1. Objectives: The Integrated Child Development Services (ICDS) Scheme was launched in 1975 with the following objectives:

2. Services: The above objectives are sought to be achieved through a package of services comprising:

The concept of providing a package of services is based primarily on the consideration that the overall impact will be much larger if the different services develop in an integrated manner as the efficacy of a particular service depends upon the support it receives from related services.

 *AWW assists ANM in identifying the target group.

Three of the six services namely Immunisation, Health Check-up and Referral Services delivered through Public Health Infrastructure under the Ministry of Health & Family Welfare.

2.1 Nutrition including Supplementary Nutrition: This includes supplementary feeding and growth monitoring; and prophylaxis against vitamin A deficiency and control of nutritional anaemia. All families in the community are surveyed, to identify children below the age of six and pregnant & nursing mothers. They avail of supplementary feeding support for 300 days in a year. By providing supplementary feeding, the Anganwadi attempts to bridge the caloric gap between the national recommended and average intake of children and women in low income and disadvantaged communities.

Growth Monitoring and nutrition surveillance are two important activities that are undertaken. Children below the age of three years of age are weighed once a month and children 3-6 years of age are weighed quarterly. Weight-for-age growth cards are maintained for all children below six years. This helps to detect growth faltering and helps in assessing nutritional status. Besides, severely malnourished children are given special supplementary feeding and referred to medical services.

2.2 Immunization: Immunization of pregnant women and infants protects children from six vaccine preventable diseases-poliomyelitis, diphtheria, pertussis, tetanus, tuberculosis and measles. These are major preventable causes of child mortality, disability, morbidity and related malnutrition. Immunization of pregnant women against tetanus also reduces maternal and neonatal mortality.

2.3 Health Check-ups: This includes health care of children less than six years of age, antenatal care of expectant mothers and postnatal care of nursing mothers. The various health services provided for children by anganwadi workers and Primary Health Centre (PHC) staff, include regular health check-ups, recording of weight, immunization, management of malnutrition, treatment of diarrhoea, de-worming and distribution of simple medicines etc.

2.4 Referral Services: During health check-ups and growth monitoring, sick or malnourished children, in need of prompt medical attention, are referred to the Primary Health Centre or its sub-centre. The anganwadi worker has also been oriented to detect disabilities in young children. She enlists all such cases in a special register and refers them to the medical officer of the Primary Health Centre/ Sub-centre.

2.5 Non-formal Pre-School Education (PSE) : The Non-formal Pre-school Education (PSE) component of the ICDS may well be considered the backbone of the ICDS programme, since all its services essentially converge at the anganwadi – a village courtyard. Anganwadi Centre (AWC) – a village courtyard – is the main platform for delivering of these services. These AWCs have been set up in every village in the country. In pursuance of its commitment to the cause of India’s Children, present government has decided to set up an AWC in every human habitation/ settlement. As a result, total number of AWC would go up to almost 1.4 million. This is also the most joyful play-way daily activity, visibly sustained for three hours a day. It brings and keeps young children at the anganwadi centre - an activity that motivates parents and communities. PSE, as envisaged in the ICDS, focuses on total development of the child, in the age up to six years, mainly from the underprivileged groups. Its programme for the three-to six years old children in the anganwadi is directed towards providing and ensuring a natural, joyful and stimulating environment, with emphasis on necessary inputs for optimal growth and development. The early learning component of the ICDS is a significant input for providing a sound foundation for cumulative lifelong learning and development. It also contributes to the universalization of primary education, by providing to the child the necessary preparation for primary schooling and offering substitute care to younger siblings, thus freeing the older ones – especially girls – to attend school.

2.6 Nutrition and Health Education:Nutrition, Health and Education (NHED) is a key element of the work of the anganwadi worker. This forms part of BCC (Behaviour Change Communication) strategy. This has the long term goal of capacity-building of women – especially in the age group of 15-45 years – so that they can look after their own health, nutrition and development needs as well as that of their children and families.

