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ThePratichiChild ReportA STUDY ON THE DELIVERY OF ICDSIN WEST BENGAL

WITH A FOREWORD BY

AMARTYA SEN

NUMBER 1 2009PRATICHI (INDIA) TRUST

4 THE PRATICHI CHILD REPORT

The Pratichi Child Report : A Study on the

Delivery of ICDS in West Bengal with a foreword by Amartya Sen

First Published February 2009

© Pratichi (India) Trust

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Photo credit : Pratichi Research Team

Cover design : Manoj Dey

Printed at S. S. Print, Kolkata 700009

DELIVERY OF ICDS IN WEST BENGAL 5

ThePratichiChild ReportA STUDY ON THE DELIVERY OF ICDSIN WEST BENGAL

With a foreword byAmartya Sen

Edited byKumar Rana and Achin Chakraborty

Research TeamField investigation and analysisKumar RanaSantabhanu SenMoumita KunduTapati BanerjeeSubhrangsu SantraMalasree DasguptaArabinda Nandy

Administration and logisticsSaumik Mukherjee


CONTENTS

Foreword

Preface

1. Introduction 17

2. The ICDS Programme in West Bengal: An Overview 23

3. Study Area and Methodology 33Study AreaMethodology

4. Infrastructure and Human Resources: Field Observations 41InfrastructureHuman Resource

5. Implementation of the ICDS 55Supplementary Nutrition ProgrammePre School Education (PSE)ImmunisationHealth ServicesNutrition and Health EducationKishory Shakti Yojona (KSY)Functioning of the ICDS CentresSupervision and Monitoring

6. Scope and Challenges 75

References 83

Appendices 85A. State-wide secondary data tablesB. Data tables on responses from fieldC. Persons (other than selected respondents) met


List of Tables, Figures and Boxes

Tables

Table 1.1 ICDS projects and coverage in West Bengal and India 20Table 2.1 Certain key Indicators for West Bengal from the three 23

rounds of NFHSTable 2.2 Trends in coverage of the ICDS programme 26Table 2.3 Break-up of the allocation of SNP: per child per day 28Table 2.4 Block wise requirement and supplied ingredients for 29

feeding in the last year (in quintal) (2005-6)Table 3.1 Basic statistics at a glance 35Table 3.2 Select indicators of women and child health services 36Table 3.3 Number of beneficiaries of ICDS in the sample districts 37Table 3.4 Districts and Blocks selected for the study 37Table 3.5 Sample centres and the total number of beneficiaries 39Table 4.1 Ownership status of the buildings of ICDS centres 42Table 4.1a Proportion of ICDS centres having own buildings 42Table 4.2 Condition of buildings of the centres studied 43Table 4.3 Equipments necessary for an ICDS centre 45Table 4.4 Centres with necessary arrangements 46Table 4.5 Posts of AWW and AWH lying vacant in the studied projects 48Table 4.5a District-wise posts of AWW and AWH remaining vacant 49Table 4.6 Distance travelled by AWW to reach the centre 49Table 4.7 Social identity of the Anganwadi Workers 50Table 4.8 Status of posting of Supervisors 52Table 4.9 Status of posting of CDPOs 53Table 4.10 Status of posting of ACDPOs 53


Table 5.1 Regularity in the supply of supplementary nutrition 56Table 5.2 Major shortage of ingredients 57Table 5.3: Supplying of eggs 57Table 5.4 Quality of the food 58Table 5.5 Priorities regarding the activities of the centre – 61

mothers’ viewTable 5.6 Delivery of pre-school education: mothers’ response 62Table 5.7 Attendance of the children (3-6 yrs) 63Table 5.8 Weighing efficiency of different districts 65Table 5.9 Types of services provided by the ICDS 69Table 5.10 Frequency of visits of the supervisors 73

Figures

Figure 2.1 Child undernutrition in India and West Bengal: 1992-3 and 2004-5 24

Figure 2.2 Progress of ICDS projects in West Bengal (Sanctioned) 26

Figure 2.3 Growth of Anganwadi Centres in West Bengal 26

Figure 2.4 SNP coverage 28

Figure 5.1 Weighing efficiency of the studied projects 65

Figure 5.2 Weighing of children – mothers’ response 66

Boxes

Box 2.1 Operational system of the ICDS programme 25

Box 4.1 Swimming in the mud 44

Box 4.2 The helping hand 54

Box 5.1 Penalty of raising voice 60

Box 5.2 Main issues supposed to be discussed in the NHE sessions 68

Box 5.3 The self-inspired worker 74

Box 6.1 Officers’ concern 80


Abbreviations

ICDS Integrated Child Development Services

A W C Anganwadi Centre

AWW Anganwadi Worker

AWH Anganwadi Helper

SNP Supplementary Nutrition Programme

CD Block Community Development Block

DPO District Project Officer

CDPO Child Development Project Officer

ACDPO Additional Child Development Project Officer

NFHS National Family Health Survey

SSK Sishu Siksha Kendra

AOWBJSWS Association of the Officers of the West BengalJunior Social Welfare Service

ANM Auxiliary Nursing Midwives

PHC Primary Health Centre

BPHC Block Primary Health Centre


FOREWORD

AMARTYA SEN

Nothing is as important for the well-being of a society as the condition of the children.And yet children’s nutrition, health, education and happiness are among the most neglected

subjects in India. The ICDS (Integrated Child Development Services) is a country-wide publicinitiative to correct that wrong, to reverse this shameful neglect. Various provisions in the ICDSapproach do indeed have much promise, but it is not altogether clear how much of that promiseis being met. The reports coming in from various parts of India show wide disparities inperformance, and while a few states (such as Tamilnadu) have achieved a lot, others have failedfairly comprehensively.

As in many other fields of social action, here too West Bengal comes somewhere inbetween the highest achievers and the low performers, with good results in some respectsand middling to bad in others. The study is a systematic attempt to evaluate, throughsample studies, how much is being achieved, what is working and what is not, howexactly the successes and failures come about, and what can be done to make the importantgoals of the ICDS better pursued and more fully achieved. This is an important studyundertaken by the Pratichi Research Team, and I appreciate the leading role that KumarRana has played, with the assistance of his colleagues in the team, to make this study asuccess.

There are lessons here, including the need for better integration of the work of theICDS with the human resources that the village communities have. The shortcomings donot invariably relate to the shortage of available funds (though in some cases that plays a


crucial role). There is need for organizational change and for making the arrangements morelocally informed, rather than globally theorized. The value of the study lies only partly in thefindings of achievements and failures – it lies at least as much in the policy recommendations thathave emerged.

It is very important to make the working of ICDS more efficient, more equitable andmore humane. The Pratichi Trust is eager to present these research findings for publicdiscussion (like the previous ones, in other fields, presented by us), and we hope thatthrough informed public discussion, we should be able to contribute to policy changesthat could make our children be better off today and more capable tomorrow. We have torise to the enormity and the urgency of that challenge.

10 February 2009


Preface

The nutritional status of the Indian children, as it is revealed by the latest round ofthe National Family Health Survey data, is rather distressing, despite the fact that India has

had a massive intervention programme in place for more than three decades now in order tocombat nutrition deprivation among children under the age of six years. The Integrated ChildDevelopment Services (ICDS), the Indian state’s answer to the challenges of undernourishmentamong children, is remarkable in its scope; and one would have little doubt about its potentialto achieve the goals envisaged at the time of its implementation in 1975. However, it nowbecomes apparent that the impact of the programme has been rather modest, as it is evidentfrom the persistence of high levels of undernutrition among children. Quite a few studies haverecently come out which throw some light on various aspects of the ICDS programme and thevarying degrees of success in implementation of the programme in different states of India. Thevariety of experiences of the programme in different states, which these studies bring forth,prompted us to embark on an in-depth study of the ICDS in West Bengal.

The study was carried out by the Research Team of Pratichi (India) Trust. Founded in 1999by Professor Amartya Sen, the Trust has been engaged in carrying out research in the areas ofprimary education, basic health, gender equality and related areas with the aim of informing andinfluencing the policy discourse. One can only hope that the wide dissemination of the researchresults would generate debates and discussions in the public sphere, which in turn wouldimprove the state of affairs. The role of public action in improving the lives of people can hardlybe overemphasised. In the specific context of ICDS too we can hardly miss the clear connectionbetween the nutritional status of children and successful implementation of the ICDS programmein Tamil Nadu. Our study identifies certain critical gaps in the implementation of the ICDSprogramme in West Bengal and suggests steps to overcome the limitations. One of theencouraging aspects of the ICDS in West Bengal in the present moment is that the experience ofsuccess with the mid-day meal programme in schools has raised the level of expectation among


the parents regarding the possibility of improvement in the quality of services. As Professor Senhas reminded us, India has a great deal to learn from itself.

We are grateful to Professor Amartya Sen, who has been the main source of inspirationand guiding force behind the study. His keen interests in the study and the extremelyvaluable suggestions that he made at various stages of the preparation of the report havegreatly enriched us. Ms Antara Dev Sen, the Managing Trustee of the trust providedexcellent leadership and tremendous support to the study team. Jean Dreze not onlyshowed keen interest in the study but also made valuable comments and suggestions onthe first draft of the report. Special thanks go to Ms Spurthi Reddy who also made valuablesuggestions on the preliminary draft. The research team is grateful to Jana Sanskriti, agroup of social activists for various kinds of support.

The team has also received help from a wide range of people, including the officials ofthe Department of Women and Child Development and Social Welfare, Government ofWest Bengal, particularly Mr. K.P.Sinha, project officers, anganwadi supervisors, andanganwadi workers and helpers. Swapan Mukhopadhyay and Gautam Ghosh deservespecial thanks for their supports in various ways.


Key Findings

According to the 2001 Census, children below six years of age in West Bengal formed14 percent of the total population as against 16 percent for all-India. Proportions of0-6 children among the disadvantaged groups, namely, Muslims (19 percent),Scheduled Castes (15 percent) and Scheduled Tribes (17 percent) in West Bengalwere higher than the state average. The socio-economic composition of childrenthus adds urgency to the necessity of proper implementation of ICDS to ensureuniversal access to nutrition-related services with assured quality.There has been a positive effect on people’s expectations regarding ICDS, consequentupon the successful launch of the Mid-Day Meal (MDM) programme with increasedemphasis and budgetary allocation, and proper implementation on ground. Prior tothe implementation of the MDM programme, the poor quality food provided in theICDS centres used to be taken for granted. Later, people tended to compare ICDSfood with the much better meal served in the primary schools, which gave rise to thebelief that the performance of the ICDS could also be improved. Thus MDM seemsto have contributed through its successful implementation to strengthening of demandfor improved delivery of ICDS.In spite of the appallingly poor quality of services in some of the AWCs, the poorersections of the children were found to attend them on a regular basis, as the foodthey get formed an important part of their daily intake. Children from relativelyaffluent families, however, tend to abstain from the centres.Apart from nutritional intervention, mothers expressed strong preference for pre-school education of their children through the AWC. They want the centres toprepare their children for primary schools.


Willingness to take part in the delivery of the services by the village community in generaland mothers in particular was observed to be very high. Community ownership of theAWC was also common which manifests in greater community participation.The programme seems to have been facing several challenges, some of which are highlightedbelow :

IRREGULARITY AND INADEQUACY OF SUPPLY

The project level data of supply of rice and other ingredients collected from 10 of the 14projects studied showed that all the projects barring one had suffered from inadequacy of supplyvis-à-vis actual requirement.

POOR PHYSICAL INFRASTRUCTURE

Only 35 percent of the centres studied had their own buildings while the rest were operatedfrom clubs, Verandas of primary schools or Sishu Siksha Kendras (SSK), temples or mosques,common places like atchala (thatch-covered, unwalled construction where village meetings areheld) or simply under the trees.

FRAGMENTED DELIVERY

In most cases the programme was found to be limited to Supplementary Nutrition and Pre-primary schooling leaving the other services aside. Even these two components seemed to excludesections of children. About 50 percent of the mothers complained about the abysmally lowquality of the food served in the centres, 28 percent mothers expressed resentment about theabsence of the PSE, about 46 percent said that weighing of their children was not done, above 70percent said that no medicine was provided and 91 percent reported that they were never invitedto meetings.

VAST UNCOVERED AREA

According to the data provided by the Department of Women and Child Development andSocial Welfare the total number of ICDS centres in the state was 88086, which covered nearly 50percent of all children eligible leaving out a large number of children who needed the benefits ofthe services.

INADEQUACY AND UNEVEN DISTRIBUTION OF STAFF

While there was a general shortage of staff noticed across the projects the uneven distributionof the staff had probably made things worse. This clearly led to the poor functioning of theprogramme as often the workload of the concerned staff becomes so heavy that she cannoteffectively deliver services in spite of her best efforts.


HEAVY WORKLOAD OF ANGANWADI WORKERS (AWW) AND ANGANWADI HELPERS (AWH)

The AWWs are often found overburdened with multiple tasks. Almost all AWWs andAWHs complained of additional workload due to various government programmes whichdepend heavily on them for implementation, such as, sanitation campaign, facilitation of self-help groups, collection of village level data, various public health related programmes etc.

POOR COORDINATION BETWEEN HEALTH AND SOCIAL WELFARE DEPARTMENT

There seemed to be a lack of coordination between various departments involved inthe maternal and child health programmes. It was observed that the areas where thecoordination between the concerned departments could effectively be established theoutcome was also quite satisfactory.

LACK OF SUPERVISION

Supervision of AWCs’ functioning seems weak in general. Only 29 percent centreswere reportedly visited by Child Development Project Officers (CDPO) in the yearprior to the survey. 18 percent of the centres were not even visited by supervisors, whowere supposed to be the main link between the centres and the project.

LACK OF TRAINING

The workers and helpers often complained that they found themselves helpless onmany occasions as they hardly had any training to handle particular situations. Theservices they are supposed to deliver range from health, nutrition and education toadministrative affairs (keeping accounts, maintaining registers, etc) and publiccommunications.

LACK OF PUBLIC PARTICIPATION

The willingness of the mothers to take part in the functioning of the programme is insharp contrast with the complete absence of any space for effectively utilizing thisexpressed desire. Only 3 percent of the mothers were aware of any centre specificcommittee. There are no mothers committees, nor are there any other public committeesto supervise the centres. Thus, public participation in the ICDS programme is almostnon-existent.


1. IntroductionTHE CHALLENGE OF PERSISTENT CHILD UNDERNUTRITION

The National Nutrition Policy (1993) observed that “widespread poverty resulting inchronic and persistent hunger is the single biggest scourge of the developing world

today. The physical expression of this continuously re-enacted tragedy is the persistentunder-nutrition, which manifests itself among large sections of the poor, particularlywomen and children.”1 According to the latest round of the National Family HealthSurvey (NFHS III, 2004-05) every second child in India is undernourished.2

A good deal of research has been undertaken in recent years to understand thedeterminants of undernutrition among children. Poor nutritional status can be the outcomeof either inadequate nutritional intake or infections and parasitic diseases that often preventthe child from absorbing nutrients. These two can often act together and reinforce theeffect of each. A low level of nutritional intake makes the child vulnerable to infections,which in turn prevents absorption of nutrients. The consequence of persistentundernourishment is slow physical and cognitive growth of the child. There is a relationshipbetween poverty, hunger and child undernutrition, but there are also other related factorssuch as poor access to health care, asymmetry in gender relationship, education, age andworking status of mothers. While undernutrition among children limits the developmentand capacity to learn, its prevalence among mothers adversely affects the health of children,their ability to learn and educational attainment. It also costs lives. The risk of death forcommon childhood diseases is strongly associated with the degree of undernutrition.About fifty percent of all childhood deaths in India could be attributed to undernutrition.The first National Family Health Survey (NFHS I) in 1992-93 found a strong correlation(0.71) between estimates of child mortality and child undernutrition.3 These problemsare particularly acute in India and South Asia in general. As Amartya Sen pointed out,


…actual under-nourishment seems to be much higher in India than in Sub-Saharan Africa.Judged in terms of the usual standards of retardation in weight-for-age, the proportion ofunder-nourished children in Africa is 20-40 percent, whereas the proportion ofundernourished children in India is a gigantic 40-60 percent. About half of all Indianchildren are, it appears, chronically undernourished. While Indians live longer than sub-Saharan Africans, and have a median age-at-death much higher than Africans have,nevertheless there are many more undernourished children in India than in sub-SaharanAfrica – not just in absolute terms, but also as a proportion of all children. If we add to itthe fact that gender bias at death is a substantial problem in India, but not so in sub-Saharan Africa, we see a picture that is much less favourable to India than to Africa (Sen,2000).

The relationship between health and poverty is multifaceted and multidimensional.Poverty could be a manifestation as well as determinant of an individual’s health. While,according to standard economic criteria, poverty has declined in India and other SouthAsian countries, deprivation levels in terms of human development indicators remainextremely high, and this applies in particular to nutrition, with nearly 50 percent ofIndian children under five being moderately or severely underweight. Undernutrition isconsiderably higher among the underprivileged social groups living in rural areas – in thedrought prone pockets, in particular – and in urban slums than among the more affluentclasses and higher castes.

The proportion of underweight children (under 3 years) in India dropped by less thanone percentage point per annum between 1992-93 and 1998-99 (from 52 to 47 percentaccording to NFHS I and II) and in the next seven years (from 1998-99 and 2005-06) thetotal reduction has been only a meagre one percentage point (from 47 to 46). This is inclear contrast to the target set by the tenth five-year plan (2002-07), which had envisaged areduction of undernutrition from 47 percent to 40 percent.

However, there are wide inter-state variations in the incidence of undernutrition inIndia. In Punjab the percentage of undernourished children is 27, whereas in MadhyaPradesh the percentage is 60. Four states, viz., Punjab, Kerala, Jammu & Kashmir andTamil Nadu are among the best performers, whereas Madhya Pradesh, Jharkhand, andBihar are among the worst. Even within the states there are disparities between differentsocio-economic groups. Rural areas lag far behind their urban counterparts in terms ofprevalence of undernourishment.

THE ICDS PROGRAMME

The persistent high levels of child undernutrition in India, which we discussed brieflyin the last section, have to be analysed in the context of the policies and programmes thatthe Indian state has pursued to improve the condition. The ICDS is one of the largestintervention programmes in the world designed specifically for the welfare of childrenunder the age of six years. The programme came into existence in 1975 following theNational Policy for Children (1974) that emphasised the importance of intervention for


balanced physical and mental development of children. It was also based on the realisation thatall the basic services crucial for overall development of the child — nutrition, health, and education– had to be provided to children simultaneously. The ICDS programme thus adopted an integratedapproach to delivery of services for child well-being, incorporating nutritional and healthinterventions and pre-school education. The programme is implemented through a network ofAWC. In each AWC there is a worker and a helper who provide the services.

The ICDS programme was designed with the following objectives:To improve the nutritional and health status of children in the age group of 0 to 6 years;To lay a foundation for proper psychological, physical and social development of the child;To reduce the incidence of mortality, morbidity, malnutrition, and school drop-out;To achieve effective coordination of policy and implementation amongst the variousdepartments to promote child development; andTo enhance the capability of the mother to look after the normal health and nutritionalneeds of the child through proper nutrition and health education.

To realise the above goals the central government made a beginning with the launching of 33projects (in as many CD blocks) across the country (including two projects in West Bengal). As of29th February 2008 this has expanded to 6068 projects, which include 1010912 operational AWCs.The coverage of these AWCs has extended to 83 million beneficiaries including 68.5 millionchildren below 6 years and 14.5 million pregnant and lactating mothers.4 The institutionalarrangement to materialise the policy objectives of ICDS is under the Women and Child WelfareDepartment, Government of India.

The ICDS programme has recently been under public scrutiny following a series of writingsby scholars and activists on the functioning of the programme5 . Responding to Public Interestpetitions, the Supreme Court intervened by issuing various orders from time to time.6 On28.11.01, the Supreme Court directed the government to ensure that every settlement has afunctional AWC, and that ICDS is extended to all children under 6, all pregnant and lactatingwomen and all adolescent girls. This order was reiterated and extended on April 29 and October7, 2004, along with further directions on ICDS. The Supreme Court passed another landmarkjudgment on 13 December 2006 on the population norms for setting up anganwadis for universalcoverage. While the apex court maintains the norm of one AWC per 1000 population, it emphasisesthat an AWC should be set up even for a population of 300 if the nearest centre is far away. TheCourt also emphasises that rural communities and slum dwellers should be entitled to an“anganwadi on demand” (not later than three months from the date of demand in cases wherea settlement has at least 40 children under six but no anganwadi). The population norms havebeen further revised by the Government of India, whereby an AWC shall be set up for every 1000population in general areas, and for every 700 population in tribal and hilly areas. Steps are alsobeing taken to set up ‘mini anganwadis’ to cover isolated settlements with less than 150 inhabitants.These mini anganwadis, however, are supposed to have limited facilities that would provide littlemore than supplementary nutrition to the children and mothers.


