|
World Food Programme - India the food aid arm of the United Nations |
|
Home About Us Policies Events Media Publications Vacancies Other Websites All Documents |
|
Strengthening Project Management in ICDS
Foreword The need for providing children with improved childhood necessities through a holistic approach, involving cooperation and liaison between disciplines and agencies are well recognised in India. The National Policy on Education placed high priority on Early Childhood Care and Development (ECCD). The policy suggested integration with the Integrated Child Development Services (ICDS) programme which is the largest child development service in the country. While ICDS has placed itself as the pivotal programme for integrating all mother and child care services, the skills of the functionaries in coordinating and tapping all existing potentialities, becomes very crucial. Therefore the need to strengthen the management skills carries far reaching implications. Efficient management of resources and services delivery has always been a priority area for World Food Programme (WFP) . Although, ECCD has not been a major focus area for WFP, the successive appraisal missions during the last decade have reviewed this component in collaboration with specialized agencies such as UNESCO, USAID and SCF. The need to strengthen this component in partnership was placed on the agenda of the 1994 WFP appraisal mission. UNESCO, an agency which intervenes at inter-agency and inter-Governmental levels for early child development programming came forward to collaborate with WFP on an action research . WFP designed a project to Strengthen ECCD, service delivery, project management and supervision in ICDS which was co-financed with UNESCO. The project was innovatively designed to facilitate and bring out the potentialities of the middle level functionaries, to harness all favourable opportunities. The project was implemented in Dhar district, Madhya Pradesh, with the help of a leading NGO, Bal Niketan Sangh. The project outcome far outweighed the input costs. This sustainable model can easily be institutionalised through the large ICDS training network available in the country.
Acknowledgements In keeping with their interest in early childhood education, UNESCO's financial support made this project a possibility. Our special thanks to Dr. Warren Mellor for his continued support. We are particularly thankful to USAID for extending financial support to meet the cost of early childhood learning materials. Our special thanks to the Government of India and Madhya Pradesh for the cooperation extended in the implementation of the project. The enthusiasm with which the Supervisors, Child Development Project Officers and Assistant Project Officers of ICDS Sardarpur, Nalchha, Gandhwani and Tirla participated in this project was remarkable. They would be trend setters in their own state for improved supportive supervision, project management and providing on-the-job training to AWWS. This project was completed successfully due to the encouragement received from Mr. Michael Ellis, the WFP Country Director. The technical and moral support received from Ms. Angela Van Rynbach, WFP Deputy Country Director, was invaluable to the project. The key person for designing, participating and overseeing the project was Dr. Minnie Mathew, National Officer, WFP. Her technical inputs and innovations were crucial for the success of the project. She took upon herself the task of redrafting and editing this report. Bal Niketan Sangh (BNS), reputed for its strength in early childhood education and a training institute for middle level functionaries was responsible for implementation of this project. The pillar of the project was Padamshri Shalini Moghe, the Director of BNS. Dr. Indu Karanpuria, the project Consultant, was responsible for implementing the early childhood component of the project. She not only designed the early education kit, but acquainted all the AWWs of the project area on the use of the kit. The devotion with which she followed up the action phase of the project was remarkably impressive. Strengthening Early Childhood Care and Development (ECCD); Service Delivery; Project Management and Supervision in Integrated Child Development Services (ICDS)
Abbreviations
Glossary of Terms
Abstract The Integrated Child Development Services (ICDS), the nationwide programme of the Government of India offers the most important interventions for addressing the nutrition and health problems and promoting early childhood education among the disadvantaged population of the country. The programme has positively influenced the nutrition and health indicators and school enrolment and retention rates. While this promise exists, the programme suffers from implementation bottlenecks such as poor delivery of services, ineffective coordination, inadequate supervision, lack of skills among functionaries and low community involvement. Ineffective coordination, inadequate staffing and supplies compounded with low awareness and demand among the community are responsible for poor delivery of health services. Poor performance of growth monitoring, nutrition and health education and early childhood education can be attributed to inadequate skills among grassroots functionaries and supportive supervision by the supervisory staff. Training which is central to effective functioning is unfortunately top-down with a high focus on ideal situations and weak in skill building inputs. Programme management is again top-down with the result the middle-level functionaries are tuned to merely following instructions and guidelines without exercising much of their problem solving capability. Supervisors fail to see their role as trainers and do not play active roles in strengthening the role of grassroots functionaries. This UNESCO/WFP collaborative project was a modest attempt to improve the programme management and supervisory skills of ICDS Supervisors and Child Development Project Officers (CDPOs), strengthening the training capability for providing on-the-job training and evolve a pattern for on-the-job training. Strengthening early childhood care and development was a crucial element of the project. The project was implemented in four ICDS projects viz., Sardarpur, Nalchha, Gandhwani and Tirla of Dhar district, Madhya Pradesh. The new approach which was developed to improve the management skills of middle level ICDS functionaries had three distinct phases which included field observations of Supervisors and CDPOs complemented by independent observations by WFP, Bal Niketan Sangh (BNS), the NGO responsible for the project implementation. Through a pre-phase workshop, individual action plans were developed by the Supervisors and CDPOs. The action plans included (i) the performance of each of the components with detailed problem analysis quantifying current performance level for individual Anganwadi centres, (ii) the reasons contributing to the problems, (iii) problem specific solutions, (iv) action to be undertaken and (v) expected outcome in quantifiable terms and (vi) the time frame within which the results can be achieved. These action plans were negotiated with the AWWs through one day orientation meetings. This forum was also used to demonstrate an early childhood education kit developed by BNS with financial support from WFP. Each AWC was provided with a kit which can be used in a variety of ways for cognitive, social, emotional, motor and fine muscle development. The second stage was an action phase when the Supervisors implemented their action plans which included improving (i) the service delivery, (ii) coordination with the health department, (iii) providing on-the-job training to AWWs. (iv) creating community awareness etc., depending on individual situations. All opportunities were utilised by them to improve the functioning of the AWCs. During the post-phase workshop which was the third phase of the project, the Supervisors came back with measurable achievements in each of the components. The outcome was the realisation among the middle level functionaries that they were managers in their own capacity and are responsible for the AWCs within their own jurisdiction. They also understood that they had a substantive influence on the success or failure of the AWCs. The model that was demonstrated was do-able and can be a pattern for supportive supervision.
