BARRIERS IN ACCESSING CHILD DEVELOPMENT … IN ACCESSING CHILD DEVELOPMENT PROGRAMME IN DARINGBADI BLOCK ... evaluation of ICDS ... Monica Das Gupta, Yi-Kyoung Lee, Meera Shekhar …

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BARRIERS IN ACCESSING CHILD DEVELOPMENT PROGRAMME

IN DARINGBADI BLOCK

JULY’2011

SUBMITTED BY MANOJ KUMAR TRIPATHY

FOR CENTRE FOR CHILDREN STUDIES

KIIT SCHOOL OF RURAL MANAGEMENT BHUBANESWAR

& UNICEF

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Content

i Acknowledgement 3 ii List of Acronyms 4 iii Glossary 5 Chapter-1 Introduction 6 Chapter-2 Literature Review 10 Chapter-3 Research Objective 14 Chapter-4 Research Methodology 15 Chapter-5 Research Findings 19 Chapter-6 Conclusion and recommendations 44

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Acknowledgements

I acknowledge to thank UNICEF Orissa and Centre for Children Studies, KSRM, Bhubaneswar for providing me the opportunity to be a part of their team. I take this opportunity to thank Mr. Onkar Tripathy of UNICEF Orissa for providing patronage and baseline support for this study. I am thankful to our Mentors for technical guidance and support throughout the internship. I am indebted to Prof. Prashant Parida of KSRM, Bhubaneswar for his guidance in Data Analysis. Further, I would like to acknowledge the feedback, response and co-operation of Anganwadi Workers and Child Development Project Officer of ICDS, Daringbadi during procurement of data and field work. I am specially thankful to the people of Daringbadi block for sharing their concerns, opinions and feedbacks for this research study.

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List of Acronyms

ASHA: Accrediated Social Health Activist AWC: Anganwadi Centre AWW: Anganwadi Worker CDPO: Child Development Project Officer ECCD: Early Childhood Care and Development ECCE: Early Childhood Care and Education ICDS: Integrated Child Development Scheme IMR: Infant Mortality Rate MDM: Mid-Day Meal MMR: Maternal Mortality Rate NRHM: National Rural Health Mission SRS: Sample Registration System THR: Take Home Ration

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Glossary Gaon Kalyan Samiti: Revenue Village level health committee, where the AWW is the convener, Ward member is the president with other 3 members from the village, responsible for holistic health approach with Rs. 10,000 untied fund allotted by NRHM Janch Committee: A committee of 6 members headed by the Ward member responsible for purchase and monitoring of food programme Mamta Diwas: Tuesday and Friday of a week for identification and referral of malnourished children at AWC Matru Committee: A committee of Women members formed under AWC for better implementation of Mother Health component Palli Sabha: Revenue Village level meeting of voters for identifying and proposing development programmes and social welfare beneficiaries to the Gram Sabha. Usually, conducted in the month of February, once in a year. Pustikar Diwas: 15th of every month at CHC headquarter, for care and treatment of malnourished children and mother

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CHAPTER-I

Introduction

Children are the future and valuable human resource of a country. Every welfare state formulate policy and design programmes to ensure each and every child to be born safe, lead a healthy life, stay protected and be developed socially as well as mentally. Government of India is implementing various schemes and programmes for the benefit of the children. The national policy for children formulated by Government of India in 1974 described children as a “supremely important assets”. This policy lay down that State should provide adequate services for children both before and after birth, and during the growing stages for their full physical, mental and social development. The measures suggested include amongst others a comprehensive health programme, supplementary nutrition for mothers and children, promotion of physical education and recreational activities, special consideration for children of weaker sections and prevention of exploitation of children. Again such programmes are implemented to ensure the service, reach the grass-root stakeholder. Early Childhood Years is a special time and place in human life cycle. It is the foundation of human life to achieve optimal physical growth and psychological development. Early Childhood Care and Development (ECCD) are important for survival, growth and development of child. The term growth and development shall have qualitative dimension. It is not intended only to physical growth or health but also mental, emotional, cognitive and social development. The first eight years of childhood are critically important and the physical growth in positive environment leads to proper mental progress and this is invariably related for the better performance in early education. This implies and it has been well recognised that Early Childhood Care and Development and Early Childhood Care and Education are the two sides of the same coin. In Orissa, the population of pre-school children (0-6 Yrs.), as recorded in Census-2001, was 5.35 Million, which constituted 14.5 per cent of the total population. Recognising the report of child tracking survey undertaken by Orissa Primary Education Programme Authority (OPEPA) that presently there are 4.13 Million children in Orissa in the 0-5 years aged group, of which 2.13 million are boys and 2.0 million are girls. Constitutional Provision in India As per Article 39-f of the Indian Constitution, Children shall be given opportunities and facilities to develop in a healthy manner and in conditions of freedom and dignity and that childhood and youth shall be protected against moral and material abandonment. The Directive Principle under Article 45 of the Constitution of India, lays down that the States within a period of ten years of commencement of the Constitution will provide free and compulsory education to all children until they complete 14 years of age. Further, the 93rd Constitutional Amendment Bill lays another substitution to Article-45 that, The State shall endeavour to provide early childhood care and education for all children until they complete the age of six years. INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) The major programme of the Government of India for ECCD & ECCE is the Integrated Child Development Services (ICDS), which was launched in 1975. The main objective of the programme include (1) reducing infant and maternal mortality; (2) improving the nutritional and health status of children and mothers; (3) laying the foundation for psychological, Physical, and social development of children; and (4) improving nutritional status of girl children in particular. The target group of ICDS include children in the age of 0-6 years, pregnant women and lactating mothers from the poorer sections of the population in rural areas and in some urban slums. The major activities undertaken through ICDS are:

to improve the nutritional and health status of pre-school children in the age-group of 0-6 years to lay the foundation of proper psychological 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 various departments to

promote child development; and

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to enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education.

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CHAPTER-2

Literature Review Literature review forms an important part of the qualitative research work. Various studies prior to this have been undertaken by different people in the field of assessment of triggers and barriers in accessing child development programmes by tribal people in particular and rural community in general. Some of the studies which are particularly relevant to this topic have been reviewed and important points are collated in the form of a matrix.

