ICDS is the world’s biggest mother and child nutrition and care programme

It is an early spring morning. We are walking deep inside hilly country in Karnataka’s Malnad region. When the monsoon comes, rainfall will be intense in these parts, and will continue for many months. This is coffee terrain.

With the great tall trees above us, and the plantation ahead of us, we have been walking on this narrow path for a while now. A turn ahead; the path narrows further, then opens into a small courtyard. A modest, single-storey structure comes into sight. The local anganwadi.

Outside, the ground has been swept clean and decorated with a rangoli. On the side is a neat line of children’s shoes.

The hall is long, with a low tiled roof. The children come running up to us. Along the length of the walls are painted murals of the fauna of the nearby Nagarhole forest: tiger, leopard, elephant, gaur, deer.

Sunlight spills on to the cool floor. We sit cross-legged in a circle with the children. Circle time gives a feeling of warmth and trust.

Namaste, makkale, I say. Hello, children!.

NAMASTE! yell the children in unison.

Chennagiddira? Are you well, I ask.

HOUDU!! NAAVU CHENNAGIDIVI! YES, WE ARE FINE, they yell.

I smother a giggle.

They are quick to notice. Mmppheheheheheheheh, they burst into a long collective physical giggle, as children do, and it runs round the circle like a tiny Mexican wave.

Thindi aayita? Have you had anything to eat or drink today?

MILK! WE DRANK MILK, is the reply.

Why should we come to the anganwadi, I ask.

They take a moment to think about this question. And then a little boy leaps up to answer.

So that we can learn THINGS and drink MILK and grow up BIG and STRONG, he shouts, stretching out his arms to show me just how big and strong. He has the brightest eyes I have seen.

I ask him his name. Rahul, he says, and he is four years old. He sits down again with a grin. Suddenly, a tiny little girl jumps into his lap and bursts into wails. The anganwadi teacher tells me she is Rahul’s sister, Aishwarya, 2. She weeps softly in her brother’s lap and he comforts her with a hug.

The anganwadi teacher tells me later that the children’s mother has left home. Their father and grandmother work in the plantation. Father, grandmother and anganwadi take turns in the care of the two children.

There’s something in my eye as I watch the two little siblings comfort each other.

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Perhaps the largest mother and child nutrition and care programme of its kind in the world, the Integrated Child Development Services (ICDS) is meant to cover six services: supplementary nutrition, non-formal early education, health and nutrition education, immunisation, health check-up, and referral services.

ICDS was launched on October 2, 1975, with about 5,000 anganwadis. Close to half a century later, with about 1.4 million anganwadis in 7,000 blocks and around 2.8 million frontline personnel, India is still grappling with child malnutrition.

The children are given milk and mid-day meals at the anganwadis. | Photo Credit: Ishaan Raghunandan

One-third of the world’s stunted children live in India. This is the highest number 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. Persistent undernutrition is a matter of deep concern, especially in the context of successive and severe droughts in many parts of the country. A stunting level of 38% (NFHS4, 2015-16) means 38% of our young are growing up with impaired development.

Poorest left out

Two important recent publications speak to this troubling problem. The first, an IFPRI (International Food Policy Research Institute) study of equity and extent of coverage of ICDS from 2006 to 2016, found that the proportion of respondents using ICDS had increased substantially in the period under study. However, the poorest sections of the population were still left out, especially in States with the highest levels of malnutrition.

The second is an insightful paper published recently by retired civil servant V. Ramani, who led Maharashtra’s pioneering Nutrition Mission. He points out that 50 districts, some larger than entire countries, figure at the bottom of the table in international comparisons of child stunting. According to Ramani, beyond the need for ICDS to be resourced better, and its presence expanded (without ICDS, child malnutrition in urban slums could be similar to those in tribal areas) the following aspects also require immediate attention — improved programme design, especially in supplementary and maternal nutrition; sharper focus on the health-ICDS synergy; more local government involvement; and decentralised data to guide frontline workers and improve service delivery.

Tackling malnutrition is not a one-time affair. It requires a lifecycle approach that addresses a gamut of issues — undernutrition among girls, child marriage, discrimination against girls and women in households. It requires multisectoral and convergent interventions from the government and civil society that covers infrastructure, sanitation and clean drinking water.

The anganwadis follow an activity-based, environment-embedded Montessori curriculum. | Photo Credit: Ishaan Raghunandan

Malnutrition often persists across generations. Breaking this intergenerational cycle means that hot cooked meals must be served to mothers as well as young children. In doing this, a space for solidarity among mothers can be created through informal social networks. Besides, it could help build sustainable livelihoods for local women’s groups in dairy, egg and vegetable production. A long-term plan should look at using technology to bring convergence among frontline health and nutrition workers so that every last woman and child can be reached. These are complex innovations, but they are doable.

Holistic and non-formal

Finally, and not least of all, beyond nutrition and health, the anganwadi can be a rich and vibrant centre for early learning activities. Rather than make them huddle over worksheets, the anganwadi can enable their holistic development through non-formal activities.

Indeed, that’s how it began. The idea of the anganwadi drew imaginative power from the work of pioneering Gandhian educators Tarabai Modak and Anutai Wagh, as well as the educational philosophies of Gandhi, Tagore and J. Krishnamurthi.

