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ICDS — The entitlement of every Indian child

Nirmala Lakshman

The role of ICDS as an instrument to secure children's right to food cannot be overstated. In States like Tamil Nadu, its functioning has yielded positive results.

A RECENT broad spectrum poll by Reuters that placed India as being the sixth most dangerous place in the world for children is in some ways uncomfortably close to the truth. Danger to children's lives need not necessarily come from gunfire or from buried landmines; nearly half the children who die in early childhood in India do so from malnutrition. India has a staggeringly high rate of children suffering from malnutrition. One in three malnourished children of the world lives in India, and malnutrition is more common here than in Sub-Saharan Africa. Figures of under-five mortality, underweight children, primary school enrolment, and basic health indicators have not shown any substantial improvement over the last decade. In fact, many of these indices record a downslide that underlines ironically the precariousness of childhood in one of the fastest growing economies of the world.

The consequences of early childhood malnutrition are well known and include physical and mental impairment that severely affect a child's growth and development. Civil society's response to crises like persistent hunger, malnutrition, corruption, the lack of accountability and poor governance has grown over the last few years, for instance through successful application of the Right to Information and the Rural Employment Guarantee Act. However, the lack of attention from policy makers and elected representatives to the grave and burgeoning crisis of malnutrition continues. This is clearly reflected in the status of the Integrated Child Development Services (ICDS), whose functioning is uneven in States across the country. ICDS includes immunisation, supplementary nutrition, health and nutrition education, growth monitoring, pre-school education and referral services. In States like Tamil Nadu, its functioning has yielded positive results. It is the only programme that extends from pregnant women and nursing mothers to cover infants and children up to the age of six. Its role as an instrument to secure children's right to food cannot be overstated.

The right to food is included in the right to life, an inviolable right as guaranteed by Article 21 of the Constitution. The Supreme Court in a historic judgment in November 2001 recognised that the right to food is justiciable, and that governments have a duty to prevent hunger, malnutrition and starvation. The judgment came in the wake of severe droughts and starvation deaths while buffer stocks were rotting in the Food Corporation of India (FCI) warehouses. Among other orders, the Court ordered that the ICDS must be made universal to cover every Indian child under the age of six years. Universalization of the ICDS means that every habitation should have a functional anganwadi centre (AWC) and apart from children below six, the services should cover all adolescent girls as well as pregnant women and nursing mothers. In 2004, the Supreme Court gave further directions on strengthening the ICDS.

Late last month, two Commissioners appointed by the Supreme Court, N.C. Saxena and Harsh Mander, submitted their update report on the progress towards universalization of the ICDS. They expressed grave concern that the orders of the Court have not been implemented and, worse, the Government has "challenged the basic principles of universalization outlined in these orders." This contradicts the United Progressive Alliance (UPA) Government's commitment in the Common Minimum Programme (CMP) which states that "the UPA will universalize the ICDS scheme to provide a functional anganwadi in every settlement and ensure full coverage of all children." Currently there are only about 7 lakh anganwadis across the country. The Commissioners state that even a conservative estimate of the requirement of 14 lakh AWCs submitted to the Court was not accepted by the Government of India, and in early 2006 the Government rejected the figure stating that it was based on a survey of drinking water facilities in which every population cluster of 250 persons is considered a separate habitation. The Commissioners point out that with such a ratio (population to AWCs), the number of AWCs will actually stand at a higher number, that is about 40 lakh. The figure of 14 lakh based on an old official norm of one AWC for every 1000 persons is in itself grossly inadequate.

The National Advisory Council (NAC) had also submitted a report to the Government of India which found that 14 lakh AWCs would be required in rural areas and another 3 lakh in urban areas. The Commissioners' report says that although the official norm of one AWC per 1000 persons has been "accepted," it is in reality not at all adequate. They explain that based on the 2001 Census figures, a habitation of 1000 persons would have around 150-160 children below six, 35-40 pregnant women or nursing mothers and 75-80 adolescent girls. How then, they ask, will it be possible for a single anganwadi worker to provide services to such a large number? Even if a second anganwadi worker is posted in each AWC, as numerous evaluations have recommended, the norm of one AWC per 1000 would be quite conservative.