Name of study/paper/research

topic

Sample size and technique used

Important findings Relevance to this project

“Impact assessment/ evaluation of ICDS programme in the state of Orissa” by CRD Orissa1

250 villages / AWCs, 12,621 children under 3 years, 12,468 children 3-6 years, 2221 pregnant women, 2686 lactating mothers

22% of the pregnant women received 3 health checkups

26.32% children aged 9-12 months had received complete immunization.

The Take Home Ration (THR) was usually shared with other members of the family

59% of the beneficiary children were malnourished compared to 69.9% of the non-beneficiary children.

Food supply is irregular AWWs are overburdened

The social and system drawbacks of programme implementation

“Nutritional health and pre-school education status of children covered under the ICDS scheme in Orissa” by Indian Institute for Social Development (IISD), New Delhi. (2003)2

1200 beneficiaries, 61 ICDS functionaries, 30 health functionaries and 108 representatives of the community across six districts of Orissa namely Khurda, Cuttack, Nayagarh, Puri, Kandhamal and Rayagada in 43 AWCs.

56.08% of the respondents were illiterate, and 79% were illiterate in tribal areas

48% of the pregnant women were not regular in the consumption of iron and folic acid tablets.

The food supplied was of very poor quality

Community members had low awareness about ICDS programme.

Major findings are relevant as the barriers of successful programme implementation

1 Dash, N.C. et al. (2006). Impact assessment/ evaluation of ICDS programme in the state of Orissa. Bhubaneswar: Centre for Rural Development. 170 p. 2 Indian Institute for Social Development (IISD), New Delhi. (2003).Nutritional health and pre-school education status of children covered under the ICDS scheme in Orissa. Bhubaneswar : IISD. 222 p.

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“ICDS and Persistent Under nutrition Strategies to Enhance the Impact” published in Economic and Political Weekly on 25th March , 2006 3

Two separate function should be adopted for nutrition intervention for 0-3 year and preschool for 4-6 year children

Services of ASHA should be incorporated

Volatile and overburdened responsibilities of AWWs

“Accelerating Malnutrition Reduction in Orissa” published in IDS Bulletin Volume-40/20094

Suggest to strengthening supply and demand for under-nutrition services through a combination of strengthening existing structures and activities and innovations

More emphasis on strengthening existing structure

3 Michele Gragnolati, Caryn Bredenkamp, Monica Das Gupta, Yi-Kyoung Lee, Meera Shekhar published in Economic and Political Weekly on 25th March , 2006 4 Mona Sharma, Biraj Laxmi Sarangi, Jyoti Kanungo, Sridhar Sahoo, Lopamudra Tripathy, Amalin Patnaik, Jyoti Tewari and Alison Dembo Rath in their report “Accelerating Malnutrition Reduction in Orissa” published in IDS Bulletin Volume-40/2009

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CHAPTER-3

Research Objective Despite the programmes and policies being implemented by the national government and Government of Orissa for the reduction of IMR to minimal, the Infant Mortality Rate is third highest in Orissa after Uttar Pradesh and Madhya Pradesh among all the States (according to AHS Bulletin 2010-11). The relatively slow decline in IMR can be attributed to several factors and in order to assess the determinants contributing to high IMR, it is necessary to put forth two components of infant mortality, viz, neo-natal mortality and post-neo-natal mortality. Neo-Natal Mortality Rate (NNMR) is the number of deaths of infant before attaining 28 days of life per 1000 live birth in a year. Post-Neo-Natal Mortality Rate is the number of deaths of infants from 28 days to 12 months of age for every 1000 live births. Infant mortality rate is usually computed for a period of one year. As per SRS 2008, IMR in Orissa was 69 per 1000 live births which ranked top in the state wise list and sensitively more than the national average of 53. In rural Orissa, it was much higher at 71 per thousand live births. In SRS 2009 (published in January 2011), Orissa has remained in the second position having IMR of 65 per 1000 live births with 68 per 1000 live births in rural area which is 15 points higher than the national average of 50 per 1000 live births. The MMR is also 258 in Orissa, which is much higher than the national average of 212. Kandhamal district remain to be the second highest with IMR of 88 after Balangir in the state as per AHS 2011 report. It is evident from previous studies that every child in Orissa does not get sufficient food, adequate nutrition, health care and opportunity to go to the school, amid several child development programmes and interventions. In tribal Orissa, this picture is more degraded and neglected. Hence, this study attempts to Understand the mechanism of implementation of the Child Development Programmes and how the

beneficiaries access to it. Identify barriers confronted by the beneficiaries while accessing their entitlements. Find out the skill level of service providers of different Child Development Programmes Assess the acceptability of Child Development Programmes by the beneficiaries

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CHAPTER-4 Research Methodology

This study focus on the Early Childhood Care & Development and Early Childhood Care & Education

component and the programmes being implemented by State related to ICDS. The target group for this study are the children in the age group of 0-6 years but as per the research

objective, the parents of the target group are the primary respondent to our study. AWWs have been interviewed to find out the manner of implementation of ICDS programme

Sample Area Daringbadi block of Kandhamal district which is considered to be next most vulnerable block in terms of School Drop-out, Malnourishment, IMR and other Child Development indicators. Daringbadi block has been selected which consists of 24 Gram Panchayat, out of 153 GPs in the district located by surrounding Kotagada Block in east, Raikia Block in the west, K.Nuagam Block in north and Mohana in south with 20 degree North and 84 degree East 3000 Ft. above sea level, having a rainfall of 1597 mm and 110 Kms distance from district headquarters. The main agriculture products are Turmeric, Ginger, Oilseeds and other income sources: Forest and Forest related products.

