Anganwadi is a government-sponsored child-care and mother-care development programmes in India at the village level. It caters to children in the 0-6 age group. They were started by the Indian government in 1975 as part of the Integrated Child Development Services program to combat child hunger and malnutrition. An Anganwadi centre provides basic health care facilities in Indian villages. It is a part of the Indian public health-care system. Basic health-care activities include contraceptive counselling and supply, nutrition education and supplementation, as well as pre-school activities. The centres may also be used as depots for oral rehydration salts, basic medicines, contraceptives and child care.
The meaning of the word ‘Anganwadi’ in the English language is "courtyard shelter". The word Anganwadi is derived from the Hindi word “Angan”, it refers to the courtyard of a house. Angan is a rural Indian term for “a place where people get together to discuss, greet, and socialize their matters”. The Angan is also used occasionally to cook food or for household members to sleep in an open air. This part of the house is seen as the heart of the house and is considered a sacred place. Therefore, the significance of this part of the house comes across in the way a worker works in an Angan and visits other Angans to perform the indispensable duty of helping with health care issues. After all, they are the most important link between the rural poor and good healthcare.
Anganwadi Programme
Integrated Child Development Services (ICDS) is the only major national program that addresses the needs of children under the age of six years. It seeks to provide young children with an integrated package of services such as supplementary nutrition, health care and pre-school education. Because the health and nutrition needs of a child cannot be addressed in isolation from those of his or her mother. The program also extends to adolescent girls, pregnant women and nursing mothers. The stated objectives of ICDS are given below:
- To improve the nutritional and health status of children below the age of six years.
- To lay the foundation for the proper psychological, physical and social development of the child.
- To reduce the incidence of mortality, morbidity, malnutrition and school dropouts.
- To achieve effective coordination of policy and implementation among various departments to promote child development.
- To enhance the capability of the mother to look after the normal health, nutritional and developmental needs of the child through proper community education.
Role of Anganwadi Worker
There are many responsibilities and duties to be performed by an Anganwadi Worker recommended by the government. Some of them are:
- Showing community support and active participation in executing this program,
- To conduct regular quick surveys of all families,
- Organize pre-school activities, provide health and nutritional education to families especially to pregnant women as to how to breastfeeding practices etc.
- Motivating families to adopt family planning, educating parents about child growth and development,
- Assist in the implementation and execution of Kishori Shakti Yojana (KSY) to educate teenage girls and parents by organizing social awareness programs, identify disabilities in children and so on.
Basics of the Anganwadi Program (ICDS)
The basic services provided under ICDS are mentioned under three headings like nutrition, health and pre-school education. Nutrition services include supplementary feeding, growth monitoring, and nutrition and health counselling. Health services include immunization, basic health care, and referral services. Pre-school education involves various stimulation and learning activities at the Anganwadi.
Nutrition
- Supplementary Nutrition: The nutrition component varies from state to state but usually consists of a hot meal cooked at the Anganwadi. It is 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: The aim of NHE is to 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. NHE is imparted through counselling sessions, home visits and demonstrations. It covers issues such as infant feeding, family planning, sanitation, utilization of health services, etc.
Health
- Immunization: Children under six are immunized against polio, DPT (diphtheria, pertussis, tetanus), measles, and tuberculosis, while pregnant women are immunized against tetanus. This is a joint responsibility of ICDS and the Health Department. The 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: A range of health services are provided through the Anganwadi Worker including 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: This service 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. And these cases are referred by the Anganwadi worker to the medical officers of the Primary Health Centres (PHCs).
Pre-School Education
- Pre-School Education (PSE): The aim of PSE is to 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. PSE is 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.
Importance of Anganwadi Programme
The Anganwadi Program is important because of its multiple child development activities. Reasons behind the importance of the program are:
- Early years of Children are Vulnerable: Because the first six years are the most vulnerable period of human life when the survival of the child is a challenge.
- A Rapid Period of Human Development: Because this is also the most rapid period of human development: from an infant unable to even hold up its head, to a chattering child, running around, asking a hundred questions, getting ready for school–this is the journey a child covers in just six years.
- First, Six Years of Life are most Important for Learning as per Scientific Findings: Because science has established that the foundations of health, language, the capacity to learn, self-confidence and personality of a human being are laid in the first six years of life. For instance, 80% of brain growth takes place in these six years.
- Nutrition, Health and Education are Fundamental Rights: Because every child has a fundamental right to nutrition, health and education - the essentials that are needed to grow and develop fully. Providing ICDS services of good quality to all children is a step towards making this right a reality.
