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children below 36 months and 15 in the 3- 6 years age group. None of the children below 3 years of age group utilised the services of the Aanganwadi centres 7 . In the 3 to 6 year age group, of the 15 children only 10 were enrolled in the Aanganwadi. This includes the one disabled boy in the urban centre household. Of the remaining 5 children who were not enrolled, 4 were in the tribal village. It is worth stressing that enrolment does not automatically imply access to services. Some children are merely enrolled and not necessarily benefiting from the ICDS programme Andhra Pradesh Enrolment Table 19: Profile of ICDS / Pre-School Visited Attendance on day of visit AWW / AWH Premises Hours Food supply Pre-school Education Rural 1 1 AWH Att to GPS Not regular Regular Rural 2 A 12 B, 14 G 8 to 10 1 AWW Rented Flexi Regular No evidence Rural 2 B 20 Total 8 to 10 1 AWW Att to GPS 9 to 12 Irregular No evidence Urban 1 A 25 Total 5 to 6 AWH AWH / Rented Flexi Regular No evidence Urban 1 B 23 Total None DOV AWW Rented Flexi Regular No evidence Urban 2 Karnataka 12 B, 19 G AWW AWH / In AWW Flexi House Irregular No evidence Rural 1 A 60 Total 30 DOV AWW / AWH Own 10 to 1.00 Regular Sometimes Rural 1 B (Golla) 56 Total 28 DOV AWW / AWH Own 10 to 1.00 Regular Sometimes Rural 2 A 54 Total 42 DOV AWW / AWH Own 9.30 to 1.00 Regular Regular Rural 2 (SC) 64 Total 40 DOV AWW / AWH Own 10 to 1.00 Regular Regular Urban 1 64 Total 50 DOV AWW / AWH Own 10 to 1.00 Regular Sometimes Urban 2 (SJSRY) Uttar Pradesh 50 Total 35 DOV Teacher Community hall 10 to 2.00 No food Teaching Rural 1 40 Total 8 to 10 AWW / AWH In AWW House 2 to 3 hours Irregular No evidence Rural 2 40 Total 25 DOV AWW only In GPS 2 to 3 hours Irregular No evidence DOV: Day of Visit 7 Non-utilisation of Anganwadi service among children less than 3 years may be on account of perceptions that they are too young to be left alone, availability of services for only ½ a day making alternate childcare arrangements necessary for the remaining half day, discrimination against children from lower-castes, dissatisfaction with food served at AWC, unhealthy environment at the AWC and better facilities for elder children at AWC. Outreach to children can therefore be improved if mothers are convinced that their children are being well looked after and that the supplement is appropriate. See (Ranjan Jayesh and Krishnamachari K. A. V. R. (1997) ‘Community based strategy for improved health care delivery in the agency areas: Case study of ITDA Rampachodavaram. Presented at the Seminar on Perspectives and Strategies for Sustainable Tribal Development Beyond 2000AD organised by Dept. of Anthropology, Andhra University, Visakhapatnam, India, April 29-30, 1997.) Educational Resource Unit Page 46 April 2003
The problem of irregular food supply was most acute in Uttar Pradesh. Our qualitative study confirms findings reported in larger surveys: ‘According to the National Institute of Public Cooperation and Child Development (NIPCCD) report (1992), 27 per cent of AWC did not receive any nutrition supplement for over 90 days, i.e., the average disruption in their supply was for 63.7 days. This in turn affected the functioning of the AWC. In some cases the AWCs are closed for weeks altogether due to non-availability of nutrition supplements. In addition there are other factors like the poor attendance of children of working parents belonging to the poorest section as a result of which these children cannot avail of these services to the fullest extent. Similarly, the provision of double ration to severely malnourished children is often ineffective, because such children are often incapable of eating much at one go. Again the morning hours appear to be the time when pregnant and lactating women are busy with domestic chores and hence attendance at AWCs for accessing these services, especially supplementary nutrition, tends to be poor’. (D B Gupta, et al, 2002) Table 20: Percentage of moderately and severely malnourished