1. Funding Pattern: ICDS is a Centrally-sponsored Scheme implemented through the State Governments/UT Administrations. Prior to 2005-06, 100% financial assistance for inputs other than supplementary nutrition, which the States were to provide out of their own resources, was being provided by the Government of India. Since many States were not providing adequately for supplementary nutrition in view of resource constraints, it was decided in 2005-06 to support to States up to 50% of the financial norms or to support 50% of expenditure incurred by them on supplementary nutrition, whichever is less.

2. From the financial year 2009-10, Government of India has modified the funding pattern of ICDS between Centre and States. The sharing pattern of supplementary nutrition in respect of North-eastern States between Centre and States has been changed from 50:50 to 90:10 ratio. So far as other States and UTs, the existing sharing pattern of 50:50 continues. However, for all other components of ICDS, the ratio has been modified to 90:10(100% Central Assistance earlier).

4. Population Norms:-
The revised Population norms for setting up a Project, Anganwadi Centre and Mini-AWC are as under:
Projects:

Further to this, for blocks with more than two lac population, States could opt for more than one Project (@ one per one lakh population) or could opt for one project only. In the latter case, staff could be suitably strengthened based on population or number of AWCs in the block. Similarly, for blocks with population of less than 1 lakh or so, staffing pattern of CDPO office could be less than that of a normal block.

Anganwadi Centres
For Rural/Urban Projects
400-800 1 AWC 
800-1600 - 2 AWCs
1600-2400 - 3 AWCs
Thereafter in multiples of 800 1 AWC

For Mini-AWC
150-400 1 Mini-AWC

For Tribal /Riverine/Desert, Hilly and other difficult areas/ Projects
300-800 - 1 AWC

For Mini- AWC
150-300 1 Mini AWC

5. Supplementary Nutrition Norms:

5.1 Financial norms:- The Government of India has recently, revised the cost of supplementary nutrition for different category of beneficiaries vide this Ministry’s letter No. F.No. 4-2/2008-CD.II dated 07.11.2008, the details of which are as under:-

5.2 Nutritional Norms:- Revised vide letter No. 5-9/2005-ND-Tech Vol. II dated 24.2.2009

5.3 Type of Supplementary Nutrition:

Children in the age group 0 – 6 months: For Children in this age group, States/ UTs may ensure continuation of current guidelines of early initiation (within one hour of birth) and exclusive breast-feeding for children for the first 6 months of life.

Children in the age group 6 months to 3 years: For children in this age group, the existing pattern of Take Home Ration (THR) under the ICDS Scheme will continue. However, in addition to the current mixed practice of giving either dry or raw ration (wheat and rice) which is often consumed by the entire family and not the child alone, THR should be given in the form that is palatable to the child instead of the entire family.

Children in the age group 3 to 6 years: For the children in this age group, State/ UTs have been requested to make arrangements to serve Hot Cooked Meal in AWCs and mini-AWCs under the ICDS Scheme. Since the child of this age group is not capable of consuming a meal of 500 calories in one sitting, the States/ UTs are advised to consider serving more than one meal to the children who come to AWCs. Since the process of cooking and serving hot cooked meal takes time, and in most of the cases, the food is served around noon, States/ UTs may provide 500 calories over more than one meal. States/ UTs may arrange to provide a morning snack in the form of milk/ banana/ egg/ seasonal fruits/ micronutrient fortified food etc.

6. Registration of beneficiaries: Since BPL is no longer a criteria under ICDS, States have to ensure registration of all eligible beneficiaries.