Introduction Millions of young children today in the developing world , live in conditions of poverty. From the perspective of overall development, they are born and brought up in an environment which is hostile. Since independence, Government of India's determination to bring essential services to all these young children is impressive indeed. Human development programmes focused on care and welfare of children occupied an important place. Despite significant improvements in the health and education sectors in recent decades, 80 of every thousand children still do not live to see their first birth day. However, the incidence of severe malnutrition has declined significantly from 15 to 8.7, but the moderate and mild malnutrition, vaccine preventable disorders such as tuberculosis, diphtheria, pertussis, and polio are still common. Apart from these, 30 percent children born under- weight who are more vulnerable to illness and death. Among the poor in tribal and rural areas, the status of children is often worse than the national figures. Madhya Pradesh (M.P.) which is having the largest tribal population in the country (23.3 percent) reflects poor development indicators: for example the Infant Mortality Rate (IMR) is still 104 per thousand which is the second highest in the country (Sample Registration System 1994). This state has a large proportion i.e., 80 percent of malnourished children below -3 SD and -2 SD (National Family Health Survey, 1995). In M. P. the literacy level is as low as 50. The gender difference in literacy is glaring with 64 for males and 34 for women. Around 45 percent of girls (6 to 14 years) are out of school. Again there is a striking difference between the urban and rural situation with 54 percent rural girls being out of school (National Family Health Survey 1995).Compounded with the problems of poverty and illiteracy is the practice of child marriage in the country i.e.73 percent are married before the age of 18. The mean age of marriage for girls is 15.3 in rural M. P. as compared to 16.5 years in India. These and other critical features adversely affect their own lives and that of the future generation. Ongoing Interventions Since
independence, the Government of India (GOI) has remained committed towards
care and welfare of deprived children. Many programmes have been started and
many policies and plans were adopted to ensure the maximum benefit of basic
services to children. In 1975, the most important, multifaceted
Integrated Child Development Scheme (ICDS) was launched by GOI. ICDS has been
India's chief vehicle for improving the prospects for healthy physical,
psychological and social growth of it's children. From a base of
33 pilot projects in 1975, the programme has expanded rapidly. As of
March 1995, 3907 projects have been launched covering three quarter of the
country. · Supplementary nutrition (children up to 6 years of age, expectant and nursing women), · Pre- school education ( 3 to 6 years of age ), · Immunisation, health check-up, referral services (children, expectant and nursing mothers). · Nutrition and Health education (NHED) for women 15 to 45 years. The Government of India has assumed most of the responsibility for financing the scheme except for providing food supplements which is a state responsibility. The scheme receives support from international agencies such as the World Bank, UNICEF, World Food Programme (WFP), CARE, UNESCO and USAID which are actively involved in bringing about qualitative improvements in ICDS. By the end of the Eighth Five Year Plan in 1977, India hopes that ICDS will reach all the 5,153 developmental blocks, reaching every needy child in the country under the age of six. The philosophy of the ICDS programme is to address children's needs holistically, for making an overall impact. In principle, each service rendered would be complemented by related services and therefore efficiency in the delivery of all the ICDS services is the key to the success of the programme. The cutting edge of ICDS -Anganwadis The basic unit of the ICDS system is the network of Anganwadis Centres (AWCs ). These centres provide a powerful mechanism for reaching mothers and their children. Anganwadis are focal points of delivery of all basic services to women and children. Each centre serve about 1000 people in rural and urban areas and 700 in less populated tribal areas. In order to improve outreach in less sparsely populated areas, AWCs can be set up for population less than what is stipulated as the norms. The AWCs are run by village volunteers viz., the Anganwadis Workers (AWWs) and the Helpers (usually local village women). The AWWs are supported by a cadre of supervisory staff beginning with the Supervisor. The Supervisors are responsible for 17 to 20 AWCs. At the block level, the ICDS project is managed by Child Development Project Officers (CDPOs) and Assistant Project Officers (APOs). They are mainly responsible for selecting AWWs, securing local facilities, ensuring food supplies, flow of health services and reporting to higher authorities. At the district level, the District Women and Child Development Officers (DWCDOs) are responsible for all the ICDS projects of the district. At the state level, the Directorate of Women and Child Development exercises overall control throughout the state. ICDS in Madhya Pradesh ICDS in Madhya Pradesh was started in 1975-'76 in two blocks. Now 230 projects are operational which service 4.25 million women and children. International agencies such as World Bank, UNICEF, WFP, CARE and USAID are actively supporting ICDS in Madhya Pradesh. The World Bank is assisting in strengthening the 113 ICDS blocks and expansion of ICDS in new 131 blocks covering an estimated population of 7.6 million. This project will seek to enhance the quality and effectiveness of ICDS services and refine further several key areas of ICDS. WFP provides food assistance to 34 ICDS blocks, with 330,000 beneficiaries. These are spread over three tribal districts i.e. Jhabua, Dhar and Khargone. WFP has also undertaken several initiatives to improve the quality of ICDS for example : The project "Empowerment of adolescent girls" has several components which contribute towards quality improvement and will be described in subsequent sections. CARE supports 916,000 beneficiaries of the ICDS programme. Several health initiatives addressing the problems of diarrhoea and respiratory infections are also attempted by CARE. UNICEF works with the
