Integrated Child Development Services

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Integrated Child Development Services
CountryIndia
Launched2 October 1975;47 years ago (1975-10-02)

Integrated Child Development Services (ICDS) is a government program in India which provides nutritional meals, preschool education, primary healthcare, immunization, health check-up and referral services to children under 6 years of age and their mothers. [1] The scheme was launched in 1975, discontinued in 1978 by the government of Morarji Desai, and then relaunched by the Tenth Five Year Plan.

Contents

Tenth five-year plan also linked ICDS to Anganwadi centres established mainly in rural areas and staffed with frontline workers. [2] In addition to improving child nutrition and immunization, the programme is also intended to combat gender inequality by providing girls the same resources as boys.

A 2005 study found that the ICDS programme was not particularly effective in reducing malnutrition, largely because of implementation problems and because the poorest states had received the least coverage and funding. [2] During the 2018–19 fiscal year, the Indian federal government allocated 16,335 crore (US$2.0 billion) to the programme, which is 60% of the funding for the programme while the states allocated the remaining 40%. [3] The widespread network of ICDS has an important role in combating malnutrition especially for children of weaker groups. [4]

Background

The infant mortality rate of Indian children is 34% [5] and the under-five mortality rate is 39% [6] and 25% of newborn children are underweight among other nutritional, immunization and educational deficiencies of children in India. Figures for India are below the standards of the developed world. [7]

ICDS was launched in 1975 [1] in accordance to the National Policy for Children in India. [8] Over the years it has grown into one of the largest integrated family and community welfare schemes in the world. [7] Given its effectiveness over the last few decades, Government of India has committed towards ensuring universal availability of the programme. [9]

Scope of services

The following services are sponsored under ICDS to help achieve its objectives: [10]

  1. Supplementary nutrition
  2. Nutrition and Health Education
  3. Immunisation
  4. Health checkup
  5. Referral services
  6. Pre-school education(Non-Formal)
  7. Contraceptive counselling for adolescents

Implementation

For nutritional purposes ICDS provides 500 kilocalories (with 12–15 grams of protein) every day to every child from 6 months to 6 years of age. [11] For adolescent girls in the age group of 10 to 19, 6 kilograms of food grain is given every months.[ citation needed ]

The services of Immunisation, Health Check-up and Referral Services delivered through Public Health Infrastructure under the Ministry of Health and Family Welfare. [1] UNICEF has provided essential supplies for the ICDS scheme since 1975. [10] World Bank has also assisted with the financial and technical support for the programme. [9] The cost of ICDS programme averages $10–$22 per child a year. [9] The scheme is Centrally sponsored with the state governments contributing up to 1.00 (1.3¢ US) per day per child. [11]

Furthermore, in 2008, the GOI adopted the World Health Organization standards for measuring and monitoring the child growth and development, both for the ICDS and the National Rural Health Mission (NRHM). [1] These standards were developed by WHO through an intensive study of six developing countries since 1997. [1] They are known as New WHO Child Growth Standard and measure of physical growth, nutritional status and motor development of children from birth to 5 years age. [12]

Challenges

Despite increasing funding over the past three decades, the ICDS fell short of its stated objectives and still faces a number of challenges. Also, though it has widespread coverage, operational gaps mean that service delivery is not consistent in quality and quantity across the country. [13]

Impact

By end of 2010, the programme is claiming to reach 80.6 lakh expectant and lactating mothers along with 3.93 crore children (under 6 years of age). [10] There are 6,719 operational projects with 1,241,749 operational Aanganwadi centres. [1] Several positive benefits of the programme have been documented and reported

However, World Bank has also highlighted certain key shortcomings of the programme including inability to target the girl child improvements, participation of wealthier and middle-class children more than low-income children and lowest level of funding for the poorest and the most undernourished states of India. [19]

