Dividing children

The Integrated Child Development Services (ICDS) scheme has been conceived as a major intervention by the Central government to deal with the high rates of infant mortality, low birth weight, and malnutrition among women and children. The scheme essentially targets children in the age group of zero to six years and women in the reproductive age group. The problem is that the ICDS is seen as the success story behind bringing down the rates of malnutrition and morbidity, but at the same time it has been held singularly responsible for the failure to reach targeted levels.

It was 10 years ago, in 2001, that the Supreme Court directed the government to universalise the ICDS by 2012 in order to cover all children under six years and open anganwadi centres in all human habitations. That target is still to be met. Many anganwadi centres are run from rented, low-budget facilities without even the basic amenities.

In Haryana, for instance, the majority of the centres are run from chaupals, or common grounds, where the scope for a toilet is extremely limited, inconveniencing not only children but anganwadi workers as well. Also, allocations for the ICDS have not increased meaningfully; in fact, only a mere Rs.538 crore was added on in the Union Budget for 2010-11. The revised Plan outlay was set at Rs.72,877.52 crore under the Eleventh Plan, though the total budget allocations so far, into the fourth year of the Plan period, have amounted to only Rs.26,998 crore.

The All India Federation of Anganwadi Workers and Helpers, which has been demanding regularisation of employment for anganwadi workers and helpers, feels that the budget outlay is a complete sell-out to a World Bank project (ICDS IV), which demands a more targeted intervention of ICDS funds. The federation feels that apart from the low budgetary allocation, the governments indifference to angawadi workers and helpers has contributed to the lack of improvement in the status of malnourished children.

The governments reluctance to consider the federations demands, despite agreeing initially to consider social security and pension for anganwadi workers, while at the same time overburdening the workers and helpers with the implementation of a scheme for adolescent girls, has not helped matters. The federation argued that the majority of the workers worked for far below the minimum wage, while helpers received one-third of the minimum wage applicable in their areas.

The problem, it said, was that even after 30 years, the ICDS was still being conceived as a scheme and not as a programme. The diffidence to give permanence of employment to anganwadi workers and helpers had not exactly strengthened the system.

The federation said there was a retirement age for the workers and helpers but no corresponding social security scheme upon retirement. Why is it that the poorest among the poor are expected to do voluntary work, be content with poor pay packages, yet have a sense of deep dedication, and end up being insecure at the time of retirement? asked an anganwadi worker in Haryana.

A typical anganwadi worker or helper is responsible for pre-school education from 9 a.m. to 11-45 a.m. for three- to six-yearolds. She has to keep records of rations every day; weigh the children, especially those who were malnourished; conduct a certain number of home visits every day; and also give immunisation shots. After 2 p.m., she is supposed to motivate people to build toilets, keep a record of how many homes have toilets, do surveys of handicapped people in the village, and sometimes even bring them to the special camps whenever they are organised. Enumeration work for any kind of census is over and above all these responsibilities.

In Haryana, some of the anganwadi workers are given the additional job of selling life insurance policies at a commission of Rs.200 for every successful transaction. As a result, they get distracted from their original mission, said a superviser.

The extra emphasis on IEC (Information, Education and Communication) is another fallacy. What good is it for me to tell these poor women to feed their children milk, vegetables, pulses, and so on when I know they dont have enough for three meals a day? said an anganwadi worker.

Under the World Bank project, several features of which are already under way in eight States, initiatives such as the setting up of mini-anganwadi centres, involvement of the private sector in ICDS activities such as food distribution, handing over management of the ICDS to panchayat centres, formation of mothers committees, and involving self-help groups (SHGs), are in place.

A.R. Sindhu, secretary of the federation, said the involvement of the SHGs in the preparation of food and other activities, including the procurement of food stuffs, had resulted in the decentralisation of corruption. She explained that it was the same limited resources from which everyone the anganwadi worker, the panchayat member, the SHG women and the members of the village-level committee had to manage not only themselves but also the centre.

She said that getting the SHG women to partake in ICDS activities was another way of pitting the poor against the poor and also denying the SHG women themselves what is rightfully due to them. A rough calculation showed that an SHG worker got only Rs.250 a month for her contribution towards cooking the food. The natural tendency is to make money out of the corpus; now everyone wants to have a share, Sindhu said.

