declining child malnutrition in maharashtra-3 the anganwadi improvements
DESCRIPTION
The Anganwadi Center (AWC) are the main system of service delivery for child care-nutrition, health, pre-primary ed etc. Over 1 lakh AWCs dot the spread of Maharashtra. The ICDS has made substantial improvements in the AWCs , attracting parents and children. This was a joint effort of the dept and the community. There is a Change indeed.TRANSCRIPT
Child Malnutrition in Child Malnutrition in
Maharashtra (India) Maharashtra (India) August 2013August 2013-- January 2014January 2014
Situation, Efforts, Decline and ChallengesSituation, Efforts, Decline and Challenges
A Review A Review
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 1
A Review A Review For the State Nutrition MissionFor the State Nutrition Mission
P o w e r P o i n t 3 / 6P o w e r P o i n t 3 / 6
AWC improvementsAWC improvements
Dr Shyam Ashtekar, MD (Community Med)
Transforming the Anganwadis in Transforming the Anganwadis in
Maharashtra (India)Maharashtra (India)
Powerpoint 3/6
A New A New AnganwadiAnganwadi Center (AWC)Center (AWC)
� AWCs got a new facelift in many districts --Aurangabad, Ahmednagar,
Latur etc.
� Repairs and maintenance of old Anganwadis was necessary but there
was no provision for this. They asked for public participation.
� New AWCs were constructed in every district --- hundreds of new � New AWCs were constructed in every district --- hundreds of new
AWCs
� Zilla Parishads provided the funds from Govt. grants.
� In Akola district the money was handed over to village panchayats.
� New models such as pre fabricated AWCs were also introduced.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 3
Transformation 2012Transformation 2012
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 4
New AWCsNew AWCs� More space for children,
Surroundings, and a compound
to protect AWC.
� Internal kitchen, toilet and
often the wash basin.
� The roofs of Zilla Parishad
structures commonly leak in
monsoons. To prevent this..In
some districts slanting roofs
were provided to prevent
leakage.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 5
AWC with Garden inAWC with Garden in AurangabadAurangabad
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 6
New Paint, Chairs and Tables.New Paint, Chairs and Tables.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 7
WaterWater--filter and a toiletfilter and a toilet
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 8
AnganwadiAnganwadi ----the Nextthe Next GenerationGeneration
� AWCs started in seventies have now completed 3-4 decades.
� Younger AWC sevikas have joined the ICDS in significant numbers.
� There is a quiet competition of the AWC with English KGs and
nurseries.
� The societal expectations about children have risen.
� The means of transport, communications and incomes have
increased.
� The AWC is also changing .
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New GenerationNew Generation and Use of ITand Use of IT
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014
The computers arrived in few Anganwadis
10
Sustaining Enrolment Sustaining Enrolment
Against CompetitionAgainst Competition
� People aspire now for better education and not just food any more.
� In many districts English schools have started buses to fetch
children.children.
� Many families are willing to offer 10-15 thousand Rs. for this
annually.
� The AWC enrolment was declining.
� The AWC had to reform itself.
� We saw that many AWCs could compete with English medium KGs.
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More Resources from More Resources from
PeoplePeople
� In many districts local communities have helped the AWCs.
� More resources came – Repairs, chairs, tables, utensils, cupboards,
fans and power in some places. fans and power in some places.
� The walls got posters, calendars, portraits etc.
� In some places AWC has TV, DVD, and even computers.
� Many AWCs have small gardens and toys for children.
� AWC has changed – scores of them.
� In many places locals have donated valuable land. Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 12
An AWC from insideAn AWC from inside
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 13
Dress,Dress, Tie and Tie and eeven Shoesven Shoes
� Parents or villagers have given 1-2 dresses for
the children, at places even tie and shoes too.
� A well dressed child is eager to attend the
AWC than sit at home—so says a CDPO.AWC than sit at home—so says a CDPO.
� It brings a sense of tidiness.
� The child knows now that he/she needs to be
in the AWC and the community knows it too.
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AnganwadiAnganwadi-- in ain a tribal block tribal block
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 15
The ISO AWCs in Aurangabad The ISO AWCs in Aurangabad
� In Aurangabad district
1300 AWCs have been
upgraded with ISO
standards.
This costs some money� This costs some money
� But this has created
ownership and pride.
� This is essential for
retaining attendance.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 16
Happiness is essential for learningHappiness is essential for learning ––
AWC has to provide the AWC has to provide the
environment environment
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 17
Also Some Discipline and Restraint Also Some Discipline and Restraint
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 18
Getting TGetting Toys from Peopleoys from People
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 19
And Kitchens improved tooAnd Kitchens improved too
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 20
AWC and Supplementary FeedingAWC and Supplementary Feeding
� 3-6 years age group � 6 months to 3 years
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 21
Weighing ScalesWeighing Scales
� AWCs have clock like weight scales
to hang from the roof.
� Some of them need repairs more
often. The kohinoor scales require
more repairs.
