Annual programme implementation plan 2011-12 department of women & child development government of Gujarat contents
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Bal Bhog Sukhadi Upma Sheera b) Status of implementation of national guidelines on infant and young child feeding practices. The Infant and Young Child Feeding practices are promoted through several IEC activities on different occasions, including Mamta Diwas. Besides the AWWs and ICDS Supervisors, the Family Health Workers are also involved in counseling the mothers. The Nutrition Associates appointed at the CDNCs also counsel the mothers on the feeding practices. c) Existing mechanism for counselling of mothers on nutrition and health issues by AWWs/Supervisors during home visits; Availability and use of NHED kits (if any). Details in section 2, strategies - 4 d) NHED sessions during VHND/NHD - use of IEC materials (tools) during NHEDs and home visits, separately. Details in Chapter 3, Section 4D. e) Monitoring mechanism At each CDNC, two teams (Block level and Village level) are formed. The Block team is responsible for organizing meetings at the village level and conducting activities like checking the weight of children below 5 years, identifying the severely malnourished children, counseling of mothers and other family members, monitoring the Bhavai show. The Village level team is responsible for informing the women about the meeting one day in advance, for maintaining the records, for maintaining contacts with parents of severely malnourished children and referring to CDNCs and follow up.
C4. Immunization Current scenario: Immunization program has five major components including Vaccination, Monitoring of vaccination coverage, Surveillance of vaccine preventable diseases, Reporting of adverse event following immunization and training. Immunization programme of Gujarat has undergone significant changes in recent years which include new policy environment (National Rural Health Mission), New Vaccine (e.g. MMR pilot project in Nirogi Bal Varsh, HPV for prevention of cervical cancer, introduction of Hepatitis B Vaccine), new technique to solve old problems (e.g.Injection safety ), new technologies for Vaccine delivery and cold chain, Skill building for vaccination, AEFI, cold chain maintenance and supervision and monitoring and universal introduction of RIMS. Current immunization coverage rates (based on DLHS 3/ICDS MPRs) in the State/CES Immunization Coverage in Gujarat Gujarat has improved on the various indicators of Reproductive and Child health but much is still required to be done on Immunization Programme. Fig 32: Immunization coverage (MIS Reporting) 
Though reported immunization coverage through MIS system is showing improvement in antigenwise coverage in Gujarat, the DLHS-3 (2007-08) & recent CES 2009 Survey reveal that antigen wise coverage is low as compared to reported coverage of the State. Fig 33: Immunization Coverage (DLHS 3 & CES 2009) 
The BCG Coverage of the State has decreased to 84.9 % (CES 2009) as compared to DLHS-3 (2007-08). The increase of mere 1% in Full Immunization coverage as per CES 2009 requires maximum attention. Fig 34: Child Immunization (Left out & Drop Out) Data Source: CES 2009 
The recent Coverage Evaluation Survey 2009 reveals that left-out children for Immunization & Drop- out is still a major concern for Gujarat. The BCG-DPT3 dropout at 19.9 % and DPT1-DPT3 Dropout of 16.5% is a major cause of low coverage of fully immunized children in the State. Existing mechanism for immunization service (including vitamin A supplementation) – such advance planning with health, its implementation and joint monitoring etc. Status of Micro planning A comprehensive micro-plan for all the 26 districts of the State is in place. All the sessions are conducted as per the micro-plan with special focus on hard to reach areas. In the year 2009-10, 339978 sessions were held against the 347585 planned. In the year 2010-11, upto November 2010, 224738 sessions have been held against the total 368236 planned for the entire year. The mechanism of coordination & convergence between ASHA and AWW AWW & ANM with the help of ASHA inform all pregnant women and lactating mothers and children below five years of age on the eve of the Mamta day to come to the AWC the next day. The AWW weighs the women and the children and record their weights in the Mamta Card. Those requiring medical attention are referred to the health facilities or Mamta Sandarbh centres. Vitamin A Supplementation- Biannual Round Vitamin A supplementation program for children 9 months to 5 years is operational in the State through the biannual round. The first dose is given to children along with measles vaccine at 9 months of age during the Mamta Diwas. Doses 2 to 9 are supplemented biannually upto 5 years of age in the months of February and August. Concurrent monitoring during biannual rounds has also being introduced for mid-course corrective action. Therapeutic dose of Vitamin A is given to children with signs and symptoms of Vitamin A deficiency, during the School Health Checkups. Apart from this, postnatal vitamin A capsule (2 Lakh IU) is supplemented to mothers within 1 week of delivery to prevent sepsis and increase vitamin A content of breast milk. Plantation of drumstick trees by Forest Department and development of kitchen and community gardens by Panchayat Department are the initiatives under Nirogi Bal Varsh aiming at improving Vitamin A supplementation. Current Status As per DLHS-2 Vitamin A Supplementation in last six months was 31.7%, this coverage rate have almost doubled as 61% as per DLHS-3, 07-08. Proposed intervention A Tribal belt of the state shall be the high focus area for interventions to reduce undernutrition and shall be monitored for service coverage (process indicators). The designing of the interventions is in progress. Target for 2010-11 = 1870168 children Nos. of children fully immunized till November 2010 (upto measles vaccination) = 602122 children C5. Health Check-ups Describe the existing mechanism for health check-ups of pregnant women (antenatal care) and children The health checkup of pregnant women is done at AWCs in coordination with the health staff. The current strategies for ANC care are as under: Dissemination of work plan generated through E- Mamta software to the field workers for early registration and tracking of each pregnant woman. Increase the rate of early registration of pregnancy by designing time- place movement plan of ASHA to ensure her regular contact with eligible women, training them for use of pregnancy test kit and counseling for early registration Increasing integrated ANC coverage through Mamta Abhiyan, increase mobilization with the participation of ASHAs as well as VHSCs. Early identification of anemia through Hb testing and addressing issue of IFA compliance through IFA DOTs, timely counseling and referral Personalized attention to all pregnant women, lactating mothers and children by community mobilizers and health workers. Supply and composition of medicine kits during the last FY Details in section 4B, b. Status of coverage of at least three ANC check-ups of the pregnant women during the last year The table below shows the coverage of pregnant women for Antenatal checkups during the year 2010-11. The data is provided as on November 2010, as reported in the State MIS of the Health Department. Table 25: Status of ANC coverage during the year 2010-11
