Transcript Human Rights Based Approach To Programming

Women and Child Development
(ICDS)
District : North Bastar
Kanker
 Government of India proclaimed a National
Policy on Children in August 1974 declaring
children as, "supremely important asset".
 10th Five Year Plan - The future of India lies in
the future of Indian children
 11th Five Year Plan – Inclusive Growth
ICDS and MDGs
Govt.
Programs
Contributing to MDG Goal
Concerned
Departments
1- Eradicate Extreme Poverty
NREGS,
and Hunger
PR & RD, WCD,
ICDS,
PDS 2- Promote Gender equity and Food & civil
etc
empower women
supplies Corp.
3- Reduce child mortality
ICDS is a unique programme, having potential to improve on many indicators
IMR
Chhattisgarh
61
Source: SRS 2006
Trend- prevalence of underweight
(moderate and severe) Children < 3 yr
70
60.3
Source:
60
52.1
Percent
50
40
49.6
NFHS I, II, III
45.9
47
Chhattisgarh
39.7
India
30
27
20
Maharashtra
10
0
1988-99
2005-06
2015
Chhattisgarh has a challenge of reducing the underweight children.
District’s indicators - Rural
Marriage
women < 18
yrs
Women 20-24
yr, birth 2+
20.8%
Women 1549), ever
married and
anemic
67.8 %
59.4 %
DLHS 07-08
DLHS 07-08
NFHS 05-06
Mothers
registered in
first trimester
34.6 %
Institutional
birth’s
Anemic
Children
Exclusively
breast fed
children
81 %
54.2 %
11.7 %
NFHS 05-06
DLHS 07-08
DLHS 07-08
DLHS 07-08
 Progress in immunization is commendable .
 Children age 6-35 months, anaemic, Chhattisgarh = 81(%), NFHS 05-06
Objectives
• Lay foundation for proper psychological development of
child
• Improve nutritional & health status of children 0-6 years
• Reduce incidence of mortality, morbidity, malnutrition &
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
Present study Covers
Findings based on information from WCD, Kanker and field
visits
The issues covered are :
1- Objectives of national programme
2- Coverage
3- Management Aspects (Human Resources,
Anganwadi building, Growth
Monitoring)
3- Implementation Issues (Nutrition, Pre- school education)
4- Issues of concerns
Findings are preliminary, needs more evidences from fields
COVERGAE
Coverage (as on March, 2009)
Total beneficiary = 1,11,882
Pregnant
Women
7%
Lactating
Women /
Children (0-6
m)
6%
Adolescent
Girls
20%
Children
(3yr - 6 yr)
30%
Children
(6m - 3 yr)
37%
Coverage (Age <6 yrs beneficiary)
120000
112,919
 Ensuring service to every
child’s is her/his right
(in numbers)
100000
81,829
80000
81,829
63,497
60000
 Gaps reflected in graphs, needs
field evidences
40000
 Urban area need to have
access of the AWC
20000
Benefitted
Enrolled
Surveyed
Children(16%
Pop)
0
 Scattered households/
habitation is a challenge
New AWC’s, mini AWC’s being proposed now would fill up the gaps.
Management Aspects
Organogram (ICDS)
DPO
District
CDPO
CDPO
AWC
SS
AWC
SS
AWC
AWC
SS
AWC
SS
AWC
AWC
SS
AWC
AWC
Village
SS
AWC
Cluster
CDPO
AWC
Janpad/
Project
DWCDO
AWC
ADPO
Post of 4CDPO and 24 Sector Supervisors are vacant .
ICDS ( Aanganwadi)
Total AWC= 1427
1600
1400
1416
Per Cent
1200
1000
800
600
345
400
200
0
Functional (out of sanction)
AWC's Inaccessible during Rains
Inaccessibility may be addressed through scheme like NREGS etc
Infrastructure – building
(as on March, 09)
Total AWC = 1427
800
752
700
583
Per Cent
600
500
400
300
200
92
100
0
Own Building
Rented Premises
Under Construction
Additional building , will also improve service quality for beneficiary.
Implementation
Prevalence of underweight (District )
60
Normal Grade,
49.72
Per Cent
50
40
Grade I, 33.13
30
20
Grade II, 16.74
10
Grade III, 0.40
0
Sept -08
Dec-08
Grade IV, 0.01
Mar-09
 The data serves the recording/ reporting purposes (its use in field is a concerns)
 Encouragement req. to promote honest reporting
 Need of special treatment at Block PHC/ CHC (NRC/ CDC concept)
Percent
50.00
51.28
53.34
51.59
Charama
56.75
60.00
Bhanupratappur
Prevalence of underweight
46.08
45.87
48.74
40.00
30.00
20.00
10.00
Janpad

