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ICDS—EVALUATION AND RESEARCH
1975 - 1988
f
(
Central Technical Committee
Department of Women and Child Development
Ministry of Human Resources Development
Government of India, New Delhi
WmBI
■■
ICDS
Integrated Child Development Services
With the compliments of
Chairman (CTC)
I C D S Secretariat
Central Technical Committee
Dept, of Gastroenterology
All India Institute of Medical Sciences
Ansari Nagar, New Delhi-110029 (India)
PROF. B. N. TANDON
M.D.1F.A.M.S.,F.N.A.
CONTENTS
From Editor's Desk
Acknowledgement
1
I.
Background
II
Health and Nutrition Coverage of Mothers and
Children and Impact on the Nutritional Status
of Children
4
Methodology
4
Annual Survey
Research by Doctoral Students (M.D. Theses) 10
11
Presentation of Data
12
Results and Comments
12
Antenatal Services
15
Postnatal Services
17
Immunisation Coverage
23
Nutritional Services Coverage
27
Nutrition Status of Preschool Children
III.
IV.
Special Research Studies
Management of Severely Malnourished
Mortality during Infancy and Early Childhood
Infancy and Early Childhood Mortality
Effects of Drought and its Management
Mothers perception of Child Development
Knowledge attitude and practices of AWW
Publication of papers and presentations by
the Central Technical Committee and the
Consultants
4
33
33
33
44
55
59
64
65
V.
Appendices
Appendix-I
List of ICDS Consultants from 1976 onwards
Appendix-II
List of M.D. Theses, Published papers.
II
XVII
Appendix-III
Tables (1-56)
Appendix-IV
Statistical Data
Appendix V
Abbreviations Used
LXVI
LXXXVII
From Editor's Desk
Several countries of the world have been expressing their deep concern for the problems
related to the child survival and the child development. From time to time, a variety of
programmes, under different names but with almost similar objectives, for reducing the
mortality rate and improving the health, nutrition and psycho-social development of children,
have been introduced by the governmental and non-governmental organizations of different
countries as well as by the dumber of international agencies. The Government of India after
Independence, has been committed to ensure optimal development for every child of the
country. The following statement of the first Prime Minister of the Country, Late Pt.
Jawaharlal Nehru aptly emphasises this point:
'But somehow the fact that ultimately everything depends on the human factor, gets rather
lost in our thinking of plans and schemes of National Development in terms of factories and
machineries and general schemes. It is all very important and we must have them but
ultimately; of course, it is human being that counts, and if human being counts, well, he
counts much as a child than as a grown up.'
The development of India has been through Five-Year Plans and we will soon be starting
the Eighth Five-Year Plan from April 1,1990. From time to time, special programmes for one
or more components of the child development have been started by the Indian Government.
On October 2,1975, the auspicious day of the Birth Day of the Father of the Nation, Mahatma
Gandhi, after a critical appraisal of the experiences in the past, an Integrated Programme for
Child Development was started as an experiment. This programme known as the Integrated
Child Development Services (I.C.D.S.), has expanded with very fast speed during the past 14
years. With a humble beginning with 33 Projects, it increased to 1952 Projects by March,
1989. Another 500 Projects have been approved for the year 1989-90. An announcement
has been made by the Prime Minister of India to cover the whole country by the ICDS in the
Eight Five-Year Plan Period (1990-95).
The ICDS has several unique features and one of them is a built-in low-cost, efficient and
realistic strategy of evaluation and research. It is realistic because it can be carried on with the
resources available for evaluation and research from the budget of the programme without
depending on the loans or grants from the international and bilateral agencies of the world.
It is efficient, because it has utilized the trained and experienced Faculty members form the
different Medical Colleges as Principal Investigators for operational research, instead of
establishing a fresh man-power organisation for this activity. It is cost effective because the
Principal Investigators and their teams have undertaken the evaluation and research as an
honorary ongoing academic activity with absolutely minimum funds necessary for field visits
and data collection. 1 can stress with all humility that the system of evaluation and research
established in the ICDS does not have any parallel example anywhere in the world. It has been
possible in India, because still the philosophy of 'Service before Self, is alive in this country.
The present document is compilation of evaluation and research data in the ICDS for a period
of slightly more than a decade. It reflects the success of the ICDS which is today the largest
and the longest duration National Programme for children in the world. It also identifies the
weaknesses which are being attended to by the planners and administrators to improve the
success rate. It will be correct to state the despite the financial constraints, the Government
of India has expanded the Programme with a fast speed, because the evaluation and research
data have convinced the Planners the relevance of the ICDS to the human resource
development in the country.
B.N. Tandon
ICDS RESEARCH AND EVALUATION
1975-1988
This document is dedicated to all my colleagues who have been serving the women
and children ofIndia with concern, commitment and compassion for their welfare
and development
Editor
B.N. Tandon
Chairman
Central Technical Committee
Department of Women & Child Development
Ministry of Human Resources Development
Government of India, New Delhi
ICDS Secretariat
Department of Gastroenterology and Human Nutrition
All India Institute of Medical Sciences
New Delhi-110029
India
^y^Ho
Editorial Assistance
— Neeru Gandhi
— Y.K. Joshi
— Umesh Kapil
— S.S. Rawat
© Central Technical Committee (ICDS), New Delhi, 1990
Laser Typeset & printed by:
FINE TYPESETTERS
30-A, Radheypuri Ext. II, Delhi-110051, Phone: 2210830.
Published by:
PROF. B.N. TAN DON
Head, Department of Gastroenterology and Human Nutrition Unit.- ’^^
All India Institute of Medical Sciences, New Delhi.
------------
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Acknowledgements
Evaluation and research in ICDS has a unique contribution of several consultants (as
listed elsewhere in this document). They have carried out the stupendous task of opera
tional research in this important National Programme with the co-operation of young
postgraduate students of their departments with full commitment and sincerity. An exem
plary role of academics in this national programmes has been established by this group of
dedicated personnels. I am extremely grateful to all of them for their valuable contribution.
All these studies have been done at a very minimal cost. However, without adequate
financial support it would not have been possible to undertake so many field investigations.
The Department of Women & Child Development of the Union Ministry of Human
Resource Development has been very liberal in providing the financial assistance and
academic freedom for evaluation and research in ICDS. I am grateful to the officials of this
Department for their generosity.
The United Nations Children's Fund—UNICEF has been providing the financial assis
tance to the Union Ministry of Human Resource Development, Department of Women &
Child Development, for a few selective activities in ICDS. I am grateful to this UN
organisation, dedicated to the cause and concern of children.
The data analysis has been carried out by the Bio-Statistics Cell of the ICDS. I am
grateful to each member of this Cell, particularly, to Prof. K. Ramachandran, who was the
leader of the team for so many years, to Dr. Ajit Sahai, who had, for several years,
organised the Biostatistics activities in ICDS and to Smt. Neeru Gandhi who has been
leading the team of young personnels in this Division for the past few years.
Shri S.S. Rawat and his colleagues have been responsible for computerisation of all
the data. Their contribution has been praiseworthy and indeed gratifying. Dr. Umesh Kapil
has played a pivotal role in collating and thereby scrutiny of the enormous data. I am
grateful to him. The Senior Advisers working at the Central Cell—Dr. B.K. Mahajan, Dr.
M.L. Roy, Dr. Y.L. Vasudeva, Shri K.S. Krishnamurthy and all the staff members of the
Central Cell have made significant contributions from time-to-time. I am thankful to all of
them.
Lastly, I express my sincere thanks to Shri N.C. Jain, for secretarial assistance.
B.N. Tandon
I.
BACKGROUND
The ICDS—Integrated Child Devel
opment Services Scheme in India was
launched on October 2, 1975. Almost at its
a.
outset in 1975
it was decided that the academic community of the medical colleges of
India would constitute its “external investiga
tor” component for evaluation and research.
In this endeavour as many as 29 senior faculty
members from 27 medical colleges, located
within a reasonable distance to 33 experi
mental ICDS projects, unanimously resolved
at a meeting held at the All India Institute of
Medical Sciences (ARMS), New Delhi in
November 1975, to act as its honorary con
sultants with twin roles of (i) evaluation and
research; and (ii) orientation as well as train
ing of the functionaries.
These consultants agreed to work
under the overall guidance of the Central
Technical Committee (CTC) of ICDS, located
at the AIIMS. The group unanimously laid
following guidelines to achieve various goals
of ICDS: (a) the evaluation and research
methodology should be developed and this
should be updated from time-to-time through
meetings of the consultants and the academic
staff of the CTC; (b) the evaluation and
research should involve minimum possible
resources with active participation of the
postgraduate students and faculty members
belonging to the respective departments of
the ICDS consultants; (c) the collation of data
and its first stage tabulation should carefully
be done by the research teams of the consul
tants; (d) the consistency checks and the final
tabulation of data should, however, be under
taken by the Biostatistics Cell of the CTC; (e)
the consultants may freely communicate the
findings of their ICDS studies in appropriate
journals; (f) the national data, as a matter of
policy, would invariably be published by the
CTC with due acknowledgement to the con
sultant’s work or their inclusion as co-authors
as the case may be; and (g) evaluation and
research data generated by the consultants
wiH be used mainly for three purposes, viz., (i)
to know the coverage and impact of jCDS
services in health and nutrition sector; (ii) for
planning the expansion of ICDS; and (iii) to
disseminate globally the results of Indian
experiments of ICDS.
The contribution by the consultants
proved to be highly cost-effective. The num
ber of consultants increased periodically, with
the expansion of ICDS. In fact progressive
increase was observed during 13 years’ pe
riod in reference to the number of projects
from initial ,33 to 1952 in 1988-89 (Figure1). Figure-la depicts the location of the con
sultants in different states of India between
1975 and 1988 (March).
Fig. 1: Progressive increase in ICDS proj
ects.
2000
1500
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2 iooo
s
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Fig. 1 A : No. of ICDS consultants
Jammu
Number of ICDS Consultants:
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5)
Appendix I lists the name of consult
ants, their academic status and institutional
affiliation and the period of association with
ICDS.
Evaluation and Research Approaches:
Following two approaches were
adopted:
I.
Multi-centre projects initiated by the
CTC. This included
(i)
Annual surveys
(ii) Infant and early childhood
mortality studies
(iii) Special research investigations
II.
Individual research projects by the
consultants, usually as operational project for
post-doctoral thesis work.
The annual survey and research stud
ies by the consultants provided data on the
coverage of the beneficiaries by the ICDS
services such as supplementary nutrition,
immunisation and primary health care and its
impact on the health and nutritional status of
the beneficiaries. However, the multi-centre special studies generated data related to the
specific objectives of the studies.
3
II.
1.
2.
3.
HEALTH AND NUTRITION COVERAGE OF MOTHERS
AND CHILDREN AND IMPACT ON THE NUTRITIONAL
STATUS OF CHILDREN
Methodology :
(a)
(b)
Presentation of data.
Results and
(a)
Comments
(b)
(c)
(d)
(e)
1.
Methodology
(a)
Annual Surveys
Annual Surveys
Research by Doctoral Students (M.D. Theses)
Antenatal Services Coverage
Post- natal Services Coverage
Immunisation Coverage
Nutritional Services Coverage
Impact on Nutritional Status of Children
Annual surveys on health and nutri
tion parameters have been conducted through
an external evaluation system by teams led by
senior faculty members of the departments of
community medicine and paediatrics of vari
ous medical colleges in the country.
The Central Bio-Statistics Cell at
AIIMS with the advice of consultants and the
CTC of ICDS on Health and Nutrition has
been developing necessary details for annual
surveys. Uniform sampling procedure and
survey techniques have been adopted. The
survey cards and dummy tabulation sets
alongwith the detailed guidelines for data
collection and tabulation analysis have been
provided by the Central Bio-Statistics Cell.
The design and mechanism of survey includ
ing sampling, methodology, formats, organi
sation of field work and the process of data
analysis has been accordingly modified with
the expansion of the programme. This evalu
4
ation process through annual surveys is re
viewed by the consultants at brain storming
sessions of Regional Meetings and Annual
National Convention.
From 1976 to 1987 as many as 627
annual surveys (baseline and follow-up) have
been carried out by the consultants. Its vari
ous components are briefly described as fol
lows :
Sampling Procedure : Sampling has been
done in two stages :
(A)
The first stage of the sampling
selects the ICDS projects (blocks/
primary health centre/a group of
urban slums); and
(B)
The second stage of sampling
indentifies the anganivadii (The
focal point for the delivery of
ICDS package of services) from
within the sampled ICDS projects.
The total population of the se
lected angan wadis then has been
subjected to the survey, by the
field research teams of the con
sultants.
(i) Projects sanctioned during 197576, where five surveys were carried
out up to 1984.
(A) First Stage Sampling :
The first stage sampling procedure has
undergone following modifications since
its inception to till date:
(a)
(b)
(c)
(ii) Projects sanctioned during 197879 and 1979-80, where at least
three surveys were conducted till
1984.
In the initial phase from 1976 till 1980,
when number of ICDS projects were not
too large (33-150 projects), it was
decided to conduct surveys in as many
projects as possible, so as to obtain
baseline and the follow-up information
on the impact of ICDS in majority of the
projects.
(iii) Projects of 1980-81,1981-82, and
1982-83, where at least one survey
was taken up till 1984.
Only those projects from each of the
above groups were considered for
1985 survey, where survey was not
carried out during 1983 and 1984.
During the following two years (i.e.,
1980-81 and 1981-82) for the first
stage sampling, the baseline surveys in
the newly sanctioned projects were
dropped, and the study was focussed on
the projects which have been opera
tional for different length of time.
During 1982 and 1983, the first stage
sampling procedure was modified so as
to include newly sanctioned projects for
baseline study, 1975-76 projects for
longitudinal study and follow-up study of
projects which have been operational
for few years. The total number of
projects at the national level were con
sidered as uniuerse to draw the first
stage sample.
(d)
During 1984 the principle of state level
sampling for larger states and clubbing
of smaller states was introduced. A few
World Food Programme supported
ICDS projects were selectively included
in the sample.
(e)
Annual survey of 1985 once again in
cluded projects both for baseline and
follow-up study. First stage sampling
was guided by following criteria :
(iv) Newly sanctioned projects for base
line study giving due consideration
to location of the projects i.e., rural,
tribal or urban.
(f)
During 1986, only baseline study for
sample of projects sanctioned in 1985
was carried out.
(g)
The annual survey methodology was
scrutinized by the CTC and consultants
in 1987 after about a decade of experi
ence and it was decided that the 1987
survey should primarily focus on essen
tial and identifiable information in the
projects which are in the category of
either baseline or 3-5 years of opera
tional period. It was also decided to
drop a few more parameters to further
simplify the format and added all those
which were considered important to
obtain essential information.
(B) Second Stage Sampling :
The second stage of the sampling has
also been modified from time-to-time.
In the first three annual surveys (19765
1978) a stratified random sample of 10 anganwadis of each’project were selected for
field study as follows :—
(a)
A map of the block to scale, indicating
the village boundaries, the PHC head
quarters (Hqs.) and the ANM centres
(of about 5000 population each) was
prepared.
(b)
Following three geographic areas were
marked out on the map :
(a) Areas within a radium of 5 kms
from PHC Hqs.
(b) Areas between 5 and 10 kms
from PHC Hqs.
(c) Areas beyond 10 kms from PHC
Hqs.
Within each of the above area, list of
ANM centres was prepared in alphabetical
order (of nearly 5000 population each). Then
using a random number table, two ANM
centres each from (a) and (b) and one ANM
unit from (c) were selected. Alternatively
consultant could use the following procedure:
To write out the serial number of the centres
with (a), (b) and (c) on small chits, separately
for each area and pick blind folded 2 chits
from areas (a) and (b), and one from area (c).
This provided a sample of five ANM centres.
From each of the five selected ANM centres
one angan wadi placed essentially at the ANM
headquarters village and the other from rest
of the anganwadis of each ANM centre, was
selected by random method. Thus a sample
of 10 AWs was obtained for each project.
The sampling method has been
schemetically presented as follows.
Sampling Method for ICDS Surveys:
Area
Distance, in km
from Block Hq.
Selecting ANM Centre’s
(random method)
Select AWs
1st at Hqs
(a)
6
<5
2 ANM Centres
2nd randomly
3rd at Hqs
4th randomly
(b)
6-10
2 ANM Centres
Sth at Hqs
6th randomly
7 th at Hqs
Sth randomly
9th at Hqs
(c)
> 10
1 ANM Centre
10th randomly
(c)
The second stage sampling was
modified in 1979-80 survey which is still
being followed at present. Instead of 10, six
AWs are selected for survey by following
method. The consultants are provided follow
ing guidelines :—
lation of the selected AWs had been subjected
to annual surveys except in 1979-80 and
1980-81, when the survey was conducted
only for preschool children.
The three geographic sectors (of
approximately equal population) under super
vision of the three medical officers of the
PHC were demonstrated on the map of the
Block (PHC area). Two serial lists of onganivadis by village name i.e., one for all
angamuadis located in the sub-centre head
quarter villages and other for all other anganuuadis located outside the sub-centre
headquarters villages was prepared for each
of the three geographic areas. The AW at the
PHC headquarters village was not included in
this list. One anganivadi was selected at
random from each of three lists (one for each
geographic sector) of anganivadis located in
the sub-centre headquarters villages. Then at
random one anganivadi each from the three
lists of anganivadis located outside the sub
centre headquaerters villages was selected.
Random picking was done by writing the
serial numbers of the anganivadis in each list
on separate chits of paper, shuffling them
thoroughly and picking one chit blindfolded.
Thus six anganivadis, three located in the
sub-centre headquarter villages (one each in
the three geographic sectors) and three lo
cated outside the sub-centre headquarters
villages (again one each in the three geo
graphic sectors) were finally available for
survey in the project.
In respect of urban slum projects
however, only one serial list was prepared for
the three geographical sectors, and at ran
dom two anganivadis were selected from
each sector.
As mentioned earlier, the total popu-
A comprehensive schedule for collec
tion of background and followup information
on a large number of parameters related to
the beneficiaries of the programme and
general population in the project area was
prepared for 1976 to 1978 surveys. The
format was adjusted to match with computer
ised data analysis system. Vital parameters
used for survey schedules are grouped be
low:—
Identification information on house
(a)
holds and target beneficiary groups to
have a complete census of the popula
tion in selected AWs.
Format and Schedule for Health Check
up and Interviews :
(b)
Demographic pattern including relig
ion and castewise break-up and family
size.
(c)
Socio-economic variables, literacy and
occupational status.
(d)
Growth and develpment of preschool
children and pregnancy and lactation
details such as order of pregnancy and
parity number etc.
(e)
Vital statistics
(0
Nutritional status of preschool children
and prevalence of major illnesses in
child population.
Coverage of essential health and nutri
tion services as follows:—
(i) Immunisation : BCG, DPT, small
pox and tetanus toxoid.
(ii) Nutrition supplementation includ
ing therapeutic food, vitamin ‘A’,
(g)
7
iron and folic acid.
(iii) Health check-up including antena
tal and postnatal care, and severely
malnourished and ill children’s care.
Separate schedule was used for every
household and individual beneficiary
of ICDS.
During 1979 and 1980, the survey
was confined to the sampled AWs. The para
meters were essentially the same, as above
but data on polio-immunisation was also
gathered. Vital statistics was not recorded.
Especially designed punch-hole edged cards
instead of computer schedules were used to
facilitate the manual compilation and analysis
of data.
1981 and 1982 survey formats in
cluded households, pregnant and lactating
women and preschool children data as had
been done in first phase up to 1978. Sepa
rate survey cards and forms were designed for
each group. Data on socio-economic condi
tions, occupation and literacy status and vital
events were not scheduled.
Consultants recommended in 1982
that punch-hole card system was not much
helpful at the time of data analysis which had
been decentralised. The cards used for subse
quent surveys were without punch-holes.
Survey cards were suitably modified to in
clude columns for occupational and literacy
status, DT immunisation, goitre, major
disabilities,family welfare, preschool and
nutrition and health education. Appropriate
alterations were also made in the organisa
tion and process of data collection and data
analysis.
Again in 1987, in the revised format
the parameters such as religion, literacy status,
vitamin A, iron and folic acid, clinical signs of
malnutrition, current illness, services for cur8
rent illness, supplementary nutrition, health
check-up, non-formal preschool education
(in the household and preschool children
format), supplementary nutrition and nutri
tion and health education (in the lactating
women format) have been dropped alto
gether. Whereas few additional parameters
like socio-economic status, eligibility for ICDS
services and utilization of services (household
composition format) have been introduced.
All the parameters of pregnant women
format except birth order and parity number
have been dropped.
Organisation of survey team and its
schedule of work:
Each consultant constituted a team of
10-15 members of their respective depart
ment. The teams included a few female
members also to facilitate the health check
ups and interviews with pregnant and lactat
ing women. Medical and paramedical staff of
the project was excluded in the survey teams.
The survey team members were oriented
about the aims and objectives of ICDS and the
various survey techniques employed. Con
sultants were advised to complete the survey
within a maximum stretch of three months
form October to December. Each team, on
an average completed the survey within 1520 days period, often in two phases of field
visits. Consultants did not make use of AWW’s
data but were advised to have cross consis
tency checks consulting registers wherever
the informant’s statement appeared doubt
ful.
Tabulation, analysis and presentation
of data:
The tabulation and analysis of data from
1976-1978 were done at the Biostatistics
Cell at AIIMS, through computerised system.
The consultants had collected the data on
pre-designed formats. Original formats were
forwarded to Central Cell after cross consis
tency checks at the project level. A compre
hensive analysis of the data was done to
prepare study reports for each project.
With the valid expansion of ICDS
projects from 1979 onwards, the consultants
decided to take up the first stage analysis at
the project level itself. At present, a decen
tralised data analysis system is operating
where the first stage analysis by the team
members of the consultants is being done at
the consultants’ headquarters and the final
stage analysis is carried out at the Central
Cell. This system is briefly described as fol
lows:—
(a)
(b)
(c)
AIIMS prepares the projectwise data
report for the whole country as dis
cussed in the CTC and at the Annual
Convention of ICDS. It is finally sub
mitted to the nodal department for the
ICDS of the Government of India, and
other appropriate agencies.
The annual survey data have been clas
sified into three major groups :—
(i)
Baseline or the control data for the year
when a survey was carried out in an
ICDS project which has been recently
sanctioned and where the services have
not yet initiated. It was classified as
baseline data. In fact, even after the ap
proval to establish an ICDS project, it
generally takes about 18 to 24 months
before it becomes fully operational with
signs of impact on health and nutrition
of mothers and children. The baseline
survey for the year under reference
becomes the control data at that par
ticular period of the study.
(ii)
Survey of fully operational projects :
The second type of projects included as
samples in the survey work are those
where ICDS has been operational at
least for one year, in other words,
generally such projects are of three
years’ duration. The coverage and the
impact of ICDS in these projects which
can also be described as experimental
projects, have been compared with the
control data as defined in para (i) above
for the reference year.
(iii)
Longitudinal survey of the project
started in 1975. (ICDS scheme was
launched with 33 Central and 3 State
projects). The baseline survey followed
by the repeat surveys in these projects
have been considered as longitudinal
After completing the survey, the con
sultants have been advised to apply
certain data consistency checks.
A set of dummy tables corresponding
to each survey card is being provided by
the Central Cell alongwith the guide
lines for tabulation.
On an average a team of 10-15
members supported by local statisti
cian takes nearly 10 days to complete
the analysis.
(d)
The consultants forward the tabulated
data to the Central Cell for scrutiny and
the lapses/lacunae/ discrepancies so
detected are immediately brought to
the notice of respective consultants.
The data screened through the above
process is finally compiled at the Cen
tral Bio-Statistics Cell.
(e)
Consultants prepare reports of the
annual surveys for the officials of the
State government which enable them
to take appropriate actions to improve
the implementation of ICDS.
(f)
Central Bio-Statistics Cell of ICDS at
9
surveys to assess the long-term effects
of ICDS on the health and nutrition
status of women and children.
Surveys allotted and completed:
Since 1976, each year after a detail
discussion on the plan of survey, the consult
ants have been alloted to conduct the studies.
The number of surveys alloted and /finally
completed each year till 1988 is shdwn in
Fig. 2. The commitment of the consultants
Medicine and Paediatrics have been a unique
feature of this nationwide programme. M.D.
students have to submit a research thesis as
part of their doctorate programme. The CTC
has not contributed funds for this activity.
However, the consultants of ICDS them
selves have alloted the subjects to their post
graduate students for their MD theses.
A total of 108 theses have been
written on ICDS subjects at different medical
colleges of the country till early 1989 (Fig. 3).
Fig. 2: Annual ICDS surveys allocated and These research studies, according to the rules
completed by the consultants.
---------- ALLOTEO
---------- SURVEYED
100
Fig. 3: Research in ICDS through M.D.
thesis projects by the post-doctoral
students of the medical colleges.
eo
60
5
L
20
20
8
0
IS7T
?S
n
so
si
•2
«3
•S
•<
S7
YE A R
and their team members has been commend
able as is reflected from the insignificant drop
out which was often related to unmanageable
local situation to complete the survey work.
(b) Research by Doctoral Stu
dents
The M.D. Theses Work of Integrated
Child Development Services:
The research studies by the students
registered for their doctorate in Community
10
1.0
%
i
0
n
•0
w
EARS
of Academic Institutions were planned and
carried out by the doctoral students under
supervision and guidance of the senior faculty
members of the department. No financial
assistance was provided from ICDS budget
for these studies. Data of these research
studies have been presented in the different
sections of the results. Appendix-II lists the
subjects, the year of study and designation of
the principal guide.
2. Presentation of Data
Enormous data have been collected
through 627 surveys, 108 research theses
and more than 12 special research projects.
It has been organized on rational and scien
tific basis, so as to provide clear message and
sound conclusions. Following approach has
been taken to organize the data :
1. Base-line data have been used as
control data. Several base-line surveys have
been done at different years during 19761988. These data have been used for three
purposes as control data (a) ‘coverage and
impact’ related to State Nutrition and Health
Services Programmes, without ICDS inputs,
at periodic intervals; (b) ‘coverage and im
pact’ associated with ICDS programme from
the base-line of 1976 to the follow-up longi
tudinal study of 1985; and (c) ‘coverage and
impact’ associated with the ICDS Programme
by comparing the results of study in 3-5 years
old ICDS project with the control data (base
line) of 1985.
2. Longitudinal study of the original
projects of 1976: The original projects of
1976 had 2-3 follow-up studies. The data of
the last study in 1985 have been used for
comparison with the base-line data of 1976
to assess the long-term effect on coverage
and impact of ICDS programme.
3. Data of 3-5 years old ICDS Project:
Several projects surveyed at different years
were in the category where the ICDS has
been analysed as a group. It has been com
pared with the base-line data, if the later was
available for the corresponding period.
4. Comparative special research study
in 3-5 years old operational ICDS project
with the matched controls : These data have
been separately analysed and its conclusions
have been compared with the results of sur
veys and doctoral MD thesis research studies.
5. Data of special research projects
have been presented separately except in
chapters of coverage and impact and infant
and early childhood mortality, where it has
been presented along with the survey and
post-doctoral thesis research studies.
11
3. Results and Comments
(a) Antenatal Services
|
l
1.
The evaluation and research studies on antenatal services show convincingly "
that the coverage of pregnant women has significantly improved in operational ICDS
projects which are of 3 years or longer duration. Since the coverage remains on an
average about 50 per cent, more team efforts of ICDS and Health Services staff were
called for to cover almost all the pregnant women. Rural group with a comparatively
lower coverage than the urban needs more attention.
2.
Comparative study of ICDS and matched control non-ICDS pregnant women
is quite revealing. Though the sample size is small, conclusions are almost similar as
that of like the other ICDS studies, annual surveys and doctoral student research in
vestigations.
(a) Coverage of pregnant women by antenatal services is almost double in ICDS
group (71.9 %) as compared to control group (40.3 %). (b) The antenatal services
coverage as revealed by this study in control group is significantly lower from those as
observed in operational ICDS projects by annual surveys and doctoral thesis research.
3.
The home delivery continues uniformly as the favoured practice in both ICDS
as well as non-ICDS groups. However, significantly high proportion of ICDS projects
pregnant women utilise trained paramedical personnel for home delivery (76.3 %) as
comapred to non-ICDS project group (49.4 %). It is obvious that ICDS is stimulating
the utilisation of trained parmedical personnel for intranatal services for pregnant
women. This trend needs to be provided a momentum so that almost all the pregnant
women are delivered by the trained personnel at the village level itself, even at their
own houses.
The consultants of ICDS evaluated
the antenatal and intranatal coverage through
following methods :
A.
Special multi-centre research studies.
Results of the Annual Surveys:
The antenatal services were evalu
ated through annual surveys and data were
compiled in projects of more than 3 years old
duration. As many as 50.8 per cent of the
pregnant women received antenatal check
up and 40.9 per cent had received both the
doses of T T. The coverage was compara
tively better in urban projects as compared to
the rural projects.
The results of these three methods
are presented in the following three sections
and the details of the data are provided in
Tables 1 to 77 and Appendices III and.IV.
The nutritional supplements to preg
nant women during antenatal care is high
lighted in ruralztribal and urban projects in Fig.
4. The coverage of supplementary nutrition
(i)
ects.
Annual surveys of operational proj-
(ii)
Research investigations by the post
graduate students (M.D. theses work).
(iii)
12
Fig. 4: Antenatal services in 3 years old
ICDS projects
(APPN-III-TAB : 4 & 5)
I
1 Rural+tribal
fll Urban
70
60 -
&E 50 -
3 40 -
S 30’
I 20'
10 -
0-
and 62.3 per cent of urban women. The
delivery by the trained person was noted in
63.5 per cent of urban and 57.8 per cent of
the rural women. There is satisfactory deliv
ery of antenatal services in the ICDS projects
(Fig. 5).
'Lit I
lli 91
Antenatal Supplementary
care
nutrition
Iron & Folic
acid
Fig. 5: Antenatal and intranatal services
in more than 5 years old rural and
urban ICDS projects (research
data)
Tetanus toxoid
(APPN-11I-TAB : 7 & 8)
tlnillllj Rural
■■ Urban
80 f70 -
and the iron and folic acid was 41.2 and 42.9
per cent respectively. The urban pregnant
women received the services in higher pro
portion as compared to the rural group (Fig.
4).
The delivery at home and by trained
personnel was investigated in 44 projects. A
total of 76.3 per cent of the women had
delivery at their own houses. However, it was
significant to note that nearly half i.e., 47.9
per cent deliveries were done by trained
personnel, either by a birth attendant or a
multi-purpose female worker (ANM).
B.
Study of antenatal services in
more than 3 years old projects as
undertaken by M.D. students :
The study was carried out in 10 proj
ects, which comprised 7 rural and 3 urban.
The coverage of antenatal services was 54.4
per cent and there was no appreciable differ
ence between the rural and urban groups.
The TT immunisation coverage was 57.5 per
cent of the rural but only 46.5 per cent of the
urban pregnant women. The home delivery
was performed in 95.9 per cent of the rural
£60 | 50 ° 40 -
3E
3 30 u
0- 20 10 -
0 Antgnatal
care
Tetanus
toxoid
Delivery through
trained person
C. Comparative Study of Antenatal
Services to Pregnant Women in ICDS
& Non-ICDS Population
Antenatal services which included
antenatal check up, tetanus immunisation,
the place of delivery and the paramedical
services for delivery were compared for the
sample of 1114 pregnant women from ICDS
projects (experimental group) of more than 3
years duration with their matched controls of
1031 women drawn from non-ICDS com
munity development blocks (control group).
Antenatal check up was done in 71.9 per
cent of the pregnant women in experimental
group as compared to 40.3 per cent of the
control group. Further, coverage of antenatal
13
check up was significantly more in rural popu
lation of, both the groups. The tetanus
immunisation was received by 70.8 per cent
in the experimental group as against 44.0 per
cent in the control group. In this case also, the
coverage was better for the rural women. The
delivery at home was recorded almost equally
in experimental (95.4 %) as well as the control
group (93.8%). The hospital delivery was
recorded in just 4.6 and 6.2 per cent respec-
tively, in two groups. The delivery was con
ducted by trained paramedical functionaries
in 76.3 per cent of the pregnant women in
the experimental group as compared to 49.4
per cent in the control group. The trained
paramedical personnel conducted the deliv
ery more frequently amongst the rural preg
nant women as compared to the urban group
(Hg. 6).
Fig. 6: Antenatal and intranatal services coverage of pregnant women in ICDS compared
to non-ICDS control population (Research data).
(APPN-III-TAB : 9 & 10)
lOOr-
90k-
95.4
r
INon-ICDS control population
]ICDS
80 -
93.8
u 70 I—
cn
o
K.
CJ
>
c
60 50
c 40
c»»
o
a. 30
20
10 0
71-9
i I I i
44 7o
Less
Antenatal
care
14
76.3
70.8
37. 8%
Less
Tetanus
toxoid
1.7 7o
Less
Home
delivery
34.6 7e
Less
Delivery through
trainea persons
(b) Postnatal Services
V
Data on postnatal services to the lactating women show that all services in ICDS
group have better coverage than the control and the baseline data. However, it is
evident that the overall success rate remains less than 50 per cent in rural and 30 to
40 per cent in tribal women. These results, though satisfactory, call for augmentation
of ICDS and-health staff activity to achieve much more success in future. Postnatal
services coverage will definitely have a positive impact on population control
programme.
