Save India's Children
Neerja Chowdhury
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Reinvent and redesign the ICDS to effectively combat malnutrition
In April this year, the UN General Assembly proclaimed 2016-25 as the Decade of Action on Nutrition. In July finance minister Arun Jaitley met with some of his ministerial colleagues, senior bureaucrats and NGO representatives to brainstorm on the constitution of a National Nutrition Mission.The problem of malnutrition has come centrestage in Indian policymakers' thinking much more than ten years ago, when National Family Health Survey III figures were released with the distressing data that almost half of India's children under five were undernourished. While NFHS IV figures show an improvement, the road ahead is a long one.
Clearly , high levels of undernutrition and stunting, which make children susceptible to physical and mental disability as well as reduced productivity when they grow up, will affect economic growth and wipe out the country's “demographic dividend“. According to some studies, malnutrition will affect the GDP of Asia by a whopping 11%.
Ten years ago, when you talked about malnutrition, the invariable one word answer that would be mumbled by policymakers was “ICDS“. Arguably the biggest social programme in the world, ICDS has nevertheless not been able to address maternal and child malnutrition in the 41 years of its existence, though there are improvements.
The UPA government had increased allocations for the programme, proposed restructuring which included provision of a second worker to lighten the load of the existing anganwadi worker. With financial devolution recommended by the 14th Finance Commission, the NDA government decided to leave it to the states to evolve their respective strategies.
With their fit-all approach, the anganwadi centres cater to a plethora of programmes. It has been validated around the world that in case of lack of proper nutrients irreversible damage can be done in the first two years of life, and the window of opportunity to stem the slide is the “first 1000 days“ (nine months in the mother's womb and first two years of life). It is essential, then, that the ICDS system should focus entirely on this critical “window“ rather than dissipating its energies on the 119 columns that an anganwadi worker has to fill every month in some states.
Surely feeding 3-6 year olds, important in itself, or teaching them songs, and alphabets and other learning activities, can be undertaken by others such as NGOs or corporate houses looking to spend their social responsibility funds?
The anganwadi worker should now concentrate only on programmes that affect the first 1000 days of life. They must focus on ensuring adequate nourishment for the pregnant mother and anaemic adolescent underweight women giving birth to underweight children is one reason why Indian figures of undernutrition are worse than those of Sub Saharan Africa while counselling families on care for girls, advising mothers to give the first hour milk, breastfeed the child exclusively for the first six months and provide nutrient-dense complementary foods till the child is two.
But above all, their task should be to convince families that nutrition is not just about the right food in the “stomach“, but also about the “brain“ and the attainment of aspirations.
This must happen in the first two years of life, and in a mission mode. After that, it is too late to undo the damage done.
A redesigned ICDS, then, is a crying need. So are Nutrition Missions, both at the Centre and in states. They are the twin engines to give the push now required to end malnutrition in India in a time bound manner.
While the Centre is considering setting up a National Nutrition Mission several states Maharashtra, Gujarat, Madhya Pradesh, UP, Jharkhand and Andhra Pradesh have gone in for it. The idea of a Nutrition Mission is to give the issue greater traction and to facilitate better coordination between concerned departments WCD, health, agriculture, rural development, panchayati raj, water and sanitation. Putting it under the CM -which ensures political backing at the top and under a respected, senior officer makes the task easier, as several states have found.
Additionally the Mission can keep watch over ICDS functioning and keep it on its toes, particularly if the Mission functions autonomously . It can ensure that data is generated frequently and not manipulated. That the latest technology and innovations and good practices get incorporated into the system, like the use of mobiles to track the growth of every child.
It can ensure capacity building of frontline workers anganwadi workers, Ashas, ANMs, CDPOs, Supervisors enlisting corporates as partners to bring in their expertise in areas of management and accountability . It can push for research in universities and medical colleges. This Mission should not be under ICDS as that will defeat the very purpose for which it is constituted.
Prime Minister Narendra Modi has not been shy of taking a hard look at archaic laws and programmes which have been less than effective. The time has come to take a hard look at ICDS.
