Are children getting a
healthy start?
A study on early childhood in urban slums
Overview of
the Study
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•
Study of Early Childhood in 18 slums across 5 metro
cities
Focus of The Study
–
Nutritional status among children in the age group of one
to six years
–
Immunization status and Supplementation history
–
–
ICDS service and its utilization by children.
Knowledge and practice of primary care giver about ICDS
service provisions.
Methodology
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Respondent : Primary caregiver for children
between 1 to 6 years
ü
Design: Household survey
ü
Sample Size: 1260 children
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Tools: Questionnaire
ü
Nutritional Assessment as per WHO guidelines
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Data Analysis using statistical package
Quality
Measures
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ü
ü
ü
Spot checks and back checks
Post data collection validation at multiple
layers
Hands on training on study tools in each
region given to Volunteers to conduct the
study
Online real-time Data entry done by using
Google spread sheet
Limitations
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ü
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ü
Few samples lost due to lack of response on certain
parameters during data collection.
Height data could not be collected from Chennai and
Kolkata.
Study does not covers the aspects like food and dietary
practices at household level, maternal health, birth
weight etc.
Respondents had to be surveyed depending on
availability which did not for a pure random sample.
Profile of
the Respondents
The respondents are mostly migrants
from neighbouring states and are from
the lower socio-economic group. They
have varied religious and linguistic
background. Most of them are employed
in the unorganized sector and are daily
wage earners.
Sampled cities
Nutritional Status of
Children
•
Underweight
Nutritional status
of children
Prevalence of children who are underweight
•
•
54.7% (normal) 20.5% (underweight) 24.8%
(severely underweight)
The % of severely underweight is in the order
of Chennai (37%), Kolkata ( 32%), Delhi (25%),
Mumbai (23%) and Bangalore ( 13.2 %)
*National data
City wise
underweight status
Basic inputs - Child health
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•
•
Immunisation
Supplementation- Vitamins and micro nutrients
De-worming
Immunisation
*National data
City wise vaccination
scenario
Vaccination Received ( 1-3 only) Bangalore
77.4%, Kolkata 58.5%, Chennai 56.5%, Mumbai
48.6%. Delhi 31.4%,
Vitamin A, De-worming
and IFA Tablets
Vitamin A
Mumbai 81.3%, Chennai 88.3%, Kolkata
68.6%, Delhi 47.9%, Bangalore 43.4%, total
63.8%
De worming
Chennai 77.3%, Mumbai 72.7% , Delhi
Anganwadis – Enrolment and Services
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•
Health and Nutrition
Learning
ICDS Enrolment
Enrolled in AWC
Bangalore
Chennai
Delhi
Kolkata
Mumbai
total
Enrolled in AWC
47.1%
58.2%
46.9%
59.4%
62.2%
54.3%
Growth Monitoring
Growth monitoring of the children
by AWW
Regular
Monitoring
Not taken
Month-wise or Periodicity
in last 6
quaterly
uncertain
months
66.1%
18.5%
15.5%
Bangalore
Chennai
75.6%
3.8%
20.6%
Delhi
59.2%
9.9%
30.8%
Kolkata
87.0%
5.0%
8.0%
Mumbai
73.3%
12.1%
14.7%
total
70.2%
11.0%
18.8%
Informing parents about
the need for treatment
AWW told parents that child is
malnourished and needs treatment
City
Yes
Bangalore
10.8
Chennai
33.8
Delhi
41.2
Kolkata
24.3
Mumbai
37.6
total
31.3
Hot cooked meal
Take home ration
Pre-school education
Where is child enrolled
for PSE
AWC
45.9%
Private preschool
44.3%
Other preschool
9.8%
Chennai
59.3%
17.6%
23.1%
Delhi
37.4%
45.5%
17.1%
Kolkata
48.3%
44.9%
6.7%
Mumbai
42.9%
44.9%
12.2%
total
44.2%
41.5%
14.3%
Bangalore
Child allowed to play
Bangalore
Yes
79.0%
No
Don’t know
19.4%
1.6%
Chennai
88.8%
11.2%
0.0%
Delhi
65.1%
34.5%
.4%
Kolkata
77.5%
20.2%
2.2%
Mumbai
84.2%
13.2%
2.6%
total
76.3%
22.5%
1.2%
Knowledge, attitude and practice
of the primary caregiver
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•
Knowledge of the age of enrolment in the ICDS
Frequency of visits and participation in the anganwadi
activities
Caregivers’ knowledge
ECCD day
Knowledge about age of enrolment
(Total 63.90% are aware of the correct age of
enrollment of the child)
Silver lining: total 82%
care givers reported that their
child likes going to the anganwadi
Recommendations
Broad Policy Recommendations
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Early Childhood Care and Development (ECCD) policy
and programmes to be contextualised to urban settings
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Entitlement for children (0-6 years) to be guaranteed by
law
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Improving the information and knowledge of parents on
ECCD
Recommendations
Recommendations for ICDS
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•
Strengthening the service delivery of all 6 services of
Anganwadi
Intervention to Improve the nutritional Status: Quality,
Quantity and Regularity
–
Growth Monitoring process to be strengthened and broad
based: Monitor Height
–
Need for Improvement in early Identification and
management cases of malnutrition
–
Strengthening the component of Nutritional Counselling
by AWW
Thank You