-
------------- -------- --
The coverage of lactating mothers by
the postnatal services was evaluated through
the annual surveys. The postnatal services
included health check-up, nutrition and health
education, family welfare advice and supple
mentary nutrition. Data from 44 projects of
more than three year duration with a sample
size of 3100 lactating mothers have been
compared with the baseline data of the corre
sponding year in 28 projects which provided
a sample size of 1938 mothers. Except for
health check-up, all other parameters showed
a significant improvement of coverage in
Fig. 7: Postnatal services in more than 3
years old ICDS projects and in non
ICDS control lactating women
(annual survey data).
(APPN-III-TAB: 11)
70 -
I
60 -
Control population
I >3 Years old projects
b-
8 4°s30'
r°-
on
12.1
_g
10 0-
3-0 7.
Less
Health
check-up
31.2 7.
Less
Fomily welfare
advice
60.1 7.
Less
Supplemenlory
nutrition
ICDS operational group as compared to the
baseline. Coverage for nutrition and health
education and family welfare advice was 44.6
and 43.6 per cent, respectively in ICDS
operational group as compared to 27.6 and
30.0 per cent respectively in control popula
tion. Distribution of supplementary nutrition
to eligible lactating women in ICDS opera
tional project was 29.4 per cent compared to
15.4 per cent in the non-ICDS (or control)
group (Fig. 7).
The health check-up, nutrition and
health education and family welfare services
are better in the urban projects followed by
rural and the tribal ICDS project of more than
three years duration. Nutritional services
coverage is almost identical in the three groups
(Fig. 8).
A nine year follow-up study for cover
age by the postnatal services in the initial
ICDS projects started in 1976 was carried out
in 13 ICDS projects and data were compared
with the baseline study in 27 projects. All the
services to lactating mothers observed a sig
nificant improvement in the coverage. The
health check-up and supplementary nutrition
coverage increased to 53.2 and 35.6 per
cent from the baseline of 10.8 and 14.2
15
per cent respectively. The family welfare, nu
trition and health” education coverage were
merely 0.3 and 0.5 per cent at the beginning
of ICDS and both increased steeply to 55.9
and 56.4 per cent in the follow-up study (Fig.
9).
Fig. 8: Comparison of perinatal services
in urban, rural and tribal ICDS
projects (annual survey data)
Fig. 9: Postnatal services follow-up study
in 1985 compared with baseline
data of 1976 ICDS projects
(annual surveys data)
(APPN-1II-TAB : 12)
(APPN-III-TAB : 13)
I----- 1 ICDS Population 1985
H Control population 1976
70
Ji
nnnnD RUroi
60
Urban
I Tribal
& 50
r
40
o
8
- 3ol
s8 20 -
2 ?°
10 -
10
OL
a
30 -
fll
Health
check-up
16
o
o 50
Nutrition and
health education
Family welfare Supplementary
advice
nutrition
35-6
Illi
79.7V. Less
Health
check up
99V. Less
Nutrition &
health
education
99.5V. Less
60*/. Less
Family
Supttementary
welfare
nutrition
advice
(C) Immunisation coverage
...............................................................................................................
•
Evaluation through different approaches estimates the significant contribution of
ICDS to increase the immunisation coverage for BCG, DPT, polio and tetanus in all
three types of population viz., rural, tribal and urban. The immunisation by 3 vaccines
for children reached to nearly 50 per cent by 1985 compared to the baseline of less
than 21 per cent. Similarly, TT immunisation for pregnant women showed more than
5-fold increase.
All the studies comparing immunisation coverage in ICDS operational project with
the baseline control population confirmed a very significant increase in the immunisa
tion rate for children below 6 years age, below 2 years age and the pregnant women
in the ICDS group. The increase though significant was of variable degree for different
vaccines. Research studies revealed higher success rate of immunisation programme
than the annual surveys.
Comparative study of immunisation in ICDS and matched control non-ICDS group
of children was done as special research project. It corroborated the conclusions of
earlier evaluation through annual surveys and doctoral students’ theses work. There
was very significant increase of the coverage by all the 3 vaccines in 0-3 and 0-6 years
age group children of ICDS project compared to the matched control non-ICDS group.
ICDS approach is successful for enhancing immunisation coverage and thus
continues to contribute significantly in achieving the goals of Universal Immunisation.
It is expected that with proper coordination between ICDS and health functionaries we
could complete our targets of immunisation much earlier than the year 2000 AD. High
cost UIP surveillance studies have also confirmed a very good immunisation coverage
in ICDS projects.
----- . -......
■
The impact of ICDS on immunisation
of the children was evaluated through the
annual surveys, research investigation by
the principal investigators (working for their
M.D. theses in various medical colleges of
the country) and by UIP evaluation team as
per guidelines of the World Health Organi
zation, Geneva.
(i)
BCG coverage was 42.9 percent
and that of DPT 45.0 per cent in
.
.
J
ICDS group as compared to 22.6
per cent in the control popula
tion. Polio vaccination in ICDS
group was 46.0 as compared to
23.1 per cent in control group.
Tetanus immunisation of preg
nant women had also shown a
significant gain in ICDS popula
tion. Immunisation coverage was
maximum in urban ICDS project,
followed by rural and tribal areas
(Figs. 10 and 12).
Immunisation evaluation through
annual surueys
(a)
.
(b)
A comparison of immunisation in
17
Fig. 10: Immunisation of preschool child
ren and pregnant women in more
than 5 years old ICDS projects
compared to non-ICDS control
group (annual survey data)
in control and 27.7 per cent in the
ICDS projects. The polio cover
age was 14.8 per cent and 28.5
per cent in control and ICDS
projects respectively.The urban
ICDS projects recorded highest
rate in term of coverage while the
success rate in rural and tribal
projects was almost similar.
(APPN-III-TAB : 14)
7°r
I
60 -
■■ Control population
I More than 3years old ICDS population
& 50 -
S 40 o
42.9
45.0
46.0
Ul.O I
30 §
-
a.
10 -
0 -
1 « Li «
Fig. 11: Immunisation of less than 2
years age children in more than
3 years old projects compared
with non-ICDS control group
(APPN-III-TAB : 15)
47.37rLess 49 87,Less
48 87. Less 40.27.Less
BCG
DPT(3doses) Polio(3doses) T.T.(2doses)
I
Fig. 12: Immunisation status of pre
school children and pregnant
women in urban, rural and
tribal more than 3 years old
ICDS projects
(APPN-I11-TAB : 14)
70
60
g. 50
Mi-11
£ 4C
o
30
6
& 20
a.
10
0
tI
LI
BCG
(Preschool children)
children of 0-2 years in 3 years
old ICDS projects with the control
population at the corresponding
period is presented in Fig. 11.
The BCG immunisation was 17.3
per cent in control and 32 per
cent in ICDS projects. DPT
immunisation was 13.7 per cent
18
l More than 3years old ICDS Projects
■■ Control population
40p
o>
o 30-
I 20-
32.0
27.7
28.5
§ 10-
I 0(C)
45.9*/. Less
50.5*/. Less
4 8.1*/. Less
BCG
DPT (3 doses)
Polio (3 doses)
The results of longitudinal studies
of immunisation coverage of the
first group of ICDS projects started
in October 1975 and studied in
1976 and follow up data of
immunisation status in 1985 are
shown in Fig. 13. The immunisa
tion coverage has shown an over
all increase in 1985 when com
pared to the baseline status in
1976. The data on polio in 1976
was not collected as it was not a
part of the National Immunisa
tion Programme. A maximum
increase in the coverage for DPT
from 4.9 to 50.2 per cent was
noticed. Similarly toxoid cover
age for the pregnant women
showed highly significant increase
from 6.0 to 32.1 per cent
Fig. 13: Immunisation status of pre
school children and pregnant
women in 1985 compared to
the baseline status of 1976
ICDS projects
This was investigated in 31 proj
ects which comprises 12 rural, 16
urban and 3 tribal projects. Of the
32,169 children, 69.9 per cent
had received BCG vaccination.
The coverage was highest in the
rural group (75.5%) followed by
urban (59.6%) and tribal (30.8%)
projects. Immunisation status of
DPT and polio was studied only in
rural and urban projects in a
sample of 32,458 children. As
many as 65.4 per cent had re
ceived all the three doses of DPT
and 64.0 per cent had received
complete immunisation with po
lio vaccine. The impact of cover
age was better in the rural proj
ects as compared to the urban
projects.
(APPN-III-TAB :16)
1 8 Years of ICDS 1985
I
HM Baseline 1976
60i—
a
a*
50 -
2 40“
50 5
cy
8 30 §20-
ran
a- 10 -
0 90.2 7. Less
58-47. Less
DPT (3 doses)
BCG
Preschool children
(ii)
11
81:37. Less
T T (2 doses)
Pregnant women
Immunisation eualuation through re
search studies:
The results of research studies by doc
toral postgraduate medical students in
immunisation coverage is presented in
Fig. 14.
Fig. 14: Immunisation coverage of child
ren in more than 3 years old
ICDS projects (research data)
(APPN-III-TAB : 17 & 18)
f
I 0-6 Years old children
0-3 Years old children
70
60
69.9
fesx
I 64x1
. 50
| 40
o
2 30
u 20
“■
1 0
0
(a)
28 57. Less
BCG
23.17. Less
DPTOdcses)
8.77. Less
Polio (3doses)
Immunisation status of 0 - 6 years
preschool children in more than 3
years old ICDS projects:
(b)
The immunisation status of 0 - 3
years age group in more than 3
years old ICDS projects.
This study was carried out in 13
projects which comprised 5 ru
ral, 4 each of tribal and urban.
Half of the 2894 children had re
ceived BCG immunisation. The
coverage for BCG was signifi
cantly more in the urban children
(80.3%) as compared to rural and
tribal children (46.0 and 40.6%
respectively). In the sample of
3113 children, 50.3 per cent
received complete immunisation
with DPT. The coverage in this
case was also significantly more
in urban group (70.4%) as com
pared to rural (50.7%) as well as
tribal projects (27.9%). The polio
immunisation was studied in 5
rural and 4 urban projects. As
19
(c)
many as 56.3 per cent of the
rural and 69.0 per cent of the
urban children had complete
immunisation with polio vaccine.
Compared to data presented for
0-6 years of age group, the im
munisation coverage was less in
the younger children (Fig. 14).
Comparative research studies in
ICDSand non-ICDS projects areas
(Fig. 15):
socio-economic status in 5 rural
and 6 urban projects each. In the
age grop 0-6 years of the rural
blocks, BCG immunisation was
38.4 per cent, DPT 50.5 per cent
and polio 51.4 per cent which is
significantly higher than the re
spective figures of 24.1,18.6 and
19.8 per cent in control popula
tion. The degree of the differ
ences was more in 0-3 years of
age group, where DPT and polio
immunisation in ICDS projects
was 65.8 and 79.6 per cent as
compared to 22.4 and 21.4 per
cent respectively in control nonICDS population (Fig. 15).
Immunisation status of the chil
dren in ICDS projects of more
than 3 years’ duration was com
pared with a matched control nonICDS population with similar
Fig. 15: Comparison of immunisation in more than 3 years old rural ICDS projects with
matched control non-ICDS group (resarch data)
(APPN-IH-TAB : 19)
80
ICDS
79.6
Non-ICDS control group
70
£ 60
658
o
o
U
50
nLi LI Ll
50.5
40
CP
30
£L
20
i
1 0
o1-
NA
BCG
I___
20
E3
66-07oLess 73-17oLess 37.27<»Less
DPT (3doses) Polio(3doses) BCG
------- 0-< 3 years---------- -1
51.4
^51
63.2 °/o Less 61.5°/cLess
DPT(3doses) Polio(3doses)
I------------- - 0-< 6 ye ars-------------- •
The immunisation status of children
in urban ICDS projects was also better than
the non-ICDS control group. The BCG, DPT
and polio immunisation in the former group
with age group <6 years was 57.4, 68.7 and
67.5 per cent as compared to corresponding
immunisation figures of 22.5,45.8and40.4
per cent respectively, in the latter group (Fig.
16).
Fig. 16: Comparison of immunisation in
children 0*6 years in urban
ICDS and non-ICDS controlgroups (research data).
(APPN-III-TAB : 20)
7° r
60 -
g1 50 -
57.4
&
8 40 "•
c 30 -
S 20 -
"'I
60 8 7. Less
BCG
This comparative study in ICDS and
non-ICDS population confirms the positive
contribution of ICDS in ameliorating the
immunisation status of the children as well as
the success of the National Immunisation
Programme. However, this study points out
o of younger children should
that the coverage
get much more attention so that prophylaxis
can be successfully carried out in the proper
age group.
The data from annual survey 198788 on complete immunisation coverage for
young children between 12 to 24 months:
Despite intensive effort through EPI and UIP,
the immunisation coverage in control group
(without ICDS component) remained low for
all the vaccines and in all the states studied
except in Tamil Nadu (urban). Immunisation
coverage is extremely poor in control group
in Karnataka, Orissa, Rajasthan, Uttar Pradesh
and West Bengal. Immunisation data in 3-5
years old project shows a significantly higher
coverage in ICDS project as compared to the
control group. In fact, coverage with com
plete immunisation in states other than Ra
jasthan, U.P. and West Bengal is nearly 50
per cent or more. Immunisation coverage for
young children during 1987-88 is better than
those of 1985 and 1982. Additional data on
immunisation for the projects surveyed in
1987-88 for non-ICDS (control) and ICDS
group are presented in Figs. 17 and 18. BCG
immunisation coverage below the age of 2
years in control group is only 23.3 per cent as
compared to 46.4 per cent in ICDS group.
Comparative data for measles in two groups
is 8.4 vs. 20.5 per cent, for DPT it is 29.3 vs.
50.6 per cent and for polio it is 27.4 vs. 48.8
per cent. Maximum increase in immunisation
coverage is recorded in urban ICDS children,
followed by tribal and rural children.
21
Fig. 17: Immunisation status of 12+ to 24 months children in 3-5 years old ICDS and nonICDS control group (annual survey data).
(APPN-I1I-TAB : 20 & 21)
] ICDS
I Non-ICDS control group
Ci>
cn 4 0
o
k-
o
c
20
20.5
G)
i 0
8.4
CL
49.8% Less
BCG
42.1 % Less 43.8°/oLess
43.8% Less 59.0% Less
DPT (3 doses) Polio(3doses) Measles
Fig. 18: Immunisation status of children (12+ to 24 months age) in urban, rural & tribal
more than 3 years old ICDS projects (annual survey data)
(APPN-1II-TAB • 20 & 21)
■■ Urban
[11111113 Rural
I
| Tribal
70r-
60 G)
cn 50 O
<s>
o 40 c
30
132.7
20
CL
18.8
1 0
c^-
0 -
BCG
22
DPT(3doses)
Polio (3 doses)
Measles
(d) Nutritional Services Coverage
Nutrition intervention by supplementary food to prevent and improve the state qf
undernutrition, iron and folic acid to control nutritional anaemia and vitamin A to
prevent blindness due to xerophthalmia, is a major component of ICDS programme.
Despite several difficulties inherent in implementing nutrition intervention programme
in remote rural and tribal villages at the doorsteps of underprivileged population, data
of survey and research studies presented in this section establishes the utility of ICDS
in improving the coverage of preschool children by nutritional services. Coverage of
urban children by ICDS is better than the rural and tribal children. This is simply
because of the difficulties in maintaining the uninterrupted supply of supplementary food, iron and folic acid and vitamin A to the remote villages. Further, older children
of 3 to 6 years show much better coverage than younger children below 3 years.
Participation of infants and very young, below 3 years age children in a spdt feeding
programme even in their own villages is rather difficult. Mother or elder sibling is
expected to bring the younger children to the angumuac/i worker. This is often not
possible daily. Some alternative strategy to improve the coverage of below 3 years age
children by nutritional services has to be evolved and tried in pilot experiments. Man
agement of quality of food and its uninterrupted supply to angumuac/is of remote
village also needs strengthening to ensure further improvement in nutritional services
in ICDS.
J
Data on the coverage of preschool
children by the nutritional services have been
presented in the following sections:
(i)
Nutritional services survey in more than
3 years old ICDS projects and their
comparison with the same years’ base
line data in newly sanctioned ICDS
projects;
(ii)
Longitudinal 8 years follow-up survey
of nutritional services in ICDS projects
started in 1975;
(iii)
Research studies (M.D. theses) for nu
tritional services coverage of 0-6 and 03 years old children in operational
projects of 3 years duration; and
(iv)
Comparative nutritional services cover
age research study in ICDS and matched
control non-ICDS groups of children.
0)
Nutritional Services to preschool chil
dren in rural, tribal and urban ICDS
projects of more than 3 years’ duration
are shown in Fig. 19. Data have been
compared with the baseline (control
population) status of these services in
newly sanctioned ICDS projects in the
same year (1985). The coverage for
each of the services in operational
projects, listed as experimental group,
is significantly more as compared to the
control population. Vitamin A, iron
folic acid and supplementary food cov
erage for preschool children in the
experimental group was 37.1, 22.5
and 42.3 per cent respectively, as
compared to 19.7, 7.2 and 23.6 in the
23
Fig. 19: Nutritional services to preschool
children in control non-ICDS and
more than three years old ICDS
projects (annual surveys data).
Fig. 20: Nutritional services to preschool
children in control population in
1976 and 1985 and experimen
tal group of 8 years old ICDS
projects (annual surveys data)
(APPN-1II-TAB : 22)
1
(APPN-III-TAB : 23)
I ICDS
Non-ICDS control group
50||40 -
IIIIIIIICl Baseline 1985
w 50 -
§ 30 - 20 -
GM
kf 1 0 -
0 -
HHH Baseline 1976
60i—
46 9’/. Less
Vitamin 'A'
a
68.0’/. Less
Iron & folic
acid
71
|
2 30 -
39-2
S 20 44.2 7. Less
Supplementary
nutrition
25.1
£-0 .
0 -
Vitamin ‘A
control group. For all the three nutri
tional services, coverage was best in the
urban ICDS projects. Tribal projects
which are generally more difficult for
the delivery of services were covered as
well as the rural projects.
(ii)
x
(iii)
Data of follow-up survey (8 years after
the start of ICDS services) for coverage
of nutritional services, is presented in
Fig. 20. Both the vitamin A coverage
and supplementary nutrition for pre
school children increased to 39.2 per
cent from 10.3 and 25.2 per cent re
spectively. Iron and folic acid coverage
was 25.1 per cent in 8 years old projects. It may be noted that without ICDS
services and through routine MCH
services of Health Department, there
has been some improvement in the de
livery of nutrition services to the pre
school children. However, coverage
showed more significant rise in 8 years
old ICDS projects as compared to base
line data of 1975 and 1985.
Number of research investigators con
ducted studies in 3 years old ICDS proj
ects to find out nutritional services
24
j 8 Years after I CDS
Iron 8. folic
acid
Supplementary
nutrition
coverage in two age groups of children
viz.,0-6 and 0-3 years. The study for
supplementary food coverage for 0-6
years age children was carried out in 2
rural, 3 tribal and 3 urban projects, in a
sample of 2884, 1811 and 888 chil
dren respectively. It was recorded that
39.9 per cent of the rural, 45.8 per cent
of the tribal and 49.8 per cent of the
urban children were receiving supple
mentary nutrition. Iron and folic acid
distribution study was carried out in two
projects (1 each rural and urban) cover
ing a total sample of 752 preschool age
children. It was noted that 48.5 per cent
of the total group (41% of the rural and
57.1% of the urban) of children studied
were receiving iron and folic acid tab
lets. The vitamin A distribution study
was carried out amongst the preschool
children in 2 each rural (n = 2884) and
urban (n = 1254) projects. As many as
77.5 per cent of the rural and 66.0 per
cent of the urban preschool children
were receiving vitamin A according to
the schedule of the National Programme
(Fig. 21).
Fig. 21: Coverage of pre-school children nutritional services was significantly more for
(0-6 years) by supplementary urban children as compared to rural and tribal
nutrition,
and folic acid
_ - iron
------------------1 and
children.
vitamin 'A' administration in ICDS
projects operational for more than
Fig. 22: Supplementary nutrition and vi
3 years (research data).
tamin A coverage to 0-3 years old
(APPN-III-TAB : 24 & 25)
children in more than 3 years old
ICDS projects (research data).
80
70
cj
■■ Urban
r
111 Rural
I Tribal
80
60
o»
| 50
70
2 40
«0i 60
■■ Urban
imnn] Rural
Tribal
° 50
S 30
V
u
S 40
£ 20
cw 30
10
S 20
0
Supplementary
nutrition
10
Iron 8. folic
acid
Nutrition intervention services to 0-3
age group were separately analysed by some
other investigators. The supplementary food
covered was studied in 2 tribal (n = 416) and
one urban (n = 140) project each. Only 16.6
per cent (69/416) of the tribal children in this
age group were receiving supplementary food
while 61.4 per cent (86/140) of urban chil
dren were covered by this service (Fig. 22).
The vitamin A distribution in this age group
was studied in 1 rural (n = 754) and 2 urban
(n = 1472) projects. Only 31.0 per cent
(234/754) of the rural children received the
vitamin A while 77.4 per cent (1139/1472)
of the urban children were covered by this
service.
It is evident that nutritional services
provided a better coverage for the preschool
children group as a whole as compared to 03 years age group in particular. To put in
other words, the elder children received a
better coverage than the younger children.
Further, it may be noticed that the delivery of
0
73 •/. Less
Supplementary
nutrition
(iv)
59.9 °/o Less
Vitamin ’A'
A comparative study for vitamin A,
iron and folic acid supplementation to
the preschool children was carried out
in 2 each ICDS and non-ICDS matched
control projects.
It is noted that taking all the projects,
rura^ and urban together, the coverage for
iron- folic acid and vitamin A was in 19.5 and
24.7 per cent of the preschool children in
non-ICDS projects. Compared to this, in the
ICDS projects which have been operational
f°r more than 3 years, iron and folic acid was
distributed to 48.5 per cent and vitamin A to
69.1 per cent. The separate analysis of the
rural and the urban sample reveals a more
significant increase in the coverage of pre
school children by these two nutritional sup
plements in rural population as compared to
the urban. The increase for iron and folic acid
was 10.4 to 41.0 per cent and for vitamin A
from 17.9 to 76.3*per cent in the rural popu25
lation. The corresponding increases in urban
population were from 28.7 to 57.1 per cent
for iron and folic acid and from 31.5 to 61.1
per cent for vitamin A distribution (Fig. 23).
Fig. 23: Comparative study of iron and folic acid and vitamin ’A’ coverage for pre-school
children in ICDS and non-ICDS population (research data).
(APPN-III-TAB : 26)
80t—
[
I Non-ICDS control group
70
w
] ICDS
76.3
I
cn6 0 o
Is?. 1
£ 50 -
69.1
61.1
o
w
~ 40 -
41.0
£ 30 -
6*
Q_
20 -
1C -
CL
74.6% Less 76.5% Less
Iron & folic
Vitamin A'
acid
— Rural-------------- 1
26
j i ;
49.77oLess 48.4% Less
Iron & folic
Vitamin'A'
L acid
I
------------ Urban------------ ‘
59.8% Less
Iron & folic
acid
64.2% Less
Vitamin X
I---------- Tota| ...
J
(e) Nutritional Status of Preschool Children
Various approaches adopted to assess the impact of ICDS on nutritional status
of 0-3 and 0-6 years old children confirm a decline in moderate and severe
undernutrition and increase in the proportion of children with norml or grade-I
undemutrition.
The longitudinal study showed that severe undemutrition amongst the pre
school children in the population where ICDS was started as pilot project in 1975,
had declined from 19.1 to 6.3 per cent in 8 years follow up study. Corresponding
decline for moderate undemutrition was from 27.0 to 19.7 percent. Further, in a very
large pooled sample of preschool age children, in the population where ICDS projects
were established for 3-5 years, the prevalence rate for severe and moderate
undemutrition was noted to be 6.4 and 18.1 per cent respectively. The research study
by doctoral student recorded severe and moderate undemutrition in 9.1 and 25.1 per
cent preschool age children, respectively. A comparative research study for undernu
trition in ICDS and non-ICDS matched control samples showed severe undemutrition
in 6.5 per cent and moderate undemutrition in 22.3 per cent of preschool age
children. All these figures tend to confirm a considerable decline of severe and
moderate malnutrition in ICDS projects.
The impact of ICDS on nutritional status of younger children between 0-3 years
age group was also positive. Moderate and severe malnutrition together was recorded
in 30.6 per cent of the children in ICDS projects as compared to 38.5 per cent in the
matched control (non-ICDS) group. Severe malnutrition in 0-3 years age group was
higher as compared to 0-6 years age group which points that ICDS nutrition services
are not reaching to younger children to the same extent as they are being provided
to the older children. Improvement in the nutrition coverage of younger children by
strengthening the current management and developing the alternate models is
strongly recommended.
J
A. Annual Surveys
Results:
(a) The longitudinal study of the ICDS
projects started in 1975 revealed im
provement in the nutritional status in
1985. Data are presented in Fig. 24.
(b)
Severe malnutrition declined from 19.1
to 6.3 per cent and grade II malnutrition
declined from 27.0 to 19.7 per cent.
Normal and grade I nutritional status in
8 years old ICDS projects improved to
72.6 per cent as compared to 47.2 per
cent in 1976.
(0
A comparative evaluation of the nutri
tional status of preschool children in the
control and experimental group was
carried out in 1985. The sample for
control was taken from 28 projects
selected for ICDS services on the same
socio-economic criteria which have been
27
Fig. 24: Longitudinal study of nutritional
status of pre-school children
(1975 to 1985) (annual surveys
data).
also more pronounced for rural and
tribal population (Fig. 25).
Fig. 25:
(APPN-III-TAB : 27)
80r—
70 -
S 60 -
S
72.6
L. I 8 Years of ICDS projects
IMI Baseline 1976
Nutritional status of pre-school
children in control and more than
3 years old ICDS projects (an
nual survey data).
(APPN-IM-TAB : 28)
| 50 L 40 -
80 ~
c 30-
HA'
£ 2010 0 -
Normal+Grade I
70 -
1 A
Grade n
fl
3]
60 -
Grade Ill+IV
50 -
I----- ) More than 3years old
ICDS projects
40 -
■■ Control group
S 30 -
2I
20 -
decided and followed since 1975. These
projects were considered for control
population as at the time of baseline
survey they still did not have inputs of
the ICDS package of services. The
sample for experimental group was
drawn from 43 ICDS projects which
have been operational for more than 3
years. The severe malnutrition in the
experimental group was 6.4 per cent as
compared to 8.4 per cent in the control
population. The difference between the
two is statistically significant (p< 0.001).
This difference was more obvious in
tribal and rural experimental group where
the severe malnutrition was 3.9 and 6.6
per cent, respectively. The grade II mal
nutrition also showed a significant re
duction in rural and tribal population but
there was an increase in the proportion
of this group in the urban population.
Normal and grade I nutritional status of
children were in a higher proportion of
73.7 per cent in the experimental group
as compared to 69.5 per cent in control
sample. The difference in this case was
28
10 0 -
(d)
5.7 7. Less
Normal+Grade I
8.8’/o More
Grade II
31.27. More
Grade 111 + IV
The control population (where ICDS
services had not yet started though the
projects have been selected) has shown
progressive decline in the severe malnu
trition and increase in normal and gradeI nutritional status children. In 1985,
severe malnutrition was recorded only
in 8.4 per cent as compared to 15.1 per
cent in 1979 and 19.1 per cent in
1976, while corresponding figures for
normal plus grade-I nutritional status
were 69.5, 56.2 and 47.2 per cent
respectively (Fig. 26).
B. Research
Nutrition status research studies in 0-6
years old children in more than 3 years old
ICDS projects:
(a)
Research studies were carried out to
record the nutritional status of 0-6 and
0-3 years old children in ICDS projects
which were functional for more than 3
years. Nutritional status assessment for
Fig. 26: Nutritional status of pre-school
children in 1976,1979 and 1985
evaluation studies (annual sur
vey data).
(APPN-III-TAB : 29)
80 70 60 -
I
I Control population 1976
WO Control population 1979
■■ Control population 1985
st! 50 tn
(b)
40 30 20 -
100 -
Grade II
Normal+Grade I
Grade Ill+lV
0-6 years age group was done in 46
projects which comprised 19 rural, 4
tribal and 23 urban projects. The total
sample size was 61725 children. As
many as 33.4 per cent had normal nu
tritional status, 32.5 per cent had grade
I and 25.1 per cent had grade II malnu
trition (Fig. 27). Tribal children had
maximum severe malnutrition amount
ing to 17.3 per cent compared to 7.4
per cent in the rural and 9.8 per cent in
the urban groups. The distribution of
moderate degree of malnutrition was
almost same in all the three groups.
However, normal and grade-I nutri
tional status was considerably less in
tribal population compared to rural or
the urban children.
Nutritional status of 0-3 years age chil
dren in more than 3 yars old ICDS
projects was studied in 11 rural, 4 tribal
and 6 urban projects drawing a total
sample of 10,141 children (Fig. 27).
Normal nutritional status was recorded
in 29.5 per cent, grade-I undernutrition
was noted in 29.1 per cent, grade-III in
10.5 per cent and grade-IV in 4.3 per
cent. It was also noted that the nutri
tional status of children in this age
group was better in the urban projects
as compared to the rural and tribal
projects. The severe malnutrition com
prising grades-III and IV was present in
9.4 per cent of the urban children as
compared to 22.0 per cent of the tribal
and 18.0 per cent of the rural children.
Fig. 27: Nutritional status of 0-6 years and 0-3 years child population in more than 3
years old ICDS projects (research data).
(APPN-I1I-TAB : 30 & 31)
60r-
s
|
50
0-3 Years child population
o 40 —
d
| 0 -6 Years child population
30
33-4
n
25.1
c 20
c»
o
Q_
10
0L
Normal
Grade-1
Grade-II
Grade-U! &IV
29
Further, it was noted that overall nutri
tional status of younger children i.e., in
the age group 0-3 years was worse than
the pre-school age group children as a
whole. Severe malnutrition in 0-3 years
age group was recorded in 14.8 per
cent which was high compared to 9.1
per cent in 0-6 years age group.
8.0 and grade-IV 3.0 (Fig. 28). Corre
sponding to this, the distribution of
nutritional status in the experimental
population was, normal 40.8, grade-I
30.5, grade-II 22.3, grade-III 5.1 and
grade IV 1.4. The severe malnutrition
comprising grades III and IV was re
corded in 11 per cent in the control
population as compared to considera
bly less proportion of 6.5 per cent in the
experimental group. The moderate
grade-II malnutrition was also less in the
experimental population. Normal and
grade-I nutritional status was considera
bly high (71.3%) in experimental group
as compared to 64.3 per cent in the
control population.
C. Comparative Studies:
Comparative Study of Nutritional Status
of Children in ICDS and Non-ICDS
Population:
(a)
The studies were carried out by several
consultants to compare the nutritional
status of the preschool age group chil
dren, 0-6 and 0-3 years of age in ICDS
projects which have been operational
for 3 years or more and matched con
trol population of non-ICDS area. This
special research was done by 12 con
sultants in 12 ICDS projects (4 rural
and 8 urban). The population covered
in the experimental group was 4980
and in the control group it was 4220.
The distribution of nutritional status in
the control population was normal 35.4,
grade-I 28.9, grade-II 24.7, grade-III
(b)
The nutritional status of younger chil
dren of 0-3 years was studied in 2 each
rural ICDS (experimental group, n =
545) and rural non-ICDS matched con
trol group n = 549. The severe malnu
trition in control group was 12.1 per
cent as compared to experimental group
of 11.5 per cent and moderate malnu
trition 26.4 compared to 19.1 per cent
(Fig. 29). The normal and grade-I
proportion was very high in the
Fig. 28: Nutritional status (0-6 yeas): A comparative study of ICDS Vs. non-ICDS Group
(research data)
(APPN-III-TAB : 32)
50
G>
(J
C
40-6
C9
20-
c 10H
O
0L
CL
30
I Non-ICDS control group
40
o 30
CL
] ICDS
I
Normal
Grade-I
F6-5
Grade-11
Grade-Ill a IV
Fig. 29: Nutritional status (0-3 years) A comparative study of rural ICDS vs. rural nonICDS group (research data).
(APPN-III-TAB : 33)
50
40
C
o
o
i-
] ICDS
I Non-ICDS control group
42.2
30
27.2
20
19.1
CL
1 0 11.5
o L-
Normal
Grade I
experimental group—69.4 per cent
compared to control group (61.6%).
The impact of ICDS in the improve
ment of nutritional status in 0-3 years
young children was considerable but
distinctly less than what was recorded
for the whole group of 0-6 years age in
dicating that the nutritional benefits
were more to the elder children above
the age of 3 years.
Fig. 30: A comparative study of clinical
vitamin B-complex, vitamin ’A’ de
ficiency and nutritional anaemia in
more than 3 years old rural, tribal
and urban ICDS projects (research
data).