Not to abandon it but to revisit, redesign and rebrand it. For the sake of those millions of Indian children who deserve a better future and who, in this day and age, should not be allowed to die on getting a bout of diarrhoea or pneumonia just because they did not get the right nutrition in the first two years of life.
The writer is a political commentator
Clearly , high levels of undernutrition and stunting, which make children susceptible to physical and mental disability as well as reduced productivity when they grow up, will affect economic growth and wipe out the country's “demographic dividend“. According to some studies, malnutrition will affect the GDP of Asia by a whopping 11%.
Ten years ago, when you talked about malnutrition, the invariable one word answer that would be mumbled by policymakers was “ICDS“. Arguably the biggest social programme in the world, ICDS has nevertheless not been able to address maternal and child malnutrition in the 41 years of its existence, though there are improvements.
The UPA government had increased allocations for the programme, proposed restructuring which included provision of a second worker to lighten the load of the existing anganwadi worker. With financial devolution recommended by the 14th Finance Commission, the NDA government decided to leave it to the states to evolve their respective strategies.
With their fit-all approach, the anganwadi centres cater to a plethora of programmes. It has been validated around the world that in case of lack of proper nutrients irreversible damage can be done in the first two years of life, and the window of opportunity to stem the slide is the “first 1000 days“ (nine months in the mother's womb and first two years of life). It is essential, then, that the ICDS system should focus entirely on this critical “window“ rather than dissipating its energies on the 119 columns that an anganwadi worker has to fill every month in some states.
Surely feeding 3-6 year olds, important in itself, or teaching them songs, and alphabets and other learning activities, can be undertaken by others such as NGOs or corporate houses looking to spend their social responsibility funds?
The anganwadi worker should now concentrate only on programmes that affect the first 1000 days of life. They must focus on ensuring adequate nourishment for the pregnant mother and anaemic adolescent underweight women giving birth to underweight children is one reason why Indian figures of undernutrition are worse than those of Sub Saharan Africa while counselling families on care for girls, advising mothers to give the first hour milk, breastfeed the child exclusively for the first six months and provide nutrient-dense complementary foods till the child is two.
But above all, their task should be to convince families that nutrition is not just about the right food in the “stomach“, but also about the “brain“ and the attainment of aspirations.
This must happen in the first two years of life, and in a mission mode. After that, it is too late to undo the damage done.
A redesigned ICDS, then, is a crying need. So are Nutrition Missions, both at the Centre and in states. They are the twin engines to give the push now required to end malnutrition in India in a time bound manner.
While the Centre is considering setting up a National Nutrition Mission several states Maharashtra, Gujarat, Madhya Pradesh, UP, Jharkhand and Andhra Pradesh have gone in for it. The idea of a Nutrition Mission is to give the issue greater traction and to facilitate better coordination between concerned departments WCD, health, agriculture, rural development, panchayati raj, water and sanitation. Putting it under the CM -which ensures political backing at the top and under a respected, senior officer makes the task easier, as several states have found.
Additionally the Mission can keep watch over ICDS functioning and keep it on its toes, particularly if the Mission functions autonomously . It can ensure that data is generated frequently and not manipulated. That the latest technology and innovations and good practices get incorporated into the system, like the use of mobiles to track the growth of every child.
It can ensure capacity building of frontline workers anganwadi workers, Ashas, ANMs, CDPOs, Supervisors enlisting corporates as partners to bring in their expertise in areas of management and accountability . It can push for research in universities and medical colleges. This Mission should not be under ICDS as that will defeat the very purpose for which it is constituted.
Prime Minister Narendra Modi has not been shy of taking a hard look at archaic laws and programmes which have been less than effective. The time has come to take a hard look at ICDS.
Not to abandon it but to revisit, redesign and rebrand it. For the sake of those millions of Indian children who deserve a better future and who, in this day and age, should not be allowed to die on getting a bout of diarrhoea or pneumonia just because they did not get the right nutrition in the first two years of life.
The writer is a political commentator
Source: Times of India, 9-08-2016