Government of Madhya Pradesh on a number of programmes guided by the overall
priority in the VIII Five Year Plan for supporting development of women and
children in rural areas (DWCRA). UNICEF supports training of ICDS
functionaries besides providing equipment such as jeeps, balances and growth
cards for growth promotional activities for children. Vaccines and
micronutrient supplements are also provided by UNICEF. Since its inception, the ICDS has generated considerable interest among academicians, planners administrators and those who are responsible for implementing the programme. Therefore, large numbers of studies have been conducted to evaluate and assess the impact of the programme. Review of these research studies indicate that ICDS has had a positive impact in terms of infant mortality, reduction in severe malnutrition, coverage of immunisation and utilization of health services, National Institute of Public Cooperation and Child Development (NIPCCD, 1992). The study also found a greater school retention by children exposed to pre- school education in preparing them for formal learning, better adjustment in primary school and promoting retention in elementary school and reducing drop-out rate. While such great potentiality exists in the programme, it is necessary to identify the short-comings and find out ways and means by which the programme can make a better impact. Research efforts have also contributed considerably to the understanding of the programme and have helped in identifying bottlenecks and lacunae in the implementation of the scheme with regard to poor delivery of services, inadequate supervision and poor community participation and limited role of ICDS supervisory staff. Several studies reported that lack of transport facilities, village level politics, ineffective coordination of ICDS staff, lack of supervision, poor interpersonal communication are major difficulties which hamper the smooth implementation of ICDS (Lakshmi Kumari, 1987, Rane, 1989, CHETNA, 1989, Murthy, 1989). The main constraint in eliciting community participation has been identified as the lack of skills among functionaries in mobilizing the community (Coonar and Mohan, 1985, Nutrition Foundation of India (NFI), 1988, Philips and Kurien, 1986, NIPCCD, 1988). Many studies have reported that NHED is a weak component of the ICDS programme. NHED is rarely conducted and the workers lack the skills of implementing it. The national evaluation of ICDS by NIPCCD (1992) shows that about 36.3 percent AWWs were not able to monitor the growth of children. The main reason that was pointed out was the lack of skills among AWWs in filling up growth charts. Lack of coordination between ICDS and health staff has been shown to affect the delivery of health services in ICDS areas. As reported in the evaluation of ICDS (1992) the percentage of health check- up performed by Medical Officers (MOs) was higher in urban AWCs as compared to tribal and rural areas. Deulkar et al. (1989) conducted a job analysis of AWWs in selected ICDS blocks. They found that verbal activities were the most frequent and out door games were the least. Instead of child centred activities, rote learning group activities were common. The NIPCCD study (1992) reported that the AWWs focused on formal methods of learning, majority of children could count up to five objects. Cognitive and manipulation competencies were found to be weak. A study conducted by Mathew (1992) in the tribal district of Jhabua in Madhya Pradesh also reflected several weakness in the implementation of ICDS. Only 43 percent of AWWs understood their job responsibility of non- formal pre-school education in a holistic manner. The time spent on non- formal pre-school education was very low and participation of children was not punctual and regular. Observations at AWCs indicated that physical activities were not popular. Very few AWCs held activities for the development of finer muscle coordination with very low participation. Activities at most centres hardly provided any intellectual stimulation. Learning through outdoor examples and interactions with the environment were noticed only in very few AWCs. Play and out door activities were not found to be stimulating. A study conducted by Singh (1984) reflected that children were huddled inside AWCs, although adequate open space was available in the centres. AWCs did not have play equipment and teaching aids for pre-school education, except counting frames and black boards. Efforts were not taken to prepare teaching materials. Children were not involved in activities for socialization and habit formation. AWWs had also not taken the initiative to educate the mothers about the objectives of pre-school education. In the context of the country's commitment to ensure basic education for all by A.D. 2000, ECCD also emerges as an area of priority. It is now established that basic learning begins at birth. Learning and development are essentially cumulative phenomenon whereby, what precedes play oriented early childhood education programmes play a significant role, both competitive/ preventive and reinforcing in compensating for the deprivation emanating from socioeconomic economic disadvantages as well as providing additional enrichment experiences, which the home situations is on its own not able to offer.
