Utilization of ICDS program by adolescent girls and implementation barriers in Urban Rishikesh, India

Abstract

Context:Adolescent girls are at higher risk of mortality and morbidity due to childbirth. Government of India therefore initiated Adolescent girls’ scheme since year 2000. However, since its inception program received various setbacks.Aims:This study was carried out to assess the utilization of ICDS program for adolescent girls through Anganwadi centers (AWC) and implementation barrier from providers point of view. Also study assessed gaps in knowledge, attitude, and practice of anemia.Settings and Design:Mixed-method sequential explanatory approach was adopted. Quantitative data was collected by community-based cross-sectional survey in Urban Rishikesh, Uttarakhand. This was followed by in-depth interview of Anganwadi worker (AWW).Methods and Materials:Twenty adolescent girls from each of 20 clusters were selected by cluster sampling. Data was collected by structured validated questionnaire using Epicollect 5. AWWs were interviewed with help of interview guide.Statistical Analysis:Variables were described as proportion and mean. The interview transcript was analyzed using content analysis.Results:Out of 400 adolescent girls, 10% were school dropouts and 59% were undernourished. Seven percent had ever visited AWC in last year. The main reason for nonutilization was unawareness. 38% had knowledge regarding symptoms of anemia. AWW faces problems due to nonavailability of iron tablet, untrained for health education sessions, and service not meeting demand of beneficiaries.Conclusions:Poor utilization of ICDS services by adolescent girls due to unawareness. There is gap in knowledge regarding anemia among adolescent girls. Adolescent girls’ scheme is not as per felt need of beneficiary and poorly implemented.

Impact of a school‐based nutrition educational intervention on knowledge related to iron deficiency anaemia in rural Karnataka, India: A mixed methods pre–post interventional study

“…[30][31][32][33] Evaluation of the Weekly Iron and Folic Acid Supplementation programme in India and other low-and-middle-income countries found that one of the key factors influencing increased uptake of IFA supplements was implementation of a coordinated and timely information education and communication strategy that dispelled misconceptions and rumours, and capitalised on the positive effects. 25,28,[36][37][38][39] Moreover, as indicated by Joe et al, 16 increased awareness and subsequent demandgeneration by target groups will help address other institutional barriers related to the supply and distribution of IFA supplements.…”

“…In their study, monthly counselling sessions on the positive effects of IFA intake contributed to a high compliance rate of over 85% 27 . Khapre et al, during their evaluation of the implementation of the Weekly Iron and Folic Acid Supplementation programme in Rishikesh, India, also report the lack of use of any information, education and communication materials as a barrier and recommend effective and frequent training for teachers 25,28 . Similarly, Priya et al 19 report misconceptions among the adolescents about IFA tablet consumption and highlight the need to address these through effective communication for the Weekly Iron and Folic Acid Supplementation programme to be successful 19 .…”

“…27 Khapre et al, during their evaluation of the implementation of the Weekly Iron and Folic Acid Supplementation programme in Rishikesh, India, also report the lack of use of any information, education and communication materials as a barrier and recommend effective and frequent training for teachers. 25,28 Similarly, Priya et al 19 report misconceptions among the adolescents about IFA tablet consumption and highlight the need to address these through effective communication for the Weekly Iron and Folic Acid Supplementation programme to be successful. 19 To this end, we conducted research to understand the extent to which adolescent students' awareness about anaemia and anaemia prevention can change through short, targeted nutritional education intervention delivered by teachers at school.…”

Impact of a school-based nutrition educational intervention on knowledge related to iron deficiency anaemia in rural Karnataka, India: A mixed methods pre-post interventional study

“…[29][30][31][32] Evaluation of the Weekly Iron and Folic Acid Supplementation (WIFS) programme in India and other low-and-middle-income countries found that one of the key factors influencing increased uptake of IFA supplements was implementation of a coordinated and timely information education and communication strategy that dispelled misconceptions and rumours, and capitalised on the positive effects. 25,[35][36][37][38][39] Moreover, as indicated by Joe et al (2022), increased awareness and subsequent demand-generation by target groups will help address other institutional barriers related to the supply and distribution of IFA supplements. 16 The present study also reported knowledge about anaemia to be low among boys before the start of the intervention, in concordance with several other studies.…”

Barriers to Access Health Care Services among Rural Adolescent Girls in Raina I Block, Purba Bardhaman, West Bengal

“…This is partly due to the unavailability of health infrastructure like Primary Health Centers (PHC), lack of health personnel, etc. and partly due to the concentration of the secondary and tertiary health facilities in the urban pockets (Khapre et al, 2019). Besides, affordability of recommended medications, waiting time before the consultation, inadequate equipment of facilities influence the health-seeking behaviour in rural areas (Ravi & Kulasekaran, 2014;Omeire, 2017).…”