Supply of IFA tablets to pregnant women through RCH II – nos. of AWCs provided IFA during last year Iron Folic Acid (IFA) tablets are provided to pregnant and lactating mothers as per the standard protocol. From June, 2009 onwards, under RCH program, the State has introduced iron syrup for children (6-60 months) on daily basis for 100 days each year. Strategy to improve health check-ups during the FY Efforts are being made to enter the data of health checkups in computers for name based tracking of women and children. Any specific interventions for tribal/rural/urban AWCs in conjunction with Tribal/Rural/Urban departments Not applicable Any linkage with AYUSH Not available Table 26: Status of Health Check-ups
Note: Except Medicine kits, no cost is involved for health check-ups in ICDS. All services provided by Health. C6. Referral Services Existing mechanism for referral services (with health) Along with the health staff, 26,000 AWWs have been trained on Integrated Management of Neonatal and Childhood Illnesses with UNICEF support and are in a position to identify the complications in children. The AWWs make home visits on regular basis for children less than 2 months and immediately refer the children to the health facilities, once the complication is identified. For children above 2 months, the parents go to the AWWs in case of any complications. The AWWs, based on the intensity of the complication, refer them to the Mamta Sandarbh, which is held every month on a fixed day. However, in cases where immediate attention is required, the AWWs refer them to the nearest health facility through EMRI 108. It is the State referral system for the PHC/CHC/DH operational in the entire State. There are in all 453 vehicles available across the State. The community is also made aware of conditions in which a woman and a child require immediate referral (the danger signs), the transport facilities available, and the place where they should go in case of various emergencies through AWWs and ASHAs. School Health Programme Total 1.53 crore children were registered in the School Health Programme out of which there were 37.69 lakhs children registered at the AWC. Details of these 37.69 lakh children are as follows:
Fig 35: Status of referrals as on January 2011 
The above graph shows the status of referrals at various levels of health facilities. It is very clear from the graph that maximum number of clients (boys, girls, and mothers) is referred to the Sub-centre, which is the nearest health post at village level. 4D. Observance of Nutrition and Health Days Mechanism for observance of monthly nutrition and health days (NHDs) – existing planning and schedule and monitoring; convergence with NRHM – VHNDs Details in Chapter 3, Section 4C, C3 e. Summary of activities that are taken up during the NHDs Activities:- Organizing Mamta Divas (health and Nutrition day) in a village every month, MAMTA divas services through mobile health units in remote- difficult- scattered area and sustaining quality ANC care at each facility Micro-planning of Mamta Divas – Beneficiaries in the village are informed well in advance to avail the services on fixed days Recording maternal health event and service details in E- Mamta to facilitate tracking of each mother. Supplementation of Micronutrients Supply of Iodized salt to mothers visiting MAMTA divas Monitoring of weight gain of the pregnant women and nutrition counseling Supply of need based equipments/instruments (weighing machine, BP instruments, urine test sticks) Supply of need based drugs, medicines, and Mamta Card supplies Organizing ANC clinics in remote, tribal, and peri-urban areas through mobile health units Developing linkages with private practitioners to take care of complicated cases at designated Mamta Sandarbh Referral Centers Involvement of NGO in increasing complete ANC coverage and ensuring safe delivery Joint monthly review meetings by ICDS and Health Department at PHC level and half yearly meeting at District level Birth micro plan to be prepared with the help of AWW/ASHA/TBA and to share EDD with EMRI of the region Whether support received from community/PRIs for observance of nutrition and health days For any village level public health activity like cleanliness drive, sanitation drive, school health activities, child care activities, care of pregnant women and lactating mothers, family planning, promotion of girl child, and HIV/AIDS awareness activities, involvement of PRIs and community is essential. The kind of support received from them is as below: In extraordinary case of destitute women or very poor household, the Village Health and Sanitation Committee grants are used for their health care. The grant is a resource for community action at the local level and only used for community activities that involve the benefit for more than one household. Nutrition awareness and Sanitation, Environmental Protection, Public Health Measures are the key areas where these funds are utilized. To organize Village Health and Nutrition Days (VHND) / Mamta Diwas in the Gram Panchayat every month. To create awareness in the Gram Panchayat about various State Health Schemes particularly Janani Suraksha Yojna (JSY), Rashtriya Swasthya Bima Yojna (RSBY). To ensure reporting and registration of all the vital health events occurring in the Gram Panchayat like Births, Deaths (including maternal, infants) with local Birth and Death registrar i.e. Secretary, Gram Panchayat. To organize Village Health and Sanitation Committee (VHSC) meetings. To maintain VHSC records. Every village is free to contribute additional grant towards the Village Health and Sanitation Committee. In villages where the community contributes financial resources to the Village Health and Sanitation Committee, additional incentive and financial assistance to the village could be explored. The intention of this grant is to enable local action and to ensure that Public Health activities at the village level receive priority attention. Any specific interventions for tribal/rural/urban AWCs in conjunction with Tribal/Rural/Urban departments Not applicable e) Status of Nutrition and Health Days/Mamta Diwas About 31,000 Mamta Diwas are being held in the State every month. As per the reports of the 2nd quarter, upto September 2010, 95239 sessions have been held against the 95783 planned. 4E. Information, Education and Communication (IEC) Describe activities carried out under IEC component during last year The role of IEC under the ICDS programme is to create awareness among the target audience (pregnant and lactating women, adolescent girls, children, family members) about the services and schemes available, benefits of the schemes and how to avail them. At service provider level, IEC materials can be used for capacity development of the functionaries on the services to be provided by them and also for using the materials in the community. Behaviour Change Communication (BCC) is a process of working with individuals, communities and societies to develop communication strategies to promote positive (different) behaviours which are appropriate to their settings and also provide (develop) a supportive environment that will enable people to adopt and sustain positive behaviour. BCC, by definition, needs to involve communities in the design of behaviour change solutions. Therefore, behaviour change strategies encompass a broad range of activities and approaches, which focus on the individual, community, and environmental influences on behaviour. Interventions to change behaviour have tremendous potential to alter current practices of sanitation. The emerging BCC practices emphasize the role of the community, social acceptance, emotion, and emulation in personal change. BCC underlies the importance of communication in influencing change. Information alone is not enough to influence sustainable