Early Childhood Care and Development (ECCD) - some experiences Early childhood education is expected to have a beneficial impact on the future life attainment and development. It provides stimulating experiences to children and facilitates optimal cognitive development. It aims at developing competencies required for formal education particularly for the vulnerable group of population. In view of the accepted significance of ECCD for the overall development of human potentials as well as for the immediate gains in terms of school retention and achievement, an ECCD project was launched with UNICEF assistance in 1982. Under the project, 65 ECCD centres were established in each state which were physically attached to primary schools. A longitudinal study to assess the impact of these ECCD centres was conduced by the National Council of Education, Research and Training (NCERT) in 1993 which showed that ECCD certainly facilitates retention in the primary grades. In Madhya Pradesh, an ECCD programme was launched in 1983. Under this programme, ECCD centres have been established in 2 development blocks of Mandala district. In 1990, an evaluation of ECCD centres which was conducted by UNICEF, found ECCD as an important programme for retention in primary school and it was suggested that these centres should be linked with ICDS AWCs and ECCD teachers were nominated as resource persons for imparting training to AWWs on aspects of ECCD. This experience in M.P. was considered to be of exceptional quality as compared to the other states. Christian Children Fund (CCF) and the M.P. Council for Child Welfare are also working in the field of child care and education in Madhya Pradesh. UNICEF has also experimented different ECCD methods i.e. Cognitively Oriented Programme for Pre-school Children (COPPC) method in selected ICDS projects for improvement of pre- school education component in Dhar, Jabalpur and Hoshangabad districts. Bal Niketan Sangh (BNS) a local non-governmental organisation (NGO) with the technical and financial assistance from UNICEF, has also been engaged in developing applied, result oriented methods for early childhood education specially for the ICDS Anganwadis. Many workshops and experimental programmes have been organised, in this series and strategies were developed for implementing the thematic approach of ECCD. The teacher empowerment programme was started in Dhar district to bring about the qualitative improvement and access of primary education. This was planned to make primary school attractive and interesting for children. This programme has proved to be a great success. An attempt was made to link it with Anganwadis but did not make much of an impact, as the main focus of the programme was on primary education rather than early childhood education. A mission carried out in the framework of the co-operative programme between WFP and UNESCO pointed out that only one and a half hours are spent on early childhood education out of the three to four hours of Anganwadi functioning. Therefore little attention is paid to qualitative aspects of experiential and participatory activities and play, which lay the foundation for children's sound psycho-social development which are prerequisite of early literacy and numeracy readiness. One of the important recommendations made in that report was the need for learning materials in the AWCs. A subsequent appraisal conducted in 1994 on the early childhood care and development component of WFP assisted ICDS also pointed out the need for learner centred activities by active learning and participatory involvement, interactive activities and the use of local materials and environment. Recommendations were also made to improve supportive supervision of the supervisory staff. The adolescent girls' scheme, an initiative of WFP encourages girls to acquire basic knowledge and skills related to health, nutrition and child-rearing. They also learn to assist the AWWs in their daily activities thereby contributing to the improvement in the quality of services delivered by the AWW. Both the WFP missions pointed out that the adolescent scheme was a good example of what can be achieved through food aid. Training is an in-built component of ICDS programme. All AWWs and Supervisors receive job training for three months and subsequent refresher training at government approved training centres. Supervisors and Instructors of Anganwadi Training Centres (AWTCs) are trained through middle level training centres. The apex training institution is NIPCCD. ICDS offers tremendous potential since it is a programme meant for the poorest communities in the country and among them to the most vulnerable segments. The potentiality that the programme offers in terms of its design and infrastructure need to be fully tapped into. This can be done by strengthening the capability of the grassroots functionaries through the training network since it is an in-built part of the programme. There are several
constraints and considerable backlog in the training of ICDS functionaries
(Sharma, 1987; CHETNA, 1989; CRD, 1988). They also suggested the
need for making training of Supervisors more practically
oriented with a focus on developing their supervisory
skills. These experiences can help the ICDS Supervisors and AWWs to
cope up with the ground realities and help them in solving the
immediate problems related to various aspects of the service. Most of
the orientation training and refresher training are currently done in
training room situations suggesting ideal ways of service delivery rather
than helping functionaries to cope with the ground reality. This is evident
from the study conduced by Mathew (1992) in Jhabua, M.P. wherein almost all
functionaries had received their basic training and most had one or two
exposures to refresher training programmes, were performing below standards).
Experiences gathered through field visits and workshops conducted by WFP:
These observations clearly lead to the designing of a project to strengthen ECCD, service delivery, project management in at least selected areas of M.P. A WFP/UNESCO
collaborative effort
Project Objectives
This project component for strengthening early childhood care and development (ECCD) is a part of a larger WFP initiative in Dhar district "Empowerment of tribal adolescent girls" which hopes to improve the quality of ICDS through training of adolescent girls. As a pre-requisite to what the adolescent girls can do to influence ICDS functioning, the basic services should be in place and well managed. Therefore this component for strengthening ECCD, project management and supervision in ICDS formed an integral part of the WFP project.
Project Area The tribal district Dhar of M.P. was recommended as the project site by the Government of Madhya Pradesh (GOMP) since Jhabua district was already covered entirely by the Government of India(GOI) adolescent girl scheme. Although it was envisaged to cover the entire Dhar district under this new initiative, it was limited to 613 AWCs in four ICDS blocks viz.,Tirla, Nalchha, Sardarpur and Gandhwani due to resource constraints. The number of AWCs in the four blocks included in the project are given below:
Dhar district is situated in the south- western part of M. P. According to the 1991 census, the total population of the district is 13,67,412 of which 53 percent population were tribals. The predominant tribal groups are the Bhil and the Bhilala. Sixty nine percent of the population of Dhar district are living below the poverty line and have very low level of literacy of 28 percent. The gender differences in literacy is glaring with 38 percent literacy for males and 16 for females. Infant mortality, a significant indicator of child survival, is 104 per thousand live births and maternal mortality has been estimated to be 44 per thousand live births. The average age of marriage is 15.Teenage pregnancy is common, since 49 percent of girls would have had their first child-birth when they are in the age group of 15 to 19. From the perspective of overall child development, the children in Dhar district live at considerable risk.
