CHHATTISGARH APIP 2012-13 DEPARTMENT OF WOMEN AND CHILD DEVELOPMENT

APIP 2012-13

Department of Women and Child Development

2012-13

C HHATTISGARH Contents

S.NO Subject Page

1. List of Tables 8 2. List of Annexure 10 3. List of Abbreviations 11 Section 1: Situation and Gap Analysis

1) Socio-Economic and Demographic profile of Chhattisgarh 13 a. Administrative units in the state 13 b. Demography 13 c. Socio Economic Situation 13 d. Population 14 e. Child Population 14 f. Districts, blocks (Rural/Urban/Tribal) 15 g. Female Literacy rate 15 h. Rural Connectivity: All weather, Seasonal road 15 i. Villages/Areas difficult to reach 16 2) State Nutrition Policy 19 a. Challenges 19 b. Factors contributing Malnutrition 19 c. Strategies for preventing Malnutrition 20 d. Activities undertaken in last two years 20 e. Follow up action 21 3) Inter- sector convergence for program implementation 21 a. Current Status of Inter-sector Coordination 22 4) Nutrition and Health Status of Women and Children in the State 25 a Breast Feeding 25 b. Ranking of Chhattisgrah by Breast Feeding 26 c. Progress of Chhattisgarh in terms of selected vital health indicators 27 d. Vitamin A supplementation Status 27 e. Nutritional status of the children 28 f. Anemia among children and women 29 g. Iodized Salt consumption 29 h. Infant Mortality rate 29 i. Ante natal care 30 j. IFA supplementation during pregnancy 31 k. Progress of Institutional deliveries 31 l. Progress of JSY Beneficiaries 32 m. Post natal care 33 n. Vaccination status 33 5) History of ICDS in Chhattisgarh 33

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S.NO Subject Page a. Year wise expansion of ICDS in the State 34 b. ICDS- Change in Efficiency of the AWCs year wise 35 6) State government financial contribution in quality implementation of 35 ICDS services a. Till now support by state government in the last two years 35 b. Budget provision by state government for 2012-13 38 c. Budget provision for central sponsored ICDS scheme 2012-13 39 7) Infrastructure status of all operational AWC Buildings 39 a. Sanctioned AWCs building in Chhattisgarh 40 b. Status of Construction 40 c. Availability of drinking water and Toilet facility in AWC 41 8) Status of operational blocks/AWCs/Mini-AWCs against sanctioned 42 9) Trends in coverage of beneficiaries for supplementary nutrition and 43 pre-school education 10) Training infrastructure – AWTCs, MLTCs 45 11) Major gaps/constraints in program implementation 46 a. Supplementary Nutrition Program 46 b. Preschool Education 46 c. Immunization and Health Checkup 47 d. Referral services 48 e. Health Nutrition Education 48 f. Current SNP arrangements 48 g. Kuposhan Mukti Abhiyan (Malnutrition Eradication Mission): 49 h. Village Health and Nutrition Day (VHND) 49 i. Others 49 12) Interdepartmental coordination (Particularly Health, Drinking Water, 50 Sanitation and Panchayat) Section-2 Vision Statement 51

Section-3 Organizational Structure of ICDS Program Management at State and District 54 Level a. Organizational Chart of the State Directorate & District Cell 54 b. Revised Population Norms for establishing AWCs under ICDS program 56 c. Office infrastructure at state, district and block level 56 d. Committees/Task force constituted by the State government 57 e. Devolution of powers at the state/ district/block levels 57 Section-4 Annual Action Plan Program Components 58

1) Human Resources 58 a. Recruitment Process 58 b. Process of Selection and Promotion of staff of ICDS 59 c. There exists specific cadre for CDPOs & Supervisor 59 d. Man positions/ Vacancies at all levels 59

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S.NO Subject Page e. State’s additional contribution for honoraria of AWWs and AWHs 64 f. Insurance coverage and welfare measures for the AWWs and AWHs 64 2) Procurement of Materials and Equipment 64 a. Status of supply of equipment 64  No .of AWCs having functional baby and adult weighing machines 64  No. and percentage of blocks with functional computers and printers 64  No. and percentage of District offices having functional computers/ printers 65  Functional vehicles at state, district and block level 65 b. Requirement during the Financial Year 65 3) Delivery of Services at AWCs 66 a. Supplementary Nutrition 66 i. Existing Mechanism for Procurement & distribution of Supplementary 66 Nutrition ii. Basic information about supplementary nutrition 67 A. Type of Supplementary Nutrition provided 67 B. Financial Norms for Beneficiaries 67 C. GOI’s Revised Feeding Norms 68 D. Comparative Table for Feeding Norms Practiced in State 69 iii. Nutrition Analysis of Food Samples 68 iv. Total and average beneficiary coverage 69 v. Special strategy for cut off area planning during monsoon 70 vi. Expenditure on supplementary nutrition during previous two years 70 vii. Quantum of food commodity approved for Wheat based Nutrition program 70 (WBNP) and lifted during 2010-11 and 2011-12 viii. Estimated budgetary requirements for the financial year 71 ix. Growth Monitoring & Promotion 71 x. Growth monitoring/ Promotion and Children’s Nutritional status 72 b. Pre-school Education 73 i. State Policy/guidelines/curriculum for Pre-school Education & Pre-School Kits 74 in ICDS ii. The strategy for preparing 3-6 children for school readiness 75 iii. Specific interventions on preschool education 76 iv. Contents of PSE Kits and supply positions 76 v. Number of AWCs received PSE kits 77 vi. Number of children graduated AWCs to formal Primary Schools 77 c. Nutrition and Health Education 77 i. State's strategy on nutrition and health education 77 ii. Status of implementation of national guidelines on infant and young child 78 feeding practices iii. Existing mechanism for counseling of mothers on nutrition and health issues 80 by AWW/Supervisor during home visit iv. Counseling on Adequate feeding during and after illness 80 v. NHED sessions during VHND/ NHD – use of IEC materials (tools) during NHEDs 81

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S.NO Subject Page

and home visits vi. Monitoring mechanism 81 d. Immunization 81 i. Current immunization coverage rates 81 ii. Existing mechanism for immunization service 83 1 Village Health and Nutrition Days (VHNDs) 83 2 Shishu Sanrakshan Maah 83 e. Health Check-ups 84 i. Existing mechanism for health check-ups of pregnant women (antenatal care) 84 and children ii. Supply and composition of medicine kits during the last FY 85 iii. Status of coverage of at least three ANC check-ups of the pregnant women 85 iv. Supply of IFA tablets to pregnant women through RCH-II 86 v. State strategy to improve health check-ups 86 vi. Linkage with AYUSH 86 f. Referral Services 87 i. Existing mechanism for referral services (with health) 87 ii. NRCs in Chhattisgarh 87 iii. Constrains in effective referral services 89 iv. Strategy to improve referral services during the FY 89 g. Observance of Nutrition and Health Days 89 i. Mechanism for observance of monthly nutrition and health days 89 (VHND/NHDs) ii. Summary of activities that are taken up during the NHDs 90 iii. IYCF counseling 90 iv. The activities that are taken up during the NHDs 90 v. Support received from community/ PRIs for observance of NHD 91 vi. Specific intervention for tribal/rural/urban AWCs in conjunction with line 91 departments h. SABLA Scheme 92 i. Objectives of the scheme 92 ii. Target Group 92 iii. Activities 93 iv. MODALITIES OF THE SCHEME 93 v. Services under the Scheme 94 i. Information Education and Communication 94 a. Activities carried out under IEC component during last year 95 b. IEC materials that have been developed 96 c. Campaigns organized on nutrition and pre-school education 96 d. Activities that are planned during the current year 96 j. Monitoring and evaluation 98 a. Existing monitoring and supervision mechanism at different level 98 b. Constraints in monitoring and supervision 100

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S.NO Subject Page c. State's revised Management and Information System 102 d. Nutrition Surveillance System 102 e. State's strategy to improve the existing MIS 102 f. Community monitoring mechanism 104 g. Structured Feedback Mechanism 104 h. Key M&E activities as per the GOI guideline 104 k. Training and capacity building 105 i. Regular Training Program 105 ii. Other Training Program 106 iii. Capacity Building and ECE 107 iv. Training Calendar 107 v. MLTC 107 Vi Training need assessment of functionaries 108 vii. Available training resource center in the state 109 viii. Location of Training Centers 111 ix. Detailed Training Calendar 112 x. Training Structure 114 xi. Capacity Building 115 xii. ECE/ICE 116 xiii. Physical and Financial performance of the State in the year 2008-09 117 xiv. Physical and Financial performance of the State in the year 2009-10 118 xv. Physical and Financial performance of the State in the year 2010-11 119 xvi. Physical and Financial performance of the State in the year 2011-12 119 xvii. Financial Requirements of Funds (Regular Training) 2012-13 120 xviii. Financial Requirements of Funds (Other Trainings) 2012-13 121 i) Convergence with line departments 122 i. Existing mechanism for convergence and coordination with line departments 122 ii. Status of joint planning with health at district, block and village level 122 iii. Joint visits /review with health and other departments 122 j). Community participation and involvement of PRIs 123 i. Nawa Jatan 123 ii. Basic Features of the Scheme 123 iii. Expected Outcomes 124 iv. Existing mechanism for community participation 124  Recruitment of AWWs/AWHs 125  Supplementary food distribution 125  Regularity of opening of AWCs and Observance of VHNDs 125  Immunization 125  Construction of AWCs 125  Mobilization of community support to AWC 125 v. AWCs participated in Gram Sabha meeting during last year 127 vi. AWCs received support from the Panchayat/Community based organizations 127 (SHGs, Mahila Mandals, Mother's committee etc)/NGOs

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S.NO Subject Page vii. Percent of monthly Gram sabha meetings attended by AWWs 127 k) Financial Management and Funds Flow Mechanism 127 i. Existing Mechanism of funds flow 127 ii. Steps taken for timely payment of honorarium 127 Innovative Activities 128 Critical needs for additional HR support or technical assistance 134 Summary of Action Plan (2011-12) 138

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List of Tables

S.NO List of Table Page

1 Demographic Profile of Chhattisgarh 14 2 Child Population of Chhattisgarh 14 3 List of Districts and Blocks 15 4 Literacy rates of Chhattisgarh 15 5 List of difficult to reach areas 16 6 Table of Inter sector linkage with other departments 26 7 Ranking of states by Exclusive Breastfeeding 26 8 Key indicators for Health services for women and children 27 9 Anemia Trend in Children: 29 10 Infant Mortality and Under-5 Mortality rates 30 11 Progress of Institutional Deliveries 31 12 Institutional Deliveries Trend 32 13 JSY Beneficiaries Trend 32 14 ICDS Expansion in the state 34 15 ICDS Efficiency Table 35 16 State Government Financial support in the last two years 37 17 Budget Provision by state government for 2012-13 38 18 Budget provision for central sponsored ICDS Scheme 39 19 Operational Blocks and AWCs 42 20 Trend of SNP coverage 43 21 Trend of PSE coverage 44 22 Interdepartmental Coordination 50 23 Population norms for AWCs under ICDS program 56 24 Honoraria for AWWs 58 25 Selection and Promotion of ICDS Staff 59 26 Man power/Vacancies at all levels 60 27 Procurement of Materials and Equipment 65 28 Type of Supplementary Nutrition provided 67 29 Financial Norms for Beneficiaries 67 30 Nutrition Analysis of Food Samples 68 31 Feeding Norms of GOI 68 32 Comparative feeding norms 69 33 Beneficiary Coverage: 69 34 Budgetary allocation and expenditure on SNP during 2010-11 and 70 2011-12 35 Wheat Based Nutrition Program 70 36 Estimated Budgetary requirement for Supplementary Nutrition 71 37 Growth Monitoring 72 38 Specific Interventions on PSE 76 39 Contents of PSE Kits 76

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S.NO List of Table Page

40 Pre-school Education 77 41 Current immunization coverage rates in the state 81 42 Some important process indicator of Immunization Source 83 43 Coverage figures of Shishu Sanrakshan Maah December 2011- January 84 2012 44 Antigen wise coverage 84 45 Health Checkup 85 46 Status of ANC coverage 85 47 Status of medicine kits 86 48 NRC Status 88 49 Proposed IEC Activities 97 50 Expenditure during last year on IEC 98 51 M&E Processes in the State 98 52 Key M&E Activities Proposal 104 53 Monitoring and Evaluation 105 54 Other Training Program 106 55 Training Need Assessment 108 56 Operational training center 109 57 Training Road Map 112 58 Summary of State Training Calendar 113 59 Training Structure 114 60 Training Equipment 115 61 Physical and Financial performance of the State in the year 117 2008-09 62 Physical and Financial performance of the State in the year 118 2009-10 63 Physical and Financial performance of the State in the year 119 2010-11 64 Financial Requirements of Funds (Regular Training) 2012-13 120 65 Financial requirements of funds for other trainings 2012-13 121 66 Training Summary 121 67 Convergence 122 68 Summary of Action Plan 138

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List of Annexure

S.NO List of Annexure Page

1 List of Address and Telephone number 145 2 State Nutrition Policy 147 3 Nutrition Surveillance System 150 4 Guidelines for SNP 154 5 Mechanism for redressal of grievances 161 6 Development Partners 166 7 Last 3 years financial expenditure 168

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ABBREVIATION

AG Adolescent Girls AIDS Acquired Immune Deficiency Syndrome ANC Antenatal Care ANM Auxiliary Nurse Midwife AWC Aanganwadi Center AWPB Annual Work Plan and Budget AWTC Aanganwadi Training Center AWW Aanganwadi Worker AYUSH Ayurveda Yoga & Naturopathy Unani Sidhdha and Homeopathy BCC Behavior Change Communication BPL Below Poverty Line CDPO Child Development Project Officer CES Coverage Evaluation Survey CINI Child in Need Institute CMBSY Chief Minister Bal Sandarbh Yojna CMHO Chief Medical and Health Officer CSIDC Chhattisgarh State Industrial Development Corporation DIET District Institute of Education and Training DLHS District Level House Hold Survey DM District Magistrate DPC District Program Coordinator DPMU District Program Management Unit DPO District Program Officer DWCDO District Women and Child Development Officer ECCE Early Childhood Care and Education ENBC Essential New Born Care FNB Food and Nutrition Board FRU First Referral Unit GOI Government of India HBNC Home Based Neonatal care HFW Health and Family Welfare HIV Human Immuno- Deficiency Virus HSS Human Sentinel Surveillance ICDS Integrated Child Development Services IEC Information Education and Communication KSY Kishori Shakti Yojana IFA Iron Folic Acid IMNCI Integrated Management of Neonatal and Childhood Illnesses IMR Infant Mortality Rate IYCF Infant and Young Child Feeding

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JSY Janani Suraksha Yojana KGBV Kasturba Gandhi Balika Vidyalaya LHV Lady Health Visitor MDG Millennium Development Goals MDM Mid Day Meal MI Micronutrient Initiative MIS Management Information System MMR Maternal Mortality Ratio MOU Memorandum of Understanding MUAC Mid Upper Arm Circumference NACO National Aids Control Organization NACP National Aids Control Program NFHS National Family Health Survey NGO Non Governmental Organization NHD Nutrition and Health Day NRHM National Rural Health Mission NRC Nutrition Rehabilitation Centers ORS Oral Rehydration Solution PHE Public Health Engineering PRI Panchayati Raj Institution PSE Pre School Education PTT Performance Tracking Table RCH Reproductive and Child Health RTC Regional Training Centre RTE Ready to Eat SAM Severe and Acute Malnutrition SCERT State Council of Educational Research and Training SDO Sub Divisional Officer SHG Self Help Group SHRC State Health Resource Centre SIHFW State Institute of Health and Family Welfare SN Supplementary Nutrition SPMU State Program Management Unit SRC State Resource Centre SRS Sample Registration Survey SSA Sarva Shiksha Abhiyan SSM Shishu Sanrakshan Mah THR Take Home Ration TSC Total Sanitation Campaign UNICEF United Nations Children's Fund VAD Vitamin A Deficiency VHND Village Health and Nutrition day WCD Women and Child Development WFP World Food Program WHO World Health Organization

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Section- 1

Situation and Gap Analysis

1) Socio-Economic and Demographic profile of Chhattisgarh:

The formation of a new state is a historic event. It is also an opportunity. The state of Chhattisgarh was born on 1st November 2000. It was a momentous occasion, the realization of a long cherished dream of the people of Chhattisgarh.

Chhattisgarh is located in the heart of India, and shares its border with six states of the country; Uttar Pradesh to the north, Jharkhand to the north-east, Orissa to the east, Madhya Pradesh to the west and north-west, Maharashtra to the south west and Andhra Pradesh to the south-east. The geographical area of the state covers 135,000 square kilometers.

a) Administrative units in the state:

The state comprises 27 districts (during the year 2012 Chhattisgarh state has created 9 new district) and 220 community development blocks, including 121 tribal development blocks. The local government is organized into three tiers Panchayat Raj system with 27 Zila Panchayats and 146 Janpad Panchayats and 9193 Gram Panchayats. The urban area in the state are governed through 8 Municipal Corporations, 28 Muncipal Councils and 40 Nagar Panchayats

b) Demography:

The census of India 2011 recorded the population of Chhattisgarh as 2.55 crore. A distinguish social feature of the state is the high population of the tribal communities accounting for 33 percent of the total population. Gonds, Bisonhorn maria, Muria, Halba, Bhatra, Dhurvaa, Karma, Saila, Suga are the dominant tribal groups while primitive tribal groups are Abhujmaria, Baiga, Pahari, Korba, Birhor and Kamar. The dalit communities account for another 12 percent. Thus the, almost 45 percent of the state comprise of socially disadvantaged groups.

c) Socio Economic Situation:

Results of socio economic surveys as well as reported data on social indicators bear out the high degree of vulnerability of the state's population. International Institute of Population Science in its study of district vulnerability has identified that 12 out of the 18 districts as socially and demographically backward with a composite index of less than 50. The UNDP human

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development study of 2005 places the predominantly tribal districts at the bottom of the development pile.

d) Population: Table-1: Demographic Profile of Chhattisgarh:

Description 2011 2001 Estimated 2.55 Crore 2.08 Crore Population Actual Population 25,540,196 20,833,803 Male 12,827,915 10,474,218 Female 12,712,281 10,359,585 Population Growth 22.59% 18.06% Sex Ratio 991 990 Percentage of total 2.11% 2.03% Population Area km2 135,191 135,191 Density/km2 189 154 Tribal Population 842825 687489 (33%) 280941 223718 SC Population (11%)

e) Child Population (based on census and ICDS household survey register) In state, the ICDS beneficiaries on the basis of Census 2001 & 2011

Table-2: Child Population of Chhattisgarh:

Children 0-6 years Boys Girls Total % of the total of age population

2001 17,54,503 18,00,413 35,54,916 17%

2011 17,59,041 18,24,987 35,84,028 14%

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f) Districts, blocks (Rural/Urban/Tribal): Seven of the eighteen districts and 86 of the 146 health blocks have tribal concentration of more than 50 percent

Table-3: List of Districts and Blocks: There are total 27 Districts in Rural Urban Tribal Total Chhattisgarh and distribution of Blocks are given here

No. of ICDS projects (220 84 15 121 220 development blocks in the state)

g) Female Literacy rate:

Table-4: Literacy rates of Chhattisgarh: Description 2011 2001 Literacy 71.04 64.66 Male Literacy 81.45 75.70 Female Literacy 60.59 55.73 Total Literate 15,598,314 11,173,149 Male Literate 8,962,121 6,711,395 Female Literate 6,636,193 4,461,754

(Source: Census 2011 & 2001)

h) Rural Connectivity: All weather, Seasonal road

Chhattisgarh, almost three-quarters of the population live in rural areas. And most parts don't have an all-weather road connection. A large section of the country's rural population is still isolated from the mainstream, thus depriving them of the benefits of the country's economic growth. It is said that nearly half of the country's habitations still remain unconnected. And improper road connectivity is one of the main reasons stopping growth in rural areas. However, things changed in Chattisgarh, when road connectivity was provided to rural areas under the Pradhan Mantri Gram Sadak Yojana. The living conditions in connected villages continue to improve, and the number of households living below the poverty line is likely to continue to decrease.

