Impact of integrated child developement services on the nutritional status of preschool children

Abstract

The present study to find out the impact of Integrated Child Development Services on the nutritional status of preschool children was conducted in Trivandrum urban project area which included four project sectors viz. Vallakadavu, Punthura, Paruthikuzhy and Veli. Comparative study was conducted among preschool children who were non- beneficiaries of Integrated child Development Services selected from the same are and socio-economic group, since such data is not available at present. Information regarding the socio-economic background and dietary habits of the families with special reference to the nutritional status of preschool children were collected through weighment, anthropometric, clinical, biochemical and growth monitoring studies. The results of the study showed that majority of the families surveyed in both experimental and control groups were of nuclear type families belonging to the under privileged section of the community, their main occupation were manual labour and fishing. Majority of the adult members in both the groups were found to be illiterates. Majority of the families subsisted below the poverty line and spent more than 60 persent of the family income on food. All the families were habitual non-vegetarians.Rice, tapioca, fish and coconut were found to be the major ingredients in their daily meal pattern. Children in both the groups were found to have unhealthy food preferences like sweets and fried foods. In the experimental group the preference given to children in serving meals may be due to the influence of nutrition education programmes implemented under Integrated Child Development Services Programmes. Results of the food weighment survey indicated that the diets of preschool children in both the groups were inadequate and unbalanced. The consumption of protective food were too low. Calorie consumption in control group of children were unsatisfactory. Since consumption of fish was high in both the groups the availability of proteins in the daily diet were above the recommended Daily Allowance. But in control group this high protein intake become inadequate in the face of calorie inadequacy as protein would be utilized for purpose of providing energy. These observations may therefore be interpreted as indicating that protein deficiency in our preschool children is conditioned to a considerable extent by low intake of calories and that primary bottleneck in the current dietaries of poor Indian Children is not protein but calories. Results of the anthropometric measurements pointed out varying degree of growth retardation in both the groups. Anaemia was the common deficiency symptoms manifested among children of these areas in both the groups. In the control group children, a high incidence of angular stomatitis and dental caries were observed. Growth monitoring for 6 months using growth charts indicated that the mean body weights of preschool children of control group was found to be more but the difference was not statistically significant. All the mothers had sufficient knowledge regarding the various components of Integrated Child Development Services except in the areas of health education and referral services. The attitude of mothers towards the programme revealed that all the mothers had negative attitude towards the method of cooking foods in the anganwadi centres and distribution of medicines for the beneficiaries. Majority of the mothers had not adopted the home production of vegetables and poultry keeping. The lacunae located in the present study as reported by the mothers were inadequate students strength in Anganwadies due to irregular management and indifference of the anganwadi worker, improper timing for supplementary feeding and immunization, lack of play space in Anganwadies, lack of referral services and nutrition and health education classes. From the present study it was clear that in the implementation of the Integrated Child Development Services Programmes all the six different components were not given equal weightage. This stresses the need for giving equal importance to all the six components, frequent visits by auxiliary Nurses and Midwives and other Medical Personnels and for proper supervision by senior field officials, so as to correct the problems located.