Model Anganwadi centre at Kamarpalli

Anganwadi Centers (AWCs) are robust platforms for service delivery in community health and nutrition at the grassroots level. AWCs are community spaces that lay a strong foundation for the child’s psychological, physical, and social development. The Anganwadi centers’ service delivery depends upon Community Involvement, followed by the infrastructure availability and the capacity of Anganwadi workers. The Malkangiri district administration worked on these three factors in transforming the Anganwadi system and delivering the health, nutrition, and preschool services to more than 60,000 children of age group 0-6 years, adolescent girls, lactating mothers, and pregnant women with community ownership.

Malkangiri District has 1250 Anganwadi centers, out of which 1241 have their own buildings. Before starting the programme, Most of the Anganwadi centers had poor Infrastructure buildings like leaking roofs, lack of playgrounds, lack of toilets, and even no electric connection. The percentage of malnourished children was around 22%.

A committee was formed, constituting mainly mothers to monitor the activities and create awareness, but the committee wasn’t functional. The Anganwadi workers were not aware of the importance of their work. From the analysis of ICDS monthly data, it was found that more than 15,000 children were malnourished under the age group of 6 years. During the field visits, it was noticed that many AWC’s were unhygienic and also unsafe for children. The “Take Home Ration” prepared for pregnant women, lactating mothers, and children were supplied by various SHG groups. These preparation centers were not maintaining any safety and hygienic procedures.

After rigorous analysis and field visits, the District Administration brought it upon as a priority task to transform the Anganwadi Centres. The various challenges and solutions were discussed in multiple brainstorming sessions, which led to the initiation of the “Transformation of Anganwadis in Malkangiri.” This initiative was launched in October 2018. The broad vision was to transform the Anganwadi’s of the district, with the following key objectives:

1. Upgradation of Infrastructure
2. Capacity Development
3. Involvement of Community, and
4. Strengthening of supervision & support

Upgradation of Infrastructure:

District Administration selected 50 Anganwadi centers (one from each sector) for redevelopment and up-gradation under this initiative using the SCA (Special Central Assistance Funds) in all 7 blocks. These 50 Anganwadi centers were equipped with interactive and child-friendly learning spaces. The children were provided with world-class preschool infrastructure and toys. Localized BALA paintings, essential nutrition-related measurement equipment, and a kitchen garden with wired fencing were put in place.

Model Anganwadi centre at Tumasapalli

Preschool activities at Model Anganwadi Centre – Malkangiri

Capacity Development :

Anganwadi workers, helpers, and supervisors from the selected 50 Anganwadi centers were trained to create a new and innovative environment in their Anganwadi centers. Anganwadi workers were provided with hands-on training on early childhood education, effective sanitation & hygiene, and also on the collection of nutrition & health-related data from the ground. These trainings were conducted at the district, block, and sector levels.

Capacity Development of Anganwadi Workers

Involvement of Community

An innovative community engagement programme, ‘Ama Sisu Sustha Sisu,’ was initiated. Through this programme, committees constituting mothers were created. They were empowered with training, creative community engagement activities like healthy mothers adopting a malnourished child to promote a peer learning environment among the community, regular celebration of the Annaprasana Diwas, Sabuja Diwas, Ankur Diwas, Shishu mela, and nutrition mela. Special meetings were conducted in every Village with women SHG leaders, Village heads, Parents of the children enrolled in AWC, and ward members to create awareness about personal and social sanitation, daily nutrition intake, etc.. Healthy mothers, WSHG leaders were encouraged to adopt a malnourished child and closely monitor their food habits, daily intake, hygiene maintenance, and personal care. They were also counselling the parents regularly.

Strengthening of Supervision & Support

To strengthen the supervisors and CDPOs, a monthly report system was developed, and district level officers were tagged with CDPOs. To improve Take Home Ration (THR) quality, the officers were tagged with preparation units, and every month a day was designated for preparation and distribution of THR. Mother committees were trained and involved in the supervision of daily activities at AWC. Trained the ANMs and strengthened the VHND services.