7. ICDs Profile in Kerala

7.1 Anganwadi Centres – Infrastructure facilities

Construction of Anganwadi building and providing infrastructure facilities to Anganwadi Centres are the primary duty of the local panchayat. But the State Govt. is also supporting by providing assistance from State Plan Fund. 1500 Anganwadi Centres have been constructed under State plan during the last 5 years. T-Sunami assistance construction of 245 Anganwadi Centres was also completed. Apart from the local panchayats is providing funds for the construction of Anganwadi Centres. Availability of land for the construction of Anganwadi Centres is a major problem. The total Sanitation Mission is providing baby friendly toilets in Anganwadi Centres. They have provided 4494 numbers of toilets under the total sanitation programme.

7.2 Age profile of Anganwadi Workers (as on 31.3.10 only permanent hand)

7.3 Caste and Community profile of Anganwadi Workers and Helpers (including temporary hand)

8 THE ICDS TEAM:

8.1 The ICDS team comprises the Anganwadi Workers, Anganwadi Helpers, Supervisors, Child Development Project Officers (CDPOs) and District Programme Officers (DPOs). Anganwadi Worker, a lady selected from the local community, is a community based frontline honorary worker of the ICDS Programme. She is also an agent of social change, mobilizing community support for better care of young children, girls and women. Besides, the medical officers, Auxiliary Nurse Midwife (ANM) and Accredited Social Health Activist (ASHA) form a team with the ICDS functionaries to achieve convergence of different services.


8.2 Role & responsibilities of AWW, ANM and ASHA:
Role and responsibilities of AWW, ANM & ASHA have been clearly delineated and circulated to States/UTs under the joint signature of Secretary, MWCD and Secretary, MHFW, vide D.O. No. R. 14011/9/2005-NRHM –I (pt) dated 20 January 2006.

Roles and Responsibilities of Anganwadi Workers

Role and Responsibilities of Anganwadi Helpers
 
8.3 STATUS OF ANGANWADI WORKERS AND HELPERS:
Anganwadi Workers (AWWs) & Anganwadi Helpers (AWHs), being honorary workers, are paid a monthly honoraria as decided by the Government from time to time. Government of India has enhanced the honoraria of these Workers, w.e.f. 1.4.2008 by Rs.500 above the last honorarium drawn by Anganwadi Workers (AWWs) and by Rs.250 of the last honorarium drawn by Helpers of AWCs and Workers of Mini-AWCs. Prior to enhancement, AWWs were being paid a monthly honoraria ranging from Rs. 938/ to Rs. 1063/- per month depending on their educational qualifications and experience. Similarly, AWHs were being paid monthly honoraria of Rs. 500/-
In addition to the honoraria paid by the Government of India, many States/UTs are also giving monetary incentives to these workers out of their own resources for additional functions assigned under other Schemes.

8.4. FACILITIES/BENEFITS EXTENDED TO AWWs &AWHs:-

9.4.1 By the Govt. of India
Honorarium: At the beginning of the Scheme in 1975, the Anganwadi Worker was paid honorarium of Rs.100/- per month (Non-Matriculate) and Rs.150/- per month (Matriculate) and Helper was paid Rs.35/- per month. Govt. has increased their honorarium from time to time, as indicated below:

Honorarium of Helper:

9.4.2 Remuneration, Incentives and other Welfare Measures of Anganwadi Workers and Helpers in Kerala

        a) Honorarium

        b) Incentives
        
        c) Welfare Fund for Anganwadi Workers and Helpers
        
        d) Retirement Age of Anganwadi Workers and Helpers

        e) Promotional Avenue
 
        f) Award to Anganwadi Workers and Helpers

        g) Employment under Dying in Harness Scheme

        e) Anganwadi Bima Karya Karthri Yojana

        f) Leave Benefits

        g) Selection of Anganwadi Workers and Helpers
        
        i) Uniform to Anganwadi Workers and Helpers

       j) Grievance Redressal Mechanism

10. ICDS Training Programme:

Training and capacity building is the most crucial element in the ICDS Scheme, as the achievement of the programme goals largely depends upon the effectiveness of frontline workers in improving service delivery under the programme. Since inception of the ICDS scheme, the Government of India has formulated a comprehensive training strategy for the ICDS functionaries. Training under ICDS scheme is a continuous programme and is implemented through 35 States/UTs and National Institute of Public Cooperation and Child Development (NIPCCD) and its four regional centres.

