 percent of A W s understood their job responsibility of non-formal pre-school education in a holistic manner. The time spent on non- formal preschool education was very low and participation of children was not punc- tual and regular. Observations at AWCs indicated that physical activities were not popular. Very few AWCs held activities for the development of finer muscle coordination with very low particii- tion. Actiiies at most centres hardly provided any intellectual stimulation. Learning throw outdoor examples and interactions with the environment were noticed only in very few AWCs. Play and outdoor activities were not found to be stimulating. A study conducted by Singh (1984) reflected that children were huddled inside AWCs, although adequate open space was available in the centres. AWCs did not have play equipment and teaching aids for pre-school education, except counting frames and black boards. Efforts were not taken to prepare teaching materials. Children were not involved in activities for socialisation and habii formation. A W W s had also not taken the initiative to educate the mothers about the objectives of pre-school education.

In the context of the country’s commitment to ensure basic education for all by A.D. 2000, ECCD also emerges as an area of

STRENGTHENING PROJECT. MANAGEMENT IN ICDS 11

priority. It is now established that basic learning begins at birth. Learning and development are essentially cumulative phenomenon whereby, what precedes play oriented early childhood education programmes play a significant role, both competitivdpreventive and reinforcing in compensating for the deprivation emanating from socio economic disadvantages as well as providing additional en- richment experiences, which the home situation is on its own not able to offer.

Early Childhood Care and Development (ECCD)-Some Experiences

Early childhood education is expected to have a beneficial impact on the future life attainment and development. It provides stimulating experiences to children and facilitates optimal cognitive development. It aims at developing competencies required for formal education particularly for the vulnerable group of population.

In view of the accepted significance of ECCD for the overall. development of human potentials as well as for the immediate gains in terms of school retention and achievement, an ECCD project was launched with UNICEF assistance in 1982. Under the project, 65 ECCD centres were established in each state which were physically attached to primary schools. A longitudinal study to assess the impact of these ECCD centres was conduced by the National Council of Education, Research and Training (NCERT) in 1993 which showed that ECCD certainly facilitates retention in the primary grades.

In Madhya Pradesh, an ECCD programme was launched in 1983. Under this programme, ECCD centres were established in 2 development blocks of Mandala district. In 1990, an evaluation of ECCD centres which was conducted by UNICEF, found ECCD as an important programme for retention in primary school and it was suggested that these centres should be linked with ICDS AWCs and ECCD teachers were nominated as resource persons for imparting training to A W W s on aspects of ECCD. This experience in M.P. was considered to be of exceptional quality as compared to the other states. Christian Children Fund (CCF) and the M.P.


Council for Child Welfare are also working in the field of child care and education in Madhya Pradesh. UNICEF has also experimented different ECCD methods i.e. Cognitively Oriented Programme for Pre-school Children (COPPC) method in selected ICDS projects for improvement of pre-school education component in Dhar, Jabalpur and Hoshangabad districts. Bal Niketan Sangh (BNS), a local non- governmental organisation (NGO), with technical and financial assistance from UNICEF, has also been engaged in developing applied, result oriented methods for early childhood education specially for the ICDS Anganwadis. Many workshops and experimental programmes have been organised in this series and strategies were developed for implementing the thematic approach of ECCD.

The teacher empowerment programme was started in Dhar district to bring about the qualitative improvement and access of primary education. This was planned to make primary school attractive and interesting for children. This programme has proved to be a great success. An attempt was made to link it with Anganwadis but did not make much of an impact as the main focus of the programme was on primary education rather than early childhood- education.

A mission carried out in the framework of the co-operative programme between W F P and UNESCO in 1993 pointed out that only one and a half hours were spent on early childhood education out of the three to four hours of Anganwadi functioning. Therefore little attention is paid to qualitative aspects of experiential and participatory activities and play, which lay the foundation for children’s sound psycho-social development which are prerequisite of early literacy and numeracy readiness. One of the important recommendations made in that report was the need for learning materials in the AWCs (Blatchford, 1995). A subsequent appraisal conducted in 1994 on the early childhood care and development component of W F P assisted ICDS also pointed out the need for learner centred activities by active learning and participatory involvement, interac- tive activities and the use of local materials and environment. Recommendations were also made to improve supportive supervision of the supervisory staff (Auer and Gibbons, 1994).

The adolescent girls’ scheme, an initiative promoted by WFP, encourages girls to acquire basic knowledge and skills related to


health, nutrition and child-rearing. They also learn to assist the A W W s in their daily activities, thereby contributing to the improvement in the quality of services delivered by the A W W . Both the WFP appraisal missions pointed out that the adolescent scheme was a good example of what can be achieved with food aid.

Training is an in-built component of ICDS programme. All A W W s and Supervisors receive job training for three months and subsequent refresher training at government approved training centres. Supervisors and Instructors of Anganwadi Training Centres (AWTCs) are trained through middle level training centres. The apex training institution is NIPCCD. ICDS offers tremendous potential since it is a programme meant for the poorest communities in the country and among them to the most vulnerable segments. The potentiality that the programme offers in terms of its design and infrastructure need to be fully tapped into. This can be done by strengthening the capability of the grassroots functionaries through the training network since it is an in-built part of the programme.

There are several constraints and considerable backlog in the training of ICDS functionaries (Sharma, 1987; CHETNA, 1989; CRD, 1988). They also suggested the need for making training of Supervisors more practically oriented with a focus on developing their supervisory skills. These experiences can help the ICDS Su- pervisors and A W W s to cope up with the ground realities and help them in solving the immediate problems related to various aspects of the service. Most of the orientation training and refresher training are currently done in training room situations suggesting ideal ways of service delivery rather than helping functionaries to cope with the ground reality. This is evident from the study conduced by Mathew (1992) in Jhabua, M.P. wherein almost all functionaries had received their basic training and most had one or two exposures to refresher training programmes, were performing below standards.

Thus to strengthen the delivery of services, it was thought appopriate to strengthen the capacities of grassroots functionaries through an entirely new approach of continuing training called “hands-on-training”, designed especially to strengthen the services of ICDS package and improve its quality. Through the WFP pilot project, an attempt was made to bring about a qualitative improvement by providing “hands-on-training”, which was found to be ef-


fective. Encouraged by the experience in Jhabua, WFP decided to scale up this input in the adjoining district of Dhar.

Experiences gathered through field visits and workshops conducted by WFP I> Inadequate use of outdoor space for conducting ECCD activi-

ties. The provision of outdoor activities could provide learning opportunities for children.