The process also has set off an unhealthy competition among the various people who were roped in ostensibly to make the system more effective. In the process, the actual beneficiaries, the children, have suffered. Sindhu said that as in Kerala, panchayats had to be given more resources. What has been done is to give power but no funds, she said. The result was that when a few sections in the ICDS hierarchy handled the resources as well as responsibility earlier, now multiple layers of people were involved but the allocations remained much the same, she said. There is competition for the limited resources as also pressure to reduce malnutrition at any cost, and the end result is that there is little qualitative change in the lives of the women involved in the process. Worse still, there is no appreciable improvement in the lowering of malnutrition levels.

As an illustration of limited resources and expanding activities, the government of Haryana was sanctioned Rs.36,657.71 lakh for 2009-10 under the ICDS scheme in the Budget, out of which Rs.18,465.71 lakh was for the implementation of the scheme and Rs.18,192 lakh was towards supplementary nutrition. The Central government provided 50 per cent of the expenditure towards the Supplementary Nutrition Programme (SNP) under approved norms. All the budget and expenditure of the village-level committees, the Sakshar Mahila Samoohs, the Best Mother Award and the sports meet for women were included in the budget and expenditure of the ICDS scheme.

The federation objected to the targeted system within the ICDS saying that it was cruel to deny food to children who came to the anganwadi centre on the grounds that they were not the poorest among the poor. It also objected to the concept note of the World Bank, which claims that malnutrition is concentrated only in a few districts and villages. How can you ask whether a child is APL [above poverty line] or BPL [below poverty line], especially when all of them come and sit together? This kind of discrimination can have a devastating social impact, said Sindhu.

The federation also objected to the system of forcing anganwadi centres to show reduced rates of malnutrition in order to show State governments in a good light. For instance, in Haryana, nutrition awards, of Rs.2 lakh, Rs.1 lakh and Rs.50,000, have been instituted at the district level. The awards go to the top three districts every year. This, the federation said, resulted in unhealthy competition among anganwadis and it was not unusual for figures of malnourishment to be fudged.

The federation demanded that anganwadi centres be run for the whole day in the form of a crche-cum-child-care centre. In New Delhi, it was learnt, anganwadi workers had not been paid their honoraria for the past seven months. Most of the centres were in rented premises, leading to constant tensions between the tenants and the landlords. With little or no variation in the quality of food, children were reluctant to eat the same food, said the federation.

Kamala, an office-bearer of the State-level federation in Delhi, said that every week the children were given the same food there was no variation in the form of eggs or fruit. She said it was not unusual for the food to go bad in summer. Sometimes there are beedis, worms and even lizards in the food, she said, on the basis of her decade-long experience of dealing with anganwadi workers and helpers.

She said that when it was pointed out that children were reluctant to eat the food, the workers were instructed by the department to give it to slum children. She felt that the norms of the Supplementary Nutrition Programme needed to be more realistic given the rise in the prices of essential commodities. At present it was Rs.2 to Rs.4 for children, Rs.2.70 to Rs.6 for severely malnourished children and Rs.2.30 to Rs.5 for pregnant and lactating mothers. The money allocated per child is the same but the prices of all food items have gone up. Naturally, quality will suffer, said Kamala.

According to a recent report by the Forum for Creche and Child Care Services (FORCES), the World Banks targeted approach to malnutrition as elucidated in ICDS IV is flawed as excluded and marginalised children are not confined to specific areas. They are found everywhere, including in the better administered States. The report says that what the concept note does is to create an artificial division among States, some for focussed attention in the new ICDS IV programme, including a best practice State, as well as within States by excluding certain districts and including others. In fact, the FORCES report quotes a report of a Planning Commission-constituted Working Group for Children Under Six as saying that the ICDS alone cannot provide all the required facilities and services. It should be seen as one component, among others, of a comprehensive strategy for children under six.

Malnourishment cannot in the least be mitigated or eliminated by a targeted approach. Neither do people choose to be malnourished or enjoy seeing their children waste away in front of their eyes.

If malnutrition has to be dealt with by the ICDS alone, which is in itself a flawed approach, then every element of the ICDS package has to be strengthened, beginning with the anganwadi worker and helper, and not weakened by creating a multiplicity of human resource.