UNESCO defines 'early childhood' as the first eight years of a child's life. This period is characterized by tremendous brain development. Research has shown that early childhood care and education are very important in laying a foundation for future learning and growth. The following graph shows the growth gap of children who do not receive early childhood education. (source: Hult Challenge of 2015)
Professor David Johnson in his talk at Oxford University on November 6th, 2014 provided concrete examples of studies that exemplified the benefits of Early Childhood Education (ECE):
1) Improved health of children who received ECE in Brazil
2) Increased intelligence of children in Jamaica, Columbia, Peru and Turkey who received ECE
3) Higher enrollment in school of kids who received ECE in Columbia
4) Less grade repetition of kids who received ECE in Brazil and Argentina
Organizations such as the World Bank, UNICEF and UNESCO are heavily invested in developing Early Childhood Care and Education (ECCE)/Early Childhood Education (ECE)/ Early Childhood Development (ECD) schemes around the globe.
What is the current state of children below the age of 6 in India?
63 infants of every 1000 born alive die before the age of one in India (ref: UNICEF). The under-five mortality rate in India is 93. This high rate of infant mortality is closely related to the high rate of maternal deaths: 540 deaths per 100,000 live births. This is because few women have access to skilled birth attendants, and to quality and emergency obstetric care. Skilled attendants handle fewer than half of all deliveries.
Childhood illnesses pose a serious threat to infants that do survive these odds. One in three children do not get a full course of DPT(diphtheria, pertussis and tetanus immunization). More than two million children are known to die every year from preventable infections (including measles and tetanus).
Compounding this, is the problem of malnutrition, which severely impedes growth. One in every three of the world's malnourished children live in India. 50% of all childhood deaths in India are attributed to malnutrition. Although the major reason for malnutrition is inadequate food intake, the availability and access to health services, the access to healthcare for children and pregnant women, the quality of that care (are hygienic practices being followed) are important factors as well (ref: UNICEF).
Due to their lower social status, girls are at a much higher risk of malnutrition than boys of the same age. Up to one third of all adult women in India are underweight, partly because of this cultural bias. Inadequate care of these women, especially during pregnancy leads them in turn to deliver underweight babies who are vulnerable to further malnutrition and disease, causing a vicious cycle to develop.
The following image has been taken from the Slum Census of India, 2011. All the problems described above are acutely present in urban slums. The table shows the abysmal sex ratios that exist (~920 females/1000 males). This is highly problematic.
What has the government done?
The Integrated Child Development Services (ICDS) in India is the world's largest integrated early childhood programs, with over 40,000 centers around the country. Started in 1975, with financial and technical assistance from UNICEF and the World Bank, the program has the dual aim to improve the health and nutritional status of children between 0 and 6 years of age, laying the foundation for their future development; as well as to help mothers look after the nutritional and health needs of their children.
The Integrated Child Development Services has developed a package of services to achieve its ambitious goal, as the outcome of one service depends on the outcomes of the others. The services offered are health, nutrition and hygiene education to mothers, non-formal preschool education to children aged three to six, supplementary feeding for all children, pregnant and nursing mother, growth monitoring and promotion, and links to primary health care services such as immunization and vitamin A supplements. This comprehensive scheme replaced the Balwadi Nutrition scheme that had been started by the government in the 'to provide food supplements to children of the age group 3 to 6 years in rural areas.
The platform of delivery of all the services of ICSD are the 'Anganwadi Centers (AWC)' (loosely translates to village courtyard). Each center is run by an anganwadi worker and one helper, who undergo three months of institutional training and, four months of community based training.
AWCs have been set up in every village in India (~1.4 million in total). Today the program covers 4.8 million expectant and nursing mother and over 23 million children under the age of six. Of these children, more than half participate in early learning activities. A number of evaluation studies of ICDS have been conducted. Broadly, community leaders were positive about the functioning of the AWCS (>80% in all states) while >70% found the program to be beneficial to the community.
What are the challenges of the scheme?
Although the ICDS policy is excellent on paper, it suffers from several implementation challenges. Professor David Johnson in his talk at Oxford, said that one of the biggest issues is maintaining a minimum quality standard in the centers. Centers are dark, housing too many children. The National Council of Applied Economic Research 2005 survey data reveals that >45% anganwadis have no toilet facilities. An appraisal conducted by the NIPCCD in 2006 revealed that 59% of the AWCs studied had no toilet facility. The appraisals also noticed breaching of procedure at the centers. For example, 36.5% of the mothers at the centers did not report weighing of new born children.
One factor that could be responsible for this, is the inadequate training of the anganwadi workers(AWWs) and their helpers. Although 84% of the AWWs are reported to have received pre-service training, in-service training has largely been neglected. One in every two AWWs in the country have been educated at least up to the matriculate level in the country. Due to this limitation, AWWs may not appreciate the importance of continuously engaging with the children and facilitating their development. Compound this, with the fact that workers are paid a pitifully low wage (Recently the government increased their wages by an honorarium of Rs 500 over their previous wage of Rs 938- Rs 1068/month) and have very little incentive to do their job well.
In addition due to the inefficient streaming of funds from various State governments, many AWCs reported forced disruption to the services due to the lack of availability of supplementary nutrition and teaching pack materials. The AWCs employ play based learning techniques. Each AWC is supposed to be provided with a kit costing Rs 1000 that contains items such as building blocks, balls etc that are supposed to facilitate this kind of learning. The government has recently tried to redistribute funding, with more onus now being on national cash flows, rather than state cashflows in order to ensure a reliable supply of such material.
Finally, on an average 66% of eligible childre and 75% of eligible women were registered at the AWCs. The participation of beneficiary women and girls has been low. This inequality needs to be addressed in order to achieve true development in this sphere
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