There was scope for improving skills among the A W W s for stimulating children using suitable techniques necessary for cognitive and psychomotor development.

I> The pre-school component observed in the BNS-run ICDS project in Jhabua district was far superior to the other ICDS projects. There were lessons to be learnt from the NGO-run ICDS.

The geographical hostility of the terrain made it difficult for pregnant and nursing women and children below three years to walk regularly to the centres to participate in the supplementary nutrition. There was a need to attempt alternate system of service delivery in such places.

I> Growth monitoring and promotional activities need to be strengthened by improving the skills of the AWWs. This was another area requiring hands-on-training since they have already been put through several class-room based training situations to no avail.

k- There was scope to involve health functionaries and local community members who have some lieracy skills, in growth monitoring and record keeping activities.

D The supervisor’s role in offering continued training during their field visits should be explored.

There was a need to remove traditional myths among the community on growth monaoring, particularly of children below one year old, immunisation and treatment of illness and create nutrition and health awareness.


D Record keeping was found to be poor and required improvement.

[> There was a need for improving coordination with the health department.

t> Referral and health check-up were observed to be the weakest link in ICDS.

D The CDPOs and Supervisors lacked setf confidence and failed to see their own strengths.

D They failed to see the opportunities that came across in the course of their work.

These observations clearly lead to the designing of a project to strengthen ECCD, service delivery and project management in at least selected areas of M.P.

A WFPAJNESCO Collaborative Effort Given the constraints of resources and the continuing need to improve the ICDS, it was necessary to identify appropriate inputs and collaborative possibilities to strengthen the programme. WFP's interest in bringing about qualitative improvements in the ICDS package delivery with a focus on ECCD prompted to undertake a collaborative project with UNESCO. WFP designed the project and provided the technical support and financial assistance for providing early childhood education materials for 61 3 AWCs in Dhar district. UNESCO provided financial support for conducting the project. Consistent with the WFP mission recommendations and UNESCO's priority for early childhood care and development and institutional strengthening components, the following were the objectives of the project.

Project Objectives b Identify and practice supportive supervisory roles for Supenri-

b Improve non-formal approaches for early childhood education.

SOTS and CDPOs.


I> Evolve a pattern for on-the-job training.

I> Improve management skills for efficient delivery of services.

b Improve programme management, training and trainer capability for providing on-the-job training.

This project component for strengthening early childhood care ‘and development (ECCD) was a part of a larger USAID funded WFP initiative in Dhar district, “Empowerment of tribal adolescent girls”, which hopes to improve the quality of ICDS through training of adolescent girls. As a pre-requisite to what the adolescent girls can do to influence ICDS functioning, the basic services should be in place and well managed. Therefore this component for strengthening ECCD, project management and supervision in ICDS formed an integral part of the W F P project.

Project Area The tribal district, Dhar of M.P. was recommended as the

project site by the Government of Madhya Pradesh (GOMP) since Jhabua district was already covered entirely by the Government of India(G0l) adolescent girl scheme. Although it was envisaged to cover the entire Dhar district under this new initiative, it was limited to 61 3 AWCs in four ICDS blocks, Tirla, Nalchha, Sardarpur and Gandhwani due to resource constraints.

The number of AWCs in the four blocks included in the project are given below:

Nalchha Sardarpur Gandhwani Tirla

21 5 21 8’ 1 50 30

Dhar district is situated in the south-western part of M.P. According to the 7 991 census, the total population of the district is 13,67,412 of which 53 percent population were tribals. The pre- dominant tribal groups are the Bhil and the Bhilala. Sixty nine percent of the population of Dhar district are living betow the pov-


erty line and have very low level of literacy of 28 percent. The gender differences in literacy is glaring with 38 percent literacy for males and 16 for females. Infant mortality, a significant indicator of child survival, is 104 per thousand live births and maternal mortality has been estimated to be 44 per thousand live births. The average age of marriage is 15. Teenage pregnancy is common, since 49 percent of girls would have had their first child-birth when they are in the age group of 15 to 19. From the perspective of overall child development, the children in Dhar district live at considerable risk.

The Project Design

preparatory Phase Preph- Workshop (Preparlng acth

Analysis of the Documentallon of fleld sltuatlon problems

problems

solutions

I I Actbn Phase

(lmplementlng the actlon plan)

One day orientation for grassroots functionarbs

I

of the Prop3

1

1 1 Slrenglhenlng weal

components

Hands-on-training for grassroots functionaries

Post Phase

workshop) @ost-ph-

experiences

achievements

conclusions

strategles

Setting time frame n


The project was designed to bring about a qualitative change, reflecting integrated implementation of health, nutrition and early childhood education services, through appropriate service delivery, management and supervision by ICDS functionaries. As is evident by the survey of literature there were several key areas requiring focal attention. The strengthening was intended to be done by improving the capability of the grassroots functionaries. This training was innovative which altogether discarded the traditional class- room training which is largely based on theoretical information.

A new approach was developed to improve the management skills of middle level ICDS functionaries which had three distinct phases: the pre-project phase, the action phase ahd the post-phase workshop.

Pre-project Phase The pre-project phase was based on the study and analysis of the issues observed by WFP, BNS, the pre-phase assessment conducted by the independent NGO, Dr. Baba Saheb Ambedker Insti- tute for Social Sciences, and the problems encountered by the ICDS Supervisors during their routine visits.

Observations made by Bal Niketan Sangh: During the first two months the BNS project team undertook a quick study of the field situation. During this study period, the team visited the project areas, observed the functioning of the Anganwadis, held discussions with the community, the ICDS beneficiaries, parents of child beneficiaries, AWWs, Helpers, Supervisors, CDPOs and MOs. The field visits provided an understanding of the problems and constraints in the implementation of ICDS when viewed from the grassroots level, the work and management potential of the ICDS functionaries specially the Supervisors and CDPOs.

Their major findings were:

than being non-formal. D The approach for early childhood education was formal rather

PRE-PROJECT PHASE

Children at the A W C

Children at the A W C

STRENGTHENING PROJECT MANAGEMENT IN ICDS 19,

b The AWCs had inadequate teaching and learning materials. The kit prepared by the A W W s during their own training was not being properly used by them in the field.

b The component of early childhood education was being totally neglected.

b According to the A W W s the main focus was on health and nutrition services.

b The'knowledge and skills of the A W W s in delivering the services was found to be poor.

b The Supervisors lacked managerial skills.

