national aanganwadi assessment 2014-15

National Anganwadi Assessment 2014-15

Introduction


• The Indian government launched the Integrated Child Development Scheme (ICDS) in 1975, to combat malnutrition, provide immunization and other healthcare facilities, and offer pre-school education to children.

• Local centers called “Anganwadi Centers” (AWC) established under ICDS provide these services to children up to 6 years of age, adolescent girls, and pregnant and lactating women.

• CRY- Child Rights and You maintains a sharp eye on exercise of children’s rights in the country.

• During the 6 months from October 2014 to March 2015, CRY mobilized its formidable team of volunteers to evaluate the implementation of the ICDS scheme and determine if the norms laid out therein are being met.

45Volunteers

5cities

159AWC’s

Over 10,900 children registered as beneficiaries in AWC’s surveyed

Contents


Background & Methodology

Enrolment vs. Turnout

Nutrition

Health & Immunization

Pre-School Non-Formal Education

Infrastructure

Operations & Registers

Conclusions

Acknowledgements

FINDINGS





Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

The National Anganwadi Assessment


Assessment of the gap between:ICDS provisions and on-the-ground realities

• Integrated Child Development Scheme• Established under Indian government’s Early Childhood

Care and Education (ECCE) PolicyICDS

• “Courtyard shelters” started under the ICDS program• Provide health, nutrition and education services to

children under age of 6, pregnant and nursing mothers and adolescent girls

• 13.3 lakh operational AWC across India

Anganwadi

• The Indian government has prescribed certain financial, nutritional, educational, and health-related minimum norms that must be met by each Anganwadi Centre (AWC).

• The purpose of this assessment was to determine if the prescribed norms are being met by the AWC and to compare the results with last year’s observations.

The ICDS Scheme


Target Group

Healthcare Services

Nutrition Services

Education Services

Children aged0-3 years • Health checkups

• Immunization• Deworming• Treatment of minor

illnesses• Referral services for

severe illnesses

• Supplementary feeding

• Growth monitoring• Take home rations

-

Children aged3-6 years

• Supplementary feeding

• Growth monitoring

• Early childhood care

• Pre-school education

• Nutrition and health education

Adolescent girls aged 11-18 years

• Health checkups• Treatment of minor

illnesses• Referral services

Take home rations

• Non-formal education

• Nutrition and health education

Pregnant women

• Health checkups• Immunization• Referral services

Take home rations Nutrition and health education

Nursing mothers

• Health checkups• Referral services

Take home rations Nutrition and health education

All women aged 15-45 years

Nutrition and health education

Assessment Locations


City No. of AWC Surveyed

Delhi 115

Kolkata 10

Chennai 11

Bangalore 22

Mumbai 1

Total 159

Methodology


Identification of AWC

Permission from Child

Development Project Officer

Field Visits

Questionnaires & Community Interactions

Evaluation of Results

Note: Necessary permissions could not be obtained in Mumbai, hence assessment of the Mumbai AWC is based upon community interactions, comprising of 81 households.

Enrollment vs. Turnout




Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

• AWC’s claim that all potential beneficiaries falling under their coverage area have been enrolled into the program.

• While that may indeed be the case, the actual turnout is far lower.

• This is because many parents do not send their children to the AWC, due to the problems highlighted further in this report.



Enrollment

Turnout



• Bangalore stands heads and shoulders above other cities in terms of turnout. Turnout of both male and female children was over 90% in Bangalore.

• In other cities, turnout of children averaged around 50% in most AWC’s.• Many parents prefer to send children to private schools, as they believe that

teaching is not up to date in AWC’s.• Parents prefer to give home-cooked food to their children rather than the

lower quality food provided by AWC’s.

Delhi Kolkata Bangalore0%

20%

40%

60%

80%

100%

66%48%

91%

59% 53%

91%

63%50%

91%

Turnout Pattern of Children Aged 0-6 Years

MaleFemaleTotal

Note: Details of turnout could not be collected for Chennai and Mumbai AWC’s.