behaviours. Knowledge and action are not necessarily connected. Information dissemination may result in increased awareness but may have limited impact on improving behavioural norms. Therefore, it is important to stimulate a shared learning through dialogue, participation and discussions with community members. Some of the key strategies of BCC have been outlined here: Institutionalize capacity within the state for strategic planning, implementation and monitoring of BCC interventions. Focus on key behaviours while giving greater importance to the interpersonal communication and context-specific social/ partners mobilization. - Promote demand for health/ nutrition services Focus on the ‘High alert’ Blocks and villages in each district Ensure research and evidence based communication materials Capacity building of implementing agents (Health/ ICDS/ RD/ Education/ NGOs & others) Promote inter-sector synergy as well as public-private partnership- Knowledge management- documentation of programme Activities in 2010-11: State level SATCOM – 22nd March 2011 to sensitize the community on importance of safe drinking water and hygiene practices on World Water Day Mahila Sammellan – Mata Yashoda Awards for AWWs of Gandhinagar district – 4th March 2011 SATCOM – 23rd February 2011 (Annaprashan Day – every 4th Friday of the month) State level Seminar for Faculties and Students of Home Science Colleges, 21st December 2010 Celebration of IDD day - 21st Oct 2010 Celebration of Hand Washing day – 11th Oct 2010 THR launch at State level by the Hon. Chief Minister on 8th June 2010. Also, Web launching, live telecast by BISAG (Bhaskaracharya Institute of Space Application and Geoinfomatics) Food & Nutrition Board – Posters and booklets provided by FNB distributed at district and block level Development of Photo Gallery Updation of Website UNICEF supported activities: IDD day celebration – provision of kits and resource material Annaprashan day celebration Pre-school Education – provision of kits and books TOT on use of WHO New Growth Standards and Annaprashan Day celebration – April 2010 Support for Mamta workshops List out the IEC materials that have been developed State level Booklet on Annaprashan Flip book on Annaprashan Diwas Flip book on Guidelines for Complementary Feeding Flip book on WHO New Growth Standards Annaprashan Toran THR pamplets Board for all AWCs on THR Flex banners for all AWCs on SNP ICDS booklet Hoardings at district level on THR Film on ICDS – about the department and its initiatives Recipe booklet – use of THR to prepare several nutritious recipes IEC materials provided by UNICEF USI spot testing kits @ 1 kit per AWC Pre-school booklet Pre-school kits IDD poster TSC posters (set of 2) Proposed interventions for the year 2011-12: IEC/BCC Strategy for ICDS ICDS Services 1. Supplementary Nutrition Programme Significance of ICDS Supplementary Nutrition Relevant messages on the on-going Take Home Ration pre-mix packets being given to all concerned beneficiaries through AWCs – who receives, how many, what does it contains, its health beneficial effects. Messages on importance of ‘Timely Initiation of Complementary Feeding’ i.e. Annaprashan Diwas and activities conducted on Annaprashan Diwas How to implemented efficiently and effectively – Annaprashan Diwas Message on hygienic preparation of ‘Supplementary Nutrition’ being provided through Matru Mandals Importance of supplementary nutrition to community members Awareness on various supplementary nutrition initiatives like providing fruits, milk etc. Immunization Ensure registration of every expectant mother and child in the AWCs, importance of Mamta Card and Mamta Diwas Ensure complete immunization calendar with details children to be vaccinated in Mamta Diwas session Importance of immunization for child’s health, center where immunization services can be availed Pre school education Importance of preschool activities Various types of preschool activities being conducted at AWCs Referral services When , in what critical conditions there is a need of referral services Nearby referral centers for the beneficiaries Type of services being provided Who provides the referral services Nutrition Health Education Relevant messages regarding care and nutrition required during pregnancy and lactation Relevant messages on importance of breastfeeding, complementary feeding, maintenance of food hygiene IMNCI protocols Adverse impact of undernutrition on health and growth and development of children Signs and symptoms of severely acute undernutrition among children Signs and symptoms of Anemia among adolescent girls and pregnant and lactating mothers Importance of consumption of iodized salt and adverse effects of iodine deficiency disorder Practicing hygienic cooking and feeding practices, use of safe potable water 6. Health Check Up - Various services and activities carried on Mamta Diwas by AWW and ANM 7. Ten Proven Essential Interventions to reduce undernutrition Develop relevant materials and promote the 10 essential intervention to reduce undernutrition that is on : Initiation of breastfeeding within one hour of birth. Exclusive breastfeeding during the first six months of life. Timely introduction of complementary foods at six months. Age-appropriate foods for children six months to two years. Hygienic complementary feeding practices. Immunization & bi-annual Vitamin A supplementation with deworming. Appropriate feeding for children during and after illness. Therapeutic feeding for children with severe acute malnutrition. Adequate nutrition & support for adolescent girls to prevent anemia. Adequate nutrition & support for pregnant & breastfeeding mothers. 8. Adolescent Girls – SABLA and Mamta Taruni Targeted beneficiary of the scheme., different types of services being given under SABLA – to whom, when, why, how Needs of adolescent girls Importance of supplementary nutrition to adolescent girls Adverse effect of anemia on growth and developments and prevention against anemia Relevant messages on Adolescent Reproductive and Sexual Health Relevant messages on life skill education, family welfare and nutrition – health education for adolescent girls How vocational skills being provided under SABLA can enable empowerment of the adolescent girls Importance of Kishori / SABLA card 9. Indira Gandhi Matritva Sahyog Yojana - IGMSY Awareness about the scheme – what is the scheme, for whom, when, under what conditions Importance of conditional cash transfer scheme How to utilize the money being provided under IGMSY How to receive the money, from what channels Awareness generation about other ICDS services and initiatives of State Details of campaigns organized on nutrition and pre-school education Kanya Kelavani and School Admission Drive Every year in the month of June, on pre-decided dates, Kanya Kelavani and School Admission Drive is organized at the village level. On this day, young children are gathered in a bullock cart and taken to school. Local leaders enroll the children into the school. The local leaders are welcomed by the children with songs and other cultural activities. During the Kanya Kelavani and School Admission Drive, activities like mothers’ meetings, decoration of home and AWCs, recipe competition, recipe demonstration etc. are conducted. All the children enrolled in the school are provided with Vidhya Laxmi bond, school bag and kit. The children from AWCs enter into the school with blessing from the local leaders. Those children not going to school are also enrolled and re-admitted to the school, to prevent dropouts. In the year 2010-11, 305908 children were enrolled in AWCs and 520953 children in schools under this scheme.