The field observations reflected the need for strengthening the pre-school component through hands-on training and provision of preschool materials suitable for cognitive, physical and social development of children.

Observations from the Pre-phase Evaluation A pre-phase evaluation was conducted by an independent agency, Dr. Baba- Saheb Ambedkar Institute for Social Sciences, located at Mhow, M.P. Their findings are given below: b Services such as health check-up, nutrition and health educa-

tion and referral services were irregular at the AWCs studied.

b Inadequate coordination with the health department was apparent.

b The communication skills of the functionaries was one of the reasons for the poor participation of women in the nutrition and health education sessions.

b A third of the functionaries could not enlist community participation.

b Half of them did not form women's groups (mahila mandals).

t> There was a need to dispel the superstitions among mothers

b Non-formal pre-school education was not conducted regularly.

regarding weighing of their infants.


D While almost 90 percent of the functionaries received training, they lacked the necessary skills to deliver services. Therefore a change in the content and style of training was suggested.

I> Since around half the A W W s were found to be illiterate they require a new approach in training. The Pre-phase Workshop: The information gathered through

the different sources provided the background for conducting the pre-phase workshop for the ICDS Supervisors. The four day pre- phase workshop included the following aspects:

P management skills of ICDS functionaries viz., CDPOs and

I> supervisory, monitoring and on the job skills;

P strengthening all ICDS services especially early childhood edu-

b building communication skills and

I> motivation and behaviour modification aspects.

Supervisors;

cation;

Proceedings of the Workshop: The first part of the workshop was devoted to discussing and documenting prevalent performance. The preparatory work helped the Supervisors to present a fairly vivid picture of the existent performance of all the ICDS components. Since the problems were many and the time frame of the project was rather short, it was decided that each Supervisor would identify five AWCs from their supervisory sector to develop individual action plans.

Analysis of the Prevalent Problems

Health Services I> Lack of coordination was highlighted to be one of the causes

for inadequate and poor quality of health services.

I> Immunisation coverage was given high priority by doctors who are overburdened with fulfilment of targets. The positive as pect is that the health machinery is very active with immumsa

The pre-phase workshop

Supervisors preparing maps


tion camps which has resulted in improved immunisation coverage. However, coverage is reported to be low in interior villages particularly for pregnant women.

b Lack of field staff at the primary health centres (PHCs) contributing to poor delivery of services.

b lack of awareness among people was also a contributory factor to poor performance. Villagers living adjacent to the f%k or tohe subcentres availed medical facilities, but those Wing in reinote villages believed in traditional medicines.

b Lack of motivation among A W W s was also a contributory factor.

Growth Monitoring b Growth monitoring is an important channel which provides

opportunities for a face-to-face communication with mothers. On an average, around 50 percent of A W W s were found t6 be capable of performing the tasks of weighing and plotting on the growth charts, and none of them were able to perform growth promotional activities and utilising it as a tool for imparting health and nutrition education to mothers.

b Mothers lacked awareness about the importance of growth monitoring.

Supplementary Nutrition The coverage of supplementary nutrition was found to be poor in areas where the distances of hamlets from An&wads were long and was the main reason for making nutrition services inaccessible to most needy people.

b The second main cause described by participants was that mothers left their homes early in the morning and were busy with agricultural activities the whole day. Their young children also went with their mothers; therefore both mothers and their young children were not able to benefit from the supplementary nutrition component. In such cases mothers preferred to have take-home rations either on a weekly or a fortnightly basis.


D In some cases problems related to poor logistical arrange- ments affected the regular delivery of the nutrition component.

[> Caste hierarchy had a negative effect on participation of beneficiaries belonging to certain backward communities. Thus, the poor and needy children and mothers from certain tribal groups were deprived of the benefit of supplementary nutrition. They were also deprived of other health service viz, immunisation, health check-up and referral services.

Nutrition and Health Education t> Nutrition and health education was organised only in 30 to 40

percent of the AWCs.

t> The main problems which were hindering the delivery of this service were lack of motivation, low literacy and lack of organisation skills among AWWs.

t> Lack of nutriiion and health educational materials and lack of communication techniques also contributed to the poor delivery of this component.

Early Childhood Education D Delivery of early childhood education component was found to

be weak in most project areas. Supervisors reported that only 40 to 50 percent of A W W s were able impart pre-school education properly. Many causes have been described for the poor implementation of this component.

D Physical set-up of AWCs were not conducive for conducting stimulating non-formal pre-school activities. The shortage of space in AWCs also affected indoor activities.

Shortage of equipment and learning materials was reported as the main cause for the poor status of early childhood education at the Anganwadis.

I> Lack of the skills among AWWs for imparting early childhood education was felt to be a negative factor by all the participants.


I> Lack of interest and motivation among A W W s was an important reason for the poor implementation of early childhood education.

b Parents lacked awareness about the concept, need and importance of pre-school education. Thus, they were not inter- ested in sending their children to the AWCs for pre-school education.

D Lack of managerial skills among Supervisors hampered their role to provide proper guidance and support to the A W W s for planning and taking up innovative activities and effective utilisation of available resources for pre-school activities.

Thus, AWWs were not able to perform the activities which can help in creating an interesting environment and attract children towards the AWCs.

During the discussions it was realised by all the participants that the concept of early childhood stimulation (ECS) was not understood and there were no activities for children under three years of age, either at home or at the AWCs. The need and importance of ECS activities, which are very important for the development of children were discussed. Stimulation in the early childhood stage involves efforts to activate child’s early development and provide learning experiences to the child so as to enhance hidher development. The nurturing experience the infant receives in the early years of life serves as the foundation for hid her subsequent learning. A home which believes in the capacity of the child and has high hopes for himlher, is the best stimulator for the child. The continued love and support of the mother lays the foundation of all future development. The pleasure of sucking, hugging and close proximity to the mother and father are all experiences which help the baby to develop the feeling of security. Play is most natural and spontaneous to children. Apart from being fun, play is significant for the child’s physical and psychological development. Listening to stories is a favoured activity of children and occupies a very important place in the ECS programme. Music too is a strong stimulator. Songs and musical riddles appeal to them. It is importarit that every mother makes an effort to learn songs, lullabies etc., and make use of them in daily life activities for


example, when the mother feeds the baby, she may hold him/her close and talk to the baby. The mother plays, smiles, cajoles and sings and the child responds and experiences physical contact, warmth and security.