Table 1.1 ICDS projects and coverage in West Bengal and India(as on 29th February 2008)

INDIA WEST BENGAL

Operational projects 6068 411

Operational anganwadis 1010912 87665

No of SNP beneficiaries 68552239 5097050(Children aged 6 months to 6 years)

No. of SNP beneficiaries 14538143 808417(pregnant women and lactating mothers)

No. of pre-school beneficiaries (3-6 years) 33061972 2275273

Source: Ministry of Women and Child Development, Government of India (2008).

That the present arrangement is grossly inadequate is beyond any doubt. The NationalAdvisory Council estimated that tripling the coverage and doubling the unit costs, at the veryleast, would be required to accomplish universal coverage of ICDS. This implied raising theannual budget allocation for ICDS to Rs 9,600 crores7 . However, the central government, in itsbudget for 2008-09, increased the amount towards ICDS to Rs 6300 crores from the previousyear’s Rs. 5293 crores. As the Focus on Children Under Six (FOCUS) report indicates, the coverageof the programme has so far been only 25 percent, implying a gross exclusion of three fourthsof the child population with urgent need for these basic services.

The exclusion can be seen as an outcome of the failures of various social agencies8 . While thecentral and state governments are directly responsible for their failures in making the programmeresponsive to the needs of a large number of children, there is apathy among the public ingeneral on this subject, particularly among the more articulate and better off groups of thesociety. The FOCUS report has shown the neglect of these issues by the media, legislature andthe vocal public. In West Bengal, in particular, while people’s representatives have taken up theissue in the state legislature, the media have remained virtually silent on the issues of childdevelopment.

Why this silence? One of the probable reasons is that the poor are not empowered to raisetheir voices, and the upper classes that dominate the policy-making and implementation processesand various social forums have little stake in the programmes like ICDS since their own childrendo not suffer from these deficiencies and neglect as they do not need ICDS services. One of theofficials connected with the implementation of the ICDS programme stated in a meeting that amajor reason behind the poor coverage of the ICDS programme was the reluctance of the well-off parents to send their children to the AWCs. As we have seen in various reports on elementaryeducation, the non-participation and utilisation of government services by the affluent section,as they are able to make alternative arrangements through private schools, hospitals and child-care centres, allows for the non-performance of state services as there is no effective monitoring


by the beneficiaries.As discussed above, voices concerning the issues of neglect have recently gained ground at the

national level, the manifestation of which can be seen in the public interest litigations andconsequent Supreme Court orders. Also there have been studies like the FOCUS report that bringout starkly the seriousness of the issue of delivery of ICDS services. Nonetheless, little work hasbeen done in the eastern part of the country, particularly in West Bengal and the present reportaims to reduce this gap.

STUDY OBJECTIVES AND SCHEME OF THE REPORT

This study aims to assess the status of the ICDS programme in West Bengal andanalyse the reasons for the gap, if any, between the actual performance and the goalsenvisaged by the policy makers. In particular, we try toi. gauge the reach of the ICDS programme in West Bengalii. assess the extent of delivery of various components of the ICDS programme – both

in actual terms and as perceived by the stakeholdersiii. assess the quality of services deliverediv. identify and analyse the constraints faced by the programmev. assess the extent of public awareness and participation in the deliveryvi. understand views of various constituencies – parents, officials, others – on how to

improve delivery of the programme.In Chapter 2, an overview of the ICDS programme in West Bengal has been presented.

An attempt has been made to highlight the achievements, shortcomings and regionalvariations of the programme in the state. The details of the methodology have been discussedin Chapter 3, which also gives a brief description of the six districts, 14 projects, and 28AWWs that we selected for the study.

The functional aspects of ICDS projects (for example, the working of the anganwadis)have been discussed in Chapter 4, which include infrastructure, staff pattern, variousagencies and partners and delivery of supplementary nutrition, pre-schooling,immunisation, health check-up, etc. Some case studies from our fieldwork have beenincorporated in the chapter. In the concluding Chapter 5 attempts have been made to drawan outline of the challenges vis-à-vis the scope of the programme.

Notwithstanding a general silence in the society on the issues of child developmentand ICDS, a small but articulate section of the functionaries involved with the delivery ofthe programme has been active in voicing their concerns. Their thoughts on the problemshave taken shape in the form of deliberations in a seminar organised by the Association ofthe Officers of the West Bengal Junior Social Welfare Service (AOWBJSWS). From thereport on the discussions in the seminar in Bangla we have produced an abridged Englishversion of the document and presented in Appendix 1. The Appendix also contains thestatistical tables and a list of person (other than the selected household level respondents) wehave met during the study.


NOTES

1 Government of India (1993) National Nutrition Policy, Department of Women andChild Development, Ministry of human Resource Development, New Delhi

2 International Institute for Population Sciences (2006)

3 Bhat and Zavier, (1999)

4 Ministry of Women and Child Development, Government of India (1993).

5 See the FOCUS Report (Citizens’ Initiative for the Rights of Children under Six,2006), Gragnolati et al (2006) and the Special Issue of Economic and Political Weekly(August 26-September 1, 2006) on ICDS.

6 PUCL vs. Union of India and Others, Civil Writ petition 196/2001.

7 Sinha (2006)

8 Sen (2007)


2. 2. 2. 2. 2. The ICDS Programme inWest Bengal: An Overview

The recently released findings of the National Family Health Survey III (2005-6) showthat the percentage of children in West Bengal who are undernourished is still rather

high, even though it has declined a bit faster than the all-India average in the recent period.As a matter fact, West Bengal’s success in reducing child undernourishment has beenrather mixed. While in terms of two indicators, viz. the percentage of stunted and thepercentage of underweight, the incidence if undernourishment has somewhat come down,in terms of the indicator of ‘wasting’ it seems to have increased (Table 2.1).

Table 2.1: Certain key indicators for West Bengal from thethree rounds of NFHS

NFHS - III NFHS-II NFHS –I(2005-06) (1998-99) (1992-93)

Children under 3 years who are stunted (%) 33 41.5 NAChildren under 3 years who are wasted (%) 19 13.6 NAChildren under 3 years who are underweight (%) 43.5 48.7 54.8Women whose Body Mass Index is below normal (%) 37.7 43.7 NAChildren age 6-35 months who are anaemic (%) 69.4 78.3 NAEver married women age 15 - 49 who are anaemic (%) 63.8 62.7 NAPregnant women age 15-49 who are anaemic (%) 62.6 56.9 NA

Even though in West Bengal the percentage of children who were underweight washigher than the all-India average in 1992-93, it has declined faster and surpassed the all-India figure in the thirteen years that followed (Figure 2.1).


Figure 2.1 Child undernutrition in India and West Bengal: 1992-3 to 2004-5

(Percentage of children under 3 years who are underweight)

Source: NFHS I, II and III

The ICDS, however, follows a different methodology to assess the nutritional status,which divides the children into five different categories based on weight-for-age data, viz.Normal, Grade I (mildly malnourished), Grade II (moderately malnourished), Grade IIIand IV (severely malnourished). The latest (2005-6) data published by the Government ofWest Bengal, however, show that while there has been an overall decline in the proportionof the Grade II children and a slight decrease in the proportion of Grade III and IVchildren over the previous year (2004-5) there have been increases in the proportions ofgrade III and IV children in 9 of the 19 districts, which are worrying (see Appendix B,Table 1 for details).

To quote from a background paper for a seminar organised by an association of thejunior officials involved in implementation of ICDS, “…however much we boast of thesuccess of the ICDS in our state the facts that have emerged from the indicators [of theNFHS III] show that the failures are also very glaring and the state government is alsoequally responsible with the Indian government.”1

In line with the national declaration and subsequent implementation, the West BengalGovernment had also launched the ICDS programme in 1975. The Department of Womenand Child Development and Social Welfare was assigned the task of implementation ofthe programme. While the department itself was responsible for the policy part of theprogramme a Directorate under the said department was given the responsibility ofimplementing the programme.

The Project Officers were posted at the district and block (called ‘project’) leveloffices to oversee the implementation process. Supervisors at the block level were postedto coordinate the programme at the AWC level. The actual delivery points are the AWCswhich are supposed to be run by one AWW with the assistance of an AWH in each centre.Roughly, this is the system that prevails today (Box 2.1).

The modest beginning with two projects providing services to 7000 children and 1000mothers has now flourished to 416 sanctioned projects covering 4 million 0-6 children


and 0.48 million mothers (as on January 31, 2007)2 . The services that the programme includes inits fold are:

Immunization – with the help of Auxiliary Nursing Midwives (ANM)Supplementary Nutrition – to provide cooked food to children and lactating mothersHealth Check-upReferral Services – Hospitals and Health CentresNutrition and Health EducationNon-formal Pre-school Education for the 0-6 children

Health Check-up, again, has four components of direct intervention:Anti-natal and Post-natal Check-up of mothersDetection of Anaemia and other diseasesPrevention of DisabilitiesChild Growth Monitoring through regular weighing and height measurement

Box 2.1. Operational system of the ICDS programme

Minister-in-charge,Department of Women and Child Development and Social Welfare

Government of West Bengal

Secretariat [State Level]

Directorate

District Project Office [District Level]

Project Office [Block level]

Anganwadi Centres [Village level]

THE COVERAGE

The ICDS in West Bengal was launched in 1975 with only 281 AWCs at the beginning,which have multiplied to 88086 during the last three decades. The Central Governmenthas recently sanctioned another 17,512 centres for hilly areas of Darjeeling, the wetlandsof Sundarbans and in the tribal areas across the state with the norm of establishing onecentre for every 350 population.3


It is clear from Figures 2.1 and 2.2 that the maximum growth in both the number of projectsand the number of centres has taken place in the past three years, presumably as a response to theseries of court directives. Between 2005 and 2008 the number of centres increased by 31326, i.e.by approximately 10000 each year, whereas in the preceding ten-year period, the number grew byapproximately 1100 per year.

The programme began with a miniscule number of beneficiaries – 7000 children and1000 mothers – in 1975. These figures have also quite predictably increased manifold.There are now nearly 5,100,000 children and 800,000 women (pregnant and lactating)under the programme’s coverage.

Table 2.2. Trends in coverage of the ICDS programme

Children Mothers Children as Mothers aspercentage of total percentage of total

beneficiaries beneficiaries

1975 7000 1000 87.5 12.51985 720000 64000 91.8 8.21995 1800000 204000 89.8 10.22005 3800000 450000 89.4 10.62007(January) 4000000 480000 89.3 10.7


Nevertheless, the sharp increases in the number of projects, centres and beneficiaries have notyet reached the desired level to meet the actual requirement for universal coverage. According tothe Government of West Bengal sources, the programme has not yet been able to extend allservices to even half of the eligible children and mothers.1 The reasons behind the failure inreaching all the eligible children and mothers, as stated by the government officials, are (a) thedifficulty faced by children in accessing the centres, (b) affluent groups’ reluctance to receive thebenefits, and (c) the difficulty of working mothers to access the centres as their working hours (forpaid employment) do not allow them to take their children to the centres.2 However, thedepartment officials do not seem to be ready to recognise the problem of the shortage of centresas a serious one.

Along with the overall inadequacy of the number of centres, the reach of the programmeseems to be constrained by some particular regional conditions. While the coverage figuresfor West Bengal (see Appendix B, Table 2 for details) give us a sharp inter-district variation,the data provided by the concerned authorities of some of our study districts bring out theintra-district (inter-project) differences in a better way (see Appendix B, Table 3 for details).We focus here on the districts that we had selected for our study3 . While in some of theprojects the coverage of the eligible children is as high as 63 percent (as in Bhagabangola Iof Murshidabad district), in some other projects, as in Hili and Gangarampur of DakshinDinajpur, it is much lower – only about one fourth of the children are provided with theservices. Again, while Bhagabangola I has 63 percent coverage, Nabagram of the samedistrict has been able to bring in only 50 percent of the total eligible children. While thecoverage in Manteswar is 50 percent it is much less (37 percent) in Ausgram II.

ACTUAL IMPLEMENTATION

The actual implementation of the programme, as can be seen from the inter-projectofficial data collected from the studied districts, has been affected not only by the overallshortages in terms of meeting goals but also by large regional variations. Let us first see thegaps between the number of AWCs sanctioned and the number actually in operation.While the sanctioning of the centres has been done in order to match the norm of serving1000 population in general and 350 in special cases (in hilly and tribal areas), the actualnumber of operational projects has fallen short of the norm. In most of the cases so far, theaverage population covered by each AWC has far exceeded the desired number (SeeAppendix B, Table 4 for details). This general deficiency is further exacerbated by regionalvariations. To take an example, while the condition of Mal of Jalpaiguri is somewhatcloser to the declared policy norm (1260 population under each AWC) the condition ofMadarihat in the same district is much worse (1783 population under each AWC).

The programme is deficient not only in terms of coverage vis-à-vis the target beneficiariesbut also in terms of actual delivery of services. The Supplementary Nutrition Programme(SNP) is one of the major components – in many cases the only component – of theprogramme. Yet the proportion of beneficiaries served under this programme is appallinglylow. The regional contrasts in the implementation of the programme seem to be a major


factor affecting the implementation. Figure 2.3 based on the summarised data on SNP availablefrom some of the district level offices clearly brings out this regrettable condition. While the SNPcoverage (percent of target beneficiaries covered) in Dakshin Dinajpur, one of the most deficientdistricts in terms of the extent of the programme, is as high as 65 percent, it is much less inJalpaiguri, in spite of the latter’s wider coverage of its target beneficiaries.

EXTENT AND QUALITY OF SERVICES

The programme was aimed at the issues related to the overall development of thechildren – their levels of nutrition, health and education, and was accordingly arrangedwith the different components mentioned in the beginning of this Chapter. In spite ofhaving a wide range of service components, it has generally been found that the SNP hasbecome the central functional intervention under the programme. Crucial as it is in itself,as a large number of children in the state suffer from undernutrition, the SNP programmein West Bengal has fallen short of expectations. The very low priority that the nutritional issues

of the children have so far received could be seen from the fact thata meagre 80 paise per children was allocated prior to January 2006.Several studies, including the Pratichi Trust’s works on education,have found that in most cases the supplementary food providedto the children had nothing to offer to supplement children’snutrition. However the West Bengal government has issued acircular to increase the allotment amount to Rs. 2 per child fromJanuary 1, 2006. The amount is supposed to be spent in thefollowing manner:

This allocation is separate from the remuneration paid tothe AWW (Rs 1,400 per month) and the Sahayika (Rs 900 permonth). In spite of the enhancement of the allocation forsupplementary feeding, one can clearly see from the numbers

Table 2.3: Break-up the allocation of SNP: per child per day

Components Quantity Value in Rupee

Rice 60 grams 63 paisePulses (Mususr dal) 25 grams 69 paiseEdible oil 08 paiseEgg Half egg, twice in a week 30 paiseSeasonal vegetables 26 paiseIodised salt 02 paiseMicronutrients 02 paiseTotal Rs 2.00

Source: Haq (2007); also offices of the DPOs of the studied districts.


presented above that it is hard to provide the required 300 k cal nutrition to the children and 500k cal nutrition to the mothers from the provision made. The market rates of rice and pulses aremuch higher than the assumed rates on the basis of which funds were allocated (we will discussmore on this in Chapter 4). Also the budget has not made any provision for the cost of fuel tobe used for cooking.

There has been a further enhancement in the budget since January 8, 2007, but only forcertain groups. The per capita allocation for severely malnourished children has beenraised to Rs 2.70 and for pregnant and nursing mothers to Rs 2.30. Though this is a positivestep taken by the government, in practice, however, this arrangement has proved to becomplicated for the anganwadi functionaries as it is hard to implement.

Despite the budget increments, the funds are inadequate to provide wholesome nutritionto children and mothers. This inadequate funding in turn makes the programmeimplementation somewhat lacklustre, and results in other undesirable consequences.One such consequence is the short and irregular supply of the ingredients needed for theSNP. We can see from Table 2.4 below that while there was a general deficit in the supplyof ingredients in the studied blocks for which data were available for the year 2005-6, insome of the projects the shortage of supply was rather overwhelming. Data available fromthe 10 projects show that all but one project had to suffer from shortages of supply of riceand pulses and the level of deficit ranged between 0 (in one case) and 73 percent in the case of rice,

Table 2.4 : Block wise requirement and supplied ingredients for feedingin the last year (in Quintal) (2005-6)

Districts ICDS Projects Rice DalRequired Supplied Deficit (%) Required Supplied Deficit (%)

Jalpaiguri Madarihat 1236 722 41.59 516 152 70.5(as on March Mal 4231.44 1442.5 65.91 1763 435.25 75.312007)

Dakshin Hilli 810 810 0 340 340 0Dinajpur (As Balurghat (U) 636 539.5 15.17 264 220.5 16.48on Dec 2006) Gangarampur 4988.7 2024 59.43 2078.62 674 67.57

Murshidabad Nabagram 3410 920 73.02 1420 500 64.79(As on Dec) Bhagawangola – I 940 520 44.68 307 137 55.37 2006

Bankura (As Bishnupur 1800 927.5 48.47 760 387 49.08on July 2006) Khatra – I N A N A N A N A N A N A

Barddhaman Aushgram – II 868.72 459 47.16 345.86 182 47.38(As on Asansol (U) N A N A N A N A N A N AJune 2006) Manteswar N A N A N A N A N A N A

Dakshin 24 Behala (U) N A N A N A N A N A N AParganas (As Gosaba 2906 2696 7.23 1211 1066 11.97on Oct 2006)


and 0 (in one case) and 75 percent in the case of pulses. The extent of shortage showed highvariation across regions: while Hilli, for example, had no deficit, Nabagram had a deficit of 73percent in case of rice and 65 percent in case of pulses. What can we expect from the anganwadi’swhen they are not even supplied the basic ingredients like rice and pulses?

When the most important programme like SNP, not only in perception, but also in practice,runs in such an erratic manner one can imagine how the other components of the scheme arebeing delivered to the children and mothers. We discuss them in some details in the followingsections.

SOME INNOVATIONS

The department, however, has made some progress in launching a special andinnovative programme called Positive Deviance (PD), which “is a community basedstrategy for prevention and reduction of malnutrition in young children through changesin behaviour and care practices of family members.” This has been operational in selectcentres in four districts, namely, South 24 Parganas, Purulia, Murshidabad and DakshinDinajpur, and in all the centres in three other districts, namely Uttar Dinajpur, Bankuraand Paschim Medinipur. These districts were selected on the basis of their backwardnesson the parameters of human development. The programme mainly focuses on theparticipation of the mothers in the operation and has apparently yielded some positiveresults. However, there is still a long way to go to implant a major change in the overallcondition of the children and mothers. A lot of emphasis is placed on the absolutelyneglected pre-schooling side. Also there is a lot to be done to improve the health services.

This programme is operational in limited areas, and there is a strong need foroverhauling the whole system, which in turn needs a radical change in the mindset of thepolicymakers and implementers. The Supplementary Nutrition Programme fulfils animportant gap in the children’s daily food intake. With alarming levels of undernutritionamongst the children, the ICDS presents an opportunity for the government to improvethe condition. The policy-makers need to devise policies to operationalise the right ofchildren to nutrition and health through ICDS and not consider it as an act of charity.


NOTES

1 AOWBJSWS (2007)

2 Haq, S N (2007) Principal secretary, Department of Women and Child Developmentand Social welfare, Government of West Bengal, Integrated Child DevelopmentServices: The West Bengal Perspective – A Quality Review, paper presented at the5th Kolkata Group Workshop organized by the Pratichi Trust, Global SecurityInitiative, Harvard University and UNICEF on Child Rights and Developmenton 12 and 14 February, 2007

3 Haq, op. cit

4 Government of West Bengal, (2006); Also, Haq (2007)

5 Haq (2007)

6 A brief description of the study districts is presented in the next chapter.


3. Study Area and Methodology

Six of the 19 districts of West Bengal were selected for a detailed study of the ICDSprogramme. The districts were chosen in such a way that the high degree of diversity

that characterises the state is adequately represented. The selected districts are Jalpaiguriand Dakshin Dinajpur in the north, Murshidabad in the north-central part of the statebordering Bangladesh, Barddhaman and Bankura in the south-central, and South 24Parganas in the south, part of which lies in the deltaic region close to the Bay of Bengal.

