Health

Integrated Child Development not serving those who need it the most, finds study

Those from lower castes and the poor miss out on education, nutrition

 
By Jitendra
Last Updated: Monday 04 March 2019
Photo: Pradip Saha

The Integrated Child Development Service, which is supposed to uniformly support nutrition and learning in India’s children and mothers, has not done so. Its beneficiaries have increased over the years, but those from lower castes and earning less — arguably the ones who need the most support — have tended to miss out, according to a new study.

The government nutrition programme expanded between 2006 and 2016, according to the study, India’s Integrated Child Development Services programme; equity and extent of coverage in 2006 and 2016.

Historically disadvantaged groups such as those from scheduled castes and tribes and the poorest households, however, remained relatively excluded from accessing nutrition due to the lack of less education about health and nutrition, it adds.

Women who receive education about health and nutrition during and after pregnancy have better access of nutrition, the International Food Policy Research Institute (IFPRI) claims after analysing Government Family Health Survey data.

The study, co-authored by Kalyani Raghunathan, Harold Alderman, Purnima Menon and Phuong Nguyen from IFPRI and Suman Chakrabarti from University of Washington, is set to be published in April.

IFPRI uses data from two rounds of India’s National Family Health Surveys (2005-06 and 2015-16).

The Integrated Child Development Service (ICDS) scheme, launched in 1975 to tackle under-nutrition, offers nutrition and health services across the continuum of care in the first 1,000 days of a child’s life. It was made universal in 2006.

ICDS provides food and primary healthcare to children under six as well as pregnant women and lactating mothers. It also provides pre-school education.

The study found that in that one decade:

  • Health insurance coverage jumped to 24.3 per cent from 3.7 percent.
  • Illiteracy among mothers fell to 27 per cent from 46.3 per cent.
  • The receipt of supplementary food by mother-child pairs increased to 37.9 per cent from 9.6 per cent.
  • Use of health check-ups increased by 23.5 percentage points
  • Health and nutrition education rose 17.9 percentage points.
  • Children receiving supplementary food monthly went up to 27.6 per cent from 19.1 per cent.

Despite such success, the programme hasn’t benefitted all social groups equally, the report cautioned the Government of India. Improvements among lower-income groups —traditionally at a disadvantage — were relatively lower than higher-income groups.

“Even though overall utilisation has improved and reached many marginalised groups such as historically disadvantaged castes and tribes, the poor are still left behind, with lower utilisation and lower expansion throughout the continuum of care,” Raghunathan said.

Such gaps were more pronounced in Uttar Pradesh and Bihar, which also carry “the highest burden of undernutrition,” the IFPRI research fellow added. “Despite improvements in 2016, both lagged behind national averages, suggesting that overall poor performance in high-poverty states could lead to major exclusions,” she said.

The poorest also faced exclusion in better-performing states such as Tamil Nadu and Karnataka due to caste equations and remote locations, according to the study that finds clear equity gaps at district levels. The study seeks further investigation to identify potential reasons for such gaps.

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