Anganwadi

• Means a “courtyard shelter”
• A government-sponsored child-care and mother-care development programmes
• At the village level
• Caters to children in the 0-6 age group.
• Started by the Indian government in 1975 as part of the Integrated Child Development Services program

SERVICES PROVIDED BY ANGANWADI

Supplementary Nutrition:

• Nutrition component varies from state to state
• Usually consists of a hot meal cooked
• Based on a mix of pulses, cereals, oil, vegetable, sugar, iodized salt, etc
• Sometimes “take-home rations” are provided for children under the age of three years.

Growth Monitoring and Promotion:

• Children under three years of age are weighed once a month, to keep a check on their health and nutrition status.
• Elder children are weighed once a quarter.
• Growth charts are kept to detect growths with the passage of time.

Nutrition and Health Education:

• Help women with age group 15-45 years to look after their own health and nutrition needs, as well as those of their children and families
• Imparted through counselling sessions, home visits and demonstrations
• Covers issues such as infant feeding, family planning, sanitation, utilization of health services, etc.
• Surveys by IDinsight across five States in November 2018 and November 2019 found that anganwadi workers were a primary source of nutrition information for families.

Immunization:

• Children under six are immunized against polio, DPT (diphtheria, pertussis, tetanus), measles, and tuberculosis, while pregnant women are immunized against tetanus.
• Joint responsibility of ICDS and the Health Department
• Main role of the Anganwadi worker is to assist health staff (such as the ANM) to maintain records, motivate the parents, and organize immunization sessions.

Health Services:

• Health services are provided
• Health checkups of children under six, ante-natal care of expectant mothers, post-natal care of nursing mothers, recording of weight, management of undernutrition and treatment of minor ailments.

Referral Services:

• Attempts to link sick or undernourished children
• Those with disabilities and other children requiring medical attention with the public health care system, also come under it.
• Cases are referred by the Anganwadi worker to the medical officers of the Primary Health Centres (PHCs).

Pre-School Education (PSE):

• Provide a learning environment for children under the age group of 3-6 years, and early care and stimulation for children under the age of three.
• Provided through the medium of “play” to promote the social, emotional, cognitive, physical and aesthetic development of the child as well as to prepare him/her for primary schooling.

CHALLENGES OF COVID

• Even as anganwadis resumed services, the closure has impacted their ability to serve as childcare centres.
• According to National Family Health Service (NFHS)-5 data, in 2019-20, less than 15% of five-year-olds attended any pre-primary school at all.
• A recent study estimates that the time women spend on unpaid work may have increased by 30% during the pandemic. In our COVID-19 rural household surveys across eight States, 58% of women cited home-schooling as the biggest contributor to increase in unpaid work. Sending younger children to anganwadis will free up women’s time, including for economic activities.
• Early childhood, the period from birth to five years of age, is a crucial developmental window. As platforms for early childhood education and nutrition support, anganwadis can play an important role for children to achieve their potential. The National Education Policy, 2020, places anganwadis at the centre of the push to universalise access to early childhood care and education (ECCE).
• Last week, the government proposed a phased rollout of ECCE programme across all anganwadis, covering one-fifth each year, starting from 2021-22.Despite being the primary information-source on nutrition, anganwadi workers can lack key knowledge – as found by studies from Delhi and Bihar. Anganwadi workers often do not have the support or training to provide ECCE.
• Surveys we conducted in 2018-19 found that among mothers listed with anganwadi workers, knowledge about key health behaviour such as complementary feeding and handwashing was low, at 54% and 49%.
• Administrative responsibilities take up significant time, and core services like pre-school education are deprioritised.
• A typical worker spends an estimated 10% of their time — 28 minutes per day — on pre-school education, compared to the recommended daily 120 minutes.
• Often lack adequate infrastructure. NITI Aayog found that only 59% of anganwadis had adequate seating for children and workers, and more than half were unhygienic.
• Issues worsen in an urban context, with the utilisation of early childcare services at anganwadis at only 28%, compared to 42% for rural areas, according to NFHS-4 data.

WAY FORWARD

• Prioritise interventions with a demonstrated history of success, and evaluate new ones. Example: Studies in Odisha and Andhra Pradesh (and globally) have found that home visits, where volunteers work with children and caregivers, significantly improved cognition, language, motor development and nutritional intake while also reducing stunting.
• Recent initiatives around home-based newborn and young child care are promising, but they need to extend beyond the first few months of a child’s life, with seamless coordination with anganwadi workers.
• Many States will have to improve career incentives and remuneration for anganwadi workers. One way to ensure they have more time is to hire additional workers at anganwadis. A recent study in Tamil Nadu found that an additional worker devoted to pre-school education led to cost effective gains in both learning and nutrition.
• Policymakers have tried linking anganwadis and primary schools to strengthen convergence, as well as expanding the duration of daycare at anganwadis. Reaching out to women during pregnancy can increase the likelihood that their children use ICDS services – as tried in Tamil Nadu. In order to boost coverage as they reopen, large scale enrolment drives, that worked in Gujarat, may help mobilise eligible children.
• As the world’s largest provider of early childhood services, anganwadis perform a crucial role in contributing to life outcomes of children across India. To improve these outcomes, we need to invest more significantly in anganwadis, and roll out proven innovative interventions.