STUDY AREA

The Study Districts at a Glance

Jalpaiguri district occupies only 7.02 percent of the total area of West Bengal with thepopulation share of only 4.2 percent. It is located in the sub-Himalayan region and isfamous for its tea gardens. The foothills of Shiwalik are ideal for tea cultivation. TheBritish started tea gardens in this region, and brought labourers from southern Bengal(Bankura, Purulia), and Chhotanagpur and Santhal Pargana of present Jharkhand(erstwhile Bihar). Many of these tea gardens closed down in the recent past, causingsevere unemployment and poverty leading to even reports of deaths due to starvation.

Dakshin Dinajpur was formed on 1st April, 1992, after the bifurcation of the erstwhiledistrict of Paschim Dinajpur into Dakshin and Uttar Dinajpurs. With only 2.5 percent ofthe total land area of West Bengal and a miniscule 1.9 percent of the total population ofthe State, Dakshin Dinajpur is a small border district in the northern part of West Bengal.Located on the left bank of Padma, the main economic activity of this district is agricultureand allied activities. It is one of the most backward districts in the state in terms of humandevelopment indicators.

Murshidabad had been the capital of undivided Bengal before it fell to the British in


1757. Currently the district occupies 5.9 percent of the total area of the State with its populationshare of 7.3 percent. The river Padma marks the boundary between India and Bangladesh. Apartfrom high dependence on agriculture, a large number of workers from Murshidabad migrate outto different parts of the country in search of manual work. Household industries, such as bidirolling, form another large area of casual employment that mainly involves women and children.

Bardhaman is located in the central part of the State. It is the nerve centre of agriculture of theState. This district was rich in coal that played an important role in establishing the flourishingDurgapur-Assansol industrial belt in the 1960s. Unfortunate as it is with many industrial unitsin other parts of the state, several units in this industrial belt too have shut down and causedsevere unemployment. However, thanks to its excellent irrigation canal network – and groundwater extraction at a later stage – a large part of the district has a flourishing agricultural base, whichhas made it the ‘rice bowl of Bengal’. With a population share of 8.6 percent the district occupies7.9 percent of the total area of the State.

Bankura, located in the south-western part of the state, is another socio-economicallydisadvantaged district. Part of this district is hilly and covered with forest. As a result, thepopulation share of this district is only 3.9 percent while the geographical area constitutes7.75 percent of the State. In spite of a number of rivers flowing through this region, thedistrict continues to depend on the monsoon rains for agriculture. The pace ofindustrialization is slow and patchy.

South 24 Parganas in the southern part was formed in 1986 after bifurcating the erstwhile24 Parganas. It continues to be a large district with 11.2 percent of the state’s geographicalarea and 8.6 percent of the population. A large part of the district forms the largest deltasystem of the world — the Ganga-Brahmaputra Delta. The lush green mangrove forestsspread over this region sustains one of the most beautiful animal species of the world —The Royal Bengal Tiger.

A Comparison of the Basic Indicators

The riverine alluvium plains of the state support the livelihood of a large population.Notwithstanding some regional variations, this has resulted in a very high density ofpopulation – 903 persons per sq km, as opposed to the all India average of 324 persons persq km. The share of rural population is nearly 72 percent. Among the six sample districts,Bankura has the highest percentage of rural population (92.63), while Bardhaman has thelowest (63.06 percent). The share of rural population in the total population of the districtis above 80 percent in the other four sample districts. The main economic activity of thestate continues to be agriculture. Nearly 44.2 percent of the total population is engaged inagriculture and allied activities.

Among the study districts, Jalpaiguri has the maximum concentration of the tribalpopulation (18.8 percent), followed by Dakshin Dinajpur (16.12 percent), Bankura (10.36percent) and Barddhaman (6.4 percent), which all have a higher concentration of the tribalpopulation than West Bengal as a whole (5.5 percent). In Murshidabad tribals are found tobe numerically marginal (1.3 percent).

Among the study districts, Jalpaiguri has a very large SC population (36.7 percent) followed


by South 24 Parganas (32.1 percent), Bankura (31.2 percent), Barddhaman (28.78 percent) andDakshin Dinajpur (26.8 percent). The percentage of SCs in total population of each of thesedistricts is higher than the corresponding percentage for West Bengal (23 percent). OnlyMurshidabad among the sample districts has a lower representation of the SCs (12 percent).

Muslims constitute 25 percent of the state’s population. Among the study districts,Murshidabad has a very high share of this religious group (63.67 percent). Dakshin Dinajpur(24 percent), South 24 Parganas (33.24 percent) and Barddhaman (19.78 percent) have alsoconsiderably large concentration of the Muslims. In Jalpaiguri and Bankura this grouphas much lower share in the population (10.85 percent and 7.51 percent, respectively).

Table 3.1 Basic statistics at a glance

Name Area in Population SC (%) ST (%) Muslims(%) Others (%) Literacy IMR**sq km Rate(%)

West Bengal 8752 80176197 23.02 5.49 25.3 2.2 68.64 53Jalpaiguri 6227 3401173 36.7 18.8 10.8 5.85 62.85 54S Din 2219 1503178 28.78 16.12 24 1.9 63.59 74Murs 5324 5866569 12 1.3 63.7 0.4 60.71 58B’man 7024 6895514 26.98 6.4 19.8 1.3 70.18 57Bankura 6882 3192695 31.24 10.36 7.5 8.1 63.44 6124 Pargana (S)* 9960 6906689 32.1 1.2 33.2 0.9 69.4 51

Source – Census of India, 2001 and Government of West Bengal (2004, 2005)* The figures for South 24 Pgs. exclude the urban areas of Behala.

** The source of IMR data is Sample Registration System, 2005

According to Census 2001, the literacy rate in West Bengal (68 percent) is slightly higher thanthe all India average (65 percent). There has been a considerable improvement over the previousdecade (57.7 percent). The percentages of literates in South 24 Parganas and Barddhaman are 69.4and 70.12, respectively, which are slightly greater than the state average. In the remaining fourdistricts the literacy rates are lower than the state average. The Infant Mortality Rate (IMR) alsovaries across the six study districts. Dakshin Dinajpur exhibits the highest rate of IMR (74) in theentire state and is much higher than the state average, which is 53 (see Table 3.1 for details).

The Delivery of Women and Child Health Services

Child health outcomes depend to a large extent on the services aimed at improvingthe health of women and children. The delivery of such services as child immunisation,antenatal check-up and ANM/health worker visits follows an uneven pattern in the studydistricts, as the data from the Reproductive and Child Health Survey, 2002, show (Table3.2). While the extent of full immunisation in Jalpaiguri was 70 percent, it was as low as28 percent in Murshidabad. The pattern is found to be equally varying for the otherindicators. Whether the mother knows about the benefits of breast-feeding within twohours of birth and the need for ORS in case the child shows symptoms of diarrhoea depends on


According to Census 2001, the literacy rate in West Bengal (68 percent) is slightly higher thanthe all India average (65 percent). There has been a considerable improvement over the previousdecade (57.7 percent). The percentages of literates in South 24 Parganas and Barddhaman are 69.4and 70.12, respectively, which are slightly greater than the state average. In the remaining fourdistricts the literacy rates are lower than the state average. The Infant Mortality Rate (IMR) alsovaries across the six study districts. Dakshin Dinajpur exhibits the highest rate of IMR (74) in theentire state and is much higher than the state average, which is 53 (see Table 3.1 for details).

The Delivery of Women and Child Health Services

Child health outcomes depend to a large extent on the services aimed at improving thehealth of women and children. The delivery of such services as child immunisation,antenatal check-up and ANM/health worker visits follows an uneven pattern in the studydistricts, as the data from the Reproductive and Child Health Survey, 2002, show (Table3.2). While the extent of full immunisation in Jalpaiguri was 70 percent, it was as low as 28percent in Murshidabad. The pattern is found to be equally varying for the other indicators.Whether the mother knows about the benefits of breast-feeding within two hours of birthand the need for ORS in case the child shows symptoms of diarrhoea depends on hercontact with health service provider.

Table 3.2 Select indicators of women and child health services

Full Women visited by Any ante-natal More than Knowledge Breast-feedingImmunization ANM/ health worker check-up 3 ante-natal of ORS within two hours

check-up of birth

Bankura 67.4 6.6 96.2 74.8 48.7 49.0Barddhaman 60.2 7.3 93.1 63.6 19.4 28.2Murshidabad 27.9 4.6 74.0 39.4 28.5 29.5West Dinajpur 60.2 11.0 91.5 68.2 34.2 32.3Jalpaiguri 69.5 22.4 95.0 61.6 32.5 21.4South 24 Parganas 54.4 19.8 94.3 65.4 43.3 31.7

Source: Reproductive and Child Health Survey, 2002

While Bankura and Jalpaiguri are better placed than others in terms of several indicators,Murshidabad lags behind others. It is somewhat puzzling that Barddhaman, which ranked5th among the districts in terms of the human development index, shows a poor record interms of the percentage of women who have knowledge of ORS and the percentage ofwomen who breast-feed within two hours of child birth. The correlation between womenvisited by ANM or health workers and breastfeeding, knowledge of ORS, etc. seems to bemuch weaker than expected.


Population served by the ICDS scheme

The ICDS programme caters to the children belonging to the age group of 0-6, alongwith the pregnant women and lactating mothers. Table 3.3 gives in detail the numbers ofchildren below 6 years of age and of the women in the reproductive age group in the sixsample districts.

Table 3.3 Number of beneficiaries of ICDS in the sample districts

District/State Pop 0-6 % share Women in reproductive % share

age group(15-49)

West Bengal 1141422 14.2 20353820 25.4

Bankura 458882 14.4 810111 25.4

Barddhaman 903438 13.1 1799377 26.1

South 24 Parganas 1050120 15.2 1700072 24.6

Dakshin Dinajpur 246034 16.4 374394 24.9

Murshidabad 1044534 17.8 1391212 23.7

Jalpaiguri 521287 15.3 864356 25.4

Source: Annual Report, 2005-06, Department of Women and Child Development andSocial Welfare, Government of West Bengal

While the children in the 0-6 age group comprise 14.2 percent of the total population,women in the reproductive age-group of 15-49 comprise 25.4 percent of the total population.It is clear from Table 3.3 that nearly one-fourth of the total population are womenbelonging to the reproductive age-group. These women, together with the children in theage-group of 0-6, form the target beneficiaries of ICDS who constitute roughly 40 percentof the total population.

METHODOLOGY

There are 363 ICDS projects functioning in the state, which are of three different types– urban, rural, and tribal. In rural and urban areas, there should be an ICDS project for1000 population, while it is 700 in tribal regions.1 18 projects are run by various NGOs,which is approximately 5 per cent of the total projects in the state.

Table 3.4 Districts and blocks selected for the study

Rural Urban Tribal Total no. of No of projects projects in the district selected for study

Jalpaiguri Madarihat - Mal 13 2Dinajpur(S) Hili Balurghat Gangarampur 8 3Murshidabad Bhagabangola I - Nabagram 26 2Bankura Bishnupur - Khatra I 22 2Barddhaman Monteswar Asansol Aushgram II 32 324 Parganas (S) Goshaba Behala - 30 2

Total – 6 6 3 5 131 14


Selection Procedure

All three types of centres were picked up through a stratified random samplingprocedure for an in-depth study: six rural projects, three urban projects, and five tribalprojects were surveyed in detail. Table 3.4 gives the details of each block chosen from eachof these districts.

Rural projects are functioning in all the districts. So the study includes one ruralproject from each of these six districts. There is no tribal project in South 24 Parganas.Therefore, one tribal project was chosen from each of the other five districts. Urbanprojects are functioning only in Bardhaman, South 24 Parganas and Dakshin Dinajpurdistricts. One urban project was selected from each of these three districts. BishnupurRural Project in Bankura district is run by an NGO called Prabuddha Bharati. Names ofall AWC surveyed are given in Table 3.5 along with the total number of children andmothers served by each of these centres. Two AWCs and ten households from each centrewere selected from each Block for in depth study.

The method of inquiry took the form of direct interviews of officials at different levelsof implementation i.e. state, district and block, combined with structured questionnairesurveys of ICDS centres and households.

Collection of Data

Secondary data were collected from the state, district and project offices in order toform an over all view about the scheme in the entire state;Primary data were collected during the field visits with the help of structuredquestionnaires.Group meetings with the villagers and open-ended interviews were held whereverpossible. This helped the researchers to develop a better understanding of thedelivery mechanism and functioning of the scheme. A profile of the entire villagewas obtained from the group meetings with the villagers, which is given in theappendix.


Districts Blocks Villages/ Wards Children Children Nursing Pregnant Total no. ofserved (7m-3y) served (3y-6y) Mothers served Mothers served beneficiaries

Jalpaiguri Madarihat(R) Nepali Line 15 39 4 2 60Islamabad 45 48 13 5 111Hidayetpur

Mal (T) Syelee Chel Line 53 72 8 14 147

Golabari 47 80 6 6 139Dinajpur (S) Hilli (R) Bahadurpur 23 27 2 3 55

Agra 30 28 14 7 79Balurghat Bazar Para 9 12 0 5 26(U) Raghunathpur 8 8 0 4 20Gangarampur Forest Road

Nandanpur(T) Adivasi Para 63 36 11 4 114

Daulatpur 32 43 7 6 88

Murshidabad (R) Bhagwangola–I Char LabangolaPrimary School II 119 108 30 18 275SubarnamrigiHafiza Madrasa 60 50 13 7 130

Nabagram (T) Pathanpara 32 41 5 12 90Bholadanga N A 89 13 11 113

Bankura Bishnupur (R) Metepatan 23 59 10 3 95ChancharDangapara 26 36 9 12 83

Khatra I (T) Kathar 14 16 7 0 37Dhagara 30 40 3 11 84

Barddhaman Aushgram–II (T) Sonai 68 70 11 8 157GopalpurAdibashipara 42 34 9 5 90

Asansol (U) GoylaparaChelidanga 29 29 5 0 63Jitdangal 23 21 4 5 53

Manteswar (R) JayarampurChotodaspara 25 15 3 4 47Mirgahar 52 63 5 10 130

South 24 Behala (U) Dhalipara 14 21 1 4 40Parganas Kanuchanda 23 27 4 2 56

Gosaba (R) Rajat Jubilee 34 27 10 8 79Jatirampur 25 27 4 6 62

Table 3.5 Sample centres and the total number of beneficiaries


Designing the Questionnaire

Specific questionnaires were designed for the CDPO, the AWW and AWH of theAWCs, and for households. Each of these three types of questionnaires was formulated tounderstand specific aspects of the programme.

The questionnaire used for interviewing the CDPOs brought out the socio-economic background of the specific block, together with his/her perspective onthe programme. Important aspects of functioning and supervision as well as therole of other agents involved in the programme, such as the members of the GramPanchayat, suppliers of the food grains (ECSC), the Health Worker, etc, weresought to be captured through these interviews.The questionnaires used for interviewing the AWW and AWH were designed insuch a way that their perceptions about the programme as well as the functioningof the centre could be extracted from the responses. The Workers and the Helpersare those who are actually involved in executing the programme. Hence it wasessential to go beyond the limits of structured questionnaire and engage in an openended discussion with them in order to understand not only their views about thefunctioning of the scheme but the difficulties or inconveniences they experiencewhile executing the programme.The questionnaire used for the household survey was aimed at bringing out theground reality vis-à-vis what the programme was expected to achieve. Tenhouseholds were surveyed in each village/centre/ward in order to gain first handknowledge about the delivery of the programme as well as the expectations andaspirations of the households. Since the programme caters to a large section of thesociety, attempts were made to cover all categories of the beneficiaries, i.e. mothersof pre-school children (0-3 years), many of whom are lactating mothers; mothers ofpre-primary children (3-6 years) and pregnant mothers.

Open-Ended Interviews

The structured questionnaire survey was supplemented by semi-structured and un-structured discussions with the District Programme Officers (DPO), the CDPO, thesupervisors and the AWW.

Group-Meetings

Group meetings with the villagers including teachers of the Primary schools, membersof SHGs, members of the Gram Panchayat, important villagers proved to be extremelyuseful for a comprehensive understanding of the functioning of the ICDS.

NOTES

1 Right to Food Campaign (2006)


4. Infrastructure and HumanInfrastructure and HumanInfrastructure and HumanInfrastructure and HumanInfrastructure and HumanResources: Field ObservationsResources: Field ObservationsResources: Field ObservationsResources: Field ObservationsResources: Field Observations

The ICDS programme in West Bengal seems to have expanded at a rapid pace, if wecompare it with the all-India trend. While there are reasons to be enthusiastic about

the advancement, the causes of concern cannot be avoided anyway, particularly whenthey are attached with the crucially important aspects of the ICDS, namely, physicalinfrastructure and human resources. Since the programme is mainly about ‘caring forchildren’, it is a human resource intensive programme. Vacant posts, insufficient trainingand irregular monitoring due to shortage of people at different levels of its organisationhave a direct effect on the success of the programme. Similarly, poor physical infrastructureconstricts the activities of the AWCs, which places additional burden on the anganwadifunctionaries and raises questions of children’s safety in the centres. We discuss thesetwo central issues in what follows.

INFRASTRUCTURE

Status of ownership and conditions of buildings

About two decades ago it was recognised that an ideal AWCs should have a roomwith sufficient space for indoor activities of the children, a kitchen and a small store, andthere should have a separate bathroom with sanitary latrine1 . Unfortunate as it is, evenafter three decades of the launching of the programme many of the AWCs in West Bengalare run in a variety of places which hardly qualify for a structure appropriate for carryingout the activities of the centres.

Having no building of their own most of the centres in our study area in general, andin the sampled institutions in particular are forced to conduct the programme at variousplaces, viz. the veranda of Primary School or Sishu Siksha Kendra, village atchala, club,


rented house (generally in Urban Projects) and even in open places. Our own data from fieldworkon the sampled centres clearly bring out the appallingly poor state of the ICDS centres even whenthey are run in their own buildings (Table 4.1)

* Source: Field work

The project level data (from some of the studied projects) provided by the authorities alsocorroborate our findings from the field (Tables 4.1 and 4.1A).

Table 4.1a. Proportion of ICDS centres having own buildings

Project District Percent ICDS centreshaving own buildings

Gosaba South 24 Parganas 13Bhagabangola I Murshidabad 3Nabagram Murshidabad 16Mal Jalpaiguri 44Madarihat Jalpaiguri 25Manteswar Barddhaman 62

* Source: Offices of the CDPOs of the corresponding projects.

We were struck by the condition of the centres running in open space, where the wholeoperation of the programme was found to be challenged by the ‘homeless’ status of the centres.The number of such ‘homeless’ centres was very high in Nabagram (31.9 percent) of Murshidabadand in Gosaba (19.9 percent) of South 24 Parganas. The problems that the AWW had to facewere manifold:

First of all, it was extremely difficult to run the nutrition programme that involvedcooking, storing the cooked food, serving, etc. Even though some of the workers hadreported to have managed to get the food cooked in some house in the neighbourhood,the serving of food itself was vulnerable to a high degree of risk of contamination owingto lack of protection.

Second, storage of the grains and other materials was another major problem: ‘whowould take the responsibility?’ asked a worker. ‘Even if someone volunteers or is giventhe charge, she may later be suspected of corruption by some people. Also the fear ofburglary or damages caused by other means can not be undermined’, she added. It’s notonly the ingredients for cooking but also many other materials that the centres need to be

Table 4.1: Ownership status of the buildings of ICDS centres

Owning Status Number of centre Percentage

Own 10 35.7Rented 4 14.3SSK (Shishu Shiksha Kendra)/Primary School 5 17.9Other (including 6 in open space) 9 32.1Total 28 100


equipped with and need to be properly kept. Some of the workers told us that they hadto take all the registers (approximately 11 in number) and required food grains to theirhome everyday and bring them back in the next morning.

Third, often it became difficult for the AWWs to conduct all the pre-school activities inthe open space. The restrictions became particularly challenging during the rainy season.An AWW who had to perform her duties in open space said to us “Dekhun ami GramerMeye, Gramer-i Bou, ki bhabe mather majkhane dariye bachchader nach gan kore sekhai bolun to –I am a village woman. It is difficult for me to conduct with children songs and dances inthe open place next to the road; this goes against the custom of the village. Isn’t it?”Another worker, who also ran the centre in open space, told us, “First and foremost, aroom is essential. Children are suffering – they get drenched in the rainy season, and facethe wrath of cold in winter. If the children have a proper place to sit in, then their urge tostudy will grow automatically”.