Connectivity impacted rural living conditions in two ways. One, it gave the communities more reliable and quicker access to outside products, services, information, and social linkages. Two, it gave external service, product providers, while social contacts improved access to rural communities. Connectivity has enabled communities to fully access existing government services that aid rural areas. Connectivity and difficult areas are discussed in the next point.

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i) Villages/Areas difficult to reach:

In last few years state has improved connectivity from one area to another, which is very important for timely health and nutrition services, but still due to inaccessibility there are few villages which are hard to reach specially in rainy season. The list of such villages is given below:

Table-5: List of difficult to reach areas: S.NO District Difficult Causes for poor connectivity Project 1 Bastar Bastanar Poor communication

Darbha Lack of Transportation facilities

Baderajpur Poor communication

Keshkal Lack of Transportation facilities

2 Narayanpur Narayanpur Lack of communication and transportation

Orchha Lack of communication and transportation

3 Kanker Durgkondal Lack of Transportation facilities

Antagarh Lack of Transportation facilities

4 Dantewada Bhanuratappur Lack of Transportation

Dantewada Matenar sector is inaccessible due to lack of communication and transportation facility

Geedam River is almost impossible to cross, many villages and panchayats have no road connectivity

Katekalyn No road connectivity

Kuakonda Few panchayats have no roads

Sukma Many panchayats have no road connectivity

Konta Few panchayats have no roads connectivity

5 Bijapur Bijapur Naxals affected area are main reasons for inaccessibility

Bhairmgarh Naxals affected area are main reasons for inaccessibility

Ussor The roads are either cut off by the naxals or there are no roads

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S.NO District Difficult Causes for poor connectivity Project

Bhopalpattnam Many parts of this project are cut off from the main stream due to lack of roads like Tarlaguda and Gola

6 Korba Kartala Hard to reach in rainy season

Pali Hilly area hard to reach

Pondi uproda Hard to reach in rainy season

Kalgorha Hard to reach in rainy season

Korba (R) Hard to reach in rainy season lack of transportation services

7 Kwardha Pandaria

S Lohara Hard to reach in rainy season lack of transportation services

Bodla

8 Raipur Deobhog

Kasdol Lack of communication and Transportation

Mainpur

9 Raigarh Dharamjaigarh Lack of communication and Transportation

Lelunga Hard to reach in rainy season

10 Bilaspur Mungeli

Lormi Hard to reach in rainy season

Kota

11 Durg Bemetara Hard to reach in rainy season Dondi

12 Dhamtari Dhamtari Rural Hard to reach in rainy season

Nageri Lack of communication and transportation

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S.NO District Difficult Causes for poor connectivity Project 13 Koria Bharatpur Lack of communication and transportation

Mahendagarh

14 Jashpur Jashpur Hard to reach in rainy season

Duldula

Bagicha Lack of communication and transportation Farsabahar

Manora

Policy Environment:

Chhattisgarh initiated several measures to improve the status of its people and to move towards universal access to health care. The State recognized the distress caused to its people due to ill health and under-nutrition and the challenges inherent in revitalizing the public health sector to address these issues. The state has a mixed bag for a policy environment with policies being framed but not being followed through. Since establishment the state has set up a women's commission and has a policy for women – but the commission tends to be dormant and the policy is rarely referred to.

A nutrition policy developed in the early 2004 and a health policy framed in 2006 are yet to receive cabinet approval. However, the state does have a robust IT policy and is seen as one of the front runners in North India to implement E-governance systems in public life. Policies in the area of social development tend to move between the populist and more innovative (Mitanin) programs. On the down side, the matter for immediate concern is that the state with almost 33% tribal population resulting in constant internal bickering over administration and flow of funds to tribal areas.

Chhattisgarh 2010- the State's Vision Document lays out the five key actions of the State over the

next 10 years and lays special stress on enhancing our human capital. In order to translate the

Vision into reality, six-monthly milestones have been prescribed; and we are well on our way to

realize the Vision for Chhattisgarh- the Fast Track State.

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2) State Nutrition Policy:

It is known and proven universal fact that to reduce infant mortality the control on malnutrition is best way for developing countries. Indian constitution also states in article 47 in state directive principals that it will be state's primary duty to improve the nutritional and life status of their people. In background of this two facts, in lieu to National Nutrition Work Plan 1995 and objective of the Tenth Plan (2002-2007), state has defined its Nutrition Policy in 2004, which has been envisaged on both short and long term strategies to combat malnutrition

The interdepartmental and inter region integrated work system have been envisaged in the state nutrition policy. Community based work; public education and behavior change communication at family level have been chosen as key strategy for change in public behavior and nutritional status. The coordination and support among government, society, non government organization, community and people will be ensured. The pregnant women, lactating mothers, adolescent girls, old age people, deprived people, handicapped, industrial/ mining employee, landless laborer and their family, migrants and their family have been targeted under the state nutrition policy.

a) Challenges:

Technical reasons for malnutrition in the state:

1. Protein Energy Malnutrition 2. Higher Low Birth Weight Children 3. Anemia in Children, Adolescent girls and Women 4. Iodine deficiency and related complications 5. Deficiency of Vitamin A 6. Nutritional imbalance in urban area

b) Factors contributing Malnutrition:

1. Food habit, livelihood and nutritional security 2. Equity 3. Lack of attention on AGs

c) Strategies for preventing Malnutrition: These are the following strategies included in the state nutrition policy of Chhattisgarh:

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1. Prevention of Malnutrition: Primary Investment

A. Strengthening of ICDS:

 Education for Nutritional food

 Motivating the Growth Monitoring

 Quality implementation of Health Nutrition Day in AWCs.

 Ensuring the availability of IFA tablets and ORS at Aanganwadi Workers.

B. Life Cycle Contact

C. Implementation of essential nutrition activities

2. Strengthening the interdepartmental coordination with Health department. 3. Synergy among different food and nutrition program 4. Adolescent girls. 5. Capacity Building for Health and Nutrition Education 6. Behavior Change Communication 7. Participatory governance 8. Gender Disparity issues 9. Nutrition related issues for urban population and old age people. 10. Partnership for change 11. Follow up and monitoring.

d) Activities undertaken in last two years: Till now as per the state nutrition policy work plan following activities have been undertaken in last two years:

1. The new SNP (Ready to Eat -RTE) arrangements through WSHGs across state started.

2. The capacity building of AWW/supervisors/CDPOs has been done on IYCF interventions, Local herbal based treatment in support of AYUSH department, and home based newborn care and management of illnesses among 0-2 month children as per standard IMNCI guidelines, on Preschool Education using a specially design kit by SCERT currently ongoing across state in support of Education Department.

3. The BCC kit material, relevant to Chhattisgarh's context has been prepared with support of UNICEF. The kit covers most of the points raised in nutrition policy for diet/food behavior.

4. Establishment of Nutrition Surveillance System (NSS).

5. A state level drive “SHISHU SANRAKSHAN MAH”, twice in a year is ongoing since 2007.

6. The Bal Bhoj, Goud Bharai, Annprashan are some of the activities which is improving community participation and behavior of the family.

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7. For the treatment of severely malnourished children Mukhya Mantri Bal Sandarbh Sewa yojana have been initiated.

8. For the cross learning and knowledge management a monthly/ quarterly /bi-annual/ annual magazine ANGANA KE GONTH has been started for all AWWs.

9. Nawa Jatan Program community based management of malnourished children

e) Follow up action: As per the State Nutrition Policy the following actions are required to fill the gap in implementation of nutrition policy. All these activities will be included in the current annual plan:

 The state nutrition mission headed by Chief Minister to observe the follow up of defined strategy.  A State Advisory Committee will be formed which will be headed by Chief Secretary.  Special provision of IFA tablets for Adolescent girls.  The joint effort of AWW, ANM and Mitanin (ASHA) ensuring the benefit of different programs to pregnant women.  Organizing the non training actions  Like joint visit of ICDS and health,  Implementation of result based reward and prize system,  Organizing the Health Mela and cross learning visits,  Developing the communication resource for the users,  Communicating the nutrition related expectation/ priorities/ key points of program to all administrative levels.  A state level nutrition communication policy to be formulated. In implementation of BCC local culture and folk based activities (Kala Jattha, Nukkad drama, Puppet show, Pandwani, Karma and other folk dance/songs) are to be included. The radio, TV, slogan writing, exhibition, film show, poster, chart etc mediums to be used for communication.  The needful literature and resource material required to be developed.  Special curriculum for capacity building on conducting joint program by CDPO and BMO.  The nutrition and health progress review by CDPO & BMO to be made mandatory agenda item for discussion and planning in Gram Sabhas.  Special nutritional package for handicapped children.  Those Panchayat, health committee, AWW, ANM, Mitanin etc, who will demonstrate the exemplary work in nutrition field, will be awarded.  To organize a comprehensive survey on important indicators that affects the nutritional status.

3) Inter- sector convergence for program implementation:

Department of Health and Family Welfare, and Department of Women and Child Development, are independent line departments headed by their own ministers and administratively under their respective Principal Secretaries. At the district level, each department has its chief executive (CMO and DPO) who report to the collector and functionally to their respective directorates. The two departments serve the same segment of population (women and children). A number of initiatives have been taken by the two departments to bring about convergence for program implementation

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If we look at the five objectives and six basic services of ICDS scheme, they clearly demand for coordination and convergence with Health, Education, Public Health Engineering, Panchayat and rural development departments. Hence from service delivery point of view and at the same time to synchronize the demand of the community in order to achieve ICDS stated objectives we need to ensure coordination at different levels and convergence of program with these departments.

a) Current Status of Inter-sector Coordination:

Health Department:

A. Village Health and Nutrition Day (VHND): In field coordination exists at AWC level in the organization of the VHND. VHND are held jointly on Tuesdays & Fridays in each village. The AWW/ANM/Mitanin meets at AWC at least once in a month due to VHND. It is mandatory for both AWW and ANM to jointly organize the VHND. Thus it is the only activity which is mandatory for both the departments i.e. WCD and Health. It provides a platform for organizing crucial activities other than immunization/ANC/IFA-THR distribution. Like conducting HNE checkup sessions as most of the beneficiaries are present. It also provides platform for community participation, like participation of SHGs/Mahatari Committee/PRIs etc. This has following issues:

 The most of the VHNDs are confined to immunization/ ANC/IFA-THR distribution activities only. Both AWW and ANM work in their respective compartments.  The community participation is low.  Mostly the VHNDs are not planned by AWW/ ANM/ Mitanin/SHG/PRI/Mahatari Committee and at sector level supervisors/LHVs do not plan it properly.  Mostly the HNE sessions are missed out.  Effective monitoring of VHND is not taking place.

B. SHISHU SANRAKSHAN MAH (SSM): SSM is organized twice a year with engagement of grassroots functionaries, the AWW-ANM-Mitanin in the state.

C. Training is conducted in an ongoing pattern with support from the Health department's technical support agency called as State Health Resource Centre (SHRC). The training curriculum includes home based newborn care (HBNC) and management of illnesses among 0-2 month children as per standard IMNCI guideline. Till now the training of all master trainer supervisors has been completed and for AWWs is ongoing.

D. Both the departments have some common reporting points but the reporting formats are different and it lacks the convergence across all the levels from village to state. Thus data variation is observed among both depts. reporting for same activity like immunization, infant mortality etc. Also no triangulation process exists leading to lack of commonality in their reporting of key health and nutritional indicators.

E. The sector, block, district and state level joint review meetings are not happening in most of the places which is an important monitoring and review mechanism. In some places these meetings are happening due to interest of specific Collector or DPO or CMHO or CDPO or BMO.

22 Chhattisgarh APIP 2012-13 Department of Women and Child Development

F. Nutrition Rehabilitation Centers (NRC) were started in 18 district hospitals in April 2010.The plan for developing NRCs does mention about the coordination and convergence for referral linkage of severely malnourished children with the help of WCD. Unfortunately it's missed out in the implementation at field level.

G. The health department is running the two important schemes for children in which the help of 2-4 lacs provided for the operation of the child. 1.Bal Hridaya Yojana (Child heart scheme) 2.Bal Shravan Yantra Yojana (child hearing aid scheme). The convergence on this will be improved so that more and needy children enrolled in AWCs will get benefit under these two schemes.

H. Lots of activities are being undertaken by both the departments for betterment of adolescents' health. Still joint efforts are essential to get effective results. Especially for ARSH training of AGs.

I. Difficult areas like Dantewada, Narainpur etc the coordination, convergence and synergy are crucial and need to improve.

AYUSH department:

With AYUSH department, the state has jointly planned training of all 35000 AWWs on Local Herbal remedies. The training named as “Sughghad Swasthya Hamar Aaspas”. The sector supervisors from all the blocks received training under this training program. The training of AWWs is being conducted in an ongoing process. The complete training expenditure is incurred by AYUSH department. The training curriculum includes – Ayurveda based life style, the local herbal remedies of fever, diarrhea, vomiting, anemia, indigestion, body ache, white discharge problem in women, care during pregnancy, care during lactation, correct behavior for some misconceptions and detail of some 48 locally available herbs in Chhattisgarh. The health checkup and ANC in support of AYUSH practitioner is required to improve.

Education:

In SSA PIP 2011-2012, there is financial provision for 670 ICDS supervisors training on PSE and the provision of PSE kit for the 10000 Aanganwadi workers. The SSA in close coordination with the SCERT is working in PSE area since last four years; in this process they have designed a PSE kit and a curriculum for AWW to improve the quality of the PSE for 3-6 years children in the state. At the same time the yearly allocation of 15 lacs to each district under the SSA has been utilized for providing mat or child card or PSE kit. At state level SSA/Education and WCD completely lack the regular- systematic coordination, synergy and convergence, although the target beneficiaries for preschool education are same for both and the quality of PSE ensures the quality of primary education too. Hence a state level cell is required to address these gaps, in which full time representative from Health, Education, Panchayat, TSC and WCD will be there along with data operator and NIC support. Coordination with the Education department is the need of the hour for intensifying adolescent girls' program activities

PHE:

AWWs contribution in Total Sanitation Campaign is remarkable across the state. The sanitation and safe drinking water related behavior change efforts are ongoing at village level. The AWWs are supporting the drive for Pakka Shauchalay across state.

23 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Panchayat and Rural development:

In the state, selection power of Aanganwadi Workers and Aanganwadi Helpers has been given to Gram Panchayat and Janapad Panchayat, they are involved in whole selection process at Gram and Block levels. But their involvement in monitoring of the Aanganwadi Centers services is yet to improve. One of the reasons for less support from them is that the capacity building of newly elected PRI members is confined to SIRD only, in which involvement of WCD is very less. In gram Sabha's the discussion on WCD not given sufficient time. Also Nutrition and other Health features were at the bottom of the list of gram sabha agenda. The regular meetings of Zila Panchayats and Block Panchayats are the platform of coordination with Panchayat department; in these meetings agenda essentially includes the point related to WCD, as one of the standing committee is directly related to WCD. But these platforms are underutilized till now.

Let us see how inter sector linkage is important with other department for achieving ICDS objectives:

Table-6: Table of Inter sector linkage with other departments:

Sector Child Maternal Safe Community Preschool Nutritional Nutrition Nutrition drinking support and education and Health and Health and Health water, monitoring and early promotion, Care Care sanitation stimulation Health and and Disease Nutrition prevention education and Cure Panchayat High High Very High Very High High High

Women and Very High Very High Very High Very High Very High Very High Child Development

Health Very High Very High Very High Very High Very High Very High

Education Moderate Moderate Moderate Moderate Very High Very High

PHE Moderate Moderate Very High Very High No Very High

24 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Sector Child Maternal Safe Community Preschool Nutritional Nutrition Nutrition drinking support and education and Health and Health and Health water, monitoring and early promotion, Care Care sanitation stimulation Health and and Disease Nutrition prevention education and Cure NGO Very High Very High Very High Very High Very High Very High

Impact Reduction in Reduction Reduction in All Increase in To improve IMR/ in MMR/ Morbidity/ objectives school the capacity Malnutrition Anemia IMR enrolment of mother and to to take care reduce of their school drop children and out all objectives

4) Nutrition and Health Status of Women and Children in the State:

According to NFHS 3rd data, 79 percent of children under-six years of age in Chhattisgarh are in areas covered by an Aanganwadi centre. Considering these children as the denominator, two-thirds (65%) receive at least one service. The most common services children receive are supplementary food (58% of children under 6 years), vaccinations (46% of children under 6 years), and growth monitoring (45% of children age 0-59 months), and early childhood care or preschool education (37% of children age 3-6 years). On comparing this indicator as per place of residence, children in rural areas are much more likely to live in areas covered by an Aanganwadi centre, and are also more likely to be taken to a centre to receive services, than the urban children

a) Breast Feeding: Breastfeeding is nearly universal in Chhattisgarh, and 82 percent of children less than 6 months of age are exclusively breastfed. About two-thirds (64%) are put to the breast within the first day of life. However, only 25 percent start breastfeeding in the first hour of life. It is recommended that nothing to be given to children other than breast milk or first 6 months. However, one-fourth of children (23%) are given something other than breast milk during that period. The three recommendations for infant and young child feeding (IYCF) practices for 6-23 months old include continued breastfeeding; feeding solid or semi-solid food for a minimum number of times per day according to age and breastfeeding status; and, including foods from a minimum number of food groups per day according to breastfeeding status. Only about half of children (52%) age 6-23 months are fed the recommended minimum times per day and about one-third (34%) are fed from the minimum number of food groups. Only 27 percent are fed according to all three recommended practices

25 Chhattisgarh APIP 2012-13 Department of Women and Child Development b) Ranking of Chhattisgrah by Breast Feeding: Table-7:Ranking of states by Exclusive Breastfeeding

Source- National Family Health Survey 3 (NFHS-3)

26 Chhattisgarh APIP 2012-13 Department of Women and Child Development

b) Progress of Chhattisgarh in terms of selected vital health indicators: Table-8: Key indicators for Health services for women and children:

Positive Indicators Chhattisgarh DLHS DLHS 3** CES Change from 2* 2009 DLHS 3 Proportion (%) of mothers who had at least 3 ante- 44.4 51.2 71.4 20.2 natal care visits for their last birth Institutional Delivery 18.1 18.1 45 27 Proportion (%) of births assisted by health 11.1 14.1 55 40.9 personnel Proportion (%) of children below 3 years who were 29.5 50.1 44.1 7.2 breastfed within an hour of birth Proportion (%) of children who are exclusively NA 78.3 90.5 12.2 breastfed for 5 months Proportion (%) of children 12-23 months fully 56.9 59.6 57.3 2.7 immunized Proportion (%) of children 12-23 months who have 66.7 69.7 73.1 3.4 received measles immunization Proportion (%) of children 12-23 months vitamin 32.4 65.1 56.2 -8.9 A in last 6 months Proportion (%) of children with diarrhoea in last 2 41.7 36.6 74.1 37.5 weeks who received ORS Proportion (%) of children with ARI in last 2 63.3 68.1 83.3 15.2 weeks who were seen by an health facility (Source*- DLHS 2, ** DLHS 3, CES 2009) d) Vitamin A supplementation Status:

Vitamin A is an important micronutrient for maintaining normal growth, regulating cellular proliferation and differentiation, controlling development, and maintaining visual and reproductive functions. Diet surveys have shown that the intake of Vitamin A is significantly lower than the recommended daily allowance in young children, adolescent girls and pregnant women. In these vulnerable sub-groups multiple nutritional problems such as inadequate intake of energy and micronutrients other than Vitamin A coexist. Inspite of the fact that there has not been any significant improvement in the dietary intake of Vitamin A and coverage under Massive Dose Vitamin A programme has been low; there is a

27 Chhattisgarh APIP 2012-13 Department of Women and Child Development decline in clinical Vitamin A deficiency in under-five children in the country. This could perhaps be due to increase in access to health care, consequent reduction in severity and duration of common childhood morbidity due to infections. However, biochemical deficiency continues to be common.