Gram Sabha Gram Sabha is organized by Gram Panchayats twice a year. The Government of Gujarat has instructed the State and District officials to remain present during the Gram Sabhas to provide opportunity to the community to come up and discuss their problems, so that on-the-spot solutions could be provided by the officials. The community is involved in the problem-solving discussion to ensure balanced development of the village through community participation. Birthday celebration Birthdays of all children are celebrated at the AWCs through community contribution. This develops a lot of confidence among the children. The parents are also actively involved in this activity. ICDS Foundation Day The ICDS Scheme was launched on 2nd October 1975. Since then, every year, this day is celebrated at the AWCs. Activities like rallies by children, fancy dress competition, recipe competition and demonstration are carried out. Children are provided supplementary nutrition, health checkups, non-formal education at the AWCs. Malnourished children are provided relevant services. Healthy baby competitions are also held at many AWCs. Children’s Day Fourteenth November is the birthday of the first Prime Minister of India, Pandit Jawaharlal Nehru. He was very fond of children and hence this day is celebrated as Children’s Day across the country. On this day, sweets are distributed at the AWCs and rallies and cultural programmes are held. The other celebrations at the AWCs include: 14th January – Kite Flying Day 26th January – Republic Day 8th March – International Women’s Day 22nd March – World Water Day 7th April – World Health Day 11th April – Safe Motherhood Day 11th April – National Energy Conservation Day 1st May – Gujarat State Foundation Day 5th June – Environment Day 12th June – Eradication of Child Labour Day 25th July – Parents’ Day 21st October – World IDD Day 1st December – World AIDS Day 3rd December – International Handicap Day Describe activities that are planned during the current year Details in Chapter 3, Section 4E, a. Table 27: Status of IEC (Information Education and Communication)
4F. Monitoring and Evaluation a) Describe existing monitoring and supervision mechanism at different levels (reporting, field visits, review meetings, feedback system etc) Reporting The Monthly Progress Report (MPR) is prepared every month for the duration 20th -19th of the previous month. The current mechanism and timeline for reporting in the ICDS department is as follows: 19th – 23rd – sector meetings organized by ICDS Supervisors, wherein, they compile MPR of each AWC and prepare the sector MPR 23rd – 25th – ICDS Supervisors submit the sector MPRs as well as the AWC MPRs at block level 25th – 30th – Block MPR is prepared and submitted to the District Programme Officer online 1st – 5th – Block MPRs are compiled online and District MPR is prepared and fed into the State portal 5th of every month – State submits the MPR to the Government of India Supervision A decentralized supervision mechanism is being followed in the State. The supervision carried out at all levels is described below: A cluster of 15-20 villages form a sector, which comprises of 20-25 AWCs. These sectors then form a Block/Project. Blocks form a district. Supervision is carried out through: Field visits – Supervisors visit all AWCs in their respective areas/ sectors every month. Additionally, ACDPOs, CDPOs and DPOs also visit few AWCs on monthly basis and review the activities of the centres. Review meetings – Review meetings are taken by the WCD Minister every Thursday at zonal/regional level. Feedback system – Feedback on the performance of the AWWs, Supervisors and other cadres is provided during review meetings, field visits, block meetings, district meetings and any other opportunity available. b) Constraints in monitoring and supervision (human resources, capacity building, mobility of functionaries etc) Due to vacant posts of the Supervisory cadre (only 1831 posts of the sanctioned 2199 posts are filled), the workload of the posted Supervisors has increased due to additional charge of other sectors. This has led to a decrease in the number of field visits made by them. Hence, the activities in the field are not monitored /supervised on regular basis and thus regular feedback of the same is not being given to the frontline workers. c) Any assessment/evaluation studies carried out by the State Govt. during last two years – brief details DWCD is carrying out a field based study on ‘Positive Enquiry of the ICDS initiatives in Gujarat’ in collaboration with GAIN and Public Health Foundation of India. THR major objective of the study is to assess the nutrition impact of ICDS –THR, understanding the perceptions of key stakeholders about all 4 types of THR. (For details see page no. 110 – Contribution of GAIN) Separate budgets have been allocated in Gujarat State Nutrition Mission for conducting Annual Block level Nutrition Indicator Cluster Surveys for getting updated information on the current maternal and child undernutrition status in Gujarat. Whether the State has rolled out revised MIS as prepared by the MWCD. Yes e) State’s strategy to improve the existing MIS. A Management Information System (MIS) committee has been created at the State level. The purpose of this committee is to translate the existing MIS system into a Decision Support System (DSS). As a first step to this, ICDS-DWCD, GoG is geographically mapping out all the AWCs using Geographical Information System (GIS). The AWCs are classified into four types namely SC, ST, Minority and Others. Following are the various levels of report views that can be accessed using GIS based DSS:
In the third phase, GIS based DSS will also help to visualize the coverage of the program, mobilization of field staff, etc. Fig 36: GIS SNAPSHOTS OF PILOT DISTRICT (PATAN)  
 
 
Table 28: Status of Monitoring and Evaluation