Map-1

The selection of GP and the village were random from the alphabetical list of GPs in the block. The selection of respondents were simple random with respect to the total no of household. Key considerations for sample size calculation were: Covered at least 1 per cent of the universe totalling to to 200 households respondents (mothers) out of 19595

households. Findings are at a confidence level of 95% and standard error of 2%. Expected correlation have been taken with previous studies Purposive sampling technique has been used based on stratification of population

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Graph-1 Socio-economic and demographic details of sample area

Researcher has used quantitative and qualitative technique for this study. Quantitative Study There was one module (Coded Questionnaire) for canvassing the responses of the parents of children in particular household. Only one member in each household has been selected in order to skew towards biasness. Module administered to the parents of children of the household, who in general is most knowledgeable about the prevailing child development programmes in their village. Qualitative Study Qualitative study has been carried out through Focus Group Discussion. The researcher has carried out the focus group discussion through observational method to assess perceptions, opinions, beliefs and attitudes towards the research parameters and recorded every details of the discussion for data analysis and interpretation purpose. To assess the Skill Level of service providers, the researcher has conducted In-depth Interviews and FGD with the AWWs regarding their educational qualification, skill based trainings, time to time knowledge up gradation and other factors related to functioning of ICDS for smooth & better management of AWCs.

Respondents Tools used

200 father/ mother of 0-6 years children Scheduled Questionnaire and One to One Interview

Parents of 0-6 year Children in Four villages named Ranganikilu, Sikaketa, Sraniketa and Relief Colony,Badabanga

Focus Group Discussions

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AWWs of 8 AWCs Scheduled Questionnaire and One to One Interview

5 AWWs Focus Group Discussions

The study was conducted in AWC Areas of Jogermaha, Takimaha and Tilori of Tilori Gram Panchayat, Sikaketa AWC Area and Badabanga AWC Area of Badabanga Gram Panchayat, Pattangi and Adivasi Colony AWC Areas of Kirikuti Gram Panchayat, Simonbadi AWC Area of Simonbadi Gram Panchayat, Sraniketa of Sraniketa Gram Panchayat and Greenbadi of Greenbadi Gram Panchayat. 200 father/mothers were interviewed with a scheduled questionnaire. 8 AWWs were interviewed with another set of scheduled questionnaire. Four FGD were conducted with parents of Ranganikilu, Sikaketa, Sraniketa and Relief Colony,Badabanga villages. Also one FGD was conducted on 5 AWWs. FIELDWORK An interview schedule and a questionnaire checklist as further research tools were designed prior to the field research. The questions were tailored for each group of respondents on the basis of their role.The fieldwork has been managed by the researcher itself in field in order to have a general feel and quality control on the fieldwork, ensuring collection of good quality data and developing a logical framework - that is, reliable and valid – to form the basis of research study. DATA ANALYSIS For handling analysis of data collected through extensive surveys, researcher has developed customized SPSS software for data entry and interpretation. Data analysis is depicted with most analysis representations i.e. charts, graphs and descriptive data from the cleaned data.

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CHAPTER-5

Research Findings

Chart-1

Education of the Respondents

About 14.5 per cent of the respondents are illiterate, Again 30 per cent are primary educated and 35.5 per cent are up to middle school. Only 20 per cent of the respondents have studied in class 10th and above high school level.

Chart-2 Type of Family

Around 75.5 per cent families are nuclear family but 20 per cent and 4.5 per cent families are with parents and joint families respectively. During our interaction with the respondents, they told us that, the working parents do not get time to accompany their child to the AWC. At times the parents use to take their child to their work place.

Table-1 Current occupation of the head of the household

Occupation Frequency Percent Valid

Percent Cumulative

Percent 1 Occu.: Level 1 10 5.0 5.0 5.0 2 Occu.: Level 2 6 3.0 3.0 8.0 3 Occu.: Level 3 184 92.0 92.0 100.0 4 Total 200 100.0 100.0

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As about 92 per cent of the respondents are unskilled labourers/ small seasonal farmers and both male and female of the household are workers. The mothers are more industrious as compared to the fathers in tribal families. During our fieldwork, we tried to have a more closer feel of the day-to-day life of our sample population. Most of the mothers agreed in our conversation that, they take the child to the work place instead of sending to the AWC. Even, the mothers of such families do not get enough time for taking proper care of their child. This point of observation was also confirmed by the AWWs and the CDPO of Daringbadi Block during our interaction with them.

Chart-3

Type of the household

About 92 per cent respondent live in Kutchha houses of straw thatching and earthen wall houses. This indicates the extreme case of poverty among people in terms of healthy dwelling which directly affect the healthy development in child.

Table-2 Average annual household income

Annual Incom Frequency Percent Valid

Percent Cumulative Percent 1 Up to Rs. 10000 184 92.0 92.0 92.0 2 Rs. 10001 -30000 2 1.0 1.0 93.0 3 Rs. 30001 – 50000 4 2.0 2.0 95.04 Rs. 50001 - 100,000

10 5.0 5.0 100.0

5 Total 200 100.0 100.0 About 92 per cent respondents earn below Rs. 10,000 a year for their livelihood, which is insufficient to cater the basic needs of the family. The nutritional need of the child remained ignored due to extreme case of poverty among most of the respondents.

Table-3 Religion

Religion Frequency Percent Valid

Percent Cumulative Percent 1 Hindu 140 70.0 70.0 70.0 2 Christian 60 30.0 30.0 100.0 3 Total 200 100.0 100.0 About 30 per cent of the respondents are Christians and 70 per cent are Hindu by religion. It was observed during FGD that the Christian community is little advanced than the Hindu respondents in terms of awareness related to child development.

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Chart-4

Social Category

About 26.5 per cent respondents of this study are Scheduled Caste and 67 per cent are of Scheduled Tribe. ST respondents are more vulnerable in the mainstream development with acute poverty, illiteracy and non-acceptance of new development in their lives.

Soc_Cat * Chld_Reg_AWC Crosstabulation Count

Chld_Reg_AWC Total Yes No Yes Soc_Cat SC 34 19 53 ST 87 47 134 General 10 3 13Total 131 69 200

The drop-out is more in case of SC pre-schoolers (35.84 %) in comparison to the ST children (35.07 %). This is only reflective of the indicators of our specific sample area. As per frequency distribution the drop-out is more in case of ST pre-schoolers but as per percentile distribution, drop-out of SC preschoolers is little higher than the ST preschoolers.