The centres, running in the veranda of primary schools or SSKs had to face the sameproblems that open space centres did. Moreover they had to ensure that the place was vacatedbefore the school or SSK started. This appeared as a severe constraint that resulted in making theschedules shorter than stipulated or desired.

While the condition of the centres with no building was worse, condition of the othercentres did not appear to be much better. Two of the 10 sampled centres which had buildings oftheir own needed immediate repairing. While some of the centres, both government and rented,were suffering from leakage of the roof, the others had a variety problems including nearlydilapidated walls or broken doors and windows and so on.

Table 4.2 : Condition of buildings of the centres studied

No of centres Percentage

Pucca 9 32.1Partly Pucca 11 39.3Kaccha 2 7.1Open Space 6 21.4Total 28 100.0

* Source: Fieldwork


Only nine of the total centres (including rented, school veranda, etc.) were housed in puccabuildings. While 11 of the buildings were partly pucca two were completely kuccha. And, as statedabove, six of them had no building at all.

Box 4.1. Swimming in the mud

In Gosaba of South 24 Parganas, the centre was running in a dilapidated roomthat belonged to the local youth club. Although the club members were reportedto be very helpful in running the centre, Parul, the AWW, had to pay from herpocket to get the room repaired every year. Nevertheless, the worker lookedundaunted and was trying her best, against all odds, to run it successfully.

Conditions of some of the rented buildings in the urban ICDS projects appeared to beprecarious. One such centre in Barddhaman district was found to have an open well in the vicinity.Mothers expressed their worries around the possible danger that their children face and were veryhesitant to send their children to the centre. The worker and the helper found it difficult topersuade the mothers to send their children to the centre. Even the limited number of childrenwho attended it found no space for pre school activities inside the rooms that were dilapidated.

No wonder, most of the workers and helpers we talked with suggested immediateimprovement of the physical capacity of the centres.

Other Infrastructural Facilities

The lack of essential pre-requisites of the centres did not seem to end with buildingsonly; the shortages form a long list.

Half of our studied centres did not have sufficient space for conducting pre-schoolactivities.Only 8 centres had separate kitchen sheds.Lack of water in the vicinity necessitated some of the workers to cook food at theirhomes or other places and carry it to the centre. More than half of the centres hadno drinking water facility and the helpers had to fetch it from outside, the timetaken for which was between five minutes to a quarter of an hour.Only 15 centres had some space to keep the cooked food safely.Only five among the 28 centres had toilet facilities. Although most of the primaryschools and SSKs are provided with this facility the concerned authorities werereported to have refused to allow the AWC to use it.

Other Essential Equipments

With its overall objective of an all-round development of the children the activities ofICDS centres should not be restricted to the delivery of supplementary nutrition alone. Asdiscussed earlier, it was envisaged that a number of activities would be carried out in anintegrated manner. This would require a variety of material equipments ranging fromkitchen utensils to equipments for indoor games. Given below a list of the materials anideal ICDS centre must be equipped with.


Table 4.3 : Equipments necessary for an ICDS centre

General Use Kitchen Equipments Bathroom Equipments Indoor Play Equipments

i) Small mats or durries

ii) One cupboard (for storage ofequipment) with 1 or 2 racks

iii) Low wooden cot with a lowtable

iv) First aid box (medical kit)

v) One lidded vessel for storingdrinking water (locally mademud pot)

vi) Files registers and records

vii) Health cards, growth charts,weighing scale

i) Tumblers, plates, andspoons

ii) Two to three vesselswith lid for cooking

iii) Wick stove (kerosene)

i) Two buckets orvessels for storingwater

ii) One or twomugs

ii) One or two soapcontainers

iii) Four towels

v) Disinfected fluid,

vi) Brooms, brushes andother cleaningmaterials

i) Building blocks (wooden, of different sizes)

ii) Counting frames

iii) Paints, paint brushes and coloured chalk sticks

iv) One dholak

v) Three or four pairs of scissors

Source: A Guide-Book for AWWs; Department of Women and Child Development, Ministry ofHuman Resource Development, Government of India, 1986

However, in sharp contrast to the recognised need most of the AWCs were found tobe very poorly equipped.

In two centres we visited workers reported that they had no medical kit in theircentres at the time of our visit.

In spite of the fact that all the 28 sampled centres had weighing machines forchildren, the conditions of the same in four centres were almost unusable, whichaffected the weighing of children in those centres. Only six of the 28 sampledcentres had a weighing machine for mothers.

In eight centres no games or toys for children were provided. In 11 centres theteaching learning materials (TLM) that had been provided were found by theworkers to be inadequate.

Though all the centres had some utensils for cooking, 16 workers and helpers saidthat the provision was insufficient. Also children bring from home their own plates,bowls and spoons.

Surprisingly, there was no water container in 10 of our studied centres.

Fifteen workers (43 percent) reported to us that they had no arrangement (Cupboardor trunk) to keep registers, medical kits, TLMs and other equipments.


Table 4.4 : Centres with necessary arrangements

Arrangements Number of Number of centrescentres equipped not equipped

Medical kit 26 (92.8) 2 (7.1)Weighing Machine for Children 28( 100) 0Weighing Machine for Mothers 6 (21.4) 22 (78.6)Games and Toys 20 (71.4) 8 (28.6)Water Container 18 (64.3) 10 (35.7)Cupboard or trunk 13 (46.4) 15 (53.6)

Source: FieldworkNote: Figures in parentheses indicate percentage

HUMAN RESOURCES

Keeping in mind the objective of the ICDS programme to deliver nutrition relatedservices, pre-school education and health referral services to the most dispossessed of oursociety, all levels of administration (state, district, project (block) and centre) were involved,with specific responsibilities devolved upon the different personnel. An AWW, togetherwith an AWH is in charge of the actual delivery of the services. The Supervisor maintainsthe link between the AWC and the ICDS project. The ICDS project is led by the CDPOwho bridges the lower levels of delivery with the district. Similarly, the office of theDistrict Programme Officer is responsible for the overall programme delivery in thedistrict as well as coordination between the projects and the state level office. TheDepartment of Women and Child Development and Social Welfare is the nodal agencyfor implementing the programme in the state. The secretariat of the department acts as thepolicy making body, while a directorate of the department takes care of the implementation.The responsibilities of each functionary are discussed in detail in the following paragraphs.

The successful delivery of the programme, needless to mention, depends heavily uponthe army of personnel engaged in the implementation and the institutional structurewithin which they are supposed to deliver the services. We start our critical assessment atthe anganwadi level and then gradually move to the supervisory level and project offices.

Main Actors of the ICDS

Anganwadi Worker Anganwadi Helper

Supervisors

Child DevelopmentProject Officer

Assistant Child DevelopmentProject Officer

District Programme Officer


Anganwadi Worker (AWW)

The AWW together with the AWH not only delivers the actual services but alsomakes her presence in the locality significant through her regular interaction with thecommunity. By regularly transmitting feedback from the community to her superiors,she links the village to the highest policy-making authorities.

Theoretically the AWW is expected to carry out a long list of activities, which aresummarised below.2

1. Survey the community to be covered to find out the number of children below sixyears of age and the number of pregnant and nursing mothers; identify those whoare at risk and bring them to the notice of the health staff; to obtain data on thenumber of families, family members and family income; register new births anddeaths and maintain vital statistics; measure and record every month weights ofall children below 6 years of age.

2. Organise non-formal pre-school education in the anganwadi for children in theage group 3 to 6 years.

3. Organise Supplementary Nutrition for children (6 months to 6 years) and forexpectant and nursing mothers.

4. Give nutrition and health education to mothers.

5. Make home visits to educate the parents, particularly in the case of children at riskso that the mother of the child is enabled to play an effective role in the child’sgrowth and development.

6. Elicit community support and participation in running the programme.

7. Assist the Primary Health Centre staff in the implementation of the healthcomponent of ICDS projects, viz. immunisation, health check-up, referral servicesand health education; give first aid and simple remedies for common ailments.

8. Maintain the prescribed registers and records.

9. Report to the Child Development Project Officer or Supervisor any developmentsin the village which require further attention.

10. Maintain liaison with other institutions and individuals in the village, e.g.Panchayat, Mahila Mandal, School Teacher, Dai, etc. and seek their support andparticipation in running the programme.

It is clear from this list that the duties of the AWWs are very demanding if notvirtually impossible to accomplish them all, at least in the present circumstances wherebasic support and facilities are often lacking. Moreover the monetary compensation thatshe is provided with is a pittance – a paltry 1400 rupees a month. Notwithstanding thepoor arrangement, however, a good number of AWWs were found to be extremelydedicated. With minimal support from the infrastructural side, their commitment and


hard work help them cope with the situation. The main source of this commitment is, as one ofthem says: “we cannot be indifferent towards the children. We forget all our difficulties when welook at their faces.” However, it is impractical to expect all the workers to have the same degree ofcommitment and effectiveness. While self-less devotion can certainly be a good basis for theeffective delivery of a system it can not in any way replace the necessity of a rational system ofprogramme implementation. Unfortunately the programme has so far not been able to moveclose to a rational arrangement, which substantially reduces the effectiveness of the AWW. Manyof the AWWs complained during the conversations with us that it was extremely difficult forthem to deliver all the duties that are expected of them. As a worker said:

Can you tell us which [of the stipulated tasks] we should leave out? It’s notsimply feeding the children or carrying out the pre-school activities. There are theregisters to be maintained, which needs more than an hour everyday. Apart fromthat we have to visit the houses, conduct meetings and several other works likehelping the health workers and so on. Another major work is carrying out thechild surveys that involves door to door interviews. Does [the department] thinkof us as if we were [the mythological] goddess Durga [who is imagined to have 10arms]?

The predicament of the AWW, however, is not entirely confined to the existing overload ofwork. At times workers are expected to manage more than one centre. Two of the workers we met(out of a total 28 centres surveyed) were in charge of one additional centre each. The additionalpressure naturally hampers her performance as the post of the worker in the latter was vacant.Such a condition does not only add to the problems of the workers but also damages thefunctioning of the centres to a large extent. A large number of posts in some districts and projectswere lying vacant. (Understaffing seems to be a general phenomenon, as we will see in a minutein the case of CDPOs and ACDPOs). Table 4.5 below gives a profile of vacant posts of AWWsand AWHs in the studied projects. Table 4.5a gives the district-wise picture of the state as a whole.

Table 4.5: Posts of AWW and AWH lying vacant in the studied projects

Districts ICDS projects Centres without Centres withoutAWW (%) AWH (%)

Jalpaiguri Madarihat(T) 0 1.3

(as on March 2007) Mal(R) 2.9 1.0

Dakshin Dinajpur Hilli(R) 27.3 23.4

(As on Dec 2006) Balurghat(U) 27.9 23.5

Gangarampur(T) 29.0 30.5Murshidabad Nabagram(T) 0.5 0.5(As on Dec 2006) Bhagawangola–I(T) 0.7 (-)5.1


Bankura Bishnupur(R) 33.5 32.9

(As on July 2006) Khatra – I(T) 17.7 19.1Barddhaman Aushgram–II(T) 0 2.0

(As on June 2006) Asansol (U) 0 1.5

Manteswar(R) 1.27 1.69Dakshin 24 Parganas Behala (U) 0 2.1

(As on October 2006) Gosaba(R) 0 5.9

(- )denotes there are excess number of AWHs than the operational AWCs.)Table 4.5a: District-wise posts of AWW and AWH remaining vacant

Districts Percent of AWW vacant Percent of AWH vacant

Bankura* 18.7 18.4Birbhum 25.1 24.6Bardhaman 23.7 26.1Kolkata 25.1 24.3Koch Bihar 19.6 21.2Darjeeling 44.3 46.2Hugli 31.1 30.7Howrah 28.3 28.1Jalpaiguri 32.2 35.1Malda 32.4 31.6Midnapur Purba 22.5 25.8Murshidabad 32.0 36.5Nadia 27.8 26.4Purulia 19.3 17.924 PGS (N) 36.5 40.2Uttar Dinajpur 33.5 32.624 PGS (S) 23.2 22.6Dashin Dinajpur 26.5 27.0Midnapur Pashim 18.0 17.3West Bengal 27.2 27.8

*Study districts are pointed out in bold lettersSource: Annual Report, 2005-2006; Department of Women and Child Developmentand Social Welfare, Govt of West Bengal

Another major problem that has negatively affected the functioning of the centres is thatsome of the interviewed workers were found to be recruited from outside the area of the centre.In such cases they needed to travel a distance which consumed some of the valuable time andadded to the physical exhaustion of the workers. This clearly indicates towards the defects of therecruitment process that not only harms in terms of time consumption but also has serioussocial consequences.


Table 4.6: Distance travelled by AWW to reach the centreWorkers Percentage

Up to 1 KM 18 64.2More than 1 KM to 3 KM 7 25.0More than 3 KM to 5 KM 1 3.6More than 5 KM to 10 KM 1 3.6Above 10 KM 1 3.6Total No. of Respondents 28 100

Source: Fieldwork

Moreover the ‘otherness’ might get further exacerbated by the differences in the social identitiesof the workers and the people they are supposed to serve. The profile of the workers (given inTable 4.7 below) clearly shows that the so called ‘other’ caste workers simply outnumbered thesocially disadvantaged – the SCs, STs and the Muslims, in spite of the latter forming theoverwhelming majority of the population served by the centres.

Table 4.7: Social identity of the Anganwadi workers

Social Identity

SC ST MUSLIM OTH

No. of AWW 3 3 4 18Percentage 10.7 10.7 14.3 64.3

Source: Offices of the CDPOs of the studied projects

Although a few cases of discrimination on the basis of social identity were reported duringour fieldwork, close affinity between the functionary and the beneficiaries resulted in betterperformance by the AWW and greater participation by the community. In an area with a greaterpresence of tribals the functioning of the centre was found to be better when the worker was alsofrom the same group. Similar was the case for the Muslims or Scheduled Castes.

Anganwadi Helper

The condition of the AWH is probably worse. She has to perform a number of jobs3 thatinvolve a lot of physical labour. But what she gets in return is a miserable package of 900 rupeesa month. Her list of assignments includes:

(a) Cook and serve the food to the children and lactating and expecting mothers.(b) Clean the Anganwadi premises and fetch water.(c) Maintain cleanliness of small children.(d) Collect small children from the village and bring them to the anganwadi.

Besides these activities, the helper is expected to take part in pre-school and other activities bythe worker. Sometimes she has to run the centre in absence the worker’s absence, which was about4 to 5 days in a month. The motivation of the AWH to perform efficiently also varied from centreto centre. Though in some cases it differed depending on the personal inclination of the AWH towork, in most cases the work-relationship between the AWH and the AWW played an important


role. If the AWH and the AWW were from different communities, the involvement of AWHwas likely to be less.

Box – 4.2 The helping handMs Bani Das (name changed) has been working as an AWH since 1998. She manages,almost single-handedly, all the day-to-day activities as the AWW was suffering from acuteasthma and had undergone a major surgery recently. She was not in a position to devotefull time to the centre.

Apart from cooking (which was done in her own house as there was no kitchen at thecentre) and serving the khichri to the children and mothers at the centre, Bani engagedherself in conducting the pre-schooling of the children. It happened to be a daily routineand there was no sign of slackening in her seriousness. In addition, she took up homevisits as the worker was not physically capable.

Pre-schooling includes teaching rhymes, drawing, music and a few games. She composedsongs which the children loved.

One such song written by her is:

tol tolre tol pataka aj tolbharot sadhin holo tai to ato golbajche kasor sankho ghori bajche dhong dhongkhoka khuku mukhe bale bande matarammayer kole thaki mora ador kori makemoder sonar bangle amra pronam kori take.“Hoist the flag, India has become independent.

You can hear the gong of a big clock, while the children shout ‘Vande Mataram’We are in our mother’s lap, we love her, and we salute her—our golden Bengal”She has earned respect from the local residents and could ensure theircooperation during the needs of the hour.

The Supervisor

The supervisor is the main link between the project office and the AWC. She guides theworker in performing all her activities, such as, home visits, building family contacts and conductingvillage meeting, especially for nutrition and health education. She has to review the progress ofthe delivery of various services.4 One supervisor is appointed for every 25 centres and she isexpected to visit each centre at least once in a month. But the notorious understaffing of theprogramme often leads to a huge gap between the designed work schedule and the actual workdone. Many of the supervisors we met reported that they had to take the responsibility of a hugenumber of centres, which often caused longer interval between two consecutive visits of a centrethan desired. In our studied projects the number of centres to be visited by supervisors variedbetween 15 and 38.


Table 4.8: Status of posting of supervisors

Districts Projects No. of centres No. of supervisor Posts No.of centresoperational Sanctioned Posted vacant(%) to be visited

by a supervisorin a month

Jalpaiguri Madarihat(T) 104 8 7 13 15(as on March 2007) Mal(R) 229 20 10 50 23Dakshin Dinajpur Hilli(R) 60 3 3 0 20

(As on December 2006) Balurghat(U) 113 5 3 40 38Gangarampur (T) 242 17 14 18 17

Murshidabad Nabagram(T) 216 16 13 19 17(As on December 2006) Bhagwangola–I (T) 118 6 5 17 24Bankura Bishnupur(R) 114 6 5 17 23

(As on July 2006) Khatra – I(T) 122 8 7 13 17Barddhaman Aushgram–II(T) 100 9 4 56 25

(As on June 2006) Asansol (U) 203 8 7 13 29Manteswar(R) 236 9 7 22 34

Dakshin 24 Parganas Behala (U) 94 4 4 0 23(As on October 2006) Gosaba(R) 186 10 10 0 19

Source: Offices of the CDPOs of the studied projects.

Along with monitoring the centres the supervisors have to complete the paper work andprepare monthly progress reports (MPR) which need her presence in the office for a substantialtime. Besides, she has to take charge of facilitating convergence with various governmentdepartments and institutions. She is expected to attend the meetings organised jointly by theHealth Department and the Gram Panchayat on every fourth Saturday. Also she has to liaisonwith the health staff, village level committees, Self Help Groups and teachers of the primaryschools. In all she is expected to monitor the overall performance of the centres very closely. Butthe possibility of delivering the multiple duties often remains unrealisable because of the seriousproblem of shortage of supervisors (Table 4.9 and 4.10) on the one hand and the lack ofnecessary pre-requisites (vehicle, etc) on the other.

It is clear from the data provided by the concerned authorities that excepting two projects(Behala and Gosaba) of South 24 Parganas and one (Hilli) in Dakshin Dinajpur there was anenormous gap – some time even more than 50 percent – between the sanctioned posts and theactual placements. The more marginalised the areas – both in geographical and social terms – thehigher is the number of posts of supervisors remaining vacant. This again works both againstthe personal life of the supervisors concerned and the project, which is supposed to ensure therights of millions of children and mother, but ends up with a lacklustre delivery.


CDPO and ACDPO

The CDPO (Child Development Project Officer) is in charge of the whole scheme at theproject level, i.e. one CDPO to supervise 4 Supervisors and 100 AWC. He is responsible forproper implementation of the ICDS in the project area. Table 4.9 depicts the picture regardingthe posting pattern of the CDPOs in our study districts. This picture too exposes the lowerpriority that the ICDS programme has so far received from public policy.

Table 4.9: Status of posting of CDPOs

District No. of CDPO Percentage ofSanctioned Posted posts vacant

Jalpaiguri (as on March 2007) 15 13 13Dakshin Dinajpur 8 6 25(As on December 2006)Murshidabad 27 26 4(As on December 2006)Bankura (As on July 2006) 22 20 9Barddhaman (As on June 2006) 32 28 13Dakshin 24 Parganas 31 31 0(As on October 2006)

Source: Offices of the DPOs of the studied districts

During our field visits we observed that four CDPOs among the 12 we met heldadditional charges of other projects. While two of them had one additional project each,the other two were overburdened with the responsibility of two projects each apart fromthe one that they were initially appointed for.

With a number of jobs to be performed, including enormous paper work, extensivefield visits, coordination with the higher authorities and other departments and so on,most of the CDPOs and the ACDPOs appeared to be in a complete mess. Clearly theposts remaining vacant make the condition rather frustrating.