4G. Training and Capacity Building As per the existing procedure, States are required to prepare a State Training Action Plan (STRAP) outlining the following: a) Training status of functionaries who are in-position and assessment of training backlogs (separately for job and refresher training) as on 1 April of the FY – Mechanism for assessing backlogs of training (computerized roaster/records at district/block level) and b) Training needs assessment of ICDS functionaries On-the-Job Training As per the Quarterly Progress Report (QPR), the on-the-job training achievement for AWWs was 52% while for AWHs was 19%. The training achievement for Supervisors was 102%. Refresher and Induction Training According to the Quarterly Progress Report (QPR), the refresher training for Supervisors was 33%. The refresher training for AWWs was 168% and that for AWHs was 112%. Training Needs Assessment In order to assess the need of the AWTCs, a Needs Assessment of all the AWTCs and MLTC was done using a questionnaire. Following this, a state level review meeting was held on 11th June 2010 with the Principals and Instructors of the training centres to understand the problems faced by them and provide on-the-spot solutions, wherever possible. The meeting was chaired by the Secretary and Commissioner, Women & Child Development; Director ICDS; representatives from NIPCCD Indore and UNICEF Gandhinagar. As per the revised norms vide GoI letter No. 11-13/2006-TR-I dated 21-04-2009, the maximum number of job training coursed taken by AWTCs is 10 courses per year. Considering the existing number and infrastructure of the AWTCs in Gujarat, there is an urgent need to increase the number of AWTCs in the state (1 AWTC per district) to meet the training needs of the ICDS functionaries effectively. Additionally, there is a need to centralize supportive job aid training and materials for effective trainings. c) Describe available training resources in the state (AWTCs/MLTCs/SRCs etc) – Sanctioned and operational AWTCs/MLTCs and their details including training status of Instructors. Indicate whether capacity of the training centres has been reviewed during the FY. d) Detailed training calendar – Training Centre wise e) Monitoring and supervision mechanism – Quality checks f) Review of performance during the last two years as per the QPRs and approved STRAPs; Give reasons for not achieving the targets in previous 2 years (if performance is less than 80% of the STRAP Targets). g) Proposal for ‘other training’ activities should include rationale for the same and their expected outcomes h) Financial requirements for the FY. Details for points c) to h) are given in STRAP document 2011-12 (Annexure 14). 4H. Convergence with Line Departments a) Joint visits/review with health and other departments; Joint training between ASHA / AWW/ANMs/Supervisors Fig 37: Status of Joint visits by ICDS (DWCD) and H&FW (January 2011) 
The above chart shows the field visits made jointly by the Medical Officers with CDPOs and ACDPOs (13%) and by ANMs/LHVs of Health Department with ICDS Supervisors (87%). 4I Community Participation and Involvement of PRIs a) Provide existing mechanism for community participation and involvement of PRIs in the implementation of ICDS programme in respect of the following: recruitment of AWWs/AWHs supplementary food distribution, regularity of opening of AWCs observance of VHNDs immunization construction of AWCs mobilization of community support to AWC, awareness generation on health and nutrition issues, etc. The ICDS department is operating through the Panchayat departments at all levels. Hence, all the above mentioned activities are carried out with the involvement of PRIs. b) Percent of AWCs participated in at least one Gram Sabha meeting during last year All Gram Sabhas take place at the AWCs and the AWWs are actively involved in it. As per the report from Development Commisisoners Officer, Department of Rural Development, March – 2011; AWWs were present in all the Gram Sabhas that were held in the 18,000 villages. c) Percent of monthly Gram Panchayat meetings attended by AWWs. Not applicable d) Percent of Bi- monthly Panchayat Samiti meetings attended by ICDS staff. Not applicable No. of districts where the Zilla Parishad have reviewed ICDS programme implementation during the last year. All ICDS programmes are operated through the Panchayat department and hence, reviewed on regular basis. 4J Financial Management and Funds Flow Mechanism a) Describe existing mechanism of funds flow from State HQs to Districts/Blocks/ Sectors; Provision of separate accounts; Delegation of powers etc 1. Under the Integrated Child Development Services, as per the budget provided by the Government of Gujarat, the details of financial provision for ICDS General and SNP norms are given. As per the approved budget, the distribution of grants by the Accounts Department is as given below: F  ig 37: Fund Flow Mechanism
2. In Gujarat, ICDS is implemented through the Panchayati Raj Institutions. Hence, all the financial transaction of the State Treasury office is done through the PLA (Personal Ledger Account) of DDO (District Development Officer) at district level and through PLA of TDO (Taluka Development Officer) at block level. The accounts are maintained under the prescribed budget heads as per the Panchayat financial norms. 3. Under the ICDS, the financial powers at the State Cell remain with the Commissioner and Director ICDS. At the District Cell, the financial powers lie with the DDO and DPO (District Programme Officer) and at the Block level with the CDPO.
To ensure that the AWWs and AWHs get their honoraria on time, the Commissioner Office provides an advance grant for 3 months to the Zilla Panchayat. The payment to the AWWs and AWHs is made through cheques only. The Government of Gujarat has decided that the payment to the AWWs and AWHs should be made by cheque only and the cheques should be deposited in their respective bank accounts. A pilot project was initiated in Ahmedabad, Mehsana and Gandhinagar districts, wherein the Zilla Panchayat office deposited the honoraria cheques of AWWs and AWHs in their respective bank accounts through R.T.G.S./N.E.F.T. system. The grant for fuel, preparation and transportation of the Supplementary Nutrition, calculated on the basis of the number of beneficiaries, is given in advance to the Zilla Panchayat. This grant is then deposited into the bank accounts of the AWWs and AWHs through the blocks.
