Module III Schemes
ICDS Integrated Child Development Services
Timeline of the Scheme
1975 (2nd October): Launched in accordance with the National Policy for Children in India.
1978: Discontinued by the Morarjee Desai government.
2002: Relaunched by the Tenth Five-Year Plan.
Background
Aims: Holistic development of children and empowerment of mothers.
Type: Centrally-Sponsored scheme.
Implementation: Primarily runs through Anganwadi centres, with 1 AWC serving a population of 300-800.
Authority: The scheme is under the Ministry of Women and Child Development.
ICDS Services
Supplementary Nutrition (SNP)
Health & Nutrition Check-Up
Immunization
Non-Formal Education for Children in Pre-School
Health and Nutrition Education
Referral services
Objectives
Improve the nutritional and health status of children aged 0-6 years.
Lay the foundation for proper psychological, physical, and social development of children, especially in rural, tribal, desert, hilly, and slum areas.
Reduce rates of mortality, morbidity, malnutrition, and school dropouts.
Coordinate policy and implementation among various departments to promote child development.
Provide nutrition and health education to mothers.
ICDS Team
The ICDS team comprises:
Anganwadi workers (AWW): Frontline workers
Anganwadi helpers
Supervisors
Child Development Project Officers (CDPOs)
District program officers
Medical officers
Auxiliary Nurse Midwife (ANM)
Accredited Social Health Activist (ASHA)
Anganwadi Workers
Background: Selected local women who serve the community.
Roles:
Provides a direct link to children and mothers.
Assists CDPO in community surveys.
Organizes non-formal education sessions.
Provides health and nutrition education to mothers.
Prepares and delivers food to beneficiaries.
Assists PHC staff in healthcare services.
Maintains records of immunization, feeding, and preschool attendance.
Works for family planning and community welfare activities.
Beneficiaries of ICDS Programme
Services Provided:
Children: Supplementary nutrition, immunization, health check-up, non-formal education.
Pregnant Women: Supplementary nutrition, immunization, health checks.
Nursing Mothers: Supplementary nutrition, health education.
Adolescent Girls (11-18 yrs): Supplementary nutrition and health education.
Supplementary Nutrition
Beneficiary Energy and Protein Requirements:
Children (6-72 months): 500 calories & 12-15 grams of protein.
Severely malnourished children (6-72 months): 800 calories & 20-25 grams of protein.
Pregnant & nursing women: 600 calories & 18-20 grams of protein.
Additional Details:
Community identification for beneficiaries.
300 days of supplementary feeding provided.
Aims to bridge caloric gaps for low-income categories.
Health & Nutrition Check-Up
Target Group: Children under 6, pregnant, and nursing mothers.
Services Included:
Record keeping of height and weight.
Monitoring developmental milestones.
Immunization against preventable diseases.
Antenatal care and vaccinations for pregnant women.
Regular health check-ups.
Treatment for common diseases.
Deworming and prophylactic treatments.
Referrals for serious cases.
Health and Nutrition Education
Target Group: Women aged 15-45 years.
Goal: Build capacities of women for health, nutrition, and development.
Focus: Programs for adolescent girls with specific body weight challenges.
Non-Formal Education for Children in Pre-School (PSE)
Significance: Backbone of ICDS scheme.
Description: Educational programs for underprivileged children, fostering a stimulating environment and optimization for growth.
Outcome: Prepares children for primary schooling and lessens family childcare burdens.
Introduction of WHO Growth Standards in ICDS
Date: 15th August 2008.
Features: New growth standard based on breastfed infants.
Implication: Accurately reflects growth potential based on nutritional needs.
Impact Indicators
Increased birth weight
Reduced malnutrition incidence
Increased immunization coverage
Decreased infant and child mortality
Public Distribution System (PDS) Overview
Objective: Manage scarcity through distribution of food grains at affordable prices.
Operational Structure: Joint responsibilities of Central and State Governments.
Evolution of PDS in India
History: Introduced as a wartime rationing measure. Expanded in the 1960s in response to food shortages.
Revamped PDS (RPDS): Launched in 1992 to enhance outreach in inaccessible areas.
Targeted Public Distribution System (TPDS): Launched 1997, focused on the poor.
Antyodaya Anna Yojana (AAY): Aimed at reducing hunger among the poorest families.
Objectives of PDS
Price Stability: Mitigate food price fluctuations.
Food Security: Ensure access to basic provisions.
Hunger and Malnutrition Reduction: Target low-income demographics.