The coverage evaluation survey 2009

shows that % children who received atleast one dose of vit A is 67.3 % whereas % of children who received at

least one dose of vit A is just 56.2 %.The overall first dose vit A coverage is 62.1% & that of second dose is 39%. State is

implementing sishu sanraksha maah to strengthen & improve coverage of vit A supplementation.

(Source: CES 2009)

e) Nutritional status of the children:

Trend’s in children’s Nutritional Status less than 3 years of age

Almost half of children (45%) 70 61 58 in Chhattisgarh under age 60 52 three are stunted, a reflection 50 45 of chronic under-nutrition. 40 NFHS 2 One-fifth of children (18%) are 30 NFHS 3 wasted, indicating acute 19 18 20 under-nutrition. 52 percent are underweight, which takes into 10 account both chronic and 0 Stunted Wasted Underweight acute under-nutrition.

28 Chhattisgarh APIP 2012-13 Department of Women and Child Development

f) Anemia among children and women :

In NFHS-3 a very high proportion (79.2%) of children between 6-35 months were found suffering from anemia. Prevalence of anemia was higher among rural as compared to urban children (72.7% to 81.2% respectively).

Anemia is also a serious health problem among adult women in the state. The NFHS-3 survey found that over half (56.2%) of the number of married women in the age group 15-49 years were suffering from anemia, the prevalence rate being 58.2% in rural and 51.5% in urban women. Among the pregnant women in the same age group anemia prevalence was 57.9% (59% rural and 54.6% urban) showing that pregnancy per se did not increase the prevalence of anemia. This could be on account of IFA supplementation to pregnant women under RCH program. The DLHS (MOHFW, op. cit) data found that about only 37.9% pregnant women in different districts of the state consumed one IFA tablet regularly.

Table-9: Anemia Trend in Children:

Anemia NFHS 2 NFHS 3 Trend Analysis

% of children (under 5 87.7 80.9 Average 1 % point years) of age with reduction per year anemia

g) Iodized Salt consumption:

Using iodized salt prevents iodine deficiency, which can lead to miscarriage, goiter, and mental retardation. Just over half of households in Chhattisgarh (55%) were using sufficiently iodized salt at the time of the survey, somewhat lower than the percentage observed during NFHS-2 (61%) h) Infant Mortality rate:

The infant mortality rate in Chhattisgarh is currently estimated at 54 deaths per 1,000 live births as per the latest available SRS 2009. Infant mortality is higher in rural areas (55 per 1000 births) is higher than urban areas (47 per 1000 births).

As per NFHS 3 data, infant mortality is 113 deaths per 1,000 live births born to teenage mothers, compared with 71 deaths per 1,000 live births born to mothers age 20-29. Spacing between births is also an important factor for determining the IMR, lesser the period of interval between births (below 2 years), higher the infant mortality rates.

29 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Infant Mortality Trend

100 86.1 79 71 50 61 54 53 0 Series 1 NFHS-2 SRS Series 1 (1998) NFHS-3 SRS (2000) SRS (2005-06) (2007) Annual (2009) Health Survey of GOI - 2011-11

Infant Mortality and Under-5 Mortality rates:

Table-10: Infant Mortality and Under-5 Mortality rates:

Mortality NFHS -2 SRS NFHS -3 SRS SRS Annual Indicators (1998) 2000 (2005-06) 2007 2009 Health Survey of GOI- 2010-11 Infant 86.1* 79 71 61 55 53 Mortality Rate Under Five 137.6* NA NA NA NA 70 Mortality Note - * data of Madhya Pradesh (Undivided Chhattisgarh) i) Ante natal care:

Among mothers who gave birth in the five years preceding the survey, 78 percent received antenatal care from a health professional (42% from a doctor and 36% from any other health personnel). About 10 percent received antenatal care from an anganwadi worker, whose task is only to mobilize pregnant women to ANMs and doctors for antenatal checkups. Eleven percent of mothers received no antenatal care. Ninety-five percent of urban women received antenatal care from a health professional, compared with only 74 percent of rural women.

30 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Mothers who had 3 antenatal care visits (%)

60 54.7

50

40 A comparison between NFHS- 33.2 2 and NFHS- 3 shows a large 30 Series 1 increase in the proportion of

20 ever-married women who received antenatal care. 10

0 NFHS-2 NFHS-3

j) IFA supplementation during pregnancy:

While 75% mothers received IFA supplementation, only 21 percent of mothers consumed them for the recommended duration of 90 days or more. Even when women receive antenatal care, they do not receive most of the services needed to monitor their pregnancy, such as weight, blood pressure, blood test, urine test and abdominal examination.

k) Progress of Institutional deliveries: (As per NFHS - 2, NFHS - 3)

Table-11: Progress of Institutional Deliveries:

Chhattisgarh India

Institutional NFHS-2 NFHS-3 Change NFHS-2 NFHS-3 Change Deliveries 15.8 18.1 2.7 11.4 33.6 20.4

31 Chhattisgarh APIP 2012-13 Department of Women and Child Development

The trend in institutional deliveries as per HMIS data for last five years is as follows:

Table-12: Institutional Deliveries Trend:

S. No. Years Total Deliveries Home Deliveries Institutional Percentage of Deliveries Institutional Deliveries 1 2007-08 563624 414599 149025 26% 2 2008-09 567135 387276 179859 32% 3 2009-10 471201 288797 182404 39% 4 2010-11 616251 280789 335462 54% 5 2011-12 353809 168995 184814 52% (Apr-11 Nov 11)

Source: NRHM CG PIP 2012-12

l) Progress of JSY Beneficiaries:

Following table shows the Progress of Janani Suraksha Yojana beneficiaries:

Table-13 JSY Beneficiaries Trend:

Year Total Janani Suraksha Yojana Deliveries Home Institutional Total Deliveries % of JSY Deliveries Deliveries beneficiaries 2005-06 568781 1659 511 2170 0.38 2006-07 596247 44642 30814 75456 12.66 2007-08 563624 74229 101749 175978 31.22 2008-09 567135 90764 134848 225612 39.78 2009-10 471201 116000 53098 169098 45.20 2010-11 616251 52615 268670 321285 52.13 2011-12 353809 27611 195548 223159 63.07

Source: NRHM CG PIP 2012-13

32 Chhattisgarh APIP 2012-13 Department of Women and Child Development

m) Post natal care:

Only 28 percent of mothers in Chhattisgarh had a postnatal check-up within 2 days of birth; most women receive no postnatal care at all. In addition it is seen that delivery at an institution does not guarantee that the post natal check-ups take place as recommended.

n) Vaccination status:

According to NFHS 3 data, half of children (49%) age 12-23 months are fully vaccinated against the six major childhood illnesses: tuberculosis, diphtheria, pertussis, tetanus, polio, and measles. Only 3 percent have received no vaccinations at all. It is important to note that between the first and third doses of the OPV DPT as per immunization schedule, the dropout rate for polio is 12 percent and the dropout rate for DPT is 28 percent.

In Chhattisgarh there has been substantial improvement in vaccination coverage since NFHS-2. Full vaccination coverage, which was only 22 percent in NFHS-2, increased to 49 percent in NFHS-3. Children in urban areas are much more likely than rural children to receive all vaccinations (75% urban, compared with 43% rural). Girls are slightly more likely than boys to be fully vaccinated (51% of girls, compared with 47% of boys).Between NFHS 2 and 3, coverage of three doses of DPT and measles increased by 22- 23 percentage points. Coverage of BCG also increased, from 74 to 85 percent.

5 percent of children in Chhattisgarh had diarrhea in the two weeks preceding the survey. Among these children, 62% were taken to a health facility. 46% were treated with some kind of oral rehydration therapy (ORT) or increased fluids, including 40 percent who were given ORS. One-fourth of children with diarrhea did not receive any type of treatment at all. Children should receive more fluids than usual during diarrheal illness, but only 3% received more liquids than normal.

5) History of ICDS in Chhattisgarh :

Launched on October 2, 1975 in thirty districts of India, ICDS program has grown as the world’s largest early childhood development program. The program approaches child health holistically and comprises health, nutrition, and education components for children less than six years of age; pregnant women and lactating mothers; and adolescent girls.

a) Year wise expansion of ICDS in the State:

Chhattisgarh is associated with ICDS right from inception as a separate state. Tokapal block of Bastar district was selected for the pilot of ICDS scheme with other 32 blocks.

33 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Year wise expansion status is as under –

Table-14: ICDS Expansion in the state:

Year No of Projects sanctioned No. of AWCs sanctioned 2000-2001 152 20289 2005-2006 158 29437 2008-2009 163 34937 2011-2012 220 43763 6548 (mini AWCs)

EXPANSION OF ICDS IN CHHATTISGARH:

43763 43763

34937 29437 No.of projects Sanctioned

No. of Mini AWCs 20289 Sanctioned No. of AWCs Sanctioned

6548 6548

2319 152 836 158 836 163 163 220

2000-01 2005-06 2008-09 2010-11 2011-12

It is very clear that in Chhattisgarh since its inception the ICDS is growing in terms of project expansion and the targeting under the ICDS. If 2000 is taken as base, graph shows that the no of AWCs have more than doubled and at the same time the targeted beneficiaries (refer graph below) have increased by 53%

34 Chhattisgarh APIP 2012-13 Department of Women and Child Development

b) ICDS- Change in Efficiency of the AWCs year wise:

Table:15 ICDS Efficiency Table:

ICDS- Change in Efficiency of the AWCs year wise

Year No .of No of No of Actual Per center Per center Per center operational surveyed beneficiaries surveyed benefited efficiency AWCs beneficiaries beneficiaries beneficiaries

2000-01 19756 1935068 1163577 98 59 60%

2005-06 20286 2824692 1804331 139 89 64%

2009-10 34493 3550194 2298090 103 67 67%

2011-12 42497 3646312 2538300 86 60 70%

Table shows that in Chhattisgarh the ICDS AWCs efficiency in terms of actual beneficiaries against the surveyed one have been increased from 60% (2000-01) to 70% (2011-12) in last twelve years

6) State government financial contribution in quality implementation of ICDS services:

a) Till now support by state government in the last two years:

Chhattisgarh state is effectively contributing in the different activities to eradicate malnutrition through worth implementation of ICDS. The key contribution in last two years is has been:

1. In ICDS out of its six services package referral services and health checkup needs to be made more effective. Currently there is provision to refer the AWCs beneficiaries to Sub Health Centre and Health centers (PHC.CHC/district hospitals), where they get the medical facility as per the need. But we have faced practical difficulties in implementation of referral services. Due to own priorities of health field staff and lack of human resource in terms of pediatricians in state yield to less no. of health checkups of AWCs children. This also becomes more critical with non-availability of required medicines. Some time the availability of medicines is also not there, which make situation worse some time. Hence for the management of the severely malnourished children (SAM), the state needs to take special efforts. To provide special/additional facilities in terms of medical specialist, medicine and health checkups for the management of the severely malnourished children, the state has started Mukhya Mantari Child

35 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Referral Scheme across the state on 6th June 2009. The Scheme entails – If government health centers lack the test facility for the SAM children then the provision of this test is made from private centers.

 If additional medicines are required which are not available in health centre then such medicines are to be purchased from market and provided.  If pediatrician is not available in health facility then

In year 2010-11 approximately 20700 children were benefited by this scheme and this number increased in the year 2011-12, total 2058080 children benefited in this year and the budget provision for the year 2012-13 has been made rupees 5.44 Cr.

• To ensure the quality human resource development in state, Chhattisgarh has established a State level Resource Centre (SRC) which acts as apex agency for training and training plan. A director (JD) is leading the centre. The two regional centers are also linked to SRC.

• To cater to the state's need of baby/adult weighing machines, state has provided 35500 adult weighing scales in the last 2 years, 14500 in 2010-11 and 21000 in the year 2011-12. State had procured 17000 baby scales in the year 2010-11 (5000 provided by UNICEF and rest 12000 procured by the state government, state government decided to provide 10000 more baby weighing scales to the AWCs in the year 2011-12 and for the same government had given funds to UNICEF to buy these scales, most likely in July 12 these scales would received and distributed to the AWCs

• To improve the quality and frequency of AWWs mobility, state government has provided a bicycle to all old sanctioned 34937 AWW in 2009-10 through ₨8.81Cr. State fund. In the year 2011-12 6000 more bicycles have been given to the AWCs by spending 165.66 lakh rupees. The provision of 86 lakh rupees has been made for the year 2012-13 for provide 2826 bicycles

• State government is providing additional honorarium of ₨500/- to AWW and ₨250 to AWH every month. Also if any AWW or AWH die during her working period then provision of ₨10,000/- relief fund is being made for her family. In the year 2011-12 35.82 rupees were spend by the state government and for the year 2012-13 the provision of 43 crore rupees has been made for the same

• For quality service delivery at AWC, building is essential. At present, 29073 buildings have been sanctioned by the state government against the 43763 AWCs. And for the year 2012-13 provision of 1146 more AWCs buildings is planned and for the same Rs. 51.57 Cr. Budget is estimated.

• State is developing the Child friendly AWCs so that it could be attractive for children. In the year 2010-11 this project was piloted in the 200 AWCs with the expenditure of rupees 20 lakhs. For the year 2012-13 the provision of Rs. 1.85 Cr. has been made to develop 1850 AWCs as Child friendly. This fund will be utilized for decorating AWCs with colors, pictures, wall paintings etc and equipping them with good quality games and toys, so that children can enjoy in the AWCs and no. will increase. • In the year 2010-11, 30,000 children were provided uniform in active support of community. In the year 2011-12 the expenditure for uniform was 373.46 lakh rupees. Finding this initiation fruitful state government has taken decision to improve the quality of PSE and to improve

36 Chhattisgarh APIP 2012-13 Department of Women and Child Development

attendance of preschool children in AWC through provision of uniform for these children. For the year 2012-13 provision of rupees 5 crore has been made to provide the uniform especially to the tribal areas AWCs. • State government has ensured the availability of fund towards land for own building for the 171 CDPO and 18 district program offices. • For effective monitoring and evaluation, projects essentially need a vehicle. State government has purchased 57 vehicles in last three years for child development projects. • There is no provision to re provide the necessary equipment like utensils, furniture etc to the old AWCs in ICDS scheme, it is required indeed. State government took initiative and made this provision for the year 2012-13. Therefore to provide such equipment to the AWCs and budgetary provision of rupees 5 Cr.

Table-16: State Government Financial support in the last two years: Till now support by state government in the last two years

Activity Fund given (Rs. Lakhs) For the management of the severely malnourish children state Mukhya 158.51 Mantari Bal Sandarbh Yojana (2010-11)

For the management of the severely malnourish children state Mukhya 242.16 Mantari Bal Sandarbh Yojana (2011-12)

Running state apex training centers-State Resource Centre (2010-11) 61.8

Running state apex training centers-State Resource Centre (2011-12 68.36

Two regional training centers (2010-11) 59.1

Two regional training centers (2011-12) 52.27

To cater the state need of Child (Salter)/adult weighing machines 89.76 (for baby) (2009-10) 86.22 (for adult)

To cater the state need of Child (Salter)/adult weighing machines 77.01 (for baby) (2011-12) 220.00 (for adult)

Training of all AWW on home based neonatal care and facility based care 150 referral management (10-11 & 11-12)

Training of all AWW on Behavior Change Communication (10-11) 195

Training of all AWW on IYCF (2009-10) 32.50

A bicycle to all old sanctioned 34937 AWW (2009-10) 881

37 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Activity Fund given (Rs. Lakhs) A bicycle to 6000 AWW (2011-12) 165.66

Additional honorarium of ₨500 to AWW and ₨250 to AWH every month 3018 (2010-11) Additional honorarium of ₨500 to AWW and ₨250 to AWH every month 3582 (11-12)

Developing 200 AWCs as child friendly centers in Kondagaon and Makadi 20 block Construction of 666 AWC buildings (2010-11) 1998.0

Construction of 1332 AWC building (2011-12) 5244.00

For the construction of 13 CDPOs office (2011-12) 195.00

For the construction of 8 training halls in CDPOs office 33.04

For the construction of supervisor sector buildings 62 (2011-12) 435.86

Purchase of 57 vehicles in last three years for child development projects. 230

Uniforms for AWCs children (2011-12) 373.46

Water filter provided to AWCs of tribal/LW affected Bastar area (7 86.67 Districts)

b) Budget provision by state government for 2012-13:

Table-17: Budget Provision by state government for 2012-13:

Activities Fund given (In Lakhs) Mukhya Mantri Bal Sandharbh yojna 544.60 Training for community based management of 322.00 malnutrition To re-provide furniture, utensils to old 500.00 sanctioned AWCs To provide uniforms to the preschool children 500.00 of tribal areas AWCs For decorating AWCs with colors, pictures, wall 185.00 paintings etc and equipping them with good quality games and toys in order to make them child friendly

38 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Activities Fund given (In Lakhs) To provide bicycle to the new AWCs 2826 86.00 Construction of 1145 AWC buildings 5157 For the construction of 10 CDPOs office 200 For the construction of 62 supervisor sector 500 buildings To make hostel building and residential 109 quarters for bilaspur RTC

c) Budget provision for central sponsored ICDS scheme 2012-13:

Table-18: Budget provision for central sponsored ICDS Scheme:

Component/Scheme Budget for 2012-13

Total Central State Government Government Share Share (10%) (90%) For ICDS General 38121.29 34309.11 3812.123

Training 717.30 645.57 71.73

7) Infrastructure status of all operational AWC Buildings:

Aanganwadi center is a focal center which plays role of nuclear body for child development services. It is very important that Aanganwadi functions smoothly, as it caters to chunk of underprivileged population. We cannot expect desired results (of preventing malnutrition and decreasing IMR, MMR) without delivering quality services. Quality of services largely depends on various factors; availability of proper infrastructure is one among those. Better delivery of services could be ensured only when there is a proper place to run AWCs. Various empirical studies and report from World Bank have proved that "fix site approach" is one of the pre-condition for enhancing and maintaining quality services under ICDS. Understanding the importance of Pacca Aanganwadi centers, state government is endeavoring to sanction 100% AWCs with building facility.