Allhough nutrition and health inputs are available to the tribal children (however imperfect) there is lack of knowledge about ECS activities which can stimulate their overall development. Besides, children under three years of age do not m e to the Anganwadis for any learning experience. Thus, they are deprived of getting a chance to boost their potential for over-all development causing delayed development. Therefore, if we educate the mothers about ECS, it will certainly have a positive impact on overall development of children. Techniques to impart education to mothers were also demonstrated during the workshop. Supervisors demonstrated the ECS activities to the A W W s who in tum provided orientation to the mothers.

Preparation of Action Plans Using the above information, the following were documented in the individual action plans: (i) the performance of each of the components with detailed problem analysis quanttfymg current performance level for individual AWCs; (ii) the reasons contributing to the problems; (iii) problem specific solutions; (iv) action to be undertaken and (v) expected outcome in quantifiable terms and (vi) the time frame within which the results will be achieved. An the 38 Supervisors who participated in the workshop prepared individual action plans on the basis of the above mentioned parameters.

This exercise was quite time consuming since they had to work out situation specific solutions. Although the original intention was to develop action plans for all the AWCs by each Supewisor, it was not feasible due to time constraints and was decided to select only five AWCs by each Supervisor. All the participants prepared their individual plans with a great deal of interest. They included details such as sectorial maps and graphical presentation of the current situation and expected outcome.

To illustrate (an example of an action plan developed for one A W C is provided at page 25).

STRENGTHENING

PROJECT MANAGEMENT IN ICDS

25

I


The Supervisors presented the individual action plans developed by them to the plenary. In all, 190 action plans were presented and discussed. This was a learning experience for the participants and the facilitators since the observations made by the ICDS Supervisors were very much in the context of individual villages. They were ‘realistic snap-shots’ and did not involve any generalisation. The problemlsituation specific discussions helped the facilitator to guide them to overcome the negative influences and take advantage of the opportunities they came across. Unlike normal training situations when trainers tend to generalise, this training situation was a unique one with focused discussions. There- fore trainees interest level was also sustamed at a very high level. Based on the discussions, the action plans were revised. Each CDPO/Supervisor participating in the workshop had to prepare their own action plans. After preparing duplicate copies, they were filed and were carried back with them. All participants left the workshop with their own working manual to follow in the field. For once, they realised that they had their own roles to play and were not merely exBcufors of instructions. While following the top down approach the grassroots functionaries do not feel responsible for the results. They looked for excuses to rationalise why things did not work the way they were intended. This attitude had emerged since there was no ownership among the functionaries who were partners in the programme and when their views were not given adequate importance.

One Day Orientation for Anganwadi Workers The next step on completion of the pre-phase workshop and preparation of the action-plans was to negotiate these plans with the AWWs, their expectations and suggestions for the qualitative and quantitative improvement plans that were outlined at the pre-phase workshop. The one day orientation sessions were conducted by the Supervisors, the BNS consultant and trainers who formed a team. These sessions were organised at the sector level. It was not only to have it in close proximity to their AWCs but demonstrating the idea of using sector level forums for discussing issues other than compilation and reconciliation of reports was important. A total of : 575 AWWs participated in the different sector level discussions.

ON€ DAY ORIENTATION SESSION FOR AWWs


The action strategies were discussed in detail with the A W W s using the working manual prepared for specific Anganwadis. During these orientation workshops, the Supervisors discussed their problems and provided them guidance and suggestions for resolving their existing problems. All aspects of the ICDS package were discussed in these workshops. The exercise created a ripple effect in that, not only those A W W s whose centres were identified for inclusion in the action phase came forward, but others were also motivated to join the discussions on effecting improvements in the ICDS service delivery. In sharp contrast to traditional training, the Supervisors and trainers used group discussions to encourage participants to interact in informal ways and develop their own ideas of how to make the services effective, attract children towards AWCs, seek community participation and demonstrate skills of communication. These exercises enabled Supervisors to identify themselves with the problems of A W W s and the A W W s also learnt to express their ideas and problems more effectively. The Supervisors mastered the skills of conducting training in a participatory fashion.

Strengthening Early Childhood Education The pre-phase workshop clearly revealed the need for special attention on the early childhood education component of ICDS. The major weakness observed were the poor management of non-formal pre-school activities at the AWCs, and lack of know-how of methodologies for conducting non-formal activities. In order to strengthen the component, special emphasis was given to early childhood education at the AWCs and mothers’ education about early childhood stimulation for children under three years of age. The attempts were directed to:

D create an environment suitable for learning,

D orient functionaries to the process of early childhood educa-

D develop skills among A W W s to organise meaningful early

tion,

childhood education.

28 STRENGTHENING PWECT MANAGEMEKT IN ICDS

provide skills among A W s suitable for creating reading and writing readiness among children,

b suggest approaches for creating parent awareness.

The BNS Consultant and trainers demonstlated activities which can be organised both indoors and outdoors; m e t W for group activities; use of locally available resources; distribution of play materials to children according to their age; stories and poem for preschool educaqon and the thematic approach for early childhood education. The activities of Early Childhood Stimulation (ECS) for children below three years of age which were totally neglected at the AWCs and homes were also demonstrated during the one day orientation. The stimulation which mothers can easily perform during their daily household activities were demonstrated to the mothers. The one day orientation programme helped the A W s under- stand the techniques of early childhw education in a practical way. The A W W s were also provided guidance on involvement of adolescent girls who were trained through the W F P project, "Em- powerment of adolescent girls".

An early childhood education kit for children 3 to 6 years of age was developed by BNS with financial support from WFP. AU the 613 AWCs included in the project were provided with the kit. They were trajned on the use of the kit by the BNS team. The kit was designed to promote cognitive, language, motor, physical, so- c&d and emotional development. It was also designed to develop communication skills, good behaviour, creativity, partnership and self confidence in children. Most of the items included in the kit could be used for more than one type of learning experience. Materials for outdoor activities were also included in the kit such as ball and rope. These were designed on the basis of COPPC method which help to promote both gross motor development and social development. The ECE kit materials were not only enjoyable for children but were also capable of stimulating development.

The materials, methodology and approach used in the early childhood education kit were as follows:

b Geometrical shapes (square, round, triangle, rectangle etc. ,): To teach concepts of shapes and their nomenclature to children. Activities would include identification and pairing of simi- lar shapes.


b Colour strips (primary and secondary) : To teach primary colour concept, identification, pairing and colour classification.

