District Level Geospatial Analysis of Utilization of ICDS Services Among Children in India

Abstract

IntroductionIntegrated Child Developmental Services (ICDS) is the most extensive government-run health program for children with its foot spread across the complete Indian Territory. ICDS Scheme, has been provided for 40 years and has been successful in some ways. The program in reducing the undernourishment among children over the past decade has been modest and slow in India than what has been reached in other countries with comparable socio-economic measure. Therefore, this study aims to identify the district level clustering of the non-utilization of ICDS services in India, and the present research also tried to relate it with socio-economic and demographic factors.Materials and MethodsThe data from the fourth round of the National Family Health Survey (NFHS-4) conducted in 2015–16 in India is used to carry out the analysis. We classified the country in 640 districts and employed geospatial techniques like Moran's I, univariate and bivariate local indicators of spatial association (LISA), and spatial error regression.ResultsThe non-utilization under ICDS scheme varied between 93% in West Siang district of Arunachal Pradesh and around 7% in the Kandhamal district of Odisha in 2015–16 in India. The univariate LISA results suggest striking geographic clustering of utilization of ICDS services among children in India (Moran's I: 0.612). On another hand, there were regions with substantially low-low clustering of non-utilization of ICDS services in southeast India, including districts in Andhra Pradesh, Chhattisgarh, Southern Madhya Pradesh, Odisha, Telangana, and West Bengal. The findings also suggest that the proportion of the rural population (−0.190), and poor households (−0.132) in the district were significantly and negatively related while the proportion of uneducated women (0.450) was positively related to the non-utilization of ICDS services within the district.ConclusionThis is the first-ever study that examined the complex interplay of the rural population, female illiteracy, poverty, SC/ST population, and Hindu population with non-utilization of ICDS services among children in the district in India. The study highlights the inter-district geographical disparities in the non-utilization of ICDS services. Further, it confirms that underprivileged districts in terms of the rural population and poor households are also disadvantageous in the utilization of ICDS services.

Utilization of Integrated Child Development Services (ICDS) and its linkages with undernutrition in India

“…ICDS service utilization improved across wealth, residential and demographic groups, associated with mother's age, education, place of residence and wealth quintile. Rural areas exhibited significantly higher utilization, consistent with the study by Kumar et al ( 2022 ). In addition, mothers’ higher education correlated positively with ICDS utilization, emphasizing the role of education in raising awareness (Ghosh & Das, 2013 ; Kumar et al, 2022 ) and therefore underscores the need to promote women's education.…”

“…ICDS service utilization improved across wealth, residential and demographic groups, associated with mother's age, education, place of residence and wealth quintile. Rural areas exhibited significantly higher utilization, consistent with the study by Kumar et al (2022). In addition, mothers' higher education correlated positively with ICDS F G U R 4 Underweight prevalence (absolute) and average annual rate of change (relative) across Indian states and union territories.…”

“…utilization, emphasizing the role of education in raising awareness (Ghosh & Das, 2013;Kumar et al, 2022) and therefore underscores the need to promote women's education.…”

Qualitative exploration for the under-foot fall in utilization of health services at Primary Health Center of Shahdol, Madhya Pradesh

“…Studies in rural areas of India by Kumar et al . [ 18 ] and Singh et al . [ 19 ] highlighted the challenges posed by long distances, poor road conditions, and limited transportation options in accessing healthcare services.…”

Integrated child development service (ICDS) coverage among severe acute malnourished (SAM) children in India: A multilevel analysis based on national family health survey-5

“…Place of residence (rural/urban), sex of the child (male/female), maternal education (no education/ primary/ secondary/ higher) were the other categorical predictors used in the analysis. The correlates were considered based on existing literature [ 22 , 30 ].…”