39 Chhattisgarh APIP 2012-13 Department of Women and Child Development

a) Sanctioned AWCs building in Chhattisgarh:

Snapshot of efforts taken by state government in building Aanganwadi centers can be understood from graph below:-

Sanctioned AWC Building In Chhattisgarh

50000 43763 40000 30000 18067 20000 12012 13684 10000 0 Total no of Buildings Sanctioned Buildings Sanctioned No. ofAWCs without Sanctioned AWCs under departmental under other than Building (31.2%) (100%) Head (27.4%) departmental Head (41.2%)

b) Status of Construction:

After third phase of expansion we have 43763 sanctioned AWCs in Chhattisgarh. Out of the 43763 AWCs, 30079 have sanctioned buildings. Department has sanctioned 12012 buildings from departmental head whereas 18067 buildings are sanctioned under other schemes like BRGF, WFP, SAP etc. In Chhattisgarh near about 69% AWCs have sanctioned own buildings, so we have to cover remaining 31% under departmental head or through convergence with other departments.

Status of Construction

35000 30079 30000 25000 20338 20000 15000 10000 4428 5313 5000 0 Total No. of Not started Incomplete Completed Sanctioned AWCs Building

40 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Nearly 68% of sanctioned buildings are complete; in near about 17% buildings work is under progress, while in about 15% AWCs work is not yet started. The construction will be started soon in these places. The delay in initiation of construction has been due to delay in land acquiring, increasing cost of construction etc. Department has submitted a proposal before finance department to get permission for construction where buildings are incomplete or work could not be started due to some reason since long.

c) Availability of drinking water and Toilet facility in AWC:

Only 13661 centers are having drinking water facility or having drinking water source in 50 meters radius of AWC .Only 11744 buildings are provided with toilet facility

Availability of Drinking water and Toilet facility in AWC

50000 43763 40000

30000

20000 13661 11744 10000

0 Total no. of Sanctioned AWC No. ofAWCs having Drinking No. of AWCs having Toilet (100%) Water Facility (31%) Facility (27%)

The above detail shows that state government has taken initiative to cover AWCs with their own buildings. Sanction for construction of buildings in more than 50% centers reflects government's commitment towards development of women and children. It is indeed a good example of inter departmental convergence. Government is working on developing child friendly AWCs in Chhattisgarh. 3 AWC one at Kondagaon, Makdi (Bastar Distt) and another at Raipur Urban. Under this project 200 Aanganwadi centers building have been taken for enhancement. In addition are being developed as child friendly centers and building as learning aid in support from UNICEF.

The Aanganwadi centre is a place to provide informal preschool education to 3-6 children, so building design critically needs some additional components which can facilitate the preschool education effectively. Also for the buildings which are already constructed a regular maintenance, repairing and additional cost provision is required.

41 Chhattisgarh APIP 2012-13 Department of Women and Child Development

In order to address these challenges State is planning to develop state policy for construction of child friendly AWC buildings and to modify existing buildings accordingly so that AWCs can be used as a learning aid. State has adopted now a uniform pattern of exterior and interior of Aanganwadi centre, for state is spending ₨10000/- per AWC. Convergence with other departments especially with Panchayat & Rural development for acquiring land in proper place and construction as per approved map/lay-out. Efforts are made to tie-up with PHE for covering AWCs with water and toilet facilities. Also about ₨150 Cr. (5000 AWCs @ ₨3 lacks per building) under 13th Finance commission will be made available for construction of AWC buildings. It is important to note that number of sanction under other department's schemes may go down if insisted on using uniform maps/lay outs because in some schemes cost of construction is estimated at 2.25 lakh to 2.75 lakh but department has approved and sanctioned ₨3.00 lakh per building. Increasing construction cost is also one of the challenges that plays major role in delaying construction.

Plan for 2012-13:

8) Status of operational blocks/AWCs/Mini-AWCs against sanctioned:

Status of operational blocks and centers is reflected in the table below. In third phase GOI had sanctioned 57 additional projects, 8826 new AWCs and 4229 mini AWCs. Sanction of additional projects is pending at state level due to some queries from finance department. Sanction for additional AWCs and Mini AWCs was issued in July 2010, almost 97.1% of AWCs are being operational as on March 2012.

Table: 19 Operational Blocks and AWCs: Project AWC Mini AWC

Sanctioned Operational Sanctioned Operational Sanctioned Operational (March 2012) (March 2012) 220 220 (100%) 43763 42497 6548 5767 (by GOI) (97.1%) (836 in the (88%) year 2005-06, 1483 in the year 2007-08, 4229 in the year 2010-11)

AWCs and Mini AWCs was issued in July 2010, more than 88 % of AWCs are being operational as on March 2012. The number of operational mini AWCs is low due to following reasons:  836 mini AWCs were sanctioned in 2005-06, out of which 119 became operational and in rest of the mini centers the AWCs have been started, hence required surrendering the 717 mini AWCs to GOI.  1483 mini AWCs were sanctioned in 2004-5, out of which 90% are already operational.  4229 mini AWCs were sanctioned in 2010-11, which will become operational in current year.

42 Chhattisgarh APIP 2012-13 Department of Women and Child Development

9) Trends in coverage of beneficiaries for supplementary nutrition and pre-school education:

For trend analysis of supplementary nutrition ICDS MPR is taken as source and Year 2007-08 as base year. The status of coverage of beneficiaries for supplementary nutrition is as follows:

Table-20: Trend of SNP coverage: Beneficiaries Year Year Year Year Year 2007-08 2008-09 2009-10 2010-11 2011-12 Children 6 982393 1088681 1046739 1125301 1129306 months to 3 years of age

Children 3 to 6 733924 773093 805229 878887 928774 years of age

Pregnant and 456232 497265 446122 488517 480220 Lactating Women

Total 2172549 2359039 2298090 2492705 2538300

% increase 8.5% 5.7% 12.8% (14.4%) from 2007-08 (base year) (Source March 2012 MPR)

Trend of SNP coverage (% Improvement) 20.00% 14.40% 15.00% 12.80%

10.00% 8.50% 5.70% 5.00%

0.00% 2008-09 2009-10 2010-11 2011-12

Base Year is 2007-08

In compliance to the order of Honorable Supreme Court the distribution of supplementary nutrition through SHGs/Panchayat/Local bodies was started in the state in April 2007. In this arrangement hot cooked meal and raw THR was served to the beneficiaries at AWCs by women SHGs/Panchayat/local

43 Chhattisgarh APIP 2012-13 Department of Women and Child Development bodies across the state. As SHG activities were vibrant in state and with active involvement of local district administration Chhattisgarh became first proud state to introduce this new arrangement of SNP distribution through women SHGs/Panchayat/local bodies, thus completely eliminating middle man. But in year 2009 (Feb.) GOI had revised financial and nutritional norms for SNP. In compliance to the same, the state endeavored second revision in method of distribution, introducing morning snacks, hot cooked meal and RTE through women SHGs/Panchayat/local bodies. This new arrangement was transition phase for the state and had its own teething problem. To set this new arrangement in place, a strategy was carved out at the state level. The essential activities undertaken to implement the strategy across all the districts are enlisted as follows:-

1. Selection of active and capable women SHGs. 2. Selection of better performing Panchayat/local bodies 3. Training of SHGs in nutrition production (locally) and PRIs 4. Setting up RTE unit for SHGs. 5. Arranging loan for SHGs. 6. Exposure visit of SHGs

All these activities were time consuming. The entire operation started from July 09 and ended up in month of December 09. During this period performance of 12 districts (Bijapur, Dhamtari, Durg, Janjgir, Jashpur, Kanker, Korea, Narayanpur, Raigarh, Raipur, Rajnandgaon, Sarguja) was not up to the mark.

Gradually the system took momentum and again there is increase in number of beneficiaries in year 2010-11. It is worth mentioning that in third phase of ICDS expansion we have curtailed our original demand of AWC to 8826 AWC and 4229 mini AWC. The matter was scrutinized in depth (coverage of every Para and Tola by the state) by GOI and sanction to operational these AWCs/mini AWCs was received from the state finance in month of July 2010. Thus it is substantiated that increase in 5.66% (25.26 – 30.92) in year 2011 was the result of better coverage and gradual strengthening of system of new arrangement of SNP distribution through women SHGs/Panchayat/local bodies.

Preschool Education : Table-21: Trend of PSE coverage: Beneficiaries Year Year Year Year Year 2007-08 2008-09 2009-10 2010-11 2011-12 Boys 379645 397511 410936 434974 458738

Girls 382946 401441 414826 441054 468583

Total 762591 798952 825762 876028 927321

% increase 4.7% 8.2% 14.8% 17.8% from 2007-08 (base year) (Source: ICDS MPR March 2012)

44 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Trends of PSE coverage (% Improvement) 20.00% 17.78% 14.80% 15.00% 10.00% 8.20% 4.70% 5.00% 0.00% 2008-09 2009-10 2010-11 2011-12

Base Year is 2007-08

From above table and graph of preschool status, it is noted that coverage of PSE is steadily scaling up over years. Also interestingly the improvement in coverage of girls as PSE beneficiary has been always better than boys.

Through filed level analysis, group discussion, different consultation and conversation (To organize consultation for preparing APIP) following facts were revealed.

 Families prefer to send girls to AWC & take boys to field along with them.  In rural areas there are many pre nursery schools at village level hence some families prefer to send boys to these schools rather than to AWCs. It shows that the gender discrimination for preschool education clearly exists.  In tribal area the sex ratio is more than 1000 per male, which is the key factor for more girls' enrolments in tribal AWCs

10) Training infrastructure – AWTCs, MLTCs:

There are 13 NGO run AWTCs, two govt. run RTCs, and one govt. run SRC (State Resource Centre) operational in state. SRC is institutionalized to cater the training need at state level. It has got its own capacity to do training of 40 participants at SRC building. The training to CDPOs/supervisor is being given by SRC. SRC do also develops quarterly AWWs magazine Angana Ke Gonth along with other training module or materials. Training to AWWs is given through AWTC and RTC. Training to AWHs is given through DTT/MTT operational in every district. Trainers of SRC/RTC/AWTC/DTT are given training through NIPCCD. District-wise location of training center in state has been earmarked in the map enclosed.

AWTC for providing furniture and equipment for newly sanctioned AWTC. This is one time grant and in view of current price level, the fund is too short to equip new AWTC. Apart this, there is no provision of fund for providing furniture and equipment for old/existing training centers. For State Resource Centre as apex training centre, which is running in rental building, we need a state level resource cum training centre of the department.

For quality services by training institute there is need to incorporate following actions in state training policy:

45 Chhattisgarh APIP 2012-13 Department of Women and Child Development

1. Availability of training tools like films, guide books, subject material etc.

2. Availability of training Aids / Equipment like LCD, TV, DVD player, flex etc.

3. Process for skill up-gradation of trainers, their capacity evaluation and regular availability of knowledge and to abreast them with latest development/amendment.

4. Training needs assessments of AWW/ supervisors to for time to time capacity building in terms of knowledge skills and field level practicalities. At present there is no impact study or institutionalized feedback system to upgrade training.

5. Mechanism for assessing backlog of training – Computerized roaster at block/district level and a training passbook (like GPF Pass book), may be provided to each individual. For this a state level system will be required, and may be included to state level BCC cum Monitoring, evaluation and study Cell.

6. Formation of a state level technical team to facilitate all above actions from state level.

Thus to ensure quality training, inclusion of above all the six components in APIP is very essential.

11) Major gaps/constraints in program implementation:

In state through different consultations, interactions, group discussions, field visits, reports review, stakeholder views the current situation have been compiled. The main operational gaps in implementation of the ICDS program are as follows:

a) Supplementary Nutrition Program:

In some of the remote area of the district (as in Bastar/ Dantewada) the SHGs are unable/ or unwilling for production. In most of the state the SNP program is effectively implemented through WSHGS. The training of WSHG needs to be included in regular annual training plan. Currently we are sending our ready to eat food samples to Mumbai for nutrition analysis. The sample number is very high as we are having more than 1400 WSHGs which are preparing the Ready to eat food therefore the sample size is also high and many of our samples remains unchecked because of the limitations of the high burden laboratory. So we suggest that in Raipur we are having a central government laboratory if government will provide the facility of nutritional analysis in the same than the Ready to eat food samples need not to send to the Mumbai for testing and we will get all our samples testing done.

b) Preschool Education:

 The AWW competency for PSE is low. The time given for PSE by Aanganwadi worker is very less due to her own departmental work load, other time to time duties /work allotted to her.  Although ECCE is a part of AWWs job but if we want to implement the ECCE policy successfully and for the effectiveness of ECCE, we strongly recommend one additional worker

46 Chhattisgarh APIP 2012-13 Department of Women and Child Development

for each AWC for the successful implementation of the policy guidelines, and also for creating 1:20 ratio as mentioned in the ECCE draft  PSE kit is not sufficient. The quality of PSE material is not good and hence it is not long lasting. Mat has not been provided since long, which affects the sitting of children and thus the PSE activities.  The supervisor's efficiency and interest is lacking on PSE.  On job support to AWW is very weak on PSE. It may be due to lack of interest and competency of supervisors. Supervisor focuses on other points except PSE during her supervisory visit to AWCs, which results on distracting Aanganwadi worker from PSE and builds AWW attitude that the PSE is not her priority rather it is record of SNP or other work.  Big gap between two trainings of AWW. At the same time the regular training of Supervisors is less on PSE.  There is no tool to assess the progress of the children in PSE age wise, since their beginning at AWC is at age of three and is till the age of six.  The convergence/coordination/synergy with SSA/SCERT/Education needs to be improved.

c) Immunization and Health Checkup:

 Coordination at sector, block and district level need to improve.  Reporting format and timing of reporting is different by both (Health & WCD) the departments although the village and beneficiaries are same.  The ANM and AWW do meet regularly at AWC on Village Health and Nutrition day but with very less prior planning for different activities. So it gets limited to few mandatory activities like immunization, THR etc of their own section. Hence the true coordination for other activities gets missed out. Same way the planning for VHND activities is also missed out at sector and block level.  State has developed the MCP cards as per the guideline of GOI, is yet to be printed (in process) and distributed.  In remote areas like Baster / Dantewada, Surguja etc due to lack of health staff immunization coverage is low, some differential planning is required (One of the poorest block of state is Orcha known as Abhujhmad, a MOU among UNICEF-Health-ICDS-Ramakrishna Mission has been signed for one year).  In urban area Immunization does not happen at AWCs, due to which there wide gap in the reporting of ICDS and Health departments.  In most of the villages ANC/health checkups take place in AWCs, but most of these AWCs lack the facility for ANC table/ screen etc ( In one district Dhamtari the provision of ANC table at AWC has been met through NRHM, which is showing good results.).  The immunization days are also used for health checkups for all beneficiaries. Due to this the health checkups are over shadowed by immunization. Although due to the implementation of NRHM the availability of testing equipment has been improved, but the carrying these equipment to AWCs on VHND and to use it is weak. Due to unavailability of equipment or problem in bringing of the equipment to AWC, the quality checkups usually miss out. The blood test, urine test, blood pressure test quality is need to improve. It is important to note that the immunization and ANC work usually over shadowed the health checkup services, hence its most of the time missed out for other beneficiaries.  The pediatric IFA supply is not regular and unavailable at AWCs, to ensure the distribution of the pediatric IFA for the anemic children should be improve.

47 Chhattisgarh APIP 2012-13 Department of Women and Child Development

 In state and district offices there are in-charge or nodal person for SNP services, but there are no in-charge or nodal for Immunization/health checkups/referral services. Due to this WCD usually miss the linkage with key health officials at State and district levels, hence the field level quality of these services cannot be ensured.

d) Referral services:

 The Mukhya Mantari BAL Sandarbh Yojana (MMBSY) is confined to only severely malnourished children, but for rest of the beneficiaries the referral service need to be strengthened especially the anemic AGs, underweight pregnant women should be included in MMBSY.  One day is fixed for MMBSY in a project, which is usually organized at Block level. A day is insufficient for whole project. For remote areas it is difficult for beneficiaries to travel to block headquarter.  A referral mechanism i.e. a loop from AWC to health centre and then health centre to AWC is missing, which may be addressed through the coordination at sector/block level between the ICDS and health.

e) Health Nutrition Education:

 In HNE there is great need of IEC material like flip book, flash cards, reference book, films etc and skills, but AWW/Supervisors lack these materials completely in the state. Hence the quality of HNE sessions without audio visual aids is poor.  The status of all behavior related indicators (refer NFHF III/ DLHS 2) are not satisfactory, which shows that the quality of HNE sessions need to improve in state. Use of growth chart for family /mother counseling is also need to be address.  HNE is provided through two different key processes first home visits and second HNE sessions on VHND or other gathering. Both processes are weak due to getting less priority in comparison to other services.  Nutrition Health Education lacks the mentoring or supportive supervision and on job support to AWW. The involvement of health staff like LHV/ANMs and other department expert is lacking.  A magazine for Aanganwadi Workers i.e. AANGANA KE GONTH started in state, in new state this is first magazine for AWWs and is very effective. There is need of IEC cum BCC cell at state level. So that it can be publish regularly.  The capacity of AWW/ supervisors on counseling is lacking, since long neither they have received skill based training on counseling nor any communication material like flip book etc.  The growth monitoring and promotion is one of the key health and nutrition subjects, which needs to be strengthen.

f) Current SNP arrangements:

 The capacity building of WSHG on SNP arrangement system is insufficient.  The regular monitoring of the SNP distribution at community level needs to improve. The strategic involvement of PRI and mothers committee is required to improve for community level monitoring.  The payment to WSHGs does differ from district to district and have different mechanism in different district.  The sufficient storage capacity for SNP needs to be ensured in the AWCs.

48 Chhattisgarh APIP 2012-13 Department of Women and Child Development

 To enhance the nutritive value of Ready to eat food addition of Vitamin Mineral powder into it is highly required

g) Kuposhan Mukti Abhiyan (Malnutrition Eradication Mission):

 Due to lack of child specialists/pediatricians in state, the treatment in some of the remote area is missed out.  In state under NRHM 20 Nutrition Rehabilitation Centers have been started, but the linkage with AWCs is very poor.  Malnutrition is not seen as a health or nutrition problem by community. Same time the weak HNE sessions have very low impact on behavior change.

h) Village Health and Nutrition Day (VHND):

 The most of the VHNDs are confined to immunization/ANC/IFA-THR distribution activities only. Both AWW and ANM work in their compartment.  The community participation is low. Effective monitoring of VHND is not taking place.  Mostly the VHND are very less planned by AWW/ ANM/ Mitanin/ SHG/ PRI/ Mahatari Committee and at sector level supervisors/LHVs also less plan.  The HNE sessions are very minimal during VHN.

i) Others:

 In state at different level the posts are vacant, which are required to fill as soon as timely. Vacant posts are affecting the managerial as well as implementation actions at different levels.  District like Dantewada, Baster, Narainpur, Kanker, Mahasamund, Dhamtari, Rajnandgaon, Durg, Surguja are fully or partially affected by naxalism. These blocks need some special focused interventions to improve the ICDS services in these areas.  Challenges in construction of AWC building: Unfinished AWC buildings are a major concern. Many of these buildings are old and require fresh sanction as per revised norms. Lack of state level policy for uniformity in construction plan and cost, lack of technical expertise in department as far as construction work is concerned, major obstacles in getting desired results. Inadequate drinking water and toilet facilities in AWCs are another big issue which needs to be addressed on priority.  Inter sector coordination and convergence among all departments especially health, education, PHE, Panchayat and rural development, tribal development, urban development and ICDS are required to be strengthened at all level.  State nutrition policy has been prepared in 2004-05 and implemented across state. Currently the gaps between the policy and the field implementation are required to address.  Nutrition surveillance System is in place, which is generating huge data and analytical reports at sector and block levels. In some places use of this data has been started for field level decisions and planning. It is time to increase the analytical capacity of CDPOs and supervisors so that they will use these results in improving the nutritional status of the targeted population.  The state is one of the poorest states of the country deserving to be included into the 10 EAG states. There is pervasive poverty, hunger, malnutrition combined with poor water and sanitation services.

