Urban areas are likely to receive a renewed focus under the government’s ICDS programme, which provides for anganwadis or day-care centres across the country for delivery of nutrition and pre-school education.
The government’s think tank, the NITI Aayog, has prepared a draft working paper, which once approved would be circulated to different ministries for consultations. These include the Ministry of Health and Family Welfare, the Ministry of Women and Child Development, the Ministry of Urban Housing and Affairs and the Ministry of Drinking Water and Sanitation.
“Health and ICDS models that work in rural areas may not work in urban areas because of higher population density, transportation challenges and migration,” a government official familiar with the deliberations, who spoke on condition of anonymity, told The Hindu .
‘Other models’
“Because of these issues it may not be possible for a community worker to keep in contact with the beneficiaries, which she is able to achieve in rural settings. We have seen some models in India, and in other countries and we are trying to synthesize learnings from those,” the official added.
According to government data from 2018, of the 14 lakh anganwadis across the country there are only 1.38 lakh anganwadis in urban areas. The Integrated Child Development Services (ICDS) provide for anganwadis or day-care centres which deliver a package of six services including supplementary nutrition, pre-school non-formal education, nutrition and health education, immunisation, health check-up and referral services to hospitals.
Urban challenges
The first-ever pan-India survey on the nutrition status of children, highlighted that malnutrition among children in urban India is characterised by relatively poor levels of breastfeeding as mothers have to travel long distances for work. It also found a higher prevalence of obesity because of relative prosperity and lifestyle patterns, along with iron and Vitamin D deficiency. Children in rural parts on the other hand suffered from higher levels of stunting, were more underweight, and wasting and the lower consumption of milk products were more prevalent.
Children in urban areas were overweight and obese as indicated by subscapular skinfold thickness (SSFT) for their age. While 14.5% of children in the age group of 5 to 9 years in cities had higher SSFT, than 5.3% in rural areas, 10.4% of adolescents surveyed in urban areas in the age group of 10-19 had higher SSFT, than 4.3% in rural areas
Avani Kapur, a policy researcher, said improving infrastructure in urban areas would be key as the government embarks on improving service delivery under the ICDS programme.
“One thing which will be crucial for anganwadi services in urban areas is strengthening safety and infrastructure,” said Ms. Kapur, Director at Accountability Initiative of the Centre for Policy Research.
“The other critical thing that needs some serious thinking with respect to ICDS strengthening is the role we expect from the anganwadi centre (AWC) and workers. With talk on merging the pre-school education component with schools in some States — we need to re-imagine their role. Nutrition is one part but we should not forget the support that the AWC provides to the community as a safe place where kids can be left and services availed,” she added.