Table-4 No. of members in a family

No. of Members Frequency Percent Valid

Percent Cumulative

Percent 1 3 Members 3 1.5 1.5 1.5 2 4 Members 45 22.5 22.5 24.0 3 5 Members 70 35.0 35.0 59.0 4 6 Members 54 27.0 27.0 86.0 5 7 Members 27 13.5 13.5 99.5 6 8 Members 1 .5 .5 100.0

With limited source of income, the families have to take care of their daily expenditure. About 35 per cent families are 5 member family, 27 per cent are 6 member family, 13.5 per cent are 7 member family. In many families the household income is inadequate for catering needs of every family member. Nutritional and educational needs of children in such families are highly neglected with limited income of family.

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Table-5 BPL Cardholders

BPL Card Frequency Percent Valid

Percent Cumulative

Percent 1 Yes 192 96.0 96.0 96.0 2 No 7 3.5 3.5 99.5 3 DK/CS 1 .5 .5 100.0 4 Total 200 100.0 100.0

96 per cent of the respondents are having the BPL card. Education of the respondents is inter-related with poverty. Lack of perennial livelihood, seasonal agriculture with traditional methods, unfertile highland soil, lack of alternative source for livelihood is prevalent, weakening the economy of this area. Low agricultural productivity and reducing forest volume directly impacts the per capita income of the respondents. The lower income of the household fails to cater the minimum needs of the family. Due to poverty the respondents are unable to expend on health and nutrition of the adult members as well as children. The supports allotted from government food programmes are still inadequate for the BPL families in terms of nutritional requirement.

Responses related to functioning of AWCs

Does the AWC opens and works regularly? Chart-5

Regular functioning of AWC

94 per cent of the respondents agree that the AWC opens and work regularly. But in FGD in certain areas in Jogermaha, Takimaha of Tilori GP, the respondents told the researcher that, the AWC opens regularly but the AWW remains absent for days and the Centre is being run by the AWC Helper, who is less educated and some of the Helpers are Illiterate Old Ladies. In such AWCs pre-school activity is highly ignored and the AWC opens only for MDM distribution to the Pre-Schoolers. Do your child go to AWC everyday?

Table-6 Regularity of children to AWC

Response Frequency Percent Valid

Percent Cumulative Percent 1 Yes 131 65.5 65.5 65.5 2 No 69 34.5 34.5 100.0 3 DK/CS 0 0 0 100.0 4 Total 200 100.0 100.0

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65.5 per cent respondents agree that their Children are going to the AWC regularly. 34.5 per cent told us that the children are not going to the AWC for pre-school. When the researcher tried to find out the reasons, the reasons are various which we tried to reflect later in this report. Is the distance of AWC is at walkable distance for your children from your house?

Table-7

Walkable Distance of AWC



About 55.5 per cent of the respondents told us that, the distance of AWC from their home is walkable for the Child, but 44.5 per cent responds find the distance not walkable for their children. Pre-schoolers of Releif Colony have to walk 3 Kms to reach the AWC of Badabanga, similarly Ranganikilu village is 4 Kms from Jogermaha AWC. The parents disagree to send their child to the AWC as the small children have to cover longer distance daily to reach the AWC. The parents also do not get enough time to accompany their children to the AWC. In some cases, the parents do not think the Anganwadi Programme is important for their child. Some of the parents think that the child does not get any improvement from such programmes. Some Parents told us that, if the AWW and Helper would pick their child from home and drop back home, then it could have been easier for them to send their child to AWC regularly. The CDPO of Daringbadi in her interview told the researcher that the AWWs and the Helpers of the AWCs are supposed to do the Pick –Drop of Children, but unfortunately most of them are not doing this.

Correlations

AWC_Walkb

l Chld_Reg_AWC AWC_Walkbl Pearson Correlation 1 .578(**)

Sig. (2-tailed) .000 N 200 200

Chld_Reg_AWC Pearson Correlation .578(**) 1 Sig. (2-tailed) .000

N 200 200 ** Correlation is significant at the 0.01 level (2-tailed).

The correlation matrix was generated to access the correlation between the distance of AWC from home of the pre-schooler and the regularity of such children to the preschool. The matrix shows that distance of AWC is positively correlated with a very high co-efficient of coorrelation of 0.578. this shows that regular attendance of children in preschool is highly correlated with distance of AWC at the confidence level of 0.01. further it confirms that in 99 per cent cases the distance of the AWC impacts the regularity of pre-schoolers to AWC.

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Is the food supplied by AWC acceptable for your children?

Chart-6 Acceptability of food supplied by AWC for children

During visit to the AWCs, the researcher tried to know the quality and quantity of MDM being supplied to the children. It is needless to say that the food is not of nutritional quality. In Some AWCs Non-preschoolers also attend during food distribution and the same quantity is being shared among all the children present at that moment. About 73.5 per cent parent think that the food is acceptable for their children but 23.5 per cent parents do not think the food is acceptable for their children. Do they monitor the growth of your child regularly at AWC?

Table-8 Growth monitoring at AWC



The AWWs have to submit a quarterly report to the Block ICDS office regularly. As it is mandatory for every AWWs, they monitor the growth of every child in order to submit the report. Where the AWW remain absent regularly and from which areas the pre-schoolers are not coming, there, monitoring of growth is not done by the AWWs. About 88.5 per cent parents agree that the monitoring is being done, where 11.5 per cent told that monitoring is not being done.

Does your child show interest in going to AWC?

