Anganwadi
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The word Anganwadi means "courtyard shelter" in Hindi. They were started by the Indian government in 1975 as part of the Integrated Child Development Services program to combat child hunger and malnutrition.
Meaning and Origin
The word Anganwadi is derived from the Hindi word “Angan” which refers to the courtyard of a house. In rural areas an Angan is where people get together to discuss, greet, and socialize. The angan is also used occasionally to cook food or for household members to sleep in the open air. This part of the house is seen as the heart of the house. It is perceived as a sacred place. Thus the significance that this part of the house enjoys is how the worker who works in an angan and visits other angans to perform the indispensible duty of helping with health care issues among other things came to be known as the Anganwadi worker. They are after all the most important link between the rural poor and good healthcare.[1]
Initiation of Anganwadi system
Quality of and accessibility to health and education facilities were one of the main challenges bombarding India. Due to this India became a nation with one of the largest population of malnourished and hunger-stricken people in the world. In addition to this the country also suffered from high infant mortality rate.
In order to fight these challenges, the Government of India in 1975 initiated the integrated child development services (ICDS). It is a scheme which focuses on fixing things at the state level rather than having a national level solution which would definitely be less effective. The scheme addresses health issues of small children all over the country. It is one of the largest child care programmes in the world that aims at eradicating child hunger, malnutrition and related issues. Under this scheme, a person is appointed who expected to act as a link between the people and organized healthcare so as to ensure that the health and educational needs of children between the age of 0 and 6 are met. This appointed person is referred to as the Anganwadi worker.[2]
Work of Anganwadi Workers
The basic work of Anganwadi workers is extremely important and needs to be carried out in the most efficient manner possible.They need to provide care for newborn babies as well as ensure that all children below the age of 6 are immunized or in other words have received vaccinations. They are also expected to provide anti natal care for pregnant women and ensuring that they are immunized against tetanus. In addition to this they must also provide post natal care to nursing mothers. Since they primarily focus on poor and malnourished groups it becomes necessary to provide supplementary nutrition to both children below the age of 6 as well as nursing and pregnant women. Consistently they need to ensure that regular health and medical check ups of women who fall between the age group of 15 to 49 years take place and that all women and children have access to these check ups. They also need to work towards providing pre school education to children who are between 3 to 5 years old.[3]
Responsibilities of Anganwadi workers as per the Government
The Ministry of Women and Child Development has laid down certain guidelines as to what are the responsibilities of Anganwadi Workers (AWW). Some of them are as follows. These include showing community support and active participation in executing this programme, to conduct regular quick surveys of all families, organize pre-school activities, provide health and nutritional education to families especially pregnant women as to how to breastfeeding practices etc, motivating families to adopt family planning, educating parents about child growth and development, assist in the implementation and execution of Kishori Shakti Yojana (KSY) to educate teenage girls and parents by organizing social awareness programmes etc, identify disabilities in children and so on.
System of workers
The Anganwadi system is mainly managed by the Anganwadi worker. She is a health worker chosen from the community and given 4 months training in health, nutrition and child-care. She is incharge of an Anganwadi which covers a population of 1000.About 10 Anganwadi workers are supervised by a Supervisor called Mukhyasevika. 4 Mukhyasevikas are headed by a Child Development Projects Officer (CDPO).
There are an estimated 1.053 million anganwadi centers employing 1.8 million mostly-female workers and helpers across the country. They provide outreach services to poor families in need of immunization, healthy food, clean water, clean toilets and a learning environment for infants, toddlers and pre-schoolers. They also provide similar services for expectant and nursing mothers. According to government figures, anganwadis reach about 58.1 million children and 10.23 million pregnant or lactating women.
Anganwadis are India's primary tool against the scourges of child malnourishment, infant mortality and curbing preventable diseases such as polio. While infant mortality has declined in recent years, India has the world's largest population of malnourished or under-nourished children. It is estimated that about 47% of children aged 0–3 are under-nourished as per international standards.
MukhyaSevika- The supervisor of anganwadi workers
Every 10 Anganwadi workers are supervised by the MukhyaSevika. They basically provide on the job training to these workers. In addition to performing the responsibilities along with the anganwadi workers they have other duties such as keeping a check as to who are benefitting from the programme from low economic status specifically those who belong to the malnourished category, guide the Anganwadi workers in assessing the correct age of children, weight of children and how to plot their weights on charts, demonstrate to these workers as to how everything can be done using effective methods for example in providing education to mothers regarding health and nutrition, and also maintain statistics of anganwadis and the workers assigned there so as to determine what can be improved. The MukhyaSevika then reports to the Child development Projects Officer (CDPO).[4]
How does Anganwadi system help
India is a country suffering from overpopulation, malnourishment, poverty and high infant mortality rates. In order to counter the health and mortality issues gripping the country there is a need for a high number of medical and healthcare experts. Unfortunately India is suffering from a shortage of skilled professionals. Therefore through the anganwadi system the country is trying to meet its goal of enhanced health facilities that are affordable and accessible by using local population. In many ways an anganwadi worker is better equipped than professional doctors in reaching out to the rural population. Firstly since the worker lives with the people she is in a better position to identify the cause of the various health problems and hence counter them. Hence she has a very good insight of the health status in her region. Secondly though anganwadi workers are not as skilled or qualified as professionals they have better social skills thus making it easier to interact with the people. Moreover since these workers are from the village itself they are trusted easily which makes it easier for them to help the people. Last but not the least, Anganwadi workers are well aware of the ways of the people, are comfortable with the language, know the rural folk personally etc which makes it very easy for them to figure out the problems being faced by the people and ensure that those problems are solved.[5]
Challenges and solutions
There have been public policy discussions over whether to make anganwadis universally available across the country to all eligible children and mothers. This would require significant increases in budgetary allocation and a rise in anganwadis centers to over 1.6 million.
Anganwadis are staffed by officers and their helpers, who are typically women from poor families. The workers do not have permanent jobs with comprehensive retirement benefits like other government staff. Worker protests (by the All India Anganwadi Workers Federation) and public debates on this topic are ongoing. There are periodic reports of corruption and crimes against women in some anganwadi centers. There are legal and societal issues when anganwadi-serviced children fall sick or die.
In announcing the 2008-2009 Budget, Indian Finance Minister P Chidambaram stated that salaries would be increased for anganwadi workers to Rs 1500 per month and helpers to Rs 750 per month. In March 2008 there is debate about whether packaged foods, such as biscuits, should become part of the food served. Detractors, including Nobel Prize winner Amartya Sen, disagreed saying it will become the only food consumed by the children. Options for increasing partnership with the private sector are continuing.
In his budget speech for the financial year 2011-12, Finance Minister Pranab Mukherjee increased the salary for Anganwadi workers to Rs 3000 per month and helpers to Rs 1500 per month.
Recently some NGO's have started working in collaboration with these anganwadies in order to contribute to their work.One of such is www.bhookh.com which donates staple food in anganwadies on per click basis of internet donators.
International efforts
Unicef and the UN Millennium Development Goals of reducing infant mortality and improving maternal care are the impetus for increasing focus on the Anganwadis.
Workers and helpers are expected to be trained per WHO standards.
References
http://india.gov.in/citizen/health/asha.php
http://www.anganwadiproject.com/
Anganwadi Information - http://healthopine.com/healthcare-infrastructure/the-anganwadi-workers-of-india-connecting-for-health-at-the-grassroots