(APPN-III-TAB : 34)
&>
A study was conducted in more than 3
years old 30 ICDS projects which
comprised 9 rural, 3 tribal and 18 urban
projects. This study was aimed to rec
ord clinical evidence of B-complex and
vitamin A deficiency and nutritional
anaemia in the preschool age children.
The B-complex deficiency was present
in 3.4 per cent with a higher frequency
in the urban and rural group as com-
50 p
o 40 w
[
I Tribal
I'lliillllllil Rural
■■ Urban
o 30 -
D. Clinical vitamin deficiency study
in more than 3 years old ICDS proj
ects
(a)
Grade III & IV
Grade II
£ 20 v
g 10 -
a.
0L
B. Complex
Deficiency
Vitamin ‘A’
Deficiency
Anaemia
pared to the tribals. Vitamin A defi
ciency features were recorded in 10.4
per cent. The clinical anaemia was
present in 25.8 per cent with highest
incidence in the rural group (Fig. 30).
(b)
The clinical evidence of vitarmn-B-<..fc
LSHOO
IO (
>'1
complex and vitamin A deficiency were
recorded in ICDS operational projects
(experimental group) and matched
control non-ICDS projects (control
group). In the experimental group Bcomplex deficiency was present in 5.5
per cent, vitamin A deficiency in 6.6
per cent and anaemia in 6.6 per cent
(Fig. 31). Compared to this, in control
group B-complex deficiency was pres
ent in 14.1 per cent, vitamin A defi
ciency in 17.3 per cent and anaemia in
11.6 per cent. Thus ICDS population
demonstrated significantly less features
of B-complex, vitamin A deficiency and
anaemia as compared to the controls.
32
Fig. 31: A comparative study of clinical vi
tamin B-complex and vitamin ’A'
deficiency and nutritional anaemia
in pre-school (0-6 years) children
in ICDS and non-ICDS projects
(research data).
(APPN-I1I-TAB : 35)
1------ IICDS
30
■■ Non-ICDS control group
c 20
v
| 10
0
ILU
15.5 J
BrComplex
deficiency
| 6-6 J
Vitamin A'
deficiency
Anaemia
III. SPECIAL RESEARCH STUDIES
Study of morbidity during infancy and early childhood leads to the following
conclusions:
l.ICDS village level infrastructure with proper linkage and supervision of health staff
of the Primary Health Centre can be successfully utilised to record morbidity and
disease specific mortality of the infants and young children. These observations can
be very useful to strengthen the primary health care for preschool age children and
achieving the goals of child survival and child development. Monitoring of the
coverage of the beneficiaries by the services of the programmes is simpler than the
assessment of the impact. Present study suggests that the impact of ICDS or any other
similar programme on morbidity of young children can be monitored by the village
level worker.
■
L1.
2.
3.
4.
5.
6.
1.
2. Epidemiology of illness in rural and urban slum setting is different as is revealed by
the present study. Crowding and air pollution contribute significantly to acute
respiratory infections which forms the major cause of morbidity in urban slums.
Personal, environmental, food and water hygiene influence the high prevalence of
diarrhoea in rural setting. Diarrhoea and respiratory infection call for maximum
attention in ICDS projects.
3. High annual frequency of illness per child per year and seasonal variations in the
morbidity pattern noted in the results of this study deserve consideration in planning
and operation of preventive and curative actions by the medical officers and the
paramedical staff. A rational approach to the strategy of medical care will be cost
effective.
----
-------- —
Management of severely malnourished children by anganwadi worker
Morbidity during infancy and early childhood
Mortality during infancy and early childhood
Effects of drought and its management
Mothers perception of child development and ICDS
Anganivadi workers knowledge, attitude and practice towards their job in
ICDS
Management of severely malnourished children by anganivadi workers.
Background
Severe protein-calorie malnutrition is
the most important singular factor associate!
with high infant and child mortality. Malnutri
tion predisposes to infection and infection in
33
Fig. 35: Children suffering from specific morbidity in a week (special research study)
(APPN-III-TAB : 40)
50
CZZ Tribal
tlllnlllllll Rural
■■ Urban
40 -
c
C9
30
Cs>
29.6
£ 20 12.7
1o -
9.0
11.2
0
Diarrhoea
I
Respiratory
infection
of 8865 children, diarrhoea was re
corded in 10.3 per cent in one week,
with a prevalence of 9.0 per cent in
urban, 10.2 per cent in rural and 12.7
per cent in tribal pre-school children.
The respiratory infection was recorded
in 15.6 per cent per week in a sample of
8660 pre-school children. The highest preva
lence was in the urban group (19.4%) fol
lowed by rural (15.3%) and tribal (11.2%)
projects.
Pyoderma
The study of pyoderma was done in
7892 children and 9.0 per cent had the
36
Eye
infection
disease with its distribution of 7.3 per cent in
the urban projects, 4.9 per cent in the rural
projects and 29.6 per cent in the tribal popu
lation. The data are presented in Fig. 35.
(b)
In the second study, number of epi
sodes of illnesses per child per year in
the pre-school children in more than 3
years old ICDS projects were recorded
in one rural, one tribal and 3 urban pro
jects. In a sample of 1863 children the
diarrhoea was recorded as one episode
per year, respiratory infection 1.5 epi
sodes per year,pyoderma 0.4, fever 1.7
and eye infection 0.4 episode per child
per year in a sample of 1065, 1027
and 1508 population respectively.
(c)
In the third study, the morbidity preva
lence amongst the preschool children
in more than 3 years old ICDS projects
was compared (experimental) with nonICDS (control) population. This study
was carried out in 4 rural and 4 urban
matched control non-ICDS projects. In
the rural ICDS projects, 17.3 per cent
The fever was studied in a sample of
8001 children and it was recorded in 9.0 per
cent in a period of one week, again with its
highest prevalence in urban (13.9%) followed
by rural (8.7%) and tribal (2.1%) children.
The study for eye infection was done in
a sample of 6317 children. It was recorded
positive in 6.3 per cent with low prevalence
in the urban group (3.1%) compared to rural
projects (7.1%).
Fever
had diarrhoea and 19.0 per cent had
respiratory infection. Compared to this
in non-ICDS control population 22.2
per cent had diarrhoea and 14.6 per
cent. had respiratory infection. The
comparative study of these two dis
eases in urban ICDS and non-ICDS
projects revealed that in case of former
group, 9.0 per cent had diarrhoea and
19.4 per cent had respiratory infection.
While in the case of later i.e., control
population, the prevalence of diarrhoea
was 16.7 per cent and respiratory in
fection was 45.8 per cent in children.
Thus, it was noted that both in rural and
urban, the prevalence of diarrhoea was
significantly less in ICDS urban and
rural projects compared to the control
urban and rural population.
common childhood diseases was considera
bly more in both rural and urban non-ICDS
control pre-school children when compared
to ICDS experimental project as shown in
Fig. 36.
The prevalence of three other dis
eases—pyoderma, fever and eye infection
were also compared in ICDS and non-ICDS
population. The prevalence of pyoderma was
5.0 per cent in rural and 7.3 per cent in urban
ICDS projects. Compared to this, the corre
sponding figures were 10.7 per cent and
22.3 percent in control population. The skin
infection was more pronounced in non-ICDS
population compared to ICDS population.
Fever was recorded in 6.8 per cent of the
rural and 13.9 per cent of the urban pre
school children of ICDS projects. The corre
sponding data for non-ICDS group was 8.2
per cent and 26.3 per cent, respectively. Eye
infection was observed in 4.3 per cent of rural
and 3.1 per cent of urban ICDS pre-school
children, while the corresponding figures in
the matched control non-ICDS group were
7.0 and 4.8 per cent. Thus, both fever and
eye infection were more common dn nonICDS population.
Study of Morbidity during Infancy
and early Childhood in ICDS
Blocks.
In conclusion the morbidity of the
Fig. 36: Percentage of children suffering
from specific morbidity in a week
(special research data).
(APPN-Iil-TAB : 42 & 43)
(ZZl ICDS
■■ Non-ICDS control group
40
| 30
3 20
S io
i 0
HWl
E3
II B I
El LI
Diarrhoea
Respiratory
Infection
UII
et!
Pyoderma
A multi-centric morbidity study amongst
infants and pre-school children was under
taken in 9 ICDS projects. This study was
aimed to record the incidence of sickness
amongst the infants of 0-12 months and the
children between 1-3 years.
The study sample (of infants and 1-3
years old children) was drawn from 15
anganivadis in each of the 9 ICDS projects.
Of the 15 anganbuadis, 10 provided the
sample for study of morbidity amongst the
infants and five children between 1-3 years.
The cluster sampling approach was followed
to select these as outlined below:
(i)
The total number of AWs in the project
area was sub-divided into the groups
(clusters) of 3 AWs each. The 3 AWs in
a cluster were close to one another for
the purpose of visits. This -process
37
provided nearly 33 clusters in rural and
urban projects. The number of clusters
in a tribal project varied from 12 to 25.
Each cluster had a population of usually
3000 distributed equally amongst the
three AWs (1000 each).
(ii)
(iii)
Five clusters of AWs were selected
randomly from the list of clusters pre
pared for the whole project area. This
was done by using a random number
table or standard system of chits with
serial numbers.
From each of the 5 selected clusters at
random, 2 AWs were fixed for the
morbidity study amongst the infants,
and sickness data in 1-3 years group
were collected from the third AW of
each cluster. The sampling procedure
provided a set of 10 AWs (2 from each
selected cluster) for the infant morbid
ity and 5 AWs (1 from each cluster) for
the early childhood morbidity study.
Data on morbidity were recorded by
anganivadi workers, especially oriented for
this study. AWWs paid a minimum of four
visits every month to every house hold for the
infant morbidity and once in 10 days in the
early childhood. A junior investigator from
the consultants’ department visited the angancuadis once a month to check the data as
recorded by the angan wadi worker and sorted
out discrepancies wherever possible. The
consultants reviewed the data once a month
,and forwarded it to the Central Cell of ICDS
at ARMS periodically.
Children who crossed the age group or
left the anganwadi area during the study
period or expired were excluded from the
investigation for the remaining period.
However, infants and children who entered
the angan wadi area by migration or as new
38
birth were registered for the rest of the study.
A format to cover 12 common illnesses was
prepared and filled by the anganwadi work
ers during their house visits. The final tabula
tion of data was done after consistency check
and discussion with the investigators by the
Central Bio-Statistics Cell of the CTC.
Results
Of the 5350 infants, 2779 (51.9%)
were males. As many as 73 per cent were
from the rural and 27 per cent from the urban
population.
The design of the study predicted a
follow-up period varying from 1 to 52 weeks
per child. The average number of weeks of
follow-up per child was determined by divid
ing the pooled total weeks of follow-up by
total number of children registered. On an
average each infant was followed for period
of 23 weeks. Average follow-up period for
male and female, as well as, rural and urban
slum areas was almost the same.
Fig. 37 presents estimated incidence
rate of different illnesses among the infants of
rural and urban location during an average
period of 6 months. Diarrhoea, cough, short
fever without rash and sore eyes were re
corded to be the common illnesses, in de
creasing order of frequency. The major cause
of infant morbidity in the present series was,
however, diarrhoea (60%). Cough was more
prevalent in urban slums (P < 0.001) but the
rest of the three diseases were significantly
more common (P < 0.001) amongst rural
infants.
Fever is recorded as the commonest
illness preceding the death of infants (32%),
diarrhoea as the next common killer disease
(20%), and prematurity has the third place in
the aetiology of infant mortality. It is recorded
Fig. 37:Percentage incidence of various
illnesses among infants (special re
search data).
Fig. 38: Percentage infant deaths by under
lying causes (special research data).
(APPN-III-TAB : 47)
(APPN-II1-TAB : 46)
■»4
m
o o
I
I
in
<'■
o o
I
I
U>
N*
o o o
T“
Diarrhoea
o
I
NJ
<«J
o o
ro
in
o
CD
o o
Diarrhoe<
20.3
Cough
14.9
13.7
Prematurity \
and/or law
birth weight
Fever without rash
~
u '‘'■lilllillll
Sore eye
Skin bolls
7.2
7.9
7.5
.3.3X
•Birth injuries
Respiratory
infection
Fig. 39: Percentage infant deaths by un
derlying cause in rural and urban
ICDS areas (special research data).
(APPN-in-TAB : 47)
Fever with rash
3.1 El 0-6
Ear discharge
2.6
Scabies
Others
Tetanus
3.7 ^T- .-J
5.2
Fever
32.4
nnnmD Rural
■■ Urban
Fever
(33.5
2 3.1
Cuts wounds and accidents
6.4 J2.0
Diarrhoea
Others
23.-1]
EUI-1
Prematurity and low
bhdl^w|^y^t
K^ri3.o|
more frequently in urban slums as compared
to rural population. Tetanus and respiratory
infection were registered as other important
causes of death and occupied the fourth
place. However, tetanus and birth injuries, as
the underlying causes of infant deaths were
recorded exclusively in rural areas. Respira
tory infection was more fatal in urban popu
lation as compared to the rural areas (Figs. 38
and 39).
Three common illnesses, viz., diarrhoea,
cough, and fever without rash have almost
similar number of episodes, during the study
period (Fig. 40). The number of episodes of
cough per sick child is recorded to be signifi
cantly higher in urban infants as compared to
the rural. There was no difference of the
Tetanus
0.0 fo. 8Respiratory infection
[iTTsl
7.0
Birth Injuries
o.o 13.7
Others
B14.0H
23.
L
40
llllllll Rural
■■I Urban
I____ L
l
l
I
30 20
10
0
10
_j___ L_
20 30 40
Percent
39
Fig. 43: Percentage incidence of various
illnesses among children (l-<3
years, (special research data).
Fig. 44: Estimated number of episodes of
various illnesses per child (1-3
years) (special research data).
(APPN-HI-TAB : 54)
(APPN-III-TAB : 56)
Diarrhoea
I... I AU children
■■ Sick children (l-<3 years)
Cough
Cough
Fever without rash
fcfil
i7s|
3.4
[to.
Diarrhoea
Sore eye
HLj
I2'9
5.7
Fever without rash
Skin bolls
4.5
3.0
amSore eye
Fever with rash
HZU0'9
[IQ-6'
Cuts.wounds and accidents.
Ear discharge
BQ
UnnUI Rural
■■ Urban
Scabies
0.2
Fever with rash
0.4
3.6
Skin boils
Cut,wounds ond accidents
2.5
I
10
I
0
0.7
Scabies
Others
I
I
I
I
I
60 50 40 30 20
mB!
3
0.2
Ear discharge
I
I
I
I
I
|
|
10 20 30 40 50 60 70
0.3
Tetanus
rfB 0-002
Fig. 45: Percentage of children (1-3 years
age) by frequency of episodes.
Paralysis of limbs
1.4
(APPN-in-TAB : 57)
0.005
Others
2
0-8
3
12.3
4
11.5
7\1
L
I
6.8
7
6
10.3
5
27.2
9.9
6
42
4
I
3
I
2
j.
1
J___ L
0
1
I
2
3
_1
4
I
5
J
6
None
9.9
12.1
J.
5
I
6+
total group of children registered for the study
’and the group of children identified as sick
.during the period of study. Morbidity was.
higher in rural group as compared to the
urban group for almost all the illnesses.
Fig. 46: Seasonwise average monthly incidence of illness.
(APPN-II1-TAB : 58)
I Jan—March
April—June
IH July—Sept.
Oct-Dec.
I
40
c
30
Jh
o ‘Ir
O
20
C9
CL
10|-
Diarrhoea
o
„ 2 <S
cn
Cough
Fever without
rash
Frequency of any illness, as none to 6
or more was calculated for rural and urban
children. Data are presented in Fig. 45. It is
noted that the highest proportion (27.2%)
had 6 or more episodes of illness in an
average follow up of 6 months. Only 9.9 per
cent remained free of any illness.
Sore
eyes
Skin boils
Others
Distribution of illness according to 4
quarters reflecting winter (1st and 4th quar
ter), summer (2nd quarter) and rainy season
(3rd quarter) is presented in Fig. 46. Cough
was more frequent in winters as compared to
summer and rainy seasons. Diarrhoea was
more frequent in summer and rainy seasons
as compared to the winter season.
43
3. Infant and early childhood mortality study
Reduction in the infant and early child
hood mortality is one of the objectives of
ICDS. Government of India collects informa
tion on vital events and provides estimates of
infant mortality rate, crude birth rate, death
rate etc. at the national and state levels. This
system does not permit separate information
for population receiving ICDS package of
services. It was decided by the CTC to study
the trends of IMR, early childhood mortality
rate and births at the National Level in a
proper sample of ICDS projects periodically.
1.
Method and Material
i
Study sample: The three stage sam
pling procedure was followed for the multi
centre study during 1982 to 1987 excepting
1984 and is being continued in the study of
1988. A few modifications were introduced
in the first and second stage samples guided
by feasibility and reliability of data collection.
(a). First stage sampling: This was done to
select adequate number of projects out of the
total ICDS projects in operation. In the first
study in 1982, 40 projects out of the 200 in
operation for more than two years providing
a sample of 1.5 per cent were selected at the
national level. The study was continued in the
same projects in 1983. In 1985, the first
stage purposive sampling was done for 21
projects with two preferential criteria viz.,
proximity to the consultants i.e., within a
distance of 15 km and projects which had
earlier annual surveys on health and nutrition
parameters. The purposive first stage sam
pling was also done in 1986 giving chance for
appropriate distribution of the selected sub
jects in rural, tribal and urban areas, besides
the period of implementation of ICDS pro44
gramme. A total of 27 projects were selected
in this study. In 1987 so as to get the informa
tion on IMR independently for large states as
well as groups of small states. All the ICDS
projects of more than three years’ duration
were taken as universe. A sample of 15-20
per cent projects in each large state or a
group of small states with stratification of
tribal, rural and urban categories was drawn.
A very significant modification has been in
troduced in 1988 to bring the methodology
of the study closer to national system of
Sample Registration System (SRS). This
approach warranted a very large sample for
states with infant mortality rate less than 80
and, therefore, it was decided to limit the
studies into 16 states bracketed in four groups
based on the range of IMR as published by
SRS in 1985.
IMR above 115: Madhya Pradesh,
(i)
Orissa and Uttar Pradesh.
(ii) IMR 108-114: Assam, Bihar, Gujarat
and Rajasthan.
(iii) IMR 87-95: Andhra Pradesh, Haryana,
Jammu & Kashmir, Tamil Nadu and Hima
chal Pradesh.
(iv) IMR 78-80: Karnataka, Maharashtra,
Punjab and West Bengal.
The sample size for each bracket of the
study could be calculated on statistically sound
principles. As-many as 102 projects in 8
states have been selected, giving due consid
eration to division of the state, rural and tribal
location and 4 years of functional age by
random sampling method.
(b) Second stage sampling: This selected
the anganwadis for the studies. During 1982
and 1983, 6 anganivadis were selected by
stratified sampling procedure. From 198587, 12 anganwadis were selected by cluster
sampling method. In 1988, the second stage
sampling has been modified. All anganwadis
are listed according to the middle level super
visor zones and divided into cluster of three
each. One cluster from each of the middle
level supervisor zone is taken up in the sample.
Minor modifications are permitted if the middle
level supervisors’ zone has less than 12 an
gan wadis.
(C) Third stage sampling: Since 1982,
this includes all the house-holds of the selected
anganivadi village for recording of the events.
Data collection : The consultant’s, in
vestigators from his department, the medical,
paramedical team of the primary health centre
and anganivadi worker formed appropriate
teams for data collection. The first point of
data collection, at the house was carried out
by the anganivadi worker, if necessary, as
sisted by local informant and entered on
appropriate forms printed in the regional
language. The verification at the first stage
was done by the investigator of the consult
ant, often taking help from the paramedical
team of the primary health centre in each
anganivadi, at a minimum frequency of once
in three months in the beginning, which was
later reduced to once in a month. At the fixed
interval, the tabulated data were sent by the
consultants to the CTC. This provided check
every 2-3 months on the quality of data and
continuation of the study in each anganivadi.
The mid-year population was collected and
reported half yearly. All data were recorded
on designed performae jointly by the consult
ants and the CTC. The data analysis was
done at the Central Cell and vital rates were
calculated in reference to estimated mid-year
population after sorting out the discrepancies
with the help of the consultants. To compare
with the SRS the methodology of data collec
tion has been substantially modified in 1988
study, as indicated below
Flow of Reports and Information
A.
Anganivadi Workers
Monthly collection of events by house
to house visit and monthly submission of
reports on the prescribed formats by
3rd of the following month.
B.
Middle level supervisors/surveyers
Independent survey of events by
house to house visit of all alloted/
determined (2 or 3 AW’s every
quarter) and submitting the reports
on prescribed formats to project level
supervisor (PHC) by 10th of the
following quarter.
C.
Matching of A & B
Supervisor of project
Recording of discre
(PHC)/ verifier/evalupancies
ator(Medical Officer/
senior most non-medical
Verification of
discrepancies
and correction of
the events (of
45
supervisor)
D.
Consultant
A&B), within 15
days i.e., 25th of
the following
month.
Meeting the consultant at the
headquarters, sending the Inland
Letter report to Central Cell signed
by Consultant by 30th of the
following month (of quarter).
Visit project after supervisor meeting
within few days for sample check, and
monthly reports of the quarter by the
consultants within 15 days (45 days
after the end of quarter) sent to
Central Cell.
Number of Infant and Early Child
hood Mortality Studies carried out till
March 1988.
The infant and early childhood mortal
ity studies were started as multi-centre proj
ects in 1982. As shown in Table I (p.52) the
number of studies allotted and carried out till
March 1988, a very high proportion of con
sultants were able to complete the infant and
early childhood mortality studies alloted to
them.
Comparative Research Study of
Infant and Early Childhood Mortality
Rates in ICDS and Non-ICDS Popula
tions.
Stat^/UT
Andhra Pradesh
Uttat Pradesh
Gujarat
Pondicherry
46
A multi-centre research study to com
pare the infant, perinatal, neonatal and post
natal mortality rates in ICDS and non-ICDS
population was planned according to the
following methodology:
(a)
The ICDS blocks which have been
operational for more than two years and
the nearby blocks matched for socio
economic factors but without ICDS were
selected to draw the sample for the
study.
(b)
The study was carried out in the sample
drawn from the following locations:-
ICDS block
Non-ICDS block
Narsapur (R)
Sohawal (R)
Gorakhpur (U)
Ahmedabad (U)
Villianur (R)
Takmal
Rudanli
Gorakhpur (U)
Ahmedabad (U)
Oulgrapet (R)
The cluster sampling system was
adopted to select the study sample from the
ICDS and non-ICDS projects. The total
number of anganwadis were grouped into
the clusters where each cluster was consti
tuted by 3 anganwadis. Thus in standard
ICDS project with 100 anganwadis, 33 clus
ters were formed.
Seven clusters were selected from each
project through randomised selection sys
tem. Thus in a standard project with 100
anganwadis, 20-21 anganwadis in 7 clus
ters constituted a study sample. Similar ap
proach was for non-ICDS matched control
study projects.
A population of 66,322 rural and
45,196 urban was indentified from 59 rural
and 42 urban angan wadis of ICDS projects
for this study. Corresponding to this nonICDS population sample size-was 64,241
and 36,718 for rural and urban group, re
spectively.
All the pregnant women of the selected
AWs were registered during the first 12
months of the study and each one was fol
lowed up till six months after delivery. All the
new boms were registered for the initial 12
months of the study and each one was fol
lowed till he/she completed 12 months of
age or had a fatal end before he reached to
this age. Three separate proformae were
used to record the events in each child.
Anganwadi worker was specially
trained for recording data by house-to-house
visit. She was assisted by informants belong
ing to the same village. The supervisor and
the junior investigator of the consultant cross
checked the events and verified the cause
specific mortality.
II.
Results
Data on infant and early childhood
mortality study were obtained through the
surveys by the consultants and by special
multi-centre research studies. Data of 198283 evaluation study were considered ade
quate to provide the national estimates at the
national level and their comparison with the
estimates of the Sample Registration System
(SRS) of the same period. The multi-centre
research data provided a comparative esti
mate between the ICDS and similar nonICDS population.
A : Infant and early childhood mortality
estimates through annual surveys 1982-83
and its comparison with the estimates of
SRS:
The detail of the methodology of the
study have already been provided earlier. A
total of 2,30,231 population was covered
belonging to 227 anganwadis.This sample
was considered good enough to provide the
national estimates.
The infant mortality rate (IMR) accord
ing to the sex and location of the project is
presented in Fig. 47. The national estimate
was 85.9 per 1000 live births in ICDS proj
ects population which was lower than 105 as
estimated by the SRS during the correspond
ing period. Both male and female sexes had
lower IMR in ICDS projects as compared to
the SRS estimates (Fig.47). However, in the
urban slums, the infant mortality rate was
80.2 in ICDS projects as compared to the
SRS estimates of 65. This was reflected in
both the sexes. The higher IMR in ICDS in
urban slums could be explained due to highly
selective location of these projects. The SRS
estimate was related to the total population of
47
Fig. 47: Infant mortality rates according to
the sex and location of the project
(special research data)
Fig. 48: Cause specific infant death rates in
ICDS projects (special research
data)
(APPN-III-TAB : 62)
(APPN-III-TAB : 61)
I. .J Rural ^Tribal
■■ Urban slum
90p
80 -
k0
co
09
i
160|5C-
40.8
14
2 20 -
03
70 -
40r
!
II 1° 0 -
0
Diarrhoea Respiratory
infection
|4°-
Tetanus
Fever
Others
2 30 -
10 -
oL
Male
Female
Total
Fig. 49: Sex specific death rates (0-4 years)
in ICDS projects compared with
SRS estimate of 1982-83 (special
research data)
(APPN-HI-TAB : 63)
the cities. Due to different methodology of
the study, it is not appropriate to compare
ICDS urban slums and SRS estimates of
’ infant mortality rates.
The cause specific infant death rate in
ICDS projects is presented in Fig. 48. Respi
ratory infections were responsible for infant
deaths in 16.4, diarrhoea in 12.5 and fever in
10.8. The less important causes of death
were tetanus and accidents. Non-specific
unexplained causes were recorded in 40.8.
The sex specific and cause specific
death rate for below 5 years old children and
neonates were estimated in multi-centre stud
ies . Fig. 49 presents the sex specific death
rates for 0-4 years old children in ICDS proj
ects as compared to the SRS estimates.
Death rate in this age group was 20.6 in ICDS
as compared to, national’estimate of 39.1.
The lower death rate in ICDS group of children was recorded both in males and females,
as well as, for the urban and rural population,
48
■ M. M<
CZZI ICDS
MH SRS Estimates
50r-
40 -
po-
«ER
B20*10-
I
0Male
43.87. less
(ICDS)
Female
5117. less
(ICDS)
Total
47.3°/« less
(ICDS)
The death rates in urban children both in
ICDS and SRS was lower than the rural and
c*1'^ren- The cause specific death rate
in this age group excluding the infants, indi
cated that diarrhoea,respiratory infection and
fever were equally common causes (death
rate respectively of 5.2,4.9 and 5.0).
Fig. 50 presents the neonatal mortality
rate estimates in ICDS population and its
comparison with SRS estimates. The comparison for sex was not possible as the SRS
data of 1982-83 did not provide the distribu-
Fig. 50: Neonatal mortality rate and cause
specific neonatal deaths rate in
ICDS projects studied in 1982-83
(special research data)
(APPN-IH-TAB : 64 & 65)
fatality due to diarrhoea, respiratory infection
anc| fever.
Fig. 51: Sex specific death rate in age group
0-3 years and 0-6 years in ICDS
projects (special research data)
70 -
5 50 -
140-
4 93
| 30* 20 a 100 -
(APPN-IH-TAB : 66)
EZZ1ICDS
■■ISRS Estimates
£ 60 -
I I
0
Diarrhoea Rslesplratory Tetanus Fever Others
Neonatal
infection
mortality rates
0-3 Years children
0-6 Years children
40 -
30 in
?! 20 o
“100 -
tion of neonatal mortality rate according to
the sex. The neonatal mortality rate in ICDS
group was 49.3 as compared to the much
higher figure (66.7) for the SRS estimates.
The neonatal mortality rate in ICDS urban
slums was higher (46.3) when compared to
38.8 of the SRS estimates for overall urban
population which included slums, as well as,
socio-economic better colonies. The neona
tal mortality rate in rural and tribal ICDS
group was 51.2 which was much lower as
compared to the SRS figure of 72.9.
31.9 I
I
30.6
Female
LfiS
29.2
HU
Mole
Total
B. Results of IMR study -1987:
State level IMR data were obtained for
g states (Fig. 52) in 1987 and for a group of
small states and compared with 1985 SRS es
timates of IMR. For all the states excepting
Rajasthan combined rural and urban IMR in
ICDS population was less than SRS esti
mates. Comparison of IMR in rural popula
tion of ICDS population was considerably less
as compared to SRS estimates in Andhra
Fig. 50 shows the cause specific neo Pradesh, Gujarat, Kerala, Orissa,Uttar
natal mortality rate. Respiratory infection is Pradesh and West Bengal. However, reverse
formed the common and important cause of was true in case of Maharashtra and Rajast
mortality.
han. The IMR was lower in female of ICDS
The death rates for 0-3 and 0-6 years population as compared to the male infants.
age groups were also calculated during this Cause specific death rate indicated diarrhoea
study (Fig. 51). In this age group for the SRS and acute respiratory infection as the most
estimate, the comparison was out of ques common causes recorded in 12.5 and 16.4
tion. It is, however, noted that the death rate per cent infant deaths, respectively. Tetanus
in 0-3 years age group was all through higher was also recorded as important cause of
for both the sexes and both the locations mortality.
(rural or urban) as compared to correspond
Cause and sex specific mortality rate
ing figure for 0-6 years age group.
below the age of 5 years and amongst the
The cause specific death rate in 0-3 and neonates were studied in Andhra Pradesh,
0-6 years age groups, also indicated the high Gujarat, Kerala, Maharashtra, Orissa, Rajast49
Fig. 52: Infant mortality rate (IMR) and
mortality rate of 0<5 years age
children in 1987 (special research
data)
accounted for high mortality rates. The pat
tern of cause specific mortality was almost
same in all the states included in the study
(Fig. 53).
(APPN-III-TAB : 67 & 68)
Rates
120110 tyO 90 80 70 60 50 40 30 20 10 0 10 20 30 40 50
______________ Andhra Pradesh
| 72.8
H'X')
Fig. 53: Cause specific mortality rate
amongst 0<5 years age group
(special research data)
(APPN-III-TAB : 69)
Gujarat
88.s
25r
Kerala
20 -
124.9
i15’
Maharashtra
10-
I 76.6
5-
Orissa
|
05.8
[4L91
Rajasthan
|
r: u „ o' . .
0 Diarrhoea Acute Tetanus Prematurity Fever
respiratory
infection
Others Accidents
114.2
Uttar Prad«sh
[ 119.4
West Bengal
ES3I
| 60.2
IMR
■■ Mortality rate of 0-<5yeors
oge children
han, Uttar Pradesh and West Bengal .
Fig. 52 shows that overall mortality
rate for both the sexes and rural and urban
combined group varied from 6.7 (Kerala) to
41.9 (Orissa). In all the 8 states the preschool
age child mortality rate was lower in ICDS
population as compared to SRS estimates.
This was true irresptective of the sex and
location (rural as well as urban) excepting an
. isolated case in Orissa where ICDS urban
group had a higher mortality rate as com
pared to SRS estimate.
Cause specific death rate study revealed
diarrhoea and acute respiratory infection as
the two major killers (14.6 and 18.5%, re
spectively). Prematurity and short fevers also
50
Data on neonatal mortality in ICDS
population in the 8 states investigated in
1987 were compared with SRS estimates of
1985. Neonatal mortality rate varied from
18.0 (Kerala) to 72.7 in Uttar Pradesh. In 6
states, it was lower in ICDS group as com
pared to SRS estimates while in the remain
ing 1 state viz., Rajasthan, it was higher than
SRS estimate in the ICDS group (Fig. 54).
C. Results of comparative research study of
IMR in ICDS and non-ICDS populations:
A total of 2074 and 1425 pregnant
women were registered in rural and urban
ICDS sample populations, respectively. Reg
istration of pregnant women in non-ICDS
population was 2164 for the rural and 1116
for the urban group. Pregnancy rate was 4.0
and 3.3 in rural and urban ICDS and 4.1 and
3.0 in rural and urban non-ICDS population.
Fig. 55 presents the birth rate and IMR in
ICDS and non-ICDS samples.
All the live births were followed up till to
the age of one year to record the infant
Fig. 54: Neonatal mortality rate in ICDS group compared with SRS estimates (1985)
(special research data)
(APPN-III-TAB : 70)
90 -
ICDS
SRS Estimates
93 -
73 -
68.9
a®
63 333
, 53 a 43 -
30 -
20 -
10 -
0 -
47.11
J
Andhra
Pradesh
[412]
■ jC.8
22.1
Gujarat
Kerala
Maharashtra Orissa
mortality rate and cause specific death rate.
Fig. 55 presents the infant motality rate
in ICDS and non-ICDS groups according to
the location (rural and urban) and its compari
son with non-ICDS group. IMR in non-ICDS
group was higher, both for the rural (85.5 cf.