Table-9 Child’s interest for AWC



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Around 51 per cent parents told us that the child is not showing interest in going to AWC regularly. In some cases the child goes to AWC but return home before it closes. When we tried to find out the reason, the parents explained that, the children do not find the AWC activities interesting except the MDM time. Some children could not cope with the environment of AWC. Due to lack of playing materials at the AWCs, the children do not find the programme interesting rather they prefer to play at home or with nearby friends. Correlations

Chld_intrst_AWC AWW_Rapport_

Chld Chld_like_AWW Chld_intrst_AWC Pearson Correlation 1 .233(**) .152(*) Sig. (2-tailed) .001 .031 N 200 200 200AWW_Rapport_Chld Pearson Correlation .233(**) 1 .760(**) Sig. (2-tailed) .001 .000 N 200 200 200Chld_like_AWW Pearson Correlation .152(*) .760(**) 1 Sig. (2-tailed) .031 .000 N 200 200 200

** Correlation is significant at the 0.01 level (2-tailed). * Correlation is significant at the 0.05 level (2-tailed). The correlation matrix among the indicators such as the child’s interest to go to preschool with the AWW’s rapport with the child and the child’s liking of the AWWs approach towards the child is positively correlated with a correlation co-efficient of 0.233 and 0.152 at the significance level of 0.001 and 0.005 respectively. This indicates that, in 99 per cent cases the AWW’s rapport with the preschoolers have an impact on the interest of the child to come to AWC regularly.. Similarly, in 95 per cent cases the children’s liking of the AWW’s approach have an impact on the interest of the child to go to preschool. Is safe drinking water available in the AWC ?

Chart-7

About 66 per cent parents told that, there is no provision of safe drinking water in the AWCs. Only 31 per cent told that there is safe drinking water being availed for children. The researcher found, there are some tube wells installed adjacent to the AWCs. But in many cases the helpers have to carry water from the nearby sources. We found in most of the AWCs the water filter is not being used and kept unused, which has been supplied for providing safe drinking water to the pre-schoolers.

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Is toilet facility available in the AWC ?

Chart-8

At Badabanga and Sranikeata AWCs, we found toilet facility is available. But, in all other AWCs we visited there is no toilet facility available at the AWC campus. The toilets are not clean and not being maintained properly. At some other AWCs like at Kirikuti, which was closed during our visit, toilet facility is available but the toilet is being used for storing fuel wood. However, about 80.5 per cent respondents told that, there is no toilet facility available in the AWC

Is the infrastructure available in the AWC suitable for your children

Chart-9 Suitability of Infrastructure

Badabanga-I, Sikaketa, Tilori, Jogermaha, Sraniketa, Simonbadi AWC are being run in ICDS infrastructure. All other AWCs we visited are being run in village community halls, private house verandah and some left over government quarters. The newly established Mini Anganwadi do not have any infrastructure either. In none of these AWCs, we found any kitchen room. The infrastructure is also of very poor quality construction with water leakage in rainy days. In rainy days it is very difficult in the parts of the AWWs to conduct pre-school activities for children in these kind of infrastructure. About 95.5 per cent respondents find the infrastructure not suitable for their children. The parents do not think it safe to send their child to AWC in rainy day. The Gram Panchayats are also silent for providing appropriate infrastructure from their fund.

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Correlations

Apprprt_infrastrctr Discsn_Palsbha_GKSApprprt_infrastrctr Pearson Correlation 1 .993(**) Sig. (2-tailed) .000 N 200 200Discsn_Palsbha_GKS Pearson Correlation .993(**) 1 Sig. (2-tailed) .000 N 200 200

** Correlation is significant at the 0.01 level (2-tailed). The matrix calculates the correlation between availability of appropriate infrastructure for the AWC and Parents discussing the issues related to the problems in Pallisabha/GKS meetings. These two indicators are positively correlated with coefficiency of 0.993 at the confidence level of 0.001. This describes in 99 per cent cases the stakeholders being silent on the problems related to AWC have an impact upon the poor infrastructure availability for the functioning of AWC. Is the food cooked in hygienic way

Chart-10 Hygienic cooking of food

As there is no kitchen room any of the AWCs we visited, we found that the food is being cooked in open space and straw thatched small herds. Wooden fuel wood is being used to cook MDM in all the AWCs. There is no water source available near many of the AWCs except some have tube wells. 74.5 per cent parents think that the food is not being prepared hygienically.

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Do the AWC provide the appropriate quantity of food as per govt norms

Chart-11 Quantity of food

About 82 per cent of our respondents agree that the AWWs supply appropriate quantity of MDM and THR as per government norms. But, 15 per cent of our respondents think that quantity is not appropriate. In some centres, we found the quantity of MDM is very less, yet we could not calculate the exact quantity, as it was cooked food. The THR is also being supplied by measuring and not being supplied in weight, whereas it should be provided in weight. During our study, we found that the THR has not been supplied to the ANC and Breastfeeding mothers from the month of April 2011. When, the researcher tried to know the reason from CDPO, Daringbadi, she told us that, due to new THR policy of government the supply has been delayed and CHHATUA will be supplied instead of food grains. But, it is not clear that, the THR quota of these 3 months will be supplied to the beneficiaries or not.

Is the quality of food provided by AWC accepted for the mother? Table-10

Acceptabillity of food quality by mothers



There is a mixed response for this query. About 54.5 per cent respondents think that the THR being supplied is acceptable for mother but another 45.5 per cent do not think the items being supplied for the ANC and Breastfeeding mothers is acceptable for the mothers. However, the researcher observed that, the THR received for the mothers are being shared among other members of the family.

Do the AWW help the child in playful learning? Chart-12

AWW facilitate playful learning

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About 55 per cent parents told us that the AWWs facilitate play mode learning in pre-school, but 43 per cent think the opposite. AWWs are being trained for facilitating play mode learning, but due to various reasons, they are unable to replicate it in their centres. We have tried to reflect some of the reasons in the successive part of this study report. Is there adequate TLM for facilitating the play mode learning?

Table-11 Availabillity of TLM


Percent Cumulative Percent 1 Yes 0 0 0 0 2 No 200 100.0 100.0 100.0 3 DK/CS 0 0 0 100.0 4 Total 200 100.0 100.0

Since 1992 no TLM has been supplied nor has any kind of toys or play materials been supplied to the AWCs for facilitating playful learning. The old materials are also damaged due to long term use and not of usable type. We could not found any kind of Charts or Pictures in the AWCs except only some wall paintings of Oriya alphabet and digits. In old AWCs there are some unused and damaged material dumped but in new AWCs there is not any kind of TLM or all painting. These centres such as Adivasi Colony, Badabanga-2, Pattangi, Greenbadi neither have infrastructure nor TLM (not even blackboard) except some registers for managing the AWCs. All

of our respondents told us that, there is not any kind of

playing material in the AWCs. When we tried to know the reason from CDPO, Daringbadi, she told us that the AWWs have been trained for developing toys from low cost or no cost materials and also have been trained for facilitating playful learning through songs, dance and games which would help in developing small muscular growth and creativity in children. But, unfortunately the AWWs are not doing so in replicating the skill.