Implications in the Way of Low Levels of Schooling
Without schooling, millions of children are pushed into child labour and condemned to a lifetime of social exclusion, low earnings, and exploitation. Some of them work for long hours as domestic helpers or in Dhabas, and others are forced into begging or prostitution, or end up as rag-pickers. When they grow up, they swell the ranks of unskilled labour at the lowest rung of our society and are denied equal opportunities and choices.
How is this Related to Children under Six and ICDS?
Learning starts from birth and it is well established that pre-school education is very significant in helping children to prepare for formal schooling. Pre-school education assists children both to enter school and to remain within the system. A child cannot fully realize his/ her right to education unless he/ she has access to quality early childhood care and education.
Some Facts about Malnutrition in Children in India
- Malnutrition begins at birth or even before this during pregnancy. However, it intensifies sharply between the ages of 6 months and three years.
- Exclusive breastfeeding is recommended for children up to six months of age for their good health. Beyond this period, mother's milk alone is not sufficient for the growing child.
- The infant is also helpless; he/ she cannot feed himself/herself, or ask for more. He/she is also more prone to infections during this period. A child at this age needs frequent meals of softened food that only an adult can give her, along with continued breastfeeding. Many children are deprived of these healthy feeding practices, and as a result, their nutrition status worsens.
But ICDS can make a difference in it. As the program is protecting children from the vicious cycle of malnutrition and poverty which requires many complementary actions such as loving care, supplementary nutrition, immunization, health services, and an environment for stimulation and learning. The aim of ICDS is to provide these complimentary services in an integrated manner.
Who is the In-Charge of providing these Services?
ICDS is a complex program with many actors playing their role in it. The basic responsibility for implementing the program rests with the State Government. The nodal department responsible for implementing ICDS at the state level is typically the Women and Child Development Department, or sometimes a related department (e.g. the Social Welfare Department).
At the ground level, the lead role is played by the Anganwadi worker who shoulders many responsibilities as the sole manager of the Anganwadis. Active Anganwadi workers are true heroines. Their effectiveness depends on the support and cooperation of many other people such as the Anganwadi helper, the Auxiliary Nurse Midwife (ANM), the supervisor, the Child Development Project Officer (CDPO), among others, and of course the village community.
- Anganwadi Worker (AWW): She is the pillar of the program. Her job is to run the Anganwadi, survey all the families in the neighbourhood, enrol eligible children, ensure that food is served on time every day, conduct the pre-school education activities, organize immunization sessions with the ANM, make home visits to pregnant mothers, and so on the full list is very long!
- Anganwadi Helper (AWH): The AWH is also central to the implementation of ICDS. She is supposed to assist the AWW in her tasks. Her main duties are to bring children to the Anganwadi, cook food for them, and help with the maintenance of the AWC (Anganwadi centre).
- CDPO: The ICDS program is organized as a collection of “projects”. Normally, an ICDS project covers a population of around 100,000 and involves running about 100 Anganwadis. Each project is managed by a Child Development Project Officer (CDPO). The CDPO's office is a sort of “headquarter” for the ICDS project.
- Supervisor: The CDPO is assisted by “supervisors”, who make regular visits to the Anganwadis. The supervisors are supposed to check the registers, inspect the premises, advise the Anganwadi Worker, inquire about any problems he/she may have, and so on.
- Auxiliary Nurse Midwife (ANM): The ANM acts as a crucial link between ICDS and the Health Department. Her main task in the context of ICDS is to organize immunization sessions, together with the Anganwadi worker. She also provides basic health care services at the Anganwadi.
- Accredited Social Health Activist (ASHA): The National Rural Health Mission is set to create a cadre of women voluntary health workers (ASHA) at the village level, who are also expected to work with the ANM and AWW to improve the nutrition and health of women and children.
- NGOs: In some areas, NGOs play an active role in the implementation of ICDS. In fact, sometimes entire ICDS “projects” are managed by an NGO. Also, international organizations such as CARE and UNICEF often provide specific support to ICDS. For instance, CARE used to supply food for the supplementary nutrition program, and UNICEF has been helping with the supply of medical kits.
- The Community: Community participation is an important element in the design of ICDS. It can do a lot to help the effective functioning of Anganwadis. For instance, the community can be mobilized to provide the Anganwadis with better facilities, to ensure that they open on time every day, or to encourage mothers to participate in counselling sessions. Community participation can take place through Gram Panchayats, Mahila Mandals, Self-Help Groups, youth groups or just spontaneous cooperation. Unfortunately, community participation in ICDS is quite limited as things stand.
Thus, the Anganwadi or (ICDS) system is passing through many ups and downs. It does not mean that it is a worthless program; but on the other hand, it helped many rural children by providing them with an early education. Therefore, for making this program successful, it is our collective duty to cooperate with each other in this pious social work.
