1. INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS)
Introduction
- Launch: Initiated in 1975 by the Ministry of Women and Child Development (MWCD).
- Core Objective: Holistic development of children in the age group of 0-6 years, pregnant women, and lactating mothers (PLW).
- Delivery Mechanism: Services are delivered primarily through village-level Anganwadi Centres (AWCs) managed by an Anganwadi Worker (AWW) and Helper (AWH).
Target Beneficiaries
- Children aged 0 to 6 years.
- Pregnant and Lactating Women (PLW).
- Women in the reproductive age group (15-45 years).
- Out-of-school Adolescent Girls (14-18 years) in aspirational districts.
The Package of Six Services
The ICDS scheme delivers an integrated package of six core services, fostering convergence between the MWCD and the Ministry of Health and Family Welfare (MoHFW):
- Supplementary Nutrition (SNP): To bridge the caloric and protein gap between the recommended dietary allowance and actual intake (delivered by AWW).
- Pre-school Non-formal Education: Early childhood care and education (ECCE) for 3-6 year olds (delivered by AWW).
- Nutrition & Health Education (NHED): Counseling for women aged 15-45 years on infant and young child feeding (IYCF) practices (delivered by AWW/ANM).
- Immunization: Routine universal immunization (delivered by ANM; AWW assists).
- Health Check-ups: Antenatal care, postnatal care, and child anthropometry (delivered by ANM/Medical Officer).
- Referral Services: Referring sick/malnourished children to Primary Health Centres (PHCs) or Nutritional Rehabilitation Centres (NRCs) (initiated by AWW/ANM).
2. SAKSHAM ANGANWADI AND POSHAN 2.0 (MISSION POSHAN 2.0)
Introduction & Evolution
- Genesis: Announced in the Union Budget 2021-22 as an integrated umbrella scheme.
- Integration: It merges and restructures the ICDS-Anganwadi Services, POSHAN Abhiyaan (National Nutrition Mission), Scheme for Adolescent Girls, and National Crèche Scheme.
- Paradigm Shift: Shifts the focus from mere calorie supplementation to “holistic nourishment”—emphasizing dietary diversity, macro/micronutrient quality, and wellness.
Core Strategic Pillars
- Maternal Nutrition, IYCF, and Treatment of MAM/SAM:
- Hyper-focus on the “First 1000 Days of Life” (conception to 2 years) as the critical window for neurocognitive development.
- Community-based management of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM).
- Delivery of Quality Supplementary Nutrition (SNP):
- Fortification of Take-Home Rations (THR) with micronutrients (Iron, Folic Acid, Zinc, Vitamin A, B-complex).
- Promotion of millets (Shree Anna) and locally sourced, culturally appropriate foods.
- Poshan Tracker (ICT-based Real-Time Monitoring):
- A robust, real-time digital platform replacing physical registers.
- Enables Aadhar-seeded tracking of beneficiaries to eliminate ghost beneficiaries.
- Auto-plots anthropometric data (height/weight) against WHO growth charts to instantly flag stunting, wasting, and underweight children.
- Convergence and AYUSH Integration:
- Establishing “Poshan Vatikas” (Nutri-gardens) at AWCs for organic, local produce.
- Integration of AYUSH systems for wellness and anemia management.
- Saksham Anganwadis:
- Upgrading physical AWCs into “Saksham” (capable) centers with improved infrastructure: internet connectivity, clean drinking water (Jal Jeevan Mission), sanitation, and smart-learning aids for ECCE.
Revised Nutritional Norms (Supplementary Nutrition Program)
Financial and nutritional norms under Poshan 2.0 are strictly defined to combat varying grades of malnutrition:
- Children (6 months to 72 months): 500 kcal and 12-15 grams of protein per day.
- Severely Malnourished Children (SAM) (6 months to 72 months): 800 kcal and 20-25 grams of protein per day.
- Pregnant Women and Nursing Mothers: 600 kcal and 18-20 grams of protein per day.
Pediatrician’s Role and Relevance
- Early Identification: Utilizing AWC data to screen for developmental delays and SAM.
- Referral Loop: Managing complicated SAM cases referred from AWCs at tertiary NRCs, and ensuring successful back-referral for community follow-up.
- Advocacy: Promoting exclusive breastfeeding for 6 months and timely, diverse complementary feeding in clinical practice, aligning with Poshan Maah (September) and Poshan Pakhwada campaigns.