Do you think that the services provided in the AWC is helpful for the psychological growth of your child

Chart-13 Helpful for Psychological growth

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About 27 per cent parents think that, despite lack of infrastructure and resources, the pre-school activity help in the psychological growth of children. Around 67 per cent parents think that the pre-school activity does not have any impact on the psychological growth of the pre-schoolers. The AWWs also do not get any specialised training on child psychology.

Correlations

AWW_Playfl_

Lrng Service_helpful_psych_grwth

AWW_Playfl_Lrng Pearson Correlation 1 .190(**) Sig. (2-tailed) .007 N 200 200 Service_helpful_psych_grwth

Pearson Correlation .190(**) 1

Sig. (2-tailed) .007 N 200 200

** Correlation is significant at the 0.01 level (2-tailed). The correlation between the methods adopted by the AWW for playful learning and impact of such service on the psychological growth of pre-schoolers indicates that the coefficiency of correlation between these two indicators is 0.190 positively at the significance level of 0.01 per cent. This implies that in about 99 per cent cases the way of implementation of playful learning by the AWC have any impact upon the psychological growth of the pre-schoolers. Do you think that the service provided in the AWCs is adequate and appropriate for your Child’s Development?

Chart-14

About 87.5 per cent parents do not think the services provided in the AWC are adequate and appropriate for child’s development. The reasons count as lack of proper infrastructure, TLM, play materials and at times the quality of MDM being served in the AWCs

Do you discuss matters related to Child Health in Pallisabha / Gaon Kalyan Samiti

Table-12 Discussion of Child Health in Pallisabha/GKS


Percent Cumulative Percent 1 Yes 0 0 0 0

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2 No 194 97.0 97.0 97.0 3 DK/CS 6 3.0 3.0 100.0 4 Total 200 100.0 100.0

In 97 per cent cases, the response is negative. The parents told us that this concern has never been raised in the village level community meetings. Construction of infrastructure and demand for better service provisions in AWCs could have been raised in the Palli sabha or Gram sabha by the beneficiaries but this concern remain unrepresented in most cases. Do you call the Toll Free Helpline No. 18003456733 related to Child Development of W&CD Dept. for any queries/problem?

Table-13 Knowledge about Toll Free Helpline No.


Percent Cumulative Percent 1 Yes 0 0 0 0 2 No 172 86.0 86.0 86.0 3 DK/CS 28 14.0 14.0 100.0 4 Total 200 100.0 100.0

About 86 per cent of our respondents told us that they do not call this helpline number and 14 per cent told that they do not know anything about such kind of provision by the government. We did not find any kind of IEC of this helpline number in the walls of AWCs or elsewhere in the villages. One flex cloth mentioning the Food provision with this helpline number in small letter in the bottom scroll, have been fixed in the inside walls of every AWCs.

Do you ever visit the AWC to know the manner of its running and functioning?

Table-14 Visit by parents to AWC



About 32 per cent respondents said that they are not visiting the AWCs ever, whereas 68 per cent respondents visit the AWCs to know the manner of it’s functioning. Correlations

Discsn_Palsbh

a_GKS AWC_visit_parents Discsn_Palsbha_GKS Pearson Correlation 1 .256(**) Sig. (2-tailed) .000 N 200 200AWC_visit_parents Pearson Correlation .256(**) 1 Sig. (2-tailed) .000 N 200 200

** Correlation is significant at the 0.01 level (2-tailed).

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The correlation matrix generated from two indicators of community ownership of child development programme indicates that discussing the matter in Pallisabha / GKS and Parents visit to AWC is positively correlated with co efficiency of 0.256 at the significance level of 0.01. This indicates that in 99 per cent case though the parents visit the AWC they do not discuss it in the Pallisabha or GKS like community meetings. Again this figure can be interpreted as lack of interest and lack of community ownership towards this programme. Is there any Parent Meeting in AWC related to your child’s development?

Table-15 Parent meeting


Percent Cumulative Percent 1 Yes 0 0 0 0 2 No 200 100.0 100.0 100.0 3 DK/CS 0 0 0 100.0 4 Total 200 100.0 100.0

During the interview with the CDPO, Daringbadi, she told the researcher that, there should be a Parent Meeting in every AWC every month, but unfortunately in none of the AWC , there is any parent meeting being conducted ever. Some of the AWWs told us that they attend the parent meeting in nearby schools. But we feel that, the parents of the school students may not be necessarily the parents of Pre-schoolers. Though, it is highly necessary to conduct parent meeting in every AWC to create awareness, ownership and concern among the parents, this concept is highly ignored. We feel strongly that, such parent meetings would have repaired a lot of gaps in programme implementation. Is there any Monitoring Committee in your village for the functions of AWC?

Table-16

Monitoring committee



About 94 per cent respondents told us that there is not any monitoring committee for observing and assessing the activities of AWC. The Janch commiitte consists of 6 member where the Ward member is the president. The Janch Committee have a joint SB account of the Ward member and AWW in the nearest bank. But, this committee is only responsible for purchase of consumables for the MDM of the AWC. The Matru committee formed in the AWCs are for availing mother health related benefits. Both, the Matru Committee and Janch Committee compensate the role of a monitoring committee up to some extent but mostly ignore the multiple angles of programme implementation.

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What are the child development programmes you know about?

