Improving Child Nutrition Outcomes In India : Can The Integrated Child Development Services Be More Effective?

Abstract

Levels of child malnutrition in India fell only slowly during the 1990s, despite significant economic growth and substantial public spending on the Integrated Child Development Services (ICDS) program, of which the major component is supplementary feeding for malnourished children. To begin to unravel this puzzle, we assess the program's placement and its outcomes, using NFHS data from 1992 and 1998. We find that program placement is clearly regressive across states. The states with the greatest need for the program ⎯ the poor Northern states with high levels of child malnutrition and nearly half India's population ⎯ have the lowest program coverage, and the lowest budgetary allocations from the central government. Program placement within a state is more progressive: poorer and larger villages have a higher probability of having an ICDS centre, as do those with other development programs or community associations. We also find little evidence of program impact on child nutrition status in villages with ICDS centers.1.

Supplementary feeding for improving the health of disadvantaged infants and children: what works and why?

“…32 Another study in India reported that supplies failed to reach the programme staff 20-30% of the time. 92 Similar failures have been seen in preschool and school feeding programmes, highlighting the challenges of delivery in low-and middle-income countries. 84,93 Programme staff are crucial to the success of supplementary feeding programmes, and skilled local staff are particularly essential in adapting the programme design to the specific local setting.…”

Supplementary feeding for improving the health of disadvantaged infants and young children

“…101 One of the studies that did not meet the eligibility criteria for the Cochrane review (but which provided important data for wider theory-building) reported that in India, supplies failed to reach those who delivered the programme 20-30% of the time. 64 In low-resource settings, trained staff may be in short supply. Much effort may need to be put into a training programme to ensure that all team members understand the intervention and are capable and willing to deliver it according to protocol.…”

From the Editor-In-Chief

“…Within states, poorer villages were more likely to be served. However, states with high levels of child malnutrition have lowest programme coverage and lowest budgetary allocations from the central government (Das Gupta et al, 2005). An evaluation by the World Bank found "only modest positive effects, probably because of low funding, work overload of community workers, and insufficient training" (Engle et al, 2007 …”