Table 4.10: Status of posting of ACDPOs

District No. of Project No. of ACDPO Percentage ofSanctioned Posted posts vacant

Jalpaiguri 15 15 4 73

Dinajpur(S) 8 6 2 67

Murshidab 27 1 1 0

Bankura 22 10 8 20

Bardhaman 32 15 11 27

24 Parganas (S) 31 23 18 22

Source: Offices of the DPOs of the studied districts


In sum, given the immense importance of the ICDS programme in improving the nutritionalstatus and overall development of children, it is disheartening to note that the implementationprocess in West Bengal has been facing challenges which are due to gross inadequacy in physicalinfrastructure and human resources. There is an urgent need for removal of the structural constraintsthat plague the ICDS in West Bengal.

NOTES

1 Government Of India (1986)





5. Implementation of the ICDS

The very design of the ICDS underscores the necessity of an integrated system ofimplementation of the programme to address various issues concerning the

development of the children. Since the well-being of the child is directly connected withthe mothers’ health and nutrition the programme incorporated in it the problems ofpregnant and lactating mothers and also of the adolescent girls – the future mothers. Theprogramme was designed in such a manner that the target group could access the servicesin their respective neighbourhoods. In this Chapter, based upon our field levelobservations, we make an attempt to draw a picture of the state of delivery of theprogramme.

SUPPLEMENTARY NUTRITION PROGRAMME

In absolute numbers, there are as many as 2.42 million deaths under the age of fiveeach year.1 A large section of the parents live with a sort of helplessness of not being ableto provide adequate stuff to eat, let alone nutritious food. The context however did notreceive the required attention until the Supreme Court’s intervention that made itmandatory for the central and state governments to provide 300 calories and 8-10 gramsprotein to every child up to six years of age and 500 calories and 20 grams protein to all thepregnant and nursing mothers every day2 .

In West Bengal, the standard food supplied from the AWCs is Khichuri (rice andpulses boiled together). In addition vegetables and eggs are also supposed to be supplied.(The break-up of the allocation has been given in Chapter 2). While the ECSC (EssentialCommodity Supplying Corporation) is the main supplying agency of rice and pulses(which they do up to the project level) the appointed carrying agencies make the materialsavailable to the centres. AWWs have been given the responsibility of procuring vegetablesand eggs from the local markets. In addition to cooked food a micronutrient called Vita


Shakti used to be supplied by CARE, an NGO, the distribution of which has now stopped. Nowin some projects a candy containing some micro-nutrients is given to the children.

Coverage

We have seen in the earlier part of this report (Chapter 4) how a large section of thetarget groups has missed the benefits of the SNP as the authorities could not extend thereach of the programme to a vast area. But, unfortunate as it is, even in the areas where theprogramme had its reach through the centres the delivery of SNP was reported to havesuffered from inconsistent supply in a substantial number of cases.

While it was heartening to find that all the children of the studied households hadreceived SNP at some time or the other, and the extent of regularity of the programme was72.5 percent, it was at the same time worrying to find out that in 27.5 cases the supply of theSNP was highly irregular. This weakness was further compounded by the extent ofcoverage of the SNP for the pregnant and lactating mothers, which was far less thanexpected – 81.5 percent had received this service at some time or the other. Furthermore,a large section of the mothers complained to have received the service irregularly and alsofor a much shorter period than stipulated. While the weaknesses of the delivery mechanismare worrying, the underlying message that we draw from the responses from the fieldclearly indicates the need to take measures for streamlining the supplies, in order tostrengthen the programme with the seriousness of purpose that it deserves.

Table 5.1: Regularity in the supply of supplementary nutrition

No of Responses Percentage

Regular 203 72.5Irregular 77 27.5

No of Respondents 280 100

Source: Fieldwork

In most of the cases the AWW was found to be in a difficult situation – sandwichedbetween the complaining mothers and the irregularity of supplying agencies. As a visiblydejected worker said to us, “can you suggest me a way out? Mothers accuse me of doingmischief; on the other hand the supplying agency fails to make the materialsavailable…sometime the centre does not receive any rice or dal for months; what can wedo?” Most of the CDPOs held the ECSC responsible for the irregularity in supply. It wasnot only the lapses in terms of supplying the materials in time the materials actuallysupplied were also reported to be in variation with the stipulated quantity and quality.

Five workers, of which four were from tribal projects, had complained about insufficientsupply of food grains. As the supply was not in accordance with the ‘requisition’ centresoften faced problems of stock of rice or pulses – some centres might have the stock of ricebut no pulses while some other might have pulses but no rice. The extent of deprivation


and hunger in some places was so high that the helpless workers had to cook whatever wasavailable and the hapless children had no other option but swallowing it without much complaint.On some occasions, the worker of a centre with no stock to cook managed to keep the centrerunning by making arrangements with some nearby centre that had some stock to lend temporarily.

Unpalatable food

It is rather strange that the supplementary nutrition provided to the children in theanganwadis took the form of a single-item menu that has remained unchanged for ever,viz. khichuri – dal and rice boiled together with salt, turmeric and very little oil and somevegetables, the quantity of which varies from time to time and centre to centre. As adisgusted worker pointed out, “even the poorest of the poor would revolt against arepetitive menu. But the children are voiceless. They are so hungry that they nevercomplain. But, you know, children whose parents can feed them well at home don’ttouch the khichuri in the centre.”

Table 5.2 : Major shortage of ingredients

Name of the projects Shortage of rice Shortage of pulses

(in percent point) (in percent point)

Mal (Jalpaiguri) 66 75Nabagram(Mursidabad) 73 65

Gangarampur (Dakshin Dinajpur) 59 68Ausgram-II (Barddhaman) 47 47Source: Fieldwork

That the food contained some vegetables and that eggs were also served to the childrenwere confirmed by most of the mothers (92 percent). However, while the majority ofthem expressed clear dissatisfaction with the quantity of the vegetable, a good number ofmothers (44 percent) told us that the supply of egg was so irregular that “it is difficult toremember when it was served last - kabe kheyechhe moneo nai”.

Table 5.3: Supplying of eggs


Regular 155 55.3Irregular 122 43.6NR 3 1.1No of Respondents 280 100

Source: Fieldwork

It was the workers’ responsibility to buy the vegetables to be added to the khichuri.Notwithstanding its high reputation as a vegetable growing state, it is not always easy to procure


vegetables in different parts of West Bengal round the year. The problem, however, as reportedby the workers, was not so much of availability of vegetables (“we can manage from one place orthe other”, so they say) as it concerned the availability of fund. “Often we have to buy it from ourpocket and get it reimbursed later on”, stated a worker. The problem of fund flow was alsoconfirmed by the concerned officials.

The quality of the food served in many centres was found to be rather unpalatable. “kakhanokakhano amaderi bomi uthe ase – some times it [the bad odour of the food] makes us feel likethrowing up”, said the worker. “Take a spoonful”, insisted the worker, “and taste what is givento the children. Because they are children and are hungry the double compulsion makes them takethe food.”

Apparently the degree of complaint was somewhat less among the mothers compared to theworkers. This, however, has to be taken with some qualification. The high incidence of hunger inmany parts of West Bengal, combined with the lack of choice and expectations, has perhaps madethe mothers incapable of judging the good from the bad. For example, in an area in Jalpaiguri,where the researchers could hardly swallow a spoonful of khichuri as it was made of rice and dalof very poor quality – the food was extremely stale and the grains that the food was made of wereinfested with bugs – most of the mothers we spoke to hardly complained about the food. Thedocility seemed to be grounded in the vulnerability of the community that has virtually no choice,not only of livelihood but also of state facilities and public argument. A longer conversation witha mother revealed the sense of maginalization more disturbingly:

Who cares for us whether we live or die? There is nobody to listen to us, let alonetaking measure to solve the problems. We are as though destined to be neglectedforever. Often we go to bed empty stomach. Our children remain uneducated. Thebabus only come during elections. There too we do not have much to do. They tell usto vote. So we do. … If we do not adhere. …God knows what will happen to us.They are very powerful… can turn the night into day.

Whether there was any difference between her perception and the reality was not known, buther belief cannot simply be ignored. Even if one insists on quantities, putting aside the ‘story’ ofan isolated individual, the number of mothers who expressed general displeasure was notnegligible: while 27 percent said the food was unpalatable, another 21 percent ranked it as average.

Table 5.4 : Quality of the foodNo of Responses Percentage

Very good 3 1.1Good 142 50.7Average 59 21.1Unpalatable 76 27.1No of Respondents 280 100Source: Fieldwork


It may be worth mentioning in this connection that the general lack of policy attention to thedelivery of the supplementary nutrition has produced even worse results in particular areas thatsuffer from gross neglect. While the food served in some areas (generally inhabited by moreprivileged communities, with higher literacy, income, access to state facilities, and relatively strongerpolitical potential) was much better, in some other areas it was just the opposite. Needless tomention, as a general case, the more neglected areas were found to be characterised by a combinationof marginalities – geographical, demographic, economic, political, social, and so on.

Four of the 28 workers interviewed explicitly stated that the quality of supplied ingredientswas poor; 15 of them graded it as average. In general, the workers and CDPOs blamed theEssential Commodities Supply Corporation (ECSC) for supplying inferior quality of foodgrains. As a norm workers are entitled to refuse the items supplied if they are found not up tothe mark. However, in practice, they had very little freedom to exercise it. The stories we were toldwere more disturbing than what the higher level government officials would like us to believe. Aworker of our study area refused to receive the supplied rice which she found to be of very poorquality. But the supplying sub-contractor appointed by the ECSC insisted, and the workerrefused to comply. This enraged the supplier who threatened the worker with dire consequences.And he kept his word: the supply of rice and other materials to the centre was stopped.


Box-5.1

Penalty of raising voice

A Muslim village, with more than 2600 population, is located near the Bangladesh border on the bank of the river Padma. The only ICDS centre ofthis relatively large village is run by the AWW Ms Najma Nasima. She caters to the needs of 149 small children; many of them, unfortunately, haveto walk for more than half-an hour to reach the centre. This is a PD (Positive Deviance) centre, selected by Unicef, which is functioning since 2000.

Najma is allowed to use one room of the primary school for keeping her records, charts, weighing machine etc. Pre-primary classes are held in thatroom, but she has to vacate the room by 10:30 in the morning as the primary school starts at 11am. The kitchen belonging to the primary school isthe place where SNP is cooked. Again, there is a stipulation that they must complete their work and vacate the premises before the activities of theprimary school begin. These difficulties, however, did not have any deterring effect on Najma.

The region faces the threat of flood and loss of life and property. Padma is notorious for changing its course every year. ‘During heavy rain, I amworried that the entire land where I am sitting with the children may get washed away due to sudden flash flood’ Najma said.

Najma has been working at this centre since 2000. Her regular and tireless effort has brought about many changes in the life of the women in thevillage. Regular mothers’ meetings (39 in the last calendar year) have resulted in better understanding about family planning. This has reduced thebirth rate in the village. Earlier, seven or eight babies were born every month, which has now fallen to two or three.

Excepting only 15 of a total 337 families, all have constructed low-cost sanitation. It was Najma’s effort that has transformed the goal of totalsanitation into reality.

There is only one child in the village who has been identified (Oct, 2006) as severely malnourished (Grade IV). It is Najma who arranged fora special fund of Rs 200 from the BDO office. This amount is given to the child every month for buying 500 gms of milk every day; this is inaddition to the dietary supplement (PUSHTI – two kgs in a month) given to all children who are in the Grade III and IV category ofmalnutrition, arranged by the concerned SDO.

Kishori Shakti Yojna (KSY), an additional feature of the ICDS programme, is yet to be implemented in most places. In Char Labangola, thereare 13 beneficiaries for this scheme. Since they do not get any benefits from KSY so far, Najma has started giving SNP to two adolescent girlseveryday. Due to her innovative ideas, they all get SNP at least once a week.

Najma took a very bold step and rejected the poor quality rice once supplied for SNP. The supervisor warned her about the possibleconsequences—she may not get any allotment for quite a while. Being extremely caring, Najma didn’t change her decision. As a result, hercentre was deprived of any rice for the next seven months.

Many of the officials connected with the implementation of the programme also expressedtheir helplessness – of course on condition of anonymity. “We have no idea as to how the sub-contractors manage to flourish. They seem to be immensely powerful, with political or othersorts of backing. Otherwise, how come they are never punished for their misdeeds?”3

In a few cases, however, mothers suspected that some of the workers were also involved insome malpractices, like using lesser than the stipulated amount of ingredients. Although there issome reason to believe in this kind of complaint made by mothers, there is good reason toaddress the faulty mode of operation that, we believe, is mainly responsible for the poor qualityof food served.

Another aspect of SNP is spot feeding of the children aged three to six years and theirmothers, where the AWH is supposed to feed the children. But, in many of the centres thepractice was not found to exist. Children and mother were instead given the food to takeaway home, which is a clear violation of the norms set up for SNP in the ICDS.

The SNP, as seen in most of the cases, is the central – if not the only – activity of thecentres. Yet, the level of performance in West Bengal, in our reckoning, is rather modest.


PRE SCHOOL EDUCATION (PSE)

There is, however, a contrast between the policy priorities and the aspirations of thepeople. While khichuri has almost become synonymous with AWCs the mothers generallyexpressed their strong preference for pre-primary schooling – another component of the ICDS– rather than for SNP. The very high levels of aspiration of the parents for acquiring educationfor their children have been repeatedly noted by a number of our studies.4 However, given thehigh degree of hunger prevalent in many areas, it remains a question whether the tendency topush SNP to the second place in the priority ranking could be attributed to low expectations dueto people’s adaptation to the poor quality of services delivered. Nevertheless, we find that, whilerequested to rank according to their own priorities the activities to be carried out by the centres, aslarge as 65 percent chose PSE as the top priority leaving SNP (14 percent) far behind.

Table 5.5: Priorities regarding the activities of the Centre-Mothers’ view


Pre schooling 181 64.6Supplementary Nutrition 40 14.3Both Pre schooling and SN 46 16.4Others 25 8.9No of Respondents 280 100

Source: Fieldwork

The high levels of aspiration, however, seemed to be at odds with the poor deliveryof the pre-school services. While 71 percent of the mothers said that their children wereinvolved with pre-schooling activities any time, 29 percent of them responded in thenegative. Further probing of the positive responses revealed that in many cases the activitywas severely affected by irregularity, half-heartedness, and so on. As in SNP theperformance of pre-school activity too seems to have a character marked with regionalvariances. Some of the areas showed better progress due to the combined efforts of theAWW, Supervisor and CDPO, or sometimes solely due to the motivation of the AWW.The pre-school children were found to be learning Bengali alphabet, counting, tellingrhymes and short stories, etc. One mother from a middleclass background told us thatthe level of learning of her child at the Anganwadi was higher than what other childrenhad done in the nearest kindergarten school. She attributed this outcome to the AWWwho, according to the mother was very committed to her work. This again points towardsthe possibility of a much better and equitable performance of the programme througheradicating the factors leading to the complaints.


Table 5.6 : Delivery of pre-school education: Mothers’ responseNo of Responses Percentage

Workers imparted PSE anytime 199 71.1

No Pre-school activity at all 81 28.9

Source: Fieldwork

The performance of the PSE programme was found to be much poorer in most of thecentres of the tribal projects. While one of the main reasons for this was the languagebarrier – workers and children spoke two different languages not comprehensible to eachother – another reason was the overall poor condition of the centre that was at the receivingend of gross neglect. In a centre of the tribal project of Murshidabd district, the workersaid, ‘they don’t understand any language, how do you teach them”? In some cases, however,the non-tribal workers have learnt the local tribal language on their own to surmount thedifficulty. The language barrier has serious consequences. It often adds to the existingsocial distances – caste and economic status. The communication gap not only hinders thetransmission of PSE but also causes disinterest amongst the children towards the centre.Despite this, it has not been recognised as a problem in the policy discussions.

Apart from the problem associated with the language barrier a large section of mothers(64 percent) felt that the workers of their respective centres lacked seriousness anddedication as far as the PSE was concerned. The causal relationship between workers’commitment and the effective delivery of PSE was also emphasised by some of the CDPOs.


Table 5.7 : Attendance of the children (3- 6yrs)

Districts Blocks Villages/Wards Number of RatePre-school children of Attendance

(3y-6y)

Jalpaiguri Madarihat (R) Nepali Line 39 37.7Islamabad Hidayetpur 48 39.7

Mal (T) Syelee Chel Line 72 22.1Golabari 80 49.6

Dinajpur (S) Hilli (R) Bahadurpur 27 93.9Agra 28 83.2

Balurghat (U) Bazar Para 12 89.6Raghunathpur Forest Road 8 69.5

Gangarampur (T) Nandanpur Adivasi Para 36 70.9Daulatpur 43 71.7

Murshidabad Bhagawangola-I (R) CharLabangola Primary School- II 108 49.4Subarnamrigi Hafiza Madrasa 50 41.4

Nabagram (T) Pathanpara 41 N ABholadanga 89 34.7

Bankura Bishnupur (U) Metepatan 59 53.0Chanchar Dangapara 36 N A

Khatra-I (R ) Kathar 16 N ADhagara 40 92.5

Barddhaman Aushgram-II (T) Sonai 70 65.7Gopalpur Adibashipara 34 47.0

Asansol (U) Goyalapara Chelidanga 29 64.9Jitdangal 21 73.3

Manteswar (R) Jayrampur Chotodaspara 15 93.6Mirgahar 63 37.3

24Parganas (S) Behala (U) Dhalipara 21 76.9Kanuchanda 27 56.0

Gosaba (R) Rajat Jubilee 27 83.7Jatirampur 27 95.8

Source: Fieldwork

Nevertheless, most of the workers – and in many cases genuinely – thought that it was theprogramme structure with abysmally poor infrastructure and other programme support thatconstrained the workers from delivering the service as expected. “Where shall we run the pre-schooling? Look at the muddy ground outside, without even a shed. Look inside the house,there is no space even to stand, let alone performing with the children”, said a dejected worker.Workers often complained that they did not even have minimum of the necessities like toys toconduct play activities for children. While the general complaints of the workers were found tobe true to a large extent in some cases, the weak commitment was found to have affected theprogramme.


IMMUNISATION

The onus of the immunization programme is mainly devolved upon the healthdepartment while the ICDS has a supportive role in it. The main responsibility of anAWW is to motivate the mothers towards the public immunisation programme, and toassist the Auxiliary Nurse Midwife (ANM) to organise immunisation sessions and maintainthe records. Besides, in areas without a health sub-centre, the place the programme isgenerally run from is the ICDS centre, which is used as outreach camps for immunisation.In our study area, almost half of the centres (13 out of 28) regularly hold such outreachcamps. This clearly brings out how crucial the role of an Anganwadi could be when it islinked with the implementation of the immunization programme. Even though ICDSprogramme is not directly responsible for providing immunisation services, in cases wherethe habitations do not have health sub-centres, the ICDS centres can play a very crucialrole by generating awareness and helping parents to avail of the immunisation serviceswhere they are available.

All the AWWs we interviewed stated that they participated in the immunisationprogramme. However, the views of some mothers contradicted this. While 58 percent ofthe mothers stated that the AWWs played some role in the immunisation exercise, 42percent clearly denied any participation by the AWW.

In some cases the AWWs were helpless onlookers. For example, a habitation in the teagarden areas was not at all provided with any health staff – doctor, nurse, or other healthworkers. This resulted in a very poor rate of immunisation in the area. Children attendingthe local anganwadi were not even issued the immunisation cards.

HEALTH SERVICES

Theoretically the AWW is to carry out a package of health services including recordingthe weight of the children under six years of age, growth monitoring and promotion,health check up of the beneficiary children, ante natal care of expectant mothers, postnatal care of nursing mothers and treatment of minor ailments. On enquiring with mothers,we got mixed responses about the delivery of the services.

Weighing

Although a key indicator of a child’s nutrition status, the recording of their weightshas not received adequate attention in the programme. This was reiterated by the mothers,where only half of them reported that their children were weighed. The data available forfour of the six studied districts show a lower efficiency in the weighing of children. Whilein Barrdhaman, the percentage of children weighed was nearly 62 it was as low as 47 inJalpaiguri.


Table 5.8 : Weighing efficiency of different districts

Districts* % of children weighted

Jalpaiguri(as on March 2007) 46.6

Dakshin 24 Parganas (As on October 2006) 58.7Barddhaman (As on June 2006 61.5Bankura (As on July 2006) 58.1

Source: Offices of the District Programme Officers of the studied districts.*Data for two districts were not available.

This programme component is also characterised by regional variation. As can beseen from the chart below, the recording of weight of children in the projects variedbetween 40 percent and 76 percent.

Data on other four projects of Murshidabad and 24 Parganas (s) districts werenot available.


Monitoring Growth Chart

Growth monitoring and maintenance of the growth chart is an important task to beperformed by the AWW, which was found to be a sporadic affair if not a rarity. Whenasked whether they had seen the growth chart of their children, a large section of themothers (83.2 percent) said they had never heard about this.