67.0) and urban (87.0 cf. 80.0) infants. The
infant mortality rate was higher in the males
as compared to the females both in ICDS and
non-ICDS populations. However, in urban
population IMR was higher in females as
compared to males in ICDS but lower in nonICDS group.
The cause specific infant mortality rate
in ICDS and non-ICDS study samples is
presented in Table D (p.52). Of the known
four important causes of high IMR death rate
due to diarrhoea and tetanus was much higher
in both rural and tribal non-ICDS infants as
compared to ICDS infant population. Whereas
acute respiratory infection (ARI) was signifi
cantly less common in non-ICDS group
compared to the ICDS group. Prematurity as
the cause specific death rate was more com
mon in rural non-ICDS as compared to the
Rajasthan
Uttar
West Bengal
Pradesh
rural ICDS group but the reverse was true for
urban group.
Fig. 55: Birth rate and infant mortality rate
in ICDS and non-ICDS control
population (special research data)
(APPN-Hl-TAB : 71 & 72)
90r80 70 -
□ ICDS
■■ Non-ICDS control
to.o
67.0
60 -
50 -
40 30 20 10 -
0 -
ri
»5
27 9
Rural
Urban
1------ Birth rate------ 1
Urban
HL Comments on IMR Research
Study:
Various ICDS projects viz., tribal and
urban are located in socio-economically back
ward areas with relatively poor MCH out
reach of rhe health department. Derm
Table I : Infant and early childhood mortality studies by consultants.
Year of study
IMR study
1982-83
1983-84
1985-86
1986-87
1987-88
No. allotted
No. completed;
(%)
48
32
28
33
113
38
26
21
27
98
(79.2)
(81.2)
(75.0)
(81.8)
(86,7)
z
■
......
Table II : Cause specific death rates in ICDS and non-ICDS infant population
Location
Diarrhoea
ARI
Tetanus
Prematurity
Rural
ICDS
Non-ICDS
8.0
17.4
15.5
11.1
4.6
12.1
10.9
12.1
Urban
ICDS
Non-ICDS
10.5
16.6
33.1
17.6
0.0
10.7
16.2
6.8
Table III : Perinatal, neo natal and post neo-natal mortality rate in ICDS vs. Non-ICDS
groups (per 1000 live births)
ICDS-projects Peri-natal
mortality
rate
Neo-natal Post neo
mortality
natal
mortality
rate
rate
Norsapur (R)
Sohawal (R)
Villianur (R)
78.7
70.6
58.1
49.8
46.5
38.7
16.1
29.7
22.9
Ahmedabad
(U)
Gorakhpur
(U)
53.0
50.2
37.7
39.0
55.0
21.1
52
Non-ICDS Peri-natal
projects mortality
rate
Tekmal (R)
Rudauli (R)
Oulgrapet
(R)
Ahmedabad(U)
Gorakh
pur (U)
Neo-natal
mortality
rate
Post neo
natal
mortality
rate
45.2
45.2
49.6
55.9
58.2
41.0
29.6
49.7
29.8
62.5
44.6
35.7
68.4
62.5
41.0
5
€
c
I
i
I
I
<
I
1
<
parameter in these are expected to be worse
as compared to the national average. The
present study was done by altogether a differ
ent design with more research input to cor
roborate if favourable trends of IMR in ICDS
reported earlier can be further confirmed
through an improved research protocol.
Important characteristics of this study- (i)
simultaneous data, by similar method, have
been collected in ICDS and comparable nonICDS population; (ii) it is a cohort study. All
children bom during the period of study in
ICDS and non-ICDS population have been
followed for 12 months; (iii) in non-ICDS
area, since there were no AWW, local village
informant system was established; (iv) super
vision for accuracy of data collection was
improved in the form of detailed methodol
ogy; (v) urban and rural data have been con
sidered separately; and (vi) sample includes
both high as well as moderate IMR areas
according to the SRS reports. There were
1746 live births in ICDS rural sample and
1894 in non-ICDS sample. IMR in these two
groups was respectively 67.0 and 85.5 which
is statistically significant in favour of ICDS
projects. Significant decline of IMR was re
corded both amongst male and female sexes.
In fact, favourable impact was more signifi
cant for female infants. Further, it was noted
that IMR in U.P. sample showed most signifi
cant decline in ICDS as compared to nonICDS group. U.P. happens to be one of the
states with very high IMR in SRS reports. It is
possible that higher the IMR, better will be the
impact of ICDS. Our current ongoing design
of IMR study will be providing more data to
suitably comment on this problem in another
3 years’ time.
< 1
I
<
<
4
Cause specific IMR showed a consider
able finding. There was considerable reduc
tion in mortality due to diarrhoea and tetanus,
the two diseases where ICDS programme can
make a very important impact. Comparative
figures for IMR due to diarrhoea in ICDS and
non-ICDS groups were 8.0 and 17.4 and cor
responding figures for tetanus were 4.6 and
12.1, respectively.
Comparative cohort study of IMR in
ICDS and non-ICDS groups at the micro level
established the following facts: (a) IMR in
ICDS group was significantly lower as com
pared to the non-ICDS group; (b) favourable
impact of ICDS was noted for both male and
female children; (c) there was greater reduc
tion of IMR in ICDS projects which to begin
with had a high IMR; and (d) there - was
considerable reduction in deaths due to diar
rhoea and tetanus in ICDS groups. This is a
strong point for expansion of ICDS in refer
ence to diarrhoeal disease control programme
at the village level and control of mortality due
to tetanus.
There was better utilization of services
of the Primary Health Centres for infants in
ICDS group as compared to non-ICDS group.
These services included referral to the hospi
tal (18.8 vs 11.1) care by PHC medical officer
(17.1 vs 13.6) and services by LHV/ANM
(11.1 vs 6.8). On the other hand local dai was
preferred assistance before infants death in
non-ICDS group (16.0 vs 8.5). These data
establish the positive role of AWW and ICDS
system for better utilization of health services
infrastructure of rural area for sick and dying
infants.
As already stated and earlier published
that the ICDS infrastructure in urban area is
almost different from rural areas. Essentially
unlike the rural ICDS, which has become
strong complement of health services at the
village, the urban ICDS remains a very weak
support for urban MCH services. Still it was
53
Table IV : Prevalence of protein-energy malnutrition (weight for age criterion)
Severe malnutrition
Moderate malnutrition
Drought
Predrought
survey
survey
(Percentage)
Drought
Predrought
survey
survey
(Percentage)
0 to below
3 years
12.3
(4203)
8.7*
(2938)
19.6
(4203)
16.5*
(2938)
3 to 6 years
10.0
(4015)
7.1*
(2954)
21.0
(4015)
22.2
(2954)
0 to below
6 years
11.2
(8218)
7.9*
(5892)
20.3
(8218)
19.3
(5892)
Figures in parentheses show no. of children studied.
* Statistically significant change.
IM
Table V : Prevalence of protein-energy malnutrition (mid upper arm circumference
criterion)
Severe malnutrition
(Percentage)
Moderate malnutrition
(Percentage)
1 to below 3 years
11.41
23.59
3 to below 5 years
6.77
19.72
1 to below 5 years
10.69
21.65
Age group
9
1
I
I
I
I
f
i
Table VI : Prevalence of protein-energy malnutrition (weight for height criterion)
l
* I
Severe malnutrition
(Percentage)
Moderage malnutrition
(Percentage)
0 to below 3 years
8.75
13.90
3 to below 6 years
9.50
14.82
1
0 to below 6 years
10.90
14.35
I
Age group
< I
I
I
S6
I
the projects, except in one case where a
decrease was reported to the range of 2
to 7 per cent in case of jowar and paddy
respectively. This fall was reported to be
due to subsidised food itmes provided by
the government to all the tribal families.
(iv) Cost of essential commodities: All the
projects reported an increase in cost of
essential commodities. The maximum
increase was recorded for oil and ghee.
(v) Cost of live stock: This was reported to
be quite variable in the projects studied.
The decreased cost of the cows and
buffalows was reported from projects
which had been under the drought for
successive 3 to 4 years and did not have
had late rains in 1987. The cost of goat,
sheeps and poultry was found high in all
the projects indicating that they have
been used as a source of non-vegetarian
foods.
Comments
1. The deficit rainfall, decrease in crop
yield, increase in prices of cereals and essen
tial commoidties and variable increase in the
price of live stock confirmed significant drought
condition in the projects studied. It was no
ticed that there was considerable variation in
the degree of drought parameters in different
projects.
2. Effect of drought on health and nutri
tional status:
(i)
Nutritional status: An unequivocal evi
dence for an increase in moderate and
servere malnutrition (weight for age cri
terion) was recorded in the age group of
0-3 and 3-6 years. The degree of nutri
tional deterioration in different projects
was variable. Underautrition by weight
for age criteria was further corroborated
by study of mid upper arm circumfer-
ence and weight for height data. Data
are presented in Tables IV, V and VI.
Data on nutritional status collected in the
present survey were compared with data
collected in previous years annual sur
veys by ICDS consultants in the same
district in similar type of population. It
was confirmed that the drought condi
tions resulted to adverse effect on the
nutritional status of children.
The degree of severe and moderately
malnourished children varied from proj
ect to project. The highest prevalence of
severe malnutrition was 20.36 per cent
and the lowest was 1.9 per cent. A
similar observation was made for mode
rate malnutrition amongst the children.
(ii)
Clinical signs of nutritional deficiency: A
considerable variation in the signs of
nutritional deficiency was found in the
different states. The signs of vitamin A,
B-complex, iron deficiency as detected
by night blindness, bitots spot, stomatitis
and pallor were found higher than the
previous studies conducted in non
drought situations in different parts of
the country. The prevalence of severe
malnutrition i.e., kwashiorkar/marasmus
was in the range of 0.23 to 7.65 per cent
in different projects. The morbidity rec
ord amongst the children with last 15
days showed an increase in the respira
tory infection and diarrohea in the cur
rent study as compared to the studies
conducted in npn-drought conditions in
ICDS projects.
3. Perception of the health and nutrition
problem in drought by Medical Officers and
Child Development Officers (CDPO).
(i) Medical Officer: The Medical Officers of
Primary Health Centre of ICDS project
57
were interviewed on a pretested semi
structured open ended questionnaire for
their perception about the adverse effects
of drought on health and nutrition status
of mothers and children and augmenta
tion of medical care activities.
Data were available from 10 projects.
Medical Officers in half of the PHC’s
reported an increase in the prevalence of
anemia amongst women, diarrhoea and
protein energy malnutrition amongst
children and increase of undemutrition in
lactating mothers. Half of the projects
studied reported an increase in supply of
medicines, vaccines, vitamin A solution,
iron and folic acid, ORS, POL funds and
bleaching powder. Three of the 8 proj
ects reported an increase in budget of the
PHC. Augmentation of health services
inputs varied from project to project.
(ii) C.D.P.O.: The Child Development Proj
ect Officer is a non-medical person. CDPO
is administrative as well as technical offi
cer responsible for the implementation of
the ICDS programme. The CDPOs were
interviewed for their perception for ad
verse effect of drought on health and
nutrition of mothers and children and also
for augmentation of activities of ICDS for
the management of drought. Nearly half
of the CDPOs reported an increase in the
prevalence of protein-energy malnutri
tion in under-6 years children and an
overall increase in prevalence of undernu
trition amongst the pregnant mothers.
Nearly half of CDPOs reported augmen
tation in the services of ICDS, which
included increase in food supply, feeding
centres, number of beneficiaries and funds
for food supply and POL.
4. Wages of manual labour: The wages
58
of the manual labourers during drought situ
ations showed a downward trend due to non
availability of work. However, we found that
there was an increase in wages of the manual
labour. The possible explanation for this find
ing is that in majority of the projects the work
was available as a drought relief measure.
5. Drought relief activities: The Sarpanch of village where anganwadis were
located were interviewed. The major drought
relief activities reported by them were as
following: (i) increase in supply of drinking
water; (ii) fair price shops; and (iii) subsidised
seeds. In more than 50 per cent anganwadis
areas, the NREP activities were being imple
mented. The other drought relief activities
like fertiliser subsidy, subsidised ration, fodder
relief were made available to the 25 to 40 per
cent of the anganwadis.
Conclusion
The special study on the effect of the
drought in ICDS led to the following conclusions:1. The drought conditions were confirmed.
There was considerable variations in the
degree of the drought in different projects.
2. There was an increase in the severe and
moderate malnutrition in ICDS projects due
to drought.
3. There was increase in the morbidity due
to diarrohea and respiratory infections.
4. The Medical Officers and CDPOs have
proper perception of drought on nutritional
status and morbidity.
5. There was augmentation of health and
nutrition services, as well as, other welfare
services in the drought effected areas which
was successful in preventing the significant
adverse effects of drought.
5. Mothers perception of child development and ICDS
A.
Background and Objectives
One of the objectives of ICDS is to
enhance the capability of the mothers to look
after the development of child. The package
of services delivered at anganivadis centre
and interaction of anganivadi workers with
women of the village, particularly, pregnant
and lactating women is the principal ap
proach for communicating health and nutri
tion education to achieve this objective. A
study was planned in a sample of ICDS
projects in two northern hill states viz.,
Himachal Pradesh and Jammu & Kashmir to
evaluate the knowledge and continued educa
tion of mothers on child development and
ICDS.
The medical students formed a team
for the study. Ten teams each consisted of
two students were constituted. The student
investigator received training for data collec
tion. For first statge data analysis 135 an
ganivadis were selected from five projects in
these two states and each team of the stu
dents collected data from 13-14 anganivadis
by the questionnraie method and direct inter
action with pregnant and lactating women.
Data were collected on a pre-planned pro
forma. The student investigators communi
cated with the Bio-Statistics Cell of the CTC
at AIIMS for final analysis of data.
Results
Table VII presents the mothers percep
tion of ICDS. As many as 48.7 per cent
expressed that anganivadis centre provided
treatment for minor illnesses. Nearly l/3rdof
the interviewed women stated that the chil
dren learned good habits, numbers and po
etry at the anganivadis. Other benefits in
cluded stimulation to the child, good health to
the child and increase in the general knowledge
etc.
Table VIII presentes the knowledge of
mothers during the pregnancy, 80 per cent or
above had the knowledge and practice for
utilization of antenatal services.
Table IX presents the views of mothers
regarding breast feeding after the delivery. A
very high proportion constituting 85 per cent
believed in the breast feeding within six hours
of the delivery.
Nearly 49.8 per cent mothers gave
weaning food to th§ clpildren in the age group
4-6 months, 30 p£r cent provided it between
6-9 months and the rest after this period.
Table X and XI present two Important
aspects of the management of diarrhoea by
mothers. Nearly l/3rd of the mothers be
lieved that the children continued to take
normal feeds and normal breast feeding. As
many as 78.9 per cent gave normal whole
milk, in diarrohoea, to the children and 74
per cent favoured for giving more or normal
quantity of liquid drinks. Sixty four per cent
had the knowledge of oral rehydration solu
tion (ORS) and 52 per cent knew how to
prepare ORS at home.
B. The Study ofBreast Feeding Prac
tices
Study on breast feeding practices was
carried out in a total of 5 projects which
comprised 2 rural projects in a sample of
561, 2 tribal projects in a sample of 334,
and one urban project in a sample of 310
59
Table VII : Benefits occurred through Anganwadi services
Benefit derived
Percentage
beneficiaries
Treatment of minor ailments
48.7
Good habit creation
Numeracy learning
33.6
30.9
Leams personal grooming
21.8
Benefit derived
Percentage
beneficiaries
Environmental stimulation
of children
Child is healthier
Stopped loitering in
the street
Others*
19.9
17.5
15.5
11.3
Other benefits include development early milestrons, does not fall ill, leams respects and gains
general knowledge.
Table VIII : Care during pregnancy
Care
Cleanliness during pregnancy
Tetanus immunisation
Iron and folic acid intake for anaemia
Health checkup (periodicantenatal care)
Supplementary nutrition receipt from AW
Delivery by trained person
Percentage mothers
90.9
87.1
86.0
83.1
82.5
78.5
Table IX : Breast feeding practice
After delivery
Percentage mothers
Within 2 hours
2-6 hours
6-12 hours
52.0
33.1
3.7
After 12 hours
10.3
60
Table X : Feeding practices of mothers during diarrhoeal episodes of children
Percentage mothers
Practices
Normal feeding
31.9
Normal milk
78.9
Normal breast feeding
28.8
More or normal water
74.1
Table XI : Knowlewdge and skills of preparation of ORS by mothers
Percentage mothers
ORS
Knowledge of ORS
64.1
Preparation of ORS
52.8
Knowledge of ingredient
mixture in preparation of ORS
49.5
(41.0)*
* have the idea of constituents with the quantitative measures.
Table XII : Breast feeding (BF) practices in more than 3 years old ICDS projects
Sample size
0-1 yr % B.F.
1-2 yr % B.F.
2 yrs + % B.F.
Rural 2
561
19.1
74.5
6.4
Tribal 2
334
16.8
50.6
32.6
Urban 1
310
16.8
72.9
10.6
All total 5
1205
17.8
67.5
14.8*
Type of project
61
6.
Knowledge, attitude and practices of and anganwadi workers in ICDS
Background
Anganwadi worker is the principal
functionary of the ICDS located at the village
where the programme is being implemented.
It was decided to conduct a study to record her
knowledge and attitude and find out how best
she was discharging her functions by interac
tion of the investigator team with anganwadi
worker, her record and local population.
Data were collected primarily by question
naire method and study of the records and
entered on the pre-planned proforma. The
same sample of anganwadis was used for this
study as was selected for investigating moth
ers’ perception of child development and
ICDS.
The study was carried out in 8 projects
which covered 134 anganwadis
and
anganwadi workers.
Results
As many as 45.5 per cent of the an
ganwadi workers were local residents of the
villages where anganwadis were located.
The remaining (54.5%) came from a distance
which varied from 1 to 30 km. In this group
80.8 per cent were residing within a radius of
5 km and 17.8 per cent within 15 km. It was
noted that 71.2 per cent of the anganwadi
workers who were not resident of the same
^village could reach to the place of work within
half an hour.
A total of 94.8 per cent of anganwadi
workers interviewed had received 3 months
ICDS formal training. Further, 64.9 per cent
were regularly receiving monthly sectorial
continued education, 84.3 per cent of the
anganwadi workers have been in service for
64
more than 2 years. Weekly home visits were
recorded by 82.2 per cent of anganwadi
workers, the remaining were also carrying on
with this function but the frequency was
irregular . 85 per cent of the anganwadi
workers were providing on the spot service to
20-40 children at each anganwadi. The
remaining had an attendance of 10-20 chil
dren. Very high proportion (98 %) of an
ganwadi workers maintained the nutritional
status recording of the children either by
weight or by arm circumference. Proper
growth charts were recroded by 76.9 per
cent of anganwadi workers in this study
group.
The anganwadi workers reported that
their primary role in immunisation was to
help the health teams, motivating the moth
ers and children and post-immunisation fol
low up. This was recorded in more than 90
per cent of anganwadi workers. 77 percent
of them kept fairly good record of immunisa
tion. The major difficulties in immunisation as
reported by anganwadi workers were non
cooperation of mothers and children and
non-availability of the health team after all the
arrangements for immunisation have been
made. Anganwadi workers had good knowl
edge of management of diarrohoea and
prevention of vitamin A deficiency and nutri
tional anemia. 80-90 per cent of the
anganwadi workers replied to the questions
related to these subjects. Similary, a high
proportion in the range of 81.3 to 95.5 per
cent responded with correct answers related
to antenatal care, post-natal care and family
welfare services. The major complaint of
anganwadi workers were less salary (66.5%)
and more work (44.8%).
IV. PUBLICATION OF PAPERS AND PRESENTATIONS BY THE
CENTRAL TECHNICAL COMMITTEE AND THE CONSUL
TANTS
The'research work carried out on ICDS
has been published in national and interna
tional journals, state journals, and presented
in various scientific meetings. Consultants
have published 59 papers in the national and
international journals, the Central Cell has
published 11 papers in the national and
international journals.
The consultants and their students have
presented 53 papers at scientific meetings
and 9 papers have been presented by the
Central Cell.
A total of 50 papers have been pub
lished in state journals by the consultants.
Central Technical Committee has published
9 papers in state journals.
The list of publication and papers pre
sented in meetings is listed in Appendix-Ill
and IV.
65
Appendices
Appendix I
LIST OF ICDS CONSULTANTS FROM 1976 ONWARDS
S.NO.
Name and designation
Period of association
1.
Dr. K.N. Agarwal
Prof, of Paediatrics
Institute of Medical Sciences
Varanasi.
1983-86
U.P.
2.
Dr. V.K. Agarwal
Prof, of Paediatrics
Motilal Nehru Medical College
Allahabad.
1981-86
U.P.
3.
Dr. Faruk Ahmad
Prof, of PSM
Assam Medical College
Dibrugarh.
1983 to date
Assam
4.
Dr. M. Ahmad
Medical Superintendent
Government Medical College
Srinagar.
1982 to date
J&K
5.
Dr. J. S. Anand
Prof, of Paediatrics
Shri M.P. Shah Medical College
Jamnagar.
1979-89
Gujarat
6.
Dr. G. Anjanlyulu
Prof, of PSM
Osmania Medical College
Hyderabad.
1983 to date
Andhra Pradesh
7.
Dr. P.V. Aswath
Prof, of PSM
Karnataka Medical College
Hubli.
1982 to date
Karnataka
8.
Dr. L. Taka, A.O.
Joint Director
Directorate of Health Services
Kohima.
1986 to date
Nagaland
9.
Dr. M.C. Bachawat
Principal, Regional F.W. Training Centre
Indore.
1981-82
M.P.
10.
Dr. Indira Bai
Prof, of Paediatrics
S.V. Medical College
Tirupati.
1982-83
Andhra Pradesh
State/UT
IV
35.
Dr. I. Ibemtombi Devi
Nameicakapam Leikari
P.O. Imphal—8795 004.
1977 to date
Manipur
36.
Dr. (Mrs.) A.B. Desai
Prof, of Paediatrics
BJ Medical College
Ahmedabad.
1978-86
Gujarat
37.
Dr. I.U. Dudani
Prof, of PSM
Jawaharlal Nehru Medical College
Ajmer.
1988 to date
Rajasthan
38.
Dr. A.K. Dutta
Associate Prof, of PSM
Sardar Patel Medical College
Bikaner.
19987 to date
Rajasthan
39.
Dr. T.P. Gandhi
Surgeon
Headquarter’s Hospital
Vijianagar.
1982 to date
Andhra Pradesh
40.
Dr. Monimoy Ganguly
Prof, of PSM
RG Kar Medical College
Calcutta.
1982-86
West Bengal
41.
Dr. B.K. Garg
Asstt. Prof, of Paediatrics
Motilal Nehru Medical College
Allahabad.
1979-84
Uttar Pradesh
42.
Dr. (Miss) S. Garod
Paediatrician
Shillong.
1980-85
Meghalay
43.
Dr. D.R. Gaur
Reader in PSM
Medical College,
Rohtak.
1988 to date
Haryana
44.
Dr. H.K. Gaur
Prof, of Paediatrics
Government "Medical College
Surat.
1979 to date
Gujarat
45.
Dr. S.D. Gaur
Prof, of PSM
Institute of Medical Sciences
Varanasi.
1987 to date
Uttar Pradesh
46.
Dr. T.R..GopaLKrishna
Principal
Health & F.W. Training Centre1
Hubli.
1988 to date
Karnataka
V
47
Dr. A.K. Govila
Prof, of PSM
Gajra Raja Medical College
Gwalior.
1987 to date
Madhya Pradesh
48.
Dr. H.N.S. Grewal
Project Director , CH Deptt.
Christian Medical College
Ludhiana.
1982-87
Punjab
49.
Dr. (Mrs.) Anu Gupta
Prof, of Paediatrics
MAM College,
New Delhi.
1982-84
Delhi
50.
Dr. Mukesh Gupta
Lecturer
Paediatrics Deptt.
UMAID Hospital
Jodhpur.
1982-86
Rajasthan
51.
Dr. (Mrs.) T.K. Guha
Principal
Health & F.W. Training Centre
Jabalpur.
1981 to date
Madhya Pradesh
52.
Dr. K. Halder
Prof, of Biochemistry &
Nutrition AIIH & PH
Calcutta.
1977-84
West Bengal
53.
Dr. O.R. Hazarika
Associate Prof, of PSM
Silchar Medical College
Silchar.
1985-87
Assam
54.
Dr. D.L. Ingole
Prof, of PSM
Govt. Medical College
Nagpur.
1979-86
Maharashtra
55.
Dr. Arvind Jaiswal
Prof, of Paediatrics
Nalanda Medical College
Patna.
1982
Bihar
56.
Dr. O.N. Jaiswal
Prof, of Paediatrics
D/66, Doctor's Colony
Kankarbagh
Patna.
1979-88
Bihar
57.
Dr. (Mrs.) Anjali Jana
Addl. Director of Health Services
Calcutta.
1982-88
West Bengal
VI
58.
Dr. M.G. Javali
Paediatrician
Civil Hospital
Belgaum.
59.
Dr. S. Jayam
1977 to date
Prof, of Paediatrics
Inst, of Child Health & Hospital for Children
Madras.
Tamil Nadu
60.
Dr. M. Jayaram
Prof, of Paediatrics
Banglore Medical College
Bangalore.
1979-88
Karnataka
61.
Dr. M. Jaypal
Selection Grade Asst.
Surgeon
Govt. Headquarter Hospital
Vellore.
1986 to 88
Tamil Nadu
62.
Dr. S.S. Jodda
Naga Hospital
Kohima.
1976-84
Nagaland
63.
Dr. C.K. Joshi
Prof, of PSM
Sardar Patel Medical College
Bikaner.
1986-87
Rajasthan
64.
Dr. V.K. Karan
Associate Prof, of Paediatrics
A.N. Magadh Medical College
Gaya.
1979 to date
Bihar
65.
Dr. V.N. Karandikar
Reader in PSM
B.J. Medical College
Pune.
1979-85
Maharashtra
66.
Dr. K.K. Kaul
Prof, of Paediatrics
Govt. Medical College
Jabalpur.
1982 to date
M.P.
67.
Mukund Ketkar
Prof, of PSM
Shyam Shah Medical College
Rewa.
1982 to date
M.P.
68.
Dr. Gopal Krishna
Prof, of PSM
GSVM Medical College
Kanpur.
1982 to date
Uttar Pradesh
1979-84
Karnataka
69.
Dr. M.V. Kulkami
Prof, of PSM
Govt. Medical College
Mysore.
1988 to date
Karnataka
70.
Dr. Birender Kumar
Deptt. of PSM
Darbhanga Medical College
Darbhanga.
1976 to date
Bihar
71.
Dr. Vijay Kumar
Prof, of Community Medicine
PGIMER, Chandigarh.
1979-85
Chandigarh
72.
Dr. Sunder Lal
Prof, of PSM
Medical College
Rohtak.
1986 to date
Haryana
73.
Dr. V. Lohidas
Prof. & Head
Deptt. of SPM
TD Medical College
Alleppey.
1983-87
Kerala
74.
Dr. B.K. Mahajan
Prof, of PSM
M.G. Institute of MedicaJ Sciences
Wardha.
1976-82
Maharashtra
75.
Dr. T. Maha Laxmi
Principal
Regional FW & H Training Centre
Bilaspur.
1986-87
M.P.
76.
Dr. H.B. Mahapatra
Associate Prof, of PSM
V.S.S. Medical College, Burla
Sambalpur.
1983 to date
Orissa
77.
Dr. N.P. Mahapatra
Associate Prof, of PSM
MKCG Medical College
Berhampur
Ganjam.
1982 to date
Orissa
78.
Dr. S.P. Mandal
Principal
Health & FW Training Centre
Jalpaiguri.
1988 to date
West Bengal
79.
Dr. S.L. Mandowara
Lecturer in Paediatrics
R.N.T. Medical College
Udaipur.
1980 to date
Rajasthan
VIII
80.
Dr. G.M. Mathur
Prof, of PSM
Jawahar Lal Nehru Medical College
Ajmer.
1986-88
Rajasthan
81.
Dr. G.P. Mathur
Prof, of Paediatrics
GSVM Medical College
Kanpur.
1979 to date
U.P.
82.
Dr. Y.C. Mathur
Paediatrician
Nilofer Hospital
Hyderabad.
1982
Andhra Pradesh
83.
Dr. N.R. Mehta
Prof, of PSM
Government Medical College
Surat.
1980-89
Gujarat
84.
Dr. S.P. Mehta
Prof, of SPM
M.A. Medical College
New Delhi.
1983 to date
Delhi
85.
Dr. F.R. Meshack
Sr. Medical Officer (Nutrition)
Medical Directorate
Port Blair.
1984 to date
Andaman & Nicobar
86.
Dr. D.M. Meshram
Reader in PSM
Officer of Health Unit
Saoner
Nagpur.
1982 to date
Maharashtra
87.
Dr. (Mrs.) P.K. Mishra
Prof, of Paediatrics
KG's Medical College
Lucknow.
1987 to date
U.P.
88.
Dr. (Miss) U.J. Modi
Prof, of Paediatrics
Medical College
Baroda.
1976 to date
Gujarat
89.
Dr. Virendra Mohan
Prof, of PSM
Medical College
Amritsar.
1983 to date
Punjab
90.
Dr. Z.K. Muana
Gynaecologist
Civil Hospital
Aizwal.
1979-87
Mizoram
IX
91.
Dr. K.L. Mukherjee
Principal
Health & FW Training Centre
Jalpaiguri.
1983-86
West Bengal
92.
Dr. G. Nanjappa
Prof, of PSM
Government Medical College
Bellary.
1984-87
Karnataka
93.
Dr. Anil Narang
Additional Prof, of Paediatrics
PGIMER, Chandigarh.
1979-81
Chandigarh
94.
Dr. K. Natrajan
Paediatrician
Selection Grade
Govt. Pentland Hospital
Vellore.
1982-87
Tamil Nadu
95.
Dr. Tara Natarajan
Addl. Prof, of Paediatrics
Madras Medical College
Madras.
1984-88
Tamil Nadu
96.
Dr. Maya Natu
Prof, of PSM
BJ Medical College
Pune.
1985 to date
Maharashtra
97.
Dr. Renu B. Patel
Prof, of Paediatrics
Grant Medical College
Bombay.
1979 to date
Maharashtra
98.
Dr. A. C. Patwari
Prof, of PSM
Gauhati Medical College
Gauhati.
1978 to date
Assam
99.
Dr. M.K. Paul
Paediatrician
District Hospita[
Ziro, Lower Subansiri District.
1985 to date
Arunachal Pradesh
100.
Dr. C.L. Pegu
Sr. Medical Officer
District Hospital
Along.
1987 to date
Arunachal Pradesh
101.
Dr. Elsie Philips
Prof, of Paediatrics
Medical College
Trivandrum.
1980-89
Kerala
X
102.
Dr. Ramesh Prasad
Prof, of Paediatrics
S.N. Medical College
Agra.
1987 to date
U.P.
103.
Dr. K. Raghava Prasad
Prof, of PSM
Siddhartha Medical College
Vijayawada.
1981 to date
Andhra Pradeshh
104.
Dr. R.K. Puri
Prof, of Paediatrics
JIPMER, Pondicherry.
1979-88
Pondicherry
105.
Dr. K.K. Rai
Principal
Regional Welfare Training Centre
Bilaspur.
1983-86
M.P.
106.
Dr. Baldev Raj
Prof, of PSM
Motilal Nehru Medical College
Allahabad.
1979 to date
U.P.
107.
Dr. T. Rajagopal
Reader in Paediatrics
Govt. Rajaji Hospital
Madurai.
1979 to date
Tamil Nadu
108.
Dr. K. Rajan
Associate Prof, of Community
Medicine,T.D. Medical College
Alleppey.
1987 to date
Kerala
109.
Dr. Manika Raju
Prof, of Paediatrics
Vani Vilas Children Hospital
Bangalore .-
1983 to date
Karnataka
110.
Dr. R.V. Raju
1981-84
Andhra Pradesh
111.
Dr. Rama Ram
Prof, of PSM
NB Medical College
Sushrat Nagar
Darjeeling.
1983-88
West Bengal
112.
Dr. Suresh Rana
Asstt. Prof, of Medicine
IG Medical College
Shimla.
1986 to date
Himachal Pradesh
113.
Dr. M. Nagaraj Rao
Civil Surgeon
Children'? Specialist
Deptt. of Paediatrics
Gandhi Hospital
Secunderabad.
1980 to date
Andhra Pradesh
XI
114.
Dr. T.M.V. Prasad Rao
Prof, of PSM
Kumool Medical College
Kumool.
1981 to date
Andhra Pradesh
115.
Dr. T. Rama Rao
Prof, of Paediatrics
Andhra Medical College
Visakhapatnam.
1987-88
Andhra Pradesh
116.
Dr. Y. Sreehari Rao
Prof, of PSM
S.V. Medical College
Tirupati.
1979 to date
Andhra Pradesh
117.
Dr. Manju Rastogi
V.Z. Hospital, Town Hall
Moradabad.
1978 to date
U.P.
118.
Dr. Rathanligana
Civil Hospital
Aizwal.
1983 to date
Mizoram
119.
Dr. A. Rauf
Prof, of PSM
Government Medical College
Srinagar.