49 Chhattisgarh APIP 2012-13 Department of Women and Child Development

 Difficult Geographic Location- With large portion of the state either covered with forests or having plateau area with poor connectivity and transport systems is a major problem for referral services.

12) Interdepartmental coordination (Particularly Health, Drinking Water, Sanitation and Panchayat): Currently state has good linkages with key departments viz. Health, drinking water, sanitation and Panchayat. We are doing following activities in collaboration with other departments:

Table-22: Interdepartmental Coordination:

S.no Program/Activities/Processes Department Level

1 Immunization, Shishu Sanrakshan Health At all levels Mah. Health Checkups, Referral, VHND, Mukhya Mantari Bal Sandarbh Yojana, HNE sessions, joint visits 2 Preschool Education, Kit Education, SSA, SCERT At all levels development, Training of AWW on PSE, Training of supervisors on PSE 3 Total sanitation Campaign, PHE At all levels Water facility in AWCs, Management of menstrual hygiene 4 Review of ICDS progress, Panchayat At all levels selection of AWW/AWH, selection for the site for AWCs building, Gram Suraj Abhiyan, solving local issues of AWCs- weighing machine, fuel for SNP etc 5 Improving quality of tribal areas Tribal department At all levels AWCs by- giving bicycle to all AWWs, supporting in development of 6 Nutrition Surveillance System UNICEF At all levels establishment, Field support for monitoring, BCC kit development, Nutrition Hand book for AWW/ Supervisors/ CDPO, technical support for IMNCI/IYCF etc 7 Sector meeting quality CARE At all levels improvement

50 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Section 2

Vision 2020 Chhattisgarh

The Chhattisgarh Government commits itself to achieving the highest attainable level of physical, mental and social health through processes that shall empower local communities and be affordable to the State and its citizens, be equitable and gender sensitive and which would reduce poverty in the State. Universal access to comprehensive quality primary health care with adequate referral linkages would be the key strategy through which this vision would be realized.

Vision 2020 Chhattisgarh- Mission Quality ICDS

The Integrated Child Development Services (ICDS) program is India's most important response for the nutritional and developmental needs of the children below six years, pregnant women and lactating mothers. The program has since become the world’s largest and unique early childhood development program. In Chhattisgarh, this program is being implemented through a network of around 44000 village-level Aanganwadi Centers (AWCs), facilitated by community based Aanganwadi Workers (AWWs) and Aanganwadi Helpers (AWHs).

The ICDS Program is the forefront of the efforts of the Government of Chhattisgarh to achieve the child nutrition related Millennium Development Goal (MDG1). The Government of India has committed to achieve the nutrition MDG of halving underweight rates from 54% to 27% between 1990 and 2015, and to achieve the education MDG of universal primary education (MDG2) and the Education For All, goal of expanding and improving comprehensive early childhood care and education, especially for the most vulnerable and disadvantaged children. GOI is also committed to reduce infant and child mortality and improving maternal health outcomes (MDGs 4 and 5). Since malnutrition is closely linked to all of these MDGs, the interventions under the ICDS program are expected to contribute towards achievement of each of these long-term goals.

The 11th Five Year Plan has envisaged increased coverage through ICDS in order to ensure rapid universalization; changing the design; and planning the implementation in sufficient details so that the program objectives are not vitiated by the design of implementation. Besides, all its original six services that need to be delivered fully for the program to be effective: (i) supplementary nutrition, (ii) immunization, (iii) health check-ups, (iv) health and nutrition education, (v) referral services, and (vi) non-formal pre-school education‟

(Planning Commission, 2008).

51 Chhattisgarh APIP 2012-13 Department of Women and Child Development

In state the coverage of beneficiaries has improved in last ten years from 1163577 (200-01) to 2362371 (2009-10) through expansion of operational AWCs from 19756 (2000-01) to 34493(2009-10)

In 2002 Mitanin program with 60000 community health volunteers called Mitanin (now ASHA for state) was launched in the state and in 2005 the NRHM state mission started. State has started different initiatives for the health of children & women like:

 In Chhattisgarh Mitanin (ASHAs) are working in hamlet based unit rather than village based. Since 2007 all 60000 Mitanins are getting medicine kit every year costing ₨7.5Cr.under the Chief Minister Dawa Peti Scheme. Also they are getting incentives for institutional delivery, malaria slide, leprosy, TB, neonatal care, immunization-VHND etc  In co-ordination with Health, ICDS and international organizations (UNICEF and MI) a drive for immunization Vit. A supplementation and health checkups is carried out. This Biannual drive is known as Shishu Sanrakshan Mah, which focuses on immunization, health checkups of pregnant women, and children, Vitamin A distribution. (See result of SSM of last three years). This is possible due to effective coordination between ANM-AWW-Mitanins.  To improve referral, NRCs were also started last year in 18 district hospitals, which are expanded to CHCs this year.  Under NRHM great reforms have taken place, the state umbrella of fund is around ₨1000Cr. with 60000 Mitanins and increased no of ANMs.

Due to these great initiatives in last five years the performance of ICDS in two services especially immunization and health checkups has improved (see latest data which says same). Hence the state scenario in ICDS (the three health related services i.e. immunization; health checkup and referral) has improved. In coming years the status of immunization coverage, first contact curative care, IMR and MMR are going to be improved. But for malnutrition status and indicators of nutrition related behaviors (see table) the situation is not so good. Hence with view of expansion of operational AWCs, child nutrition related Millennium Development Goal (MDG1) and planning commissions guidance to changing the design, state will be focusing on State Specific Need Based Improved ICDS as follows:

 Early Child Development (ECD) - Focus on ECCE, early stimulation of child, school readiness.  Health Nutrition Behaviors and Empowerment (HNBE) - Focus on HNE, strengthening the role of WSHGs in HN, Vit A/IFA/iodine salt related actions, quality SNP consumption by beneficiaries.  Improved Referral Mechanism (IRM) - improved linkage between NRC and Chief Minister Bal Sandarbh Yojana, home based management of under nutrition.  Healthy mother and children- Continuous support to SSM, NRHM, health for immunization and health checkups.

Without duplicating the expenditure and efforts in health, with the advantage of NRHM, and focuses efforts for Nutrition and Education, our state vision- mission is defined as follows

52 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Vision 2020 statement

Suposhit Chhattisgarh Viksit Bacche

Va Sashakt Mahila

(Chhattisgarh a malnutrition free state with developed children and empowered women)

Chhattisgarh a malnutrition free state with developed children and empowered women

Mission 2020 – Quality ICDS:

 To act equitably for attainment of the highest level of efficiency & quality in whole ICDS system:  To provide the accessible and quality State Specific Need Based Improved ICDS program for the children and women esp. the poor, vulnerable, excluded and deprived section of the community to make them healthy and developed one.

Strategies:

 Initiating actions/process to strengthen the on job training for both the education related services i.e. PSE and HNE.  For the coordination-convergence-synergy at all level with key departments through establishing coordination cell.  The quality of HNE and training institutions through IEC/BCC- technical cell and equipping all AWW with BCC kit.  Improving the capacity of the ICDS functionaries at all level through training, exposure visit and on job support.  Improving the monitoring and evaluation at all level through establishing M&E cell.  Implementing the state nutrition policy.  Designing the AWCs building policy as Child Friendly followed by quality implementation.  Initiating the actions on already formulated early child stimulation policy.  Timely management of all severely malnourished children through expansion of Chief Minister Child referral scheme and adopting the home based care for SAM.  Ensuring regular study and research on selected topics to enhance the state action on nutritional improvement.  Contracting out the consultant /human resource for research/study/IEC-BCC etc

53 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Section-3

Organizational Structure of ICDS Program Management at the State and District Level

a) Organizational Chart of the State Directorate & District Cell:

At State Directorate - In state a separate WCD directorate is working as shown below:

Commissioner

WCD

JD JD JD (F)

DD DD DD

AD AD AD AD AD

Accounts Others Officer

54 Chhattisgarh APIP 2012-13 Department of Women and Child Development

At District Cell: District Program Officer

District Women and Assistant Program Child Development Officer Officer

Program Coordinator

Other Supporting Staff

Block Level Field Staff:

Child Development Project officer

Assistant Statistical Officer

Assistant Child Development Officer

Supervisor

Aaganwadi Worker

Aaganwadi Helper

Mini Aaganwadi Worker

55 Chhattisgarh APIP 2012-13 Department of Women and Child Development

b) Revised Population Norms for establishing AWCs under ICDS program:

Table-23: Population norms for AWCs under ICDS program:

Old Revised

CDPO Block 30,000 to 1,00,000 – 1/project A For blocks with >2lac population, state unit for sanction of an ICDS project could opt for more than one project on in Rural/tribal irrespective of one per 1lac. In the later case staff villages & population could be suitably strengthened.

Sector Supervisor S 20,000 to 30,000 – 1/sector 25,000 – 1/Sector

AWC Rural/ urban one AWC on a population of 500- 400 to 800 – 1 AWC 1500 800 to 1600 – 2 AWC

1600 to 2400 – 3 AWC

In multiples of 800/AWC

Mini AWC 150 to 500 – 1 Mini AWC 150 to 400 – 1 Mini AWC

AWC tribal 300 to 1500 – 1 AWC 300 to 800 – 1 AWC

150 to 300 – 1 Mini AWC 150 to 300 – 1 Mini AWC

ICDS program functions under the Department of Women and Child Development. It has a separate Directorate headed by a Director/Commissioner. In the district the organization is headed by the District Program Officer (DPO). In larger districts he is supported by DWCDO (District Woman and Child Development Officer). At the block level, the program is managed by Child Development Project Officer (CDPO) assisted by Assistant Statistical Officer and Assistant Project Officer. At the village level each AWW has two honorary workers viz. Anganwadi Worker (AWW) and Anganwadi Helper (AWH). For every 25 AWCs a Supervisor has been provided. The area covered by the Supervisor is known as a sector.

c) Office infrastructure at state, district and block level:

Department of Women and Child Development having its own building in state head quarter. State government has ensured the availability of fund towards land for own building for the 171 CDPO and 18 district program offices.

56 Chhattisgarh APIP 2012-13 Department of Women and Child Development

d) Committees/Task force constituted by the State government:

For effective implementation of ICDS with, quality and timely administrative and financial processes state has formulated following committees-

 State level monitoring committee- This committee do random visit to district cell i.e. DPO / CDPO office and field to monitor the field level actions. On the basis of findings suggest the commissioner/director to take necessary actions.  State level ICDS purchasing Committee- This committee takes all decisions related to purchase in ICDS program time to time. Secretary is head of the committee.  State level Training Committee- This committee suggests the actions required for the training / STRAP in state to secretary. Committee comprises of joint director, deputy director and assistant director.  State level Committees for ICDS different components- There are committees for PSE, M&E in state. These give suggestions for the effective implementation of different components.

e) Devolution of powers at the state/ district/block levels:

 The devolution of power at all levels is yet to be worked out; currently state is exercising the similar powers as were used in old state. The financial and administrative powers are clearly distributed at all levels.

 The printing of AWWs registers, growth charts, purchase of medicine kit, preschool children uniform, appointment of supervisors etc are the example of centralized power.

57 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Section-4 Annual Action Plan Program Components

1) Human Resources:

a) Recruitment Process: For the recruitment of CDPO/Supervisors and AWW state follows GOI guidelines and has specific norms and process.

Recruitment of AWW: The minimum qualification prescribed by GOI for selection of AWW is Matriculation. But some of the AWW who were recruited earlier do not possess the minimum prescribed qualification

Educational Qualification and experience-wise scale of honoraria for AWWs:

Table-24: Honoraria for AWWs:

S.N. Qualification & experience of Honorarium (Rs) Honorarium (Rs) Honorarium (Rs) AWW (effective 1.4.02) (effective 1.4.08) (effective 1.4.11))

1 Non-Matriculate 938 1438 2938

2 Non-Matriculate with 5 years 969 1469 2969 of work

3 Non-Matriculate with 10 years 1000 1500 3000 of work

4 Matriculate 1000 1500 3000

5 Matriculate with 5 yrs 1031 1531 3031 honorary work

6 Matriculate with 10 yrs 1063 1563 3063 honorary work

7 Anganwadi Helper 500 750 1500

8 AWW of Mini AWC 500 750 1500

The selection of AWW is made by CDPO on the recommendation of Gram Sabha. For selection of AWW it is essential that she should be resident of the local village

58 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Recruitment of Supervisors and senior level staff: Recruitment and promotion process of Supervisors and senior level staff of ICDS is summarized in table

b) Process of Selection and Promotion of staff of ICDS:

Table-25: Selection and Promotion of ICDS Staff:

S.N. Designation of Direct recruitment Recruitment by promotion posts

1. Joint Directors - 100 percent by promotion of DPOs/Deputy Directors

2. DPOs/Deputy - 100 percent by promotion of Directors DWCD/Asst. Director

3. DWCD/ Assistant 50 percent 50% by promotion of CDPOs Director

4. CDPOs 50 percent 50% by promotion of APO/Supervisors

5. Supervisors 75% by selection and 25% reserved for AWWs who have to qualify the examination

6. Anganwadi Selected by District Panchayat and Worker/Mini AWW on merit basis

7. Anganwadi Helper Selected by District Panchayat and on merit basis

c) There exists specific cadre for CDPOs & Supervisor: State has a clear promotion policy for the AWW/supervisors and CDPOs. The 75% posts of supervisors are filled through open recruitment process, while rest of the 25% by promoting AWW via an open selection process. Hence AWWs get promotion to supervisor post not by direct promotion but through an open selection process. The 100% posts of APOs are filled by promotion of supervisors. Time to time publishes the gradation list of DPO/ DWCDO/ CDPO/ Supervisors/ AWWs

d) Man positions/ Vacancies at all levels: Is given in the following charts:

Table-26: Man power/Vacancies at all levels:

59 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Functionaries Sanctioned In- Timeline Pay band Pay Grade Pay Salary/ Estimated Salary/ Estimated Position for filling band Pay structure Honoraria budgetary Honorari budgetary up the as on per month requirement a per requirement vacancies 12-13 for the FY month for the FY (In Process) Joint Director 1 1 15600 39100 28170 7600 60809 60809 729708 60809 729708 Dy. Director 2 2 15600 39100 23520 6600 51204 102408 1228896 102408 1228896 Asst. Director 2 2 15600 39100 19690 5400 42653 85306 1023672 85306 1023672 Accounts 1 1 15600 39100 19690 5400 42653 42653 511836 Officer 42653 511836 A.S.O. 2 2 9300 34800 13080 4300 29546 59092 709104 59092 709104 Stenographer 1 1 5200 20200 10560 2800 22712 22712 272544 22712 272544 Data Entry 2 0 5200 20200 9390 2400 20043 40086 481032 Operator 0 0 Asst. Grade I 1 1 5200 20200 10560 2800 22712 22712 272544 22712 272544 Accountant 2 1 5200 20200 9390 2400 20043 40086 481032 20043 240516 Asst. Grade II 1 1 5200 20200 9390 2400 20043 20043 240516 20043 240516 Asst. Grade III 1 1 5200 20200 7180 1900 15436 15436 185232 15436 185232 Driver 1 1 5200 20200 7180 1900 15436 15436 185232 15436 185232 Peon 1 1 4750 7440 5950 1300 12325 12325 147900 12325 147900 Total 18 14 6469248 5747700 Expenditure

60 Chhattisgarh APIP 2012-13 Department of Women and Child Development

District Level: Sanctioned In Position Functionaries Sanctioned In Time Pay band Pay Grad Pay Salary/ Estimated Salary/ Estimated Position line or band as e pay Structur Honorari budgetary Honorari budgetary filling on 12- e a per requireme a per requirement up 13 month nt for the month for the FY vacanc FY ies District 16 7 15600 39100 23520 6600 51204 819264 9831168 358428 4301136 program Officer Program 7 2 15600 39100 19690 5400 42653 298571 3582852 85306 1023672 Coordinator Asst Program 5 1 15600 39100 19690 5400 42653 213265 2559180 42653 511836 officer A.S.O. 14 3 9300 34800 13080 4300 29546 413644 4963728 88638 1063656

Superintenden 16 9 9300 34800 13080 4300 29546 472736 5672832 265914 3190968 t Asst. Grade I 2 5 5200 20200 10560 2800 22712 45424 545088 113560 1362720

Asst. Grade II 16 9 5200 20200 9390 2400 20043 320688 3848256 180387 2164644

Asst. Grade III 16 13 5200 20200 7180 1900 15436 246976 2963712 200668 2408016

Driver 14 9 5200 20200 7180 1900 15436 216104 2593248 138924 1667088

Peon 16 14 4750 7440 5950 1300 12325 197200 2366400 172550 2070600

Total 122 71 38926464 19764336

61 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Project Level: In Sanctioned In Position Functionaries Sanctioned In Time line Pay band Pay Grade Pay Salary/ Estimated Salary/ Estimated Position or filling band pay Structu Honorari budgetary Honorari budgetary up as on re a per requireme a per requirement for vacancies 12-13 month nt for the month the FY FY CDPO 163 85 9300 34800 13080 4300 29546 4815998 57791976 2511410 30136920 ACDPO 103 47 9300 34800 11940 4200 27438 2826114 33913368 1289586 15475032 Supervisors 1617 1444 5200 20200 9390 2400 20043 32409531 388914372 28942092 347305104 Asst. Grade I 157 81 5200 20200 10560 2800 22712 3565784 42789408 1839672 22076064 Clerk- typist 287 122 5200 20200 7180 1900 15436 4430132 53161584 1883192 (Asst Grade III) 22598304 Driver 154 72 5200 20200 7180 1900 15436 2377144 28525728 1111392 13336704 Group D

Peon 230 214 4750 7440 5950 1300 12325 2834750 34017000 2637550 31650600 ii. Chowkidar 152 22 0 0 3750 0 3750 570000 6840000 82500 (Collect orate) 990000 Other, If any 108 101 5200 20200 9390 2400 20043 2164644 25975728 2024343 (Give Details) 24292116 Total 2971 2188 671929164 42321737 507860844

62 Chhattisgarh APIP 2012-13 Department of Women and Child Development

AWC Level:

Functionaries Sanctioned In - Salary/ Estimated budgetary position Honoraria per requirement for the FY month

AWCs 43763 42169 3000 1575468000

AWWs (Mini AWCs) 6548 5685 1500 117864000

AWHs 43763 41268 1500 787734000

Additional worker (if any) provided by - - - 0 the state

TA OF AWW & AWH 40934000

Total 94074 89122 6000 2522000000

63 Chhattisgarh APIP 2012-13 Department of Women and Child Development e) State’s additional contribution for honoraria of AWWs and AWHs: State do provides additional ₨500/- per month honoraria to AWWs and 250/- per month honoraria to AWHs. f)Insurance coverage and welfare measures for the AWWs and AWHs: State has given insurance support to all AWWs and AWHs. A yearly premium of ₨280/- being shared by the GOI (₨100/-), the state government (₨100/-) and the beneficiary i.e. AWW/AWH (₨80/-). Under the insurance plan the beneficiary gets the benefit of

 ₨30000/- on general death.  ₨75000/- on accidental death.  ₨75000/- on permanent disability due to accident.  ₨35000/- on partial permanent disability due to accident.  ₨2000/- support on risky disease

Under the scheme there is additional provision in terms of scholarship for the children of beneficiary (i.e. AWW/AWH). The premium exemption will be given to all AWW/AWH till 31st March 2013. Under the insurance scheme the 18-59 years AWW/AWHs are insured

Also on death of working AWW family get financial support of ₨10000/-

2) Procurement of Materials and Equipment:

a) Status of supply of equipment:

 No .of AWCs having functional baby and adult weighing machines- There are 50311 total sanctioned AWCs & Mini AWCs in the state out of these in 40280 AWCs weighing scales are functional and approximately in 9000 AWC the weighing scales are not functional. Adult weighing scales are functional in 38500 AWCs. In last 3 years department has provided weighing scales in large number through state funds. In the year 2009-10 & 2010-11 UNICEF has provided 500 weighing scales and state also purchased 12000 baby weighing scales through UNICEF. In the same way in 2009-10, 14500 and in the year 2011-12, 21000 adult weighing scales were provided. In the remaining 9000 AWCs where weighing scales are not functional, 10000 more weighing scales are being procured and by July 2012 these would be distributed to all the AWCs. So by July 2012 all the AWCs would be having functional weighing scales.

