Faltering badly at the last mile

At first, it looked like an abandoned building, run down and pockmarked. But on a closer look, I could spot a yellow-and-black signage on the pale white walls that identified the single-storey structure as an anganwadi, an outreach centre of the 35-year-old Integrated Child Development Services (ICDS) programme. I could not read the name of the village, only the district, Baran, and the state, Rajasthan.

Inside, 20-odd under-six children sat on a tattered black and red duree spread on an uneven floor, oblivious of the dust and dirt wafting in the air. An anganwadi worker and her helper were trying to keep them busy with whatever little educational aids they had. The growth chart that monitors the development of the children hung on the walls like an old calendar, unusable and forgotten.

Looking at the condition of the anganwadi, the last mile link between ICDS programme and its beneficiaries (under-six children and pregnant and nursing women), it was not difficult to understand why India always finds itself at the bottom of development indicators, especially when it comes to children and women. These ICDS centres, our outposts in the fight against malnutrition, are supposed to provide supplementary nutrition, healthcare and non-formal pre-school education to children and also cater to the needs of adolescent girls, pregnant women and nursing mothers. But with working conditions like this, their output is anybody’s guess.

Every village in India has a centre; very soon, every human settlement will have one. The total number of centres will then go up from 10 to about 14 lakh. But, as a World Bank report says, more attention has been given to increasing the coverage than to improving the quality of service delivery and to distributing food rather than changing family-based feeding and caring behaviour. This, the report adds, has resulted in limited impact. The number of underweight children in India is among the highest in the world, nearly double that of sub-Saharan Africa and it is a concentrated phenomenon.

“I wish our centre is also transformed like the other one,” said Mangi Bai, the worker in charge of the centre, as she pointed towards the next village, Chainpura Sunda, barely a few kilometres away, where a ‘model’ has been set up. A short drive later, I realised why she sounded so excited.

Right in the middle of a brown patch of land was a colourful red and yellow anganwadi. At first it looked like a fancy nursery school. Inside, the room meant for children was painted in bright orange with proper flooring. The walls had educational posters, and even a Mickey Mouse.

Like the first anganwadi I visited, this too was in a similar state of disrepair a couple of months ago. But thanks to the efforts of ICDS, government and World Vision, an external aid agency, it has been remodeled so that it could cater better to the needs of the poor tribal community that live around it.

However, this makeover has not been superficial. One of the main reasons the ICDS has not managed to deliver as much as it should have is because a key constituent of the scheme, the anganwadi workers, are not motivated enough due to several factors: low salary and no incentive, and lack of proper infrastructure and monitoring. A 2004 NCAER report found that more than 40% centres are neither housed in ICDS buildings nor in rented buildings; 45% have no toilet facility and 40% have only a urinal. Though the allocation of ICDS has been increased from R6,705 crore in 2009-10 to R8,700 crore in 2010-11, more is required and states need to chip in wholeheartedly with their share. Many states often cite financial crunch to avoid contributing their share in ICDS.

To fix these infrastructural and human resource issues, Rajasthan has signed an Memorandum of Understanding with World Vision to provide technical support and help monitor 60 ICDS centres in 40 villages in Baran district. “Supervision and training are important. But due to staff shortage, it was difficult for the government to do it,” said Harish Chand, programme manager, Baran project. Now, instead of anganwadi workers going to nearby towns for training, trainers re-skill them at the field level. Random sampling is done and special focus is being laid on counselling skills. The community and the panchayat of Chainpura Sunda are being sensitised and motivated to monitor the centres. The other sore point in Rajasthan (as in many other states) is the honorarium of the workers: for their responsibility (six days a week as well as additional tasks as and when required by the government), in Rajasthan, the main anganwadi worker gets just R1,800, the helper much less. There’s no job guarantee or pension. For the target communities, there’s no (across India) grievance redressal system.

Down south, in Tamil Nadu, the same system has been working better, thanks to political will and better financial allocation. The anganwadi workers are better paid (R4,600, house rent allowance, bonus and increments) and the nutritional component of the meals for children are much better devised. The pre-school learning is not only about rhymes and letters but focused on cognitive and social learning as well.

Even as we reach the home stretch of the Millennium Development Goals (No 4 and 5 deal with child and maternal health), we desperately need to shore up the ICDS system. Economic growth alone will not improve the health of our children. Otherwise, when 2015 (the target year for the MDGs) comes and the reports are tallied, India will be scurrying for cover.