An anganwadi centre to feed children and to sing them rhymes is the only pre-school that millions of children in rural India have. Many of those who manage to go to anganwadi centres (the coverage in Bihar was just 1.5 per cent five years ago) may have benefited from the twists and turns in the programme introduced by funding bodies such as Unicef, USAID and the World Bank.
A Unicef model anganwadi has been in existence in many blocks in Orissa for the past decade and a half. It got mothers to cook the meals in anganwadis. It was supposed to transform the state's nutrition status, which remains unchanged since 1998.
Again, a USAID-Care India model has been active in nine states, scattered over 2.5 lakh anganwadis for 15 years until December last year. The main focus has been the integration of health and nutrition through special monthly functions where health and anganwadi functionaries meet mothers and children at the centres. So, immunisation is ensured for pregnant women.
Care India officials are confident the intervention would have transformed the nutrition charts in the nine states where they were active. The fourth round of the National Family Health Survey may show if their efforts have borne fruit.
Integrated Child Development Services, with an allocation of Rs 8,700 crore, has been fund-starved like the health sector. Both have thus been welcoming funding bodies with open arms even if it meant forcing the state resources and manpower to mould themselves into the designs of the funding agencies.
The Uttar Pradesh health department has been for nearly two decades working in tandem with the birth control-cum-health care regime of USAID, calling its health care programme SIFPSA or State Interventions in Family Planning Services. The European Union has reached the end of its decade-long support for reproductive child health programme and is finalising its exit/extention plans.
The World Bank’s presence in the area of nutrition has been considerable, through six projects, since 1980. With an overall investment of $712.3 million in the sector, India accounts for the largest volume of the Bank group’s lending devoted specifically to nutrition programmes. Support to ICDS, in particular, has been provided in three overlapping phases: phase one in which the bank supported the Tamil Nadu Integrated Nutrition Project from 1980 to 1997, phase two in which it extended support to ICDS in Orissa, Andhra Pradesh, Bihar and Madhya Pradesh from 1991 to 2000 and phase three from 1999 to 2004 in Andhra Pradesh.
Whatever these models may achieve, World Bank studies show the presence of an ICDS centre does not decrease the likelihood of a child being underweight. When using data on actual attendance at anganwadi centers in six states, it was found that only in Kerala is the presence of an anganwadi associated with better nutritional status, these studies say.
According to nutritionist Dr Arun Gupta, unless the programme reaches out to every citizen -- whether it is in health care or nutrition -- it is futile to expect results. He feels that permitting external agencies to use state manpower and resources to run their programmes has been a bad practice.
Kerala's anganwadis are run by Panchayats and get food supplied by self-help groups. The pre-school children get pampered with milk and eggs once a week besides being fed with wheat and jaggery puddings daily. The goodwill enjoyed by these anganwadis, which double up as day-care centres running till 3 pm, ensures their well-being much better than any intervention by aid agencies.