I> Jigsaw puzzles: Children learn problem solving through the jigsaw puzzles.

b Floor mosaic: Develop problem solving capability among children. Useful for teaching different colours, shapes and de-

b Dominoes: Help children to learn identification, discrimination and association of colours.

b Games to find the missing parts: Develops minute observation power and concentration.

b Gradation exercise with the help of pictures of different sizes: Develops concepts of size, shape and the ability to compare besides improving their capaoity for minute observation.

b Correlation games: Help in learning association and relation-

b Animal puzzle sets: Develops capacity for observation, analysis and problem solving capacity of children.

b Rod puppets: To be used for story telling. Develops vocabu- lary, imagination, concentration, learning readiness and provides emotional satisfaction among children.

b Balls: They can be used in a variety of physical activities for motor development, coordination and developing competitive spirit. Children can also learn counting in a play-way method.

signs.

Shjp.

b Musical instruments: Develop rhythm in children. b Rope: A rope can be used in a variety of ways. Can be used

for cognitive development, language, rhythm, coordination, balance, imagination, social and gross motor development.

b Masks: Develops confidence in children. They learn to dramatise; encourage language development and imagination.


3 Sewing board: Boards of different shapes and colours with hdes and boot lace were provided. When they pass the lace through the holes they develop coordination, toncentration and fine muscle development. They learn to make different stitches and learn to wear shoes. By providing boards of different colours and shapes, concepts of colour and shape can also be taught.

The intention of providing the kit material was not to limit the AWWs to the use of the kit alone. Therefore they were familiarised to many other activities like painting with the help of thread and waste paper, spray painting with the help of net and brush and making floor designs with the help of seeds. leaves, flowers etc. Suggestions were made for organising the activities in such a marrier that the AWW can keep her eyes on every child and be able to provide the necessary guidance to them. While indoor activities are being organised, there should not be any outdoor activities because it diverts the attention of children. The indoor activities were designed to begin with simple ones, gradually pro- gressing to complicated ones. The children should perform the simple activities in the beginning and only when hdshe is able to do them perfectly should they attempt activities which are more complicated. If a child is able to perform the activities quickly and is able to grasp the concept earlier than the entire group, the AWW should give special attention to the child and try to enrich the environment favourable for development.

Many other alternate methods were also suggested for making ECE a pleasant experience for both children and the AWWs. They were taught how to make stories interesting with masks, charts and puppets and sing songs with action and movement; how to interact with children; prepare useful and attractive playing and learning materials from waste or low cost locally available resources.

Some guidelines for organising pre-school activities at the AWCs:

I> The environment of the AWCs should be attractive. D Learning aids should be within easy reach of children.

L> Every child should have equal opportunity to play with all the learning materials.

THE ACTION PHASE

NHED session using community growth charts

Health check-up for ICDS beneficiaries

Learning habits of hygiene

W o m e n learn to prepare ORS

A W W using the early childhood education kit

Using Rod Puppets for Early Childhood Education


b A W W s should provide guidance to children for certain activi-

t> Learning should be in a conducive atmosphere and the A W W

ties which have educational value.

should be loving and polite with children.

Action Phase The action phase was from February to July 1995. During the action phase the ICDS Supervisors and CDPOs strengthened their management roles, improved their supervision and undertook their role as trainers of the A W W s in their jurisdiction. Some of the key issues addressed through the action phase were:

b Provide hands-on-training to A W W s on aspects which required strengthening.

L> Take on certain specific responsibilities such as growth-monitoring wherever A W W s cannot perform this responsibility effectively.

I, Use all opportunities such as departmental campaigns for immunisation, literacy etc., to positively influence the ICDS functioning.

P Involve the community and local leaders to help in running the Anganwadi activities.

L> Each supervisory visit to be invested as an opportunity to improve the AWC’s functioning.

Supervisory visiis to focus on specific issues rather than being general in nature. The BNS consultant retained a true copy of the individual

action plans evolved by the ICDS Supervisors. This was used for follow-up during the action phase. The Supervisors and A W W s accepred this experiment as a challenge and used it as an opportunity to display their capability to show improvement in the functioning of their own centres. Normally when state level instructions are received for undertaking certain special activities, field level functionaries consider it as a burden.


During the action phase, there was a special drive to improve the coverage of health services which was launched by the Rajiv Gandhi Health Mission of the Government of M.P. Under this drive, rallies and campaigns were organised in every village. A “Rajiv Gandhi Jattha”, which included the Chief Medical Officer, doctors, ANMs., CDPOs and Supervisors, went to every village. The A W W s and Supervisors took advantage of the “Jattha” to undertake health check-up of children and pregnant mothers which was the weakest component as reflected in the pre-phase workshop. This is an example of how the functionaries learnt to take advantage of opportunities that they came across routinely. They also benefitted by beefing up the immunisation. Health and nutriiion education sessions were also organised by the” Rajiv Gandhi Health Jattha” conveying messages of oral rehydration, hygiene, sanitation and other relevant information on various aspects of health and nutrition. These health campaigns helped in improvement of health services at the AWCs and also improved coordination among health and ICDS functionaries.

The A W s and Supervisors contacted local leaders and requested them to encourage people to take advantage of the ICDS services by sending their children to the AWCs. During community meetings, local leaders were present and took active part in the discussions. Since they have an influence over people in their villages, this effort brought about positive changes in the attitude of the community. Healthy baby competitions were organised to communicate the value of good health and generating awareness among people, specially among mothers. Mothers also expressed their problems in the meetings and the health team responded with appropriate solutions to their problems.

The new approach of continuing education through hands-on- training while on the job was emphasised in order to strengthen and improve the quality of the various services. During the preparatory phase, the Supervisors had identified areas requiring hands- on-training and the A W W s who required the additional training. Based on this, the action plans were prepared and were followed in the action phase. Therefore there was a selective approach based on the specific requirements. This approach was time effective and was able to produce results. The A W s were able to develop skills more effectively. Any number of class-room expo-


sures cannot produce results equal to that of on-the-job training. In short, a combination of inputs to suit the different situations was applied. All the focused efforts such as the community meetings to enlist community support, home visits to increase participation, community awareness, the inputs of the Rajiv Gandhi Health Mis- sion and the hands-on-training were helpful in producing the intended results.

