Anganwadi Centres: The key pillar of Poshan Abhiyan

The prime minister recently said, “One cannot build a strong building on a weak foundation. Similarly, if the children of the country are weak, the progress of the country will also slow down”. India is home to one of the largest populations of malnourished children in the world. To address this issue The National Nutrition Mission, —now christened POSHAN has been launched by the Government.

About the program

• The program aims to drastically reduce the prevailing high incidence of malnutrition, stunted growth and anaemia.
• To achieve its mission POSHAN abhiyan aims to converge mass movement and technology. Anganwadi centres (AWCs) are the focal point of this programme as AWCs play a crucial role in delivery of health and nutrition services for pregnant women, lactating mothers and children.
• In recent times, there have been improvements in the quantity, quality and coverage of services provided to the beneficiaries through AWCs which have reflected positively in maternal and child health indicators.

Unfortunately, despite improvements, there is still much left to do in terms of achieving universalization of coverage and advanced service delivery.

Problems with these Anganwadi centres (AWCs)

• Lack of Basic amenities: many of the AWCs lack basic amenities and face infrastructure problems. Around 24% of them lacked their own building and operated from small rented premises, and around 14% lacked pucca buildings. Only 86%, 67% and 68% of AWCs had drinking water facilities, electricity connections and toilets respectively, some of which are either dysfunctional or could not be used due to conditions imposed by landlords.
• Infrastructural Deficit: According to the Rapid Survey on Children (2013-14) carried out by the Union ministry of women and child development, 74% of AWCs had functional baby-weighing scales and 23% of them had adult-weighing scales
• Irregular Data collection: a 2015 evaluation carried out by NITI Aayog had found that over 24% of the AWCs surveyed maintained poor records.
• Lack of training of anganwadi workers: To overcome the challenges of the tedious and irregular system of manually maintaining daily registers and monitor growth efficiently, information and communications technology-enabled real time monitoring (ICT-RTM) has been rolled out in POSHAN Abhiyan districts. However, it was rendered ineffective due to the limited capacities of AWWs to handle smartphones owing to their lack of technological literacy.
• Lack of financial support: Despite their indispensability, nearly 40% of AWWs had to use their personal money to run the AWCs, 35% of them complained of delayed payments (Progress of Children Under Six Report, 2016), and administrative duties like organizing functions, and conducting exams and surveys distracted them from their core health and nutrition responsibilities. Thus, overburdened with work, undervalued and underpaid, AWWs have become demotivated and demoralized.

Thankfully, realising the importance of anganwadi centres in building a healthy India, government have decided to take some essential measures to revamp these AWCs.

• Expeditious construction of 36,000 AWCs which meet the required standards of space, cleanliness, convenience of locality etc.
• NITI Aayog is aiming to leverage its aspirational district program to replicate the best performing AWCs in other areas.
• The program also aims to involve otherwise unsupportive panchayat leaders in construction of AWCs and improvement in the quality of village health sanitation and nutrition.
• The government should vest more powers in the district administration to fill vacant posts in AWCs, it would be a significant step towards overcoming the problem of shortage of staff.
• Comprehensive periodical and refresher training of AWWs, especially when it comes to usage of tablets for monitoring growth among malnourished children and high risk pregnant mothers, is crucial.
• Further, supply of iron/folic acid tablets, allotment of ‘take-home rations’ and supplementary nutrition needs to be regular.
• The prime minister’s recent video conference with front-line workers and the announcement of an increase in their remuneration, as well as the recent POSHAN Maah awards, send the right signals about the government’s commitment to recognizing and honouring AWWs’ efforts.

Finally, supply side investments need to be complemented with the enhancement of the traditionally weak demand for health and nutrition services. Moreover, it must be realised that the problems which hinder effective implementation of the programme are not insurmountable. But the basics must be fixed first for operationalizing POSHAN Abhiyan advanced features.
 

By: Atul Sambharia