� But older scales provided by Unicef
(salter) are still working
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 22
New Growth ChartsNew Growth Charts
� Separate Charts for girls and babies
� Growth chart is the basic record in AWC
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 23
Some AWCs have Electronic Some AWCs have Electronic
Weighing Scales Weighing Scales
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 24
Height MeasurementHeight Measurement
� No standard equipment for height
measurement.
� Most AWCs have a digitally printed
measuring tape fixed on the wall.
� In some AWCs they have a
steredometer(?) fixed on top to be
pulled to the head.
� Better height measurement calls for
better instruments and methods.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 25
Height Weight Tables.Height Weight Tables.
� From height and weight chart
we can grade the child by
checking in the booklet.
� This chart has three grades-� This chart has three grades-
normal, moderate wasting and
severe wasting.
� However the ICDS is currently
not monitoring stunting
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 26
Mid Upper Arm Circumference Mid Upper Arm Circumference
((MUACMUAC))� The AWC has a colored MUAC tape. This is for a
child of age 6 months to 36 months.
� This is applied on the mid point of the left arm.
� The color appearing in the window of the tape
suggests grade-- red severe wasting, yellow is suggests grade-- red severe wasting, yellow is
border-line and green is normal
� But MUAC probably underestimates malnutrition.
We need to remodel this measurement (12.5cm as
cut of point for severe wasting)
� Currently this is only an additional test to find
severe malnourishment.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 27
Pre Primary Education (PPE)Pre Primary Education (PPE)
� Among the 6 AWC tasks Pre Primary
Education (PPE) no less important.
� PPE implies involve only sensitizing and
exposing the sense-organs of the child.
That is Pedagogy.That is Pedagogy.
� AWC has started much more than that.
� AWC has introduced play, hygiene,
discipline, social interaction, etc.
� Many AWCs have ensured this happens.
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PPEPPE-- Talking wallsTalking walls
� Marathi � And English also
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 29
PPE PPE –– Educating through PicturesEducating through Pictures
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 30
PPE PPE –– Educating through PicturesEducating through Pictures
� A toilet wall in an AWC in Akola talks to the child.
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Some AWCs got even TV & Some AWCs got even TV &
computercomputer
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 32
Beyond Beyond PPEPPE
� Many AWCs offer good PPE component.
� Beyond this many AWCs expose a child to letters (Marathi and
English), numerals, songs and stories and in some places craft
too.
� We saw introduction of English even in some tribal AWCs in
Navapur, not to speak of non-tribal districts.
� Competition with private KGs makes all this necessary.
� But we must also think and discuss about it from pedagogy
point of view.
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Mother tongue and the Multilingual childMother tongue and the Multilingual child
� Many tribal blocks have local dialects.
� But in the AWC both the dialect and Marathi coexist.
� But the script is Devnagari.
� In some places English is introduced.� In some places English is introduced.
� In some blocks even Hindi is used as spoken language.
� The AWC Sevikas are adept at all this and pass it on to
the children.
� This is welcome!
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 34
But its Not Rosy EverywhereBut its Not Rosy Everywhere
� Many AWCs in tribal blocks are badly leaking.
� Many are dingy and depressing,
� Many are less equipped. � Many are less equipped.
� Some places are without an AWC shelter and
in some places there is no place at all except
under the tree or in a temple.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 35
Leaking AWCs & broken toilets are not rareLeaking AWCs & broken toilets are not rare
� A leaky AWC in Nandurbar � A broken AWC toilet in Akola.
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 36
Even then...Even then...
• Maharashtra State has 1.7 lakh AWCs including mini AWCs
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014
including mini AWCs
• The picture is changing and will change further.
• Community participation is the watch-word
37
Some Four Thousand Supervisors are Some Four Thousand Supervisors are
Monitoring the AWCsMonitoring the AWCs
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The Geographic Information SystemThe Geographic Information System
RJMCHN has now extended a GIS system for the entire state.
� This GIS is available on www//:mhnss.ind.in
� Basically it has all the 1206 boxes of the monthly
This can help to
� Generate MIS from AWC to state level and update within 48 hrs
� Generate info for action on every level.
� It can generate both boxes of the monthly progress Report-MP
� The AW sevika can get it done in 30 Rs provision and within 30 min.
� She can upload the AWC abstract info (5-7 KB file)on the site thru the Sangramsoftware at village level.
� It can generate both process and outcome indicators
� We can generate about 1500 reports from this data
� It also provides camera sites for physical verification at each AWC
Transforming the Anganwadis in Maharashtra,A Review 2013- 201439
For community participation For community participation � See this website .. http://www.icds.gov.in/#
� Also this one http://nutritionmissionmah.gov.in/Site/Home/Index.aspx
� Think of CSR
� You can adopt an AWC (s)
� s)Your help will take the movement a step ahed, enjoy the involvement
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 40
Best WishesBest Wishes
Dr Shyam Ashtekar (MD, Community
Medicine)
21 Cherry Hills Society, Anandwalli,
Nashik 422013
Cell +919422271544
Website:
arogyavidya.org,
bharatswasthya.net
A study of Anganwadis and campaign against
malnutrition in Maharashtra for and with support of
Rajmata Jijau Mission,
August to Dec 2013
Transforming the Anganwadis in Maharashtra,A Review 2013- 2014 41