Nutrition




Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

Nutrition


Food Item Malnourished Lactating Normal

Rice 50 grams 70 grams 50 grams

Daal 25 grams 30 grams 50 grams

Eggs 4.25 (4 times/week) 4.25 (4 times/week)

4.25 (4 times/week)

Vegetables 60 grams 33 grams 23 grams

ICDS Food Norms for Children

Freshly cooked food provided at almost all AWC’s

ICDS norms met by nearly all

AWC’s, although complaints exist

Food Quality & Quantity


Delhi Kolkata Chennai Bangalore0%

20%

40%

60%

80%

100%

74%

50%

100% 95%95% 90%100% 100%

Satisfaction With Food Quality & Quantity

QualityQuantity

• Most respondents expressed satisfaction with the quality and quantity of the food provided at the AWC’s.

• Chennai led the way with all AWC’s providing food of satisfactory quality and quantity.

• Bangalore followed close behind with observation of low quality food at just 1 out of 22 AWC’s. Food quantity was sufficient in all Bangalore AWC’s.

• Food quality as well as quantity was comparatively poorer in Delhi and Kolkata AWC’s, as detailed ahead.



• In Delhi, a majority of the respondents were satisfied with the food quality. Still, the proportion of respondents discontent with the quality was higher than in Chennai and Bangalore.

• An exceptional case in Delhi was the Mandangir village, where 70% of the respondents were unhappy with the quality of the food.

• In Kolkata, respondents complained of poor quality of rice in 5 out of 10 AWC’s.

• Food quantity was insufficient in one AWC each in Delhi and Kolkata.

Delhi and Kolkata Lag in Food Quality

• The most common complaint regarding poor food quality was adulterated food. Some respondents even complained of finding stone chips and worms in the food.

• Another recurring complaint was lack of variety in food, although the situation has improved considerably since last year in this aspect.

Complaints



• In Mumbai, about 10% of the respondents expressed discontent with the food quality.

• However, another 10% respondents claimed that they were either unaware of the ICDS facility, or the food was simply not being provided to them.

• Further, a few respondents claimed that they had to pay money for the food provided by the AWC, which is a blatant violation of ICDS norms.

• These facts indicate a lack of supervision of the ICDS scheme in Mumbai, which may be preventing its proper implementation.

Observations in Mumbai

Lumpy dalia served at a Delhi AWCKhichdi served with soya bean at Sikdar Bagan, Kolkata

Malnutrition



2%

4%

6%

8%

10%

8%

4%

0%

9%

Percentage of Malnour-ished Children

• Bangalore and Delhi had the highest percentage of malnourished children.

• However, a majority of the cases in Bangalore and Delhi were of Grade 1 malnutrition, which is the least severe category.

• On the other hand, in Kolkata, half of the children suffering from malnutrition were categorized as Grade 3, which is severe malnutrition.

City No. of Malnourished Children

Delhi 416

Kolkata 22

Chennai 0

Bangalore 8

Total 465

Take Home Rations


ICDS norms: Take Home Rations (THR) are prohibited except if:

The child/mother is sick The mother is 8 months pregnant or has a baby younger than 1 month

• With the exception of AWC’s in Delhi’s Dwarka region, AWC’s generally adhere to ICDS’ prohibition on THR.

• Most AWC’s in the Dwarka region completely ignore the restriction on THR, as in most cases children pack the food provided at the AWC’s and take it home.

• Other AWC’s do not allow THR except for valid exceptions like ill health, late stage pregnancy, emergencies, festivals, etc.

Food menu at a Delhi AWC





Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

Healthcare Services


ICDS norms - Healthcare:• Regular visits by Auxillary

Nurse Midwife (ANM)• Healthcare of children less than

6 years of age• Treatment of minor illnesses• Antenatal care of expectant

mothers• Newborn care• Post-natal care of nursing

mothers


20%

40%

60%

80%

100%

60%

90% 91% 86%77%50%

91% 91%80% 70%

100% 95%

Healthcare Services

Regular ANM Visits Regular health checkups Treatment of minor illnesses

• Chennai’s AWC’s are the most reliable in providing regular healthcare services.

• Healthcare services are inconsistent in Delhi and Kolkata’s AWC’s.

• In one AWC of Delhi and Kolkata each, there is no ANM.

• In many cases, the healthcare services are provided by medical centers rather than the AWC’s.

Healthcare Services


• In Kolkata’s Young Society Club AWC, an ANM has not been appointed since the last 5-6 years after the previous ANM retired. Similarly, no ANM is appointed in one AWC in South Delhi.

• No healthcare services are being provided in these two ANM’s. This is a serious oversight that should be addressed immediately.