children: State Normal Children 6-12 months 13-36 months 37-72 months Moderately malnourished (Grade I & II combined) 6-12 months 13-36 months 37-72 months Severely malnourished (Grade III & IV 6-12 months combined) 13-36 months Uttar Pradesh 99.6 98.3 93.5 0.4 1.6 6.3 0.0 0.1 0.2 Karnataka 82.4 79.4 79.9 14.6 19.2 19.3 3.0 1.4 0.8 Andhra Pradesh 77.1 80.3 77.7 17.7 17.8 21.0 5.2 1.9 1.3 All States 92.3 80.7 91.9 6.4 7.7 15.7 1.3 3.6 1.4 Source: NCAER, ICDS Field Survey 1999 37-72 months The above analysis was confirmed during our investigations. Discussions with AWW revealed that there is no system for identifying the severely malnourished for providing double rations. While we saw pregnant and lactating mothers coming to AWC in Karnataka and Andhra Pradesh, we did not come across even a single woman who came to the AWC in Uttar Pradesh. Most distressing was that in Uttar Pradesh the fortified ‘dalia’ meant for the AWC was being sold in the local shops with people buying it both for their own consumption as also to feed their cattle! While recording the food habits of children in the three states, we were alarmed to see that in Uttar Pradesh most often the children ate roti with salt, this in a region where a wide variety of green leafy vegetables are grown and locally available. The customary bias against eating Educational Resource Unit Page 47 April 2003
Page 1 and 2: Publication released by World Bank
Page 3 and 4: Acknowledgements My first and heart
Page 5 and 6: LIST OF TABLES Table 1: ICD Concept
Page 7 and 8: GLOSSARY Ab iska kahan fayada hota
Page 9 and 10: Taluka Administrative unit - often
Page 11 and 12: concentric domains that span proxim
Page 13 and 14: Taking its cue from the above frame
Page 15 and 16: The rising cost of healthcare can h
Page 17 and 18: This emerging phenomenon of ‘hier
Page 19 and 20: day workshop in Hyderabad in late A
Page 21 and 22: Profile of the study area: Key indi
Page 23 and 24: stable, Uttar Pradesh continues to
Page 25 and 26: Village Village 1 UP Village 2 UP V
Page 27 and 28: SECTION TWO: THROUGH THE LIFE CYCLE
Page 29 and 30: implicated, wholly or partially, in
Page 31 and 32: women. Since, most children began t
Page 33 and 34: families… The incidence of low bi
Page 35 and 36: Box 4: Devdasi woman of Karnataka K
Page 37 and 38: odies. Running noses, skin rashes a
Page 39 and 40: low, as is knowledge about the link
Page 41 and 42: Box 7: Glimpse of healthcare facili
Page 43 and 44: years, in our sample, suffer from e
Page 45: Measurements taken in the course of
Page 49 and 50: Box 10: The Aanganwadi worker of th
Page 51 and 52: other services (looking after the c
Page 53 and 54: women who are pregnant and those wh
Page 55 and 56: completed primary education, 13 nev
Page 57 and 58: The same issue was reiterated as we
Page 59 and 60: instance, let us take the example o
Page 61 and 62: gradually becoming more common. Wha
Page 63 and 64: desired. In Uttar Pradesh free text
Page 65 and 66: fuzzy. Learning outcomes are integr
Page 67 and 68: discussed earlier, dry rations seem
Page 69 and 70: mixed village pointing to the need
Page 71 and 72: and further fragment the experience
Page 73 and 74: poverty line. The households survey
Page 75 and 76: databases in recent years on the is
Page 77 and 78: and are able to cross the initial b
Page 79 and 80: contrary to current received wisdom
Page 81 and 82: - Height and weight for age an impo
Page 83 and 84: eliable and regular immunisation, m
Page 85 and 86: Table 27: Utilisation of health rel
Page 87 and 88: Aanganwadi worker irregular +++ +++
Page 89 and 90: impedes retention in school is the
Page 91 and 92: for both. Enhancing access without
Page 93 and 94: SECTION FOUR: POLICY IMPLICATIONS A
Page 95 and 96: o While in-service teacher training
Page 97 and 98:
Balwadis of Pratham (Mumbai, Delhi
Page 99 and 100:
and monitoring, poor cold chain mai
Page 101 and 102:
BIBLIOGRAPHY AND REFRENCES 1. Aggar
Page 103:
47. Sundaram, K. 2001. ‘Employmen
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