1981 to date
J&K
120.
Dr. K.J. Reddy
Prof, of PSM
Kumool Medical College
Kumool.
1983 to date
Andhra Pradesh
121.
Dr. Venkat Ram Reddy
Prof, of Paediatrics
Nilofer Hospital
Hyderabad.
1983-85
Andhra Pradesh
122.
Dr. Bikash Roy
Sr. Paediatrician
V.M. Hospital
Agartala.
1982 to date
Tripura
123.
Dr. (Mrs.) D. Roy
Director of Health Services
(MCH)
Shillong.
1979 to date
Meghalaya
124.
Dr. Sitesh Roy
Deptt. of PSM
Calcutta National Medical College
Calcutta.
1979 to date
West Bengal
125.
Dr. S.S. Saha
Senior Medical Officer
District Hospital
P.O. Tezu
Distt. Lohit.
1981-88
Arunachal Pradesh
XII
126.
Dr. M.K. Sainaba
Assoc. Prof, of Paediatrics
Medical College
Calicut.
1981-89
Kerala
127.
Dr. H.V. Sakhrie
Jt. Director
Directorate of Health Services
Kohima.
1986 to date
Nagaland
128.
Dr. Ganga Saran
Prof, of Paediatrics
Patna Medical College
Patna.
1977-80
Bihar
129.
Dr. C.K. Sasidharan
Asstt. Prof, of Paediatrics
Institute of Maternal and
Child Health.
Calicut.
1979 to date
Kerala
130.
Dr. P.V. Sathe
Prof, of PSM
Grant Medical College
Bombay.
1982-87
Maharashtra
131.
Dr. R.K. Satpathi
Prof, of Paediatrics
MKCG Medical College
Behrampur, Ganjam.
1983 to date
Orissa
132.
Dr. D.M. Saxena
Prof, of Paediatrics
Government Medical College
Surat.
1989 til date
Gujarat
133.
Dr. P.N. Saxena
Prof. & Head
Deptt. of Pediatrics
KG's Medical College
Lucknow.
1980-87
U.P.
134.
Dr. V.B. Saxena
Prof, of PSM
Pt. J.N. Memorial Medical College
Raipur.
1982 to date
M.P.
135.
Dr. S.K. Sen
Prof. & Head of Paediatrics
V.S.S. Medical College
Burla, Sambalpur.
1980-82
Orissa
136.
Dr. Vimlesh Seth
Additional Prof, of Paediatrics
AIIMS
New Delhi.
1976-85
Delhi
XIII
137.
Dr. D.N. Shah
Prof, of PSM
Medical College
Baroda.
1988 to date
Gujarat
138.
Dr. Usha Shah
Prof, of PSM
B.J. Medical College
Pune.
1979-81
Maharashtra
139.
Dr. Rajiv Sharan
Reader in Paediatrics
S.N. Children’s Hospital
Allahabad.
1980-86
U.P.
140.
Dr. Daya Sharma
Prof, of Paediatrics
Kalavati Saran Children’s Hospital
New Delhi.
1982 to date
Delhi
141.
Dr. P.N. Sharma
Prof, of PSM
RNT Medical College
Udaipur.
1978-85
Rajasthan
142.
Dr. S.P. Sharma
Paediatrician
Distt. Hospital
Kathua.
1980 to date
J&K
143.
Dr. Usha Sharma
Associate Prof, of Paediatrics
SMS Medical College
Jaipur.
1984 to date
Rajasthan
144.
Dr. B.K. Shee
Assoc. Prof, of PSM
Rural Health Centre
Jagat Singhapur
Cuttack.
1982 to date
Orisa
145.
Dr. C. Shivraman
Prof, of PSM
Government Medical College
Bellary.
1987 to date
Karnataka
146.
Dr. C.M.S. Siddhu
Prof, of PSM
K.G's. Medical College
Lucknow.
1975-77
U.P.
147.
Dr. A.L. Singh
Prof, of PSM
Bhagalpur Medical College
Bhagalpur.
1985-86
Bihar
XIV
148.
Dr. E.Y. Singh
Asstt. Prof, of PSM
Medical College
Imphal.
1981 to date
Manipur
149.
Dr. Harjit Singh
Associate Prof, of Paediatrics
Medical College
Rohtak.
1982-84
Haryana
150.
Dr. R.N. Singh
Prof, of Paediatrics
Dr. S.N. Medical College
Jodhpur.
1978 to date
Rajasthan
151.
Dr. Surinder Singh
Prof, of PSM
GGS Medical College
Faridkot.
1985 to date
Punjab
152.
Dr. Y.D. Singh
Reader, Deptt. of Paediatrics
BRD Medical College
Gorakhpur.
1988 to date
U.P.
153.
Dr. B.N. Sinha
Assoc. Prof, of Nutrition &
Dietetics, AIIH & PH
Calcutta.
1982 to date
West Bengal
154.
Dr. R.K.P. Sinha
Prof, of Paediatrics
Naland Medical College
Patna.
1988 to date
Bihar
155.
Dr. R.P. Sinha
Prof, of Paediatrics
Rajendra- Medical College
Ranchi.
1989-87
Bihar
156.
Dr. S.N. Sinha
Prof, of PSM
JN Medical College
Aligarh Muslim University
Aligarh.
1984 to date
U.P.
157.
Dr. Subhash C. Sood
Prof, of Paediatrics
Medical College
Rohtak.
1979-81
Haryana
158.
Dr. V.P. Sood
Prof, of PSM
Medical College
Rohtak.
1982-88
Haryana
XV
159.
Dr. D.K. Srinivasan
Prof, of PSM
JIPMER, Pondicherry.
1988 to date
Pondicherry
160.
Dr. B.C. Srivastav
Prof, of PSM
KG's Medical College
Lucknow.
1979-85
U.P.
161.
Dr. M.V.G. Subramaniyam
Prof, of Paediatrics
S.V. Medical College
Tirupati.
1984 to date
Andhra Pradesh
162.
Dr. P.K. Suneja
Paediatrician
Hindu Rao Hospital
Delhi.
1982-86
Delhi
163.
Dr. S.P. Suri
Prof, of PSM
Government Medical College
Jammu.
1981 to date
J&K
164.
Dr. Ramesh Thakur
Paediatrician, District Hospital
Mandi.
1980 to date
H.P.
165.
Dr. Kurian Thomas
Prof, of Paediatrics
Medical College
Calicut.
1981 to date
Kerala
166.
Dr. A.D. Tiwari
Reader in Paediatrics, Medical College
Rohtak.
1980 to date
Haryana
167.
Dr. V.N.S. Tomar
Prof, of PSM
SMS Medical College
Jaipur.
1980 to date
Rajasthan
168.
Dr. (Mrs.) S. Upadhyaya
Prof, of PSM
MGM Medical College
Indore.
1988 to date
Madhya Pradesh
169.
Dr. K.K. Vadhera
Prof, of PSM
Christian Medical College
Ludhiana.
1987 to date
Punjab
170
Dr. S.N. Vani
Prof, of Paediatrics
BJ Medical College
Ahmedabad.
1979 to date
Gujarat
XVI
171.
Dr. Y.L. Vasudeva
Prof, of PSM
Medical College
Rothak.
1979-83
Haryana
172.
Dr. M.K. Vasundhra
Prof, of PSM
Bangalore Medical College
Bangalore.
1980 to date
Karnataka
173.
Dr. B.N.S. Walia
Prof, of Paediatircs
PGIMER, Chandigarh.
1976-84
Chandigarh
174.
Dr. S.U. Warerkar
Prof, of PSM
BJ Medical College
Pune.
1979 to date
Maharashtra
175.
Dr. D.K. Yadav
Asstt. Prof, of PSM
IGIMS, Sheikhpura
Patna.
1985 to date
Bihar
176.
Dr. N.D. Yajnik
Prof. Of Obtet. & Gyn.
BJ Medical College
Ahmedabad.
1980 to date
Gujarat
177.
Dr. M. Zaheer
Prof, of PSM
JN Medical College
Aligarh Muslim University
Aligarh.
1977 to date
U.P.
1
Appendix II
List of MD Theses
Year
Title
Name of Consultant & Institution
1978
Job awareness and performance of
anganwadi workers and ANMs and impact
of ICDS on health status of children.
Dr. R.N. Singh, Dr. S.N. Medical College,
Jodpur, Rajasthan.
1978
An epidemiological survey to assess the
health and nutritional status of children
0-6 years in rural community of Kathura
Block District Rohtak.
Dr. Y.L. Vasudeva, Medical College, Rohtak,
Haryana.
1978
An epidemiological study of protein energy
malnutrition in the children aged below
6 years of a rural population of Uttar
Pradesh.
Dr. B.C. Srivastava, K.G.’s Medical College,
Lucknow, U.P.
1979
Morbidity study in pre-school children (3-6)
years of age (selected group) attending
Anganwadis in Chiri Community Develop
ment Area, District Rohtak, Haryana State.
Dr. Y.L. Vasudeva, Medical College, Rohtak,
Haryana.
1979
Study of dietary practices, attitude and
knowledge of pregnancy/lactating/mothers
and early childhood feeding/rearing as a
basis for sound nutrition education
programme.
Dr. Y.L. Vasudeva, Medical College, Rohtak,
Haryana.
1979
A study of ICDS in Vengara (Malappuram
District).
Dr. K.C. Rajagopalan, Institute of Child Health,
Calicut, Kerala.
1980
Assessment of nutritional status of pregnant
mothers in urban slums of Nagpur City
covered by ICDS Scheme.
Dr. D.L. Ingole, Govt. Medical College, Nagpur,
Maharashtra.
1980
Impact of ICDS scheme on health status
of pre-school children and health know
ledge of anganwadi workers in Garhi
block, Rajasthan.
Dr. B. Bhandari, R.N.T. Medical College, Udai
pur, Rajasthan.
1980
A study of ICDS Scheme in Calicut urban
area'.
Dr. K.C. Rajagopalan, Institute of Maternal &
Child Health, Calicut, Kerala.
1980
Dr. R.N. Singh, Dr. S.N. Medical College,
A study of child rearing practices under six
Jodhpur, Rajasthan.
years of age in~one of the tribal areas of
Rajasthan (Pindwara Block of Sirohi District).
)
XX
1983
Extent of physically handicapped children
(0-6 years) in selected rural community of
Kathura Block and their medico-social
problems.
Dr. Y.L. Vasudeva, Medical College,
Rohtak, Haryana-
1983
Comparative study of infant and early
childhood mortality in rural selected
blocks of Beri and Kalanaur.
Dr. Y.L. Vasudeva, Medical College,
Rohtak, Haryana.
1983
Mortality patterns in infants and
children below six years in urban slums
of Gorakhpur City under ICDS scheme.
Dr. G.P. Mathur, B.R. D. Medical College,
Gorakhpur, U.P.
1983
Monitoring of PEM (Grade-Ill & IV of
3 to 6 years old children) in slums of
Baroda Anganwadi over a period of
6 months.
Dr. U.J. Modi, Medical College and
S.S.C. Hospital, Vadodra, Gujarat.
1983
Some observations on vital statistics in
a captive population of urban slum of
Lucknow.
Dr.S. Thakur and Dr.P.N. Saxena,
K.G's. Medical College, Lucknow, U.P.
1984
Dr. B.C. Srivastava, K.G.'s Medical
Study of impact of six years exposure to
College, Lucknow, U.P.
ICDS (Integrated Child Development
Services) Scheme on growth, development
and health status of target children in Dalmau
project area (Uttar Pradesh).
1984
Surveillance of severely malnourished
(Grades-III & IV) under five children in urban
slums of Nahari-Ka-Naka (Jaipur).
Dr. V.N.S. Tomar, S.M.S. Medical College,
Jaipur, Rajasthan.
1984
Disability in ICDS.
Dr. G.P. Mathur, B.R.D. Medical College,
Gorakhpur, U.P.
1984
A study of community reaction to the
scheme df Integrated Child Development
Services and its package of services.
Dr. Sunder Lal, Medical College, Rohtak,
Haryana.
1984
Study of problems encountered by health
personnel (Front line workers and middle
level supervisors) in delivery of health
services in ICDS project area.
Dr. Vidya Prakash, Medical College,
Rohtak, Haryana.
1984
Health status of children (0-6 years) with
special reference to rearing practices and
immunisation status against EPI group of
diseases in Deeg rural ICDS block.
Dr. V.N.S. Tomar, S.M.S. Medical College,
Jaipur, Rajasthan.
1984
Monitoring of servere malnutrition
(Grades-III & IV) in Integrated Child
Development Services (ICDS) scheme
(A study of 150 cases with 8 months,
Dr.S.N. Vani, B.J. Medical College,
Ahmedabad, Gujarat.
follow-up).
XXI
Dr. S.N. Vani, B.J. Medical College,
Ahmedabad, Gujarat.
1984
Knowledge, beliefs and other aspects about
measles, and impact of measles vaccine in
ICDS and non-ICDS areas.
1984
Dr. V.B. Saxena, J.N.M. Medical College,
A study of the health and nutritional
Raipur, Madhya Pradesh.
status of children, 0 to 6 years’ age group,
in the tribal block of Tokapal, Bastar District,
Madhya Pradesh (India).
1984
A study on impact of ICDS scheme on
health and nutritional status of children
(1 to 5' years of age) of an urban slum of
Calcutta.
Dr. B.N. Sinha, All-India Institute of Hygiene
& Public Health, Calcutta, West Bengal.
1984
Effect of mass deworming on children
aged 2 to 5 years on nutritional and health
status.
Dr. K.G. Kamala, Institute of Child Health and
Hosital for Children, Egmore, Madras,
Tamil Nadu.
1985
Incidence of sicknesses in infants as
determined by anganwadi workers in
ICDS block Kathura.
Dr. Vidya Prakash Sood, Medical College,
Rohtak, Haryana.
1985
A study of abilities of primary health care
workers in using simple anthropometric
measurements for assessment of
nutritional status of pre-school children
(3-6 years) in block Kathura (Erstwhile).
Dr. Sunder Lal, Medical College, Rohtak,
Haryana.
1985
Assessment of nutiritional status of 0-6
years children in ICDS block Beri,
district Rohtak.
Dr. Vidya Prakash, Medical College,
Rohtak, Haryana.
1985
A study of morbidity pattern in pre-school
children (1-3 years) as determined by
anganwadi workers in Erstwhile block
Kathura.
Dr. Vidya Prakash, Medical College,
Rohtak, Haryana.
1985
A prospective annual study of births and
deaths in a defined urban slum population.
Dr. K.K. Kaul, Govt. Medical College,
Jabalpur, Madhya Pradesh.
1985
An assessment of functioning of 96
anganwadis in urban slum ICDS project of
Amritsar alongwith study of Knowledge,
attitude and practices of the functionaries.
Dr. V. Mohan, Medical College, Amritsar,
Punjab.
1985
A clinico-epidemiological study of
vitamin-A deficiency in pre- school
children in ICDS urban project, Gorakhpur.
Dr. G.P. Mathur, B.R.D. Medical College,
Gorakhpur, U.P.
1985
A follow-up study of pre-school children
P
Z.'. ~Medical College,
Dr. ''
M. Ketkar, M.G.M.
of Grades-IU & IV malnutrition in ICDS Urban Indore, Madhya Pradesh,
project Dhar (MP).
XXIV
1987
A study of adequacy, utilization and impact
of health inputs provided to anganwadi
workers in Integrated Child Development
Services.
Dr. P.V. Raval, Saurashtra University,
Gujarat.
1987
Feeding and weaning practices in infancy &
childhood.
Dr. M.K. Sainaba, Medical College, Calicut,
Kerala.
1987
Study of health status of beneficiaries and
health care provided under ICDS in slums
of Surat City, Gujarat.
Dr. N.R. Mehta, Govt. Medical College,
Surat, Gujarat.
1987
Study of drug exposure in infants and
children below six years and in pregnant
and lactating mothers in ICDS urban
projects, Gorakhpur.
Dr. G.P. Mathur, B.R.D. Medical College,
Gorakhpur, U.P.
1987
A longitudinal study of morbidity pattern
in pre-school children (0-6 years) of an
urban slum covered by an ICDS block.
Dr. S.N. Vani, B.J. Medical College,
Ahmedabad, Gujarat.
1988
A study of morbidity and mortality in 0-5
years age group with special reference to
child rearing practices in rural ICDS.
Dr. V.N.S. Tomar, S.M.S. Medical College,
Jaipur, Rajasthan.
1988
Study of better domicilliary management of
respiratory diseases in ICDS urban project
Grokhpur.
Dr. G.P. Mathur, G.S.V.M. Medical College,
Kanpur, U.P.
1988
A clinical study of morbidity and mortality
pattern of children under five years of age
in slum area of Jodhpur(Westem Rajasthan).
Dr. R.N. Singh, Dr. S.N. Medical College,
Jodhpur, Rajasthan.
1988
A clinical study of birth and mortality
pattern of children under five years of age
in rural area of Western Rajasthan Jodhpur.
Dr. R.N. Singh, Dr. S.N. Medical College,
Jodpur, Rajasthan.
1988
Growth monitroing of children (0-3 years) by Dr. Sunder Lal, Medical College, Rohtak,
village level workers in Kathura block.
Haryana.
Immunisation coverage evaluation under
Dr. V.P. Sood, Medical College, Rohtak,
universal immunisation programme in ICDS Haryana.
and non-ICDS areas undertaken by Medical
College, Rohtak.
1988
1988
A study'of weaning practices and subsequent Dr. Y.D. Singh, B.R.D. Medical College,
growth of infants exclusively breast fed for
Gorakhpur, U.P.
first six months of life.
1988
Impact of ICDS scheme on health and
nutritional status of rural children.
Dr. J.S. Anand, M.P. Shah Medical College,
Jamnagar, Gujarat.
1988
Health, nutritional and immunisation profile
Dr. J.S. Anand, M.P. Shah Medical College,
Jamnagar, Gujarat.
of pre-school children in urban ICDS block
(Jamnagar) - A study of 885 children.
XXV
1988
A study of weaning practices and subsequent Dr. G.P. Mathur, B.R.D. Medical College,
Gorakhpur, U.P.
growth of infants exclusively breast fed for
first six months of life.
1988
A study of child rearing practices in ICDS
blocks of Jaipur slums.
1988
Dr. M. Jayaram, K.C. General Hospital,
Health and nutritional status of children
aged 0-6 years, follpw-up study for one year Malleswaram, Bangalore, Karnataka.
during January-December, 1987, in Bangalore
under urban ICDS project: Its impact on the
pattern of birth and deaths in the area.
1988
Evaluation of knowledge, attitude and prac
tices of mothers on diarrhoeal disorders
and sugar and salt solution.
Dr. K.G. Kamala, Institute of Child
Health and Hospital for Children,
Egmore, Madras, Tamil Nadu.
1988
Evaluation of Universal Immunisation
Programme in ICDS area.
Dr. K.G. Kamala, Institute of Child Health
and Hospital for Children, Egmore, Madras,
Tamil Nadu.
1989
A study of nutritional status of the
children below six years of age in drought
affected ICDS project area Degana,
District Nagaur.
Dr. G.M. Mathur, J.L.N. Medical College,
Ajmer, Rajasthan.
1989
Dr. G.M. Mathur, J.L.N. Medical College,
An evaluation study of Integrated Child
Development Services(ICDS) scheme at ICDS Ajmer, Rajasthan,
block Degana district Nagaur (Rajasthan).
Dr. Usha Sharma, S.M.S. Medical College,
Jaipur, Rajasthan.
PAPERS PUBLISHED IN NATIONAL AND
INTERNATIONAL JOURNALS :
1.
Lal S. and Joshi V.S. Mid-course assessment of impact of ICDS programme on nutritional status
of preschool children in Kathura Block (Haryana). Indian J Prev Soc Med 1977, 8: 129-31.
2.
Walia B.N.S. Evaluation of knowledge and competence of Anganwadi workers as agents for health
care in rural population. Indian Paedtr 1978, 15: 797-801.
3.
Chopdar A. and Samal N.C. Nutritional status of preschool children at Subdega Tribal ICDS project
(Orissa). Indian Paedtr 1979, 46: 87-91.
4.
Chopdar A. ICDS - A new approach to MCH services - its activities in Orissa. Indian J Paedtr 1979,
46: 53-7.
5.
Indira Bai K., Raghavaprasad K., Srinath V., Kumar R. and Reddy C.O. Nutritional and
anthropometric profile of Primary school children in rural Andhra Pradesh (Kambadur ICDS Block).
Indian Paedtr 1979, 26: 1085-90.
6.
Lal S. Child bangle for screening of severely malnourished children. Indian J Prev Soc Med 1979
10: 165-7.
7.
Seth V., Sundaram K.R., Ghai O.P. and Gupta M. Profile of morbidity and nutrition status and their
effect on the growth potentials in preschool children in Delhi, India. Trop Paedtr Environ Child
Health. 1979, 23-29.
8.
Seth V., Sundaram K.R. and Gupta M. Growth reference standards for developing countries
(determination of criteria for India). J Trop Paedtr Environ Child Health 1979, 37-41.
9.
Lal S. Better Primary Health Care utlization through ICDS scheme in Haryana. Indian J Paedtr
1980, 47: 293-6.
10. Sundaram K.R., Seth V. and Gupta M. Law-like relationship between height and weight of infants
and preschool children. Indian J Med Res 1980, 71: 263-7.
11.
Udani R.H. Evaluation of knowledge and efficiency of Anganwadi workers. Indian J Paedtr 1980
47: 289-92.
12. Bhandari B. and Mandowara S.L. Nutritional and immunisation status of children in an ICDS block.
Indian Paedtr 1981, 18 : 187-91.
13. Bhandari B., Chhaparwal R. and Mandowara S.L. Outcome of children with severe grades of
protein energy malnutirion in an ICDS block. Indian J Paedtr 1981, 49: 289-92.
14. Lal S. Field assessment of impact of package of interventions on the incidence of severe
malnutrition. Indian J Prev Soc Med 1981, 12: 144-8.
15.
Lal S.'At risk factors in a rural area. Indian J Paedtr 1981, 48: 605-8.
16. Lal S. and Vasudeva Y.L. Anganwadi worker as PHC worker for vulnerable group in rural ICDS
project area. Indian J Comm Med 1982, 7: 19-24.
XXVII
17. Lal S. Monitoring of severley malnourished children and domicilliary management in rural settings
by Anganwadi workers under Intergrated Child Development Services Scheme. Indian Paedtr.
1982, 19: 409-13.
18. Patel R.B., Udani R.H. and Khanna S.A. Pediatric dermatoses and eradication in slums. Indian J.
Paedtr 1982, 49: 135-139.
19. Patel R.B. and Udani R.H. Impact of ICDS on preschoolers of urban slums. Indian J Paedtr 1982,
49: 215-8.
20
Rao P.S.S., Prasad K.R. and Indira Bai K. A study of leprosy among urban and rural school children
of Andhra Pradesh. Leprosy India 1982, 54: 100-9.
21. Bhatnagar S„ Dharamshaktu N.S., Sundaram K.R. and Seth V. Effect of food supplementation in
the last trimester of pregnancy and early post-natal period on maternal weight and infant growth.
Indian J Med Res 1983, 77: 366-72.
22. Kushwaha K.P., Mathur G.P., Mathur S. and Singh Y.D. Delivery of better maternal and child health
(MCH) services through continuous monitoring of grades III and IV malnourished children in ICDS
shceme. Indian Paedtr 1983, 20: 37-40.
23. Lal S. and Vasudeva Y.L. Integrated development and growth performance of under six in ICDS
project, Kathura. Indian J Comm Med 1983, 7: 20-4.
24. Mathur G.P., Gupta A.H., Mathur S., Singh Y.D. and Mishra P.C. Role of Anganwadi workers in
identification of handicapped children and youth in the community. Rehabilitation in Asia 1983,
24: 18-24.
25.
Udani R.H. and Patel R.B. Impact of knowledge of anganwadi workers on slum community. Indian
J Paedtr 1983, 50: 157-9.
26. Vasundhara M.K. and Srinivasan B.S. Integrated Child Development Services: Impact on fertility
regulation. Indian J Family Welfare 1983-84, 30: 3-7.
27. Basu M:, Moitra K. and Gupta S.S. A few observations on Measels Immunisaion Programme. Indian
J Public Health 1984, 28: 159-62.
28.
Gupta S.B., Srivastava B.C., Bhuahan V. and Sharma P. Impact of ICDS in U.P. Indian J Med
Res 1984, 79: 363-72.
29. Indira Bai K., Prasad R. and Srinath V. Assement of food and nutrient intake of rural children. J
Trap Paedtr 1984, 30: 4-6.
30. Kant L., Gupta A. and Mehta S.P. Assessment of Anganwadi workers. Indian Paedtr 1984, 21:
807-9.
31. Kant L., Gupta A. and Mehta S.P. Profiles of Anganwadi workers and their knowledge about ICDS.
Indian J Paedtr 1984, 51: 401-2.
32. Rao M.N. and Hamath. Domicilliary management of severe PEM. Indian Paedtr 1984, 21: 38994.
33. Bhandari B. and Mandowara S.L. Evaluation of delivery of Nutrition and Health Services in an ICDS
block. Indian Paedtr 1985, 22: 579-82.
XXVIII
34. Lal S. Early childhood mortality. Indian J Comm Med 1985, 10: 23-8.
35. Lal S. Impetus to Immunisation Programme in ICDS Project. Indian J Comm Med 1985 10-1518.
36. Lal S. Pattern of community development in child development. Indian J Hosp Admn 1985 21'119-40.
37. Raj B., Verma M., Sharma S., Joshi P.L. and Bhattacharya M. A study on protein-energy
malnutrition in children below six years of age in rural areas of Allahabad. Indian J Preu Soc Med
1985, 16: 39-44.
38.
Saxena V.B. Some lessons in health management revealed during an epidemiological investigation
of "NETTUR POTTA" epidemic in Bastar District during 1984. Indian J Preu Soc Med 1985
16: 86-9.
39. Chaturvedi S., Srivastava B.C., Prasad M., Nirupama S. and Rastogi A.K. Impact of ICDS scheme
on mental development of children. A pilot study. Indian J Clin Psychol 1986, 13: 161-4.
40. Kushwaha K.P., Mathur G.P., Mathur S., Singh Y.D. and Sati T.R. Superstitious therapy during
illnesses of preschool children. Indian Paedtr 1986, 27: 163-8.
41. Kushwaha K.P., Mathur G.P. and Mathur S. Impact of health and nutrition education of mothers
in rearing of children. Rehabilitation in Asia 1986, 27: 12-9.
42. Lal S. and Goomer R. Identification of simple indicators of nutrition surveillance for Primary Health
Care workers in field situations. Indian J Comm Med 1986, 11: 143-9.
43. Mathur G.P., Kuahwaha K.P. andLeleS.N. Childhood disability - A challenge to the nation. Indian
Paedtr. 1986, 23: 663-7.
44. Prabhakara G.N., AswathP.V., Shivaram C. and Viswanath A.N. A study on the food consumption
pattern in slums of Bangalore. Indian J Comm Med 1986, 11: 163-72.
45
Singhal P.K., Mathur G.P., Mathur S. and Singh Y.D. Perinatal mortality: In ICDS urban slum area.
Indian Paedtr 1986, 23: 339-43.
46. Singhal P.K., Mathur G.P., Mathur S. and Singh Y.D. Mortality patterns in under six children in
ICDS urban slums. Indian Paedtr 1986, 23: 617-22.
47. Somasundaram C., Mehta N.R. and Shah D.A. Impact of Integrated Child Development Services
on demographic and vital statistics of a tribal block in South Gujarat. Indian J Comm Health 1986
2: 14-20.
48. Thora S/, Awadhiya S., Chansoriya M. and Kaul K.K. Perinatal and infant mortality in urban slums
under ICDS scheme. Indian Paedtr 1986, 23: 595-8.
49. Tidke R.W., Joshi U. and Patel R.B. Paralytic poliomyelitis in slums of Bombay. Indian J Paedtr
1986, 53: 109-13.
50. Verma D.R. arid Saxena V.B. A comparative study of child development in tribal and non-tribal
populations in Kasdol block of Raipur district in Madhya Pradesh. Indian J Preu Soc Med 1986
17: 31-7.
XXIX
51. Chaturvedi S., Srivastava B.C., Singh J.V. and Prasad M. Impact of six years exposure to ICDS
shceme on psycho-social development. Indian Paedtr 1987, 24: 153-60.
52. Chaturvedi S., Srivastava B.C. and Singh J.V. Impact of total six years exposure to Integrated Child
Development Services on growth and health status of target children in Dalmau Project area (Uttar
Pradesh). Indian J Med Res 1987, 86: 766-74.
53. Dattal M.S., Behl L„ Gupta P., Gupta B.P. and Sharma S.L. Immunisation status of infants and
children in ICDS Project in Tribal area of Himachal Pradesh. J Indian Med Assoc. 1987,85:2958.
54. Kushwaha K.P., Mathur G.P. and Om Prakash. Infant feeding practices of peri-urban areas of
Gorakhpur. Indian Paedtr 1987, 24: 899-901.
55. PrabhakaraG.N., AswathP.V., ShivaramC. andViswanath A.N. Infant feeding patterns in slums
of Bangalore. Indian Paedtr 1987, 24: 895-8.
56. Sharma S.K., Mathur G.P. Mathur S., Singh Y.D., Kushwaha K.P., Prasad V.N., Yadav N.R. and
Saxena S.P. Xerophthalmia in preschool children. Indian Paedtr 1987, 24: 645-50.
57. Singhal P.K., Mathur G.P. and Mathur S. Morbidity in preschool children in India. J Trap Paedtr.
1987, 33 : 349.
58. Bhandari B., Mandowara S.L., Aggarwal H.R. and Jagdev D.K. High infant mortality in rural areas
of Rajasthan: An analysis based on prospective study. Indian Paedtr. 1988, 25: 510-4.
59. Singh S., Singh T„ Goel R.K.D., Singh J., Oberoi S.K. and Mittal S. A study of 370 live births in
a rural area of Punjab. Indian J Comm Med 1988, 13: 15-22.
PUBLICATIONS IN STATE JOURNALS
1.
R'and Goel S- Referra! system in health component of ICDS. Haryana Health J1979,10:
2. Lal S. and Vasudeva Y,L. MCH services in PHC Kathura quantified before and after ICDS Scheme.
Haryana Health J 1979, 10:
3. Lal S. and Vasudeva Y.L. Emerging referral system and pattern of medical and health care at ICDS
block Kathura at different levels of Primary Health Centre with special rference to MCH services
in relation to AW and sub-centres. Haryana Children News Bulletin Dec. 1979, 4 & 5:
4. Vasudeva Y L. and Lal S. Tuning and transforming of Auxiliary Nurse Midwife of Kathura for new
philosophy of work as given out by I.C.D.S. scheme. Haryana Health J 1979,10: 1-5.
5. Vasudeva Y.L. Infrastructure for health and nutrition education in ICDS scheme. Haryana Health
J 1979, 10: 16-9.
6. Verma K. and Chawla S. ANM's home visits evolved in ICDS. Haryana Health J 1979, 10: 235.
7. Vasudeva Y.L. Training of health manpower for primary health care—some experiences.
Appropriate Tech, for Primary Health. Care 1981, PP. 112-121.
8. Prabhakara G.N., Aswath P.V., Shivaram C. and Viswanath A.N. A study on the health profile of
tihe^beneficiaries under ICDS scheme in slums of Bangalore. Bangalore University, Bangalore,
9. Udani R.H., Patel R.B., Tapaswi A.M., Rathi V.T., Mehkarkar P.K. and Shah P.M. Morbidity
and nutritional status of preschoolers in Bombay slums. Paedtr Clinic India July, 1982, 22-6.
10. Gupta S.B., Srivastava B.C., Sharma P. and Bhushan V. Impact of ICDS scheme—Prevalence of
malnutrition and morbidity. Proc XIII Natl. Conf. Indian Assoc, of P.S.M., Jan. 3-5, 1983.
11. Joshi P.L., Bhattacharya M.and Raj B. Pattern of breast feeding in a rural community. Proceedings
XIII Natl. Conf. Indian Assoc, of P.S.M., Jan. 3-5, 1983.
12. Karandikar, V.N. ICDS—Pune urban block. Med J W. India 1983, 1: 11.
13. Ketkar, M. A survey of an ICDS block. Proc XIII Natl. Conf. Ind. Assoc, of P.S.M. Jan. 3-5,1983.
14. Khobragade M.D., Fulare M.B., Deotale P.G. and Majumdar R.D. Study of Intestinal Parasitic
Infestation in a slum population of under fifteen years. Proc XIII Natl. Conf. Indian Assoc of
P.S.M., Jan. 3-5, 1983.
15. Lal S. ICDS and infant mortality in rural area. Proc XIII Natl Conf Indian Assocl of P.S.M,, Jan.
3-5, 1983.
16. Mathur G.P., Gupta A.H., Mathur S„ Singh Y.D., Mishra P.C. and Rastogi C.K. Detection of
mentally retarded children and problems of their rehabilitation in an urban slum area. Federation
for the Welfare of the Mentally Retarded (India) News Letter Vol IX, Issue 3, March, 1983.