The project design The project was designed to being about a qualitative change, reflecting integrated implementation of health, nutrition and early childhood education services, through appropriate service delivery, management and supervision by ICDS functionaries. As is evident by the survey of literature there are several key areas requiring focal attention. The strengthening was intended to be done by improving the capability of the grassroots functionaries. This training was innovative and altogether discarded the traditional class room training which is largely based on theoretical information. A new approach was developed to improve the management skills of middle level ICDS functionaries which had three distinct phases.
Pre-project phase The pre-project phase was based on the study and analysis of the issues observed by WFP, BNS, the pre-phase assessment conducted by the independent NGO, Dr. Baba Saheb Ambedker Institute for Social Sciences, and the problems encountered by the ICDS Supervisors during their routine visits. Observations made by Bal Niketan Sangh During first two months the BNS project team undertook a quick study of the field situation. During the quick study period, the team visited the project areas, observed the functioning of the Anganwadis, held discussions with the community, the ICDS beneficiaries, parents of child beneficiaries, AWWs, Helpers, their Supervisors, CDPOs and MOs. The field visits provided an understanding of the problems and constraints in the implementation of ICDS when viewed from the grassroots level, the work and management potential of the ICDS functionaries specially the Supervisors and CDPOs. Their major findings were:
The field observations reflected the need for strengthening the pre-school component through hands-on training and provision of pre-school materials suitable for cognitive, physical and social development of children. Observations from the pre-phase evaluation A pre-phase evaluation was conducted by an independent agency, Dr. Baba Saheb Ambedkar Institute for Social Sciences, located at Mhow, M.P. Their findings are given below:
The pre-phase workshop
Proceedings of the workshop The first part of the workshop was devoted to discussing and documenting prevalent performance. The preparatory work helped the Supervisors to present a fairly vivid picture of the existent performance of all the ICDS components. Since the problems were many and the time frame of the project was rather short it was decided that each Supervisor would identify five AWCs from their supervisory sector to develop individual action plans. Analysis of the prevalent problems Health services
Growth monitoring
Supplementary nutrition
Nutrition and health education
Early childhood education
Thus, AWWs were not able to perform the activities which can help in creating an interesting environment and attract children towards the AWCs. During the discussions it was realised by all the participants that the concept of early childhood stimulation (ECS) was not understood and there were no activities for children under three years of age, either at home or at the AWCs. The need and importance of ECS activities, which are very important for the development of children were discussed. Stimulation in the early childhood stage involves efforts to activate child's early development and provide learning experiences to the child so as to enhance his/her development. The nurturing experience the infant receives in the early years of life serves as the foundation for his/her subsequent learning. A home which believes in the capacity of the child and has high hopes for him/her, is the best stimulator for the child. The continued love and support of the mother lays the foundation of all future development. The pleasure of sucking, hugging and close proximity to the mother are all experiences which help the body to develop the feeling of security. Play is most natural and spontaneous to children. Apart from being fun, play is significant for the child's physical and psychological development. Listening to stories is a favoured activity of children and occupies a very important place in the ECS programme. Music too is a strong stimulator. Songs and musical riddles appeal to them. It is important that every mother makes an effort to learn songs, lullabies etc., and make use of them in daily life activities for example, when the mother feeds the baby, she may hold him/her close and talk to the baby. The mother plays, smiles, cajoles and sings and the child responds and experiences physical contact, warmth and security. Although nutrition and health inputs are available to the tribal children (however imperfect) there is lack of knowledge about ECS activities which can stimulate their overall development. Besides, children under three years of age do not come to the Anganwadis for any learning experience. Thus they are deprived from getting a chance to boost up their potential for over all development causing delayed development. Therefore, if we educate the mothers about ECS, it will certainly have a positive impact on overall development of children. Techniques to impart education to mothers were also demonstrated during the workshop. Supervisors demonstrated the ECS activities to the AWWs who in turn provided orientation to the mothers. Preparation of action plans Using the above information, the following were documented in the individual action plans: (i) the performance of each of the components with detailed problem analysis quantifying current performance level for individual AWCs; (ii) the reasons contributing to the problems; (iii) problem specific solutions; (iv) action to be undertaken and (v) expected outcome in quantifiable terms and (vi) the time frame within which the results will be achieved. All the 38 Supervisors who participated in the workshop prepared individual action plans on the basis of the above mentioned parameters. This exercise was quite time consuming since they had to work out situation specific solutions. Although the original intention was to develop action plans for all the AWCs by each Supervisor, it was not feasible due to time constraints and was decided to select only five AWCs by each Supervisor. All the participants prepared their individual plans with a great deal of interest. They included details such as sectorial maps and graphical presentation of the current situation and expected outcome. To illustrate( an example
of an action plan developed for one AWC):
The Supervisors presented the individual action plans developed by them to the plenary. In all, 190 action plans were presented and discussed. This was a learning experience for the participants and the facilitators since the observations made by the ICDS Supervisors were very much in the context of individual villages. They were 'realistic snap-shots' and did not involve any generalisation. The problem/ situation specific discussions helped the facilitator to guide them to overcome the negative influences and take advantage of the opportunities they came across. Unlike normal training situations when trainers tend to generalise, this training situation was a unique one with focused discussions. Therefore trainees interest level was also sustained at a very high level. Based on the discussions, the action plans were revised. Each CDPO/ Supervisor participating in the workshop was provided plain papers to prepare their action plans. After preparing duplicate copies, they were filed and were carried back with them. All participants left the workshop with their own working manual to follow in the field. For once, they realised that they had their own roles to play and were not merely executors of instructions. While following the top down approach the grassroots functionaries do not feel responsible for the results. They looked for excuses to rationalise why things did not work the way they were intended. This attitude had emerged since there was no ownership among the functionaries who were partners in the programme and when their views were not given adequate importance.