See also

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References

  1. 1 2 3 4 5 6 "INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME". Government of India. Retrieved 18 February 2019.
  2. 1 2 Michael Lokshin; Monica Das Gupta; Michele Gragnolati andOleksiy Ivaschenko (2005). "Improving Child Nutrition? The Integrated Child Development Services in India" (PDF). Development and Change . 36 (4): 613–640. doi:10.1111/j.0012-155X.2005.00427.x . Retrieved 11 February 2015.
  3. "Integrated Child Development Services (ICDS)".
  4. "Has the ICDS helped reduce stunting in India?". ideasforindia.in. Archived from the original on 20 October 2015. Retrieved 9 October 2015.
  5. "Infant Mortality Rate (IMR) (per 1000 live births) | NITI Aayog, (National Institution for Transforming India), Government of India". niti.gov.in. Retrieved 18 February 2019.
  6. "India's Under-5 Mortality Now Matches Global Average, But Bangladesh, Nepal Do Better". IndiaSpend. 20 September 2018. Retrieved 18 February 2019.
  7. 1 2 "UNICEF - Respecting the rights of the Indian child". UNICEF. Retrieved 22 March 2011.
  8. Kapil U (July 2002). "Integrated Child Development Services (ICDS) scheme: a program for holistic development of children in India". Indian Journal of Pediatrics. 69 (7): 597–601. doi:10.1007/bf02722688. PMID   12173700. S2CID   37879920.
  9. 1 2 3 4 5 Dhar A (27 January 2011). "Infant mortality rate shows decline". The Hindu. Archived from the original on 25 October 2012.
  10. 1 2 3 "The Integrated Child Development Services (ICDS)". UNICEF. Archived from the original on 26 June 2012. Retrieved 22 March 2011.
  11. 1 2 "Supreme Court Commissioners". sccommissioners.org. Archived from the original on 13 August 2009. Retrieved 22 March 2011.
  12. "The WHO Child Growth Standards". World Health Organisation. Retrieved 22 March 2011.
  13. "Early childhood development and nutrition in India". Oxford Policy Management. 22 March 2018. Retrieved 11 June 2020.
  14. Kinra S, Rameshwar Sarma KV, Mendu VV, Ravikumar R, Mohan V, Wilkinson IB, et al. (July 2008). "Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trial". BMJ. 337: a605. doi:10.1136/bmj.a605. PMC   2500199 . PMID   18658189.
  15. Kinra S, Gregson J, Prabhakaran P, Gupta V, Walia GK, Bhogadi S, et al. (July 2020). "Effect of supplemental nutrition in pregnancy on offspring's risk of cardiovascular disease in young adulthood: Long-term follow-up of a cluster trial from India". PLOS Medicine. 17 (7): e1003183. doi: 10.1371/journal.pmed.1003183 . PMC   7373266 . PMID   32692751.
  16. Nandi A, Behrman JR, Kinra S, Laxminarayan R (January 2018). "Early-Life Nutrition Is Associated Positively with Schooling and Labor Market Outcomes and Negatively with Marriage Rates at Age 20-25 Years: Evidence from the Andhra Pradesh Children and Parents Study (APCAPS) in India". The Journal of Nutrition. 148 (1): 140–146. doi:10.1093/jn/nxx012. PMC   6289970 . PMID   29378047.
  17. Nandi A, Behrman JB, Laxminarayan R (15 February 2019). "The Impact of a National Early Childhood Development Program on Future Schooling Attainment: Evidence from Integrated Child Development Services in India". Economic Development and Cultural Change. 69 (1): 291–316. doi:10.1086/703078. ISSN   0013-0079. S2CID   224806490.
  18. Nandi A, Ashok A, Kinra S, Behrman JR, Laxminarayan R (April 2015). "Early Childhood Nutrition Is Positively Associated with Adolescent Educational Outcomes: Evidence from the Andhra Pradesh Child and Parents Study (APCAPS)". The Journal of Nutrition. 146 (4): 806–813. doi:10.3945/jn.115.223198. PMC   4807645 . PMID   26962175.
  19. "CHAPTER 2 THE INTEGRATED CHILD DEVELOPMENT SERVICES PROGRAM (ICDS) – ARE RESULTS MEETING EXPECTATIONS?" (PDF). World Bank. Retrieved 22 March 2011.