Indian childcare creates a malnourished nation

As India battles acute malnutrition among its children, data accessed by Asia Times via a Right to Information (RTI) application discloses grave shortcomings in the nation’s policies protecting young children and their mothers.

India’s Integrated Child Development Services (ICDS), aimed at providing primary healthcare to children under six years of age and their mothers, was first launched in 1975 by then Prime Minister Indira Gandhi. However it was discontinued only three years later by Morarji Desai’s government. Under the tenth five-year plan (2002-2007), a resurrected ICDS was linked with “Anganwadi Centers (AWCs)”, an old program to combat child hunger, malnutrition, and illiteracy. More than a decade later, the situation has yet to show a significant improvement, and observers ask themselves why childcare is still not a priority for Indian legislators.

According to the fourth round of the National Family Health Survey (NFHS), only around 10% of children aged six months to 23 months receive an adequate diet, despite the ICDS scheme remaining in place.

According to the report of the fourth (2015-16) NFHS, 35.7% of children under the age of five are underweight and 38.4% are stunted. Meanwhile, neighboring Sri Lanka has made tremendous gains in reducing the number of underweight children under the age of five, which went from 34% in 1987 to 13% in 2012. The RTI response from the Ministry of Women and Child Development’s (MoWCD), sought by Asia Times failed to cite the NFHS (2015-16) report’s data on severely wasted (low weight for height) children under age five, which saw a 2% increase between 2005 and 2015.

In a stark revelation, the MoWCD also denied [via the RTI] receiving any funds from the UNICEF and the United Nations Millennium Development Goals for reducing infant mortality and improving maternal care in the country. UNICEF within India has been receiving donations from a strong donor base of 150,000 including the IKEA Foundation and the Bill & Melinda Gates Foundation, while others are corporate entities donating through their headquarters such as Barclays plc, H&M and Starwood Hotels. This raises questions about the functioning of UNICEF to enhance ICDS in India on child and maternal care and the Indian government’s monitoring of the process. In the truest sense, UNICEF has failed to implement its action plan to develop community-based early childcare intervention.

There are 1,363,300 Anganwadi Centers working in India, the RTI query reveals. But when asked about state charts with information of child density per square kilometer, the ministry denied maintaining any such data. Without such information, it is impossible to determine if the Anganwadi centers are adequate in number.

In rural areas, the Anganwadi Program appears to have become a soft node for corruption. The Indian government allocated 163.3 billion rupees for ICDS Core (Anganwadi Services) in the fiscal year 2018-19. But an accountability brief by Avani Kapur and Prerananandita Baisnab shows that many existing Anganwadi Centers do not even have vital facilities despite the funds. For instance, as of September 2016, only 70% of Anganwadi Centers had drinking water facilities and only 63% had toilet facilities. Around 20% of sanctioned Anganwadis in Bihar were not operational as of September 30, 2017.

The workers and helpers, also known as Sevika and Sahayika, are local women volunteers. They are responsible for the implementation of the program and receive a monthly honorarium of only 3,000 rupees and 1,500 rupees, (US$42 and $21), respectively. Anganwadi workers in many states have been protesting for increased wages and better working conditions but the state governments have largely remained apathetic.

The Delhi State Anganwadi Workers and Helpers Union even threatened last year to boycott the upcoming 2019 general election alleging irregularities in the implementation of the ICDS scheme. They said that some of the Non-Governmental Organizations, who had been blacklisted from the Mid Day Meal Scheme due to the substandard food they provided government schools, continue to supply to Anganwadis.

However, several complaints against Anganwadis have surfaced in the recent past. Reports of corruption by slashing the funds meant for Supplementary Nutrition (SNP), as well as Child Development Project Officers (CDPOs) appointing Anganwadi workers by taking bribes, are all-too commonplace.

The appointment of the workers and helpers is completely controlled by the Gram Panchayats (village administration) and local officials. Valmiki Yadav, an RTI activist from Bihar was allegedly murdered for complaining about the “selection” of an underqualified Anganwadi worker.

In light of such allegations, a five-tier monitoring system for Anganwadis was introduced last year by the government.

The accountability system for the ICDS delivery appears to be in a state of shambles. The last performance audit of the ICDS scheme conducted by the Comptroller and Auditor General of India (CAG) was back in 2012-13. It summarized that the Supplementary Nutrition (SN) component had failed to improve the health status of beneficiaries, and the implementation of health check-ups had failed widely. Referral services were also found deficient and due to non-fixation of targets and absence of a monitoring mechanism, full coverage under immunization could not be assured besides many other findings.

The data on the beneficiaries of “pre-school education” (for children aged 3-6 years) are alarming. Even with the fertility rate of two children per woman, Uttar Pradesh saw the number of beneficiaries plummet from 9,491,098 in March 2008 to 5,852,814 in March 2018, representing a 39% decline. A population facing geometric growth while suffering declining literacy is not a good indicator. The fall in the number of literate beneficiaries emerges as a shortfall of the Anganwadi’s pre-schooling program.

Moreover, lack of education and awareness among the poor parents of beneficiaries make them think that education is only for rich Indians with enough time and money. They are unaware of government programs and scholarships; many do not even know about caste-based reservations in education and employment. This highlights the gap between executives and beneficiaries while welfare policies fall short of reaching the most deprived.

It is certain that there are major lapses entrenched in the bureaucratic and legislative system circling the Anganwadi-ICDS. A growing tide of discontent with the system is appearing across the nation’s media, lending credence to the view that the futility of this critically important program does not reside in its framework but in its execution. Public opinion asserts that, as the scheme has failed for decades, the Indian government should either discontinue or revolutionize the whole program.