Another serious lacuna according to the Commissioners is that the Government of India failed to specify the time frame within which the ICDS would be extended to all children below six as directed by the Supreme Court. Given the mammoth nature of the task, the Commissioners suggest a one-year time frame for covering all Scheduled Castes/Scheduled Tribes (SC/ST) hamlets and three years for universal coverage. The percentage of undernourished children among these populations stands at 53.5 per cent and 55.9 per cent respectively. They also stress the need to extend ICDS services to children living in urban slums, such as the children of migrant workers who may not have proper addresses or identity documents. Exemplifying this view, recent data from ICDS shows that in Mumbai over 50 per cent of the under-six are malnourished, with a large proportion suffering from severe malnutrition. Food insecurity is therefore a growing phenomenon, with islands of deprivation in the midst of an ocean of plenty.

Considerable difference

However, as a field survey called Focus On Children Under Six (FOCUS) conducted in 2004 in six States revealed, an effective ICDS programme can make a considerable difference in the lives of nutritionally compromised children. For instance, the ICDS functioning in Tamil Nadu, when compared to five other States, (Chhattisgarh, Uttar Pradesh, Maharashtra, Rajasthan and Himachal Pradesh) was far better in terms of indicators such as longer opening hours, the number of infants in the under three age group who attend regularly, basic infrastructure facilities and salaries paid regularly to the AWC workers. The quality of services including pre-school education, supplementary nutrition, health and immunisation services was found to be satisfactory by nearly 90 per cent of the mothers who used these services. According to economist Jean Dreze, who was associated with the FOCUS survey, one reason for the success of ICDS in Tamil Nadu is that "women have helped to make health and nutrition political issues, and also hold the system accountable". Anuradha Rajivan, currently senior economist with the United Nations Development Programme (UNDP) says that "Tamil Nadu politics has retained the combating of hunger and malnutrition as one of its priorities, well before judicial intervention triggered responses at the Centre" adding that the State "is on the verge of establishing child rights to nutrition security," and emphasising that malnutrition "is a problem wider than poverty."

The emergence of a rights perspective with regard to the well-being of children has a direct effect on policy implementation as the example of Tamil Nadu so aptly demonstrates. Ms. Rajivan calls this a `sandwich' situation where pressure from above in the form of political will and pressure from below through wide public acceptance and expectation, with a wide network of services in between sustains these programmes. The FOCUS survey reveals that other States like Maharashtra are also catching up with Tamil Nadu. Other studies suggest that in States like Jharkhand and Bihar, already plagued by issues of poor governance, the ICDS has not fared well and has even faced severe disruptions. The Food Insecurity Atlas of Rural India, an initiative of the M.S. Swaminathan Research Foundation (MSSRF), suggests that in some States like Rajasthan the poorest are actually not even covered by the programme. Dispersed marginal households and tribal hamlets tend to get left out. The patchiness of the current state of ICDS notwithstanding, "the FOCUS survey draws attention to the enormous potential of ICDS," as Jean Dreze puts it. "The sensible way to go," he says, "is to make better use of this potential, given that the foundations of ICDS are already in place throughout the country."

The universalization of the ICDS as the Court-appointed Commissioners pointed out has to be a time and action bound programme with improved norms consistent with the idea that all children and eligible women will have access to its services. It is also imperative that the ICDS remain a government programme without any invasion of private interests. The UPA Government must adhere to the commitment made in the CMP on the universalization of the ICDS. The UPA chairperson, Sonia Gandhi, in a recent speech said, "It is now time for aggressive political activism on behalf of children", and this must happen. The legal enforcement of state accountability, policy initiatives by State Governments and public activism are all required to push this agenda firmly forward to establish the entitlements of the nation's children.

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