NUTIRIONAL AND GROWTH STATUS OF PRE-SCHOOL CHILDREN (2-6 YEARS) IN SOME ANGANWADI’S OF BANKHEDI BLOCK, (HOSHANGABAD DISTRICT) M.P.
Dr. Vanmala Buchke (Supervisor)
Swati Rai (Research Scholar)
Abstract- The present research is an attempt to study the nutritional and growth status of pre-school children (2-6 years) of integrated child development service ICDS beneficiaries in Bankhedi block. A sample of 200 children‟s was selected from Bankhedi block of Hoshangabad district. The technique was adopted for sample selection survey method, dietary survey and clinical assessment. Results of the study revealed that awareness and the implementation of services was at satisfactory level as desired by the objectives of ICDS.
Keywords: ICDS, Anganwadi, Nutritional status, Pre-school education.
1 INTRODUCTION
When health improves, life improves by every measure. We have to take the responsibility of the future in terms of making the world a „Better place‟ health wise and other wise. India being the second largest populated country in the world, and with a multitude of health problems encompassing both communicable and non communicable diseases and other public health related problems. India‟s burden in terms of maternal, new born, and child mortality is one of the highest in the world. India has witnessed significant changes in public health, despite signify can‟t achievements in some areas. There remain many public health issues that are of immediate concern. India has one of the highest percentages of the severe malnourished children‟s in the world along with Sub- Saharan Africa region.
The Government of India initiated the Integrated Child Development Service (ICDS) scheme on experimental basis from 2nd October 1975 to reduce the level of infant and child mortality rates. Today ICDS represents one of the world's largest programmes for early childhood development. The main objective of this programme is to cater to the needs of the development of children in the age group of 0-6 years. It is one of the largest child care programmes in the world aiming at child health, hunger, malnutrition, pre- school education and it‟s related issues.
ICDS services are provided a vast network of ICDS centers, it is known as
“Anganwadi”. Under the ICDS scheme, one trained person is selected to focus on the health and educational needs of
children age 0-6 years this person is the Anganwadi worker (AWW). The Anganwadi worker is a community based front line voluntary worker of the ICDS programme.
The Integrated Child Development Service (ICDS) scheme is utilized to help the family especially mothers to ensure effective health and nutrition care, early recognition and timely treatment of ailments. Integrated Child Development Service Scheme is a unique programme, which encompasses the main components of human resource development, namely - health, nutrition and pre-school education. The National Policy for children adopted in 1974 has emphasized the need to accord priority to children, in the country's developmental efforts. The objectives of the program are achieved through an integrated package of services including supplementary nutrition, immunization, health check-ups, referrals, non-formal preschool, and health and nutrition education. This integrated approach is delivered through Angadwadi centers located in poorer areas that are most in need of primary health care and nutrition. The program is coordinated at the village, block, district, state and central government levels. The primary responsibility for implementation lies with the Ministry of Women and Child Development. Although the ICDS scheme is the largest early childhood development program in the world, its success in achieving its primary goal of reduction in child malnutrition has remained uncertain. While the program intends to serve those most in need, there seems to be a gap between program objectives and
implementation; even though the ICDS budget was 1.5 billion dollars in 2008.
The policy statement focuses on preventive and promotive aspects of child health and nutrition for expectant and nursing mothers. It aims to provide adequate services for children both before and after birth and throughout the period of growth to ensure their full physical, mental and social development. The nations of the world are ranked according to their achievements in fulfillment of child rights and progress for women. A majority of children live in impoverished economic, social and environmental condition, which impedes their physical and mental development. Recognizing the Indian government has been greatly concerned about safeguarding and enhancing the development of children particularly those from the weaker sections of society. ICDS therefore takes holistic view of the development of the child and attempts to improve both his/her prenatal and postnatal environment. Accordingly, besides children in their formative years (0-6 years), women between 15 to 45 years are also covered by the programme as these are child bearing years in the life of a women and her nutrition and health status has a bearing on the development of the child. Welfare services for the young child therefore, have become an integral part of the country's developmental plans, At the heart of these lies the Integrated Child Development Services Scheme.
Children's development can be enhanced with appropriate timely and quality programme that provide positive experiences for children and support for parents. Early care and nurturing have a decisive and lasting impact on how children grow to adulthood and how they develop their ability to learn and their capacity to regulate their emotions.
Reasonable learning opportunities provided during the Early Childhood years are crucial for the development of Intellectual. Two environmental factors have the greatest effect on the child's intellectual development. These are nutrition and stimulation, serious and prolonged deprivation of these during early childhood years result in almost permanent damage to intellectual growth.