During the follow-up visits to the project. area, AWCs were visited and the community and local leaders were contacted. It was found that the drab and dull AWCs were transformed to attractive centres with the kit and other learning materials prepared by the AWWs. The skill and motivation levels were high. Proper techniques were adopted for organising ECE. Participation of the children also showed improvements as a result of creating parent awareness. Every child at the A W C was observed to be actively engaged with the learning materials, with songs and outdoor play activities. The BNS team visited the AWCs and ensured whether the Anganwadi activities included the following activities in their daily schedule:

D ensuring that children at the A W C are clean; D encourage conversation skills among children;

D include songs to develop rhythm among children;

D inculcate imagination among children through role play;

I> encourage creativity through hand-work;

D include story telling for language development, imagination, emotional development and convey messages on health and hygiene;

b have nature walks to encourage learning from environment;

D organise weekly campaigns to create awareness in the com-

The supervisory skills of the Supervisors also showed considerable improvement. The Supervisors who previously concentrated only on scrutinising records, started providing support and guidance to A W s . They were found to pay attention on learning materials,

munity about ECE requirements of children.

STRENGTHENING PROJECT MANAGEMENT IN ICDS ’#

34

the pre-school teaching techniques, growth monitoring, immunisation status, supplementary nutrition and beneficiary participation. They helped the A W W s in community contact and eliciting their cooperation. The regularity of service delivery improved as a result of, improved management skills of the Supervisors.

The Post-phase Workshop The post-phase workshop served as a forum for exchange of experiences through individual presentations. All the Supervisors who prepared action plans and went through an action phase participated in the post-phase workshop. A component-wise summary of the presentations is as follows:

Supplementary Nutrition

Almost all Supervisors reported an increase in the’coverage of supplementary nutrition. The average coverage of supplementary nutrition which was reported to be approximately 60 percent in the pre- phase workshop, increased to 70 to 75 percent. There was an improvement in the coverage of pregnant and lactating mothers. The Supervisors and A W W s conducted meetings of mothers who were not participating in the supplementary nutrition and paid frequent home visits and requested them to come to the AWC. They created awareness among them on the advantages of supplementary nutrition. As mentioned in the pre-phase discussions, the mothers went for work in the field very early and were not able to come to the A W C to benefii from the supplementary nutrition. The schedule for distribution of the supplementary food for mothers was changed. The ACDPO of ICDS Nalccha, Usha Joshi reports, “Before implementation of the action plan the average attendance of mothers was around 8 to 70 out of 20 to 25 mothers who re enrolled for participation in an A WC. After changing the time o distribution of the supplementary food for them, these mothers o went to the

The long distances to the AWCs was also reported\{o be a prob- !em. In those areas, the supplementary nutrition with the help of adolescent girls, who took the mentary meals to the hamlets and distributed to

field also benefitted by the supplementary nutrition a ~ c4mponent’:


Supplementary Nutrition In Selected ICDS Projects

. _ i

so Target ~3 Achievement f =.

. . .. . -. . . -

Sardarpur Nalchha Gandhwani Tirla

nursing mothers. Lack of hygiene among children was a serious problem which had to be addressed. Several other situation swifii solutions were attempted during the action phase by the Supervi- sors and AWWs to improve the implementation of the supplementary nutrition component.

Immunisation, Health Check-up and Referral Services The pre-phase findings and presentations accented the poor performance of health check-up and referral services. Supervisors fully capitalised on the opportunity thrown open by the special campaigns on health check-up and dmrrhoea control they had to organise in collaboration with the Rajiv Gandhi Health Mission. Through the campaigns, intensive health check-up and immunisation drives were organised. Several un-immunised children were immunised during these drives.

P.eople of Goomanpura village of Ringnod sector, which is isolated from all amenities depend very much on the services rendered through the AWC. Owing to long distances to the Primary


Referral Services In Selected ICDS Projects


Health Check-uD In Selected ICDS Projects ___

I - --



Heatth Care (PHC) centre and lack of transportation facilities, many women have died during child-birth. The Supervisor of this sector, Vandhana Billore, held discussions with the Panchayat leaders and explained the need to do something about this fatal problem the women in their village experienced. The response was unbelievably good since they collectively organised a vehicle for emergency requirements such as child-birth. The Supervisor also organised a special survey and identified 8 malnourished children who were not previously identified or registered in the AWC. The AWW was familiarised with the referral system and during the action phase several cases were referred to the hospital. But for this effort to organise hands-on-training, several components would have remained grey areas for the AWWs.

Nutrition and Health Education (NHED) Several innovative approaches were adopted to strengthen the

NHED component. Through the WFP project "Empowerment of tribal adolescent girls", the AWWs also underwent training along

Nutrition & Health Education In Selected ICDS Projects

Sardarpur Nalchha Gandhwani Trla


with the adolescent girls. The participatory approaches used in the training provided them a good exposure to the methodology suitable for organising NHED sessions. The WFP modules were based on the local problems and situations using local culture and enter- tainment to make them interesting. Those A W W s who previously did not have communication skills, were able to organise NHED sessions very effectively. The community growth charts were also utilised to create awareness in the community and counselling of mothers. As reported by Amarjeet Kaur, a Supervisor of ICDS Sardarpur, “I used the community growth chart for community education where I explained the need, importance and method of growth monitoring in a community meeting . The meeting was attended by both women and men. They carefully watched the procedure and at the gathering, a mother who never used to’ come to the A WC, came forward and requested me to weigh her child. Similarly several mothers came foward for weighing their children. As a result, four cases of malnutrition were identified. This effort proved to be a very successful approach to impart community education”.

Early Childhood Education The early childhood education kits provided to the AWCs and the training on the use of the kits was repotted to be the main contributory factor in influencing ECE at the AWCs. There was a shift from the formal, dull approaches to creative non-formal approaches. Attractive learning environment was created. Sangita, the Supervi- sor of Nalchha ICDS sector, reports on one of the AWCs included in the action plan, “All that used to happen in this centre was the distribution of supplementary food. The pre-school programme was attended by only 5 to 70 children. Beneficiaries arrived for collect- ing their supplementary meals and went away. Through the action phase, ECE activities were organised systematically; the kit materials and other local learning materials were used for organising ECE; adolescent girls were involved in organising non-formal pre- school acfivities and created parent awareness. These efforts brought about a change in the environment and children have started participating in the entire session on pre-school education. ”

Parents education was important for the successful implementation of the pre-school programme. When they saw their children


Non-formal Pre-school Education In Selected ICDS Projects

. . __

U Target El khievement

Sardarpur Nalchha GandhwaniITiir(a

enjoying the outdoor activities at the AWCs, they were thrilled and watched all the activities with a great deal of interest and realised the need and importance of such activities. If parents are aware of the concepts of ECE, they will bring their children to the AWCs, and if they take interest in the activities of their children and encourage them to recall the activities, songs and stories at home and appreciate their efforts, the confidence among children will be built, which will prompt their learning and curiosity. In this way, the link between A W W s and parents was built up, which will definitely contribute to the holistic development of children.