• In Delhi, only 60% of the AWC’s have regular visits from the ANM’s.• Regular health checkups of children are being done only in 50% of the

AWC’s surveyed in Kolkata.

Detailed Observations

Community interaction in Mumbai

Immunization


Immunization for: Polio, Diptheria, Tetanus, Tuberculosis, Measles

Immunization of children done in all AWC’s except

in Kolkata

In 5 AWC’s in Kolkata, children

are referred to corporation

medical centers for immunization

Growth Monitoring


ICDS norms

Children must be weighed once a month and a growth chart should

be maintained.

• Only one AWC in Chennai and Delhi each do not take monthly weight of children.

• It is worth noting that several AWC’s in Delhi refused to share their growth monitoring information.

• This indicates that such AWC’s may apprehensive about letting their non-adherence come to light. Delhi Kolkata Chennai Bangalore

86%

88%

90%

92%

94%

96%

98%

100%

99% 100%

91%

100%

Regular Weighing of Children

In Mumbai, 62 of 83 households surveyed were not aware that

growth monitoring services are provided by AWC’s.





Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

Pre-School Education


ICDS norms: Children in the age group 3-6 years should be actively engaged in educational program of at least 3 hours


20%

40%

60%

80%

100%

69%50%

100%77%

Minimum 3 Hours Educational Program

• All AWC’s in Chennai conduct minimum 3 hours of educational programs as required.

• Educational programs in AWC’s in the other three cities are inconsistent, with only 50% AWC’s in Kolkata fulfilling the ICDS norms. However, the time spent on educational programs was less than 3 hours in all Kolkata AWC’s.

• In Delhi, even in AWC’s supposedly fulfil the 3-hour requirement, we found that children are not engaged in any productive activities. Rather, they just sit in the classroom and play with toys.

• Parents in Delhi’s AWC’s do not seem to believe in the program’s educational benefits.

• They only enrol their children in the AWC’s to avail the free meals for their kids.

Pre-School Education


116

9

15

18

Medium of Instruction

Hindi BengaliTamil Kannada


20%

40%

60%

80%

100%

63% 60%

100%

64%57%

100%73% 68%

Classroom Environment

Child-friendly classrooms

Toys & learning material

• Most AWC’s do not have child-friendly classrooms except in Chennai. Many classrooms are cramped and unclean, making them highly unsuitable for children.

• In a few AWC’s, cooking materials like gas cylinders and stoves are kept inside the classroom itself, which poses a serious safety risk for children.

• Availability of toys and learning materials for children is also inconsistent. Where toys are available, they are often in a dilapidated condition.

Infrastructure




Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

Infrastructure



20%

40%

60%

80%

100%

12% 10%

82%

32%

9% 10%

82%

14%

Indoor and Outdoor Space

30 sq. mt. indoor space


20%

40%

60%

80%

100%

60%

30%36%

55%

27% 30%

82%

14%

Building and Surroundings

Safe & clean building Child-friendly surrounding

• Infrastructure is extremely poor in all cities other than Chennai.

• Almost all AWC’s in Delhi and Kolkata are extremely cramped. Some AWC’s in Kolkata had indoor space of as little as 5 sq. mt.

• Similarly, most AWC’s are located in old buildings in poor localities, making them unsuitable for children.

• The condition of the classrooms is also very poor in numerous AWC’s. Problems like insufficient lighting, leaking roof, and water logging was noticed at many centres. Water logged cooking area at a Kolkata AWC

Infrastructure



20%

40%

60%

80%

100%

42%

90%

64% 59%

7%0%

55%

9%19%

0%

36% 32%

Infrastructure Facilities

Drinking water Separate toilets for boys & girls Hand wash area

• Sufficient drinking water is available in most AWC’s, but it is not necessarily safe. For instance, in Kolkata, none of the AWC’s have provision for boiled drinking water. Corporation water is provided to children, which is unfit for consumption.

• The worrying aspect is that a number of AWC’s do not have a drinking water facility at all. Less than half centres in Delhi have provision for drinking water.

• Except in Chennai, separate toilets for boys and girls is a rare facility in AWC’s. However, none of the AWC’s in Kolkata had even a single toilet, since the centres are operating out of rented rooms.

• Similarly, a separate hand wash area is not available in a majority of the AWC’s.

