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Meeting with State Secretaries Review of Integrated Child Development Services (ICDS) Scheme 28 th October 2010. Ministry of Women and Child Development Government of India. 1. PART - I. ICDS : Universalization. ICDS: Universalization. Operationalization :
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Meeting with State Secretaries Reviewof Integrated Child Development Services (ICDS) Scheme28th October 2010 Ministry of Women and Child Development Government of India 1
PART - I ICDS : Universalization
ICDS: Universalization • Operationalization : • Delay in operationalization ( against 14.0 lakh, operational 12.14 lakh • Target date for operationalisation was September 2010. • Firm date of operationalisation may be given & ensured ! • ‘Operationalisation’ per se • States/UTs to ensure • Adherence to the revised population norm in total- ground verification • Certification that all habitations are covered • Upload a list of AWC locations on web sites of States/ UTs • Full coverage of urban slums/ areas with local innovations • Address issues of social exclusion • Optimise coverage of all eligible beneficiaries
ICDS: Location of AWCs • 10 States namely Andhra Pradesh, Arunachal Pradesh, Assam, Madhya Pradesh, Maharashtra, Orissa, Delhi, Punjab, Tripura and Uttar Pradesh have uploaded information onto their website. They may also ensure that cen per cent information of all AWCs are uploaded. • Remaining 25 States/UTs may upload the information onto their website and inform the website address by 30th November positively.
ICDS : Services • Supplementary Nutrition Programme (SNP): • Adoption of norms • Implement Revised calorific and cost norms in letter & spirit. • Morning snack & hot cooked meal for children 3-6 years • Quantity/ weight of SN per bene. actually given, • THR for children below 3 yrs and P&L mothers • Calorific and nutritional norms • Optimization of coverage: 729 lakh children receiving SN as • against 1195 lakh child (6 – 72 months) population as per AW survey register • Quality • Age appropriate and palatable • Local nutritious and varied recipes • Micronutrients !
States not conforming to the revised nutritional norms: deficiencies Deficiencies: • Andhra Pradesh (50 Kcal) • Himachal Pradesh (80 Kcal) • Punjab (200 Kcal; 6 gm Pr) • Jammu (200 Kcal; 3 gm Pr) • Puducherry (200 Kcal; 3 gm Pr) • Jharkhand (50 Kcal) • Orissa (100 Kcal) • Karnataka (150 Kcal; 3 gm Pr) • West Bengal (100 Kcal) • Assam ( 500 Kcal; 12 gm Pr) • A & N Islands (4 gm Pr) • Uttar Pradesh (50 Kcal) • Kerala (100 Kcal) • Chandigarh (200 Kcal; 3 gm Pr) Source: MPR , FNB
Recent Disruption in SNP • Assam : No food supplies since Nov 2009 • Punjab : Insufficient ingredients • Uttar Pradesh : disruption in HCM; Reduced ingredients due to price rise leading to low nutritive values • Manipur: No feeding provided in 3 centres out of 7 centres visited (June 2010) • Bihar : Out of 11 units visited in May 2010 only one provided SNP. In the month of September 14 centres did not provide any SNP.
SNP : Not as ICDS norms • THR (Hot cooked meal): • Chandigarh • Haryana • Himachal Pradesh • A & N Islands • West Bengal • Puducherry • THR (Dry food grains): • Goa • Bihar [target 40 children (6m-3yrs) for SN, 8 pregnant & 8 lactating women] • Jharkhand • States not providing morning snacks : • Puducherry • West Bengal • Bihar • A & N Islands • Chandigarh
ICDS : Services • Supplementary Nutrition Programme (SNP): • Micronutrient fortification : The supplementary food may be fortified with essential micronutrients (energy and protein excluded) with 50% of RDA level per beneficiary per day • HCM: leafy veg; THR: through GMP( manufacturers); Fruits. • Sprinkler: NO; • Sachet: ? ( only in centralised and monitored kitchens !)