When a demonstration was going on at a remote A W C Qf ICDS Nalccha situated on a hill top, one of the parents remarked, “I have never witnessed the experience of joy and excitement of children playing in this way, therefore I have never understood anything about the pre-school activities. Now I a m convinced and will convince other pargnts in my village to send their children to the A WC”. A four year old child at an A W C remarked. “I love to play here because I do not have any play material at home”. These

40 STRENGTHENING PROJECT MANAGEMENT IN lC0S

responses reflect the need and importance of demonstrating Anganwadi activities to create community awareness . Many AWWs, who were considered as dull and lazy, became active and started performing very well; they started demanding more and more inter- action with their Supervisors. Adolescent girls who received training through the WFP training programme were also found to be facili- tating the activities of ECE. These inputs increased the confidence of A W W s who were motivated to work hard for successful implementation of ECE activities.

The efforts to strengthen the ECE component were provided with a view to promoting long term effects through parents’ education. This aspect was emphasised for building bridges between the A W C and the home and it was presumed that this effort would definitely bring about a positive impact on ECE activities. Develop- ment of A W W s skills in making learning materials through local resources, can make ECE activities enjoyable for children and will help them organise the ECE activities without much additional financial or technical assistance.

A Very Difficult But a Rewarding Experience The supervisor of Chaklya sector, Bharti Chauhan, took up an interior village under the action plan. The situation of all the services in that A W C was grim. There was no coordination between the health and ICDS functionaries. The situation of health services, specially the health check-up and referral services, was not satis- factory. Only around 50 to 60 percent of the children were weighed and the A W W was not able to fill up the growth charts. Many cases of malnutrition were unidentified and many needy children were deprived of the benefits of supplementary nutriiion. She said that, although while preparing the action plan in the pre-phase workshop, she had set up a target of 80 percent performance, she was very apprehensive about achievement. The attitude of the community was totally negative towards ICDS and they did not come to the A W C to participate in the services. However, when the action plan was implemented in the village, several innovations were intro- duced: the adolescent girls who were recently trained under the WFP project, were involved in the Anganwadi activities; with the help of the ‘Rajiv Gandhi Health Mission Jattha’, and other health staff, the health services received a big boost; the A W W s and


Supervisors organised community meetings and impressed them about the benefits of the services available at the AWC. During the implementation of the action plan, much emphasis was given to the management of health and nutrition services and nutrition and health education; special efforts were made by the Supervisor to improve the coverage of immunisation. Special attention was paid to growth monitoring by inproving the skills of A W W s through special orientatin and performing the growth monitoring task during home visits and community meetings. This attempt improved the coverage of ICDS services providing benefits to those needy women and children who were not benefiting.

Conclusions t> The project was visited by W F P and Government of Madhya

Pradesh officials besides the BNS team who could observe the enthusiasm among the participants of the project. They were serious about the implementation of their individual action plans. During the action phase the project was also visited by an ECCD expert from USAID, Washington, who was a mem- ber of the WFP appraisal team. She could observe the striking difference in the project area when compared to the pre- project phase. During the follow-up visits, the local leaders, parents and functionaries of other departments were contacted. AII the follow-up reports revealed the changed sce- nario of ICDS.

b AWCs which were drab and dull became attractive with the learning materials. After the skill and management orientation and the oneday orientation workshops, the Supervisors and A W W s were motivated to work. They adopted proper techniques of ECE and also engaged children with learning experiences.

b The education of parents helped in increasing regular attendance of children at AWCs. The average attendance which was reported to be around 15 to 20 children increased to 20 to 30 after implementation of the project.


I> The action plans prepared by the Supervisors were executed in the field and the efforts suggested to strengthen the services were adopted by the AWWs. Community meetings and home visits improved the performance of growth monitoring and other health services.

D On the basis of individual documentation maintained by the CDPOs and Supervisors and observations from the field situation revealed the improved supervisory roles of Supervisors and CDPOs. The Supervisors started to provide guidance and support to A W W s in organizing the activities and solving their problems.

D The regularity in the delivery of service was maintained. The schedule for the A W C was properly planned.

D All opportunities were utilised for strengthening the ICDS services.

I> During the implementation of the action plan, all the Super- visors and A W W s realised the need and importance of the working manual in which they had defined their own strategies for bringing about improvement in their own areas of responsibility. Therefore, they did not feel any burden in implementing the approaches.

I> Decentralisation of power was the secret of success of the project.

D The communication skills of the A W W s were strengthened as a result of their participation in the W F P project “Empow- erment of tribal adolescent girls”

D It became apparent through the pt-phase presentations that the Supervisors had realised that the efforts taken by them during the intervention phase of the project was entirely their own responsibility. They were not responding to instructions received from persons of power, imposing additional burdens on them. The approaches were very do-able and totally self- sustaining. The activities which were carried out were according to their own plans and therefore they were able to rnan- age them effectively.


b All the Supervisors and the CDPOs however, felt that the project duration was very short. Given more time, the results could be more encouraging.

Recommendations P Since the effort to bring about improvement in the quality of ECCD and other services of the ICDS package showed impressive results, these efforts can easily be replicated in other

b The approach adopted in this project to improve the supervisory and management skills of Supervisors and CDPOs, through identification of problems, deciding the strategies for effecting improvement, the inputs they can invest within their own control, was found to be effective and should be part of their regular training.

b At the project level, CDPOs should review the programme on the basis of grasSroots level functioning and suggest mea- sures to improve them.

P To improve the overall qualiiy of services, training sessions of short durations should be organised at the sector level so that A W W s can easily participate in them without hampering the functioning of the AWC. These brief exposures help in updat- ing the workers with the latest knowledge and skills.

b There is a need to develop the AWW's skills through hands- on-training.

b Distribution of supplementary nutrition for pregnant and lactating mothers and children below three years, specialty those living in interior areas, should be adjusted to suit their conve- nience.

b Supervisors should be oriected to adopt the team approach, for effective coordinatiin among all the functionaries of ICDS.

b For improving the quality of ECE at the AWCs there should be some, provision for purchase of raw materials to make learning materials. Whenever possible, kits should be pro-

pkes.


vided to each A W C with facilities for repair and replacement. From time to time there should be training inputs on approaches and methodology of ECE.

