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Henri hoped that the Consultation would help identify issues and provide insights to develop a standard blueprint that would allow a transition from ‘knowledge to practice’. He explained that all workers needed supportive supervision and counselling to create a sustainable reality for India’s frontline workers who were the front runners in ensuring child rights and child health. Emerging Needs and Responses for Strengthening Supportive Supervision Dr. Shreeranjan, Joint Secretary, Ministry of Women and Child Development acknowledged ICDS as a well-structured programme with an inbuilt supervisory mechanism that included elaborate guidelines for all levels. According to him, ICDS was in a continuous state of evolution, and an embodiment of care and empowerment. A reason for its being well run and managed was that it followed a system of decentralised decision making. Also, its design provided scope to follow a convergent approach to supervision. In his view, supervision comprised of two words, namely, super and vision. The ‘super’ part referred to knowledge while ‘vision’ related to its dissemination. WCD was one of the biggest stakeholders of NRHM apart from programmes like water and sanitation, drinking water and NREGA which were Universalised post 2007-08 in the country and were now finding their feet. He admitted that in the 12th plan, these programmes would need more mindful action, dedication and commitment than just money. Window of opportunity in ICDS was its evolving to a stage of mission mode and being Universalised. Its strengthening and restructuring had been approved by the government. More than 37,000 technical persons were being added, mostly at the block and district level. He apprised that ICDS itself has 14 lakh AWCs and 7776 projects. The advocacy and locking and interlocking in the system seamlessly with NRHM, ICDS and other programmes like water and sanitation would be an important aspect of Supportive Supervision. 14 Consultation on Supportive Supervision to Strengthen Capacity of Frontline Workers and Service Providers
Key Features of ICDS ICDS was a well structured programme. Prior to NRHM in 2005-06, only 45% habitation/ villages were covered by ICDS and the only health worker prior to ASHA, was ANM. There were villages where there was no outreach or health worker and therefore nutrition and health outcomes suffered. The anganwadi was a platform that served as a first outpost of health, nutrition, early learning and care. The issue needed more thrust. There were supervisors and a convergent approach to supervision between ANMs. With 1.4 lakh ANMs across the country, an average of 5-15 AWCs fall under one sub-centre. Spread of health institutions and structures at both sub-centres and PHCs had been more political than actual on the ground. The issue right now was of location which would need to be addressed through GIS and micro planning. In 2009, a guideline was issued in October, 2010 making it mandatory for supervisors to visit at least 50% women/anganwadis in their area. Joint visits were prescribed but only 30-40% were visited. With ICDS covering 15 states a year, the biggest challenge was to bring down burden of IMR, MMR, nutrition and governance, especially in Bihar, Madhya Pradesh, Uttar Pradesh or Jharkhand. It was time for Planning Commission to release funds for infrastructure, linking these to health outcomes. Vacancies needed to be filled and mobility support strengthened. Issues of Supervision • y Knowledge on programme components. • y Skill for supervision, facilitative actions and supervisory relationships. • y Availability of simple and appropriate tools for supervision. • y Training ( knowledge and skill based). • y Clarity of roles and accountability framework. Explaining these constraints, he said that there were challenges to conducting supervision at different levels. Vacancies of Supervisors and CDPOs was a commonly reported problem. In many places, there was a skewed AWC: Supervisor ratio. In remote areas, problem of mobility was seen as a hindrance to regular supervision. Many supervisors, for sake of convenience chose to stay close to sector/ block headquarters, visiting villages under their care occasionally. Apart from physical and logistical constraints, in many places, quality of supervision was patchy, restricted Fact File: ICDS supervision at grassroots level Villages: 6 lakh; Panchayats: 236,350 lakh Village Health and Sanitation Committee (VHSNC): 5 lakh AWC: 13.19 lakh ANM: 1.4 lakh ASHA: 8.49 lakh Sub-health Centres: 1.5 lakh ICDS supervisors: 35702 as against 54103 sanctioned AWC per sector: 25 Consultation on Supportive Supervision to Strengthen Capacity of Frontline Workers and Service Providers 15
Page 1: Consultation on Supportive Supervis
Page 5 and 6: Acknowledgments UNICEF is grateful
Page 7: RI : Routine Immunization SHRC : Sy
Page 11 and 12: Introduction & Background Defining
Page 13 and 14: In the corporate world, this approa
Page 15: Proceedings of the Consultation The
Page 19 and 20: AWC. This included representation f
Page 21 and 22: “I have been to the field and fou
Page 23 and 24: These supervisory checklists should
Page 25 and 26: Title of Project: Mitanin Programme
Page 27 and 28: District Coordinators: They are app
Page 29 and 30: Medical Officers. They aimed to inc
Page 31 and 32: Results “If ASHAs could not fill
Page 33 and 34: Learnings • y Functional overlap
Page 35 and 36: Key Incentives to Support Supervisi
Page 37 and 38: Leveraging Support through Communit
Page 39 and 40: contributed to slowing down of the
Page 41 and 42: • y Absence of performance benchm
Page 43 and 44: Discussion • y When the process w
Page 45 and 46: UNICEF operates in Karnataka, West
Page 47 and 48: SESSION 6: Supportive Supervision f
Page 49 and 50: ecords and data collection); assess
Page 51 and 52: There were things that did not impr
Page 53 and 54: • y Joint supervision of Block He
Page 55 and 56: Key challenges in providing support
Page 57 and 58: Annexure 1: Programme Agenda Consul
Page 59 and 60: DAY 2 - 23 nd Nov 2012 Time Topic F
Page 61 and 62: 31. Anagha Khot, Project Management
Page 63 and 64: Importantly, supportive supervision
Page 65: Participants The workshop participa

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