Health check up

Health check up of children is generally done by the ANM in the outreach camp of thevillages. Pregnant and nursing mothers have to go to the sub centres for their ante-nataland post-natal check ups. The AWW’s responsibility in this connection is to motivate themothers to avail the health check up for their children as well as themselves. Duringpregnancy women are supposed to visit the sub centres or outreach camps for takingtetanus injection and receive antenatal care from ANM or doctor. While 61 percent mothersreported having received this service at least three times during their pregnancy period,the picture was just opposite in case of post natal care: 83 percent mothers did not receiveany post natal care after their delivery.

Providing Medicine

A medical kit is being supplied to AWC containing medicines for minor ailments likecold and cough, minor injury etc. However, a majority of the respondent mothers statedthat very rarely did they receive any medical help for their children. Only 29 percentmothers responded positively in this regard. One mother at a tribal centre complained tous, “Where do I go for help if my child is sick? This centre was closed for one month because therewas no supply of ration”.

Workers, on the other hand, seemed to have their own problems. First, the suppliedmedicines were far too insufficient to meet the requirement. Second, and perhaps morevalid, the workers had no proper health training, which made them very cautious whileusing the medicine. Any mistake could lead to a cataclysm. So most of the workers


reported to have shown a general reluctance to give medicines to the ailing children. Workers ofonly 19 centres (out of 28) reported to us that they provided de-worming tablets to children.

Identification of disabled children is another important duty of the worker. While 22 of the28 workers told us to have carried out this task on a regular basis, mothers’ responses did notconfirm this in entirety.

Referral Services

This service is meant to provide special medical attention for the severely malnourished anddisabled children and pregnant women. Mothers informed us that sometimes workers hadadvised them to visit the nearest sub-centre or the nearest hospital during emergencies. For theurban project, there was a medical officer and two ANMs dedicated to the ICDS alone, but therewere no such arrangements for the rural and tribal projects.

NUTRITION AND HEALTH EDUCATION

The aim of NHE is to help women aged 15-45 years to look after their own health andnutrition, as well as those of their children and families. NHE is imparted through counsellingsessions, home visit and demonstrations. It covers issues such as infant feeding, family planning,sanitation, utilisation of health services, etc.

The workers reported to us that they had to visit a fixed number of homes every day. All buttwo of the workers informed us that they had visited all the houses within their area in a month.But again, the mothers’ responses were in conflict with this – only 20.4 percent mothers confirmedregular home visit by the workers.

Similar was the case with counselling sessions or mothers’ meeting. While almost all theworkers said that they organised regular mothers’ meetings, it found support only among asmall section (13 percent) of the mothers. So much so, that about three fifths of the mothershad reportedly not even heard of such meetings. On the contrary, the AWWs complained aboutpoor participation of mothers in the counselling sessions. According to them mothers in therural area were generally preoccupied with domestic and other activities which in combinationwith their poor level of awareness prevented them from attending the meeting.


Box 5.2. Main issues supposed to be discussed in the NHE sessions

Importance of mothers’ milk Importance of Anti-Tetanus injection during pregnancy Importance of mothers’ health, nourishing food for pregnant and lactating mothers’,

tension-free life style during pregnancy. Hygiene and cleanliness of the mother and child Health check up at the hospital or health centre during pregnancy Common ailments such as Malaria, Filaria, Dengue, AIDS, Diarrhoea. Various social issues that have local relevance Family planning Immunization and pulse-polio Pre-school activities Importance of nutritious food, as well as iodine, and vita-shakti

Proper, systematic care of the child, protection during winter and rainy season Mobilizing public participation regarding public health IMR and MMR Preparation of ORS Preparation of healthy and nutritious meal Safe motherhood/delivery with the help of trained mid-wives Regular check up of child’s weight Awareness about the relevance of education and nutrition

Only 28.6 percent mothers reported that AWWs had imparted knowledge about infantfeeding. The help extended by the workers during the pregnancy period of the motherswas also deemed as a rare occurrence. Only a quarter of the mothers responded positivelyin this regard. Similar was the case with awareness generating programme by AWWsduring diarrhoea, where only 22.5 percent mothers responded affirmatively.

KISHORY SHAKTI YOJONA (KSY)

As the ICDS includes the adolescent girls within its coverage it has a special componentcalled the Kishory Shakti Yojona. This programme was mainly designed to address thegirls of 11 to 19 years age group. It is a two-fold programme in which organisation ofawareness campaigns regarding nutrition and health among the adolescent girls form onecomponent and the other component is to arrange vocational training (tailoring, netting,weaving, beauty parlour training, physiotherapy training, etc) for the beneficiaries inorder to facilitate gainful employment for them. The CDPOs are to take the responsibilityof arranging these training programmes based on local demand.

Another programme, Nutritional Mission Programme for Adolescent Girls (NPAG)was also attached to the KSY. According to this programme a girl of the targeted age groupwith less than 35 kg of bodyweight is entitled to six kg of rice per month through the Public


Distribution System (PDS). Nevertheless, this programme component was not found to bevisibly implemented in the study areas. In three districts of Jalpaiguri, Dakshin Dinajpur andMurshidabad, the officials told the survey team about vocational training programmes havingbeen conducted for adolescent girls, but no such information was given by the lower-levelfunctionaries. According to the Supreme Court order dated 28 November 2001 each adolescentgirl should get 500 calories and 20-25 grams of protein from the ICDS. But no girl of this agegroup in our studied projects received this nutritional input.

It is quite clear from the above that the main activity of the centres revolves aroundSNP. Non formal pre school education had got attention in some centres but the deliveryof other services received little priority under the programme. Table 5.7 below based onthe responses of the mothers on the performances of different services reveals the conditionin a self explanatory way.

Table 5.9 : Types of services provided by the ICDS


Supplementary nutrition 276 98.6Non-formal pre-school education 199 71.1Weighing 129 46.1Providing basic medicines 82 29.3Information about immunization 26 9.3Mothers’ meeting/ NHE 10 3.6Home Visit 57 20.4Others 4 1.4Total No. of Respondents 280 100.0

Source: Fieldwork(Responses are not mutually exclusive)

In a centre where only SNP was provided a mother suggested us, ‘centre e sudhu aktamike deben, ranna hoye gele didi ekta haak debe, sabai giye khaabar niye asbe’-‘Just give thema microphone so that they can announce that the food is ready, after all , that’s all that is donehere at this centre’.

While the higher officials and some sections of the public identified the workers asresponsible for the frail delivery of the programme – as the poorly paid workers are asdefenceless as their voice is not heard – the major problem perhaps lies in the very policythat has not only failed to prioritize the scheme but also not cared to recognise thechildren as having basic human rights. In the next section we identify a few importantaspects of the nature of functioning of the ICDS centres that would supplement ourunderstanding of the gap between the intent and the actual implementation of theprogramme.


FUNCTIONING OF THE ICDS CENTRES

Working Schedule of the Centres

The field level data suggested that in spite of the general tendency of keeping thecentres open on a regular basis at least in 18 percent cases there were some major variationson this count. This was attributed by the mothers to the concerned workers who “remainedabsent from the centres”. While the commitment factor cannot be ignored one has also togive some attention towards the actual arrangements of the centres. In some of the“irregularly running” centres it was found that they were suffering from some majorcrises, such as the vacancy of the post of the worker or the helper, in which case theabsence of the supporting actor resulted in exigencies leading to the closure of the centre.

The main problem, however, seemed to lie elsewhere. Despite the opening of the centres ona more or less regular basis in most of the centres the variation between the stipulated and theactual running time of the centres was enormous. While only 57 percent of the interviewedAWWs said that they kept the centre open for scheduled four hours, none of the mothers’responses was in agreement with this. As far as the mothers could recall, the longest hours thatthe centres remained open was three. That too was the response of only 4 percent (19) of themothers. A large section of the mothers often informed us that the centres remained open, “untilthe rice and pulses are cooked - oi chal dal seddha hote jatakkhan”.

The disparity between the statements made by the workers and mothers widened whenspecific questions on the activities in the centres were asked. It appeared somewhat ironic that inspite of the widely acknowledged status of the anganwadis as solely nutrition distributioncentres – so much so that the shortage of supply of food even caused to stop the running of thecentres – some of the workers tried their best to create an impression that all the stipulatedactivities were carried out in the centres. It was perhaps their fear of some adverse action by thehigher officials that made them pretend that everything went well. The dilemma of the workerswas perhaps best articulated by a worker:

There is no cooperation from the higher authorities. We do not have thebuilding. All other material supports are just absent. NO toys and games. NoTLM (teaching learning material). No medicine. Not even some open space.Even the rice, dal, oil and other materials for SNP are in short supply. Whatshall we do? We are at the receiving end of the accusations by the mothers inthe village and the authorities in the office. Amra to jantakale indurer mato pareachhi – ours is a situation like a rat caught in the trap.

This is not to say that all the workers were equally dedicated towards their duties. Thepoint, however, is that the problem cannot be seen in isolation; rather it is important tonote the linkages between the functioning of the centres and the larger issues of programmedesign, support structures, administrative accountability, and so on. The lower rate ofattendance of the target group in the centres – for which the workers and parents found it easy toblame each other - elaborates this issue further.


Attendance of the members of AWCs and their beneficiaries

While in some cases mothers accused the workers of irregular functioning some of theworkers, on the other hand, hold the mothers responsible for not keeping regular contact withthe centre, not coming to receive SNP and not sending their children, particularly the pre-schoolchildren to AWC regularly. Nevertheless, the different problems associated with the functioningof the centres as perceived by the mothers and workers gave a clear indication towards areconstruction of policies as well as implementation:

Little children were unable to go to the distant centres (crossing the high roads, canals,jungles, railway lines etc.) without any adult companion. The mothers could notaccompany them as they had to go out for their own earning or get engaged withhousehold chores.

In some cases mothers were afraid of sending their children to the centres as the latterwere not well protected. There was hardly any boundary wall or fence, and many of thebuildings were about to collapse. In one of the urban centres there was an open wellwithin the premises of the ICDS centre. Since the mother thought that it would not bepossible for the worker and helper to take individual care of the children who might meetfatal accidents they developed a strong reluctance to sending the children to the centre.

Due to a lack of storage space, the AWWs often had to keep the ingredients at her ownhouse and take the hassle of bringing the required amount everyday. In addition, theyhad to carry the registers and other articles, like TLM, toys and games, etc. to home owingto the want of security in the centre.

There had been some reports of gaps in sharing information that affected the functioning.For example, in some cases the shortages in supply of materials led to the discontinuingof the SNP, but mothers were not properly informed about this. As a consequencechildren returned home unfed and this made the mother’s unhappy. The dissatisfactionrose to a higher level when some mothers, who visited the centre for the stipulated foodhad to go back empty-hand, because of the discontinuation of the SNP.

In some of the centres, especially in tribal areas the barrier of language and sometimesthe attitude of the non-tribal worker made the children uncomfortable leading to poorattendance at the centre

In some centres the enrolled children of the pre-school age from affluent householdsdid not attend the centres as they attended the private schools in the vicinity.

Nevertheless, attendance of the pre-school children was found to be better in the centreswhere the worker or the helper brought the children along with them while coming to thecentres. In a centre of Murshidabad an AWW told us how the children eagerly waited for her inthe morning for coming to the centre — It should take only 5 minutes to come to the centre, butI end up taking half-an hour — all the children want to come with me. So I bring them alongfrom their houses.


SUPERVISION AND MONITORING

No programme can survive on good-wishes. It is important to have an operational systemof supervision and monitoring, the role of which could stretch well beyond ‘policing’ to actuallybuild up a mechanism of communication between the lower level delivery points and the policylevel authorities. Different agents, namely the official agents such as the block level officials andsupervisors, the peoples representatives, parents and other locales, can play different roles inseeing the centres running meaningfully.

Role of the official agents

Heavy official workload along with the large number of centres under their charge hardlyallowed the block level project officers – the CDPOs and ACDPOs – to visit the AWCs. Only fiveout of the 28 studied centres were reported to be visited by any official (DPO, CDPO, ACDPO)in the last three months (prior to our visits). While asked about visits by officials’ many AWWsresponded –‘konodini aseni’- ‘the officials never visited’. However it is worthwhile to mention thatone of the block officials not only visited the centres regularly but graded the centres according totheir functioning as well. The official took active part in the pre-school activities of the centre,which helped motivate the AWWs as well as the mothers to a considerable extent.

In some cases block level officials mentioned that the unavailability of official vehicles restrictedtheir mobility and their ability to visit the centres. With this general trend, we were fortunate tomeet a CDPO who refused to be deterred by the constraints and made his best efforts to visit thecentres regularly. He used his own vehicle for the purpose, he said. However the success of aprogramme cannot be made to depend on individual zeal and self-less commitment, it shouldrather be pursued through improvement in the institutional structure within which anyone hasreason to act in a way that leads to success.

In the present study, 57 percent AWWs reported that the supervisors generally visited thecentres at least once in a month. It had been observed that each of the supervisors was in chargeof a large number of centres (ranging between 15 and 38). Consequently, it became very difficultfor them to visit all the centres every month and subsequently the remote centres were often leftout. The visit of the supervisors not only stimulated the activities of the workers but also helpedmotivate the mothers. In many cases the mothers’ meeting and weighing of the children hadbeen performed in the presence of supervisors.

Some of the workers told us about their experiences of such visits that had enriched them.While the workers received innovative ideas about pre-school activities and other services fromthe supervisors, the supervisors in turn reaped new ideas from the centres to disseminate themelsewhere. The supervisors complained that the shortage of time due to the heavy workloadoften constrained the AWWs from using the skills they had learnt in their training courses. Inspite of having such opportunities for proper implementation of the scheme the activities of thesupervisors seem to have been reduced to checking of the registers.


Table 5.10 : Frequency of visits of the supervisors*

Frequency Centres

At least once in a month 16 (57.1)

Once in two months 5 (17.9)More than two months 7 (25.0)

Total number of centres 28 (100)

Source: Fieldwork * Figures in the parenthesis show percentage

Role of other agents

The role of the people’s representatives turned out to be crucial. The functioning of theAWCs was found to be comparatively better where the panchayat members (in rural areas) andcouncillors (in urban areas) took an interest in the functioning of the centres. Workers also widelyacknowledged that the interventions of the local peoples’ representatives helped them to getaround unfavourable or hostile situations. In some areas mothers and local self-help groupswere also found to be alert in looking after the functioning of the centres, although in most casestheir role was found to be restricted only to checking the quality and quantity of the food servedunder the supplementary nutrition programme. In a few cases the AWWs reported the existenceof centre specific beneficiary committees but few mothers had any knowledge of it.


Box 5.3. The Self-inspired Worker

Located in the picturesque Sunderban delta, Rajat Jubilee Pathar Para is a fairly large village with a population of 1650. This village isregularly affected by various natural calamities such as cyclone and flood. The infamous man-eaters are reported to have taken manylives.

The AWW Ms Parul Mandal was looking after the mothers and children of the village for last 25 years through this ICDS centre. Thedilapidated room in which the centre was functioning belonged to the local club. Although the club members were very helpful inrunning the centre, Parul had to pay from her pocket to get the room repaired every year. It is hard to believe, until one sees it, that acentre could run in a room that looks no different from a pile of straws. We heard from the CDPO that his office had no financialprovision for the repairing of the house.

Regular, systematic pre-primary schooling had enabled the children to recite poems and sing songs fluently. The affectionate nature ofParul Mondal had brought the children very close to her. They learnt basic hygiene too – washing their hands before and after eating,sitting down and eating the khichuri in a disciplined manner.

Mothers informed that they had learnt the rudiments of health care for the entire family, importance of taking green vegetables, familyplanning, etc from the worker dedicated to the cause.

This remote village in one extreme corner of West Bengal seemed to have realized the need for education which the villagers hopedwould help them move forward to remove the miseries. The motivation resulted in the parents’ sending their children to the centreon a regular basis even when there was no meal to serve or even the children had no decent clothes to wear.

NOTES

1 Sinha, (2006)

2 Supreme Court Order dated 28 November 2001

3 It is pertinent to note the Supreme Court order, of 7th October 2004, on ban ofcontractors in the supply of nutrition in ICDS, “Contractors shall not be used forsupply of nutrition in Anganwadis and preferably ICDS funds shall be spent bymaking use of village communities, self-help groups and Mahila Mandals for buyingof grains and preparation of meals.” This order was given in the PUCL vs. Unionof India & Others, CWP 196/2001.

4 Rana et al (2002)


6. Scope and Challenges

According to the 2001 Census, the number of children below six years of age in WestBengal was 1,14,14222. They formed about 14 percent of the total population as

against the all India average of 16 percent. However, the proportions of 0-6 childrenamong Muslims (19 percent), Scheduled Castes (15 percent) and Scheduled Tribes (17percent) in West Bengal were higher than the state average (and than the national averageamong the Muslims and Scheduled Tribes as well). The 0-6 population among thesetraditionally disadvantaged groups formed 64 percent of the total 0-6 population. Mentionmay here be made that these three communities formed more than two thirds (71 percent)of the total agricultural labourers. In all our previous studies we found that on the onehand the children of the disadvantaged sections were in a dire need of state support, andon the other, they found themselves at the receiving end of the discriminatory practicesthat take various forms of exclusion from the services provided by the state. We have seenhow the ferocity of hunger forced families to keep their children of school-going ageenrolled in ICDS centres just to get the small dough of flour that they used to get in 20011 .This was when the Mid-day Meal programme had not yet been implemented; and thebudget allocation for the ICDS programme was far too inadequate to provide the childrena meal of reasonable quality. Today the situation is different. The MDM is operationaland per child allocation has increased by over 100 percent2 . In spite of the appallinglypoor quality of services in some of the AWCs the poorer sections of the children werefound to attend them on a regular basis while it was reverse in case of the children fromrelatively better off families.

And now, when the budget allocation has increased and the quality of food hassomewhat improved the attraction of the centres and their relevance in the lives of thechildren seem to have increased. For example, the Supplementary Nutrition Programme


(SNP) did not seem anymore to be the sole focus of the ICDS centres as the parents we spoke towanted the centres to extend their activities to include better pre-schooling and health referral (a)in places where they already exist as a programme of somewhat secondary kind and (b) initiatethem in places where they were not in operation at all. In addition to this, the launching of theMid-day Meal programme, the Employment Guarantee Scheme (EGS) and their positiveoutcomes inter alia (such as growing aspiration to acquire education, seeking better health facilities,and above all seeing the state programmes as a right rather than charity) have resonantly preparedthe ground for more public attention towards the basic services.

Many of the parents we talked to resented the quality of food served at the ICDS centres. Theresentment was clearly grounded on the much better performance of the Mid-day Meal programmethat has offered the people an opportunity to make a comparative evaluation of the ICDS: “whenthe same government offers a delicious meal to the primary school children why does it discriminateagainst the smaller children?” The increased popularity of schooling among the children fromdisadvantaged strata as a result of the MDM programme and other factors seems to have broadenedthe understanding of the process of acquiring education. The day-to-day experiences in theprimary schools (where the difficulties pertaining to the delivery of quality education often dampenthe possible benefits that the enhanced enrolment and attendance have created) have perhapstaught the people to ensure some pre-school learning for their children with the expectation thatthe children would perform better when in primary school.

Mention may here be made that the MDM programme saw several difficulties duringits launching phase. The major problem that the programme had to face was the resistancefrom the affluent sections of the society, as they questioned, “who would tend our cattle,if the chhotolok children attend schools?”. This resistance took the form of newspaperreports, public meetings, breaking the school chullah etc. They found support from thebureaucracy and sections of the media as well. The attitudinal hostility of the elite combinedwith the shortfalls in arrangement (inadequate allocation, lack of infrastructure, etc.) ledto a shaky start of the MDM programme. But within a very short time the programme sawa remarkable change brought out through multiple public interventions. The MDMprogramme is indeed an excellent example of how better commitment and effectivecoordination can help us get around the problems of implementing a programme.3

Apart from the growing aspiration for education and the urgency to eradicatewidespread hunger and malnutrition the very process of implementation of the ICDSprogramme has the potential, as found in the study, to widen the scope of participation ofthe local people, particularly the mothers. Almost all the mothers expressed their keennessto join the meetings and taking part in other activities. While this has in offer a much betterdelivery of the programme through the mothers’ involvement in the activities, the scopecan extend itself further to enhance the level of awareness on different aspects, particularlyhealth and nutrition. Also the linking of the programme with the self-group throughwhich rice and other ingredients could be procured locally can actually ensure a doublebenefit: while guaranteeing good quality of materials it will provide income-earningopportunities to the SHGs. In fact, in some parts of the state, namely Bankura, such an initiativeproved to be quite useful4 .