Modak and Wagh drew their child-centred pedagogy from the work of Italian educationist Maria Montessori, and set it in an Indian context. Montessori came into the field of early childhood education when she started the Casa dei Bambini, literally ‘Children’s Home’, for children from low-income families whose parents were at work. She discovered that when children found themselves in an environment where they had activities designed to support learning, they were able to learn independently. Her educational pedagogy focused on the maxim: ‘First the education of the senses, then the education of the intellect’.

Montessori not only visited Shantiniketan in 1939 but stayed in India for seven years during World War II, training over a thousand Indian teachers in child-centred early education. In their correspondence, Tagore and Montessori discussed the limitations of what he described as the “officialised system of education” prevalent in India. For Montessori, the child was “both the hope and the promise of humankind.”

Modak, called the ‘Montessori Mother’ of India, graduated from the University of Bombay in 1914, became the first Indian woman principal of a women’s college, and gave it all up to start the first early education centre. After years of work in Mumbai, coming under the influence of Gandhian ideas on basic education, Modak decided to move her work to a coastal community in Thane. B.G. Kher, then Chief Minister of Bombay, inaugurated the project: “Tarabai came to this village with the blessings of Mahatma Gandhi. She is sowing the seeds of child education. This seed will grow into a big tree and spread all over India.”

Wagh, widowed within six months of marriage by the age of 13, did her matriculation by enrolling in night school and joined Modak in her work. They developed the programme by inviting children in with songs, processions, and mornings spent clearing dry grass with child-sized kurpis (sickles). When they realised the children were hungry, they began feeding them too. They called the centres ‘balwadis’ (literally, orchards of children) and ‘anganwadis’ (courtyard schools).

Twigs, pebbles and leaves

Their activity-based, environment-embedded Montessori curriculum for Indian conditions used what Wagh called “collections of interesting objects” such as feathers, seeds, twigs, pebbles, flowers, and leaves. They were influenced by Gandhi’s idea of education as the “all-round drawing out of the best in child and human — body, mind and spirit”. Modak and Wagh believed that in order to keep the early education programme truly localised and sustainable, the balwadi teachers should themselves make or assemble play materials, using locally-available resources, or get them made by local artisans.

Wagh’s classic 1979 manual, How to Run a Balwadi, speaks of the beautiful, humane vision of the Thane tribal project. Children began their learning activities out in the open. Every single thing was a learning activity, starting with: ‘To wander about’; ‘To water plants’; ‘To fill in alpana designs with flowers and seeds.’

Today, in many ways, local communities are still carrying forward this great project. The anganwadi is at the heart of the community. Many anganwadi workers collect seeds and pebbles to teach games, texture and numeracy. Parents often gift uniforms to the children so that their anganwadi is nothing “less” than a private preschool. A tailor father gets the uniforms stitched at his tailoring unit. A mason father uses colourful tiles to create patterns on the anganwadi floor. A young MSW graduate, now married and pregnant, comes daily to the anganwadi to have her hot meal and meet her friends.

A Halakki Vokkaliga grandmother, a forest tribal woman in Karwar, walks her grandchild to the anganwadi, waits for him, and walks him back every day. A group of former sex workers takes a loan to set up a unit to supply chikkis to anganwadis.

A gram panchayat member gifts vegetables and coconuts from her orchard to the anganwadi each week. A grandmother exclaims that since the anganwadis are serving hot meals to mothers, she will offer homemade uppinkai (pickle). An anganwadi supervisor who has a haemoglobin level of 8 has begun to take better care of herself. An anganwadi helper grows soppu, green leafy vegetables, in innovatively recycled foodgrain bags, to add nutritive value to the children’s meals.

I could go on. But the fact is, it’s time to see how, despite the challenges, anganwadis make a difference in the life of the local community: in working for the well-being of mothers and children, enabling the labour force participation of women, and guiding the social and emotional development of little ones. Every anganwadi can be a way to ensure that health and nutrition services reach the village; every anganwadi toilet means a generation of young children will grow up with reduced exposure to soil-borne diseases and diarrhoea. Every anganwadi means safe childcare, while mothers earn a livelihood, on an MGNREGA site or agricultural field, in a garment factory or in domestic work. Additional income for mothers also means families are better off economically, with reduced vulnerability to domestic violence — and a better future for the children.

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It is December, and we are in the village of Asoga, by the banks of the Malaprabha river. On the riverbank is a small medieval temple from the Kadamba period. The anganwadi supervisor tells me that this is where, in the film Abhimaan (1973), Amitabh Bachchan first sees Jaya Bhaduri and hears her sing ‘Nadiya Kinare’.

Inside the anganwadi, the children have had their lunch, and are napping on the floor. Outside, there is a papaya tree, and a small kitchen garden planted with greens.

In the years to come, children from this anganwadi will enrol in the nearby school. They will be a healthier and better nourished generation. They will be well-adjusted, will learn better and miss fewer days of school because of better immunity. They will have a better future.

The beautiful artwork on the anganwadi walls says, in Marathi and Kannada, Vidya Heche Vaibhava. Vidyeye Balina Belaku. Education is the light of life.

And the anganwadi system is trying to ensure that it lights up the lives of these children.

The writer is in the IAS, currently based in Bengaluru.