Impact of Nutritional Services of Anganwadi Workers in Improving Nutritional Status of Infants in Delhi: A Study by Mixed Method Technique

Abstract

Background:Despite the presence of integrated child develop ment services (ICDS) program in rural area of Delhi, the real impact of nutritional services of ICDS program on nutritional status of infants is not very clear, therefore, studying this area may provide new insights in this field. Materials and methods:This study was carried out from 1st January 2015 to 31st March 2015 (3 months). All children up to 1 year of age (in AWC 1 and 2 area of a one rural ICDS block) were examined for their nutritional status by weight for age criteria. The registered infants of both these Anganwadi centers (AWCs) and their mothers were simultaneously observed for all kind of nutritional services they received from Anganwadi workers (AWWs) by way of key informants interviews and this was further confirmed by applying secret customer technique. Results:The prevalence of mild to moderate malnutrition among infants in both the AWC area (AWC 1 area-6 months to 1 year category-52.9%, AWC 2 area (from 0-6 months and 6 months-1 year-69.3%) was higher. The key feeding factors identified for such scenario were: Improper colostrums feeding, wrong age of initiation of semisolid feeding, exclusive breastfeeding not done for 6 months, etc. [especially for AWC 2 area (p < 0.05) and AWC 1 area (p > 0.05)] among the AWCs. These factors were further confirmed by poor efforts of both AWWs in providing nutritional services toward mother and infants. Conclusion:Anganwadi workers need to focus on quality of nutritional services provided toward mothers of infants and this area needs regular monitoring and supervision from ICDS and health system meticulously.