Evaluation of Project Manthan for Strengthening, Icds in High-Priority District of Assam

Abstract

BACKGROUND IMR, U5MR and MMR in Assam, highest in the country. Nutrition plays important role in physical, mental and social development of child. UNICEF and North East Diocesan Social Forum (NEDSF) partnering on community-based innovation for child growth, development and nutrition titled project 'Manthan', which involved strengthening of AWCs (FLS, field learning sites) delivering ICDS services. The aim of the study is to evaluate the effect of project Manthan and to assess the status of ICDS services in High-Priority District (HPD) of Assam. MATERIALS AND METHODS Two districts selected randomly from 6 high-priority districts. To compare effect of intervention, 30 FLS-AWC were assessed along with 30 nearby AWC and 30 AWC situated in a distant location (non-intervention). In each site, facility assessment (90) along with knowledge assessment of AWW (90) and beneficiaries (mothers of children under 2 years, pregnant women (180 each) was done and compared between FLS, nearby and non-intervention AWC. Predesigned, pretested format used. Qualitative assessment was done by observation method along with photographic evidence. RESULTS Functional weighing machine available in 65.6% (59) AWC, while MUAC tape available only in 2.2% (2) AWCs. Twenty percent AWW (18) having MUAC tape amongst FLS (p=0.018). Height chart available in 34.4% (31), while safe water in 42.2% (38) AWCs. Availability of soap, significantly different in FLS and nearby AWC compared to distant/non-intervention AWCs (p=0.016). Growth monitoring, significantly better in FLS and nearby AWCs (p=0.058). Significant improvement in knowledge seen amongst workers working in FLS, nearby AWW compared to non-intervention AWWs (p<0.001). Similarly, knowledge about care during pregnancy (p=0.009), key points of complementary feeding (p=0.003) was also significantly high amongst FLS. CONCLUSION Development of FLS was found effective. Though, overall, there was gap in facility, knowledge and utilisation of services. There is a need to further strengthen ICDS system.