During the 11th Five Year Plan, the Government of India has laid much emphasis on strengthening the training component of ICDS in order to improve the service delivery mechanism and accelerate better programme outcomes. An allocation of Rs. 500 crore has been kept for the ICDS Training Programme during the 11th Five Year Plan.
 
Financial norms relating to training of various ICDS functionaries and trainers have been revised upwardly with effect from 1 April 2009.

Also, specific need based training programmes are organized under the ‘Other Training’ component, whereby the States/UTs are given flexibility to identify state specific problems that need specialized issue based training and take up such training activities.

Based on the needs, State Governments identify and open up AWTCs and MLTCs after due approval by the Government of India. As on 31.3.2009, 13 AWTCs and 1 MLTCs were operational across the state. 

In Kerala 13 NGO - run Anganwadi Training Centres and through these institutions job training as well as refresher trainings were being imparted.

Name and Address of the Training Centres

11. Existing Monitoring System under ICDS Scheme:

11.1 Central Level
Ministry of Women and Child Development (MWCD) has the overall responsibility of monitoring the ICDS scheme. There exists a Central Level ICDS Monitoring Unit in the Ministry which is responsible for collection and analysis of the periodic work reports received from the States in the prescribed formats. States have been asked to send the State level consolidated reports by 17th day of the following month.

The existing status of monitoring of these six services is as under :

Analysis & Action
The information received in the prescribed formats is compiled, processed and analysed at the Central level on quarterly basis. The progress and shortfalls indicated in the reports on ICDS are reviewed by the Ministry with the State Governments regularly by review meetings/ letters.

11.2 State Level
Various quantitative inputs captured through CDPO’s MPR/ HPR are compiled at the State level for all Projects in the State. No technical staff has been sanctioned for the state for programme monitoring. CDPO’s MPR capture information on number of beneficiaries for supplementary nutrition, pre-school education, field visit to AWCs by ICDS functionaries like Supervisors, CDPO/ ACDPO etc., information on number of meeting on nutrition and health education (NHED) and vacancy position of ICDS functionaries etc.
 
11.3 Block Level
At block level, Child Development Project Officer (CDPO) is the in-charge of an ICDS Project. CDPO’s MPR and HPR have been prescribed at block level. These CDPO’s MPR/ HPR formats have one-to-one correspondence with AWW’s MPR/ HPR. CDPO’s MPR consists vacancy position of ICDS functionaries at block and AWC levels. At block level, no technical post of officials have been sanctioned under the scheme for monitoring. However, one post of statistical Assistant/ Assistant is sanctioned at block level to consolidate the MPR/ HPR data.

In between CDPO and AWW, there exist a supervisor who is required to supervise 25 AWC on an average.

CDPO is required to send the Monthly Progress Report (MPR) by 7th day of the following month to State Government. Similarly, CDPO is required to send Half-yearly Progress Report (HPR) to State by 7th April and 7th October every year.
 
11.4 Village Level (Anganwadi Level)
At the grass-root level, delivery of various services to target groups is given at the Anganwadi Centre (AWC). An AWC is managed by an honorary Anganwadi Worker (AWW) and an honorary Anganwadi Helper (AWH).

In the existing Management Information System, records and registers are prescribed at the Anganwadi level i.e. at village level. The Monthly and Half-yearly Progress Reports of Anganwadi Worker have also been prescribed. The monthly progress report of AWW capture information on population details, births and deaths of children, maternal deaths, no. of children attended AWC for supplementary nutrition and pre-school education, nutritional status of children by weight for age, information on nutrition and health education and home visits by AWW. Similarly, AWW’s Half yearly Progress Report capture data on literacy standard of AWW, training details of AWW, increase/ decrease in weight of children, details on space for storing ration at AWC, availability of health cards, availability of registers, availability of growth charts etc.