The initial 50 AWCs (one in each sector), which were developed as Model AWC through Special Central Assistance funds (SCA), were inaugurated through rigorous participation; all the PRI members at all the levels were involved. They were suggested to take up the Model AWC projects in their Gram Panchayats with available GP funds. After the inauguration, it was observed that the daily attendance and the time spent by the children at AWC increased. The parents in other villages also demanded more Model AWCs in their respective villages, which led to a proposal by the PRI members to transform the remaining AWCs into Model AWCs. District Administration approved the proposal to convert the remaining AWCs to Model AWC’s with the convergence of GP funds, MGNREGA, and Horticulture.

The Innovative ‘Ama Sisu Sustha Sisu’ programme was designed in consultation with the CDPOs, Supervisors, and few Anganwadi workers. A special drive was conducted to measure the weight of all the children under the age group 0-6 years, and malnourished children were identified. Village level meetings were conducted with the village head, SHGs, other line department officials, malnourished children’s parents. In the meeting, undernourished children were adopted by SHG leaders and Healthy parents, and also the parents were counselled to change the eating behavior to include more nutritious food.

Green, yellow and red-coloured stars were awarded to each household as per the child’s malnutrition status, which helped to categorize the children. The progress of malnourished child’s weight, along with a photograph of the child and the adopted family, is displayed in the AWC. Every child has to take five meals, including Egg, Hot cooked nutritious meal, Halwa, Ragi porridge, and Chhatua (THR) at AWC regularly. A platform was provided to celebrate progress in the child’s health, and the child’s mother and adopted parents are routinely appreciated.

Every Thursday is declared and celebrated as “Sabuja Divas,” where a meeting is held among the mother of the child, and the guardian/person adopting the child, to discuss the problems faced by the mother and also the availability of different benefits from the government. Ankur Divas is celebrated on the 19th of every month with Poshan mela, and a rally is conducted in the Village to eradicate malnutrition. Shishu Mela is also arranged regularly. Various food items are demonstrated with their nutrition information. Mothers are appreciated whose child has moved to the green category, and the child is also awarded. During VHND, Sabuja Divas, Ankur Divas’ mother, are sensitized about child care and a balanced nutritional diet in every community gathering.

The outcomes of this Project are:

1. All the AWCs are taken up for converting into Model AWCs with all the facilities.
2. The malnourishment status of the district improved, and a more significant number of children gained good health.
3. All parents, especially mothers, were sensitized on hygiene, regular diet for children and females, and effective sanitation at home.
4. High-quality preschool activities were conducted at all AWCs with active participation by the Anganwadi worker, which assisted in the child’s physical and the contingent development.
5. Due to a safe and clean environment in the AWC’s, the attendance percentage improved at all the developed AWCs.
6. The peer to peer from this programme is adopted by other departments for collective improvement.

Summary

The project “Transformation of Anganwadi System in Malkangiri” aimed to nurture a conducive child-centric environment with a clearly laid-out emphasis on learning methods & tools which shall be built upon extensive community participation, and which would directly impact the nutritional status and the learning levels of the children in the district. The Project was designed to transform the ICDS department’s working and change the perceptions at the ground level. The Project created a transformation in the Infrastructure, service delivery, community ownership, and also led to behavior change of ICDS staff and the community towards malnutrition and preschool activities. The infrastructure component was initially taken up under the SCA(by MHA) for 50 AWCs, but later due to the increasing demand from the ground, the remaining 1200 AWCs were also transformed using the GP funds with the convergence from Horticulture and MGNREGS.

The Project emphasizes strong community engagement by creating Nutrition awareness, introducing a peer learning system in the community, changing food habits, maintaining personal and social hygiene, etc. Simple reporting formats were developed for monthly reporting of the child’s nutritional status. District level officers were tagged with the AWC’s to strengthen the supervision & support to the Anganwadi workers. Capacity building of the Anganwadi workers and supervisors was completed through special training.

Through this project, the children’s attendance and the time spent in the AWC’s increased drastically. The percentage of underweight children came down from 23.86% to 15.03%, and the malnourishment status of children from 18.47% to 0.99%. The number of ECCE activities also improved in the district.