D Supervisory visits should be used for improving the quality of the services.

D The adolescent girls who are assisting AWWs.in the activities of ICDS should be encouraged to take part in activities of ECE.

D AWCs should be linked with primary schools.

I, The NHED component, which is very weak, can be strengthened by using the WFP modules used for training adolescent girls which are tailor-made to suit the culture specific problems of the area.

D The register maintenance procedure should be simplified keeping in view the A W W s with lower literacy levels.

[> Community growth charts, which were found effective during the action phase of the project, should be used routinely in community awareness campaigns. A W s growth monitoring skills should be further strengthened and encouraged to undertake growth promotional activities as an important aspect of health and nutrition education.

I> Parents training is essential to promote ECCD with a focus on ECS. Parents should help in preparing learning materials.

D It was observed that ICDS has remained merely as a govern. ment programme. Only with adequate peoples' participation, it is likely to fulfill its true objectives. Besides creating awareness among them, they should be encouraged to be partners and owners of the programme.

D The project should be scaled up to cover the entire district of Dhar.

D The application of the techniques learned should be broad- ened to other integrated social sectors both in Dhar district and in selected other districts

I, The UNESCONVFP collaboration should continue.


References Blatchford, Iram, Siraj. Nourish and Nurture: Assistance for Early Childhood

Education in India's ICDS. UNESCO Education Sector Monograph No. 3,1995.

Carie, Auer., Gibbons, Michael. Appraisal and design report of the early childhood care and development component of WFP assisted ICDS, 1994.

Centre for Health Education, Training and Nutrition Awareness (CHETNA). Training needs assessment for ICDS Supewisors, 1989.

Centre for Research and Development (CRD). Report on the study of middle level supervision by Mukhya Sevikas of ICDS Propcl in old Chandrapur district of Maharashtra, 1987.

Coonar, P.S., Mohan, V. An assessment of functioning of 96 Anganwadis in the Urban Slum ICDS Project of Amritsar along with the study of knowledge, attitude and practices of functionaries. Amritsar (Punjab), Medical College Amrikar, Department of Preventive and Social Medii cine, 1985.

Deulkar, D., Khalakdina, M., Rao, A Job analysis of Anganwadi Workers in selected ICDS blocks. Lady Irwin College, 1984.

District Rural Development Agency. District Profile for Dhar District, 1995. Government of India. A data sheet on ICDS, 1995. Government of Madhya Pradesh. Madhya Pradesh State Plan of M i n . A

Lakshmi Kumari. Assessment of Supervisor's job towards prwschool edu-

Mathew, M. Adolescent girts in tribal ICE, WorM Food Programme, 1994. Murthy, L S. N., Mathur, Sunita. Project Management: A study of ICDS

prow New Delhi, 1984. National Family Health Survey (MCH and Family Planning), International

Institute for Population Sciences, 1995. National Institute of Public Cooperation and Child Development

(NIPCCD).lmpact studies of community participation in ICDS, 1988. National Institute of Public Cooperation and Child development. National

Evaluation of ICDS, 1992. Nubibn Foundation of India. Integrated Child Development Services. A study

of some aspects of the system, 1988. Philips, W. S. K., Kurien, N. A Time work allocation and effectiveness of

the work of Anganwadi Workers. lndore School of Social Work, 1986.

Commitment to the Child, 1994.

cation. JBAS Women's College, 1987.


Rane, Asha, J., Narayan, Lata. Time allocation and effectiveness of the work of Anganwadi Workers in ICDS Projects in Chandrapur district, Maharashtra, Bombay, Tata Institute of Social Sciences, Unit fo child and youth research, 1989.

Reddy, V. R., Sastry, N. P., Kashinath, J. G. Nutrition trends in India. National Institute of Nutrition, 1993

Sample, RTgistration System, Registrar General, India, Ministry of Home Af@rS, 1994.

Sharma, Adarsh. Monitoring Social components of ICDS: A pilot project, New Delhi, NIPCCD, 1987.

Singh, K K, ICDS in Patan- a case study, NIPCCD, 1984. United States Agency for International Development (USAID ). Integrated

Child Development $erVices: Innovative approaches to enhance Ser- vices, 1992.

World Food Programme, Technical report: Redirection and redeployment of early childhood education and development in ICDS in India, 1993.

World Food Programme, Appraisal and design report of the early childhood care and development component of WFP assisted ICOS, 1994.

STRENGTHENING PROJECT MANAGEMENT IN ICDS

Glossary of Terms

47

Anganwadi

Anganwadi Centre

Anganwadi Worker

Helper

Sector

Supervisor

ICDS Project/block

CDPO

Job training

Middle level training centre

BhiVBhilala

Jattha Mahila Mandal

Panchayat

Village courtyard

Village centre which serves as a focal point for delivery of nutriiion, health & education services of the Integrated Child Development Services Sche- me.

Village volunteer who works at the Anganwadi Centre. A grassroots functionary.

A village woman who helps at the Anganwadi Centre.

A group of villages. Functionary resposible for the management of a sector.

Comprises more than 100 villages. Equal to a Community Development Block

Officer responsible for the management of an ICDS project.

Preservice training

Training centre for ICDS Supervisors Aboriginals of Madhya Pradesh

Campaign

Women’s group

Local self government at the village level


ANM APO AWC AWTC A W W BNS CARE CCF CDPO CHETNA

COPPC

CRD DWCDO DWCRA ECCD ECE ECS GO1 GOMP ICDS IMR M O MP NCERT NFI NGO NHED

Abbreviation

Auxiliary Nurse Midwife Assistant Project Officer Anganwadi Centre Aganwadi Training Centre Anganwadi Worker Bal Niketan Sangh Cooperative for American Relief Everywhere Christian Children Fund Child Development Project Officer Centre for Health Education, Training & Nutriiion Awareness Cognitively Oriented Programme for Preschool Children Centre for Research & Development Distriit Women & Child Development Officer Development of Women & Children in Rural Areas Early Childhood Care & Development Early Childhood Education Early Childhood Stimulation Government of India Government of Madhya Pradesh Integrated Child Development Services Infant Mortatility Rate Medical Officer Madhya Pradesh National Council of Education, Research & Training Nutrition Foundation of India Non-Government Organisation Nutrition & Health Education

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