One day orientation for Anganwadi Workers The next step on completion of the pre-phase workshop and preparation of the action-plans was to negotiate these plans with the AWWs, their expectations and suggestions for the qualitative and quantitative improvement plans that were outlined at the pre-phase workshop. The one day orientation sessions were conducted by the Supervisors, the BNS consultant and trainers who formed a team. These sessions were organised at the sector level. It was not only to have it in close proximity to their AWCs but demonstrating the idea of using sector level forums for discussing issues other than compilation and reconciliation of reports was important. A total of 575 AWWs participated in the different sector level discussions. The action strategies were discussed in detail with the AWWs using the working manual prepared for specific Anganwadis. During these orientation workshops, the Supervisors discussed their problems and provided them guidance and suggestions for resolving their existing problems . All aspects of the ICDS package were discussed in these workshops. The exercise created a ripple effect in that, not only those AWWs whose centres were identified for inclusion in the action phase came forward but others were also motivated to join the discussions on effecting improvements in the ICDS service delivery. In sharp contrast to traditional training, the Supervisors and trainers used group discussions to encourage participants to interact in informal ways and develop their own ideas of how to make the services effective, attract children towards AWCs, seek community participation and demonstrate skills of communication. These exercises enabled Supervisors to identify themselves with the problems of AWWs and the AWWs also learnt to express their ideas and problems more effectively . The Supervisors mastered the skills of conducting training in a participatory fashion.
Strengthening early childhood education The pre-phase workshops clearly revealed the need for special attention on the early childhood education component of ICDS. The major weakness observed were the poor management of non-formal pre-school activities at the AWCs, and lack of know-how of methodologies for conducting non-formal activities. In order to strengthen the component special emphasis was given to early childhood education at the AWCs and mothers' education about early childhood stimulation for children under three years of age. The attempts were directed to:
The BNS Consultant and trainers demonstrated activities which can be organized both indoor and outdoor; methods for group activities; use of locally available resources; distribution of play material to children according to their age; stories and poems for pre-school education and the thematic approach for early childhood education. The activities of Early Childhood Stimulation (ECS) for children below three years of age which were totally neglected at the AWCs and homes were also demonstrated during the one day orientations. The stimulation which mothers can easily perform during their daily household activities were demonstrated to the mothers. The one day orientation programme helped the AWWs understand the techniques of early childhood education in a practical way. The AWWs were also provided guidance on involvement of adolescent girls who were trained through the WFP project," Empowerment of adolescent girls". An early childhood education kit for children 3 to 6 years of age was developed by BNS with financial support from WFP. All the 613 AWCs included in the project were provided with the kit. They were trained on the use of the kit by the BNS team. The kit was designed to promote cognitive, language, motor, physical, social and emotional development. It was also designed to develop communication skills, good behaviour, creativity, partnership and self confidence in children. Most of the items included in the kit could be used for more than one type of learning experience. Materials for out- door activities were also included in the kit such as ball and rope which were designed on the basis of COPPC method which help to promote both gross motor development and social development. The ECE kit materials were not only enjoyable for children but were also capable of stimulating development. The materials, methodology and approach used in the early childhood education kit are as follows:
The intention of providing the kit material was not to limit the AWWs to the use of the kit alone. Therefore they were familiarised to many other activities like painting with the help of thread and waste paper, spray painting with the help of net and brush and making floor designs with the help of seeds, leaves, flowers etc. Suggestions were made for organising the activities in such a manner that the AWW can keep her eyes on every child and be able to provide the necessary guidance to them. While indoor activities are being organised, there should be not be any outdoor activities because it diverts the attention of children. The indoor activities were designed to begin with simple ones, gradually progressing to complicated ones. The children should perform the simple activities in the beginning and only when he/she is able to do them perfectly should they attempt activities which are more complicated. If a child is able to perform the activities quickly and is able to grasp the concept earlier than the entire group, the AWW should give special attention to the child and try to enrich the environment favourable for development. Many other alternate methods were also suggested for making ECE a pleasant experience for both children and the AWWs. They were taught how to make stories interesting with masks, charts and puppets and sing songs with action and movement; how to interact with children; prepare useful and attractive playing and learning materials from waste or low cost locally available resources. Some guidelines for organising pre-school activities at the AWCs:
Action phase The action phase was from February to July 1995 . During the action phase the ICDS Supervisors and CDPOs strengthened their management roles, improved their supervision and undertook their role as trainers of the AWWs in their jurisdiction. Some of the key issues addressed through the action phase were:
The BNS consultant retained a true copy of the individual action plans evolved by the ICDS Supervisors. This was used for follow-up during the action phase. The Supervisors and AWWs accepted this experiment as a challenge and used it as an opportunity to display their capability to show improvement in the functioning of their own centres. Normally when state level instructions are received for undertaking certain special activities, field level functionaries consider it as a burden. During the action phase, there was a special drive to improve the coverage of health services which was launched by the Rajiv Gandhi Health Mission of the Government of M.P. Under this drive, rallies and campaigns were organised in every village. A "Rajiv Gandhi Jattha" which included the Chief Medical Officer, doctors, ANMs., CDPOs and Supervisors, who went to every village. The AWWs and Supervisors took advantage of the "Jattha" to undertake health check-up of children and pregnant mothers which was the weakest component as reflected in the pre-phase workshop. This is an example of how the functionaries learnt to take advantage of opportunities that they came across routinely. They also benefitted by beefing up the immunisation. Health and nutrition education sessions were also organised by the" Rajiv Gandhi Health Jattha" conveying messages of oral rehydration, hygiene, sanitation and other relevant information on various aspects of health and nutrition. These health campaigns helped in improvement of health services at the AWCs and also improved coordination among health and ICDS functionaries. The AWWs and Supervisors contacted local leaders and requested them to encourage people to take advantage of the ICDS services by sending their children to the AWCs. During community meetings, local leaders were present and took active part in the discussions. Since they have an influence over people in their villages, this effort brought about positive changes in the attitude of the community. Healthy baby competitions were organised to communicate the value of good health and generating awareness among people, specially among mothers. Mothers also expressed their problems in the meetings and the health team responded with appropriate solutions to their problems. The new approach of
continuing education through hands-on-training while on the job was
emphasised in order to strengthen and improve the quality of the
various services. During the preparatory phase, the Supervisors had
identified areas requiring hands-on-training and the AWWs who required the
additional training. Based on this, the action plans were prepared and were
followed in the action phase. Therefore there was a selective approach based
on the specific requirements. This approach was time effective and was able
to produce results. The AWWs were able to develop skills more effectively.
Any number of class-room exposures cannot produce results equal to that
of on-the-job training. In short, a combination of inputs to suit the
different situations was applied. All the focused efforts such as the
community meetings to enlist community support, home visits to increase
participation, community awareness, the inputs of the Rajiv Gandhi Health
Mission and the hands-on-training were helpful in producing the
intended results.
The supervisory skills of the Supervisors also showed considerable improvement. The Supervisors who previously concentrated only on scrutinising records started providing support and guidance to AWWs. They were found to pay attention on learning materials, the pre-school teaching techniques, growth monitoring, immunisation status, supplementary nutrition and beneficiary participation. They helped the AWWs in community contact and eliciting their cooperation. The regularity of service delivery improved as a result of improved management skills of the Supervisors.
The post-phase workshop The
post-phase workshop served as a forum for exchange of experiences through
individual presentations. All the Supervisors who prepared action plans and
went through an action phase participated in the post-phase workshop. A
component-wise summary of the presentations is as follows: Almost all Supervisors reported an increase in the coverage of supplementary nutrition. The average coverage of supplementary nutrition which was reported to be approximately 60 percent in the pre- phase workshop, increased to 70 to 75 percent. There was an improvement in the coverage of pregnant and lactating mothers. The Supervisors and AWWs conducted meetings of mothers who were not participating in the supplementary nutrition and paid frequent home visits and requested them to come to the AWC. They created awareness among them on the advantages of supplementary nutrition. As mentioned in the pre-phase discussions, the mothers went for work in the field very early and were not able to come to the AWC to benefit from the supplementary nutrition. The schedule for distribution of the supplementary food for mothers was changed. The ACDPO of ICDS Nalccha, Usha Joshi reports, " Before implementation of the action plan the average attendance of mothers was around 8 to 10 out of 20 to 25 mothers who were enrolled for participation in an AWC. After changing the time of distribution of the supplementary food for them, these mothers who went to the field also benefitted by the supplementary nutrition component". The long distances to the AWCs was also reported to be a problem. In those areas, the supplementary nutrition was distributed with the help of adolescent girls, who took the prepared supplementary meals to the hamlets and distributed to the pregnant and nursing mothers. Lack of hygiene among children was a serious problem which had to be addressed. Several other situation specific solutions were attempted during the action phase by the Supervisors and AWWs to improve the implementation of the supplementary nutrition component. Immunisation, Health check-up and Referral services The pre-phase findings and presentations accented on the poor performance of health check-up and referral services. Supervisors fully capitalised on the opportunity thrown open by the special campaigns on health check-up and diarrhoea control they had to organise in collaboration with the Rajiv Gandhi Health Mission. Through the campaigns, intensive health check-up and immunisation drives were organised. Several un-immunised children were immunised during these drives. People of Goomanpura village of Ringnod sector, which is isolated from all amenities depend very much on the services rendered through the AWC. Owing to long distances to the Primary Health Care (PHC) centre and lack of transportation facilities, many women have died during child-birth. The Supervisor of this sector, Vandhana Billore, held discussions with the Panchayat leaders and explained the need to do something about this fatal problem the women in their village experienced. The response was unbelievably good since they collectively organised a vehicle for emergency requirements such as child- birth. The Supervisor also organised a special survey and identified 8 malnourished children who were not previously identified or registered in the AWC. The AWW was familiarised with the referral system and during the action phase several cases were referred to the hospital. But for this effort to organise hands-on- training, several components would have remained grey areas for the AWWs. Nutrition and health