ICDS : Services • Supplementary Nutrition Programme (SNP): • Management • Supply chain • - commodity management • - uninterrupted distribution at AWC • Regularity and timelines • Adopt normative approach and reduce wastage • WBNP: • States/ UTs to give basis and details of requirements of food grains urgently • Rationale for not availing food grains • Regular lifting position to be provided; Previous quarter lifting by 70% for future allocation
ICDS : Weighment & Growth monitoring • 8th & 9th December, 2009 States given commitment to roll out the new WHO Growth Standards by June 2010. • RFD target 5000 projects for the WHO Growth Standards and Joint MCP Cards: 1536 Projects achieved. • Most of the states have indicated printing stage and committed to roll out by December 2010 in all projects and AWCs. • Must be ensured ; failing which constrained not to release funds; • fortnightly monitoring by secretaries and reporting.
ICDS: Management Manpower • Vacancies: • Large vacancies at all levels in almost all States • Timeliness to fill up vacancies at all levels [10% deduction from grant if vacancies of Supervisors , AWW s & AWHs 40% or more; 20% deduction if 50+%? ] • Promotion: • AWW to Supervisor • AWH to AWW • Dedicated cadre • Tenure stability • Disengagement of ICDS functionaries from non- ICDS related activities [10% deduction from grant if? ]
ICDS: Management Issues • Fund flow mechanism • Timely payment of honoraria: mechanism to be put in place • Motivation • Additional honoraria by state • Insurance coverage of LIC & other benefits • Proposed Rastriya Swasthya Bima Yojana (possible sharing 75:25) • Proposed pension scheme (Quantum of State share say 1000 per anum / per benef.)
ICDS: Management Issues Pending Construction of AWCs building sanctioned for NE States since 2001-02 till 2006-07: • No fund for ICDS general would be provided unless UCs and progress report is given along with any undertaking by the Secretary
ICDS : Services • Pre-School Non-formal Education: • Pre-School Education Kits: 10 States/UTS viz. Andhra Pradesh, Bihar, Haryana, J&K, Jharkhand, Kerala, Chandigarh, Lakshadweep, Puducherry and Mizoram have not made any procurement during 2008-09 and 2009-10 on the PSE kits • Ensure availability of PSE kits • Usage of Local materials & effective communication • Methods used for joyful learning and improve Quality • Optimize coverage of children (3-6 years) for PSE • Ensure PSE activities on regular basis at all AWCs • Assess and ensure school readiness (Section 11 of RTE) & Leverage resources for strengthening ECE; Linkage and leverage with RTE
ICDS : Services • Health and Nutrition Education: • Joint home visits • Training • IEC and campaign – Observation
ICDS : Services • Coordination & Convergence: • Health: • Effective arrangement for health related services at AWCs • Immunization • Supply of IFA tablets and Vitamin “A” • Health check ups and referrals • Management of severally undernourished • Reflect ICDS related services separately and categorically in • NRHM PIPs at all levels • Holding of VHND • Institutional arrangements for effective engagement of health • sector • DDWS: • - Provision of safe drinking water • Provision of child friendly toilet • Awareness on sanitation and safe drinking water
ICDS – Infrastructure • Construction of AWCs Buildings • Tap MPLADS, MLALADS, BRGF, RIDF, PRI, State Plan including ACA, MSDP, BADP, etc for AWCs buildings (13% of total constructed ) • Construct good model buildings with full amenities • Provide adequate space, other facilities and equipments • State/UTS were requested to submit Action plans for strengthening quality of infrastructure at AWCs by September 2010. • No State has sent so far.