Koilibeda
Durgkondal
Narharpur
Antagarh
Kanker
0.00
AWC’s need to look their efforts link, with reducing malnutrition.
Growth monitoring and sanitation
 Improving in use of community
growth monitoring charts – sharing
with parents (esp. up 3 yr child)
For growth monitoring
1500
1300
Per Cent
1100
900
667
700
Need on improving the hygiene
behavior of children
519
500
300
200
Need to improve on the use of
existing toilets
152
100
-100
Baby
Weighing
scales (req.)
Adult
Growth
Community
Weighing
Monitoring
Growth
scales (req.) Charts (req.) Charts (req.)
Updating of the toilet facility, drinking water coverage status is in process
Nutrition Mgt. – AWC’s role

Calibration standards vary

Feeding interruption due to supply of rice

Except for the 3-6 years, the distribution of THR has no
variation during month

Food for 3-6 years given in one go

Role of counseling (issues counseling - setting priority, link with growth
monitoring, use of the literature material, art of making it effective)
Nutrition – SHG’s involvement
Nutrition- managed by(AWCs)
By
Panchay
ats
1%
Others
10%
By SHG
89%

Generally through the SHGs

Ensuring quality because of rates

SHGs require to internalize
significance of their role

Monitoring of nutrition by SHGs
needs improvement

SHG’s role in counseling of
parents
Nutrition – Beneficiary’s involvement

Not able to response for imp. of taking THR , high dilution

Pregnant lady needs to increase frequency of diet in daily
routine (family counseling is req.)

Need addressing to social traditions (son’s preference,
women’s gender role etc)

Not able to link nutrition with growth monitoring

Nutrition, service quality are not on the priority
Ms. Ramsila (weight – 40 kg.) from village Kulgaon, has 4 children already and she is
looking for another one for male preference.
Pre-school Education
 Coverage is good but need to work on quality
 Learning from exposure to the successful AWC
 Improving on pre- school teaching planning by AWW
 Need of developing age group wise (3-4, 4-5, 5-6), tentative
learning standards (identify, read etc)
 Need of refresher training for the AWW on the Pre-school
education
 AWW’s may self-decide on children’s learning outcome from
the pre-school activity
Probably work load of AWW is high, that affects the focus on PSE focus
services
OtherOther
Services
at AWCs
Immunization;
 Fixed immunization day
 Children are immunized according to schedule
 Pregnant women are immunized for the TT-I, TT-II.
Health Check Up:
 Health check up at AWC is done by ANM on her visit
 Necessary medication and suggestions are provided
Referrals;
 The AWW/ Mitanins use to facilitate the process
 Referral as per the cases (acute illness, pregnant lady’s
symptoms etc)
Recap – concerns
1. Increasing Access – new AWCs (in urban too)
2. Improving Management by- filling HR gaps
3. Improving infrastructure – Own building, coverage update of toilet/
water facility, availability of baby weighing scale
4. Use of the existing data in the village with household/
community(of
education…)
growth
monitoring,
immunization,
pre
–
school
5. Linking interventions with outcome by AWW and deciding self
goal (as reducing malnutrition to …, children’s learning outcome for their
age as……)
6. Need of Provision/ mechanism of intensive treatment of the severely
malnourished children
Recap – concerns
7. Improving Service quality by:
 Reporting mechanism of interruption in supply of nutrition/ rice
 Focus on developing habits (hygiene, toilet use etc)
 Initializing & strengthening parent’s/ family feedback in growth
monitoring
 Counseling (use of growth monitoring, literature, involving male etc.)
 Capitalizing SHG’s strength to address malnutrition issues
Thank You