Evaluation of Integrated Child Development Services program in Gujarat, India.

OBJECTIVE To evaluate Integrated Child Development Services (ICDS) program in terms of infrastructure of Anganwadi centers, inputs, process, coverage and utilization of services, and issues related to program operation in twelve districts of Gujarat, India. DESIGN Facility (Anganwadi) based study. SETTING Twelve districts of Gujarat, India (April 1, 2012 to March 31, 2013). PARTICIPANTS ICDS service providers (60 Anganwadi workers from 46 rural and 14 urban Anganwadi centers) and their beneficiaries. MAIN OUTCOME MEASURES Coverage of supplementary nutrition, pre-school education, immunization and referral services. RESULTS Supplementary nutrition coverage was reported in 48.3% in children. Interruption in supply of supplementary nutrition during last six months was reported in 61.7% Anganwadi centers. Only 20% centers reported 100% pre-school education coverage among children. Immunization of all children was recorded in only 10% Anganwadi centers, while in 76.7% centers, no such records were available. Regular health checkup of beneficiaries was done in 30% centers. Referral slips were available in 18.3% Anganwadi centers and referral of sick children was done from only 8.3% centers. CONCLUSIONS There are program gaps in coverage of supplementary nutrition in children, its regular supply to the beneficiaries, in pre-school activities coverage, recording of immunization, and regular health check-up of beneficiaries and referral of sick children.