Evaluation of the Integrated Child Development Services Scheme in a Hilly Tribal District of Manipur: A Cross-Sectional Study

Abstract

Introduction: The Integrated Child Development Services (ICDS) Scheme, the largest program for promotion of maternal and child health nutrition in India, is operational for more than four decades. Objective: To evaluate Integrated Child Development Services Scheme in Kangpokpi District of Manipur in terms of input, process and outcome indicators. Method: A community-based cross-sectional study was conducted at a tribal hilly district of Kangpokpi in Manipur. The study included ICDS staff and beneficiaries of 35 randomly selected Anganwadi Centres (AWCs). Data related to ICDS was collected by using interview schedules and checklists. The descriptive data were expressed in terms of mean, standard deviation and percentage. Association between important background characteristics and Anganwadi centre attendance was analysed using chi-square test. Ethical clearance was obtained from the institutional Ethic Committee of JNIMS, Imphal before conducting the study (study period: May 2018 to April 2021) Results: Input indicators: The study found that86% anganwadi centres were run in anganwadi worker’s own house. Two-thirds of the anganwadi workers (65.7%) were found to have separate toilet and 22.9% had separate kitchen. Process indicators: Even though the proportions of beneficiaries accessing services from anganwadi centres were high, the number of days Supplementary Nutrition (SN) was provided in a month was comparatively low (mean: 2.97 and SD: 0.618 for under-6 children and mean: 1 and SD: 0.000 days for adolescent girls, pregnant women and lactating mother in a month) due to frequent interruption of supplementary nutrition supply. There was no supplementary nutrition stock in 74.3% of the anganwadi centres on the day of visit. Outcome indicators: Regarding the nutritional status 90% of Under-6 children were found to be normal, 9% underweight and 0.6% severely underweight. Conclusion: The Integrated Child Development Services Programme in the study area was found to have several short-comings both in terms of inputs and process. There were not only inadequate facilities and infrastructure, but the anganwadi centres also lacked essential equipment like weighing machines and medicine kits, rendering a vital activity like growth monitoring to be almost completely absent. Supervisory visits were far below satisfactory.