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Disintegrated services

By Nandini Nayak

There are large gaps between the intentions and implementation of the ICDS, the only government programme aimed at providing nutrition, health and education-related services to children, adolescent girls and mothers

The ICDS (Integrated Child Development Services) is aimed at providing nutrition, health and education-related services to 0-6-year-old children, pregnant women, nursing mothers and adolescent girls. It was started as a small pilot project in 1975. At that time, the high incidence of mortality, morbidity and malnutrition among children was recognised as a matter of concern. It was acknowledged that the first four plan periods had neglected the health, nutrition and education needs of the ICDS target groups.

Thirty years later, the ICDS remains the only government programme of its kind in India. It continues to be critically important, not only because the ‘target population’ has a right to the services under the ICDS, but also because the health and nutrition of these target groups in India is in a dire state and in need of urgent attention. 

As many as 47% of India’s children are undernourished and about a third are born with low birth weight, according to the Human Development Report 2005. The ICDS is the only public programme intended to address this situation. The National Policy for Children (1974), in consonance with which the ICDS was started, says, “Programmes shall be implemented to provide nutrition services with the object of removing deficiencies in the diet of children.” It also says, “Programmes will be undertaken for the general improvement of the health and for the care, nutrition and nutrition education of expectant and nursing mothers.” The Tenth Five Year Plan says, “The ICDS is envisaged to provide supplementary feeding to bridge the nutritional gaps that exist in respect of children below six years and expectant and nursing mothers". Despite the clear mandate for implementation of the ICDS, the service has caught the imagination of communities only in isolated pockets where it is relatively well implemented, mainly in areas with some political mobilisation. In large parts of the country the potential of the ICDS remains untapped.

Attention was sharply drawn to the ICDS in November 2001 when the Supreme Court directed the central and state governments to provide all its beneficiaries with the services promised under the ICDS (order dated November 28, 2001, in Civil Writ Petition 196/2001, People’s Union for Civil Liberties v. Union of India and others).

The National Plan of Action for Children (NPAC), 2005 of the Government of India, speaks of “'universalisation of ICDS as per Supreme Court orders” as a strategy for achieving the nutrition-related goals including the “elimination of child malnutrition as a national priority”. Four years after the SC order, however, the Supplementary Nutrition Programme (SNP) component of the six ICDS services reaches a mere 25% of 0-6-year-old children, 20% of pregnant women and nursing mothers, and 0.3% of adolescent girls (N C Saxena and Harsh Mander, Sixth Report of the Commissioners of the Supreme Court in PUCL v  UOI and others, CWP 196/2001).

Volumes can be written about the implementation of the ICDS. Some of the more serious problems are low financial allocations by both the central and state governments and poor coordination between government departments responsible for implementing the ICDS. “Coordination of policy implementation among various departments to promote child development” was in fact one of the original objectives of the ICDS. This lack of political will has led to a magnified failure in attending to doubly vulnerable groups like disabled children and street children.

Monitoring the implementation of the ICDS involves several issues. The mismatch between policy statements and actual implementation in field projects is of a magnitude that is not recognised or acknowledged by policy makers. Only an effectively implemented community-based programme can hope to meet the nutritional requirements of the people targeted by the ICDS. The wide gap between policy intent and the reality of implementation must be bridged.

To illustrate the mismatch: A limit is set at the anganwadi centres to the number of beneficiaries of the SNP. Government policy says there is in fact no such limit. Despite clear Supreme Court orders to cover all the beneficiaries and statements in other documents like the NPAC, the financial allocations made by both state and central government for the SNP are limited.  The number then gets limited to 100 persons at each anganwadi centre.

This is a matter of serious concern for several reasons. First, the limit on the number raises concerns about the selection of the beneficiaries. This is particularly pertinent in the context of social exclusion. As with all social schemes, ICDS benefits often get concentrated in the hands of a socially and economically affluent class, crowding out families and communities more vulnerable to hunger and malnutrition. This happens because anganwadi centres are often inaccessible to isolated hamlets, mostly of dalit communities. The SC’s order to give priority to opening anganwadis at SC/ST hamlets and in urban slums is rarely implemented.
 
Second, this issue is particularly critical in terms of policy. In correspondence with the Commissioners appointed by the Supreme Court, the Government of India said that about 46% of the eligible beneficiaries access ICDS services. The central and state governments justify the low financial allocations for the SNP on the pretext that less than 50% of the eligible beneficiaries are interested in the service. The ground reality indicates that almost all eligible beneficiaries are interested, but many are denied the benefits.
 
When they are excluded because of questionable caps, many people feel dejected and think it is not worthwhile to spend time seeking the benefits of the SNP. Rather than a “lack of interest”, many intended beneficiaries stay away because earning a livelihood, childcare and tending to their homes are primary concerns. During a visit to the Goilkera block in West Singhbhum district in Jharkhand, several families doing daily wage labour categorically told me that the amount of food given to them at the anganwadi centre is not worth losing a day of work. In many instances, when the women go to collect the food, they are told they are not “entitled” to it.

In the juggling of numbers, the imperative of tackling malnutrition takes a beating. For a population vulnerable to malnutrition, only token coverage under the supplementary nutrition programme is not likely to help. Policy statements must be translated into reality. In the absence of any real implementation, the well being of millions of India’s young children, adolescent girls and mothers remains precarious.

(Nandini Nayak is a Research Associate with the Office of the Commissioners to the Supreme Court. The views in this article are her own and not of the Office of the Commissioners or of the Right to Food Campaign.)

InfoChange News & Features, October 2006