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Photograph of Mother and Child
Title of Women Development, Child Welfare and Disabled Welfare Department
 

1.Overview
Integrated Child Development Services (ICDS) is a unique and single largest integrated scheme of Child Development in India. It was started in the state of Andhra Pradesh in Utnoor Block, Adilabad district and Kambapur Block, Ananthapur District in 1975.
The State has since then witnessed tremendous increase in the coverage year after year in terms of growing numbers of ICDS Projects as well as the Anganwadi Centers (AWCs). The no. of new AWCs increased steeply between the period of 1991 to 2002-2003 when 110 blocks of the predominantly tribal and drought prone areas were selected for ICDS implementation
In 2005-06, the scheme was universalized and the coverage increased within existing projects as well as to newer areas. All the villages/ habitations with population of 800 in Urban areas, 300 in Rural areas and 150 in Tribal areas are covered with AWCs in the State. Govt. orders sanctioning the projects, various posts and the AWCs are at   Annexure-I
2.Objectives
Improve the nutritional and health status of children in the age group of 0 - 6 years
Lay foundation for proper psychological, physical and social development of the child
Reduce the incidence of mortality, morbidity, malnutrition and school dropouts
Achieve effective coordination of policy and implementation among various departments to promote child development
Enhance the capability of the mother to look after the normal health and nutritional needs of the child, through proper health and nutrition education
3.Services
Supplementary Nutrition to 6 months to 6 years aged Children, Pregnant and Lactating Mothers
Immunization to Children and Women
Health check-ups to Children and Women
Referral services to Children and Women
Nutrition and Health Education to Mothers and Adolescent Girls
Non-formal Pre-School Education to 3-6 years Children
4.Supplementary Nutrition Programme (SNP)
Supplementary Nutrition Programme (SNP) is the main component of ICDS to tackle malnutrition. SNP services are provided to the target groups of Pregnant & Lactating women and children between 7 months to 6 years.
The cost norms for Supplementary Nutrition Programme under " Restructured" ICDS were revised by Government of India (GOI), as per details given below
Target GroupRevised Norms
(per beneficiary per day)
Children(7-72 months)Rs.6.00
Severely Underweight children (7-72 months)Rs.9.00
Pregnant and Lactating womenRs.7.00
The nutritive norms for Supplementary Nutrition Programme as prescribed by Government of India (GOI), are as follows
Category Nutritive values
Calories
(K Cal)
Protein
(g)
Children(7-72 months) 500 12-15
Severely Underweight children (7-72 months) 800 20-25
Pregnant and Lactating women 600 18-20
With the revision of cost norms, food models were revised in consultation with stakeholders for the target groups to provide for calories / protein/RDA as per GOI norms and to ensure that the Supplementary food is acceptable to the target groups
In brief, the Supplementary Nutrition provided for the various categories of target groups is as follows
  • Pregnant & Lactating women get “one full meal” under Anna Amrutha Hastham (AAH) with one egg, 200 ml of milk, rice, dal and vegetable every day. Where AAH is not implemented, Pregnant & Lactating women receive Take Home Ration(THR) of 3 kg rice, 1 kg dal, ½ ltr oil and 16 eggs in a month on 1st of every month(i.e. on NHD-1)
  • 7 months to 3 years children receive weaning food i.e the fortified Balamrutham packet of 2 ½ kgs and 8 eggs in a month. This is distributed as THR to the mothers on 1st of every month (i.e on NHD-1)
  • 3 to 6 years children as part of Pre-school get a hot meal of rice, dal, vegetables daily, 4 eggs in a week and snacks of AP Food/ chana dal/ peanuts daily
  • Malnourished children i.e SUW/SAM/MAM children between 7 months to 3 years are given additional supplementation of 1 egg, 100 ml milk, mini meal+ extra oil daily at the Anganwadi centre
  • Malnourished children i.e SUW/SAM/MAM between 3 to 6 years are given additional supplementation of 1 egg, 100 ml milk, oil ( with hot meal), 50 gms of Balamrutham daily at the Anganwadi centre
Feeds for Malnourished children of age groups 7 months to 3 years and 3 to 6 years, are supervised and certain feeds are given at the AWC itself. The additional supplementation are made part of model menus which are appropriate for the malnourished children. Detailed guidelines issued for the “Special care and Supervised feeding” of malnourished children upto 5 years include methodology of identification and categorization of children as Severely Underweight (SUW)/ Severe Acute Malnutrition(SAM)/ Moderate Acute Malnutrition (MAM), and the details og the Model Menus
5.Immunization
Immunization of Pregnant women against tetanus and immunization of infants against six vaccine-preventable diseases – poliomyelitis, diphtheria, tetanus, pertussis, tuberculosis and measles is provided at the AWC with the assistance of Health functionaries on the Nutrition and Health Day-2
6.Health check-up
This includes healthcare of children less than six years of age, antenatal care of expectant mothers and post-natal care of nursing mothers. The various health services provided for children by AWWs and Auxiliary Nurse Midwife (ANM) include regular health check-ups, recording of weight, immunization, management of malnutrition, treatment of diarrhoea, deworming and distribution of simple medicines, etc. Pregnant and Lactating women are examined at regular intervals by the ANM who also diagnose minor ailments and distribute simple medicines during Nutrition & Health Days (NHDs)
7.Referral Services
During health check-ups and growth monitoring, sick or severely malnourished Children and high risk Pregnant Women are identified and they are referred to the Medical Officer, Primary Health Centre. The AWW 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
8.Nutrition and Health Education (NHED)
NHED is a key element of the work of the Anganwadi worker. 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 and nutrition needs as well as that of their children and families. The components of NHED comprise basic health and nutrition messages related to childcare, infant feeding practices, utilization of health services, family planning and environmental sanitation. NHED is imparted on both NHD-1 and NHD-2
9.Early Childhood Care and Education (ECCE)