• No. and percentage of blocks with functional computers and printers: In the year 2011-12 163 computers were procured and send to each project, Therefore the current status of computers in the project is this: out of 163 projects there are 3 computers in 12 projects and in remaining 151 there are 2 computers in each project

64 Chhattisgarh APIP 2012-13 Department of Women and Child Development

• No. and percentage of District offices having functional computers/ printers In each district program office, two computers are available. In five districts four computers and in six districts three computers are available. Each district has two printers. In five districts three and in two districts four printers are available.

• Functional vehicles at state, district and block level In the year 2011-12 there were 9 new districts and 57 new sanctioned projects were sanctioned. Therefore total number of districts is 27 and total number of projects is 220. Out of these 27 districts 16 DPO and 2 DWCDO offices are having their own vehicles and out of 220 only 100 projects are having their own vehicles. For rest of 120 projects and 9 districts and 1 for state we require vehicle hiring. Therefore total hiring vehicle requirement is 130

b) Requirement during the Financial Year:

Table-27: Procurement of Materials and Equipment

Items No. No. to be Estimated Timeline of Means of available in procured budgetary supply verification working during the requirement during FY (MPRs/UCs) condition year (in rupees) (Tentative date) State level To supply utensils, 8826 36.00 lakh August Dec.2012/ UC furniture for new AWCs 2012 of 2nd Quarter and MINI AWCs (in the 4 districts where the money was not drawn during last year,i.e Bemetara, Balaudabazaar, Gariaband & Raipur)

Medicine Kits for AWC - 43736 26257800 Sep 2012 Oct 2012/ UC of 2nd quarter

Medicine Kits for mini 6548 1964400 Sep 2012 Oct 2012/ UC AWCs of 2nd quarter

Uniforms for AWWs/AWHs 188000 188148 37629600 Nov 2012 Jan. 2012/UC of 3rd Quarter

65 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Items No. No. to be Estimated Timeline of Means of available in procured budgetary supply verification working during the requirement during FY (MPRs/UCs) condition year (in rupees) (Tentative date) One set of computer and - 66 (@1 lak) 6600000 Nov 2012 Jan. 2012/UC printer , photocopier & fax of 3rd Quarter for all new projects & dpo cell (Contingency Component)

1 Computer and printer for - 66 3300000 Nov 2012 Jan. 2012/UC new sanctioned child (@50000) of 3rd Quarter development projects & dpo cell ( in furniture & equipment component)

Furniture etc for for new - 66 (@1 lakh) 6600000 Sep 2012 Dec 2012/UC sanctioned child of 3rd quarter development projects & dpo cell ( in furniture & equipment component)

At District level :

Preschool kits for AWCs 34937 43763(X250) 1637000 Nov 2012 Jan. 2012/UC of 3rd Quarter

Preschool kit for mini AWCs 2319 6548(X300) 1964400 Nov 2012 Jan. 2012/UC of 3rd Quarter

At Project level :

Name badges for - 94074 2351850 Sep 2012 Dec 2012/UC AWWs/AWHs of 3rd quarter

3) Delivery of Services at AWCs:

a) Supplementary Nutrition (SN): i)Existing Mechanism for Procurement & distribution of Supplementary Nutrition: ICDS is providing Supplementary Nutrition to its beneficiaries in two forms -hot cooked meal & Ready- to- Eat (R-T-H).

66 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Since 2009 the Supplementary Nutrition is produced and distributed to AWCs through WSHGs in the state. 1424 WSHGs are preparing Ready to Eat RTE (as per specification) at 220 ICDS projects and supplying it to 42194 AWCs (April 2012). They are also supplying the SNP for spot feeding of 3-6 years of children. All The WSHGs have been trained on complete production- distribution record keeping in phase wise manner for the smooth facilitation of SNP new initiative. ii) Basic information about supplementary nutrition:

A. Type of Supplementary Nutrition provided

Table-28: Type of Supplementary Nutrition provided:

Types of SNP 6 months to 6 years (Items in PW & LW (Items in detail) detail) THR Ready To Eat Composition for 100 gms. RTE Composition for 100gms RTE (per day) 135 gms Normal Child Wheat 55gms Wheat 55gms

211 gms Malnourished child Grams 15gms Grams 15gms

165 gms PW and LW Soybean 5gms Soybean 5gms

Sugar 22gms Sugar 22gms

Oil 3gms Oil 3gms

B. Financial Norms for Beneficiaries: (Per unit cost of Supplementary nutrition provided)

Table-29: Financial Norms for Beneficiaries:

S.no Beneficiaries Govt. of India State State Norms Norms Norms (Revised) (Previous) 1 6 months to 3 years Normal Children Rs. 4/- Rs. 3.41/- Rs. 3.83/-

2 6 months to 3 years Severely Rs. 6/- Rs. 5.46/- Rs. 5.99/- malnourished Children 3 3 to 6 years Normal Children Rs. 4/- Rs. 3.69/- Rs. 3.99/-

4 3 to 6 years Severely malnourished Rs. 6/- Rs. 5.59/- Rs. 5.98/- Children 5 Pregnant women and Lactating Rs. 5/- Rs. 4.37/- Rs. 4.68/- Mothers

67 Chhattisgarh APIP 2012-13 Department of Women and Child Development

iii) Nutrition Analysis of Food Samples:

Calorific & nutritive analysis of hot cooked meal & Snacks is not done in laboratories as more than 17000 agencies are involved in procurement & distribution. However user's Group Committee, including PRIs locally known as Mahatari Samitis, monitors the quality of the food. In THR, where RTE is provided as SNP, the samples are sent for nutritional analysis to the FNB laboratory in Mumbai. In year 2011-12, 4241 samples were sent for analysis and results of 3264 samples have been received and the results are as below:-

Table-30: Nutrition Analysis of Food Samples:

No. of Samples sent for Sample reports received Samples Result as per prescribed Nutritional Analysis (2011-12) nutritional norms

4241 3264 1496

C. GOI’s Revised Feeding Norms:

Table-31: Feeding Norms of GOI

S.no Category Calories Protein (K cal)/day (grams)/day 1 Children (6-72 months) 500 12-15

2 Severely underweight children (6-72 months) 800 20-25

3 Pregnant women and lactating mothers 600 18-20

68 Chhattisgarh APIP 2012-13 Department of Women and Child Development

D. Comparative Table for Feeding Norms Practiced in State:

Table-32: Comparative feeding norms:

S.no Beneficiaries Food Items Govt. of India Revised Government of Chhattisgarh Feeding Category Feeding Norms Norms Previous Norms Revised Norms (w.e.f. Feb.2012) Calories Protein Calories Protein Calories Protein (kcal/day) (grams/ (kcal/da (grams/ (kcal/da (grams/d day) y) day) y) ay) 1 6 months – 3 Ready-to- 500 12-15 504.38 16.98 514.2 15.13 year Normal Eat Children 2 6 months – 3 Ready-to- 800 20-25 807.02 27.16 803.6 23.65 year Severely Eat Malnourished Children 3 3 – 6 years Snacks and 500 12-15 519.55 14.065 652.9 14.41 Normal Hot cooked Children Meal

4 3 – 6 years Snacks and 800 20-25 802.00 23.571 919.54 22.25 Malnourished Hot cooked Children Meal and additional Ready-to- Eat 5 Pregnant Ready-to- 600 18-20 645.6 21.73 628.4 18.49 women and Eat Lactating mothers iv) Total and average beneficiary coverage: Per AWC by rural-urban-tribal category as on March 2012 (Children 6 months to 6 yrs; P & L women) and gaps in coverage (against surveyed child population) as follows:

Table-33: Beneficiary Coverage: Target Group Surveyed Population Enrolled Benefited Beneficiary Beneficiary Children 6 months to 3 years normal 1390556 1306076 1129306 Children 3 – 6 years normal 1352630 1151207 928774 Pregnant and Lactating Mothers 589811 551673 480220 Severely undernourished children birth 25564 (13742- Girls & 11822- Boys) to 3 years Severely undernourished children 3years 12966 (6960- Girls & 6006- Boys) to 5 years

69 Chhattisgarh APIP 2012-13 Department of Women and Child Development

v) Special strategy for cut off area planning during monsoon:

During rainy season, several villages in the State are cut off from the district head quarter because of poor road communication, For all the cut off areas (the list is given in section 01) during the Mansoon, state ensures the availability of SNP for four months by 15th June in each district. In the leadership of all district collectors and DPOs/DWCDOs ensure this action and state monitor this meticulously.

For SNP all the essential actions are delivered by WCD across state. Presently there is no other strategy or differential strategy for tribal area. In Urban area the SNP is provided by local bodies self help groups. vi) Expenditure on supplementary nutrition during previous two years:

Budgetary allocation and actual expenditure incurred (GOI and State Shares separately)

Table- 34: Budgetary allocation and expenditure on SNP during 2010-11 and 2011-12

Financial Year Budget allocation Actual Expenditure % Utilization

2010-2011 30000.00 lakhs 25938.16 lakhs 86.46

(50% from GOI and 50% from state government)

2011-2012 37200.00 lakhs 30150.63 lakhs 81.05

(50% from GOI and 50% from state government)

vii) Quantum of food commodity approved for Wheat based Nutrition program (WBNP) and lifted during 2010-11 and 2011-12:

Table-35: Wheat Based Nutrition Program: Unit: Metric ton Year Allotment of Allotment of Lifted Rice Lifted Wheat Rice Wheat 2010-11 24892 33201 18938 32619

2011-12 20666 38859 20458.05 3844.60

70 Chhattisgarh APIP 2012-13 Department of Women and Child Development viii) Estimated budgetary requirements for the financial year:

Table-36: Estimated budgetary requirement for Supplementary Nutrition:

Population No. of Target Unit Budgetary Means of as per beneficiaries for cost requirement verification Beneficiaries AWW’s (as on March current (in for current FY (MPRs/Ucs) survey 2012) FY Rs.) (Rs. Lakh) register (March (in Lakhs) 2012)

Children 1390556 1129306 11.90 1200 14280 MPR 6mths – 3yrs

Children 3- 1352630 928774 9.50 1200 11400 MPR 6yrs

Pregnant 589811 480220 4.99 1500 7494 MPR Women & Lactating Women

Severe 180000 1.80 1800 2970 MPR Underweight children

Total 3332997 271830 28.19 36144 -

ix) Growth Monitoring & Promotion:

 No. and percentage of AWCs using WHO New Growth Charts:

The entire operational AWCs 42497 and 5767 mini AWCs are using WHO growth charts for the identification of underweight children.

 Percentage of AWCs using New Mother Child Health Cards/any other tools for counseling:

The entire operational AWCs 42497 and 5767 mini AWCs are using Mother and Child Health Cards as a tool for counseling the families, as it is very useful and informative.

71 Chhattisgarh APIP 2012-13 Department of Women and Child Development

x) Growth monitoring/ Promotion and Children’s Nutritional status:

Distribution of nutritional status of children using weight for age criteria (MPR March 2012) is shown in the following Table:

Table-37: Growth Monitoring:

Age group No. of No. of Nutritional Status (as per WHO New Means of children children Growth Standards) Verification enrolled at weighed at Normal Moderately Severely AWCs (as on AWCs (as on underweight Underweight March March 2012) 2012) Below 3 years

Boys 648730 427373 209535 11822

Girls 648515 423404 211369 13742

Total 1703871 1297245 850777 420904 25564 MPR

3 years to 5 Years

Boys 392477 259494 126977 6006

Girls 394696 254763 132973 6960

Total 1090252 787173 514257 259950 12966

2084418 1365034 680854 38530 Grand Total 2794123 (65.4%) (32.6%) (1.8%)

72 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Graph showing overall nutritional status of children from birth to 5yrs

(Using WHO New Growth Standards)

Nutritional Status of 0-5 years of Children

38530

Normal weight children (65.4%) 680854 Moderately underweight Children (32.6%)

1365034 Severely Underweight Children (1.8%)

Source: AWWs MPR March 2012

b) Pre-school Education:

The first 6 years of a child’s life are globally acknowledged to be the most critical years for lifelong development since the pace of development in these years is extremely rapid. Recent research in the field of neuroscience, particularly on the brain, has provided convincing evidence of the ‘critical periods’ located within these early years for the forming of synaptic connections in the brain and for the full development of the brain’s potential. Research has also indicated that if these early years are not supported by, or embedded in, a stimulating and enriching physical and psychosocial environment, the chances of the child’s brain developing to its full potential are considerably, and often irreversibly, reduced. This stage in life is also important as a foundation for the inculcation of social values and personal habits, which are known to last a lifetime. What follows logically is the crucial importance of investing in these early years to ensure an enabling environment for every child, and thereby a sound foundation for life, which is not only the right of every child but which will also impact, in the long term, the quality of human capital available to a country. Pre-School Education derives its importance from this rationale. The pre-school education component under ICDS Scheme is an important component of the package of services envisaged under the scheme. It aims at school readiness and development of positive attitudes towards education. Strengthening of pre-school education would also supplement the effort in achieving the national goal of universal primary education. It is to be noted that right to education, which has been accepted by the government as a national policy cannot succeed without PSE.

73 Chhattisgarh APIP 2012-13 Department of Women and Child Development

i)State Policy/guidelines/curriculum for Pre-school Education & Pre-School Kits in ICDS:

State in close collaboration with SCERT and SSA developed a policy for Early Childhood Care and Education, which mainly focuses and ensures the key interventions for holistic development of 6 months 3years (means early childhood) and 3-6 years children. In lieu of the policy preschool curriculum has been developed.

The state ECCE policy aims to care of 6 months -3 years and 3-6 years children. For 6 months -3 year's children the appropriate nutritional care, protection and facilitation of healthy environment for child development have been envisaged. For 3-6 years children, practical education has been envisaged to ensure the physical and mental readiness of children for primary school formal education. This ECCE policy targets the mental development of children, reaching 100% under 6 years age group children, laying down the foundation for holistic development of the children, developing positive attitude of family members specially mother- father, ensuring development for healthy childhood . It has following key objectives:

 Under early child care and education promoting play based enjoyable activities, awareness for environment and development of healthy habits.

 Building logical thinking and understanding in parents for the rearing up of

children.  Developing positive attitude, problem solving skill and decision making capacity in children.  Motivating community, voluntary organizations, and institutes for child development, and developing the community management skill on this.

Keeping these guiding points for ECCE- it is completely informal, education and should not be burdened and must be enjoyable, the learning process must be constructive one, child's JIGYASU nature must be utilized, keeping local context and experiences in learning processes, including local art, songs, and stories in activities.

Along with SCERT, SSA and education department state decided to perform the following activities in coordination with the above mentioned departments:

 Identification of children with special need by the AWWs on Wajan Tyohaar day has been done.  SSA is having funds of 140 lakhs rupees for the early identification and checkup of children with special needs  Distribution of Udaan kits and training to all the AWWs and ICDS Supervisors, proposal of this training would be made by the department  For evaluating the progress of ECE provision of progress cards has been made. These cards would also be referred for preschool admission of the children

74 Chhattisgarh APIP 2012-13 Department of Women and Child Development

The key actions under the ECCE are based on following facts:

 Good parenting and healthy environment are basic requirement for children's holistic development.  To reach all 0-6 years children for ECCE that no area is derived from ECCE and thus formal education.

 For the ECCE involvement of voluntary organizations, and Gram Panchayats, the informal education program will be based on people's interest and hope.  The quality will be the focus in operational activities. The participation of NGOs, Gram Panchayats, and parents will be ensured while developing the program for AWCs.  State has geographical and linguistic variations, which will be considered during the implementation of ECCE. The curriculumUnderdeveloped development, areas training, will be study, priority operational for implementation research, monitoring, of ECCE. evaluation will be key program The components ultimate result under of informal ECCE implementation education program. will be The linking operational of 100% system children for ECCEto formal will be throughprimary a convergence education. committee of WCD, Health, Education, Panchayat and Tribal welfare departments. A resource centre will be established at all levels i.e. at state, district and block. In close convergence with SSA, training of 20000 AWWs of 80 blocks has been done on PSE in last two year. In 2011-12 they are going to train 650 supervisors on PSE.

ii) The strategy for preparing 3-6 children for school readiness:

The existing gaps or weaknesses in delivery of PSE have been analyzed and explained in chapter 1. State ICDS is very closely working with SCERT, SSA and education. PSE is focus area of ICDS of and following key points will be focused in state to improve PSE quality

a. A tool like age wise PSE progress card for each child will be provided so that the AWW will be able to monitor each child for PSE and put her effort accordingly. This will be an innovative activity b. As most of the villagers and PRI members understand (as they have not much understanding over the concept of informal education, also they do compare AWC with the private nursery school activities) that in PSE Aanganwadi worker has to provide some component of formal education like English/Hindi letters or numbers knowledge etc. Hence some of these will be included in the PSE kit. c. The time period for PSE will be increased in AWC. For at least 2-2.30 hours

2. Using existing supervisors especially for PSE through improving their competencies on PSE and increasing their time in AWCs for PSE as mentor. 3. Have PSE mentor or specialist who can support Aanganwadi worker for full on job support, at least for two days in a week/month along with supervisor linked to this process essentially to avoid gap. 4. Either a honorary teacher from Education department to give on job training to each Aanganwadi worker at least twice a week, along with supervisor linked to this process essentially to avoid gap. 5. State is planning to implement the first one. e. As in most of the rural and in some tribal areas, the pre nursery private schools are there, the community compares the activities of these pre nursery to the AWCs activities, so it will be better to have some formal materials like slate/ chalk for children in PSE kit.