The Government of Gujarat is in the process of formation of Gujarat State ICDS Society for the implementation of the ICDS Project. The Society will be formed after approval from the relevant Office. This will be followed by formation of such societies at district level. d) Provide detailed minor head-wise break-ups of allocation for different programme activities Details in Annexure 15. e) Attach statement of expenditure (SOE) of previous year with trend analysis. Details in Annexure 16. CHAPTER 4 SUMMARY OF ACTION PLAN PHYSICAL TARGETS AND FINANCIAL ESTIMATES Details in Annexure 17. CHAPTER FIVE ADDITIONAL INFORMATION Names, addresses and contact nos. (with email IDs) of key Programme Officials (State/District level) Contact Information of Key Officials at State level: Mrs. Sunaina Tomar IAS Secretary and Commissioner, Department of Women and Child Development, Government of Gujarat, 9/6 Sardar Bhavan, Gandhinagar, Gujarat. Phone: 079 - 232-54259 Fax: 079 - 232 - 54823 Email: sec-wncw@gujarat.gov.in
Director, ICDS 16/1 Dr. Jivraj Mehta Bhavan, Gandhinagar, Gujarat. Phone: 079-232-53305 Fax: 079-232-53308 Email: dir-icds@gujarat.gov.in
Monitoring Officer, ICDS 16/1 Dr. Jivraj Mehta Bhavan, Gandhinagar, Gujarat. Phone: 079-232-53305 Fax: 079-232-53308 Email: spo.icds@gmail.com
The centrally sponsored ICDS scheme is implemented in the State since 1975. under the scheme, Anganwadi Workers and Anganwadi Helpers who are honorary women functionaries at grass root level providing vital services to young children, girls and women in the Anganwadi centres. Their role is crucial in promoting child growth and development. Looking to the key role in the close and continuous contact with the people of the Anganwadi workers and helpers, the Government of India has suggested to constitute a committee at District level to solve their grievances and day to day problems regularly and expeditiously, vide letter nos. 1/9/2000/CD.I dated 14.8.2000 and 24.10.2000 from Ministry of Human Resources Development, Department of Women & Child Development, New Delhi. Resolution at State level Based on the above mentioned directives from the GoI, the Government of Gujarat instructed the District Program Officers, vide Resolution No. ICD/102000/GOI/292/R Sachivalaya, Gandhinagar, dated 29.6.2001, to constitute District level Grievances Redressal Committee for Anganwadi Workers and Helpers of the Integrated Child Development Services (ICDS) Scheme in each district, consisting of the following members: 1. District Development Officer - Chairman 2. Chief District Health Officer - Member 3. Child Development Project - Member Officer (CDPO) 4. A representative of Anganwadi - Member Workers
5. A representative of Anganwadi - Member Helpers
6. A Social Worker - Member (to be appointed by District authority) 7. Programme Officer (ICDS) - Member Secretary
The Committee meets once in a quarter during the year. Table. 29: Relevant data on ICDS (including programme component wise expenditures during last three years)
Brief details of support received from the Development Partners in ICDS (brief description of their interventions on nutrition and pre-school components of ICDS) To meet the challenges of Universalization of ICDS, convergence of all resources is very important. The experiences of Development Partners and local NGOs are being elicited by involving them as active partners in the ICDS programme. A highlight of the Annual Programme Implementation Plan would be seeking PPP (Public-Private-Partnership) model of implementation of programmes under ICDS as per the need. The details of the partners presently working in the State to achieve the goals of ICDS are given below: UNICEF, GUJARAT UNICEF has been a major support both technically and financially in supporting the Department of Women and Child Development and Government as a whole towards its efforts in improving the quality of life and health and nutritional status of children and women of Gujarat. UNICEF primarily provides support in all ICDS endeavors especially Early Childhood Nutrition & Development, Micronutrient Nutrition and Anemia Control. The focus is on Systems Strengthening and Capacity Building of human resource of ICDS and NRHM programs through skilled-based methodologies to deliver evidence-based, high-impact child nutrition and development interventions and measurable results. The recent contributions of UNICEF, Gujarat have been: Capacity Building of ICDS staff State-level Master trainers (ICDS and NRHM) trained in national-level workshop on new growth standards and capacity building and sensitization of ICDS functionaries in the state for rolling out WHO growth standards, Annaprashan Diwas, Supportive supervision during Mamta Diwas Over 26,000 ICDS & NRHM frontline workers have been trained in IYCF during IMNCI training. Supporting the implementation and supervision of Mamta Diwas (Village Health and Nutrition Day) with a special focus on Valsad (tribal district) of Gujarat Advocated and supported ICDS for its first capacity building initiative using Information and Communication Technology (ICT) Supported preparation of guidelines for various schemes and programmes of ICDS to be sent to districts like Annaprashan Diwas, Mamta Abhiyan, Mamta Taruni, SABLA, IGMSY etc. Initiated and supported regular review of AWTCs by State and training of AWTCs faculty in IMNCI, sensitization on IYCF and new growth standards. Piloted Geographical Synchronization of ICDS and Health supervisory area in Valsad district which was later scaled up State – wide for better delivery and supervision of Health and ICDS services State Nutrition Technical Unit: A techno-managerial unit within ICDS Directorate has been set up. This centre is manned with five technical consultants (Nutrition, Capacity Building, IEC/BCC, MIS and WASH) to support ICDS to accelerate implementation of interventions which can reduce undernutrition. Technical support in conceptualizing and Institutionalizing ‘Gujarat State Nutrition Mission’ and pushing forward the Nutrition Agenda. Provided technical support during the ‘Chintan Shibir – 2011’ – a brain storming session of Ministers and Bureaucrats of Gujarat. Supported a State Consultation on Community Based Approaches for reducing undernutrition in Gujarat for learning various best practices of other States and adopting the key components for implementing the same in Gujarat. Nutrition Surveillance (NS): Established and streamlined a Nutrition Surveillance system in Valsad by ICDS and Health functionaries. Weight recorded on Mamta Day is monitored on a quarterly basis using new WHO 2006 standards and colour coding system has been introduced for prioritization of home counseling visits. Children weighed with grading in Valsad improved to 73% in June’09 Vs. 50 % in Sept’08. Re-orientation of workers on IYCF and new WHO 2006 stds for NS. Two Quarterly review meetings held; reporting of this activity streamlined along with IMNCI review. Child Friendly Model Anganwadi Centre Initiative in 50 AWCs in Dharampur and Kaprada: Providing gap filling supply, building the capacity of AWW for better delivery of services in a child friendly conducive environment. Promoting Behaviour Change Communication through Synergistic Partnerships with Milk Dairies: Vasundhara Dairy and Charvada partnership launched production of Iodized salt on 15 January 2009 and distribution in tribal areas using dairy and SHG networks in Valsad. The initial mandate