ICDS: Management Issues • Community Participation • Replication of Best practices • Effective monitoring • Training: • Cross sectoral, horizontal and vertical integration of training both in content and participation; circular trg. intrasector/ intra project and inter project • Make STRAP a meaningful exercise . Send proposal for 2011-12 by January 2010. • State level Task Force • Peer group
WBNP States/ UTs lifted below 50% allotment (2009 - 10): Uttarakhand, Manipur, Maharastra, J & K, DN & Haveli, Arunachal Pradesh For 2011-12, allocation of foodgrains to States/ Uts will be made who have lifted lifted 70%+ of the foodgrains allotted so far (including revalidated quantities)
ICDS: Review and field visits Review of ICDS Scheme and field visits to AWCs from time to time • MOS (I/c), MWCD visited Guwahati (Assam), Jhabua (M.P.), Sikkim and Uttrakhand • Secretary, MWCD visited to AWCs in Haryana, Uttrakhand, Punjab, Chandigarh & U.P. And reviewed implementation of ICDS • Area Officers are also reviewing the implementation and visiting AWCs
ICDS: Review and field visits (Contd..) Major issues emerges: • Operationalisation of pending AWCs/ mini-AWCs; • Filling up of vacant posts; • Compliance of GOI directions on supplementary nutrition as per revised norms; • Need to devise a normative approach for reporting attendance; • Maintenance of WHO Growth Chart and training to AWWs • Convergence with line departments on drinking water, sanitation etc.
ICDS: Monitoring • State level consolidated MPR in Format I & II to be sent with regularity • Officer i/c Monitoring must be held responsible: Late submission cause for withholding the salary of concerned monitoring officer • Revised MIS being Field tested in 6 blocks in 6 states. • Revised records & registers at AWCs and MPRs/ ASRs being implemented from 1.4.2011 • Web based MIS being developed by NIC on revised MIS..
ICDS: Monitoring contd… • CMU, NIPCCD in operation since 2009-2010. Medical Colleges, Home Science Colleges and School of Social Science involved in monitoring and supervision of ICDS • Proposal to revise monitoring committees at all levels • Check list for field visit for monitoring and supervision finalised. • Proposal to involve National Level Monitors (NLMs) rtd civvil servants and defence personnels.
Summary Findings • Coverage of target groups – Children • 49% of the size of the eligible group (vide census) are actually registered for ICDS benefits. • At the national level, of those recorded in the delivery register for ICDS benefits: • 64% received Supplementary Nutrition (may not be for all 300 days), immunization and other benefits, • 12% received other benefits but not supplementary nutrition and • 24% have not received any benefits;
Coverage - Continued The proportion receiving all ICDS benefits varies across States: • High Performers: More than 70% of the children receiving supplementary nutrition out of the total children recorded in the delivery register (not necessarily as per norms) are: Andhra Pradesh, Assam, Chhattisgarh, Gujarat, Himachal Pradesh, Jammu & Kashmir, Jharkhand, Karnataka, Kerala, Tamil Nadu, Uttarakhand and West Bengal. • Low Performers: Bihar (53%), Haryana (52%), Rajasthan (56%) and Uttar Pradesh (41%), Punjab (59%).
Infrastructure A. AWC Buildings: • Overall 42.5% of sampled AWCs have their own buildings, 17.4% are in rented buildings, 17.3% are located in primary schools and other 22.9% are running from AWW/AWH house, panchayat and community buildings. • More than 60% AWCs run from their own buildings in the states of Tamil Nadu (85.6%), Chhattisgarh (92.6%), Assam (69.6%), Maharashtra (68.5%), Karnataka (65.3%), Kerala (65%) and Gujarat (61.5%). • Space for indoor activities was found to be adequate in most AWCs (71.8%). Almost all States had similar dimensions of the AWC buildings. • Average room area: 315 sq ft (average length : 20 ft, breadth: 15 ft), lowest being reported in Himachal Pradesh and J&K (160 sq ft).
