Dr. Neelam Gupta, Founder President & CEO, AROH Foundation

Dr. Neelam Gupta is the Founder President and CEO of AROH Foundation. After doing a doctorate in Agricultural Sciences, she ventured into printing and publishing business and established herself as a successful entrepreneur. She started the AROH Foundation to realize her childhood dream of giving back to the society. Set up and registered in 2001, AROH was initially focusing on research and strategy planning support to programs run by the Government of India. Realizing the great need for developmental work at the grassroots level, she took up interventions that provided direct benefits to people. At present AROH is working on multi-sectoral development initiatives in CSR domain and government schemes.

Early childhood development (ECD) is one of the most important facets of social development, especially for a developing country like India, which is home to more than 158 million children in the age group zero to six (Census 2011). It is well recognized that early childhood care is a significant determinant of overall development of a child and has a long-term impact on a person’s income ability, health and emotional well-being.

More than 50 years ago, National Policy on Education (NEP), 1968 emphasized the need for holistic interventions in early childhood development which was addressed through Government’s flagship programme of Integrated Child Development Services (ICDS). The National Policy for Children-2013, added support to the scheme as it aimed to protect and encourage the rights of the children to survival, health, nutrition, education, development, protection and participation. Recently introduced National Education Policy 2020 continues to hold early childhood care and education as the most significant aspect of growing up years and recommends building strong foundation at the very beginning of a child’s educational journey — the first step of the learning ladder.

Integrated Child Development Services (ICDS) is the centrally-sponsored scheme under the Ministry of Women and Child Development, implemented on-ground through Anganwadi Centers (AWCs) or Anganwadis, managed by the field-level functionaries called Anganwadi workers and anganwadi helpers, and monitored through a three-tier governance mechanism. In addition to administrative monitoring, community-based monitoring mechanism is also promoted under ICDS to foster accountability through the establishment of Village Health Sanitation and Nutrition Committee (VHSNC).

Launched on October 2, 1975, with 5,000 anganwadis, currently ICDS boasts of a network of 1.4 million anganwadis in 7,000 blocks of India engaging 2.8 million frontline personnel, making it the largest mother and child nutrition and care programme in the world. Some of the childcare services provided under ICDS through anganwadis are supplementary nutrition, non-formal early education, health and nutrition education, immunization, health check-up, and referral services while also providing pre- and postnatal care for mothers.

Malnutrition and its subsequent repercussions remain as on of India’s most serious problems, yet marginally addressed. The recent Global Nutrition Report (GNR), 2020 has come out with a disappointing set of figures stating that India is among the 88 countries that are likely to miss global nutrition targets by 2025.

Today India is home to the largest number of stunted children (46.6 million) and wasted children (25.5 million) in the world. Stunting in children is associated with underdeveloped brains and long-term harmful consequences for learning capacity, school performance, and later earning ability. Malnutrition often persists across generations. The intergenerational cycle is broken by providing nutritious meals for both, the mother and child. It has been facilitated through deeply meshed ICDS framework in the remotest locations of the nation. This deep meshed ICDS framework has been the foundation pillar of a nutrition revolution in India.

Holistic healthcare and nutrition services are provided to mother and child through ICDS machinery and anganwadis, supported by schemes like Mid-Day Meal (MDM) and National Rural Drinking Water Programme (NRDWP). The National Food Security Act, 2013 entitles free meals to every pregnant woman and lactating mother, during pregnancy and 6 months after childbirth, and for children in the age group of 6 months and 6 years through local anganwadis. ICDS and anganwadis also receive support from other national schemes like Sarva Shiksha Abhiyan (SSA), MNREGA and Reproductive Child Health Programme. Auxiliary Nurse Midwives (ANM) and medical officers of Primary Health Centers provide healthcare support to the anganwadis.

The anganwadi functionaries, who have a deep and wide reach in Indian villages, have been playing a critical role in fighting the pandemic at the grass root level, helping people in different states cope with the deadly virus and its fallout. These new responsibilities with high-risk are over and above their already assigned workload of delivering nutrition to women and children and other health outreach services such as mass-immunization, and forging a vital link between the government and the community. This resilience and tenacity of the anganwadi workers, besides their usual chores has enabled the Government to proactively implement relief and health protocols.

Anganwadi centers and functionaries have reimagined and rapidly equipped themselves with new skills to respond to the higher burden on public healthcare. They have been infusing private/ philanthropic capital to further capacitate established government systems which can lead to exponential impact. Also imperative to leverage technology to fundamentally redefine doorstep service delivery till the last mile, anganwadi ecosystem has been fostering social cohesion by combating stigma and discrimination.

ICDS programme is unique because it accounts for the fact that caregivers largely shape kids’ early experiences. Accordingly, Anganwadi workers give nutrition and health education to the mothers of children who attend their centers. The anganwadi center is a place where parents feel safe leaving their kids, and it also helps in keeping unattended or destitute children off the streets. The cognitive skills of the child are nurtured, maternal health is taken care of, and early childhood years are shaped. ICDS are, in a way, hub of development for an entire community.

Although ICDS is unarguably one of the most appreciated and studied early childhood programs in the world with a range of interlinked services being delivered through ICDS centers. Various challenges arise in ensuring high enrolment of children, standardized delivery and quality assurance, due to differing demographic and socio- economic patterns, awareness around importance of early childhood development, capabilities of field level functionaries, etc. Although there is a strong system of Early Childhood Care and Education (ECCE) policy and framework, yet systems are not in place and the key issues include: Inadequate skills of field level functionaries, and community engagement has not been effectively leveraged to build ownership of the anganwadis. Monitoring and evaluation of ECD activities is weak and needs strengthening, many anganwadis lack basic facilities such as drinking water and toilets, which are essential for providing a healthy environment for children in their early years.

Government has launched several additional schemes to support and improve the nutrition status in the country, like the National Health Mission, the Janani Suraksha Yojana, the Matritva Sahyog Yojana, the Mid-Day Meal Scheme, and the National Food Security Mission, Poshan Abhiyaan and the recent integration of NEP2020. Few other remedial practices to overcome challenges include Geographic Monitoring & Information System (GMIS), quality certification of for AWC or mobile anganwadi vans to provide services to the socially and geographically excluded populations in the remote interior areas.

The anganwadi system forms the backbone of India’s integrated child development services. It is world’s largest community-based programme to holistically address health, nutrition and educational needs of children and future mothers. Smart anganwadis are the need of the hour as early childhood development is emerging as a significant development driver in the Indian context. NEP-2020 is vocal about the need to set up robust delivery systems of learning continuum from early childhood. Reduction in malnutrition and improvement in school learning outcomes require interventions from the early years of a child to develop the requisite physical, social, cognitive and emotional capabilities and it is important to institutionalize and scale up such practices to ensure standardization and impact creation at the national level. Anganwadis certainly are the means and mode of delivery of these practices and honing their strength can help in build a generation of strong, well-nourished and well-educated children.

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