was to bring about behavior change at the family level and bring outreach services closer to the community and there had been a marked improvement on several indicators as a direct consequence of the initiative as depicted in Multi Indicator coverage evaluation survey of UNICEF. Documenting various reports for State to take timely corrective actions like: State of maternal and child undernutrition in Gujarat: Status report, Urban poor Nutrition and Health Statistics for Gujarat: Disaggregated data from NFHS-3, analysis, Accelerating Child Survival and Development in Gujarat: A strategy note, MICES Gujarat 2008-09 progress chart, UNICEF – Coverage Evaluation Survey. GAIN and PUBLIC HEALTH FOUNDATION OF INDIA GAIN in collaboration with PHFI is carrying out a study on “Positive Enquiry of the ICDS initiatives in Gujarat”. The study has been initiated in January 2011. the major objective is to assess the nutrition impact of ICDS THR, understanding the perception of key stakeholders (both functionaries and beneficiaries) about all 4 types of THR. In this regard, an orientation was held from 18-20 February 2011 at the Indian Institute of Public Health (IIPH), Gandhinagar. Currently, data collection in the field is in progress in the selected districts of Gujarat. Arrangement for protections from elements/harsh natural conditions like snow fall, high temperature, and monsoon (cut off area planning) Not applicable ISSUES Provision of Supplementary Nutrition as per Supreme Court’s norms: Looking to the high rates of undernutrition and anemia among the children as well as pregnant and lactating mothers, Government of Gujarat has launched a massive drive to combat undernutrition. Since 2007, a number of initiatives have been taken towards food fortification in the state of Gujarat like provision of Bal Bhog for young children, provision of Sheera, Upma and Sukhadi for children coming to AWC, adolescent girls and pregnant and lactating mothers. All these ‘Ready to Cook’ foods have been fortified with 8 essential micronutrients as per guidelines of Government of India, dated 24-02-2009. Nutri candy enriched with 4 micronutrients namely Iron, Folic Acid, Vitamin C and Vitamin A is given to children coming to AWC. Besides ICDS, Government of Gujarat is also providing fortified flour and fortified oil for Mid-day Meal, and PDS for Antyodaya and BPL families. The Hon’ble Supreme Court by order dated 7-10-2004 banned contractors and directed that ‘The contractors shall not be used for supply of nutrition in AWCs and preferably ICDS funds shall be spent by making use of village communities, Women Self Help Groups (SHGs) for buying of grains and preparation of meals’. The same order was reiterated by the Hon’ble Apex Court in 2006 and 2009. In its fresh order dated 22-04-2009, Hon’ble Supreme Court of India has directed all State Governments to comply directions of GoI dated 24-02-2009 without fail. The above mentioned guidelines of GoI lays stress on provision of Micronutrient Fortified blended food. Such micronutrient fortified blended food has to be procured through original manufacturer and the food with essential micronutrient has to be prepared in strictly controlled hygienic conditions. Government of Gujarat has been providing the requisite calories, proteins and micronutrients to all ICDS beneficiaries – children less than 6 years, adolescent girls, pregnant and lactating mothers. However, the State is experiencing the following difficulties in implementing the GoI order: In case of decentralization, the food is procured and prepared by the Self Help Group (SHG). Since the ingredients are procured from the local stores and prepared in the village, it is difficult to comply with the requirement of food fortification with essential micronutrients. Also, ensuring the compliance of the nutritional norms prescribed by GoI is extremely difficult at local level. Besides this, procurement of Soyabean as a rich source of protein is difficult in many villages especially in the tribal areas. Supervision and Quality monitoring is very difficult at village level. Besides, adherence to Prevention of Food Adulteration Act and Integrated Food Law as per the directions of GoI becomes impossible. Further, GoI doesn’t provide any honorarium or incentives to the members of the SHG to work. So it is very difficult to find women who are ready to contribute for this scheme without any remuneration. Formation of ICDS Society Currently, ICDS does not have a Society at the State level, as it exists under NRHM. Hence, the entire fund transfer is done through DDOs and TDOs of Panchayat Department. There is no flexibility in terms of fund transfer and expenditure. This leads to delay in procedures and implementation. There is an urgent need to form the ICDS Society in the State and prior permission from GoI is requested in this regard. Flexibility in recruitment of Staff In ICDS, many positions at various levels (details in Table 17) are vacant. The current procedure of recruitment is also time- consuming. There are too many procedures are involved. There is a need from GoI to provide the flexibility to hire contractual staff for carrying out the activities of the vacant positions so as to facilitate the functioning in absence of the regular staff. Hence, flexibility in expansion of staff positions at various levels, procedure of recruitment, for filling up of the vacant posts and guidelines for the same is requested by the State. Sanction of additional Posts Over the years, there has been an expansion in the Projects in the State. However, there is no increase in the number of sanctioned posts at various levels. In absence of the required human resource staff, most of the operations are carried out by staff – in – charge. This leads to increased workload and delay in implementation. This also leads to lack of motivation and responsibility and commitment level. In some districts, the number of Projects to be handled by the Programme Officers is more and hence proper follow up of activities is not possible. For example, (a) in Ahmedabad district, there are 26 Blocks being handled by only one Programme Officer, (b) Since there are only two blocks in Dangs and Porbander there is no sanctioned position of PO – ICDS which leads to difficulty in functioning of ICDS – Anganwadi centers and their monitoring and supervision activities. Training of ICDS Staff According to the training guidelines, the ICDS staff / AWWs receive on the job training on appointment. They receive the first refresher training after 2 years of appointment. The second refresher training is held one and a half years after the first refresher training. There are number of schemes and programmes initiated by the GoI for the welfare of women and children. Hence, there is an urgent need to increase the frequency of refresher trainings for the AWWs, who are the actual implementers in the field/ community. There are only 17 AWTCs and 1 MLTC in the State, while there are in all 2199 Supervisors and 50226 AWW positions in the State. Hence, the State has a heavy training load and the existing setup is inadequate to handle this load. There is a need to take up this issue in a mission mode and involve local NGO partners in the training of AWWs to speed up the process. Also, there is a need for the new Guidelines/revised norms from the GoI for training of AWWs. Flexibility is also required in the training curriculum as per the need of the State.