Infrastructure (Contd.) B. Drinking Water facility at AWCs: Country-wide, a total of about 87% AWCs (58.8% with hand-pump, 28.4% with pipe water facility) were found to have drinking water supply. C. Sanitation Facility at AWCs: About half the AWCs across the states had toilet facilities in the premises. However, most AWCs (about 80%) in Bihar, UP and Orissa were without toilets. D. Equipments/Kits at AWCs: 69% of sampled AWCs having functional baby weighing scale; 49% of AWCs having utensils; 48% of AWCs having cooking vessels; only 44% of AWCs having PSE kits and 62% of AWCS having medicine kits. E. Overall Infrastructure Index (20 major States): • Top 5 States: Tamil Nadu, Kerala, Maharashtra, Andhra Pradesh and Gujarat are ranked as top five states • Bottom 5 States: Rajasthan, UP, Punjab, J & K, and Bihar
Service Delivery • 82% of AWWs reported to have been involved in other government schemes during the last year with an average no. of days spent as 14 with 6 hrs/day. (Table 6.12 pp-64) • Only 41.2% AWCs reported to have updated child growth chart (Table 6.16) • 93.6% of sampled AWWs reported to have been adequately trained to conduct PSE (Table 6.17) • Average visits made to AWC in six months: By Supervisors - 5 visits; By CDPOs – 1 visit. Their main focus during the AWC visits has been record keeping (pp-76). • About 40% of AWWs reported getting some help from Panchayat with about 36% in monitoring and 34% in providing infrastructure (pp-83) • 31% AWWs reported getting help from Village leaders/Committee with 41% in monitoring and 26% in providing infrastructure (pp-84)
Service Delivery (Contd.) • About 70% of the community leaders felt that the ICDS programme was very useful to the community (pp-102); • 51.2% children (12-23 months) were found to be fully immunized (pp-121); • 49% of children were observed to be able to write alphabets/ words; • Only 24% women reported to have attended NHE meetings; • Average attendance of no. of children 3-6 yrs based on three sudden visits by the Research Team was found to be 14 (pp-121);
Programme Outcomes • Intended behavioral changes of varied intensity observed in Kerala, Himachal Pradesh, Andhra Pradesh, Tamil Nadu, Maharashtra, West Bengal and Jharkhand; Bihar, Uttar Pradesh, Rajasthan, Haryana and Punjab ranked very low in terms of intended behavioral changes among ICDS beneficiaries. • In general, the practice of breast feeding within an hour of birth is found to be more widespread among ICDS beneficiaries; • ICDS has positively influenced formal school enrolment and reduction in early discontinuation among beneficiaries; • At the national level, ICDS programme has impacted the immunization coverage, specially measles vaccination (Table 8.9). • There is no significant difference in the nutritional status among children 7-60 months between ICDS and non-ICDS populations (Table 9.2, pp-146)
Changes Required for Better Performance • Universalization Vs resources • Job security and compensation of AWW • AWC infrastructure • Convergence of complementary services • Monitoring and verification of office records • Revision of per capita norms in keeping with inflation
Ranking of States : Overall Performance in ICDS • Based on seven indicators: • Ave. no. of days SNP received in last 3 months, • % of children 12-23 months fully immunized, • % of children who are able to write alphabets/words, • % of women reporting NHE meetings, • % of mothers reporting seeking help from AWW when their child gets sick, • % mothers reporting received deforming tablets from AWC, and • Ave. attendance of 3-6 year old (based on 3 visits by NCAER) • Top Six States: Karnataka, Maharashtra, Andhra Pradesh, West Bengal, Jharkhand and Tamil Nadu • Bottom Six States: Punjab, Uttarakhand, Rajasthan, UP, Assam and Bihar
PART - II ICDS : Restructuring
ICDS Restructuring details provided in the agenda for 16th /17 th June: States were requested to provide suggestions by August 2010: Implementation in flexible mode – different models and institutional arrangements for delivery of services States/ UTs had to submit successful models after stakeholders consultation at various levels & validation [still pending] State PIPs for ICDS from 2011-12 with accountability for administration/ delivery arrangements; nutrition and early learning outcome. State to confirm constitution of Nutrition Council and State Nutrition Action Plan. ICDS: Restructuring
Nutrition Challenges • State Nutrition Council • Executive Committee • District Level Council • State and Multisectorial Nutrition • Action Plan
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