Social Equity: Distribute food grains to the most vulnerable populations.
Functioning of PDS in India
Roles of Central & State Governments: Procurement and distribution logistics.
Issues Associated with PDS in India
Beneficiary Identification Problems: 61% exclusion and 25% inclusion errors.
Leakage: Significant food losses during transportation.
Storage Deficiencies: Inadequate government storage capacity.
Challenges Facing Food Security
Poverty and Malnutrition: High rates reported affecting quality of life.
Unequal Land Distribution: Concentration of ownership in a small population.
Food Waste: Approximately 68.7 million tons wasted yearly.
Addressing Challenges
Subsidies & Support Prices: To assist farmers and consumers.
Investing in Agricultural Innovation: Development of climate-resilient crops.
Empowering Women: Enhance their role in agriculture.
Technology Integration: Improve beneficiary identification and reduce leaks.
PDS vs. Cash Transfers
National Food Security Act, 2013: Introduced reforms for cash transfers.
DBT Objectives: Reduce reliance on physical transfers, enhance targeting.
Digital India Initiatives
e-PDS Centre: Using technology to improve the public distribution system's efficiency.
Aadhaar Compliance: For beneficiary identification and reducing fraud.
National Rural Employment Guarantee Act (MGNREGA)
Overview: Launched in 2005, aims to provide 100 days of guaranteed wage employment to every rural household.
Legal Framework: Rights-based approach addressing the causes of poverty.
MGNREGA Objectives
Employment generation and food security.
Focus on marginalized communities.
Legal entitlement for employment within 15 days of demand.
Key Features of MGNREGA
Women Participation: One-third of job availability guaranteed.
Asset Creation: Focus on durable assets like roads and water bodies.
Community Involvement: Emphasizes participation and ownership by local communities.
Challenges in Implementing MGNREGA
Delayed Payments: Affecting worker participation.
Caste-Based Discrimination: Variation in payments based on caste.
Quality of Work and Monitoring: Issues with project completion and quality.
Allocate Considerations for MGNREGA
Public Funding Challenges: Decreased government allocations observed.
Pending Wages: Reporting significant amounts owed to workers.
Social Audits in MGNREGA
Importance: Anti-corruption mechanism mandated to ensure accountability.
Current Status: Varies by state, with Kerala leading in completion of audits.
Ombudspersons in MGNREGA
Responsible for grievance handling and monitoring implementation.
Ensures stakeholder accountability.
Aadhaar Based Payment System in MGNREGA
Implementation: Payment through Aadhaar numbers for efficiency.
Adoption Rates: High eligibility for workers in the scheme.
National Health Policy, 2017
Vision: Universal access to equitable and quality health care services.
Aim: To address health system challenges through the National Health Mission.
National Rural Health Mission (NRHM)
Launch Date: 12 April 2005.
Focus: Quality health care access, especially for vulnerable populations.
Rural Focus States: Targeting 18 states with weak health indicators.
Objectives of NRHM
Reduce maternal and infant mortality rates.
Strengthening health delivery and promoting preventive care.
Challenges Facing NRHM
Public Spending: Low investment in preventive health care.
Health System Strain: Emergent health crises demand urgent responses.
NRHM Components
Community Participation: Emphasizes local involvement in health care services.
Accountability Systems: Employment of social audits and public participation.
Availability of Critical Manpower
Strategies in place to address manpower shortages in rural health settings.
Initiatives by NRHM
Empowering local health workers (ASHAs) for active community involvement.
Expanding access via mobile medical units and free ambulance services.
National Urban Health Mission (NUHM)
Focus on urban populations, especially slum dwellers and marginalized groups.
National Health Insurance Schemes Overview
Featured Schemes: RSBY, ESIS, CGHS, AABY, JBY, UHIS, Aayushman Bharat.
RSBY Specifics
Target Group: BPL families including unorganized sector workers.
Benefits: Cashless hospitalization, coverage up to ₹30,000 for family.
Enrollment Process: Streamlined using biometric smartcards.
National Rural Employment Guarantee Act (MGNREGA)
Overview
Launched in 2005, MGNREGA was designed to combat rural poverty by providing guaranteed wage employment to rural households. This program plays a crucial role in enhancing livelihood security, allowing families to meet their daily economic needs.
Specifically, it guarantees 100 days of wage employment in a financial year to every rural household whose adult members volunteer for unskilled manual work.
Legal Framework
The act adopts a rights-based approach, which grants workers a legal entitlement to seek work under the scheme. By mandating that workers can demand employment within 15 days, it ensures that rural citizens have access to work when they need it most, thus providing a safeguard against hunger and poverty.