75 Chhattisgarh APIP 2012-13 Department of Women and Child Development f. Through public private partnership (As state is doing with BALCO and Vision India for Raipur, Rajnandgaon, Mahasamund, Kabirdham, Korba, Sarguja districts) may be expended for developing AWC as Child Friendly Center. iii) Specific interventions on preschool education: In convergence with tribal department to improve the coverage as well as quality of the PSE following financial support was received from tribal department and Sarve Shiksha Abhiyan:

Table-38: Specific Interventions on PSE:

S.no Year Department Support Specific intervention

1 2012-13 Tribal 5 Cr. Uniform for preschool children in Tribal areas 2 2011-12 Tribal 3.75 Cr. Uniform for preschool children in Tribal areas 3 2011-12 Tribal 1.12 Cr. Weighing machine for children 4 2010-11 Tribal 90 lakh Water filter for tribal area AWCs- to ensure safe drinking water in AWC 5 2010-11 Tribal 2 lakh Child friendly AWCs in tribal area 6 2011-12 SSA From education Training of 600 ICDS department supervisors

iv) Contents of PSE Kits and supply positions:

Contents of PSE Kits and supply positions during previous two years:

Table-39: Contents of PSE Kits:

S.no Year PSE Kit Items for AWCs PSE Kit Items for mini PSE kit provided to AWCs – No of AWWS (%) 1 2010-11 Slope, Ring, Ball, Plastic building blocks, 34937 Counting frame Ring, Ball 2 2011-12 Tricycle, Sponge ball, Rubber/Sponge ball, 42709 Plastic bat and ball, Plastic bat and ball, Ring, Toddler, Skipping Ring/Toddler, Skipping rope, Plastic Big ball rope, Plastic Big Ball

76 Chhattisgarh APIP 2012-13 Department of Women and Child Development

v) Number of AWCs received PSE kits:

Table-40: Pre-school Education

No. of No. of No. of 3-6 yrs Target for the Estimated budget Means of AWCs children children FY requirement Verification providing 3-6 yrs attended (lakhs) for PSE Kits (@₨ 1000/- (MPRs/ASRs/U preschool as per PSE for at per kit Cs) education AWWs least 16 per AWC per year) (lakhs) (as survey days in the AWC Mini AWC Mini Total March register previous AWC AWC 2012) (as month March (as on March 2012) 2012)

42497 1352630 1151207 43763 6548 437.63 19.64 457.27 MPR

vi) Number of children graduated AWCs to formal Primary Schools:

In year 2011-12 WCD organized a campaign “VIDYARAMBH” for the admission of all 6 years school ready children of AWCs. As a result of these campaign 155014 boys and 160321 girls i.e. total 315335 children were admitted in school during July 2011-sept 2011 period. In current year also similar campaign will be undertaken.

c) Nutrition and Health Education

i)State's strategy on nutrition and health education:

It has been observed that in spite of various efforts being made to improve the Nutrition and Health Status of Children. Adolescent Girls and women through providing different services not much improvement has been observed in the nutritional status of children. The main reasons behind seems to be lack of awareness among masses about the nutrition and health which requires more attention.

Health and nutrition education is one of the state priorities for effective implementation of strategy across all AWCs state has devised four approaches. The nutrition and health education is provided though four key processes in state by AWWs at AWC

77 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Opportunities for Nutrition and Health Education:

1. Home Visits

2. VHNDs and THRs Tuesdays and

Fridays

3. WHSGs Meetings

4. Other activities like Goud Bharai, Annaprashan, Breast feeding week

celebration etc.

Goud Bharai, BAL Bhoj, Annprashan are the key community processes organized regularly at AWCs, where community involves directly and practice the methods under the guidance of AWWs and WSHGs. In 'Goud Bharai' function the newly identified pregnant women are being felicitated by giving a coconut and key messages about ANC are given to them in presence of other women. In 'BAL Bhoj' all the children eat community donated food, once in a month in which AWW demonstrate the correct IYCF practices and growth chart. The 'Annprashan' is organised at AWC with the support of community. These activities promote the essential ANC behavior, the timely initiation of complimentary feeding, correct and appropriate complimentary feeding etc. These functions provide the platform for AWWs for NHE and ensure community participation. Every year the breast feeding week, Nutrition week, ICDS day, Children's day have been celebrated with lots of awareness activities like healthy baby show, education sessions, demonstration of nutritive food and complimentary feeding, races etc. ii) Status of implementation of national guidelines on infant and young child feeding practices:

The IYCF guidelines are followed in all the AWCs. UNICEF has provided technical support. In year 2009- 2010 a team of experts has done TOT of master trainers (master supervisors and SRC/RTC's trainers), who have trained all AWWs on IYCF. During these training skills of correct breast feeding, correct and appropriate complimentary feeding had been imparted to AWWs. The AWWs are practicing these skills during their home visits and nutrition health sessions.

78 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Infant and young child feeding analysis:

Children below 3 years breast fed with in one hour of birth Average 2.5 % point increase per year in the 60.00% 50.10% number of children 50.00% 40.00% below 3 years of age 29.50% 30.00% 24.50% who started 20.00% 13.90% breastfeeding within 10.00% one hour of birth. 0.00% NFHS 2 NFHS 3 DLHS 2 DLHS 3

Children 6 months and above Exclusively breast fed The number of children 100.00% who were exclusively 82% 78.30% 80.00% 64.20% breast fed was increased 60.00% in 2005 to 2007. 40.00% However coverage has 20.00% fallen down recently 0.00% NFHS 2 NFHS 3 DLHS 3

79 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Children from 6 months to 24 months received semisolid/solid food along with the breast feeding Average 4% increase per year 60.00% 54.50% 56.80% in the number of 50.00% 40.00% children who 27.30% 30.00% received 20.00% solid/semisolid 10.00% food along with 0.00% breast feed NFHS 2 NFHS 3 DLHS 3

iii) Existing mechanism for counseling of mothers on nutrition and health issues by AWW/Supervisor during home visit:

Pregnant and Lactating women are given counseling on nutrition and health issues by AWWs, Supervisors, ANMs, LHVs during home visits. Members of Matri Sahayogini Samiti have also been trained to provide counseling to mothers.

The AWW provide counseling to mothers in four ways across state a. During home visits b. During VHND and THR Tuesdays c. During WSHGs meetings d. Celebration of Goud Bharai, Balbhoj, Annprashan, Breast feeding week, Nutrition week etc

iv) Counseling on Adequate feeding during and after illness

A cycle of illness and malnutrition can be deadly for vulnerable children, particularly those under two. Appropriate feeding both during and after illness is critical not only for recovery from a current illness but to prevent a child from succumbing to this vicious

cycle over time. Approximately half of all children who die from common illnesses would

survive if they were properly nourished.

Currently they do not have the NHE kit, which state has taken very seriously and with support of UNICEF has developed BCC kit for AWW and supervisors. This BCC kit consists of 1. Set on 5 flip books on Neonatal care, Adolescent- Pregnant- Lactating mother care, Malnutrition in children, Sanitation and hygiene, Women empowerment.

80 Chhattisgarh APIP 2012-13 Department of Women and Child Development

2. A local food book. 3. A set of 58 flash cards. 4. A decision board for AWW. 5. A set of three films, key messages and Sector meeting. 6. A hand book on Nutrition

State will be doing procurement of these kit items and most of the items will be procured from IEC funds v) NHED sessions during VHND/ NHD – use of IEC materials (tools) during NHEDs and home visits:

The AWWs are not provided with kit/material for the nutrition health education session since long. The state has taken steps to develop BCC kit in technical support from UNICEF. This kit will be very useful for home visits and HN education sessions. Growth monitoring is very important process to know the nutritional status of the children and is a tool to provide effective counseling. All the operational (34994) AWCs have been provided with new WHO growth charts last year (2010-11), and all AWWs have been trained on how to use new chart. Currently operational 42497 of AWCs are using WHO New Growth Charts. The Nutrition surveillance system is working since 2007, which effectively strengthened the process of weighing and use of growth charts. The effective monitoring of all the children inspires AWW for proper weighing and use of growth charts. vi) Monitoring mechanism:

Local ANM and ASHA, women from Mahila Mandal, Matri Sahayogini Samiti and other community based organizations attend the VHND camps. Members of Matri Sahayogini Samiti also make home visit with AWW. There is, however, scope for strengthening home visits by the stake holders.

d) Immunization:

i) Current immunization coverage rates:

Table-41: Current immunization coverage rates (based on DLHS-3 and NFHS -3) in the state:

Indicator DLHS-3 (2007-2008) Total (%) Rural (%) Urban (%)

Mothers who had at least one tetanus toxoid Injection 78 76 90.8 (%) Children 12-23 months fully immunized (%) 59.3 57.2 71.4

Children 12-23 months not received any vaccination (%) 4.2 4.4 3.2 Children 12-23 months who have received BCG vaccine 94.8 94.4 96.8 (%) Children 12-23 months who have received 3 doses of DPT 71.4 70 80.1 vaccine (%). Children 12-23 months who have received 3 doses of 69.7 68.1 78.3 polio vaccine (%)

81 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Indicator DLHS-3 (2007-2008) Children 12-23 months who have received measles 79.9 79.1 84.4 vaccine (%) Children (age 9 months and above) received at least one 65.1 64.1 71.4 dose of vitamin A supplementation) (%)

Percentage of children age 12-23 months received BCG + 3 Polio + 3 DPT Measles 60 49 50

40

30 22 20

10

0 NFHS 2 NFHS 3

Percentage of Children received all 3 polio doses 90 85 80 70 57 60 50 40 30 20 10 0 NFHS 2 NFHS 3

82 Chhattisgarh APIP 2012-13 Department of Women and Child Development ii) Existing mechanism for immunization service:

In state two very important processes which have contributed qualitatively for improving the immunization services, Vitamin A, de-worming and IFA distribution are:

1. Village health 2. Shishu and nutrition Sanrakshan

day and follow Maah up days

1. Village Health and Nutrition Days (VHNDs):

Organization of VHND at AWC provides platform for effective coordination. Both departments jointly organize on designated Tuesday of Friday in their village. AWW/ANM/Mitanin at AWC once in a month. It is mandatory for both AWW and ANM to jointly organise VHND jointly and is the only activity which is mandatory for both the departments i.e. WCD and Health. It provides a platform for organizing crucial activities other than immunization/ANC/IFA-THR-Vitamin A distribution. The monitoring of VHND is ongoing.

2. Shishu Sanrakshan Maah:

Shishu Sanrakshan Maah is a Child Survival Initiative by the State Government to protect children against various infections and diseases. The program is conducted in the months of June and December and focuses on coverage and follows up of routine immunization, administration of Vitamin A for children from 9 months to 5 years of age in regular intervals of six months, Iron Folic Acid supplementation for pregnant women, appropriate complementary feeding (ACF).

Table-42: Some important process indicator of Immunization Source: Shishu Sanrkshan Maah report- Jan-2011 & July-August 2011:

S.No Indicator July-2011 Jan-2011

1 Sessions where Jaccha Baccha Raksha Card was available in 89.6 96.7 adequate quantity 2 Sessions where Tab Albendazole was available 74.5 96.5 3 Sessions where Tab IFA (large) was available 48.9 94.9 4 Sessions where Tab / Syp IFA (small) was available 42.1 89.3 5 Sessions where pregnant women were given IFA tablets 95.8 6 Sessions where DPT was administered on antero lateral aspect 80.8 74.7 of thigh 7 Sessions where time of reconstitution of BCG 93.2 93.1 and measles vaccine written on vial 8 Sessions where ANC checkup been carried out 83.4 91.2

83 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Table-43: Coverage figures of Shishu Sanrakshan Maah December 2011- January 2012:

Vitamin A Target 9m - 5 yrs 2439129 Vitamin A achievement 9m- 5 yrs 2079028 Vitamin A % coverage 85.24 Albendazole Target 2389352 Albendazole Coverage 1670412 Albendazole % Coverage 69.91 IFA Target Pregnant Women 657072 IFA Target Pregnant Women Coverage 181062 IFA Target Pregnant Women % Coverage 27.56 IFA Target Lactating Women 597242 IFA Target Lactating Women Coverage 0 IFA Target Lactating Women % Coverage 0 IFA Target 6months -5years 2688020 IFA Coverage 472062 IFA % Coverage 17.56 No of Salt testing done 98558

Table-44: Antigen wise coverage:

S. No. Child Immunization DLHS -3 DLHS - 2

1 BCG 94.8 88.0

2 3rd dose of DPT 71.4 67.6

3 3rd dose of Polio 69.7 68.3

4. Measles 79.9 66.7

e) Health Check-ups: i)Existing mechanism for health check-ups of pregnant women (antenatal care) and children:

The health checkups are done during three important processes –

1. On village health and nutrition day by ANM /LHV. 2. During the referral fixed day of Chief Minister BAL Sandarbh Yojana at CHC level, but it is for only severely malnourish children.

84 Chhattisgarh APIP 2012-13 Department of Women and Child Development

3. During the health camps organized by WCD/under NRHM.

ANC is being conducted by ANM at AWCs on VHNDs. It has one practical problem as no AWCs have ANC table and screen; it directly affects the quality of the ANC checkups. State is seriously looking in to it

Table-45: Health Checkup:

Health Checkup by Mo/LHV/ANM in last two years

Year Birth to 3 3 to 6 First ANC Second Third ANC Lactating Adolescent years years of ANC Mothers Girls children children

2010-11 228310 214806 29288 24177 16286 68911 26479

*2011-12 153467 136451 29943 23260 14679 55535 16001

Source: ICDS MPR *(Till October 2011 and excluding Koria and Bastar) ii) Supply and composition of medicine kits during the last FY: No medicine kits were supplied to the AWCs in the last financial year 2011-12, because of the tender failure. iii) Status of coverage of at least three ANC check-ups of the pregnant women: DLHS 3 data shows that the status of ante natal care has improved in comparison to DLHS 2, but still IFA consumption, delay in first checkup, BP checkup are some key issues which state need to pay attention

Table: 46 Status of ANC coverage: Indicator DLHS-3 (2007-08) DLHS-2 (2002-04) (in percentage) Total Rural Urban Total Rural Urban Mothers who received any antenatal check- 79.6 77.7 92.1 78.1 75.0 90.5 up Mothers who had antenatal check-up in first 38.6 33.9 68.2 37.2 33.1 53.5 trimester Mothers who had three or more ANC 51.2 47.3 75.9 44.4 37.7 71.4

Mothers who had at least one tetanus 78.0 76.0 90.8 74.1 70.5 88.3 toxoid injection Mothers whose Blood Pressure taken 39.1 34.3 68.9 29.4 22.2 58.0

Mothers who consumed 100 IFA Tablets 20.8 19.9 26.8 15.9 14.9 19.8

Mothers who had full antenatal check-up 13.0 11.3 24.0 10.8 9.3 16.7

85 Chhattisgarh APIP 2012-13 Department of Women and Child Development

iv) Supply of IFA tablets to pregnant women through RCH-II:

At village level, IFA distribution is an effective way of convergence, although its compliance at home level is concern. In all the AWCs, AWW get IFA Tablets under RCH II allocation. In the year 2011-12 44.205 lakhs IFA tablets were supplied to the beneficiaries under RCH II.

v) State strategy to improve health check-ups:

In state the ANC checkup is a critical issue (refer above DLHS data). The ANC takes place in AWCs. But in almost all the AWCs two essential support aid ANC table and screen is not available. Under NRHM also there has been no provision of ANC table and screen for AWCs since last 5 yrs and for 2011-12, except for the last year in one district Dhamtari where from NRHM district flexi pool the arrangement ANC table and screen was made. It directly affects the clinical examination does not need table it can be done when patient is sitting. Hence state focus on:

 Ensuring ANC tables in all AWC in convergence with NRHM.  Improving the quality of the HND (VHND) for health checkups.  Emphasizing ANC checkups in Shishu Sanrakshan Mah rounds.  Motivating VHSC and Gram Panchayats to provide the ANC tables/screens in AWCs.

vi) Linkage with AYUSH:

AYUSH department conducted the training of all AWWs on AYUSH for three days, in which they had given information on AYUSH dispensaries and its services, especially for pregnant, lactating and children. Due to this the health check up at dispensary are improving for the AWCs beneficiaries.

Health Check up:

Table-47 Status of medicine kits:

No. of AWCs No. of AWCs received Target for the F/Y Estimated budget Means of operational (As Medicine Kit during (# AWCs and Mini for Medicine Kits verification on 31 March previous year (As on 31 AWCs) (@ Rs. 600/- per kit (MPR) 2012) March 2012) per AWC)

42497(AWCs) 0 43736 (AWCs) 285 Lakhs MPR

5767(Mini AWC) 6548 (Mini AWCs)

86 Chhattisgarh APIP 2012-13 Department of Women and Child Development

f) Referral Services: i)Existing mechanism for referral services (with health) :

There are six mechanisms for referral of AWC beneficiaries to health:

1. Referral after the health checkups on VHND and other days of Health Shivirs etc.

2. A special referral drive under the state sponsored Chief Minister Bal Sandarbh Yojana, in which specially identified severely malnourished children by AWW at AWCs are referred to CHCs on fixed two days in a month for each block, where the special hired doctor perform health checkup of the referred children and give medicines advice. In 2011-12 more than 28000 severely malnourished children received benefit under the scheme.

3. Three days training of AWWs are in process (8 districts completed) on home based newborn care and the management of 0-2 month's infant illnesses in technical support of health department. The referral for 0-2 months has been started in trained blocks.

4. Under NRHM 18 district hospitals the Nutrition Rehabilitation Centers have been started in year 2010-11. In 2011-12 another 20 NRCs started at CHCs. AWWs are referring severely malnourished children to these NRCs

5. Under NRHM the “108 Ambulance Scheme” has been started in two larger districts – Raipur and Bastar. It resulted in effective and timely referral of pregnant women. With the AWWs' active support good no. of pregnant women have been referred till now.

6. Health department is running two state specific schemes for the children. First - Chief Minister BAL Hriday Yojana (children are referred for heart operations) and second one - Chief Minister Shravan Yantra Yojana (children are referred for hearing equipment). AWWs are providing great referral support for children

ii) NRCs in Chhattisgarh: (Management of SAM Children)

The screening of children for admissions at NRC’s are conducted at VHND. During the sessions the AWW does the weighing of the children & plots it in the growth monitoring register. Based on the findings of the plotting of weight of child, she does the counseling of mother. Moreover if the children develop complications & have low weight are also referred to NRC’s. The state provides EMRI facility for to & fro transportation of Sam children.

The (NRC) initiative is a program for severely malnourished children of the age 1 to 5 years. The Centre not only provides regular health check-ups, medicine and required nutritious food to the children, it also counsels the parents regarding proper dietary feeding habits. So far state has established 40 Nutrition rehabilitation centers. Their are 6 additional centres at Narayanpur Orcha block which are run with UNICEF support under A Hope project & are run by Ram Krishna Mission. The NRC’s are functioning as per the national NRC guidelines & have shown

87 Chhattisgarh APIP 2012-13 Department of Women and Child Development considerable improvement in reduction of malnutrition in the area. The table shows the district wise existing NRC’s (excluding the 6 run by A Hope project):

Table-48: NRC Status:

District No of existing NRC's

Bastar 3

Bijapur 1

Bilaspur 3

Dantewada 1

Dhamtari 2

Rajnandgaon 2

Janjgir 2

Jashpur 2

Kanker 3

Kawardha 2

Korba 3

Koriya 2

Mahasamund 2

Narayanpur 1

Raigarh 2

Raipur 4

Durg 2

Surguja 3

Total 40

Source: NRHM Chhattisgarh APIP 2012-13

88 Chhattisgarh APIP 2012-13 Department of Women and Child Development

iii) Constrains in effective referral services:

 The CMBSS referral services are confined to only severely malnourished children, for rest of the beneficiaries the referral service needs to be strengthened. The anemic AGs, underweight pregnant women need to be included in CMBSS.  CMBSS is organized for one fixed day and at block level and single day is insufficient for whole project. Also it is difficult for remote areas beneficiaries to reach block level.  A referral mechanism i.e. a loop from AWC to health centre and then health centre to AWC is missing.

iv) Strategy to improve referral services during the FY:

State is planning following activities for the improvement of the referral services

 Increasing the geographical range and fixed days of Mukhya Mantari BAL Sandarbh Yojana.  Improving the linkage for NRCs and provision of incentives for AWW for referring children to NRCs. Similarly improving the linkage for AWCs children for Chief Minister BAL Hriday Yojana (children are referred for heart operations) and - Chief Minister Shravan Yantra Yojana (children are referred for hearing equipment).  Improving the quality of VHND or HND  Better IEC for MMBSY and NRCs.

