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JOURNAL OF COMMUNITY MEDICINE |
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INDIAN ASSOCIATION OF PREVENTIVE AND SOCIAL MEDICINE ORISSA CHAPTER |
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Editor Email: editor@jcmorissa.org |
Dr. S.C. Panda |
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ICDS NEEDS RADICAL CHANGE |
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The Integrated Child Development Services (ICDS) is the government’s flagship programme and is designed to address the comprehensive needs of children under six. What are the shades of achievements and failures of ICDS after three decades of its implementation? The special correspondent of Hindu [1] has mentioned the percentage of children with low birth weight has decreased to 29 in the year 2006 from 41 in 1992. Similarly, the percentage of severely malnourished children in the age group of 0-3 years has reduced from 7 per cent in 1992 to 1 per cent in 2006 and in case of children in the age group of 3-5 years it has reduced from 4 per cent in 1992 to 0.8 per cent in 2006 according to the National Institute of Public Cooperation and Child Development (NIPCCD). The evaluation has also shown that the number of beneficiaries under the ICDS scheme is increasing.
This report gives us a rosy picture. But in the report `Focus on Children under Six,' the scenario is different. While releasing this report Prof. Sen, the Nobel laureate said: "In the country as a whole, the population of underweight children has not gone down. Most of them are also anaemic.” [2][ As per this survey, [3] nearly half of all Indian children were underweight in 1998-9 and 2005-6 in both years. Even the decline of stunting in that period is about one percentage point per year. If the incidence of stunting continues to decline at this rate, it will take another twenty-five years or so to reach levels similar to those of China today. (“NFHS-3”) The general pace of change in child health is much slower than countries like Bangladesh. And despite its sophisticated medical system and vast army of health personne, India has not been able to achieve higher rates of child survival than any of its neighbors except Pakistan. As per Focus survey the effective coverage of ICDS remains quite limited: barely one fourth of all children below six are covered under the supplementary nutrition component. About 11 crores children, out of a total of 16 crore in the 0-6 age group, remain unreached. These are startling figures and the situation calls for urgent action. Showing concern our Prime Minister Dr. Singh told. “There is strong evidence that the programme has not led to any substantial improvement in the nutritional status of children under six. Our prevalent rate of under-nutrition in this age group remains one of the highest in the world. Immunization status under ICDS continues to be poor.”[4]In this regard he stressed upon “universalization with quality” as core objective of the ICDS Scheme in the 11th Plan.
After the Supreme Court order in 2004 the Government has increased the budgetary provision and has started increasing the number of Anganwadi in a phased manner. Further, another landmark judgment of the apex court has opened the way of involvement of SHG and Mahila Mandals of the locality to shoulder the responsibility of supply nutrition by which the contractors with commercial interest can’t have access to the program.
. Focus survey [4] revealed that “at one end of the spectrum, Tamil Nadu is doing very well: anganwadis are open throughout the year, nutritious food is available there every day, regular health services are also provided, and even the pre-school education programme is in good shape. At the other end, a day in the life of a typical anganwadi in Uttar Pradesh is little more than a brief ritual, involving the distribution of a bland, monotonous “ready-to-eat” mixture (called panjiri) to the children and some hasty filling – or fudging – of registers. Between these two extremes, there are many shades of achievement and failure in different states.” Prof. Sen said the authorities had to figure out why the scheme was doing well in certain places and fallen short of expectations elsewhere. [2]
The lack of proper physical infrastructure, inadequate training, and overburden of the foot soldiers of ICDS are some of the constraints in implementing this largest child welfare program.
These reports and surveys led our Prime Minister to believe that proper implementation of the programme critically depends on political will, decentralized monitoring and meticulous attention to day-to-day operational issues. [4]Prof. Sen urged upon finding effective ways and means to be able to make a radical change in the present situation and make the lives of our children more bearable and it should be every individual's concern. [2] Prime Minister opines there is a need to adequately empower Panchayati Raj Institutions (PRIs) and Urban Local Bodies (ULBs) to monitor and supervise the working of these centers and to make the line officials firmly accountable for their actions. [4]
According to a recent UN report, 10 children die from malnutrition in the developing countries every minute. About three quarters of the undernourished children come from just 10 countries of which 57 million are from India and 8 million each in Bangladesh and Pakistan.[5 ] It is a matter of utter surprise that neither people in general are not concerned about this issue nor it becomes an issue in any sociopolitical context. Exhorting anganwadi workers to mobilize the community to address issues related to children, Magsaysay awardee Shanta Sinha said: "Surprisingly, there is no outrage or shock expressed in this country where so many children are dying. Children's issues are universal issues. Democracy is incomplete unless you talk about the rights of children."[2] ICDS should reach the unreached. ICDS needs nurture through political will, quality, evaluation and participation of community. If we want happiness for a life time we must help the next generation.
Reference: 1.Special Correspondent, Fewer low birth weight children in ICDS areas, THE HINDU, Online edition, Saturday, Aug 05, 2006, URL: http://www.hindu.com/2006/08/05/stories/2006080501970900.htm, Date of access: 26-01-07 2.Parul Sharma, India has failed in childcare and nutrition, says Amartya Sen ,Online edition of India's National Newspaper, Wednesday, Dec 20, 2006, URL: 3. “Focus on children under six” Abridged Report, December 2006 Citizens’ Initiative for the Rights of Children Under Six, New Delhi Website: www.righttofoodindia.org.pp. 31-42 URL:http://www.righttofoodindia.org/data/rtf06focusreportabridged.pdf Date of access28-01-07
4.Singh. M.PM Writes to CMs asking them to take Urgent Measures: January 16, 2007
5.Papia Lahiri Malnutrition: roadblock to India’s development (MSWord Malnutrition) TERRAGREEN- THE NEWS TO SAVE EARTH, Issue 112, 15July 2006, URL: http://static.teriin.org/terragreen/issue112/feature.htm Date of access:26-01-07 |