Chart-15

All most all the participants know about Janani Surakshya Yojan and MDM programme as they are getiing benefited in cash and kind from these government programmes. About 180 and 174 respondents out of 200 respondents know about Mother-Child Immunisation and Pulse Polio Immunisation.But none of the respondents know anything about Pustikar Diwas and Mamta Diwas initiatives aimed at preventive and curative reduction in malnutrition of Child and Mother. Lack of awareness and lack of communication is the main cause for ignorance about such important government interventions. The researcher conducted Focus Group Discussions with the parents of 0-6 yrs children and mother beneficiaries of ICDS programme across four villages of namely, Ranganikilu, Sikaketa, Sraniketa and Relief Colony, Badabanga to assess the problems,opinions, beliefs and attitudes of the stakeholders towards this child development programme. The following facts are revealed during our study: Education and Poverty Most of the stakeholders are illiterate or undereducated. Mostly these under educated people are daily wagers or small scale seasonal farmers. Unavailability of perennial livelihood support with seasonal agriculture leads to enormity of poverty in these families. The cultivation is done on highland which is not fertile and gives an unproductive yield. Irrigation facility is also not available for the agricultural lands. Income of families dependent upon the minor forest produce is also not encouraging with rapid rate of deforestation. Many families are indebted with loans and liabilities which is another constraint for improvement of financial position of these families. The scene of poverty is so acute that the families find it difficult to earn a square meal round the year. This leads to insufficient dietary intake of family members. Again, there is a practice that female members have to work in land and forest to support the family income. The laborious mothers do not get adequate food as per their calorie requirement. Even, the ANC and Breastfeeding mothers have to go for work as cultural practice. The subsidised food grain available in Public Distribution system is still insufficient to meet the quantitative and qualitative dietary requirement of large families. The THR received from the AWCs for the ANC and Breastfeeding mothers is often

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shared among other family members. During working time, the parents take their children to the work place instead of sending them to AWC. Perception regarding functioning of AWC Given the lower education level, it also leads to lack of awareness and Ignorance among people. Poverty stricken parents with lower level of education do not consider the programme to an important intervention. Concern on earning livelihood for family is the prime lookout and ignores the importance of early childhood development. The parents expect a pick-drop service of child for pre-school by AWCs, which is not a practice in most of the AWCs. Also, the poor infrastructure facilities, lack of amenities, TLM, Play Learn Materials, etc. enrich the negative perception of parents towards Pre-School activity in AWCs. In some AWCs like, Jogermaha, Takimaha , Kumbharmunda, people told this researcher that the manner of functioning of AWCs are not satisfactory. AWWs are not going to the AWCs regularly and often the AWCs are being managed by the Helpers. Though, THR is distributed, the Pre-school activity is highly neglected due to irregular presence of the AWWs in the AWCs in these centres. This case may not be representative of the whole area but, this researcher strongly felt during his visit to several AWCs beyond scope of study, that, the AWCs do not open in time and some centres remain closed for days on different pleas. One, Kirikuti-1 AWC had been closed for three days as the AWW was told to be on leave, similarly Kirikuti-2 was closed as the AWW went for training and Kirikuti-3 was also closed on the day of visit. No alternative arrangement has been made from the Supervisor side to manage the AWCs during those days. Kumbharmunda AWC has been closed since one year due to unavailability of AWW. Parent’s participation In none of the AWCs in our study area, there is any Parent Meeting is being conducted. The parents do not feel any attachment towards the activities of AWCs. They consider this programme only as a source of getting some dietary benefit. In community meetings like Pallisabha and other local village meetings, the key focus is on roads, ponds, canals, old-age pension, dwelling units, etc. but the issues related to child development is never being discussed and largely ignored. There is not any significant attempt from the ICDS side to involve parents and other beneficiaries for holistic development of Child development. The Matru committee formed in the AWCs are also inert and for namesake. Janch Committees are also limited to perform the duty of purchasing of consumables only. Though, the formation of Parent-AWW Association is highly necessary, this activity is highly ignored from the ICDS side as well as from community side. Exclusion of villages Children of 3-6 years of Kumbharbadi, Somagota, Gedemaha of Sikaketa AWC area, Padampali of Kotasingi AWC area, Ranganikilu of Jogermaha AWC area, Mugupanga of Tilori AWC area, Baradikilu of Pattangi AWC area, etc. are depraved of Pre-school and MDM programme due to geographical distance. The population of these villages are not suitable for establishment of Mini Anganwadi as per govt. norms. There are many villages in this block, which face this problem. The health and development of the children of such areas remain untouched and unrepresented. Cultural Practices In these villages, early marriage is a common practice. The girls usually get married in a year or two after getting puberty. In some cases, the girls are not physically strong enough to bear child. Lack of knowledge on reproductive health and lack of counselling, tend them to conceive early pregnancy. Anaemic girls are highly vulnerable to early pregnancy and related complications. Kishori Mandals are not conducted in any of the AWC area to raise awareness and concern regarding early marriage complications. There is not any kind of counselling support from the AWCs for such adolescents. AWW of Sikaketa told that, it is a practice among tribal adolescent to marry early and they are not ready to receive any kind of counselling. During our FGD with the stakeholders, this fact has been supported, that early marriage is a cultural practice. This practice leads to early pregnancy resulting in Still Birth or babies with Low-Birth Weight. The Anganwadi Worker’s Profile We conducted interviews with 8 AWWS and 1 FGD with 5 of the AWWs. All the AWWs are of 8th class above. Some them are of 10th class standard. The AWWs of old AWCs have undergone Job Course Training of 3 months, but the AWWs of AWCs formed after 2004 have not undergone any Induction training. Some of the AWWs

