A CROSS-SECTIONAL STUDY OF INTEGRATED CHILD DEVELOPMENT SERVICE SCHEME IN RAJASTHAN, HEALTH PROMOTIONAL- ISSUES AND CHALLENGES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 11
Abstract
BACKGROUND Integrated Child Development Services (ICDS) scheme is a specific nutritional intervention launched since 1978 to combat malnutrition through life cycle approach in children. The scheme is in operation in state for the past forty-five years. This study is a scheme analysis designed to find the impact on its objectives. MATERIALS AND METHODS Study Design- A cross-sectional study. Study Units- Child Development Projects (CDPO) and Anganwadi Centres (AWC). Since the study duration was three years, the total sample size was 36 CDPO and 180 AWC, but we decided to study 39 CDPO and 442 AWC. Sample size was taken conveniently. Sampling- Simple random sampling was done. Study Objectives- Evaluate the ICDS scheme in Rajasthan- its present status in Rajasthan. Setting- Department of Community Medicine, JNU Medical College and Hospital, Jaipur-302017. RESULTS 64% of the beneficiaries were registered, 24% of them only availing supplementary nutrition. Hot supplementary food was cooked and served in all the AWC. The menu in all was found to be hot and sweet khichdi. The mean attendance of children was 5 only. 78% of the take-home food was not taken by beneficiaries, as it was stated to be stale and unfit for consumption. Vit A and IFA was given to all entitled. Deworming was done in all children. In 100% of AWC Antenatal and Postnatal Clinics, immunisation were not undertaken by the Auxiliary Midwife as the facilities for their conduct were not available. 98% of the AWC were operating in a single room accommodation, of which 17% were not electrified. Moderate malnutrition prevalence in 0 - 3 years was 42%, while in 3 - 6 it was overall 31.5% and 0.2% severe malnutrition overall. There has been significant reduction in severe malnutrition cases for the past 6 years (p < 0.005). CONCLUSION The ICDS scheme has been in operation over more than 45 years in the state. It has succeeded in arresting increase in moderate malnutrition which is stagnant at 42% in 0 - 3 years of age, but has significantly reduced prevalence of severe malnutrition to 0.2% only (p < 005), while health aspect has shown marginal increase especially in immunisation increased to 88%, but 72% of them were irregularly immunised giving partial immune status. The scheme is underutilised due to departmental inertia. ICDS has so far succeeded in reducing severe malnutrition. Other key indicators continue to be low. It raises doubts that should we continue with it? Can we really afford to continue feeding for long time to combat malnutrition or some other approach is required?
Authors and Affiliations
Shiv Lal Bhardwaj, Om Parkash Sharma
Keywords
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- EP ID EP411662
- DOI 10.14260/jemds/2018/321
- Views 94
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