The combination of the different factors mentioned above has given much needed urgencyand relevance to the activities of the AWCs in the eyes of the public. This has, in fact, widened thescope to take up this immensely rewarding challenge of seeing the ICDS programme effectivelyimplemented.

The challenges that the ICDS programme in West Bengal now face are interconnected.There are different problems at different levels of policies and implementation. But, themajor challenge perhaps is the low priority that the government administration andsections of the elite have so far given to this programme. Some of the major challenges arediscussed below.

Irregularity and inadequacy of supply

While irregular supply was found to be a general phenomenon of the ICDS programme,the inadequacy of the supplied materials perhaps made things even worse. The projectlevel data of supply of rice and other ingredients collected from 10 of the 14 studiedprojects showed that all the projects barring one had suffered from inadequacy of supplyvis-à-vis actual requirement. The deficit ranged from 7 percent to 75 percent, which againpointed towards an uneven allocation of supplies among the projects. While some of theprojects were fortunate to have nearly adequate supply, some had received so little thatmany of the centres under them had nearly stopped the SNP.

The Essential Commodity Supplying Corporation (ECSC – a government undertakingagency) has been given the responsibility of supplying the materials. But the collectiveexperience – of the district and block level officials, workers and parents – regarding thesupply by the ECSC was not at all satisfactory. Often the CDPOs complained that therehad always been a great variation between the sample given to them and the actual supplymade to the centres. The (mal) practice was actually attributed to the ECSC’s method ofsub-contracting, which provided an opportunity to pilfer the grains and substitute themwith poor quality grains.

Nevertheless, it was the lower priority accorded to the development of the childrenthat has probably resulted in various sorts of malfunction. While the per capita allotmentitself was low the rates at which the government wanted the suppliers to supply materialsdid not seem to be quite rational. In 2006, when the government price for purchasingpulses was Rs 27 per kg, the market price for the same was much higher. Similar was thecase for rice and oil.

Poor Physical Infrastructure

The low priority was even conspicuous in the physical infrastructural conditions ofthe ICDS centres: only 35 percent of the centres surveyed had their own buildings whilethe rest were operated from clubs, Verandas of primary schools or Sishu Siksha Kendras,temples or mosques, common places like atchala or simply under the trees. No wonderthat some of the ICDS centres were named as amtala centre (centre beneath the mangotree) or lichutala centre (centre beneath the lichu tree). This too, like other aspects, has beenmarked with wide regional disparities. While in Manteswar (rural) of Barddhaman 62 percent of


the total centres had their own buildings, in Gosaba (rural) of South 24 Parganas the correspondingfigure was only 13 percent.

The poor condition of the infrastructure has affected the programme in many ways. Ithas its adverse effects on pre-schooling, storage of materials, keeping the teaching learningmaterials and other equipments and papers, and so on. The lack of a separate kitchen shedaffected the SNP. Non-availability of a source of water (for both drinking and otherpurposes) is another serious problem. In some cases AWHs had to carry water fromsources 1- 2 kms away from the centre. Even open pond water was found to be used –undermining the hygiene issue – in some centres. The other inadequacies involved weighingmachines and other equipments. We discussed these at length in Chapter 4.

Poor quality of services

The poor delivery of the services was found to be a major area of concern. Regrettableas it was in most cases the programme was found to be limited to Supplementary nutritionand Pre-primary schooling leaving the other agendas aside. Even these two programmeshad apparently failed to gain appreciation from parents. A large number of parentsexpressed their dissatisfaction with the services, which led to disappointment of parentsand poor attendance by children.

Vast uncovered area

A large number of new centres have been established recently. Nevertheless, for manychildren, particularly from the underprivileged background, the inaccessibility of thecentres was found to be a major problem.

Inadequacy and uneven distribution of staff

While there was a general shortage of staff noticed across the projects the unevendistribution of the staff had probably made things worse. We have already discussedearlier (in Chapter 4) about the shortages of the CDPOs, ACDPOs, Supervisors andworkers. This clearly led to poor functioning of the programme as often the workload ofthe concerned staff becomes too heavy to deal with. The unevenness of distribution addedto the predicament further. A good number of persons in the supervisory and administrativerole are forced to shoulder the responsibility of a much larger number of centres than thenorm because many posts are lying vacant.

Heavy workload of AWWs

Often the AWWs were found to be overwhelmed with excessive workload. In additionto the regular activities concerning SNP and pre-primary schooling they needed to maintaina number of registers, carry out home-visits, conduct meetings, helping in health relatedprogrammes and so on. The condition was alleged to be much worse when some moreworks related to various social programmes, such as, sanitation, SHG, collection of villagelevel data, etc. were also added to the list of the AWWs’ work schedules. At the time of our fieldwork in Dakshin Dinajpur the AWWs were found to be engaged in carrying out the SNP even on


Sundays. This was to comply with the Supreme Court’s order to provide SNP for 300 days in ayear. Clearly, it was the failure of the policy that attracted Supreme Court’s attention, but thepenalty was imposed on the poorly paid workers who had to sacrifice even the Sundays. Theexcess work load of the workers, in effect, seemed to have a negative impact on the quality of theservices delivered.

Poor coordination between Departments of Health and Social Welfare

There seemed to be a lack of coordination between various departments involved in thematernal and child health programmes. While this resulted in an overall fragile delivery system,it also created problems for delivery of services in different areas. Like all other cases the deliveryof immunisation and pre and post natal services were also found to be rather uneven. It wasseen that the areas where the coordination between the concerned departments could effectivelybe established the outcome was also quite satisfactory.

Lack of supervision

The weak nature of supervision of the programme has been discussed earlier (Chapter 5).While the slack in supervision had its obvious negative influence on the workers’ motivation,the penalties were found to be rather heavy. Supervision does not mean policing. It is a processthat bridges the lower level delivery points with the higher level policy authorities. As was seen insome areas the visits of the supervisors and block level officials had actually helped the workersby providing various inputs including motivation and confidence, technical assistance, and soon.

Lack of training

The workers and helpers often complained that they found themselves helpless on manyoccasions as they did not have sufficient training to handle particular situations. The inadequacy,as reported, concerned various issues – from service-delivery (health, nutrition, education, etc.)to administrative affairs (keeping accounts, maintaining registers, etc) and public communications.

Lack of public participation

Public participation – a major key to the success of any social programme – was found to beat a very low level, if not completely absent. Participation of the parents and community memberswas found to be limited since there were no formal or informal channels to transmit the viewsand suggestions that the members of the community might have on the possible ways ofimprovement of the services. Only a few of the centres studied were found to have conductedregular meetings. This, in fact, was a locally initiated step. Nevertheless parents and others in theneighbourhood showed their keenness to take part in the process of delivery of the services. Yet,there has been no systematic attempt to move the policy in the direction of more participation.

Indifferent officials

Some of the government officials were found to be detached, lacking in enthusiasm, andeven discouraging in their attitude. A top level official in Kolkata told us that he did not believein social programmes, which were “detrimental to economic progress of the country.” “Why


should we spend public money on feeding the children free of cost?” he asked. One can wellimagine the sort of result the programme could yield under the leadership of such an official.Nevertheless, we came across many dedicated officials and workers during the course of the study.As a matter of fact, a section of concerned officials have come forward to find solutions to thevarious problems that the implementation of the ICDS faces. They recently organised a seminar(see Box) on this and the deliberations in the meeting could prove to be very helpful for furthermodifications in the policy.

T

Box 6.1: Officers’ concernThe Association of the Officers of the West Bengal Junior Social Welfare Service (AOWBJSWS) in a background paper preparedfor a seminar on Emerging Challenges before ICDS on the Onset of the 11trh Five Year Plan, held on 16 June 2007 in Kolkata, expressesits apprehensions about the realisability of the potential of ICDS by highlighting the poor state of affairs. The Association wonderswhy the state did so little until the court had to interfere and direct the state to perform its fundamental duty to ensure that allchildren flourish into healthy human beings. In what follows, we highlight a few issues raised by the Association in the context ofthe proposals contained in the 11th Five Year Plan.

The measure that has been suggested by the Expert Committee of the Planning Commission to improve quality andefficiency is appointment of specialised workers on contractual basis. But, there is no indication how the existing gapbetween the human resources needed and what are actually in place will be bridged. Without any significant quantitativeexpansion of and qualitative improvement in human resources, any attempt to increase services will put unbearable pressureon the existing staff.The administrative set-up for programme implementation is almost centralised at the state level, with a very week structureat the district level. The department has no training centre of its own, nor is there any resource or research/evaluation wing.Pre-primary education (PPE) is the most neglected among all other delivery programmes. The environment in which mostof the AWCs are functioning is unattractive and unsuitable for development of a child’s mind. AWCs seldom have a properbuilding, and there is almost no provision for materials and equipments for PPE. There is no evaluation of the outcomeeither.Children of 7 months to 6 years get same quantity of food. Even the severely malnourished child gets the same khichuri(however in some more quantity) as what others get. The government has no special nutritional planning for the malnourishedchildren.Nutrition and health education is supposed to be provided through the mothers’ meetings. Unless the AWCs have theinfrastructure – its own decent building – the mothers will not be attracted to participate in the meetings. There arecommittees at project and district levels, which are supposed to oversee functioning of ICDS. But unfortunately, they existonly in government orders.There is no expert official in the department to look into these problems, nor is there any special cell or assessment, databank or academic interest. Everything moves conventionally, the main concerns revolve around the number of days offeeding that appears in a monthly progress report. It seems that the department does not consider malnutrition as a seriousone at all. There is no initiative from within; it is ‘business as usual’ until a central government directive or a court order isthrust upon the state government.There is no resource centre in the state, nor does the government have its own training centre. The state government officialsseldom visit the ICDS projects. There is no inspection report format in the department, all the efforts end up in makingallotment and spending it.


The challenges are certainly formidable, the possibilities for success are many more. TheICDS programme in West Bengal could make a huge difference in terms of well-being of thesociety in general children in particular if the deficiencies identified in this study could be removed.

NOTES

1 Sinha, (2006)

1 Rana et al (2002)

2 Rana et al (2005)

3 See for details, Pratichi Research Team (2005), The Impact of Cooked Mid-day MealProgramme in West Bengal, Delhi and Santiniketan. The report can also be accessedfrom www.righttofoodindia.org.

4 District Panchayat and Rural Development Officer, Bankura ( 2006)


References

Ajker Panchayat Barta (2007) Anganwadi Pariseba Nie Bivinnya Samaye Supreme Courter Nirdesh, Howrah, 1April.Bhat P N Mariand Fracis Zavier (1999), “Findings of National Family HealthSurvey: Regional Analysis”, Economic and Political Weekly, October 16-22, 1999.Director of Census Operations, Census of India 2001.Dreze, Jean (2006) “Universalisation with Quality: ICDS in Right Perspective”,Economic and Political Weekly, Vol. XLI No 34, 26th August – 1st September 2006,MumbaiGovernment of India (1986), A Guide-Book for Anganwadi Workers:; Department ofWomen and Child Development, Ministry of Human Resource Development,Government of IndiaGovernment of India (1993) National Nutrition Policy, Department of Women andChild Development, Ministry of Human Resource Development, New Delhi.Government of India (2007) Economic Survey, 2006-07, Ministry of Finance,Economic Division.Government of West Bengal (2004) West Bengal Human Development Report,Development and Planning Department, Govt. of West Bengal, KolkataGovernment of West Bengal (2005) Statistical Abstract, Bureau of AppliedEconomics and Statistics.Government of West Bengal (2006) Health on the March 2004-05, State Bureau ofHealth Intelligence, Directorate of Health Services, Government of West Bengal,Govt of West Bengal (2007) Annual Report, 2005-2006, Department of Women andChild Development and Social Welfare, Govt of West Bengal.Gupta, A (2006) Infant and Young Child Feeding, Economic and Political Weekly,Vol. XLI No 34, 26th August – 1st September 2006, Mumbai


Haq, S.N (2007).: Integrated Child Development Services: The West Bengal Perspective – AQuality Review, Department of Women and Child Development and Social welfare,Government of West Bengal, paper presented at the 5th Kolkata Group workshop,organised by Pratichi Trust, UNICEF, Global Equity Initiative, Harvard University andInstitute of Development Studies Kolkata, on Child Rights and Development at the AlipurCampus of Calcutta University, Kolkata, on 12-14 February 2007.

Radhakrishna, R (2002) Food and Nutrition Security, India Development Report, OxfordUniversity Pres, New Delhi.Rajan, A.K (2006) Tamilnadu: ICDS with a Difference, Economic and Political Weekly,Vol. XLI No 34, 26 AugustRana K, A. Rafique and A. Sengupta (2002) The Pratichi Education Report-I, with anintroduction by Amartya Sen, TLM Books in association with Pratichi (India)Trust, Delhi.Rana K, et al (2005) The Impact of Mid-day Meal Programme in West Bengal, PratichiTrust; also available in the net: www.righttofoodindia.orgSecretariat of the Right to Food Campaign (2006), Focus on Children Under Six:Abridged Report, New Delhi.Sen, A (2000) Development As Freedom; Oxford University Press, New Delhi.Sinha, S (2006) Infant Survival: A Political Challenge, Economic and Political Weekly,Vol. XLI No 34, 26th August–1st September, MumbaiUNICEF (2005) State of World Children 2005.


Appendix – A

Table 1. District wise nutritional status of children

District Grade II (in percentage) Grade III and IV (in percentage)

Mar-05 Mar-06 Variation Mar-05 Mar-06 Variation

Bankura 20.31 19.03 -1.28 0.88 1.07 +0.19Birbhum 24.86 22.77 -2.09 0.54 0.67 +0.13Burdwan 19.35 18.50 -0.85 1.06 0.76 -0.3Kolkata 11.52 10.96 -0.56 0.36 0.25 -0.11Coochbihar 14.90 13.13 -1.77 0.39 0.42 +0.03Midnapur(E) 17.47 17.16 -0.31 0.90 0.69 -0.21Murshidabad 16.31 13.60 -2.71 0.87 0.74 -0.13Nadia 15.49 14.58 -0.91 0.24 0.25 +0.01Purulia 20.75 19.70 -1.05 1.00 1.10 +0.124 PGS(N) 13.71 13.71 0 0.30 0.36 +0.06Darjeeling 13.34 14.15 +0.81 0.34 0.27 -0.07Hoohgly 14.63 13.60 -1.03 0.51 0.39 -0.12Howrah 13.88 13.03 -0.85 0.38 0.52 +0.14Jalpaiguri 16.15 16.32 +0.17 0.88 0.59 -0.29Malda 21.70 18.51 -3.19 0.61 0.78 +0.17Uttar Dinajpur 15.91 13.61 -2.3 0.56 0.60 +0.0424 PGS(S) 15.60 14.94 -0.66 0.51 0.35 -0.16Dakshin Dinajpur 13.58 13.51 -0.07 0.70 0.62 -0.08Midnapur(W) 21.44 21.04 -0.4 1.15 1.09 -0.06West Bengal 17.32 16.29 -1.03 0.68 0.63 -0.05

Source: Annual Report,2005-2006; Department of Women and Child Development and SocialWelfare , Govt of West Bengal


Table 2. Reach of the ICDS programme in West Bengal: supplementary nutrition andpre schooling as on march 2005 (Percentage)$

District No. % centre % 0-6 % L& T % of % of 3-6 Girls as % toA W C with SNP children mothers A W C children total PSE

covered covered with covered coverageunder under PSE underSNP SNP SNP also

coveredunderPSE@

Bankura 2796 55.83 55.3 40.5 99.07 90.55 49.5Birbhum# 2404 56.32 31.0 35.8 100.00 135.49 50.0Barddhaman 4749 80.69 54.1 51.8 96.65 96.65 49.7Kolkata 1118 99.11 50.6 40.4 99.73 74.49 50.7Koch Bihar 1925 99.53 64.9 49.0 100.00 70.53 49.5Darjeeling 1020 66.27 86.2 44.0 99.61 54.67 49.7Hugli 3152 95.75 62.8 35.6 99.97 82.70 50.5Howrah 2366 89.64 66.1 69.2 99.87 77.89 50.4Jalpaiguri 2404 84.90 49.6 37.6 98.75 72.04 51.1Malda* 1905* 101.84 57.0 66.8 107.87 94.54 49.2 Medinipur (E) 3546 77.02 58.4 37.3 97.46 69.83 51.1Murshidabad 3941 68.16 40.7 37.2 99.70 94.26 50.6Nadia 3121 93.62 45.5 46.8 99.84 91.37 50.6Purulia 2424 90.76 70.7 73.9 99.92 95.84 50.0U.24 Pargana 4395 68.19 47.5 34.4 99.66 80.43 50.3U Dinajpur 1578 81.81 52.6 41.8 99.18 82.91 49.2D. 24 Pargana 5115 74.43 50.2 44.9 99.90 77.32 49.7D. Dinajpur 1277 84.03 49.9 51.1 100.00 82.84 50.4Medinipur (W) 4680 67.88 54.8 32.0 97.91 80.97 50.3Total 53916 78.74 52.8 44.8 99.41 84.59 50.1

$ Computed from, Annual Report, 2005-6, Department of Social Welfare, Government of WestBengal, Table 1.A. 16, pp 64-5

# It’s surprising that the number of children covered under PSE is higher than number of childrencovered under SNP. Whether this is actually a deviation from the general pattern (where PSEcoverage is lower than that of SNP) or a typographical error cannot be ascertained.

@ No break up for 3-6 children is available; this calculation shows the proportion of children whohave received SNP also received PSE

* Both the percentages of centres having SNP and PSE programmes exceeded the actual numberof operational centres. Whether it was out of some problems of record keeping or printing errorwas could not however be verified.


Table 3. 0-6 Children covered by the selected ICDS projects#

Districts ICDS 0-6 Population* Total no. of Percent of Total no. of No. of No. ofProjects Children 0-6 children Mothers Children Mothers

covered covered covered per centre per centre

Jalpaiguri Madarihat 29744 9094 30.57 1439 49 8(as on March 2007) Mal 45919 20410 44.45 3098 50 8

Dakshin Dinajpur Hilli 12373 3387 27.37 655 44 9(As on Dec 2006) Balurghat 12452 3258 26.16 533 28 5

Gangarampur 43411 11352 26.15 4619 47 19

Murshidabad Nabagram 33796 16943 50.13 3241 60 12(As on Dec 2006) Bhagawangola – I 30407 19081 62.75 3053 117 19

Bankura Bishnupur 22726 8375 36.85 1139 73 10(As on July 2006) Khatra - I 14912 9115 61.13 1708 75 14

Barddhaman Aushgram – II 19682 5190 26.37 1617 27 8(As on June 2006) Asansol (U) 29728 9408 31.65 1254 46 6

Manteswar 33886 17285 51.01 2973 73 13

Dakshin 24 Parganas Behala (U) 41971 4524 10.78 307 45 3(As on October 2006) Gosaba 34164 13535 39.62 2613 61 12

# Computed from Monthly Progress Report (MPR) data provided by district level authorities.* according to 2001 Census, current estimates were not available.

