His name is ‘Today’ We are guilty of many errors and many faults,
but our worst crime is abandoning the children, neglecting the fountain of life.
Many of the things we need can wait. The child cannot. Right now is the time his bones are being formed, his blood is being made, and his senses are being developed. To him we cannot answer ‘Tomorrow,’ his name is today. - Gabriela Mistral
INTEGRATEDCHILDDEVELOPMENTSERVICES
Dr Subodh S Gupta
Integrated Child Development Services
India’s response to the challenge of meeting the needs of its children To break vicious cycle of malnutrition To promote child development
Largest public initiative in the world (1975)
One of the eight flagship programs of GOI
Objectives of ICDS
Lay the foundation for proper psychological development of the child
Improve nutritional & health status of children 0-6 years
Reduce incidence of mortality, morbidity, malnutrition and school drop-outs
Enhance the capability of the mother and family to look after the health, nutritional and development needs of the child
Achieve effective coordination of policy and implementation among various departments to promote child development
Beneficiaries
Children in age-group 0-6 years Pregnant and lactating women Women in the reproductive age-group Adolescent girls
Intergenerational cycle of malnutrition
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Childpoor early development
poor school achievementbehavioural problemspoor stimulation,
nutrition & health
Intergenerational transmission of poverty
adultlow educational attainment
low skilled job / no work high fertility
depressed/stressed
nationaleconomy
Services provided
Nutrition Supplementary nutrition Growth monitoring and promotion Micronutrient supplementation/ promotion
Pre-school non-formal education
Health Immunization Periodic health check-up Referral services Nutrition and health education
Target Group & Services under ICDS
Services Target Group AccountabilityPre-School Education Children 3-6 years AWW
Growth monitoring Children below 6 years AWW
Supplementary Nutrition
Children below 6 years; Preg & Lact Mother
AWW & AWH
Micronutrient supplementation/ promotion
Children below 6 years; Preg & Lact Mother
ANM /MO
Immunization* Children below 6 years; Preg & Lact Mother
ANM /MO
Health Check-up* Children below 6 years; Preg & Lact Mother
ANM / MO/ AWW
Referral Services Children below 6 years; Preg & Lact Mother
AWW /ANM /MO
Nutrition & Health Education
Women (15-45 years) AWW/ ANM/ MO
Supplementary Nutrition
Beneficiaries Calories (cal)
Protein (g)
Children 6 month – 6 years
500 12-15
Severely malnourished children (6 months – 6 years)
800 20-25
Pregnant & Lactating Mothers
600 18-20
Mother and Child Protection Card
Mother and Child Protection Card
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Why focus on early child development?
Brain development is most rapid and vulnerable from conception to five years
The factors known to affect child development are common, especially in low/middle income countries
Impaired child development has life-long effects
Interventions in early childhood are more cost effective than at other ages
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Pathways to poor development
Psychosocial risk factors
Biological risk factors
CNS development and function
Socio-emotional
Sensori-motor
Cognitivelanguage
Child development
Socio-cultural
risk factors
Poverty
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Child growth Child development
Nutrition Maternal competence
Population Norms
One AWC for every 800 population For Rural/ Urban Projects
400 – 800 – 1 AWC; 800-1600 – 2 AWCs 150-400 – 1 Mini AWC
Tribal/ Desert/ Hilly areas 300 – 800 – 1 AWC 150-300 – 1 Mini AWC
Coverage with ICDS
ICDS Projects Approx 7073Operational AWC Approx 14
Lakhs
Other approaches
Rajiv Gandhi National Crèche Scheme for Working Mothers
Initiatives by Non-government Ruchika, SEWA, Nutan Bal Sangh ECE Centers in Private Sector Courses in Early Childhood Care and
Development
Three Mismatches in ICDS
Service Mismatch Beneficiary mismatch Need mismatch
Challenges faced in the present interventions Poor quality of child development services Overburden on the ICDS Capacity of Child Care Workers
Not recognized as skilled work Unavailability of trained manpower in ECCD
Poor attention to age-group 0-3 years Involvement of the family and community Minimum standards and regulatory mechanisms No viable information on indicators of ECCD Poor documentation of efforts in Voluntary sector
Restructuring of ICDS Scheme (Programmatic reforms) Repositioning AWC as a vibrant child friendly
ECD center (Bal Vikas Kendra) Extended duration of functioning Additional AWW in 200 high burden Piloting of crèche service in 5% AWC Greater ownership of women and communities Provision of adequate infrastructure Facilities; e.g. safe drinking water, toilets,
hygienic SNP arrangements, wall painting, play space & a joyful learning environment
Other services for adolescent girls (SABLA Yojana)
Restructuring of ICDS Scheme Redesigning & reinforcing of the package of
ICDS services, including a new component New component of child care & nutrition counseling
by regular and prioritized visiting at critical contact points for improving maternal care & nutrition, IYCF
Enhancing nutritional impacts with revised nutrition and feeding norms Joint kitchens with mid-day meal Continuum of care
Community-based prevention and care of Severely underweight children
Restructuring of ICDS Scheme (Management reforms) Community mobilization and monitoring Improved human resources Training and capacity building Strengthening civil society partnerships Increased public accountability by
strengthening role of PRIs, VHNSCs Convergence with related sectors Strengthened monitoring system
Restructuring of ICDS Scheme (Institutional reforms) ICDS missions at different levels Setting up of national/ State ICDS Mission
resource centers Living Universities Community ownership Accreditation system Focused attention Increased NGO participation Service standards