Utilisation of Supplementary Nutrition Service at Anganwadi Centres in a Block of Ganjam District, Odisha: A Cross-sectional Study

Abstract

Introduction: In India, the Integrated Child Development Services (ICDS) scheme provides a package of services to different groups of the target population. The Anganwadi Centre (AWC) is the focal point for delivery of these services. At AWCs, supplementary food is provided to children below six years, adolescent girls, pregnant women and lactating mothers. Aim: To assess the pattern of utilisation of supplementary nutrition by the beneficiaries and to explore the factors leading to non utilisation of supplementary nutrition. Materials and Methods: This was a cross-sectional study conducted from October 2016 to October 2018 in AWCs in Ganjam district, Odisha, India. Multistage random sampling was used to select the AWCs. By using table of random numbers, 24 AWCs were selected. From each AWC, 12 beneficiaries were selected randomly. So a total of 288 beneficiaries were selected. Out of 288 beneficiaries, 240 beneficiaries were eligible for supplementary nutrition. Rates and proportions were calculated. The Chi-square test was used for testing association between variables. Results: All the AWCs were providing supplementary food as per menu chart and were using standard measure for distribution of raw food. Supplementary food was consumed by 188 (78.3%) beneficiaries. The reason given by most of the respondents {28 (53.8%)} for non utilisation of supplementary nutrition was that they did not like the taste of the food. A statistically significant association was found between utilisation of supplementary nutrition and factors like education, socio-economic status and occupation of women. Conclusion: Although supplementary nutrition was provided by all the AWCs, it was not consumed by some beneficiaries due to lack of variety, taste and bad quality of food. The Take Home Ration (THR) was shared among the family members resulting in dilution of the service.

Utilization of Nutritional Supplementation Services and Their Predictors in Pregnant and Lactating Women Living in an Urban Resettlement Colony of Delhi, India: A Cross-Sectional Study

“…Lower rates of utilization of ICDS services by urban pregnant (38.8%) and urban lactating (35.6%) women were reported in NFHS-4 (2015-16) while the NFHS (2019-20) reported overall 66% of pregnant and lactating women as utilizing ICDS supplementary nutritional services [ 13 , 16 ]. Our study findings corroborate findings from previous studies suggestive of low utilization of ICDS supplementary nutrition services, with a higher proportion of lactating compared to pregnant women utilizing these services [ 7 - 12 ].…”

“…This study observed no association of education with ICDS utilization although there is mixed evidence in this regard [ 8 , 17 ]. Similar to our study, Sabat and Karmee (2021) in the Eastern state of Odisha reported a universal preference for sharing of ICDS THR by female beneficiaries with their family members, suggestive of a common cultural practice prevalent across diverse geographies in India [ 12 ].…”

“…Another study from Southern India in Ernakulam district reported that lack of time, improper communication with AWWs, poor behavior of AWWs, the distance of AWC from home, and lack of knowledge were the main barriers restricting the usage of Anganwadi nutrition services [ 18 ]. A study from Eastern India in the Ganjam District reported the association of factors like socioeconomic status (SES), literacy, and occupation with the extent of ICDS utilization [ 12 ].…”

“…Furthermore, nutritional inadequacy during lactation is highly detrimental to fetal and child growth during the crucial first 1000 days of life that involve the development of the brain, immune system, and overall growth [2][3][4]. Nevertheless, despite the efforts taken by GOI, the utilization of Anganwadi services among pregnant women in India remains suboptimal [7][8][9][10][11][12]. A large nationally representative cross-sectional survey (2015-16) reported that 46% of the pregnant and 51% of the lactating women did not receive any ICDS service [13].…”

“…Nevertheless, despite the efforts taken by GOI, the utilization of Anganwadi services among pregnant women in India remains suboptimal [ 7 - 12 ]. A large nationally representative cross-sectional survey (2015-16) reported that 46% of the pregnant and 51% of the lactating women did not receive any ICDS service [ 13 ].…”