Table 4. Average population served by each AWC: targeted and actual

Districts ICDS Total No. AWC Population No of AWC PopulationProjects Population Sanctioned to be served operational actually served

in the by each AWC by each AWCProject area

Jalpaiguri Madarihat 185470 185 1003 104 1783(as on March 2007) Mal 288610 411 702 229 1260

Dakshin Dinajpur Hilli 77250 77 1003 60 1288(As on Dec 2006) Balurghat 135737 115 1180 113 1201

Gangarampur 260173 242 1075 242 1075

Murshidabad Nabagram 196608 281 700 216 910(As on Dec 2006) Bhagawangola – I 163466 163 1003 118 1385

Bankura Bishnupur 200715 115 1745 114 1217(As on July 2006) Khatra - I 102569 122 841 122 841

Barddhaman Aushgram – II 136263 194 702 100 1363(As on June 2006) Asansol (U) 263812 203 1300 203 1300

Manteswar 213498 237 901 236 904

Dakshin 24 Parganas Behala (U) 543137 100 5431 94 5778(As on Oct 2006) Gosaba 222822 223 999 186 1198


Table 5: Post of AWW and AWH Vacant (district wise) as on March 06

Districts Percent of Percent ofAWW vacant AWH vacant

Bankura* 18.7 18.4Birbhum 25.1 24.6Bardhaman 23.7 26.1Kolkata 25.1 24.3Koch Bihar 19.6 21.2Darjeeling 44.3 46.2Hugli 31.1 30.7Howrah 28.3 28.1Jalpaiguri 32.2 35.1Malda 32.4 31.6Midnapur Purba 22.5 25.8Murshidabad 32.0 36.5Nadia 27.8 26.4Purulia 19.3 17.924 PGS (N) 36.5 40.2Uttar Dinajpur 33.5 32.624 PGS (S) 23.2 22.6Dashin Dinajpur 26.5 27.0Midnapur Pashim 18.0 17.3West Bengal 27.2 27.8

*Study districts are pointed out in bold lettersSource: Annual Report,2005-2006; Department of Women and ChildDevelopment and Social Welfare , Govt of West Bengal


APPENDIX – B

Responses of the mothersIdentification

1. Sample design

Districts Projects Centres Parents

24 Parganas (South) 2 4 40Barddhaman 3 6 60Bankura 2 4 40Murshidabad 2 4 40Dinajpur (S) 3 6 60Jalpaiguri 2 4 40Total 14 28 280

2. Social identity of the respondents

Households Percentage

S C 80 28.6ST 82 29.3Others 74 26.4Muslim 44 15.7Number of Respondents 280 100

3. Educational level of the respondents

Responses Percentage

Illiterate 120 42.8Up to Class 4 40 14.3Class 5 to 8 77 27.5Class 9 to 10 35 12.5Class 11 to 12 7 2.5Above 1 0.4Number of Respondents 280 100

Quality of Services

4. Services provided to children


Supplementary nutrition 276 98.6Non-formal pre-school education 199 71.1Weighing 129 46.1Providing basic medicines 82 29.3Information about immunization 26 9.3Mothers’ meeting/ NHE 10 3.6Games and singing, dancing 23 8.2Others 4 1.4Number of Respondents 280(Responses not mutually exclusive)


5. Type of SNP provided from the centres

Type of food Responses Percentage

Khichuri with vegetables 259 92.5Khichuri without vegetables 21 7.5Number of Respondents 280 100

6. Providing eggs under SNP


Regular 155 55.3Irregular 122 43.6Can’t say 3 1.1Number of Respondents 280 100

7. Regularity in supply of SNP


Regular 203 72.5Irregular 77 27.5Number of Respondents 280 100

8. Perception on quality of food


Good 3 1.1Moderate 142 50.7Poor 59 21.1Unpalatable 76 27.1Number of Respondents 280 100

9. Weighing of pre-school children

Frequency Responses Percentage

Regular 142 50.7Irregular 138 49.3Number of Respondents 280 100

10. Maintaining monthly growth chart


Maintained 45 16.1Not maintained 233 83.2Can’t say 2 0.7Number of Respondents 280 100

11. Enrolment of mothers in the ICDS centre


Enrolled 232 82.9Not enrolled 44 15.7NA* 4 1.4Number of Respondents 280 100* They were not natural mothers and adopted the concerned children; hence these mothers werenot enrolled in the centre.


12. Did the AWW extend any help during pregnancy?


Yes 49 21.1No 183 78.9Number of Respondents 232 100

13. Did pregnant and nursing mothers receive SNP?


Received 189 81.5Not received 40 17.2Not taken 3 1.3Number of Respondents 232 100

14. Extent of SNP received by the mothers during pregnancy

Months Responses Percentage

Up to 3 months 12 6.54 to 6 months 105 57.47 to 9 months 66 36.1Number of Respondents 183* 100

* Two mothers were unwilling to receive SNP and in case of the other four mothers SNP was notgiven to them during their pregnancy period

15. Extent of SNP received by the mothers during nursing period

Months Responses Percentage

Up to 3 months 8 4.54 to 6 months 123 69.17 to 9 months 18 10.1Till date 29 16.3Number of Respondents 178* 100

*11 mothers were still pregnant

16. Extent of pre-natal care received by the mothers


At least 3 times 168 60.94 to 6 times 47 17.0More than 6 times 12 4.3Not at all 49 17.8Number of Respondents 276 100

17. Extent of post-natal care received by the mothers


At least once 27 10.22 to 3 times 15 5.7More than 3 times 4 1.5Not at all 219 82.6Number of Respondents 265* 100

*11 mothers were still pregnant and four children were adopted


Functioning of the Centre18. Average working hours of the studied centres


Up to one hour 11 3.9One hour to less than two hours 141 50.4Two hours to less than three hours 117 41.8More than three hours 11 3.9Number of Respondents 280 100

19. Reported functioning of the centre


Opens regularly 230 82.1Opens occasionally 21 7.5 Seldom opens 26 9.3Don’t know 3 1.1Number of respondents 280 100

20. Reasons why the centre was closed on working days


Absence of the worker 33 66.0No food supply 19 38.0Ill health of the worker 3 6.0No specific reason 1 2.0Number of Respondents 50 100.0

(Responses not mutually exclusive)

Mothers’ views on the AWWs work21. Mothers’ view about the performance of the AWW


Satisfied 148 52.9Dissatisfied 130 46.4No response 2 0.7Number of Respondents 280 100

22. Reasons for dissatisfaction over the AWW’s work


No pre-school activities 83 63.8Irregular attendance of AWW & AWH 60 46.1Irregular, inadequate and poor quality of the SN 49 37.7Unclean nature of the worker 3 2.3No medical facility (including weighing) 27 20.8No home visit or mothers’ meeting 32 24.6No proper care of the children 16 12.3No activities 13 10.0Others 14 10.8Number of Respondents 130 100.0



23. Priorities regarding the activities of the centre


Pre schooling 181 64.6Supplementary Nutrition 40 14.3Both Pre schooling and SN 46 16.4Others 25 8.9No of Respondents 280 100


24. Whether the AWWs made regular home visits



25. Extent of mothers’ meetings

Frequency Responses Percentage

Once a month 35 12.5Once in every two months 11 3.9Occasionally 65 23.2Never 160 57.1Don’t know 9 3.2Number of Respondents 280 100

26. Topics discussed in mothers’ meeting


Health and nutrition of the child 51 45.9Health and nutrition of the mother 43 38.7Counselling on food habits: increase intakeof green and leafy vegetables 36 32.4Overall childcare and cleanliness 61 55.0Immunization programme 10 9.0Family planning 6 5.4Social issues 6 5.4Regular attendance of children at the centre 15 13.5Others 4 3.6Number of Respondents 111 100.0


27. Role of the AWW in the immunization programme


Informing the villagers’ 162 57.9No role 118 42.1Number of Respondents 280 100.0


28. Role of AWW in enhancing awareness on diarrhoea


Generating awareness 63 22.5No role 217 77.5Total no. of Respondents 280 100.0

29. Whether AWW’s counselled on feeding the children



29a. Counselling done on


Importance of breast milk for the first six months 57 71.25Feeding green and leafy vegetables 32 40Quantity and type of food according to the age 26 32.5Others 9 11.25Number of responses 80


Suggestions to improve the Programme30. Suggestions as to how to improve the functioning of the centre


Improve the quality and regular availability of the SNP 94 33.6Improve the non-formal pre-school activities and increase the TLM 181 64.6Improved infrastructure including toilet facilities 144 51.4Increase the number of workers 11 3.9Awareness generation by regular mothers’ meeting 10 3.6Regular presence of AWW and AWH 34 12.1Availability of safe drinking water 32 11.4Regular weighing and provide basic medicines 19 6.8Attendance of children should be assured 15 5.4Workers’ Language should be same with the majority of children 18 6.4Centre should be in the locality 11 3.9Others 54 19.3Number of Respondents 280


31. Participation of mothers in the functioning of the centre


Participated 141 50.4Did not participate 114 40.7Participated occasionally 25 8.9Number of Respondents 280 100


Peoples’ Participation32. Help extended by the villagers


Supplying new clothes once a year 8 5.7Providing infrastructural facilities 36 25.5Helping in cooking and other help 56 39.7Supplying vegetables and firewood 9 6.4Supervision 28 19.9Helping in teaching 5 3.5Helping at the time of medical need 4 2.8Any other 31 22.0Number of Respondents 141


33. Existence of centre-specific committees

Responses PercentageExisted 7 2.5Did not exist 239 85.4Did not know 34 12.1Number of Respondents 280 100

34. Necessity of centre-specific committee


Necessary 258 94.5Not necessary 3 1.1Don’t know 12 4.4Number of Respondents 273 100

35. Perception on provision of legal power to the centre specific committees


Required 226 87.6Not required 5 1.9Don’t know 27 10.5Number of Respondents 258 100

36. Suggested activities of the centre-specific committees


Extending help to the AWW and AWH 30 11.6Achieving cent percent attendance at the AWC 59 22.9Organizing regular mothers’ meeting to improve their health-awareness 64 24.8Improving the infrastructure of the centre 30 11.6Arranging drinking water facilities 10 3.9Monitoring the pre-school activities 93 36.0Monitoring the food supply including the regularity and qualityof the cooking 86 33.3Overall supervision (excluding the pre-school activities and food supply) 161 62.4Monitoring the activities of AWW & AWH 20 7.8Ensuring regular supply of medicine 9 3.5Others 22 8.5Number of responses 258



Responses of the AWWs

Objective condition of the centres37. Number of ICDS centres studied

Name of the District Number of Centres Percentage

24 Parganas (South) 4 14.3Barddhaman 6 21.4Bankura 4 14.3Murshidabad 4 14.3Dinajpur (S) 6 21.4Jalpaiguri 4 14.3Total 28 100.0

38. Ownership of buildings

Percentage

Own buildings 10 35.7Rented Buildings 4 14.3SSK & Primary School Building 5 17.9Club 4 14.3Common space of villagers 2 7.1Others 3 10.7Total 28 100.0

39. Building condition of the studied centre

Percentage

Pucca 9 32.1Partly Pucca 11 39.3Kaccha 2 7.1Open Space 6 21.4Total 28 100.0

40. Training received by the AWWs

Percentage

Received 25 89.3Not received 3 10.7Total 28 100.0


Enrolment41. Status of full enrolment of the children of the locality in ICDS centres

Percentage

Full Enrolment 8 28.6Partial Enrolment 20 71.4Total 28 100.0

42. Reasons of not attaining full enrolment

Percentage

Presence of Private Schools 14 70Inaccessibility to the ICDS centre 10 50Total 20 100


Quality of services

43. Quality of Supplementary Nutritional food provided

Percentage

Good 10 35.7Average 12 42.9Bad 6 21.4Total 28 100.0

44. Regularity in the supply of fund

Percentage

Regular 10 35.7Irregular 18 64.3Total 28 100.0

Functioning of the ICDS centres45. Working hours of the centres

Workers Responses Percentage

Up to two hours 2 7.1Up to three hours 6 21.4Up to three and half hours 4 14.3Up to four hours 16 57.1Total 28 100.0

46. Persons visited the centre in the month prior to the study

Yes No Total

ANMs 15(53.6) 13(46.4) 28Supervisors 23(82.1) 5(17.9) 28CDPOs 8(28.6) 20(71.4) 28GP Member/councillor 22(78.6) 6(21.4) 28


AAAAAPPENDIXPPENDIXPPENDIXPPENDIXPPENDIX – C – C – C – C – C

Persons (other than the selected respondents) met

Name Designation AddressMr. Kanta Prasad Sinha Director, Social welfare Directorate of the Social Welfare, West BengalMr. S. Jana Research Officer Directorate of the Social Welfare, West BengalMr. D.K Mitra Programme Officer ICDS West BengalMr. Sadananda Chatui DPO, ICDS JalpaiguriMr. Anil Sarker DPO, ICDS Dakshin Dinajpur

DSW Dakshin DinajpurMr. Manaj De DPO, ICDS MurshidabadMr. Chittaranjan Bhowmik DPO, ICDS BankuraMr. Kailashnath Mukherjee DPO, ICDS BarddhamanMr. Pradip Kumar Barui DPO, ICDS South 24 ParganasMr. Madan Mohan Ghoshal DPO, ICDS BirbhumMs. Gitanjali Sengupta CDPO Behala (U) 24 Parganas (S)Mr. Piyush Saha CDPO Bishnupur-II, 24 Parganas (S)Ms.Runa Roy Chatterjee CDPO Falta, 24 Parganas (S)Mr.Arabinda Banerjee CDPO Gosaba, 24 Parganas (S)Mr. Billadal Karan CDPO Aushgram-II, Barddhaman.Mr. Sarat Kumar Hazra CDPO Manteshwa, Barddhaman.Mr. Chanda Mukherjee CDPO in charge Assansol (U) Barddhaman.Mr. Rajat Majumdar CDPO in charge Barddhaman(U) Barddhaman.Ms. Chandana Ghosh Sarkar CDPO Memari-II, Barddhaman.Mr. Debrajan Raj CDPO Bishnupur, Bankura.Mr. Janardan Mitra CDPO Khatra-I, Bankura.Mr. Samsul Huda CDPO Nalhati- I, Birbhum.Mr. Amit Kumar Das CDPO Bolpur- Sriniketan, Birbhum.Mr. Subhendu Mondal CDPO Nabagram, Murshidabad.Mr. Syamaprasad Mukherjee CDPO Bhagawangola- I, Murshidabad.Mr. Tapan Saha CDPO in charge Bhagawangola- I, Murshidabad.Mr. Sudip Kishor Mukherjee CDPO Hili, Dakshin Dinajpur.Mr. Brindaban Das CDPO Gangarampur, Dakshin DinajpurMr. Joy Gopal Sikdar CDPO Balurghat(U), Dakshin DinajpurMr. Ajit Kumar Singha CDPO Mal, JalpaiguriMr. Prabir Kumar Sarkar CDPO Madarihat, JalpaiguriMs.Saswati Sarkar District Coordinator, PD MurshidabadMs. Charchita Ganguli Supervisor, ICDS Asansol (Urban), BardhamanMs. Rekha Mandal Supervisor, ICDS Asansol (Urban), BardhamanMs. Pratima Datta Supervisor, ICDS Khatra I, BankuraMr. Debu Ghatak Councillor Asansole, Ward Number 5Mr. Subrata Biswas Councillor Asansole, Ward Number 25Ms. Natika Bibi GP Member Mirgahar, BarddhamanMr. Amirul Mandal Member, Gram Committee Mirgahar, BarddhamanMr. Kanak Hembram Member, Panchayat Samiti Aushgram-IIMr. Ramen Ray Executive Assistant Bandapani Panchayat, JalpaiguriMS. Rita Ray Supervisor, ICDS Bishnupur, BankuraMs. Tanushree Mandal Supervisor, ICDS Bishnupur, BankuraMs. Sita Kumari Change Agent, ICDS Jeetdangal, AsansoleMs. Bandita Dev Sarkar Health Worker Kolkata Urban Health Project IIITapasi Majumdar Supervisor, ICDS Gosaba, 24 Parganas (S)Pradhan Gram Panchayat Layekbandh, Bishnupur, BankuraMs. Supria Mandal Worker, ICDS Falta, 24 Parganas (S)


Name Designation AddressMs. Shikha Naskar Helper, ICDS Falta, 24 Parganas (S)Ms. Kalpana Mandal Das Worker, ICDS Falta, 24 Parganas (S)Ms. Sushama Sardar Helper, ICDS Falta, 24 Parganas (S)Ms. Sulekha Das Worker, ICDS Nalhati, BirbhumMs. Bani Das Helper, ICDS Nalhati, BirbhumMs. Ranjita Karmaker Worker, ICDS Nalhati, BirbhumMs. Dipti Mondal Helper, ICDS Nalhati, BirbhumMs. Babli Sarma Helper, ICDS Madarihat, JaqlpaiguriMs. Sita Ray Pradhan Helper, ICDS Madarihat, JalpaiguriMs. Sarita Kujur Helper, ICDS Mal, JalpaiguriMs. Hirubala Ray Helper, ICDS Mal, JalpaiguriMs. Reba Mandal Helper, ICDS Hilli, Dakshin DinajpurMs. Juthika Sheel Helper, ICDS Hilli, Dakshin DinajpurMs. Archana Chakraborti Helper, ICDS Balurghat, Dakshin DinajpurMs. Shephali Mahanta Helper, ICDS Balurghat, Dakshin DinajpurMs. Tarini Singh Helper, ICDS Gangarampur, Dakshin DinajpurMs. Amina Bibi Helper, ICDS Gangarampur, Dakshin DinajpurMs. Chenbanu Khatun Helper, ICDS Bhagawangola I, MurshidabadMs. Madhabi Das Helper, ICDS Bhagawangola I, MurshidabadMs. Lili Chatterjee Helper, ICDS Nabagram, MurshidabadMs. Shikha Acharya Helper, ICDS Bishnupur, BankuraMs. Soma Chakraborti Helper, ICDS Bishnupur, BankuraMs. Rani Hembrem Helper, ICDS Khatra I, BankuraMs. Sulekha Kundu Helper, ICDS Khatra I, BankuraMs. Mira Chattopadhaya Helper, ICDS Aushgram II, BarddhamanMs. Baduli Ankure Helper, ICDS Aushgram II, BarddhamanMs. Kalidasi Manna Helper, ICDS Asansole, BarddhamanMs. Geeta Prasad Helper, ICDS Asansole, BarddhamanMs. Shephali Das Helper, ICDS Manteswar, BarddhamanMs. Mamtaj Khatun Helper, ICDS Manteswar, BarddhamanMs. Ashalata Khatun Helper, ICDS Behala, 24 Parganas (S)Ms. Sandha Das Helper, ICDS Behala, 24 Parganas (S)Ms. Parbati Mandal Helper, ICDS Gosaba, 24 Parganas (S)Ms. Lila Mirdha Helper, ICDS Gosaba, 24 Parganas (S)Ms. Jatra Ghosh Helper, ICDS Aushgram II, BarddhamanSwapna Thapa Worker, ICDS Bandhapani T.G, Madarihat , JalpaiguriRejia Begam Worker, ICDS Islamabed, Hidayatpur, Madarihat , JalpaiguriMarsela Xalxo Worker, ICDS Sylee T.G, Mal, JalpaiguriLakshmi Dey Sarker Worker, ICDS Golabari, Mal, JalpaiguriRekha Mahato Worker, ICDS Bahadurpur, Hilli, Dakshin DinajpurMamata Mandal Worker, ICDS Agra, Hilli, Dashin DinajpurSikha Datta Worker, ICDS Bajarpara, Balurghat (U), Dakshin DianjpurKrishna Datta (Chanda) Worker, ICDS Raghunathpur, Balurghat (U), Dakshin Dinajpur,Ashima Das Worker, ICDS Nandanpur, Gangarampur, Dakshin DinajpurKrishna Mallik Worker, ICDS Doulatpur Adibasipara, Gangarampur, Dashim

DinajpurNajma Nasima Worker, ICDS Charlabangola, Bhagawangola I, MurshidabadNasima Khatun Worker, ICDS Subarnamrigi, Bhagawangola I, MurshidabadTandra Adhikari Worker, ICDS Pathanpara, Nabagram, MurshidabadChabi Ghosh Worker, ICDS Bholadanga, Nabagram, MurshidabadSujata Mandal (Saha) Worker, ICDS Metepatan, Bishnupur, BankuraShyamali Chakrabarty Worker, ICDS Chanchor Dangapara, Bishnupur, BankuraPurabi Hembram Worker, ICDS Kathar, Khatra I, BankuraChuramani Soren Worker, ICDS Dhagara, Khatra I, BankuraSandhya Chaterjee Worker, ICDS Snoai, Ayushgram II, Bardhaman

Name Designation AddressDipali Biswas Worker in charge, ICDS Gopalpur Adibasipara, Ayushgram II, BardhamanKuheli Bhattacharja Worker, ICDS Goyalapara, Chelidanga, Asansole(U), BardhamanSubarna Roy Worker, ICDS Jitdangal, Asansole(U), BardhamanLina Basu Worker, ICDS Jayrampur Chotodaspara, Manteswar, BardhamanAspia Khatun Worker, ICDS Mirgahar, Manteswar, BardhamanTulika Chakrabarty Worker, ICDS Dhalipara, Behala, Dakshin 24 ParganaAnima Das Worker, ICDS Aurabinda Basu Nagar, Behala, Dakshin 24 ParganaParul Mandal Worker, ICDS Rajat Jubili Patharpara, Gosaba, Dashin 24 ParganaSabita Mandal Worker, ICDS Jatirampur Adibasipara, Gosaba, Dakshin 24 ParganaShila Mukherjee Worker, ICDS Patharkuchi, Ayushgram II, Bardhaman

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