Social development is the acquisition of
the ability to behave in accordance with social expectations. The forms of social behavior necessary for successful social adjustment appear and begin to develop at this age. The entire development of the child is very much influenced by its social contact. Physical development applies to all aspects of growth of human organism.
Early childhood represents a remarkable period of physical and motor development. Physical development influences the child's behavior directly or indirectly. Directly it determines what the child can do and indirectly it influences his attitude towards himself and others.
Physical growth influences behavior, thoughts, attitudes, ideals, emotional reactions and activities.
The combination of economic growth, agricultural surpluses, and a slew of programmes aimed at increasing access to food might be expected to yield more than a modest decline in child malnutrition. To begin to unravel this puzzle, we examine the functioning of the ICDS programme, which seeks to directly provide nutritional supplementation and pre-school education to children in need.
Given the importance of the programme‟s objectives and the size of the budget, it is important to assess whether it is effective in its main objective of enhancing child nutritional status.
1.1 Objectives of the Study:-
1. To know about the impact of the programme.
2. To improve the nutritional status of pre-school children.
3. To know about the growth development status of pre-school children.
2 REVIEW OF LITERATURE
McElroy et al (1979); Pelto et al 1999.
The UNICEF conceptual framework is an ecological model, applicable globally, as it encompass factors not only at the individual level but also recognizes community, organizational and political factors, and their interaction to influence child health.
Ajjaz R. (1987)A study was conducted on baseline survey and repeat survey to evaluate the extent of coverage of the target group and the impact of the Integrated Child Development Services (ICDS) program in 8 blocks comprising 3
rural, 3 tribal, and 2 urban units in the States of Karnataka, Rajasthan, Nagaland, and the Union Territory of Delhi (India). 310 families were interviewed to determine their opinion of the program. Supplementary nutrition was provided to children below age 6 and nursing and expectant mothers from low income families. The study results showed that awareness among the 310 families interviewed regarding the benefit of the schemes was poor, but 81% who reported supplementary feeding helped to increase the growth among children. The study conclude that the nutrition and health education was to be given to all women 15-45 years. Awareness about health and nutrition education was very low among the surveyed households.
Sengupta B. et al (1998) A study was conducted at an Integrated Child Development Services (ICDS) Scheme project in North Calcutta among 656 mothers having children less than 3 years of age to assess their perception and practice regarding pulse polio immunisation (PPI). It was revealed that 91.8% of under 3-year children received PPI on 9-12-1995 and 94.4% on 20-1- 1996. Major reasons for not accepting the services on those two days included 'mothers unaware' (22%), 'child too small' (30.5%), etc. Major source of first information was television (TV)/radio (57.2%) followed by anganwadi workers (AWWs) (33.8%). However, majority of the mothers were finally motivated for PPI by AWWs (58.8%) followed by the role of TV/radio (34.1%). The study results shows that a 70.7% mothers knew the name of the vaccine correctly, only 3.5%
mothers could tell the exact purpose of its administration. Most mothers (73%) opined that 2 drops of oral polio vaccine (OPV) was administered to their children and only 14.6% hoped that such programmes will be conducted by the Government in future.
Engle et al., (1999) It recommends various indicators and assessment strategies to measure various constructs listed in the framework within the cultural context and recommends to measure variability within as well as between the cultures with regard to these constructs.
Aruna et al (2001); P. L. Engle et al. 2000 The framework suggests that apart from the immediate determinants of child‟s nutritional status, like child‟s dietary intake or morbidity, there are the underlying determinants namely maternal care and feeding behaviors, in addition to food security, health care services, and a healthy environment, which are critical for children's survival, growth and development.
Gillespie et al (2002) Child care has received important attention in recent years, since the relation between income per capita and child nutritional status was found to be less significant than expected.
Vanisha S. et al. The average Indian child has a poor start to life. Both infant and under-five mortality rates for Indian children is 67 and 93 respectively, it is higher than the developing country on average. One in four newborns is underweight. Only about one in three is exclusively breastfed for the first six months. Nearly one in two children under five years of age suffer from moderate or severe malnutrition. One in three children does not get a full course of DPT (diphtheria, pertussis and tetanus immunization), and only one in three has the opportunity to be in an early learning programme. Just about one in five is protected against vitamin A deficiency.