XXXI
17. Meshack F.R. ICDS in Andamans. Swasth Hind, 1983.
18. Mukhopadhyay S.P. Delivery of MCH services. Indian Paedtr News Letter 1983, 20: 462.
19. Rao Y.S. An assessment of functioning of ICDS in Adilabad in A.P. A.P.J. Comm. Med. Vol IV,
Dec.
20. Shah D.N. Felt need, impact and evaluation of ICDS programme in a tribal block. Ann Natl Med.
Sci (India) 1983, 19: 35-6.0.
21. Srivastava B.C. Impact of ICDS Scheme—Prevention of malnutrition and morbidity. Proceedings
of IAPSM, Lucknow, U.P., 1983.
22. Tomar V.N.S., Pokarna K.L., Kashyap A., Sen V. and Joshi S. Health profile of children (0-6) in
ICDS block, Gangapur City. Proc XIII Natl. Conf. Indian Assoc, of PSM, Jan. 3-5, 1983.
23. Vasundhara M.K, A study of diarrhoeal disorders among 374 children in 7 Anganwadi areas. Proc
of IAPSM, Lucknow, U.P., 1983.
24. Chandra S„ Krishna G. and Srivastava V.K. Health status of preschool children in rural community.
Surasth Hind,1984, 28: 165.
25. Khanna S„ Patel R.B. and Udani R. A comparative study of effect of socio-economic status and
mothers education on children care and feeding practice in normal malnourished infants in urban
slums of Bombay City. Souvenir Nepas J 1984, 3: 53-60.
26. Natarajan, T. Impact of ICDS inTamil Nadu. lAP-Bull Salem, May, 1984.
27. Shee, B.K. Interlacing of ICDS in health care . Bull Comm Med Vol II, April, 1984.
28. Vasundhara M.K. A study of AWWs regarding their role in ICDS. Swasth Hindi 1984.
29. Problems in rehabilitation of mentally retarded children. NIPCCD News Letter Vol. 6, No. 3,NovDec., 1985.
30. Shee B.K. Integrated Child Development Services—Organisational aspects of Primary Health
Centres in India. Booklet—Medical College,Cuttack, 1985.
31. Subramanayam G., Raghunatha R.B., Narasimha, R.S. and Sreehari R.B. Morbidity pattern
among children (0-3 years) in the slum areas of Vijayawada. Sidhartha Med. J. 1985, 2: 1-9.
32. Thayar T.P. and Chandra P. Experiences in ICDS project IX Madras (Urban) Southern Scientists
Assoc. Proceedings of Conference, Sept., 1985.
33. Aswath P. V., Shivaram C. and Viswanath A. N. A study on some of the characteristics of the children
beneficiaries under ICDS in slums of Bangalore. Karnataka J Comm Health, 1986, 2: 41-4,
34. Bhandari B., and Mandowara S.L. ICDS: Realities and course of desired changes. Editorial Indian
Indian Paedtrl986, 23: 575- 8,
35. Jayam, S. ICDS past, present and future. State IAP Bull 1986.
36. Mehendale S.M., Karandikar V.N. and Natu M. Role of ICDS in the delivery of certain MCH
services—A comparative study in the ICDS and non-ICDS areas. Publ. NIPCCD, PP. 342-344,
1986.
XXXII
37. Rao, Y.S., Subramanayam, G. and Raghunanda, R.B. Nutritional status of the under privileged
children of Vijayawada. Sidhartha Med J. 1986, 5: 13-20.
38. Seth V., Sundaram K.R. and Gupta M. Growth norms for a developing country—Construction of
normal zone. In researches in child development—a book of reading compiled by National Council
of Res. in Edn. and Trg., P. 140, 1986.
39. Zaheer M. The impact of ICDS on the intellectual status of children. Res. Abst. ICDS, NIPCCD
1986.
40. Zaheer, M. The impact of ICDS on the nutritional status of children. Res. Abst. ICDS, NIPCCD,
1986.
41. Zaheer, M. Acceptability and impact of various components of ICDS scheme in different socio
economic groups. Res. Abst. ICDS, NIPCCD, 1986.'
42. Ahmed, M. Monitoring of health aspects for a community children's programme in India. The Club
of KOS for Health Care, U.S.A., 9: 3-4, 1987.
43. Mehendale S.M., Karandikar V.N. and-Natu M. A follow-up of severely malnourished children in
selected Anganwadis of Pune urban ICDS project. Indian Med Gazette, CXXI: 196-200, 1987.
44. Phalgune, D. and Natu, M. Urban project, Pune—An evaluation study. Med J Western India 1537-42, 1987.
45. Yaima, E., Indibor, Y., Manihar, Y., Achouba Th., Gambhir T. and Ibungomcha, N. Nutritional and
Immunisation status of rural preschool children of Manipur: A study of an ICDS project area. J Med.
Society, RMC, Imphal, 1987.
46. Mathur G.P., Singh Y.D., Kushwaha K.P. and Prakash O. Drug exposure in children below six
years in Peri-urban areas. J. U.P. Chapter IAP 1988, 2: 16-9.
47. Prabhakara G.N., Aswath P.V., Shivaram C. and Vishwanath A.N. Distribution of grades of
malnutrition among child beneficiaries under ICDS scheme in slums of Bangalore. Karnataka J
Comm Health. Vol. IV, 1988.
48. Sood V.P., Gaur, D.R., Malik J. and Sood A.K. The consumption of the supplementary foods
distributed by the Anganwadis by the 6 months to 24 months beneficiaries—a study in the ICDS
blocks of Beri and Kathura, Rohtak. Haryana Med J 1988, 8 : 259.
49. Sood V.P., Gaur D.R. and Sood A.K. Increasing immunization coverage in the rural areas.
Haryana Med JI 988, 8 : 307.
50. Subramanayam G., Rao Y.S., Rama, K.D. and Raghunanda R.B. A profile of childhood mortality
in slums of Vijayawada. Sidhartha Med College J 1988, 5: 8-15.
ICDS PAPERS PRESENTED/READ IN
THE MEETINGS/CONFERENCES
1. Patowary, A.C. Delivery of Health Services in ICDS: Operational problems and difficulties. ICDS
review meeting at Gauhati, 1980.
2. Kushwaha, K.P., Mathur,G.P., Mathur, S. and Singh, Y.D. Continuous monitoring of grade III and
grade IV malnutrition in ICDS Urban Project, Gorakhpur. IV Annual Conference,'U.P. Chapter of
IAP, 1981.
3. Kushwaha, K.P., Sinha, V.K., Singh, Y.D., Mathur, S., Mathur, G.P. and Sati, T.R. Impact of health
delivery system in ICDS urban project, Gorakhpur. XVIII National Conference of IAP, Hyderabad,
1981.
4. Vasudeva, Y.L. Community involvement and community participation in health care delivery and
end of line health care delivery through health centres (Indian Scene). Third International Congress
of the World Federation of Public Health Association, Geneva and 25th Annual Conferehce of the
Indian Public Health Association and XI National Conference IAPSM, Calcutta, 23-26, 1981.
5. Patowary, A.C. Comparative evaluation of the nutritional status of the children in the Boko ICDS
block, Assam. ICDS Annual Convention, Feb. 4-6, 1982.
%
6. Ibetombi, D.L. and Singh,E.Y. Study of two ICDS projects in Manipur. ICDS Annual Conference,
1983.
7. Kushwaha K.P., Mathur, G.P., Mathur, S., Singh, Y.D. and Sati, T.R. Impact of health and nutrition
education of mothers in rearing of children. VI Annual Conference of U.P. Chapter of IAP, Agra,
1984.
8. Lal, S. Innovative approaches in immunization programmes. National Seminar on Improving
Immunization coverage in ICDS projects—A report. NIPCCD, New Delhi, July 18-19, 1984.
9. Mangal, D.K., Jaimini, B.K.,Gupta, S.D., Tomar, V.N.S. and Sharma, R. Use of field workers disc
in detection of PEM in a rural ICDS block. XIV IAPSM Conference, Jaipur, Rajasthan, Feb. 16-18,
1984.
10. Mathur, G.P. Childhood disability—Needs your sincere attention. Souvenir, VI Annual Conf. U.P.
Chapter of IAP, Agra, 1984.
11. Pansari, K., Bhupatani,T. and Yajnik, N.D. Pattern of weight gain in norml pregnancy and its
usefulness for monitoring antenatal patients. National Neotology Forum, Sth Annual Convention,
Oct. 1984.
12. Singhal, P.K., Mathur, G.P., Mathur, S., Singh, Y.D. and Kushwaha, K.P. Mortality patterns in
infants and children below six years in ICDS urban slum area. XXI Annual Conference IAP, Bombay,
1984.
13. Tomar, V.N.S. and Manohar, R.K. Surveillance of severely malnourished under five children in
urban slums of Nahar-Ka-Naka (Jaipur). XIV IAPSM Conference at Jaipur, Rajasthan, Feb. 16-18,
1984.
XXXIV
14. Yajnik, N.D. High risk pregnancy. ICDS Annual Convention, Nov. 1984.
15. Aswath, P.V., Prabhakara G.N., Vishwanath, A.N. and Shivaram, C. A study on the prevalence
of intestinal parasitism among children beneficiaries under ICDS scheme in slums of Bangalore. IX
ICDS Annual Confereence, 1985.
16. Chandra, P. Strengthening ICDS by Training Municipal Corporation Health Personnel. Annual
Convention of Indian Association of Paedtr., Bombay, Feb., 1985.
17. Lal, S. Community support to health and family welfare programmes in rural areas of Haryana—
An experience. Workshop on Community Participation, NIHFW, New Delhi, May, 1985.
18. Lal, S. Birth weights and survival during infancy focussing prevention of low birth weight. National
Seminar on Reducing Incidence of Low Birth Weight Babies in India, Dec. 17-19,1985—A Report
NIPCCD PP. 42-53.
19. Mohan, V., Rathore, M.S. and Arora, P.P. A baseline survey of ICDS block Nadala, District
Kapurthala, Punjab. IAPSM National Conference, Srinagar, Oct. 14-16, 1985.
20. Prabhakara, G.N. and Viswanath, A.N. Fertility and mortality trends in selected Anganwadis of
ICDS Scheme. IX ICDS Annual Conference, 1985.
21. Prasad, K.R.Study of infant mortality in Satyavedu (Rural) Block. ICDS Annual Convention, New
Delhi, Feb. 14, 1985.
22. Shah, D.N., Baxi, R.K., Rajagopal, T. and Durvasula, R.S. Delivery of Health Care through ICDS—
Need, for interprevention through the Risk Approach. Decade of ICDS Research by NIPCCD—
Vigyan Bhavan, New Delhi, Jan. 25-27, 1985.
23. Tomar, V.N.S. Report on physical handicapped children (0-14 years) in U.C.D. project area (Urban
ICDS slum, Jaipur). A report in collaboration with UNICEF and Deptt. of PSM and SMS Med.
College, Jaipur, 1985.
24. Chandra, P. Role of Paediatrician in Primary Health Care. XVIII International Congress of Paedtr.
Honolulu, July 7-12, 1986.
25. Lal, S. Health and nutrition education inputs of personnel, materials, techniques and methods at
ICDS block Kathura (Haryana). National Conf, on Res. on ICDS by NIPCCD, Vigyan Bhavan, New
Delhi, Feb. 25-27, 1986.
Learning of epidemiology in the settings of Integrated Child Development Services.
International Epidemiological Association Regional Scientific meeting, Jhansi, Feb. 25-28, 1986.
26. Lal, S.
27. Lal, S. Surveillance of acute diarrhoeal diseases at village level for effective home management of
diarrhoea. International Epidemiological Association Regional Science meeting, Jhansi, Feb. 2528, 1986.
28. Lal, S. and Raj Wati. Non-formal pre-school education—An effort to enhance school enrolment.
National Conf, on Res. in ICDS, New Delhi, Feb. 25-27, 1986.
29. Lele, S.N., Mathur, G.P., Mathur, S., Singh Y.D. and Kushwaha, K.P. Role of Anganwadi workers
in early detection of disability. XXIII National Conference of IAP, New Delhi, 1986.
XXXV
30. Mohan, V. and Cooner,P.P.S. An assessment of functioning of 96 anganwadis in the urban slum
ICDS project of Amritsar, alongwith study of knowledge, attitude and practices of the functionaries.
ICDS Annual Convention, 1986.
31. Patowary, A.C. and Sarna, R. The impact of health input on the efficiency and the working of
Anganwadi workers in ICDS scheme. ICDS National Convention, 1986.
32. Saxena, V.B. and Verma, D.R. Child development in tribal and non-tribal communities of Kasdol
block in Raipur District, Madhya Pradesh. ICDS National Convention, Oct. 3, 1986.
33. Singh, R.N. An experience of ICDS scheme in Rajasthan, Souv. Indian Acad. Paedtr., Rajasthan,
Kota, 1986.
34. Suresh, S. and Rajagopal, T. Impact of health education on immunization strategy. National Conf,
on Res. in ICDS by NIPCCD, New Delhi, Feb. 25-27, 1986.
35. Vasundhara, M.K. and Prabhakara, G.N. Evaluation of the ICDS training programme for M.Os. X
Annual Conference of ICDS, 1986.
36. Krishnan, U.S., Gopala, A.V. and Sainaba, M.K. A study of vital events in a rural community of
Kerala. 24th National Conference of IAP, Madras, 1987.
37. Krishna, G., Singh, G. and Sharma, S.N. An epidemiological study of impact of interventions on
the health of pre-school children in a rural area of Kanpur. XI Scientific Meeting of the International
Epidemiological Association, Helsinki, Finland, Aug. 8-13, 1987.
38. Anjaneyulu, G. Comprehensive study of immunisation status in Urban and Rural ICDS projects.
XVIII Annual Conference, IAPSM, Gwalior, M.P. December 29-31, 1988.
39. Chandra, P., Karunakaran, G. and Elangovan, P. Integration of nutrition with health and welfare
programmes. Asian Congress of Paedtr., Tokyo, 1988.
40. Chandra, R., Srivastava, V.K. and Nirupam, S. Some health effects following laparoscopic
Sterilization. XVIII Annual Conference, IAPSM, Gwalior, M.P. December 29-31, 1988.
41. Chaturvedi, S., Singh, J.V., Prasad, M. and Srivastava, B.C. Mother's attitude towards child's health,
education and play in ICDS and non-ICDS areas. XVIII Annual Conference, IAPSM, Gwalior, M.P.
December 29-31, 1988.
42. Kashyap, A., Chaturvedi, S.K. and Tomar, V.N.S. Epidemiological study of physically handicapped
children 0-15 years in urban slums of ICDS block. XVIII Annual Conference, IAPSM, Gwalior, M.P.
December 29-31, 1988.
43. Ketkar, M. and Kulkarni, A.S. The drought survey in Jhabua District under ICDS. XVIII Annual
Conference, IAPSM, Gwalior, M.P. December 29-31, 1988.
44. Krishna, G., Srivastava, J.P., Gupta, S.C. and Rasania, S. Assessment of utilization of ICDS pack
age in Rural Kanpur. XVIII Annual Conference, IAPSM, Gwalior, M.P. December 29-31, 1988.
45. Mohan, V. Evaluation of vaccination coverage in ICDS and non-ICDS areas of urban slums of
Amritsar. XVIII Annual Conference, IAPSM, Gwalior, M.P. December 29-31, 1988.
XXXVI
46. Misra, P.K. and Thakur, S. Nutritional and health status of female child. Symposium on the Girl
child organised by UNICEF, Lucknow, April 29-30, 1988.
47. 'Prasad, K.R. and Rao, R.V.P. Effect of therapeutic nutrition in management of PEM in an ICDS
block. VII Annual Conf.A.P. Chapter of Indian Association on PSM, Hyderabad, Feb. 1988.
48. Prasad, K.R., Rao, U.N. and Rao, K.V.P. A comparative study of infant and child mortality in
Satyavedu ICDS project. VII Annual Conf. A.P. Chapter of Indian Association of PSM, Hyderabad,
Feb. 1988.
49. Singh, S. Comparative study of immunization coverage in ICDS and non-ICDS blocks. XVIII Annual
Conference, IAPSM, Gwalior, M.P. December 29-31, 1988.
50. Subodh, M., Gaur, A.K., Verma, Y.S.,Sule,D., Dixit,S. and Govila, A.K. Breast feeding and
weaning practices in lactating mothers and the nutritional status of their children in the tribal area
of ICDS block, district Morena (M.P.) XVIII Annual Conference, IAPSM, Gwalior, M.P. December
29-31, 1988.
51. Suri, S.P., Singh, B., Jamwal, D.S., Singh, G., Mengi, V. and Singh, S.D. Birth and death study
in ICDS block Billawar (J & K). XVIII Annual Conference, IAPSM, Gwalior, M.P. December 29-31,
1988.
52. Tripathy, R.M., Das, B.C. and Mahapatra, N.P. A study on acceptance and non-acceptance of
Anganwadi services by the beneficiaries (mothers). XVIII Annual Conference, IAPSM, Gwalior,
M.P. December 29-31, 1988.
53. Vadhera, K.K. Integrated Child Development Services (ICDS). A study of some particular aspects
of the system pertaining to children's well being. XVIII Annual Conference, IAPSM, Gwalior, M.P.
December 29-31, 1988.
PUBLICATIONS BY ICDS CENTRAL CELL AT A.I.I.M.S., NEW DELHI
PAPERS PUBLISHED IN NATIONAL AND INTERNATIONAL JOURNALS :
1.
Tandon B.N. et al. Integrated Child Development Services— A coordinated approach to children's
health in India. Lancet-, 1981,1: 650-653.
2.
Tandon B.N., Ramachandran K. and Bhatnagar S. Integrated Child Development Services in India
: Objectives, organistation and baseline surveys of the project population. Indian J Med Res 1981,
73 : 374-384.
3.
Tandon B.N., Ramchandran K. and Bhatnagar S. Integrated Child Development Services in India:
Evaluation of the delivery of nutrition and health services and the effect on the nutritional status of
the children. Indian J Med Res 1981, 73: 385-394.
4.
Tandon B.N. et al. A coordinated approach to children's health in India, progress report of the five
years of ICDS (1975-80). Lancet; 1983, 1: 109-111.
5.
Tandon B.N., Sahai A. and Vardhan V.A. Impact of Integrated Child Development Services on
infant mortality rate in India. Lancet; 1984, ii:157.
6.
Tandon B.N. Management of severely malnourished children by village workers in ICDS in India.
J Trap Paedtr 1984, 30: 3-74.
7.
Tandon B.N. and Sahai A. Medical schools can help and learn from health care development. World
Health Forum 1985, 6: 3.18-319.
8.
Balaji L.N. and Arya S. Study of physical and psycho-social development of preschool children. J.
Trap Paedtr 1987, 33: 107-109.
9.
Tandon B.N., Sahai A., Balaji L.N. and Vardhan V.A. Morbidity pattern and cause specific mortality
during infancy in ICDS projects. J Trap Paedtr 1987, 33: 190-193.
10. Tandon B.N. and Sahai A. Immunisation in India: contribution of Intergated Child Development
Services Scheme to Expanded Programme of Immunisation. J Trap Paedtr 1988, 34: 301-304.
11. Tandon B.N. Nutritional intervention through Primary Health Care. Impact of ICDS Projects in
India. Bull WHO (1989), 67: 77-80.
PUBLICATIONS IN STATE JOURNALS:
1.
Tandon B.N. National programmes for health care of the children. Ann Natl Acad Med Sci, 1979,
15 : 206-210.
2.
Tandon B.N. Integrated Child Development Services (ICDS) in India. Food and Nutr Bull 1983,
5: 1-4
3.
Tandon B.N. ICDS system - A model for human development. Sivasth Hind 1984, 28: 56 : 58.
4.
Tandon B.N. et al. Evaluation of health component of ICDS. ICCW News Bulletin, Aug-Sept.
1984, P.24-27.
5.
Tandon B.N. Integrated Child Development Services: Progress report upto 1983. Swasth Hind,
Jan. 1985.
6.
Tandon B.N. Participation of Medical Colleges in National Health Programmes - An experiment
in India. NFI Bull, July, 1986, 7: 1-3.
7.
Vasudeva Y.L. Integrated child Development Services and Immunization Programme. Swasth
Hind, March-April, 1987, .87-90.
8.
Tandon B.N. Nutrition in Primary Health Care - How to integrate nutiriton components into
Primary Health Care and Problems of implementation. Contributed for First National "Workshop
Manual" Diet, Digestion and Diabetes, Madras, 1987.
9.
Tandon B.N. Integated Child Development Services (ICDS). Souvnr. Annl. Function Allahabad
Branch of P.M.S. Assoc., U.P., Jan., 1988.
PAPERS PRESENTED/READ IN THE MEETINGS/CONFERENCES:
1.
Tandon B.N. Evaluation of Health Care Planning with special reference to Integrated Child
Development Services. Proceedings National Conference on Evaluation of Primary Health Care
Programmes ICMR; April 1980, 321-330.
2.
Tandon B.N. ICDS - Consultants Training and Orientation, Monitoring and Periodic Evalutation of
Health and Nutrition parameters. NIPCCD, New Delhi, 23-24 Aug.1980.
3.
Tandon B.N. Immunization in ICDS Project. National Seminar on "Improving Immunisation
Coverage in ICDS Projects". July 18, 1984.
4.
Tandon B.N. Impact of ICDS on the child health in India, Srinagar, Oct.28-30, 1985.
5.
Tandon B.N. Role of Academicians in National Health Programme. Central Council of Health,
Ministry of Health & Family Welfare, Govt, of India, Sept. 1986.
6.
Tandon B.N. ICDS and Family Welfare. Coordinating Health and Family Planning Infrastructure
with ICDS functionaries - Issues, operational mechanisms and perspectives. National Seminar on
ICDS and Family Welfare at NIPCCD, New Delhi, Oct.21-22, 1986.
7.
Tandon B.N. ICDS and immunisation. DIP meeting, Ministry of Health & Family Welfare, Govt,
of India, May 14, 1987.
8.
Tandon B.N. Monitoring of Social Development Programmes. Refresher Trg. Course on Women
and Child Development, NIPCCD, Nov. 21, 1987.
9.
Tandon B.N. Monitoring of Health and Nutrition in ICDS - An Illustration. IAS Refresher Course,
NIPCCD, Jan.4-9, 1988.
Appendix-Ill
TABLE 1. DISTRIBUTION OF ICDS PROJECTS AND CONSULTANTS FROM
________ 1976 TO MARCH 1989
Year
Number of
1976- 77
1977- 78
1978- 79
1979- 80
1980- 81
1981- 82
1982-83
1983- 84
1984- 85
1985- 86
1986- 87
1987- 88
1988- 89
Projects
' 33
45
116
179
246
365
722
929
1117
1318
1612
1738
1952
Consultants
27
27
28
104
98
98
103
104
113
115
109
99
103
TABLE 2. ANNUAL SURVEYS BY CONSULTANTS : FROM 1976-77 TO
1987-88
Year of
Annual survey___________
survey
No. alloted
No. Surveyed
1976- 1977
1977- 1978
1978- 1979
1979- 1980
1980- 1981
1981- 1982
1982- 1983
1983- 1984
1984- 1985
1985- 1986
1986- 1987
1987- 1988
Figures in parentheses are percentages
* Involvement of district level health staff.
29
27
26
89
83
60
72
76
92
64
22
84
27(93.1)
26(96.3)
16(61.5)
60(67.4)*
56(67.5)’
56(93.3)
65(90.3)
72(94.7)
87(94.6)
62(96.9)
20(90.9)
80(95.2)
XLI
TABLE 3. DISTRIBUTION OF M.D. THESES SINCE 1976 TO MARCH, 1989 ON
ICDS SUBJECTS
Year
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
Number of MD Theses
3
3
4
11
8
11
11
9
16
15
15
2
(March)
108
Total:
TABLE 4. ANTENATAL CARE AND TETANUS TOXOID IMMUNISATION IN
MORE THAN 3 YEARS OLD ICDS PROJECTS
Antenatal check up
by trained personnel
Type of
project
No. of
projects
Sample
size
Percentage
covered
Rural + Tribal
Urban
All
33
10
43
1766
648
2414
47.2
60.6
50.8
Tetanus toxoid
(2 doses)
Sample
size
919
341
1260
Percentage
received
37.6
49.8
40.9
XLIV
TABLE 10. DELIVERY OF SERVICES IN ICDS (EXPERIMENTAL GROUP) AND
NON-ICDS POPULATION (CONTROL GROUP)
Type of
project
ICDS :
Rural
Urban
Total
Non-ICDS :
Rural
Urban
Total
Home delivery
Delivery by trained personnels
Sample size
Number covered
Number covered
1592
352
1944
1532 (96.2)
322 (91.5)
1854 (95.4)
1260 (79.1)
224 (63.6)
1484 (76.3)
942
355
1297
882 (93.6)
335 (94.4)
509 (54.0)
132 (37.2)
641 (49.4)
1217 (93.8)
Figures is parentheses are percentages
TABLE 11 < COVERAGE OF POSTNATAL SERVICES TO LACTATING MOTHERS
IN CONTROL (BASELINE) AND EXPERIMENTAL (OPERATIONAL
ICDS) GROUPS
Services
Control population
> 3 years old projects
Trained personnel
29.9
29.3
Total receipt
48.2
49.7
Nutrition and health education
27.6
44.6
Family welfare advice
30.0
43.6
Eligible receipt
15.4
29.4
Total receipt
12.9
32.3
1938
3100
28
44
Health check-up
Supplementary nutrition
No. of lactating women
'No. of projects
XLV
TABLE 12. POSTNATAL SERVICES TO LACTATING MOTHERS IN RURAL,
TRIBAL AND URBAN ICDS PROJECTS
Services
Health check-up:
Trained personnel
Total receipt
Nutrition and health education
Family welfafe advice
Supplementary nutrition:
Eligible received
Total received
No. of lactating women surveyed
No. of projects
More than 3 years old ICDS projects
Rural
Tribal
Urban
23.2
52.5
43.3
40.8
20.6
28.8
29.9
32.3
47.0
57.2
56.2
56.3
30.4
32.2
1707
24
33.0
33.2
548
10
24.8
31.5
851
10
TABLE 13.POSTNATAL SERVICES TO LACTATING MOTHERS IN CONTROL
POPULATION (BASELINE) IN 1976 AND EXPERIMENTAL (FOLLOW
UP) POPULATION
Services
Health check-up:
Trained personnel
Total receipt
Nutrition and health education
Family welfare advice
Supplementary nutrition:
Eligible receipt
Total receipt
No. of lactating women
No. of projects
Control population
1976
ICDS population
1985
N.R.
10.8
0.5
0.3
43.3
53.2
56.4
55.9
N.R.
14.2
6091
TH
41.5
35.6
805
13
XLVI
TABLE 14. IMMUNISATION COVERAGE IN 0-<6 YEARS AGE CHILDREN IN
MORE THAN 3 YEARS OLD ICDS PROJECTS AND IN CONTROL
GROUP WITHOUT ICDS SERVICES
(Data are percentage values)
Control
> 3 years old projects
Rural
Tribal
Urban
All
BCG
22.6
38.7
32.4
56.8
42.9
DPT (3 doses)
22.6
39.1
39.4
59.1
45.0
Polio (3 doses)
23.1
TT (pregnant women) (2 doses)
24.5
40.0
29.3
51.4
Children surveyed
6,751
17,567
5,628
Number of projects
28
24
9
9,565 32,760
10
43
1,464
1,293
473
Pregnant women surveyed
46.0
41.0
2,414
648
TABLE 15. IMMUNISATION COVERAGE IN 0 - 2 YEARS AGE CHILDREN IN
MORE THAN 3 YEARS OLD PROJECTS AND CONTROL
POPULATION IN 1985
(Data are percentage values)
Control
BCG
DPT (3 doses)
Polio (3 doses)
Children surveyed
Number of projects
17.3
13.7
14.8
66,751
28
> 3 years old projects
Rural
Tribal
Urban
All
29.6
22.9
22.6
5,422
24
20.6
27.3
24.4
1,946
9
43.5
36.4
41.7
3,059
10
32.0
27.7
28.5
10,427
43
XLVII
TABLE 16. IMMUNISATION STATUS IN CHILDREN 0-6 YEARS AND PREG
NANT WOMEN IN 1976 BASELINE AND 8 YEARS OPERATIONAL
ICDS PROJECTS IN 1985
Baseline 1976
8 years of ICDS 1985
21.0
4.9
NR
6.0
50.5
50.2
51.2
32.1
27,726
1,210
9,867
654
BCG
DPT (3 doses)
Polio (3 doses)
TT (2 doses; pregnant women)
Sample size:
(a) Preschool
(b) Pregnant women
TABLE 17. IMMUNISATION STATUS IN CHILDREN 0 - 6 YEARS IN MORE
THAN 3 YEARS OLD ICDS PROJECTS
Type of
project
No. of projects
BCG
DPT
Polio
Rural
Tribal
Urban
Total
12
3
16
31
22732 (75.5)
985 (30.8)
8452 (59.6)
32169 (69.9)
23801 (67.4)
23587 (64.7)
8657 (59.9)
32458 (65.4)
8657 (62.3)
32244 (64.0)
Figures in parentheses are percentages
_____
TABLE 18. IMMUNISATION STATUS IN CHILDREN 0 - 3 YEARS IN MORE
THAN 3 YEARS OLD ICDS PROJECTS
Type of
project
No. of
projects
BCG
DPT
Polio
Rural
Tribal
Urban
Total
5
4
4
13
1811 (46.0)
641 (40.6)
442 (80.3)
2894 (50.0)
2238 (50.7)
433 (27.9)
442 (70.4)
3113 (50.3)
2238 (56.3)
Figures in parentheses are percentages
442 (69.0)
2680 (58.4)
XLVIII
TABLE 19. STATEWISE PERCENTAGE COVERAGE OF 12+ TO 24 MONTHS
CHILDREN BY IMMUNISATION DURING 1987-88
Sample
size
Andhra
Pradesh
Karnataka
Kerala
Maharashtra
Orissa
Punjab
Rajasthan
Tamil Nadu
Uttar Pradesh
West Bengal
875
81
115
145
171
150
104
154
221
201
Non-ICDS (Control)
3-5 years old ICDS
BCG DPT Polio Mea- Sample BCG DPT Polio
3
3 sles
size
3
3
doses doses
doses doses
Mea
sles
52.1
69.8
63.5
53.4
45.1
52.0
31.1
78.4
22.5
36.2
10.2
36.4
17.1
11.8
32.3
18.8
3.2
42.2
6.0
19.7
20.1
3.7
40.9
49.0
10.5
39.3
5.8
90.2
9.9
3.0
41.2
17.3
41.7
46.2
0.0
64.7
17.3
87.7
14.0
14.4
41.7
17.3
32.2
46.9
0.0
64.7
17.3
87.7
14.9
8.0
8.3
0.0
2.6
20.0
13.4
18.7
2.9
38.3
2.7
0.0
599
536
428
382
536
292
341
612
1025
594
24.9
75.2
62.8
41.4
43.5
43.1
2.0
65.8
32.7
32.0
53.1
68.1
63.5
55.2
45.1
51.7
28.4
78.8
26.5
36.5
If-
■I
-
«
TABLE 20. PERCENTAGE COVERAGE OF 12+ TO 24 MONTHS CHILDREN BY
BCG AND MEASLES VACCINATION DURING 1987-88
Location
Rural
Tribal
Urban
All
Sample size
Non-ICDS
3-5 yr
of ICDS
1241
651
126
2018
4831
1819
1452
8102
Non-ICDS
BCG
Measles
30.4
13.6
7.1
23.8
10.4
4.9
7.1
0.4
3-5 years of ICDS
BCG
Measles
46.3
40.2
54.4
46.4
17.4
18.8
32.7
20.5
XLIX
TABLE 21. PERCENTAGE COVERAGE OF 12+ TO 24 MONTHS CHILDREN BY
DPT AND POLIO (3 DOSES) VACCINATION DURING 1987-88
Location
Sample size
Non-ICDS
3-5 yr
of ICDS
1241
651
126
2018
Rural
Tribal
Urban
All
4831
1819
1452
8102
Non-ICDS
DPT
Polio
(3 doses) (3 doses)
39.1
17.0
0.8
29.3
35.7
17.3
1.6
27.4
3-5 years of ICDS
DPT
Polio
(3 doses)
(3 doses)
46.4
38.1
69.6
48.8
47.9
42.7
69.2
50.6
TABLE 22. NUTRITIONAL SERVICES IN CONTROL AND MORE THAN THREE
YEARS OLD ICDS PROJECTS
(Data are percentage values)
Nutritional
services
Control
group
Rural
Experimental group
All
Tribal
Urban
Vitamin A
Iron and folic acid
Supplementary food
Sample size:
Preschool children
19.7
7.2
23.6
32.9
19.5
39.8
27.8
19.8
41.9
50.1
29.6
47.3
20605
17567
(24)
5628
(9)
9565 32760
(43)
(10)
Figures in parentheses indicate the number of projects evaluated
37.1
22.5
42.3
L
TABLE 23. NUTRITIONAL SERVICES IN CONTROL POPULATION IN 1976
AND 1985 AND EXPERIMENTAL GROUP OF 8 YEARS OLD ICDS
PROJECTS
(Data are percentage values)
Nutritional
services
Control population
1976
Vitamin A
10.3
N.R.