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undergo refresher training conducted time to time at ICDS, Daringbadi and Sarva Sikshya Abhiyan. But, none of the AWWs have undergone any specialised training on Child Psychology,Nutrition and Birth Attendance. Some of the AWWs have undergone trainining on IMNCI at Phulbani. Surprisingly, the AWWs of Mini Anganwadi Centres have not undergone any kind of training till the conduct of field work of this research study. We also came to know that, there is not any kind of Performance Appraisal mechanism of the AWWs. In the other hand, the AWWs expressed that, they are heavily burdened with multiple tasks of assessment of old age pension beneficiaries, accompanying the mobile health check-up team of NRHM and other assignments apart from the ICDS activities. Also, they told us that they have to attend minimum 6 days of meetings during working days in a month. The AWWs raised their concern over the community participation that, the parents neglect their duties towards their children as most of the parents are daily wager below poverty line. Also, the AWWs find the infrastructure and materials provided by the government is not appropriate to facilitate play mode learning to enhance psychological growth in children. The ARUNIMA kit provided to the AWWs conatains only a book consisting of Oriya Rhymes and some games. The AWWs think that, Early marriage and Labour during pregnancy is the main cause of ANC complications, IMR and Low Birth Weight. When asked about providing counselling to Adolscent girls and mothers, the AWWs told that only in Matru committee meeting they get the chance of interacting with the mothers and girls, as they do not come to the AWC for counselling. Researcher’s own observation When we visited to the field, we found very low attendance in most of the AWCs. When we asked about the reason, the AWWs explained us that, due to rainy season and agriculture time, the Pre-schoolers are not coming, but it is not the normal scenario, they told. We found Sraninketa and Pattangi AWC are functioning very impressively. In these two centres, the AWWs have a very good rapport with the children as well as the Parents. We found AWCs like Kirikuti-1,Kirikuti-2,Kirikuti-3 was closed during our visit. When we tried to find out the reason it was told that the AWW of Kirikuti-1 was on leave for three days. No alternative arrangement had been done to open the AWC in her abscense. Simillarly. Kumbharmunda AWC has been closed since one year due to unavailability of AWW. In Jogermaha AWC area, the people told us that, the AWW does not come regularly to the centre and the AWC is being managed by the Helper in her absence. In such areas, the pre-school as well as Mother-Child health programme is highly neglected. We also visited some villages where there is no AWC. There the people told that, they can’t send their child to far off AWCs as it may be risky. Baradikilu village is 4 Km away from Pattangi AWC. In this village only the under 3 years child and ANC- Breastfeeding mothers are getting the THR, whereas 3-6 year children do not get any food supply. In mini Aanganwadis, the AWWs have not got any MDM or THR since April 2011 to distribute or function the MDM programme. In little urbanised villages like Simonbadi, the parents do not think the AWC suitable and necessary for their child. Interaction with the CDPO, Daringbadi During our interaction with the CDPO,Daringbadi, She tried to explain some of our queiries. She thinks that, Unscientific care of the ANC mothers, Poverty, Laborious Mothers and Ignorance are the main reasons for Neo-natal death. When we asked about the non-availability of THR, she explained that due to new THR policy effective from 1st April 2011, the ICDS is trying to supply CHHATUA to the AWCs at an earliest date. The preparation of CHHATUA has been entrusted on two SHGs and they are trying to produce sufficient quantity of this mixed grain packet in time. The CDPO showed us the CHHATUA packets to be distributed to the AWCs

The CHHATUA is being prepared at Rs. 25/- per Kg. to cater the need of 15,000 beneficiaries of the block. The blue packet containing 2 Kg,Yellow packet of 2.5 Kg. and Red packet of 3 Kg. are meant for 7 month- 3 year children, Mothers and malnourished child respectively.

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She explained that Parents meeting is highly necessary in AWCs but unfortunately formation of parents group has been neglected. Accordingly, the AWWs need to visit home to home for Pick-drop of children, which is not being done. It would have been helped in building rapport with parents. The AWWs are being trained on developing playing material with paper and other low cost and no cost material, which is to be replicated to the pre-shoolers for developing small muscular growth and creativity. But they are not doing it in the AWCs. She also told us that 20 AWCs and 38 Mini anganwadis have been sanctioned to be formed. Conclusion From the above interpretations, opinions, beliefs and attitudes, it is clear that there are so many social, cultural , economic, geographical barriers in successful implementation of Child Development and Mother’s Health programme like ICDS. For, Pre-school geographical distance from home to AWC has been evolved as the prime barrier for the Pre-schoolers. Poverty and Education of parents are another reason for lacking awareness and ignorance for Child Development Programmes. In poverty stricken families it becomes difficult to provide nutritional food to the child and mother. Lack of proper infrastructure and lack of resources in AWCs are another cause of disinterestedness in the parts of the children and parents. Lack of awareness and ignorance are the notions for Non-ownership of the programme in the community. Early marriage and labour during pregnancy with unscientific care lead to Low Birth Weight and malnutrition of Children. The AWWs are multi-tasked in different government programmes other than programmes related to Child Development. The frequency and quality of training is not sufficient to enable the AWWs to impart their role properly. The AWWs are lacking rapport with the stakeholders. Monitoring of AWCs is also not regular or rigorous. Absence of Parent Forums in the AWCs result in lack of interest and lack of community ownership. IEC for generating awareness about importance of ICDS programme among public is negligible. Recommendations This study suggests the following measure to fill the gaps and overcome the barriers for successful implementation of ICDS programme: Interpersonal Communication with the help of Service providers like ASHA, ANM, and School Teachers

should be encouraged and abundant IEC activities should conducted among people to generate awareness and concern related to Child Development among people.

Formation of Parent-Teacher Forum and Conduct of Parent meetings in AWCs should be made mandatory by the ICDS authorities and regular conduct of such meeting should be ensured.

More AWCs should be established and the provision of population ratio for establishing AWCs should be reduced in tribal areas.

Adequate funds should be provided to the AWCs to cater the growing financial needs of Infrastructure, Materials, Food and other suitable expenditure

Monitoring and evaluation should be regular and frequency should be enhanced. Rigorous Monitoring by Authorities and Stakeholders should be ensured

Frequency and quality of training for AWWs should be improved and proper implementation of skills should be ensured.

Interface for health counselling for mothers and adolescents should be improved and institutionalised to prevent early pregnancy and related repercussions

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Bibliography

1. Census of India 2011, Vital Statistics, Sample Registration System Bulletins, January’2011 and June 2011 2. Constitution of India, 86th Amendment Act 2002, Article-45 3. Research Abstracts on ICDS 1998-2009, NIPCCD, New Delhi 4. Economic and Political Weekly March 25, 2006 5. IDS Bulletin Volume 40 Number 4 July 2009 6. The halfway mark and state of realizations of MDGs in Orissa : Katha Rakhiba Sarkar Campaign,

Orissa,2007

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