3 RESEARCH METHODOLOGY
The present study was undertaking to evaluate the nutritional and growth status of pre-school children (2-6 years) of ICDS beneficiaries. This study deals with the method and procedure that was adopted to conduct the present study. The present study conducted in Bankhedi block (Hoshangabad district) was selected and it‟s ten anganwadi centers were chosen for this study purpose. Two hundred children were selected from anganwadis, the children were chosen from 2-6 years.
The study was conducted by totally survey method, dietary survey and clinical assessment. Dependent and independent variables were used and statistical tools were used in the study such as mean, correlation, chi-square etc.
4 FINDINGS
1. Age-wise distribution of children
Table 1 Age-wise distribution of children
Age-group
(years) Frequency Percentage (%)
2-4 51 25.5
4-5 102 51.0
5 and above 47 23.5
Total 200 100.0
Age-wise distribution of children shows that more than 25.5 percent children were of age-group 2-4 years and 51.0 percent children were of age-group 4-5 years. 23.5 percent children were belonged to 5 and above age-group.
Children of 4-5 years age-group actively participate in anganwadi.
2. Nutritional status wise distribution of children (2-6 years)
Table 2 Nutritional status wise distribution of children Nutritional
status Frequency Percentage (%)
Normal 92 46
Moderate acute malnutrition
76 38
Severe acute
malnutrition 32 16
Tota l
200 100%
Nutritional status wise distribution of children shows 46 percent of children were at normal state, and 38 percent of children were at moderate acute nutritional state whereas, 16 percent of children at severe acute malnutrition state.
3. Religion-wise distribution of children
Table 3 Religion-wise distribution of children
Religion Frequency Percentage (%)
Hindu 169 84.5
Muslim 29 14.5
Sikh 2 1
Christian 00 00
Total 200 100.0
This table shows that 84.5 percent children were belonged to Hindu Family, where as 14.5 percent children were belonged to Muslim Family. 1 percent children Sikh and there is not a single child were belonged to Christian Family.
4. Distribution of children on the basis of number of meal per-day
Table 4 Distribution of children on the basis of number of meal per-day Particulars Frequency Percentage
(%)
Twice 165 82.5
Thrice 35 17.5
Total 200 100.0
Table 4 depicts that Distribution of children on the basis of number of meal per-day 82.5 percent children were taking meal twice where as 17.5 percent children were taking meal three times a day.
5 CONCLUSION AND DISCUSSION On the basis of summarize result in respect of nutritional and growth status of children, It was concluded that-
The ICDS programme has get beneficial effect on its subjects due to its integrated approach of nutrition intervention and education. Doubtless increased work efficiency of workers coupled with enough supplementation of diet to beneficiaries would have way to absolute success of ICDS programme. The quantity of supplements given to children seems to be good to substantiate the normal growth pattern. Low nutritional status of the ICDS children was because of low socio-economic, religious status, and illiteracy, lack of knowledge, absence of children.
Overall, levels of child malnutrition have fallen slowly in India during the 1990s, although this was a decade of fairly rapid growth in all sectors of the economy. The main gains in nutritional status have been amongst the upper socio-economic groups the high incidence of underweight amongst the children of the highest socio-economic groups (with adequate per capita nutritional intake) indicates that exposure to disease is a major cause of poor child growth, and that the later cannot be attributed solely to poverty. The ICDS programme to focus more efforts on improving environmental hygiene and child feeding practices, in order to improve child nutritional outcomes. The programme currently places heavy emphasis on supplementary feeding, which has been found to be ineffective in many large-scale programmes.
Nevertheless, many studies have highlighted problems with the implementation of the ICDS programme,
which would limit its impact and are consistent with our result.
In sum, we find that the ICDS programme is meeting its goals of reducing child malnutrition in India.
Some modifications are also needed towards this end. Firstly, programme coverage and fund allocation need to be shifted towards states with the highest prevalence of child malnutrition.
Secondly, efforts have to be made to ensure that funds are fully utilized in the few states where this is not the case.
Thirdly, the impact of the programme on recipients can be enhanced by changing some aspects of programme design and implementation. With such changes, the substantial resources allocated to the ICDS can be used more effectively for raising future generations of healthy children. And also there is a strong and intense need for improving the training quality provided to anganwadi workers before letting them go into the field jobs.
REFERNCES
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3. Engle, P. L., Menon, P., & Haddad, L.
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4. Gillespie, S., & Allen, L. (2002). What works, and what really works. Public Health Nutr, 5(4), 513-514.
5. Gillespie, Stuart and Lawrence Haddad (2001) „Attacking the Double Burden of Malnutrition in Asia‟. ADB Nutrition Development Series No 4. Manila: Asian Development Bank and IFPRI.
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