AWW is required to send these Monthly Progress Report (MPR) by 5th day of following month to CDPO’ In-charge of an ICDS Project. Similarly, AWW is required to send Half-yearly Progress Report (HPR) to CDPO by 5th April and 5th October every year.

Note : Details of various circulars/ orders on monitoring/ MIS issued from GOI and existing Management Information System (MIS) on ICDS are given at ‘Child Development’ portion of the web-site of the Ministry viz. www.wcd.nic.in

12. Evaluation of ICDS Scheme: A number of evaluation studies on implementation of ICDS Scheme have been conducted in the past viz., Programme Evaluation Organisation of the Planning Commission in 1982, National Evaluation of ICDS Scheme conducted by National Institute of Public Cooperation and Child Development (NIPCCD) in 1992, Evaluation Results of Annual Survey during 1975-1995, published by Central Technical Committee on Integrated Mother and Child Development on completion of 20 years of ICDS and Nationwide Evaluation of ICDS by National Council of Applied Economic Research (NCAER) 1998-1999. Main findings of study conducted by NCAER (1996-2001) are as follows:-

i. Most of the AWCs across the country were located within accessible distance (100-200 meters) from beneficiary households. A majority of the beneficiary households was within 100 metres of the AWC. Another 10 per cent were about 150-200 meters away. The rest were beyond 200 meters. Thus, the factor of distance of beneficiary households from the AWC was unlikely to affect attendance at the AWC during inclement weather.

ii. Most of the AWCs in the country, except those in Tamil Nadu, Kerala, Karnataka and Orissa were functioning from community buildings. The type of building plays an important role in safeguarding against any natural hazards. Of those sampled, about 40 per cent were functioning from pucca buildings.

iii. Nearly 50 per cent AWCs reported adequate space, especially for cooking.

iv. One out of two AWWs was found to be educated at least up to matriculate level across the country. In all central and southern states, less than 50 per cent of the AWWs were ‘at least matriculate’; more than 75 per cent of AWWs were matriculates in the northern and eastern states of the country. Gujarat and Rajasthan reported lowest percentage of matriculate functionaries.

v. Though about 84 per cent of the functionaries reported to have received training, the training was largely pre-service training. In-service training remained largely neglected.

vi. The day to day functioning of the AWC is a critical indicator of the effectiveness of the ICDS programme. An assessment of on-going activities of sample AWCs through observations, record reviews and personal interviews with the AWWs revealed that, on average, an AWC functioned for 24 of 30 days in a month. On a given day, the AWC functioned for about 4 hours. By and large, environmental factors did not affect the functioning of the AWC.

vii. On an average nearly 66 per cent of eligible children and 75 per cent of eligible women were registered at the AWCs. This indicates lack of motivation on the part of the AWW in identifying and registering the entire eligible population.

viii. Community leaders were generally positive about the functioning of the AWCs (more than 80 per cent in all states) while more than 70 per cent found the programme to be beneficial to the community.

ix. Participation of beneficiary women and adolescent girls in AWC activities was reported to be low. These two segments of population form the foundation for any child care programme and their involvement is imperative for successful implementation of the ICDS Services.