Key Features
Reservations for Women: To promote gender equity, MGNREGA reserves one-third of the job availability for women. This empowers women economically and socially in rural areas.
Focus on Durable Asset Creation: The scheme aims not only to provide immediate wage employment but also to create durable assets such as roads, water bodies, and irrigation facilities. This contributes to long-term economic development in rural areas, fostering sustainable growth.
Community Involvement: It emphasizes the participation of the local community in project implementation, encouraging ownership and collective responsibility among villagers.
Challenges
Delayed Payments: A significant challenge in the implementation of MGNREGA is the delayed wage payments, which undermine the morale of workers and discourage participation.
Caste-Based Discrimination: There are reports of caste-based disparities influencing wage variations and the allocation of employment, which can perpetuate existing social inequalities.
Quality of Work and Monitoring Issues: Concerns about the quality of work completed under the program and the timely completion of projects must be addressed to enhance accountability.
Social Audits
As an anti-corruption mechanism, social audits are mandated under MGNREGA. This process assures the transparency of transactions and the effective utilization of funds, enabling communities to play an active role in monitoring the program’s effectiveness.
National Rural Health Mission (NRHM)
Launch Date
Established on April 12, 2005, the NRHM was conceptualized to enhance healthcare access and improve health indicators in rural areas, which often lag in health service delivery.
Objectives
Reduction of Maternal and Infant Mortality Rates: A primary aim of NRHM is to tackle the high rates of maternal and infant mortality through comprehensive care and targeted health initiatives.
Strengthening Health Service Delivery Systems: NRHM seeks to build efficient health infrastructure, ensuring that health services reach the most vulnerable populations.
Promotion of Preventive Healthcare Measures: By emphasizing preventive care, NRHM strives to reduce disease prevalence and incidence through health education and epidemiological surveillance.
Enhancing Community Participation: Local health workers, especially ASHAs (Accredited Social Health Activists), are trained to engage communities actively, promoting awareness and facilitating access to services.
Challenges
Low Public Spending: Insufficient investment in preventive healthcare hampers the effectiveness of health programs, leading to an overburdened healthcare system.
Emerging Health Crises: The health system often struggles to respond swiftly to emerging healthcare needs, especially during outbreaks or public health emergencies.
Community Health Demand Responses: Addressing specific, urgent health needs poses challenges in terms of resources and timely interventions.
Community Involvement
Empowering local communities by involving them in health service provision is central to NRHM. By utilizing trained health workers for grassroots mobilization, the mission seeks to raise health awareness and community engagement in the health sector.
National Urban Health Mission (NUHM)
Focus
NUHM specifically targets urban populations, particularly those residing in slums and informal settlements. The primary aim is to bridge the urban health divide and ensure equitable access to health services for marginalized communities.
Objectives
Reducing Health Disparities: The mission aims to address the disproportionate health outcomes faced by urban poor populations, focusing on increasing health equity.
Enhancing Health Status: Provide comprehensive healthcare services that cater to the unique needs of urban families living in slums, thereby improving their overall health status.
Tailored Healthcare Services: The program seeks to customize healthcare delivery to meet urban needs, ensuring services are accessible, affordable, and effectively targeted.
Implementation
A collaborative partnership with municipal authorities and local governments is essential for the successful implementation of NUHM. The engagement of community-based organizations helps identify health needs and develop responsive programs that prioritize local health issues.
Rashtriya Swasthya Bima Yojana (RSBY)
Target Group
Launched to specifically address the healthcare needs of Below Poverty Line (BPL) families, RSBY targets unorganized sector workers and their dependents, ensuring they have access to medical services.
Benefits
Cashless Hospitalization: The scheme facilitates cashless healthcare for beneficiaries, alleviating the financial burden associated with emergency and chronic health conditions.
Coverage: Each family can receive coverage of up to ₹30,000 for various medical expenses, making healthcare more accessible to impoverished populations.
Reduction of Out-of-Pocket Costs: By minimizing out-of-pocket expenses, RSBY significantly improves healthcare access for families living in poverty, promoting overall well-being.
Enrollment Process
The enrollment process is designed to be user-friendly, utilizing biometric smartcards that streamline access and ensure that deserving families can avail the services with minimal bureaucratic hindrances.
Impact
The implementation of RSBY has led to a notable reduction in financial barriers to healthcare access among the poorest demographics, contributing to improved health outcomes and ensuring better health security for low-income families.