Infrastructure



20%

40%

60%

80%

100%

13%60%

100%

41%7% 0%

82%

36%

76%100% 91% 91%

Infrastructure Facilities

Cooking area Nap area First-aid kits

• All AWC’s in Chennai have a separate cooking area, while only 15 out of the 115 AWC’s surveyed in Delhi had such a provision.

• Similarly, over 80% of AWC’s in Chennai have a nap area for children. In other cities, rarely any AWC’s have a separate nap area.

• Most AWC’s have first-aid or medical kits in all four cities. However, 28 centres in Delhi do not have a first-aid kit, which should be a minimum requirement for operating an AWC.

Cramped room at a Kolkata AWC





Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

Operations



20%

40%

60%

80%

100%

70%100% 100%

68%83% 90% 100%

64%

100% 90% 91%73%

AWC Operations

AWC's Operating on Schedule Both staff present Teacher trained in pre-school education

• All AWC’s in Chennai and Kolkata are operational during the scheduled time.

• In Delhi and Bangalore, AWC’s close in 1-2 hours due to absence of teachers. Some AWC’s are operational only for the mid-day meal.

• Both staff, namely, the teacher and the helper are generally present in all AWC’s.

• Most teachers are trained in pre-school education, except in case of Bangalore.

AWC in Mumbai

Registers


The following registers must be maintained by the AWC’s:

• Family Survey Register• AWC Attendance Register• Birth and Death Register• Growth chart Register• Services for Pregnant and

Lactating Women Register• Immunization Register• Supplementary nutrition and

pre-school education Register• Home visit Register• Daily diary Register

All registers are maintained by at least 80% AWC’s

in all cities

The Daily Register is an exception, as

it is not maintained by 57

of 159 AWC’s surveyed.

Conclusions




Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

Conclusions


Average turnout of around 50% in most AWC’s due to outdated

teaching methods and poor food quality

OBSERVATIONS RECOMMENDATIONS

Regular monitoring of teaching standards and food quality to

encourage attendance

1/3rd of the AWC’s surveyed are not being visited by ANM’s

regularly

ANM’s should be held accountable if AWC’s are not

visited regularly

Pre-school educational activities not conducted properly for

prescribed duration in 46 of 159 AWC’s

Regular monitoring of teaching standards and teachers to be

held accountable for shortcomings

Extremely poor infrastructure in most AWC’s except in Chennai

Increase in government funding so that better centers can be

rented

30% AWC’s in Delhi and Bangalore not operational for

prescribed duration

Surprise visits by Supervisor; AWC staff to be held accountable

for shortcomings

Acknowledgements




Nutrition



Infrastructure


Conclusions

Acknowledgements

FINDINGS

Acknowledgements


We would like to thank the Child Development Project

Officers and the AWC staff for their cooperation and

support, without which this project could have come to

fruition.

Most important of all, we would like to thank the

thousands of children benefitting from the ICDS program,

who were often the source of the most unbiased and

honest feedback.

We would also like to extend our heartfelt thanks to

members of the community for trusting us with their views

on the ICDS program, which was instrumental in carrying

out a true and fair assessment of the scheme.

Last but not the least, we would like to thank our tireless

volunteers, who contributed much time and effort for

making this assessment a reality.

Volunteers


D. KishoreV. Sandhya

Disha Chowdhary

Bansal KarthikHarsha Srinivas

Ramanjeet Singh

ShravanSubramanayam

Ishana CAmanda

ChakravartiAjay Kumar

Nikita PaulsonSannutha

Shetty

Report compiled by: Varun Chandak

Ankita MathurRavish Jaiswal

Akshay KatnaurShivanjali Sharma

Kiran PrasadAparna Singhal

Smriti RattuNived ChadhaAkshay GabaAnkur Jain

Somejyoti MukherjeeSuvajit DeRajiv SinghShubham Bhatter

Nikita DugarNishant Minz

Arunima Sengupta

Sneha Kuriakose

Farah SultanaRiju Banerjee

Fatema PatelNiharika Sahu

Shradha IndulkarShafique Ahmad

Vijay YadavMadiha ShaikhYesbir SinghalRahul RokadeRavi RaipuriyaMohit YadavRavi Sharma

DELHI BANGALORE KOLKATA MUMBAI

CHENNAI


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