Non-ICDS related work to AWWs The Anganwadi Workers are most numerous in number and the closest to the community. They are the most important link between the Department and the Community. However, it has been observed that due to their close link / association to the community and easy access, they are overloaded with additional work during the AWC timings and hence they are not able to do their routine work effectively. It is requested to treat this issue as most urgent and to ensure that the AWWs are not loaded with additional work during the Anganwadi Centre timings. Flexibility in operationalization of Schemes and Staff for new Schemes There are several new Schemes, initiated by the GoI for the welfare of the women and children. Guidelines for implementation of the Scheme by the State with budget details are provided. However, there is a need to have some flexibility at State level in utilization of the funds for operationalizing the Scheme across the State. With the current setup at State level as well as District and Block level, it is difficult to implement the new Schemes coming up. There is an urgent need to have/recruit additional Staff for the proper implementation of the Schemes and provision of budget for the same. Conversion of mini AWCs into regular AWCs Currently, there are 1585 mini AWCs in Gujarat. The criterion for opening mini AWCs is that the area should have a population of 150-400. However, in many areas the population is increasing. There is a demand from the community to convert the mini AWCs into regular AWCs. Hence, Guidelines in this regard is requested from the GoI. Revision of Monthly Progress Report (MPR) format The Monthly Progress Reports are prepared at various levels as per the formats provided by the GoI. However, with the introduction of various Schemes there is a need to collect information regarding implementation of the schemes and programme from the field. Hence, there is a need to revise the MPR formats as per the information required to be collected from the field. Setting up of Regional Offices There are 26 districts in the State. To ensure smooth and effective implementation of the programme and schemes, it is necessary to have regular review meetings. According to the Health Department, the State is divided into 6 regions. It is recommended to establish regional offices of ICDS with complete administrative setup and staff having a Regional Director / Joint Director heading the Office and reporting to the State ICDS Director. Necessary supporting staff needs to be provided to each Regional Office. Programme Officer for district less than 5 blocks For having a Programme Officer’s position in a district, the guidelines say that the district should have a minimum of 5 Blocks. However, certain Districts are small and have less than the required number of Blocks and so a Programme Officer’s position cannot be sanctioned in these districts. However, these districts may have their own issues and problems, like being Tribal, poor accessibility etc. In order for the programme to be implemented efficiently and without delays and to avoid administrative problems, it is suggested that appointment of Programme Officers in such districts be permitted. Necessary Guideline in this regard is requested from the GoI. Criterion for provision of funds by GoI It is recommended that the funds provided by the GoI should be linked with the performance of each State. This will create a healthy competition amongst the States and work as a motivating factor to improve their performances. Table 30 : SUMMARY OF INTERVENTIONS UNDER ICDS
1 MDGI: Eradicate extreme poverty and Hunger. Target 2: Halving the proportion of people who suffer from hunger. Indicator 4: Prevalence of underweight children under 5 years of age. 2 “I must caution that outlays did not necessarily mean outcomes….We shall also ensure that programmes and schemes are not allowed to continue indefinitely…without an independent and in-depth evaluation…” (Ministry of Finance, Government of India, Outcome Budget 2005-06, http://finmin.nic.in/reports) 3 Office of the Registrar General and Census Commissioner, India. Census of India, 2001: India at a glance – rural and urban distribution and state profiles. New Delhi: Office of the Registrar General and Census Commissioner of India; 2001. 4 Office of the Registrar General and Census Commissioner, India. Population Projections for India and the States 2001-26. New Delhi: Office of the Registrar General and Census Commissioner; 2006. 5 NSSO. National Sample Survey (61st round) of poverty estimates for the year 2004-05 based on uniform recall method. NSS report no. 514. New Delhi: NSSO, Ministry of Statistics and Program implementation, Government of India; March, 2007. 6 Re-analysis of NFHS-3 (2005-06) data for Gujarat by wealth index quartiles. Directory: download download -> Performance Tuning Guidelines for Windows Server 2008 May 20, 2009 Abstract download -> Northern England’s set-jetting locations download -> Bbc archives: Beyond the programme download download -> Occupational health and safety download -> Dynatest 3031 lwd light Weight Deflectometer download -> Forth coming competitive exams download -> English Olympiad Tasks: 10 th form Аудіювання, 10 клас. Текст download -> Brush High School Morning Announcements Friday, September 05, 2014 all school download -> Year 9 The Arts — Music download -> Years 7 and 8 standard elaborations — Australian Curriculum: Music draft Download 5.36 Mb. Share with your friends:
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