Rapid facility Survey by NCAER: The National Council of Applied Economic Research (NCAER) conducted a Rapid Facility Survey on ICDS infrastructure in 2004. The report submitted by NCAER in February, 2005 has, inter-alia, brought out that:

i. More than 40 per cent AWCs (Anganwadi Centres) across the country are neither housed in ICDS building nor in rented buildings. One-third of the Anganwadis are housed in ICDS building and another one-fourth are housed in rented buildings.

ii. As regards the status of Anganwadi building, irrespective of own or rented, more than 46 per cent of the Anganwadis were running from pucca building, 21 per cent from semi-pucca building, 15 per cent from kutcha building and more than 9% running from open space.

iii. It is quite encouraging to observe that average number of children registered at the Anganwadi centre is 52 for boys and 75 for girls.

iv. The survey data reveal that more than 45 per cent Anganwadis have no toilet facility and 40 per cent have reported the availability of only urinal.

v. Of the 39 per cent Anganwadis reporting availability of handpumps, half of the handpumps were provided by the Gram Panchayat and 12 per cent provided by the ICDS;

vi. Regarding the provision of services at the Anganwadi centres, more than 90 per cent Centres provided supplementary food, 90 per cent provided pre-school education and 76 per cent weighed children for growth monitoring;

vii. Only 50 per cent Anganwadis reported providing referral services, 65 per cent health check-up of children, 53 per cent for health check-up of women and more than 75 for nutrition and health education;

viii.  Average number of days in a month in which services are provided at the Anganwadi centres are 24 for supplementary food, 28 for pre-school education and 13 for Nutrition and health education;

ix. More than 57 per cent of Anganwadi centres reported availability of ready-to-eat food and 46 per cent availability of uncooked food at the Anganwadi centres;

x. Nearly three-fourth of the Anganwadis have reported the availability of medical kits and baby weighing scale. On the other hand adult weighing scale has been reported only by 49 per cent of the Anganwadis.

Three Decades of ICDS – An appraisal by NIPCCD (2006)

The study covered 150 ICDS Projects from 35 States/UTs covering rural, urban and tribal projects. A total of five Anganwadi centres (AWCs) were randomly selected from each sample projects covering 750 AWCs. The main findings of the appraisal is as under:

i) Around 59 per cent AWCs studied have no toilet facility and in 17 AWCs this facility was found to be unsatisfactory.

ii) Around 75% of AWCs have pucca buildings;

iii) 44 per cent AWCs covered under the study were found to be lacking PSE kits;

iv) Disruption of supplementary nutrition was noticed on an average of 46.31 days at Anganwadi level. Major reasons causing disruption was reported as delay in supply of items of supplementary nutrition;

v) 36.5 per cent mothers did not report weighing of new born children;

vi) 29 per cent children were born with a low weight which was below normal (less than 2500 gm);

vii) 37 per cent AWWs reported non-availability of materials/aids for Nutrition and Health Education (NHED).

13. Wheat Based Nutrition Programme (WBNP) The Scheme started from 2009-10 onwards. The total quanity of food grains allotted and lifted during 2009-10 and 2010-11 are as follows: 

14. Recent Initiatives

15. INTRODUCTION OF WHO GROWTH STANDARDS IN ICDS -
The World Health Organization (WHO) based on the results of an intensive study initiated in 1997 in six countries including India has developed New International Standards for assessing the physical growth, nutritional status and motor development of children from birth to 5 years age. The Ministry of Women and Child Development and Ministry of Health have adopted the New WHO Child Growth Standard in India on 15th of August, 2008 for monitoring the Growth of Children through ICDS and NRHM.
Implications
- Change in current estimates
- increase in total of normal weight children
- decrease in severely underweight children
- decrease in underweight children (mild/moderate and severe) in age group of 0-6 months.

ii.    The requirement of funds for SNP; Centre and State contribution would be almost double.

iii.    The Anganwadi Worker with the help of New Growth Chart would be able to assess correctly severely underweight children and number of such children would increase in each Anganwadi Centres. The number of normal children would also increase in all the Anganwadi Centres.

iv.    The new charts would now help us in comparing growth of our children within projects, districts, states & also other countries.

16. Achievements: There has been significant progress in the implementation of ICDS Scheme during X Plan both and during XI Plan (up to 2008-09), in terms of increase in number of operational projects and Anganwadi Centres (AWCs) and coverage of beneficiaries as indicated below:-