The main objective of Pre-School Education is to cater to the needs of the development of Children in the age group of 3-6 years. Pre-School Education aims at ensuring holistic development of the Children and to provide learning environment to Children which is conducive for promotion of social, emotional, cognitive and aesthetic development of the Child

The Pre-school activities also strengthen the Child to get ready for primary school education with required skills. It aims at improving school enrollment and school retention in rural areas, relieve the older sibling mostly girls from the burden of Child care and enable her to attend school and to prepare the Children to adjust to formal school going.

The Pre-School material like Story cards, charts, indoor and outdoor play material, color concept, puzzles, school readiness kit, Activity kits etc are supplied to all the Anganwadi Centers every year at a cost of Rs.3000/- per Main AWC and Rs.1500/- for Mini AWC as per GOI norms

10.Nutrition and Health Days (NHDs)
Nutrition and Health Days (NHDs) are conducted twice in a month. NHD-1 is conducted on 1st of every month. On this day, the weight of children is taken to monitor their growth and “Take Home Ration” is also distributed on the same day. NHD-2 is conducted on a fixed day of the month as per the schedule of ANM. The focus of NHD-2 is on Ante Natal Check-ups (ANC) and Immunization. Both the NHDs are conducted as a convergence effort of ICDS and Health department with support from Panchayati Raj and Rural Development Department. The Anganwadi Worker (AWW), ASHA, Village Organisations (VOs) including SHGs along with the Village level Coordination Committee (VLCC) conduct the NHD-1, while the ANM joins the team for NHD-2 to provide ANC and Immunization services.
11.Coverage of Beneficiaries under ICDS (as per MPR of AWCs of March 2014)
Sl NoNo. of AWCs FunctioningNo. of Beneficiaries Enrolled
CategoryNo of AWCsCategoryNo Enrolled
1Main802457months to 3 years Children29,00,970
2Mini104393-6 years children20,83,150
Pregnant & Lactating Women14,79,344
Total9068464,62,464
3Severely Underweight children (7months to 6 years )59,996
12.Strengthened and Restructured ICDS

The Government of India has approved continued implementation of the ICDS scheme in the 12th Five year Plan period and under the “Strengthened and Restructured ICDS” Scheme programmatic, management and institutional reforms have been introduced by GOI in a Mission Mode to reposition the AWC as first village outpost for providing services for health and nutrition to Pregnant and Lactating women and children under 6 years, care and nutrition counseling particularly for mothers of under 3s, focus on under-3s, identification and management of severe and moderate underweight through community based interventions early learning, decentralized planning and management, flexibility to States in implementation for innovations, strengthening governance - including PRIs, partnerships with civil society, introducing APIP and MOUs with States/UTs, etc.

The core package of services under “Restructured ICDS” are as follows

i. Early Childhood Care Education & Development (ECCED) (Non-formal Pre-School Education/Early Childhood care & Education (ECCE)and supplementary nutrition)

ii. Care & Nutrition Counseling (Growth Monitoring; Infant and Young Child Feeding (IYCF) counseling; Lactation support; Maternal care counseling; Nutrition, Health & Hygiene Education; Monitoring & Promotion of Child Growth & Development; Community based management of Severely & Moderately Underweight children)

iii. Health Services (Immunization, Health check-up and Referral services)

iv. Community Mobilization, Awareness, Advocacy & IEC ( Sensitization & Engagement of PRIs/Mothers Committees, SHGs on Nutrition & Child Development; Social mobilization campaign in partnership with Song & Drama Division of Ministry of Information & Broadcasting; Us of Mass media for Awareness Generation; Awareness campaigns/Village contact Drives through local /Folk Media; Interpersonal communication; Voluntary Action)

13.References
GOI lr.No 1-8/2012-CD-1 Ministry of Women & Child Development, New Delhi, dt.22nd October, 2012
Strengthening and Restructuring of Integrated Child Development Services(ICDS) Scheme
ICDS Mission Framework book
GOI Lr Ministry of Women & Child Development, New Delhi, dt. 27th Sept 2013
Annual Programme Implementation Plan(APIP) 2013-14 Administrative sanction