education ( NHED)
Early childhood
education Parents education was important for the successful implementation of the pre-school programme. When they saw their children enjoying the outdoor activities at the AWCs, they were thrilled and watched all the activities with a great deal of interest and realised the need and importance of such activities. If parents are aware of the concepts of ECE, they will bring their children to the AWCs, and if they take interest in the activities of their children and encourage them to recall the activities, songs and stories at home and appreciate their efforts, the confidence among children will be built, which will prompt their learning and curiosity . In this way, the link between AWWs and parents was built up, which will definitely contribute to the holistic development of children. When a demonstration was going on at a remote AWC of ICDS Nalccha situated on a hill top, one of the parents remarked, " I have never witnessed the experience of joy and excitement of children playing in this way , therefore I have never understood anything about the pre-school activities. Now I am convinced and will convince other parents in my village to send their children to the AWC". A four year old child at an AWC remarked, " I love to play here because I do not have any play material at home". These responses reflect the need and importance of demonstrating Anganwadi activities to create community awareness . Many AWWs, who were considered as dull and lazy, became active and started performing very well; they started demanding more and more interaction with their Supervisors. Adolescent girls who received training through the WFP training programme were also found to be facilitating the activities of ECE. These inputs increased the confidence of AWWs who were motivated to work hard for successful implementation of ECE activities. The efforts to strengthen the ECE component were provided with a view to promoting long term effects through parents' education. This aspect was emphasised for building bridges between the AWC and the home and it was presumed that this effort would definitely bring about a positive impact on ECE activities. Development of AWW's skills in making learning materials through local resources, can make ECE activities enjoyable for children and will help them organise the ECE activities without much additional financial or technical assistance. A very difficult but a rewarding experience The supervisor of Chaklya
sector, Bharti Chauhan, took up an interior village under the action plan.
The situation of all the services in that AWC was grim. There was no
coordination between the health and ICDS functionaries. The situation of
health services, specially the health check-up and referral services, was not
satisfactory. Only around 50 to 60 percent of the children were weighed and
the AWW was not able to fill up the growth charts. Many cases of
malnutrition were not identified and many needy children were
deprived of the benefits of supplementary nutrition. She said that,
although while preparing the action plan in the pre-phase workshop, she had
set up a target of 80 percent performance, she was very apprehensive about
achievement. The attitude of the community was totally negative towards ICDS
and they did not come to the AWC to participate in the services. However,
when the action plan was implemented in the village, several innovations were
introduced: the adolescent girls, who were recently trained
under the WFP project, were involved in the Anganwadi activities; with the
help of the ' Rajiv Gandhi Health Mission Jattha', and other health
staff, the health services received a big boost; the AWWs and
Supervisors organised community meetings and impressed them about the
benefits of the services available at the AWC. During the implementation of
the action plan, much emphasis was given to the management of health and
nutrition services and nutrition and health education; special efforts
were made by the Supervisor to improve the coverage of immunisation.
Special attention was paid to growth monitoring by improving the skills of
AWWs through special orientation and performing the growth monitoring
task during home visits and community meetings. This attempt
improved the coverage of ICDS services providing benefits to those needy
women and children who were not benefiting. Conclusions
Recommendations
References ·
Centre
for Health Education, Training and Nutrition Awareness (CHETNA). Training
needs assessment for ICDS Supervisors. ·
Centre
for Research and Development (CRD). Report on the study of middle level supervision
by Mukhya Sevikas of ICDS Project in old Chandrapur district of Maharashtra,
1987. ·
District
Rural Development Agency. District Profile for Dhar District, 1995. ·
Government
of India. A data sheet on ICDS, 1995. ·
Government
of Madhya Pradesh. Madhya Pradesh State Plan of Action. A Commitment to the
Child, 1994. ·
Lakshmi
Kumari. Assessment of Supervisor's job towards pre-school education. JBAS
Women's College, 1987. ·
Mathew,
M. Adolescent girls in tribal ICDS, World Food Programme, 1994. ·
Murthy,
L S N., Mathur, Sunita. Project Management: A study of ICDS project New
Delhi, 1984. ·
National
Institute of Public Cooperation and Child Development (NIPCCD).Impact studies
of community participation in ICDS, 1988. ·
National
Institute of Public Cooperation and Child development. National Evaluation of
ICDS, 1992. ·
Nutrition
Foundation of India. Integrated Child Development Services. A study of some
aspects of the system, 1988. ·
Philips,
W S K., Kurien, N A. Time work allocation and effectiveness of the work of
Anganwadi Workers. Indore School of Social Work, 1986. ·
Reddy,
V R., Sastry, N P., Kashinath, J G. Nutrition trends in India. National
Institute of Nutrition, 1993. · United States Agency for International Development (USAID ). Integrated Child Development Services: Innovative approaches to enhance Services, 1992.
|
|
World Food Programme 2 Poorvi Marg, Vasant Vihar, New Delhi - 110057, India Tel:91-11-26150000, Fax:91-11-26150019
Contact:
|