25.2
27726 (23)
Iron and folic acid
Supplementary nutrition
Sample size:
Preschool children
8 years after ICDS
1985
Control population
1985
39.2
25.1
39.2
9867 (13)
19.7
7.2
23.6
20605 (28)
Figures in parentheses indicate the number of projects from where the sample was obtained.
TABLE 24. COVERAGE OF PRESCHOOL CHILDREN (0-6 YEARS) BY SUPPLE
MENTARY NUTRITION IN ICDS PROJECTS OPERATIONAL FOR
MORE THAN 3 YEARS
Type of project
Supplementary nutrition received
No. of projects
Sample size
No.
Urban
2
3
3
2884
1811
888
1151(39.9)
830(45.8)
442(49.8)
Total
8
5573
2423(43.4)
Rural
Tribal
Figures in parentheses are percentages
LI
TABLE 25. COVERAGE OF PRESCHOOL CHILDREN (0-6 YEARS) BY IRON &
FOLIC ACID AND VITAMIN A ADMINISTRATION IN ICDS PROJ
ECTS OPERATIONAL FOR MORE THAN 3 YEARS
Type of
project
Iron and folic acid received
No. of
Sample
No.
projects
size
Rural
Urban
1
1
400
352
164(41.0)
201(57.1)
2
2
2884
1254
2235(77.5)
828(66.0)
Total
2
752
365(48.5)
4
4138
3063(74.0)
Vitamin A received
No. of
Sample
No.
projects size
Figures in parentheses are percentages
TABLE 26. COMPARATIVE STUDY OF IRON AND FOLIC ACID AND VITAMIN
A COVERAGE FOR PRESCHOOL CHILDREN IN ICDS AND NONICDS POPULATION
(Data are percentage values)
Type of project
Sample size
Iron and folic acid
received
Vitamin A
received
ICDS
Rural
Urban
Total
400
352
752
41.0
57.1
48.5
76.3
61.1
69.1
Non-ICDS
Rural
Urban
Total
357
355
712
10.4
28.7
19.5
17.9
31.5
24.7
L1I
TABLE 27. LONGITUDINAL STUDY OF NUTRITIONAL STATUS OF PRE
SCHOOL CHILDREN (1975 TO 1985)
(Data are percentage values)
Nutritional status
Baseline (1976)
8 years old ICDS
projects (1985)
Normal and grade I
47.2
72.6
Grade II
27.0
19.8
Grades III and IV
19.1
6.3
Not recorded
6.7
1.3
Sample size
23
13
TABLE 28. NUTRITIONAL STATUS OF PRESCHOOL CHILDREN IN CONTROL
AND ICDS POPULATION
(Data are percentage values)
Experimental group (> 3 years old projects)
Nutritional
Control
status f
group
Rural
Tribal
Urban
All
Normal and
grade-I
69.5
75.0
82.8
65.9
73.7
Grade II
19.7
16.1
12.1
25.1
18.1
and IV
8.4
6.6
3.9
7.5
6.4
Not recorded
2.4
2.3
1.2
1.4
1.8
Sample size.
20605
(28)
17567
(24)
5628
(9)
7565
(10)
32760
(43)
Grades III
Figures in parentheses represent number of projects evaluated
bill
TABLE 29. NUTRITIONAL STATUS OF PRESCHOOL CHILDREN IN 1976
1979 AND 1985 EVALUATION STUDIES
(Data are percentage values)
Nutritional status
Control
1976
1979
1985
Normal and grade-I
47.2
56.2
69.5
Grade-II
27.0
28.2
19.7
Grades-III and IV
19.1
15.1
8.4
Not recorded
6.7
0.5
2.4
Sample size
27726
27487
20605
(28)
Figure in parentheses represents number of projects evaluated
TABLE 30. NUTRITIONAL STATUS OF 0-6 YEARS CHILDREN IN MORE THAN
3 YEARS OLD ICDS PROJECTS
(Data are percentage values)
Project
Type
No.
Sample
size
Normal
Grade-I
Grade-II
Grades III
and IV
Rural
19
31712
34.8
33.1
24.8
7.4
Tribal
4
3711
29.5
27.6
25.5
17.3
Urban
23
26302
32.3
32.6
25.3
9.8
Total
46
61725
33.4
32.5
25.1
9.1
LIV
TABLE 31. NUTRITIONAL STATUS OF 0-3 YEARS IN MORE THAN 3 YEARS
OLD ICDS PROJECTS
(Data are percentage values)
Projects
Sample size Normal
Grade-I
Grade-II
Grades III and IV
Type
No.
Rural
11
3866
29.4
26.6
25.9
18.0
Tribal
4
1700
29.1
24.2
24.7
22.0
Urban
6
4575
29.8
33.1
27.7
9.4
Total
21
10141
29.5
29.1
26.5
14.8
Rural +
Tribal
15
5560
29.3
25.9
25.6
19.2
TABLE 32. NUTRITIONAL STATUS OF 0-6 YEARS CHILDREN: A COMPARA
TIVE STUDY OF ICDS Vs. NON-ICDS GROUPS
(Data are percentage values)
Normal
Grade-I
Grade II
Grades III and IV
No.
Sample
size
ICDS
Rural
4
1741
48.3
28.5
17.2
6.0
Urban
8
3239
36.7
31.6
25.0
6.7
Total
12
4980
40.8
30.5
22.3
6.5
Rural
4
1610
40.6
29.1
21.3
9.0
Urban
8
2610
32.2
28.8
26.8
12.2
Total
12
4220
35.4
28.9
24.7
11.0
Projects
type
Non-ICDS
LV
TABLE 33. NUTRITIONAL STATUS OF 0-3 YEARS CHILDREN : A COMPARA
TIVE STUDY OF ICDS Vs. NON-ICDS GROUPS
(Data are percentage values)
Projects type
(n = 2)
Sample
Normal
Grade-I
Grade-II
Grades III and IV
ICDS rural
545
42.2
27.2
19.1
11.5
Non-ICDS rural
549
37.9
23.7
26.4
12.1
TABLE 34. STUDY OF VITAMIN B-COMPLEX, VITAMIN A DEFICIENCY AND
NUTRITIONAL ANAEMIA IN MORE THAN 3 YEARS OLD ICDS
PROJECTS
Project
B-complex deficiency
Vit. A deficiency
Anaemia
Number
Sample
Number
Sample
Number
Rural
6054
232(3.8)
7384
547 (7.4)
5863
2134(36.4)
Tribal
3301
51(1.5)
2301
317(13.8)
1120
205(18.3)
Urban
5147
203(3.9)
10371
1224(11.8)
5475
874(16.0)
All
14502
486(3.4)
20056
2088(10.4)
12458
3213(25.8)
Rural+
Tribal
9355
283(3.0)
9685
864 (8.9)
6983
2339(33.5)
Figures in parentheses are percentages
Sample
LVI
TABLE 35. COMPARATIVE STUDY OF VITAMIN B-COMPLEX AND VITAMIN A
DEFICIENCY AND NUTRITIONAL ANAEMIA IN ICDS AND NONICDS PROJECTS IN PRESCHOOL CHILDREN 0-6 YEARS
Project
No. of
B-complex deficiency Vitamin A deficiency
type
projects
Sample
Number
Sample
Number
Sample
Number
Rural
2
614
31 (5.0)
614
5 (0.8)
243
32(13.2)
Urban
7
1057
61 (5.8)
2239
183 (8.2)
500
17 (3.4)
Total
9
1671
92 (5.5)
2853
188 (6.6)
743
49 (6.6)
Rural
2
571
35 (6.1)
571
33 (5.8)
154
42(27.3)
Urban
7
1057
195(18.4)
1630
347(21.3)
500
34 (6.8)
Total
9
1628
230(14.1)
2201
380(17.3)
654
76(11.6)
Anaemia
ICDS
Non-ICDS
Figures in parentheses are percentages
TABLE 36. PERCENTAGE PREVALENCE OF SEVERELY MALNOURISHED CHIL
DREN ACCORDING TO AGE AND SEX DURING 1979-1981 AND
1982-83
Location
Sample size
of sample
Sex
Age, years
73
3-<6
Male
Female
Study period: 1979-81
Rural
2395
75.3*
24.7
38.0
62.0*
Tribal
967
63.2*
36.8
46.7
53.3*
Urban
930
57.6*
42.4
41.4
58.6*
All
4292
68.7*
31.3
40.7
59.3*
Study period: 1982-83
Rural
561
63.1
36.9
42.2
57.8
Tribal
253
61.3
38.7
41.1
58.9
Urban
830
56.6
43.4
39.5
60.5
All
1644
59.5
40.5
40.7
59.3
* Prevalence of severe malnutrition was significantly higher (P < 0.001) in lower age group
(0- < 3 yr) of preschool children and for females, irrespective of the location of sample.
LVII
TABLE 37. MORTALITY FROM NUTRITIONAL DEFICIENCY AS THE UNDER
LYING CAUSE DURING 1979-81 AND 1982-83
(Data are percentage of children died during the course of study)
Location
Age group, years
<3
3-< 6
0-<6
Rural
5.8
1.9
4.9
Tribal
1.0
0.8
0.9
Urban
0.4
1.0
0.6
All
3.8
1.4
3.0
Rural
1.6
0.0
1.1
Tribal
0.6
1.0
0.8
Urban
1.9
0.6
1.3
All
1.6
0.5
1.2
Study period: 1979-81
Study period: 1982-83
TABLE 38. TREATMENT OF ASSOCIATED ILLNESSES IN SEVERE MALNUTRI
TION
Illness-wise percentage distribution of children
Treatment received
Diarrhoea
Respiratory
infection
Fever
Others
At the Anganivadi
83.8
82.8
84.4
88.4
Referred to PHC
16.7
17.2
15.6
11.6
By MO at PHC
8.2
8.9
8.1
8.0
LVIII
TABLE 39. PROGNOSIS OF SEVERELY MALNOURISHED CHILDREN
Outcome, in percent
Location
Improved
No change
Deteriorated
Rural
83.4
5.5
4.2
Tribal
82.9
9.5
3.7
Urban
91.3
4.7
2.2
All
85.0
6.3
3.6
WW''
TABLE 40. CHILDREN SUFFERING FROM SPECIFIC MORBIDITY IN A WEEK
Fever
Eye infection
(4.9)
4922 (8.7)
5063 (7.1)
1120 (11.2)
1120 (29.6)
1120 (2.1)
1754 (19.4)
1959
(7.3)
1959(13.9) 1254 (3.1)
8660 (15.6) 7892
(9.0)
8001 (9.0)
Type of
project
Diarrhoea
Resp. inf.
Pyoderma
Rural
5786 (10.2)
5786 (15.3)
4813
Tribal
1120 (12.7)
Urban
1959
(9.0)
Total
8865 (10.3)
6317 (6.3)
Figures in parentheses are percentages
TABLE 41. NUMBER OF EPISODES PER CHILD PER YEAR IN ICDS POPULA
TION
Type of
project
Diarrhoea
Sample Epis.
size
p.yr.
Rural
Tribal
Urban
643
155
1065
Total
1863
NR: Not Reported
Fever
Eye infection
Sample Epis. Sample
Epis.
size
p.yr. size
p.yr.
Resp. inf.
Episodes
per year
Pyoderma
Sample Epis.
size
p.yr.
1.2
1.3
0.8
2.4
1.3
0.9
N.R.
N.R.
1065
N.R.
N.R.
0.4
643
155
229
2.1
1.4
1.0
643
N.R.
865
0.7
N.R.
0.1
1.0
1.5
1065
0.4
1027
1.7
1508
0.4
LIX
TABLE 42. PERCENTAGE OF CHILDREN SUFFERING FROM SPECIFIC MOR
BIDITY IN A WEEK
Type of population
Sample
size
ICDS
3299
Non-ICDS
2569
Sample
size
Resp.
inf.
409(12.4)
3094
596(19.3)
503(19.6)
2367
665(28.1)
Diarrhoea
Figures in parentheses are percentages
TABLE 43. PERCENTAGE OF CHILDREN SUFFERING FROM SPECIFIC MOR
BIDITY IN A WEEK
Type of
population
Sample
size
Pyoderma
Sample
size
Fever
Sample
size
Eye inf.
ICDS
2540
172 (6.8)
2649
319(12.0)
2085
75(3.6)
Non-ICDS
1769
332(18.8)
1912
379(19.8)
1367
84(6.1)
Figures in parentheses are percentages
TABLE 44. STUDY SAMPLE OF INFANTS FOR THE MORBIDITY STUDY
Location of sample
No. of ICDS
Number of infants studied
projects
Male
Female
All
Rural
6
2024
(52.1)
1858
(47.9)
3882
Urban
3
755
(51.4)
713
(48.6)
1468
Combined
9
2779
(51.9)
2571
(48.1)
5350
Figures in parentheses are percentages
LX
TABLE 45. AVERAGE NUMBER OF WEEKS OF FOLLOW-UP
Location of sample
Weeks of follow up/infant
Male
23.1
Female
All
Rural
22.8
22.9
Urban
23.5
23.0
23.3
Combined
23.2
22.9
23.0
TABLE 46. PERCENTAGE INCIDENCE* OF VARIOUS ILLNESSES AMONG INFANTS
Location of sample
Illness suffered
Rural
Urban
Combined
Diarrhoea
Cough
Fever without rash
Sore eyes
Skin boils
Fever with rash
Ear discharge
Scabies
Cuts, wounds and accidents
Tetanus
Paralysis of limbs
Others
64.4
53.1
62.8
42.1
15.2
10.6
7.3
3.9
2.0
0.3
0.1
13.5
4Z2
68.1
34.1
3..7
7.2
3.1
2.6
5.2
5.4
0.1
0.2
26.5
59.7
57.2
54.9
31.6
13.0
8.5
6.0
4.2
3.0
0.2
0.1
17.1
Estimated incidence rate is based on an average follow up 6 months period.
LXI
TABLE 47. PERCENTAGE INFANT DEATHS BY UNDERLYING CAUSE
Location of sample
Underlying cause of death
Fever
Diarrhoea
Prematurity and/or
low birth weight
Tetanus
Respiratory infection
Birth injuries
Others
Total infant deaths
Rural
Urban
Combined
72 (33.5)
43 (20.0)
6(23.1)
6(23.1)
78 (32.4)
49 (20.3)
28 (13.0)
19 (8.8)
15 (7.0)
8 (3.7)
30 (14.0)
215(100.0)
5 (19.2)
0 (0.0)
3(11.5)
0 (0.0)
6 (23.1)
26 (100.0)
33 (13.7)
(19 (7.9)
18 (7.5)
8 (3.3)
36 (14.9)
241 (100.0)
Figures in parentheses are percentages
TABLE 48.ESTIMATED NUMBER OF EPISODES OF VARIOUS ILLNESS PER
THOUSAND SICK INFANTS
Illness episodes
Illness sufferred
Rural
Urban
Combined
Cough
5.0 (3.1)
8.2 (5.7)
5.9 (3.8)
Diarrhoea
5.5 (3.9)
5.3 (3.0)
5.4 (3.7)
Fever without rash
4.9 (3.5)
4.9 (1.9)
4.9 (3.1)
Sore eyes
Cuts, wounds and accidents
3.9 (2.0)
2.0 (0.09)
3.8 (1.5)
2.4 (0.05)
4.4 (0.3)
3.4 (0.1)
Fever with rash
3.2 (0.4)
2.3 (0.09)
3.1 (0.3)
Skin boils
2.9 (0.6)
3.8 (0.3)
3.0 (0.5)
Scabies
2.4 (0.1)
3.9 (0.3)
2.9 (0.2)
Ear discharge
2.8 (0.3)
3.0 (0.09)
2.8 (0.2)
Tetanus
2.7 (0.006)
1.4 (0.001)
2.5 (0.005)
Paralysis of limbs
1.1 (0.002)
1.3 (0.005)
6.1 (2.2)
1.2 (0.003)
4.2 (0.9)
2.7 (0.5)
Others
Figures in parentheses indicate the rate of episodes in reference to 1000 infant population.
LXII
TABLE 49.
ESTIMATED SICKNESS LOAD PER INFANT PER ANNUM
Estimated number of epi______ sodes* during infancy
Location of
Sample
Estimated number of sickness
+ve weeks** per infant/annum
General
population
(all infants)
Affected
population
(sick infants)
Rural
14.3
47.9 •
15.5
Urban
14.0
52.0 •
13.8
Combined
14.3
49.2 •
15.1
*
Episodes of all illness.
Simultaneous occurrence of three to five illnesses has been a common feature in
infants fallen sick.
•
Absolute number of sickness positive weeks experienced by individual sick infant
is predicted to be significantly higher than the average for the combined group.
TABLE 5Q. PERCENTAGE OF INFANTS BY FREQUENCY OF EPISODES*
(Data are percentage values)
Location of sample
Frequency of
episodes
Rural
Urban
Combined
None
1
2
3
4
5
6
6+
Infants studied
8.5
7.2
14.4
20.0
11.2
8.3
7.1
23.3
1897
8.5
5.3
10.3
10.5
7.4
12.0
7.8
38.2
702
3.1
2.4
4.8
6.3
3.7
3.3
2.6
9.8
2599
Episodes of an illness suffered during a continuous follow-up period of 6 months.
LXII1
TABLE 51.
SEASONWISE AVERAGE MONTHLY INCIDENCE OF ILLNESS
(Data are percentage values)
Average monthly incidence of illness
Morbidity condition
Jan-Mar
Apr-June
July-Sept
Oct-Dec
Diarrhoea
17.6
26.4
Cough
26.8
Fever without rash
Sore eyes
Skin boils
Fever with rash
Ear discharge
Scabies
Cut, wounds and accidents
Tetanus
Paralysis in limbs
Others
18.2
3.8
1.3
2.2
1.4
33.9
19.2
25.0
15.1
4.0
0.6
0.03
0.02
19.4
25.1
20.8
7.3
2.1
2.0
1.3
0.8
0.5
0.02
0.01
5.9
4.6
18.6
22.8
12.8
5.1
1.6
1.9
0.9
2.6
2.3
1.4
0.8
0.07
0.01
5.8
0.6
0.7
0.0
0.05
4.4
TABLE 52. DISTRIBUTION OF MORBIDITY OF CHILDREN BY SEX AND LO
CATION
Children (1- < 3 years) studied
No. of ICDS
projects
Male
Female
AH
Rural
6
1803 (54.0)
1536 (46.0)
3339
Urban
3
656 (51.7)
613 (48.3)
1269
Combined
9
2459 (53.4)
2149 (46.6)
4608
Location of sample
Figures in parentheses are percentages
LXIV
TABLE 53. AVERAGE NUMBER OF WEEKS FOLLOW-UP PER CHILD ACCORD
ING TO SEX AND LOCATION
Location of sample
Weeks of follow-up per child
Male
Female
Combined
Rural
28.5
29.9
29.2
Urban
28.7
30.0
29.3
Combined
28.6
30.0
29.2
TABLE 54. PERCENTAGE INCIDENCE
CHILDREN (1- < 3 YRS)
OF VARIOUS ILLNESSES AMONG
Illness suffered
Diarrhoea
Cough
Fever without rash
Sore eyes
Skin boils
Fever with rash
Ear discharge
Scabies
Cuts, wounds and accidents
Tetanus
Paralysis of limbs
Others
Location of sample
Rural
Urban
Combined
59.9
66.2
70.1
35.4
28.6
14.6
12.08.6
6.9
0.1
0.4
16.0
45.7
53.3
51.5
5.7
10.6
10.6
2.7
3.6
6.6
0.1
0.1
24.3
56.0
62.7
65.0
27.2
23.7
13.5
9.4
7.2
6.8
0.1
0.3
18.3
Estimated incidence rate is based on an average follow up of 6 months' period.
LXV
TABLE 55. ESTIMATED SICKNESS LOAD PER CHILD PER ANNUM.
Location of sample
Estimated number of sickness
+ve weeks**/child/annum
Estimated number of episodes*/child/annum
General
population
(all children)
Affected
population
(sick children)
Rural
14.4
45.7+
16.4
Urban
8.9
40.8+
11.3
Combined
12.8
44.7+
14.9
♦
**
+
Episodes of all illnesses.
Simultaneous occurrence of 3 to 5 illnesses has ben a common feature in children
fallen sick.
Absolute number of sickness positive weeks experienced by individual sick child is
predicted to be significantly higher than the average for the combined group.
TABLE 56. ESTIMATED NUMBER OF EPISODES OF VARIOUS ILLNESSES PER
CHILD
Cough.
Diarrhoea
Fever without rash
Sore eyes
Cuts, wounds and
accidents
Fever with rash
Skin boils
Scabies
Ear discharge
Tetanus
Paralysis of limbs
Others
Combined
Urban
Rural
Illness
Sick
All
Sick
All
Sick
All
5.1
4.8
4.9
2.3
3.7
3.2
3.7
1.2
5.0
3.8
5.1
4.6
4.5
3.0
3.4
1.5
2.8
2.1
1.4
0.1
2.5
2.5
2.5
2.5
0.2
3.0
2.1
0.2
0.2
0.2
2.2
2.3
1.5
1.4
2.6
0.3
0.002
0.006
0.5
0.3
0.1
0.1
0.001
1.001
1.5
2.6
2.2
2.5
2.6
2.4
0.3
1.3
1.4
3.5
0.002
0.005
0.4
0.8
0.3
2.9
3.1
3.6
1.0
1.0
1.4
2.9
3.0
0.9
0.4
0.7
0.2
0.8
TABLE 57 .
PERCENTAGE OF CHILDREN BY FREQUENCY OF EPISODES*
(Data are percentage values)
Frequency of episodes
None
1
2
3
4
5
6
6+
Children studied
Location of sample
Rural
Urban
Combined
9.2
7.3
11.8
14.4
12.1
11.2
9.0
25.0
2291
11.6
5.5
10.8
7.5
12.1
8.2
12.2
32.1
993
9.9
6.8
11.5
12.3
12.1
10.3
9.9
27.2
3284
* Episodes of all illnesses suffered during a period of 6 months continuous follow up.
TABLE 58 .
SEASONWISE AVERAGE MONTHLY INCIDENCE OF ILLNESS
(Data are percentage values)
Morbidity condition
Diarrohoea
Cough
Fever without rash
Sore eyes
Skin boils
Fever with rash
Ear discharge
Scabies
Cuts, wounds and accidents
Tetanus
Paralysis of limbs
Others
Average monthly incidence rate
Jan-March
April-June
July-Sept.
Oct.-Dec.
14.2
23.7
19.1
4.3
23.3
3.2
1.6
0.8
1.1
0.01
0.01
6.0
22.6
15.6
20.5
8.4
5.1
3.5
2.6
1.7
1.1
0.03
0.08
3.7
22.1
19.5
19.0
9.0
8.7
2.7
2.8
2.0
1.5
0.0
0.08
5.0
18.0
27.6
25.0
4.3
4.1
1.8
1.7
1.2
1.1
0.001
0.01
5.9
TABLE 59 .
INFANT AND EARLY CHILDHOOD MORTALITY STUDIES BY
CONSULTANTS
IMR study
Year of study
No. completed
No. allotted
38
26
21
27
98
48
32
28
33
113
1982- 83
1983- 84
1985-86
1986- 87
1987- 88
(79.2)
(81.2)
(75.0)
(81.8)
(86.7)
Figures in parentheses are percentage
TABLE 60 .
SAMPLE SIZE FOR THE IMR STUDY IN 1982-83
Sample size
Location of the sample
No. of AWs
Population covered
Rural
Tribal
Rural + Tribal
Urban slums
84
53
137
90
93,1455
43,589
1,36,734
93,497
Total
227
2,30,231
TABLE 61 .
INFANT MORTALITY RATES ACCORDING TO THE SEX AND LOCATION
OF THE PROJECTS
Infant mortality rate
Location
Male
Female
Total
Rural
Tribal
Rural + Tribal
Urban slum
88.4
98.7
91.9
88.9
86.4
87.8
86.8
61.2
87.5
93.5
89.5
80.2
Total
90.8
77.4
85.9
/
TABLE 62 :
CAUSE SPECIFIC INFANT DEATH RATES IN ICDS PROJECTS
Location of the
sample
Diarrohoea
Rural
Tribal
Rural + Tribal
Urban slum*
12.8
12.1
12.6
12.3
Total
12.5
*
**
-Respiratory
12.4
29.4
18.2
13.3
16.4
(Per thousand live births)
Cause of death
Accidents,
Tetanus
injuries and
burns
1.8
0.9
1.8
3.4
1.8
1.8
1.5
2.4
1.7
2.1
Fever
Others**
12.8
8.7
11.4
9.9
10.8
46.8
28.6
40.4
37.0
39.1
Cause specific infant deaths were not available for one urban slum project (6 anganwadis)
Includes prematurity, low birth weight and convulsions.
n
TABLE 63 :
]
SEX SPECIFIC DEATH RATES (0-4 YRS) IN ICDS PROJECTS AS COM
PARED TO SRS ESTIMATE OF 1982-83.
Male
Location
(Per 1000 '0-4 yrs’ population)
Death rates (0-4 years)
_____ Female_______
ICDS
SRS
ICDS
SRS
Rural + Tribal
Urban slum
21.4
21.3
42.2
21.2
22.4
15.8
Total
21.3
37.9
19.8
TABLE 64 .
Total
ICDS
SRS
45.7
20.5
21.9
18.7
43.9
20.9
40.5
20.6
39.1
NEONATAL MORTALITY RATES ACCORDING TO THE SEX AND LOCA
TION OF THE ICDS PROJECTS COMPARED WITH NATIONAL SRS
ESTIMATE OF 1982-83
(Per 1000 live births)
Neonatal mortality rates
Total
Female
Male
Location
ICDS
SRS
ICDS
SRS
ICDS
SRS
Rural + Tribal
Urban slum
57.5
53.0
NA
NA
44.1
36.1
NA
NA
51.2;
46.3
72.9
38.8
Total
55.8
NA
41.1
NA
49.3
66.7
CAUSE SPECIFIC NEONATAL DEATH RATES IN ICDS PROJECTS STUD
IED IN 1982-83
TABLE 65 >
Location of
the sample
Diarrohoea
Rural + Tribal
Urban slum
Total
*
2.7
2.5
2?6
Res
piratory
infection
9.3
7.8
8.8
( Per 1000 live births)
Cause of death
Fever
Tetanus Accidents
injuries &
burns
2.4
0.9
1.2
2.0
1.5
2.0
2^2
1.1
1.5
Others*
More
than one
illnesses-
32.9
29.5
31/7
r?”
NIL
It"”
Includes prematurity, low birth weight and convulsions.
E
TABLE 66 .
SEX SPECIFIC DEATH RATES IN AGE GROUP 0-3 AND 0-6 YEARS IN
ICDS PROJECTS
Death rate (0-6 yrs)
Death rate (0-3 yrs)
Location
Male
Female
Total
Male
Female
Total
Rural + Tribal
Urban slums
32.1
31.5
33.0
23.3
32.6
27.5
18.7
17.2
19.5
12.9
19.1
15.1
Total
31.9
29.2
30.6
18.1
16.8
17.5
TABLE 67 .
IMR IN 8 STATES IN ICDS POPULATION (1987) AS COMPARED TO SRS
ESTIMATES (1985)
S. No.
State
IMR-ICDS (1987)
1.
2.
3.
4.
5.
6.
7.
8.
Andhra Pradesh
Gujarat
Kerala
Maharashtra
Orissa
Rajasthan
U.P.
West Bengal
72.8
88.5
24.9
75.6
125.8
114.2
119.4
60.2
IMR-SRS estimate 1985
79.0
97.0
26.0
66.0
126.0
103.0
126.0
72.0
TABLE 68 .
MORTALITY RATE OF 0-5 YEARS AGE CHILDREN IN 1987 AS COM
PARED TO SRS ESTIMATES OF (1985)
S. No.
State
ICDS rate 1987
SRS estimate 1985
1.
2.
3.
4.
5.
6.
7.
8.
Andhra Pradesh
Gujarat
Kerala
Maharashtra
Orissa
Rajasthan
Uttar Pradesh
West Bengal
20.0
26.4
6.7
18.9
41.9
33.0
31.9
15.0
29.0
37.3
10.3
23.3
46.2
45.5
54.0
27.3
1
TABLE 69 .
CAUSE SPECIFIC MORTALITY RATE IN RURAL, URBAN, BOTH AND ALL
THE STATES COMBINED SAMPLE AMONGST 0-5 YEARS AGE GROUP
S. No.
Cause
1.
2.
3.
4.
5.
6.
7.
% mortality rate
Cause
Acute respiratory infection
Tetanus
Prematurity
Fever
Others
Accidents
14.6
18.5
6.1
13.9
14.7
29.8
2.3
TABLE 70 .
NEONATAL MORTALITY RATE (NNMR) IN ICDS GROUP (1987) AS
COMPARED WITH SRS ESTIMATES (1985)
S. No.
State
ICDS NNMR (1987)
SRS estimate for NNMR (1985)
1.
2.
3.
4.
5.
6.
7.
8.
Andhra Pradesh
Gujarat
Kerala
Maharashtra
Orissa
Rajasthan
U.P.
West Bengal
47.1
49.7
18.0
45.3
68.9
72.3
72.7
36.8
56.8
66.0
22.1
45.1
88.9
65.0
87.3
43.2
TABLE 71 .
LIVE BIRTHS AND BIRTH RATES IN ICDS AND NON-ICDS POPULATION
ICDS
Number of
Live births
1746
1237
Rural
Urban
TABLE 72 .
Birth
rate
26.3
27.4
Non-ICDS
Number of
Birth
rate
live births
1894
1023
29.5
27.9
MORTALITY RATE IN ICDS AND NON-ICDS POPULATION
Infant Mortality Rate
Number of
live births
registered
Male
Female
Total
ICDS
1746
75.6
57.9
67.0
Non-ICDS
1849
88.4
82.4
85.5
ICDS
1237
67.1
94.0
80.0
Non-ICDS
1023
94.4
79.4
87.0
Location
Rural
Urban
TABLE 73 .
CAUSE SPECIFIC DEATH RATES IN ICDS AND NON-ICDS INFANT
POPULATION
Diarrhoea
ARI
Tetanus
Prematurity
ICDS
8.0
15.5
4.6
10.9
Non-ICDS
17.4
11.1
12.1
12.1
ICDS
10.5
33.1
0.0
16.2
Non-ICDS
16.6
17.6
10.7
6.8
Location
Rural
Urban
Appendix-IV X
SERVICES TO ANTENATAL MOTHERS
ANTENTAL CHECK UP
TH. NO
TYPE
SAMPLE
SIZE
32 R
90 R
121R
35 R
26 R
56 R
66 R
53 R
123 R
21 R
124 U
95 U
94 U
136 U
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
386
173
44.8
117
305
326
312
400
65
121
155
300
245
55,6
39.7
47.5
96.2
61.3
RURAL
URBAN
TOTAL
RECEIVED
NUMBER
%
SAMPLE
SIZE
DELIVERY CONDUCTED BY
TRAINED PERSONNEL
SAMPLE
TRAINED PERSONNEL
AT HOME
NUMBER
% •
SIZE
NUMBER
%
PLACE OF DELIVERY
T.T.. IMMUNIZATION
RECEIVED
NUMBER
%
SAMPLE
SIZE
386
30
149
14
38.6
46.7
386
371
96.1
386
129
33.4
305
326
121
155
39.7
47.5
305
326
302
315
99.0
96.6
305
326
151
48
49.5
14.7
400
1192
385
1147
96.3
96.2
400
1192
229
1031
57.3
86.5
240
149
. 211
91
87.9
61.1
240
149
59
94
24.6
63.1
352
200
322
24
91.5
12.0
352
224
63.6
2849
701
3550
2731
437
3168
95.9
62.3
89.2
2849
501
3350
1647
318
x965
57.8
63.5
58.7
240
149
50
352
71
49
26
230
29.6
32.9
52.0
65.3
1192
110
240
149
50
352
2086
551
2637
1130
305
1435
54.2
55.4
54.4
2579
551
3130
936
45
63
31
25
200
78.5
45.0
26.3
20.3
50.0
56.8
1483
256
1739
57.5
46.5
55.6
COMPARATIVE DATA OF SERVICES FOR ANTENATAL MOTHERS IN ICDS & NON ICDS GROUPS
TH. NO.
TYPE
RECEIVED
SAMPLE
NUMBER
%
SIZE
53
56
66
90
123
95
94
ICDS
53
56
66
90
123
95
94
NICDS
R
R
R
R
R
U
U
SAMPLE
SIZE
1192
312
400
300
245
RECEIVED
NUMBER
%
936
78.5
96.2
61.3
DELIVERY CONDUCTED
PLACE OF DELIVERY
T.T. IMMUNIZATION
ANTENATAL CHECK UP
AT HOME
SAMPLE
NUMBER %
SIZE
_____________ BY TRAINED PERSONNEL
AT HOSTPITAL SAMPLE
NUMBER
%
NUMBER
% SIZE
1192
1147
96.2
45
3.8
1192
1031
86.5
400
385
96.3
15
3.8
400
229
57.3
14
45
25
200
46.7
45.0
50.0
56.8
352
322
91.5
30
8.5
352
224
63.6
50
352
26
230
52.0
65.3
30
100
50
352
RURAL 712
URBAN 402
TOTAL 1114
545
256
801
76.5
63.7
71.9
1322
402
1724
995
225
1220
75.3
56.0
70.8
1592
352
1944
1532
322
1854
96.2
91.5
95.4
60
30
90
3.8
8.5
4.6
1592
352
1944
1260
224
1484
79.1
63.6
76.3
585
223
38.1
585
534
91.3
51
8.7
585
411
70.3
357
348
97.5
9
2.5
357
98
27.5
R
R
R
R
R
U
U
308
357
264
71
85.7
19.9
11
355
3
77
27.3
21.7
100
65
11
355
RURAL 665
URBAN 366
TOTAL 1031
335
80
415
50.4
21.9
40.3
750
366
1116
79
21
8
160
79.0
32.3
72.7
45.1
355
335
94.4
20
5.6
355
132
37.2
323
168
491
43.1
45.9
44.0
942
355
1297
882
335
1217
93.6
94.4
93.8
60
20
80
6.4
5.6
6.2
942
355
1297
509
132
641
54.0
37.2
49.4
r
x
<
3 r
X
<
IMMUNIZATION STATUS IN CHILDREN (0-6 YRs)
BCG
TH. NO.
66
35
31
103
20
123
121
99
21
52
19
55
71A
28
71
106
116
118
82
119
95
42
6
22
124
94
125
105
8A
74
129
SAMPLE
SIZE
400
TYPE
R
R
R
R
R
R
R
R
R
R
R
R
T
T
T
U
U
u
u
u
u
u
u
u
u
u
u
u
u
u
u
TOTAL
RURAL
TRIBAL
URBAN
31
12
3
16
DPT
RECEIVED
NUMBER
%
56
14.0
469
830
853
300
2204
181
340
16309
214
632
410
155
420
597
500
500
285
207
119
189
154
1459
140
28
14761
43
4
114
83
106
254
296
178
285
44.1
14.3
22.1
51.3
66.2
77.3
8.2
90.5
20.1
0.6
27.8
53.5
25.2
42.5
59.2
35.6
100.0
1021
1096
200
105
867
335
125
885
857
605
544
611
878
147
80
375
64
85
331
695
473
287
59.8
85.6
73.5
76.2
43.2
19.1
68.0
37.4
81.1
78.2
52.8
32169
22732
985
8452
22501
17159
303
5039
69.9
75.5
30.8
59.6
SAMPLE
SIZE
400
1069
469
830
853
300
2204
181
340
16309
214
632
POLIO
RECEIVED
NUMBER
%
SAMPLE
SIZE
NUMBER
%
RECEIVED
183
58
181
118
87
174
298
133
97
14498
119
103
45.8
5.4
38.6
14.2
10.2
58.0
13.5
73.5
28.5
88.9
55.6
16.3
400
1069
469
830
853
300
2204
181
340
16309
217
67
219
6
87
125
269
133
108
14024
54.3
6.3
46.7
0.7
10.2
41.6
12.2
73.5
31.8
86.0
632
1
0.2
597
500
500
285
205
1021
1026
200
105
867
335
125
885
857
605
544
222
400
395
274
15
777
851
136
37
328
194
106
373
568
389
123
37.2
80.0
79.0
96.1
7
76.1
82.9
68.0
35.2
37.8
57.9
84.8
42.1
66.3
64.3
22.6
597
500
500
285
205
1021
1026
200
105
867
335
125
885
857
605
544
239
259
398
271
53
815
922
127
40
452
197
106
373
584
396
158
40.0
51.8
79.6
95.1
25.9
79.8
89.9
63.5
38.1
52.1
58.8
84.8
42.1
68.1
65.5
29.0
32458
23801
21236
16048
65.4
67.4
32244
23587
20645
15255
64.0
64.7
8657
5188
59.9
8657
5390
62.3
4
IMMUNIZATION STATUS IN CHILDREN (0-3 YRs) IN ICDS
TH. NO.
31
57
29
49
21
30
28
30A
71
67
82
6
22
SAMPLE
SIZE
TYPE
R
R
R
R
R
T
T
T
T
U
U
U
U
POLIO
DPT
BCG
RECEIVED
NUMBER
%
251
754
595
87
696
27
34.7
92.3
4.5
211
164
113
156
208
45
186
135
76
23
63
56
92
49
17
176
99
63
10.9
38.4
49.6
59.0
23.6
37.8
94.6
73.3
82.9
SAMPLE
SIZE
RECEIVED
NUMBER
%
27.5
88.1
5.9
65.8
40.3
8.5
46.9
34.6
251
754
595
427
211
92
661
71
340
96
36.7
87.7
11.9
79.6
45.5
30
166
92
23
66.7
89.2
68.1
30.3
45
186
135
76
30 '
163
85
27
66.7
87.6
63.0
35.5
SAMPLE
SIZE
RECEIVED
NUMBER
%
251
754
595
427
211
164
113
156
69
664
35
281
85
14
53
54
45
186
135
76
TOTAL
13
2894
1448
50.0
3113
1566
50.3
2680
1565
58.4
RURAL
5
1811
833
46.0
2238
1134
50.7
2238
1260
56.3
TRIBAL
4
641
260
40.6
433
121
27.9
URBAN
4
442
355
80.3
442
311
70.4
442
305
69.0
X
X
r
x
x
5
COMPARATIVE DATA OF IMMUNIZATION STATUS OF CHILDREN IN 1CDS Vs NON ICDS (0-3 YRS)
TH. NO.
TYPE
49 ICDS R
49 A NICDS R
POLIO
DPT
BCG
SAMPLE
SIZE
RECEIVED
NUMBER
%
SAMPLE
SIZE
427
425
NA
NA
427
425
%
SAMPLE
SIZE
65.8
22.4
427
425
RECEIVED
NUMBER
281
95
RECEIVED
NUMBER
340
91
%
79.6
21.4
6
COMPARATIVE DATA OF IMMUNIZATION STATUS OF CHILDREN IN ICDS Vs NON-ICDS (0-6 YRs)
TYPE
TH. NO.
99 ICDS
19 ICDS
31 ICDS
66 ICDS
123 ICDS
94 ICDS
95 ICDS
8A ICDS
116 ICDS
118 ICDS
119 ICDS
19A
31A
66A
99A
123A
94A
95A
8B
116A
118A
119A
RURAL
URBAN
TOTAL
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
RURAL
URBAN
TOTAL
R
R
R
R
R
U
U
U
U
u
u
5
6
11
R
R
R
R
R
U
U
u
u
u
u
5
6
11
POLIO
DPT
BCG
SAMPLE
SIZE
RECEIVED
NUMBER
%
181
133
73.5
469
400
300
335
1021
857
500
500
205
219
217
125
197
815
584
259
398
53
46.
54.3
41.6
58.8
79.8
68.1
51.8
79.6
25.9
50.5
68.7
63.0
8.3
7.2
4.8
26.9
62.0
41.2
39.2
12.0
66.9
60.0
3.0
1350
3418
4768
694
2306
3000
51.4
67.5
62.9
458
357
186
250
342
199
167
480
500
202
34
1
50
163
147
90
20
195
266
45
7.4
0.3
26.9
65.2
43.0
45.2
12.0
40.6
53.2
22.3
18.6
45.8
33.9
1251
1890
3141
248
763
1011
19.8
40.4
32.2
SAMPLE
SIZE
RECEIVED
NUMBER
%
64
611
695
296
178
77.3
20.1
44.1
14.0
51.3
19.1
59.8
81.1
59.2
35.6
181
214
469
400
300
335
1021
857
500
500
205
133
119
181
183
174
194
777
568
400
395
15
73.5
55.6
38.6
45.8
58.0
57.9
76.1
66.3
80.0
79.0
7.3
480
500
600
1844
2444
23
43
31
96
160
36
97
43
175
28
38.4
57.4
51.2
10.7
9.4
8.7
51.6
64.0
10.5
48.7
25.7
36.5
5.6
1564
3418
4982
214
458
357
186
250
342
199
167
480
500
202
790
2349
3139
18
33
17
50
155
141
78
20
321
300
6
1465
1688
3153
353
379
732
24.1
22.5
23.2
1465
1890
3355
273
866
1139
SAMPLE
SIZE
RECEIVED
NUMBER
%
181
214
469
400
300
335
1021
857
500
500
140
43
207
56
154
1564
3213
4777
214
458
357
186
250
342
199
167
r
X
X
r
X
X
7
SUPPLEMENTRY NUTRITION COVERAGE
IN CHILDREN (0-6YRS)
NUTRITION
RECEIVED
NUMBER
%
TH. NO
TYPE
SAMPLE
SIZE
66
62
34A
108
34
8
95
94
R
R
T
T
T
U
U
400
2484
390
950
471
293
243
352
56
1095
156
509
165
216
42
184
14.0
44.1
40.0
53.6
35.0
73.7
17.3
52.3
2884
1811
888
5583
1151
830
442
2423
39.9
45.8
49.8
43.4
RURAL
TRIBAL
URBAN
TOTAL
u
VIT-A COVERAGE IN CHILDREN
(0-6 YRS)
TH. NO
TYPE
62
66
95
94
R
R
U
U
COVERAGE OF IRON & FOLIC ACID IN CHILDREN
(O-6YRS)
VITAMIN-A_______
SAMPLE
RECEIVED
TH. NO
SIZE
NUMBER
%
2484
400
902
352
1930
305
613
215
77.7
76.3
68.0
61.1
68
94
RURAL
2884
2235
77.5
URBAN
TORAL
1254
4138
828
3063
66.0
, 74.0
TYPE
R
U
IRON & FOLIC ACID
SAMPLE
RECEIVED
SIZE
NUMBER
%
400
352
164
201
41.0
57.1
RURAL
400
164
41.0
URBAN
TOTAL
352
752
201
365
57.1
48.5
8
VITAMIN-A COVERAGE IN CHILDREN
(0-3YRS)
SUPPLEMENTARY NUTRITION COVERAGE
IN CHILDREN (0-3YRS)__________
TH. NO.
TYPE
SAMPLE
SIZE
NUTRITION
NUMBER
RECEIVED
%
TH. NO.
34A
34
8
T
T
U
179
237
140
34
35
86
19.0
14.8
61.4
57
8A
8
TRIBAL
URBAN
TOTAL
416
140
556
69
86
155
16.6
61.4
^7.9
TYPE
SAMPLE
SIZE
RECEIVED
VIT—A
%
NUMBER
R
U
U
754
617
855
234
523
616
31.0
84.8
72.0
RURAL
754
234
31.0
URBAN
TOTAL
1472
2226
1139
1373
77.4
61.7
r
x
X
>—-
r
9 X
X
>—«
<
COMPARATIVE DATA OF IRON & FOLIC ACID AND VITAMIN-A COVERAGE IN CHILDREN (0-6) YRS
IRON & FOUC ACID
vit-a
RECEIVED
RECEIVED
SAMPLE
TH. NO. TYPE
NUMBER
%
NUMBER
%
66
R
ICDS
400
164-
41.0
305
76.3
94
U
ICDS
352
201
57.1
215
61.1
ALL TOTAL
752
365
48.5
520
69.1
66
R
NICDS
357
37
10.4
64
17.9
94
U
NICDS
355
102
28.7
112
31.5
GRAND TOTAL
712
139
19.5
176
24.7
ICDS
NICDS
SIZE
10
NUTRITIONAL STATUS OF CHILDREN (0-6) YRS
SAMPLE
NORMAL
GRADE I
TH. NO.
TYPE
SIZE
NUMBER
%
NUMBER
31
16
103
21
31R
23
115R
123
66
35
52
121
62
29
61
20
55
69
15
71A
34
44
34A
118
125
24
92
106
8A
82A
6
94
137
72
119
75
42
95
129
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
T
T
T
T
U
U
U
U
572
686
830
303
469
200
200
300
400
710
16209
2204
2484
1123
209
853
632
1479
1849
410
1181
1000
1120
500
125
1581
380
597
617
229
200
352
200
6357
205
2079
1026
902
544
249
177
166
108
207
54
57
162
223
148
6216
681
777
426
85
393
176
489
229
161
379
178
378
197
9
139
78
118
125
64
112
241
38
1943
43
645
552
307
157
43.5
25.8
20.0
35.6
44.1
27.0
28.4
54.0
55.8
20.8
38.3
30.9
31.3
37.9
40.7
46.1
27.8
33.1
12.4
39.3
32.1
17.8
33.8
39.4
7.2
8.8
20.5
19.8
20.3
27.9
56.0
68.5
19.0
30.6
21.0
31.0
53.8
34.0
28.9
140
237
231
91
147
55
60
106
103
197
5726
714
899
297
75
291
203
609
302
101
331
250
342
139
53
206
124
179
221
101
41
60
81
2043
74
700
283
352
149
u
u
u
u
u
u
u
u
u
u
u
u
GRADE II
GRADE III
GRADE IV
%
NUMBER
%
NUMBER
%
NUMBER
%
24.5
34.5
27.8
30.0
31.3
27.5
30.2
35.3
25.8
27.7
35.3
32.4
36.2
26.4
35.9
34.1
32.1
41.2
16.3
24.6
28.0
25.0
30.5
27.8
42.4
13.0
32.6
30.0
35.8
44.1
20.5
17.0
40.5
32.1
36.1
33.7
27.6
39.0
27.4
134
181
263
51
78
57
67
27
61
167
4017
608
611
302
39
129
181
317
564
100
270
372
206
116
54
401
142
182
204
51
35
46
60
1779
71
584
139
206
1$5
23.4
26.4
31.7
16.8
16.6
28.5
33.4
9.0
15.3
23.5
24.8
27.6
24.6
26.9
18.7
15.1
28.6
21.4
30.5
24.4
22.9
37.2
18.4
23.2
43.2
25.4
37.4
30.5
33.1
22.5
17.5
13.1
30.0
28.0
34.6
28.1
13.5
22.8
34.0
42
91
125
36
33
14
16
3
9
105
223
159
165
80
6
31
61
64
459
40
152
154
141
33
9
457
24
76
57
13
8
4
16
383
15
124
39
29
42
7.3
13.3
15.1
11.9
7.0
7.0
8.0
1.0
2.3
14.8
1.4
7.2
6.6
7.1
2.9
3.6
9.7
4.3
24.8
9.8
12.. 9
15.4
12.. 6
6.6
7.2
28.9
6.3
12.7
9.2
5.7
4.0
1.1
8.0
6.0
7.3
6.0
3.8
3.2
7.7
7
0
45
17
4
20
0
2
4
93
27
42
32
18
4
9
11
0
295
8
49
46
53
15
0
378
12
42
10
0
4
1
5
209
2
26
13
8
11
1.2
0.
5.4
5.6
0.9
10.0
0.0
0.7
1.0
13.1
0.2
1.9
1.3
1.6
1.9
1.1
1.7
0.0
16.0
2.0
4.1
4.6
4.7
3.0
0.0
23.9
3.2
7.0
1.6
0.0
2.0
0.3
2.5
3.3
1.0
1.3
1.3
0.9
2.0
Contd...
X
X
<
rx
x
Contd
SAMPLE
SIZE
________ NORMAL
NUMBER
%
GRADE I
NUMBER
U
U
u
u
u
u
u
605
885
855
6858
505
500
200
204
389
276
2255
308
208
77
33.7
44.0
32.3
32.9
61.0
41.6
38.5
185
224
288
2787
82
129
64
30.6
25.3
33.7
40.6
16.2
25.8
32.0
166
137
225
1660
52
116
52
27.4
15.5
26.3
24.2
10.3
23.2
26.0
38
86
52
138
33
38
7
6.3
9.7
6.1
2.0
6.5
7.6
3.5
12
49
14
18
30
9
0
2.0
5.5
1.6
0.3
5.9
1.8
0.0
46
19
4
23
61725
31712
3711
26302
20604
11023
1096
8485
33.4
34.8
29.5
32.3
20072
10483
1024
8565
32.5
33.1
27.6
32.6
15465
7854
948
6663
25.1
24.8
25.5
25.3
3930
1722
487
1721
6.4
5.4
13.1
6.5
1654
630
156
868
2.7
2.0
4.2
3.3
TH. NO.
TYPE
74
105.
8
140
45
116
115U
TOTAL
RURAL
TRIBAL
URBAN
%
GRADE II
NUMBER
%
GRADE III
NUMBER
%
GRADE IV
NUMBER
%
*
I f •
J
)
'J
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
11
NUTRITIONAL STATUS OF CHILDREN (0-3YRS)
SAMPLE
GRADE I
NORMAL
GRADE IV
GRADE III
GRADE II
NUMBER
%
NUMBER
%
NUMBER
%
NUMBER
u
294
251
695
881
151
200
340
105
595
130
224
511
564
181
444
237
311
144
457
286
3140
127
103
207
101
36
64
73
38
231
27
130
177
171
75
72
71
83
37
192
75
906
43.2
41.0
29.8
11.5
23.8
32.0
21.5
36.2
38.8
20.8
58.0
34.6
30.3
41.4
16.2.
30.0
26.7
25.7
42.0
26.2
28.9
70
78
245
137
51
58
104
38
136
46
67
145
156
38
72
65
95
56
127
81
1089
23.8
31.1
35.3
15.6
33.8
29.0
30.6
36.2
22.9
35.4
29.9
28.4
27.7
21.6
16.2
27.4
30.5
38.9
27.8
28.3
34.7
64
40
192
297
23
45
92
21
162
42
25
101
115
50
154
76
99
39
98
66
890
21.8
15.9
27.6
33.7
15.2
22.5
27.1
20.0
27.2
32.3
11.2
19.8
20.4
27.6
34.7
32.1
31.8
27.1
21.4
23.1
28.3
27
26
51
213
21
22
71
4
52
14
2
60
88
14
100
20
24
12
27
40
178
9.2
10.4
7.3
24.2
13.9
11.0
20.9
3.8
8.7
10.8
0.9
11.7
15.6
7.7
22.5
8.4
7.7
8.3
5.9
14.0
5.7
6
4
0
133
20
11
0
4
14
1
0
28
34
4
46
5
10
0
13
24
77
2.0
1.6
0.0
15.1
13.2
5.5
0.0
3.8
2.4
0.8'
0.0
5.5
6.0'
2.2
10.4
2.1
3.2'
0.0
2.8
8.4
2.5
21
11
4
6
10141
3866
1700
4575
2996
1137
495
1364
29.5
29.4
29.1
29.8
2954
1030
411
1513
29.1
26.6
24.2
33.1
2691
1003
420
1268
26.5
25.9
24.7
27.7
1066
503
262
301
10.5
13.0
15.4
6.6
434
193
112
129
4.3
5.0
6.6
2.8
TH. NO.
TYPE
31
31R
69
15
35
21
16
61
29
57
120
34A
34
71A
44
129
74
82A
8
106
72
R
R
R
R
R
R
R
R
R
R
R
T
T
T
T
U
U
U
U
U
TOTAL
RURAL
TRIBAL
URBAN
SIZE
%
NUMBER
%
rx
x
>—<
)
r
x
14
x
SIGN & SYMPTOMS OF VITAMIN B-COMPLEX, VITAMIN-A DEFICIENCY
AND ANAEMIA IN CHILDREN (0-6YRS)
%
TH. NO.
TYPE
59
103
60
16
55
66
29
19
15
34A
44
34
22A
22
119
138
137
106
114
42
124
95
125
68
94
105
115
111
24
92
RURAL
TRIBAL
URBAN
TOTAL
R
R
R
R
R
R
R
R
R
T
T
T
U
u
u
u
u
u
u
u
u
u
u
u
u
u
u
u
u
u
9
3
18
30
I
SAMPLE
SIZE
NUMBER
1150
82
686
632
400
1123
214
1849
1120
1000
1181
112
112
205
500
51
24
25
24
6
20
19
22
10
1
15
5
34
%
7.1
7.4
3.8
6.3
2.1
2.8
1.1
1.7
2.2
0.8
0.9
13.4
2.4
6.8
597
28
4.7
1026
867
55
4
5.4
0.5
1376
352
39
22
2.8
6.3
6054
3301
5147
14502
232
51
203
486
ANAEMIA
VIT-A DEFICIENCY
B-COMPLEX DEFICIENCY
3.8
1.5
3.9
3.4
X
SAMPLE
SIZE
NUMBER
%
1150
830
500
686
632
400
1123
214
1849
1120
34
69
9
105
60
2
239
3
26
158
3.0
8.3
1.8
15.3
9.5
0.5
21.3
1.4
1.4
14.1
1181
105
112
205
159
10
43
8
13.5
9.5
38.4
3.9
200
597
118
1026
867
902
125
1376
352
885
200
1376
1545
380
7384
2301
10371
20056
25
174
86
132
26
17
27
151
5
187
74
151
54
54
547
317
1224
2088
12.5
29.1
72.9
12.9
3.0
1.9
21.6
11.0
1.4
21.1
37.0
11.0
3.5
14.2
7.4
13.8
11.8
10.4
NUMBER
%
830
500
686
632
243
1123
228
289
544
364
32
598
27.5
57.8
79.3
57.6
13.2
53.3
1849
1120
79
205
4.3
18.3
112
112
25
50
22.3
44.6
500
17
3.4
597
106
17.8
1026
867
328
23
32.0
2.7
1376
132
9.6
885
193
21.8
5863
1120
5475
12458
2134
205
874
3213
36.4
18.3
16.0
25.8
SAMPLE
SIZE
15
COMPARATIVE DATA OF SIGN AND SYMPTOMS OF VITAMIN-A, VITAMIN B-COMPLEX DEFICIENCY
AND ANAEMIA IN ICDS & NON ICDS IN CHILDREN (0-6YRS)
B-COMPLEX
TH. NO.
TYPE
SAMPLE
SIZE
19
66
92
94
95
115
119
137
138
R
R
U
U
VITAMIN-A
NUMBER
%
SAMPLE
SIZE
NUMBER
214
400
6
25
2.8
6.3
352
22
6.3
•214
400
380
352
902
200
205
200
3
2
54
5
17
74
825
ANAEMIA
%
SAMPLE
SIZE
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
205
5
2.4
500
34
6.8
ICDS
ALL TOTAL
RURAL
URABN
1671
614
1057
92
31
61
5.5
5.0
5.8
2853
614
2239
188
5
183
6.6
0.8
8.2
19
66
92
94
95
115
119
137
138
R
R
U
U
U
U
U
U
U
214
357
8
27
3.7
7.6
355
40
11.3
214
357
404
355
169
300
202
200
18
15
116
16
4
117
24
70
8.4
4.2
28.7
4.5
2.4
39.0
11.9
35.0
NICOS
u
u
u
u
u
NICOS
NICOS
NICOS
NICOS
NICOS
NICOS
NICOS
NICOS
NICOS
202
10
5.0
500
145
29.0
ALL TOTAL
RURAL
URBAN
1628
571
1057
230
35
195
14.1
6.1
18.4
2201
571
1630
380
33
347
1.4
0.5
14.2
1.4
1.9
37.0
3.9
12.5
17.3
5.8
21.3
NUMBER
%
243
32
13.2
500
17
3.4
743
243
500
49
32
17
6.6
13.2
3.4
154
42
27.3
500
34
6.8
654
154
500
76
42
34
11.6
27.3
6.8
r
x
x
x
rx
x
X
16
PREVALENCE OF SPECIFIC MORBIDITY PER WEEK IN CHILDREN
SAMPLE
NUMBER
SIZE
%
SAMPLE
SIZE
NUMBER %
TH. NO
TYPE
31
123
15
29
66
47
99
19
34
94
119
138
95
R
R
R
R
R
R
R
R
T
U
U
U
U
509
250
1849
1123
400
1260
181
214
1120
352
205
500
902
59
83
12
77
41
265
49
7
142
22
36
40
79
11.6
33.2
0.6
6.9
10.3
21.0
27.1
3.3
12.7
6.3
17.6
8.0
8.8
509
250
1849
1123
400
1260
181
214
1120
352
21
95
65
98
72
464
67
4
125
45
4.1
38.0
3.5
8.7
18.0
36.8
37.0
1.9
11.2
12.8
500
902
160
136
32.0
15.1
RURAL
5786
1120
1959
593
142
10.2
12.7
5786
886
177
9.0
1120
1754
GRAND TOTAL 8865
912
10.3
8660
TRIBAL
URBAN
SAMPLE
SIZE
NUMBER
EYE INF.
FEVER
PYODERMA
RESP INF.
DIARRHOEA
%
SAMPLE
NUMBER %
SIZE
509
29
5.7
42
11
2.3
1.0
SAMPLE
SIZE NUMBER %
250
1849
1123
400
1260
181
21
17
200
5
104
10
8.4
0.9
17.8
1.3
8.3
5.5
352
18
5.1
902
21
2.3
1849
1123
400
1260
181
3
183
18
22
11
0.2
16.3
4.5
1.7
6.1
1849
1123
1260
181
328
18
26.0
9.9
1120
352
205
500
902
332
19
15
65
44
29.6
5.4
7.3
13.0
4.9
1120
352
205
500
902
24
12
16
135
109
2.1
3.4
7.8
27.0
12.1
4813
1120
237
332
428
24
357
7.1
143
272
8.7
2.1
13.9
5063
1959
4.9
29.6
7.3
4922
125
341
15.3
11.2
19.4
1254
39
3.1
1352
15.6
7892
712
9.0
8001
724
9.0
6317
396
6.3
1120
1959
17
NUMBER OF EPISODES PER CHILD PER YEAR
DIARRHOEA
TH. NO. TYPE
65
28
6
42
82
R
T
U
U
u
RURAL
TRIBAL
URBAN
GRAND
TOTAL
RESP. INFECTION
PHODERMA
SAMPLE
SIZE
EPISODE
E/YR
EPISODE
E/YR
643
155
200
636
229
802
199
243
169
439
1.2
1.3
1.2
0.3
1.9
1566
205
347
292
324
2.4
1.3
1.7
0.5
1.4
643
155
1065
802
199
851
1.2
1.3
0.8
1566
205
963
2.4
1.3
0.9
1065
1863
1852
1.0
2734
1.5
1065
FEVER
SAMPLE
SIZE
EPISODE E/YR
200
636
229
SAMPLE
SIZE
EYE INFECTION
EPISODE E/YR
SAMPLE
SIZE
EPISODE E/YR
643
155
1345
224
2.1
1.4
643
435
0.7
1.0
0.2
0.4
229
227
1.0
636
229
65
37
0.1
0.2
2.1
1.4
1.0
435
0.7
0.4
1345
224
227
643
439
643
155
229
865
102
0.1
439
0.4
1027
1796
1.7
1508
537
0.4
191
152
96
r
x
X
X
r
X
18 X
X
COMPARATIVE DATA OF POINT PREVALENCE OF SPECIFIC MORBIDITY IN CHILDREN IN 1CDS AND
NON 1CDS GROUPS
SAMPLE
SAMPLE
TH. NO.
31
66
99
123
94
•95
119
138
TYPE
R
R
R
R
U
U
U
U
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
ICDS
4 URBAN
4 RURAL
8 TOTAL
31
66
99
123
94
95
119
138
R
R
R
R
U
U
U
U
4 URBAN
4 RURAL
8 TOTAL
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
NICDS
PYODERMA
RESP INF
DIARRHOEA
EYE INF
FEVER
SAMPLE
SAMPLE
SAMPLE
SIZE
NO.
%
400
181
18
11
4.5
6.1
181
18
9.9
32.0
352
902
205
500
19
44
15
65
5.4
4.9
7.3
13.0
352
902
205
500
12
109
16
135
3.4
12.1
7.8
27.0
341
255
596
19.4
19.0
19.3
1959
581
2540
143
29
172
7.3
5.0
6.8
1959
690
2649
272
47
319
13.9
6.8
12.
500
357
186
300
355
169
13
67
56
60
64
25
2.6
18.8
30.1
20.0
18.0
14.8
500
41
8.2
357
186
39
19
10.9
10.2
186
15
8.1
500
380
76.0
355
169
202
500
34
10
35
195
9.6
5.9
17.3
39.0
355
169
202
500
18
19
41
245
5.1
11.2
20.3
49.0
1024
1343
2367
469
196
665
45.8
14.6
28.1
1226
543
1769
274
58
332
22.3
10.7
18.8
1226
686
1912
323
56
379
26.3
8.2
19.8
SIZE
NO.
%
SIZE
NO.
%
509
400
181
250
352
902
205
500
59
41
49
83
22
79
36
40
11.6
10.3
27.1
33.2
6.3
8.8
17.6
8.0
509
400
181
250
352
902
21
72
67
95
45
136
4.1
18.0
37.0
38.0
12.8
15.1
500
160
1959
1340
3299
177
232
409
9.0
17.3
12.4
1754
1340
3094
500
357
186
300
355
169
202
500
80
55
52
111
38
18
83
66
16.0
15.4
28.0
37.0
10.7
10.7
41.1
13.2
1226
1343
2569
205
298
503
16.7
22.2
19.6
SIZE
NO.
%
509
29
5.7
SIZE
NO.
%
400
181
250
352
902
5
10
21
18
21
1.3
5.5
8.4
5.1
2.3
1254
831
2085
39
36
75
3.1
4.3
3.6
357
186
300
355
169
7
21
31
22
3
2.0
11.3
10.3
6.2
1.8
524
843
1367
25
59
84
4.8
7.0
6.1
19
BREAST FEEDING PRACTICES IN MOTHERS
TH. NO
TYPE
SAMPLE
SIZE
0-1 YR.
%
DURATION
1-2YR
%
2YR+
21
66
28
30
94
2
2
1
R
R
T
T
U_____
RURAL
TRIBAL
URBAN
240
321
170
164
310
561
334
310
52
55
34
22
52
107
56
52
21.7
17.1
20.0
13.4
16.8
19.1
16.8
16.8
185
233
60
109
226
418
169
226
77.1
72.6
35.3
66.5
72.9
74.5
50.6
72.9
3
33
76
33
33
36
109
33
1.3
10.3
44.7
20.1
10.6
6.4
32.6
10.6
5
TOTAL
1205
215
17.8
813
67.5
178
14.8
%
COMPARATIVE DATA OF BREAST FEEDING PRACTICES IN MOTHERS IN ICDS AND NON ICDS
GROUPS
TH. NO
TYPE
66
R
94
U
ICDS
NICDS
ICDS
NICDS
ICDS
NICDS
SAMPLE
SIZE
0-1 YR.
%
DURATION
1-2YR
%
2YR+
321
282
310
305
55
47
52
55
17.1
16.7
16.8
18.0
233
205
226
222
72.6
72.7
72.9
72.8
33
30
33
28
10.3
10.6
10.6
9.2
631
587
107
102
17.0
17.4
459
427
72.7
72.7
66
58
10.5
9.9
%
r
x
x
x
20 X
X
X
<
WEANING PRACTICES IN CHILDREN
TH. NO
TYPE
21
23
66
28
30
67
92
R
R
R
T
T
U
U
3
2
2
7
RURAL
TRIBAL
URBAN
TOTAL
SAMPLE
SIZE
0-6 MONTHS
240
200
349
170
164
45
120-
22
0
’34
0
8
0
14
9.2
0.0
9.7
0.0
4.9
0.0
11.7
61
50
193
8
15
18
98
789
334
165
1288
56
8
14
78
7.1
2.4
8.5
6.1
304
23
116
443
%
AGE AT WEANING
7-12 MONTHS
%
12 MONTHS+
%
25.4
25.0
55.3
4.7
9.1
40.0
81.7
157
150
122
162
149
27
8
65.4
75.0
35.0
95.3
90.9
60.0
6.7
38.5
6.9
70.3
34.4
429
311
35
775
54.4
93.1
21.2
60.2
COMPARATIVE DATA ON WEANING PRACTICES IN CHILDREN IN ICDS AND NON ICDS GROUPS
TH. NO
TYPE
66
R
92
U
SAMPLE
SIZE
0-6 MONTHS
ICDS
NICDS
ICDS
NICDS
349
294
120
120
34
11
14
10
9.7
3.7
11.7
8.3
193
42
98
105
ICDS
NICDS
469
414
48
21
10.2
5.1
291
147
%
AGE AT WEANING
7-12 MONTHS
%
12 MONTHS+
%
55.3
14.3
81.7
87.5
122
241
8
5
35.0
82.0
6.7
4.2
62.0
35.5
130
246
27.7
59.4
Appendix V
Abbreviations Used
AIIMS
All India Institute of Medical Science
ANM
Auxiliary Nurse Midwife
AP
Andhra Pradesh
AW
Anganwadi
AWW
Anganwadi Worker
BCG
Bacille Callmetti Gueun
BF
Breast feeding
CTC
Central Technical Committee
DPT
Diphtheria, Pertussis Tetanus
DT
Diptheria & Tetanus (toxoid)
HP
Himachal Pradesh
ICDS
Integrated Child Development Service
J&K
Jammu & Kashmir
MCH
Maternal & Child Health
MP
Madya Pradesh
ORS
Oral Rebydrotion Solution
PGIMER
Post Graduate Institute of Medical Education & Research
PHC
Primary Health Centre
PSM
Preventive & Social Medicine
SRS
Sample Registration System
TN
Tamil Nadu
TT
Tetanus Texoid
DIP
Universal Immunization Programme
UP
Uttar Pradesh
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