Severely underweight children would be referred by AWW to the ANM and ANM will examine the children and if required will further refer the children to NRC

After discharge from NRC, follow up would be made by the AWW on

fortnightly basis

g) Observance of Nutrition and Health Days :

i) Mechanism for observance of monthly nutrition and health days (VHND/NHDs): MOHFW guidelines describes the importance of conducting monthly Village Health Nutrition Days, defines the required relevant procedures and logistics; the role of each cadre of health worker including supervisors; and the various activities that should be conducted on the day. Under NRHM the Village Health and Nutrition Day is planned to provide comprehensive Maternal and Child health and nutrition services, and ensure early registration, identification and referral of high risk children and pregnant women. The department of WCD actively participates in the Nutrition and Health Days organized by the department of HFW. NHDs are held once a month in the villages covered under sub health centre area by rotation. Women and children, particularly pregnant and lactating women, in the village where NHD are organized are mobilized for attending the meeting. Village Health and Sanitation Committee

89 Chhattisgarh APIP 2012-13 Department of Women and Child Development members, members of Matri Sahayogini Samilt, Mahila Mandals, SHG, and other community based organizations are also contacted to extend support for NHDs.

ii) Summary of activities that are taken up during the NHDs:

NHD activities are jointly carried out by health staff (ANM/LHV), AWWs and ASHA. AWWs play important role in community mobilization besides helping in organizing the activities. NHD camps are generally held at sub health centre or AWCs. Pregnant women are registered for antenatal care, if already not registered. Health check up of women is done. Two doses of tetanus toxoid vaccine are administered and IFA tablets (total 100 tablets) are given. Children who attend NHD are given health check up. Primary immunization (BCG, 3 doses of DPT and Polio each, and Measles) is administered to children. Vitamin A supplement is also given. Mother and Child card is used to record the services provided to the beneficiaries. IEC activities on nutrition of pregnant/ lactating women and children, importance of immunization, family welfare methods, and personal hygiene form important aspect of NHD activities.

iii) IYCF counseling is very important during VHNDs. With special focus to:

 Early initiation of breastfeeding

 Exclusive breastfeeding

 Timely complementary foods

 Food diversity and feeding frequency

iv) The activities that are taken up during the NHDs:

 Immunization.  Health checkups- esp. ANC  SNP distribution.  Weighing of children and pregnant women and counseling of mothers.  Filling of Mother Child health card.  Nutrition Health education session.  Demonstration of growth chart.

90 Chhattisgarh APIP 2012-13 Department of Women and Child Development

v) Support received from community/ PRIs for observance of NHD:

Support is sought from community/ PRIs for observance of Nutrition and Health days. The support is extended by way of participation in the event, community mobilization, publicity, use of PRI resources including Panchayat Bhavan) to organize the events.

In following activity AWCs get support from community esp. WSHGs and PRI

 Weighing of the children.  Motivation the beneficiaries for SNP, immunization, ANC checkups etc  SNP distribution.  Providing weighing machine/mat etc

vi) Specific intervention for tribal/rural/urban AWCs in conjunction with line departments:

Tribal development department supported ICDS in the following ways:  Financial support for providing bicycles to the AWWs  Financial support for providing weighing scales to the AWCs  Provided financial support for providing uniform for the children of AWCs  Great contribution for AWWs & AWHs honorarium and funds for building AWCs  Financial support for providing water filters to the AWCs  Financial contribution for developing model AWCs

SSA and Education department provided Udaan kits, books and Training on the same to the AWWs and ICDS supervisors

91 Chhattisgarh APIP 2012-13 Department of Women and Child Development

SABLA

A comprehensive scheme, called Rajiv Gandhi Scheme for Empowerment of Adolescent Girls or SABLA, merging the erstwhile KSY and NPAG schemes has been formulated to address the multidimensional problems of and for holistic development of adolescent girls. i)OBJECTIVES OF THE SCHEME:

The objectives of the scheme are to:  enable self‐development and empowerment of Adolescent girls;  Improve their nutrition and health status;  Spread awareness among them about health, hygiene, nutrition, Adolescent  Reproductive and Sexual Health (ARSH), and family and child care;  Upgrade their home‐based skills, life skills and vocational skills;  mainstream out‐of‐school Adolescent girls into formal/non formal‐education; and  Inform and guide them about existing public services, such as PHC, CHC, Post Office, Bank, Police Station, etc.

ii)Target Group: In Chhattisgarh SABLA scheme was launched with the following five districts:

 Sarguja  Jagdalpur  Rajnandgaon  Raipur  Raigarh

But in the year 2012, these five districts were divided into ten; therefore this scheme is now running in ten districts of Chhattisgarh. The name of additional five districts is given below:

 Balrampur  Surajpur  Kondagaon  Balodabazaar  Gariyaband

For giving proper attention to the adolescent girls, the target group is divided into two subgroups:

A. 11 to 14 years old adolescent girls B. 15 to 18 years old adolescent girls

92 Chhattisgarh APIP 2012-13 Department of Women and Child Development

iii) Activities carried out for these groups are as follows:  Provision of supplementary nutrition for 11 to 18 years old out-of-school adolescent girls  Provision of supplementary nutrition for all the 14 to 18 years old school going adolescent girls  Nutrition and Health education for all the 11 to 18 years old adolescent girls  To provide guidance about family welfare, reproductive and sexual health, child care practices  Inform and guide them about Home management, legal rights, life and vocational skills, use of existing public services, such as PHC, CHC, Post Office, Bank, Police Station, etc  IFA tablet distribution to all the out-of –school adolescent girls  Vocation training for 16 to 18 years old adolescent girls out of school girls

iv) MODALITIES OF THE SCHEME:  Formation of Kishori Samooh

 Training Kit: A training kit will be provided at every Anganwadi Centre to assist Adolescent girls to understand various health, nutrition, social and legal issues by conducting activities in an interesting and interactive manner. The training kit will have a number of games and activities so that the girls enjoy while learning. The Sakhi and Saheli will be trained to use these kits for imparting peer education. The contents of the kit are following:

S.No Proposed kit materials

1. 16’’ by 12’’ flap mat bag 2. SABLA Module 3. 3 Filp books 4. 9 posters of messages related to the subject 5. Stationary (Pen, Dairy, Pencil, Rubber, Sharpener) 6. Needle thread, Embroidery kit 7. 4 Caps for Sakhi, Saheli, and AWW 8. 2 Skipping rope 9. 2 Flying disc 10. 1 Ring 11. Story book

 Kishori Diwas: will be a special health day, celebrated once in three months. On this day, the AWWs with the help of health functionaries, including Medical Officer, Auxiliary Nurse Midwife (ANM)

 Health Card: A card for each AG will be maintained at the AWC. This will contain information regarding the weight, height, Body Mass Index (BMI), Iron Folic Acid (IFA) supplementation, referrals and services received under Sabla.

 Counselling/Guidance on family welfare, ARSH, child care practices and home management

93 Chhattisgarh APIP 2012-13 Department of Women and Child Development

 Life Skill Education and accessing public services  Includes efforts to mainstream into Formal / non formal education  Vocational training (for girls aged 16 and above) using existing infrastructure of other Ministries /Departments  To maintain the connection between the AWC and the adolescent girl.  IFA supplementation  Nutrition Provision

v) Services under the Scheme: There are two major components under the Scheme; Nutrition Component and Non Nutrition Component as under: i) Nutrition Component: 11‐14 years Adolescent girls: Out of school girls 14 ‐18 years Adolescent girls: All girls ii) Non Nutrition Component For Out of school Adolescent girls: a) 11‐18 years:  Nutrition provision,  IFA supplementation,  Health check‐up and Referral services,  Nutrition & Health Education (NHE),  Counselling/Guidance on family welfare, ARSH, child care practices,  Life Skill Education and accessing public services

b) 16‐18Years:  ‐ Vocational training under National Skill Development Program (NSDP) For school going Adolescent girls of 11‐18 years, the services at ii) a) will be provided twice a month in school days and four times a month in vacations.

i) Information Education and Communication:

To bring about change in the health behavior, including service seeking behavior of community towards ICDS, the IEC division of the Department of WCD has developed appropriate strategies. Programs of the department focus on promotion of health and nutrition of mothers and children. Special emphasis is given on promotion of breast feeding, immunization, growth monitoring, and pre-school education Both traditional and modern communication methods are used for IEC activities. The following are the important IEC activities of the department:

94 Chhattisgarh APIP 2012-13 Department of Women and Child Development

a) Activities carried out under IEC component during last year:

As per the State Nutrition Policy, state has strategically focused through IEC and community mobilization on (1) creating awareness among mass and improving the ICDS image at all levels (2) to affect and sustain behavioral and attitudinal changes in child caring, nutrition and health behavior (3) facilitating the process of development of IEC material development within the ICDS and in convergence/ synergy with others.(4) Stimulating the demand of ICDS services and ensure community participation.

In state under IEC and community mobilizations following different activities were organized during last year:

1. State specific cultural based activities were the focus. Across state different days, weeks were organized in each AWC. In support of community at all operational AWCs God Bharai, BAL Bhoj and Annprashan were organized every month. These activities are key to decipher required nutrition and health information / messages to the community. The VHND was used for dissemination of the information on key subject/issues to community.

2. A drive was initiated on 6th June 2009 “Kuposhan Mukti Abhiyan” to create awareness among community against malnutrition among children. This campaign was initiated by a state wide Torch Rally in which 35 lacs people participated and taken oath at Gram Panchayat office to fight against malnutrition and they had taken responsibility of taking care of all malnourished children by ensuring all ICDS services , regular weighing and counseling to them at AWCs. Community has taken responsibility of 13620 malnourished children till March 2011, out of which 9950 children recovered from the severely malnourished grade to moderate and normal grade. On 6th June 2010, in continuation with state drive against Kuposhan, a block level 'Suposhan Mela' was organised in 163 blocks in convergence with Chief Minister BAL Sandarbh yojana. Nawa Jatan Scheme also started in January 2012, it’s a community based approach for the management of severe malnourished children.

4. The Breast feeding week and Nutrition week was celebrated in each AWC, different activities planned and organized with an expenditure of 16.30 lacks for both the weeks' celebrations.

5. “Aangana Ke Gonth” a magazine for AWW was published in June- Sept-Dec and March 2012 for all the AWCs and Mini AWCs. It includes the technical features, important information on different yojana and Chhattisgarh specific information along with key instructions. 6. As per the GOI mandate, state has ensured the display boards and name board in 50 AWCs with an expenditure of 80 lacs.

7. across state 50 hoardings at different block have been displayed to create awareness among people about ICDS services. This process will be continued for coming years.

8. During Rajyotsav, 26th Jan and 15th Aug, Jhanki and exhibition has executed at state and district levels to spread ICDS related information across the state.

9. For strengthening the Kuposhan Mukti Abhiyan campaign across state the honorable WCD minister Ms. Lata Usendi made a history by doing herself a Walk March of 40 Km from 2 to 4 Feb 2011, between

95 Chhattisgarh APIP 2012-13 Department of Women and Child Development the two tribal blocks Makadi and Kondagaon of Baster district. It was first ever Walk March in country by any Minister on Malnutrition. The objective of this March was to spread awareness in the community on Malnutrition. The health Camps, Departmental exhibitions etc were also organised. It was very successful. 10. In one of the LWE district Dantewada 1.8 lacs has been spend on hoardings and communication material for the spread of the ICDS services.

b) IEC materials that have been developed:

Last year following materials were developed as IEC material for AWCs-

1. Angana Ke Gonth- A magazine has been introduced for AWWs. It includes the technical features, important information on different yojana and Chhattisgarh specific information along with key instructions. Till now three editions have been published.

2. Nawa Jatan book has been published for Supervisors, AWWs, AWHs, Suposhan mitra, Gram Panchayats, Selp help groups and NGOs. This is a referral book for community based management of malnourished children. In this book all the details of the Nawa Jatan scheme are present and also about the roles and responsibilities of all the stakeholders.

c) Campaigns organized on nutrition and pre-school education:

State level campaign against malnutrition is on since last 4 years.

A state level campaign for admission of preschool children 'Vidyarambh' was organised.

d) Activities that are planned during the current year:

 The publication of AWWs magazine Aangana Ke Gonth will be continued.  The state level activities like organization of Rajyotsav, campaigns, state level workshops etc will be organized in the current year.  The electronic (TV and Radio) media will be used for mass communication.  The provision has been made for print media like news paper messages and advertisements will be used for the promotion and mass communication for the activities like Nutrition week, Breast feeding week celebration, ICDS days, Bal Diwas celebration, and other activities that would be planned in the current year  To organize various workshops/programs to celebrate Breastfeeding week, Nutrition week, ICDS days, Bal Diwas, etc for demand generation of these child development services among community  Activities at Aganwadi center level: “Vajan Tyohaar” will be celebrated on 6th of June 2012 in each Aganwadi center of the state, for knowing the current situation of the malnutirion after the

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implementation of new WHO Growth Charts in the state. For this activity a village level group would be formed in each village to facilitate this activity. On that particular day aganwadi worker would weigh, plot (in the new WHO growth chart) and assess the nutritional status of children (0-6 years) in the community with community participation, and to counsel the family of the severely malnourished children. And provision has been made to distribute certificates and prize to the well nourished children.  The provision has been made for the activities like exhibition, workshops etc at district level for the advertisement and creating awareness of ICDS services  The provision of flex for own hoardings has been made for the financial year 2012-13  Advertisement of the ICDS messages through hoardings in the state by “Chhattisgarh Samvaad”  Printing of Broachers, Posters, and other IEC materials  Preparation and Distribution of film CDs  To provide time table to all the Aganwadi centers  Progress cards to children  Nawachaar and other emergent activities

Table-49: Proposed IEC Activities:

Activity (2012-13) Reallocated

fund (in Lacs)

Printing of Angana Ke Gonth 40 lakhs

State level activities like organization of Rajyotsav, campaigns, state level 20 lakhs workshops Advertisement through media, hoardings, etc 74 lakhs

Organization of various workshops/programs, Vajan tyohaar, District level 121 lakhs activities etc

Printing of Broachers, Posters, and other IEC materials, Time Table, Progress 172 lakhs cards for PSE, Nawachaar etc

Preparation and Distribution of film CDs 10 lakhs

Total 437 lakhs

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Table-50: Expenditure during last year on IEC: No.of No. of AWCs No. of AWCs Allocation and Estimated Means of operational supplied IEC carried out expenditure budgetary verification AWCs material any IEC during last year requirement for (UCs) (2011-12 during last campaign the financial F/Y) year during last year year 42709 (AWC) 48688 48688 399.39 lakh 437.00 lakh UC of 1st, 2nd, 5979(mini) 3rd and 4th quarter

j) Monitoring and evaluation:

a) Existing monitoring and supervision mechanism at different level:

Monitoring and Evaluation is a system which comprises of a framework from top to bottom for:  Systematic collection and analysis of the information with the progress of the project  To improve the efficiency and effectiveness of every individual and all key processes and thus of the project  To assess the progress of the project on the monthly basis and to take necessary corrective action

An information system will be established as a base for evaluation with the following components –

 Defining specific indicators for different activities and process  Strengthening the existing information collection system  Regular, timely analysis of the collected information  Establishing the regular feedback system on at state, district and block level

In state following are the key monitoring and evaluation processes:

Table-51: M&E Processes in the State: Level Key Process

State State level monitoring

State level DPO’s /DWCDO’s meeting

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Level Key Process

Response to all assembly questions

MPR analysis and feedback by the state M&E in charge. Due to lack of M & E team members it is a weak Publishing of quarterly NEWS letter Angana Ke Gonth.

Performance grading of district/block/sector/AWCs by using the Nutrition surveillance System. Directorate has formed a team for different districts for exercising the field visit to district, block, sector, AWC. Yearly reward for best performing AWWs at state level.

District District level CDPO’s /Supervisors meeting.

Quarterly review of ICDS in Zila Panchayats General assembly meeting.

The response to all assembly questions

MPR analysis and feedback by district M&E cell.

Field visit to block, sector, AWC, Village by DPOs/ DWCDOs. This is weak.

Joint field visit by DPO/CMHO. This is weak.

Joint review of Health and ICDS by collector. This is weak.

Review of CDPO and supervisor’s diary and providing the feedback to them. This is weak. Performance grading of block’s, sectors, AWC’s through NSS.

Block Block level monitoring and advisory committee meeting.

Monthly review of ICDS in Block Panchayats General Assembly meeting.

Block level supervisors /AWWs meetings.

Joint field visit by CDPO/BMO. This is weak.

MPR analysis and feedback follow-up. This is weak.

Field visit to sector, AWC’s, villages by CDPO/supervisors.

Review of supervisor’s diary. This is weak

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Level Key Process

Performance grading of sector /AWC’s through NSS.

Sector Sector review meeting.

Field visit to AWC’s/Village.

Sector report analysis and feedback. This is weak. Joint visit by LHV/Supervisors/ANM to AWC’s/village. This is weak.

Performance grading of AWCs and planning. This is weak

Community growth chart and ECE performance card of children at gram Sabhas/NHD etc Yearly reward and recognition

Gram Use of individual new WHO growth monitoring chart for all children. Panchayat and village/ Use of new MPR based on NSS. Community level Gram Sabha during Gram Suraj Abhiyan one in a year. monitoring Use of community growth in gram sabha , VHND, Bal bhoj etc

Community level meetings:  NHD and Balbhoj  God Bharai  Mahatari committee meetings  VLRM and quarterly survey  VHSC monitoring

b) Constraints in monitoring and supervision: State has experienced following constraints in monitoring and supervision.

Human resource issues

 With the years of ICDS implementation the field level activities and responsibilities are increasing day by day, but the human resource is not developed in quantity and quality with the same pace.  For field level functionaries the implementation related work is continuously increasing and the monitoring /evaluation is also expected from them. This affects the quality of work as well as quality of monitoring/evaluation processes. Hence state needs additional human resource and the capacity building of current field functionaries on monitoring and evaluation

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Technical issues  The analytical skills of AWW/Supervisors/CDPO are low.  Existing implementation staff has the responsibility of monitoring and evaluation too. No monitoring and evaluation cell is working at state and other level. Due to which existing system is not able to provide relevant, essential and timely feed back to districts and blocks. Similarly districts and blocks also lack in capacity either as a system or a process. The field level functionaries lack the capacity to link information to outcome/impact.  Data collection process is weak, no triangulation exists.  Field level monitoring by supervisor is weak. It's a “fault finding” exercise instead of supportive supervision.  The monitoring of Outcome /Impact indicator is less, lots of data is available but only activities based on budget are monitored.  No reward and recognition system is in place. (Which as per the GOI guideline will be established)  Community level monitoring (for community and by community) system is weak.  The study / research/ operational research processes are completely missed out in state to evaluate the impact of different activities and programs due to lack of resources.

Operational issues

 Functionaries' focus is on “data collection and reporting”. No additional monitoring and evaluation cell exist at state/ district /block level. Each level passes on the reports to other higher level in expectation of getting feedback. The focus on “analysis of information, feedback and corrective action” is required to establish. AWWs analytical skills need to be improved  The field visits by block and district level officials are need improvement. It directly affects the quality of data collection at all levels  The ongoing meetings at sector, blocks and districts are focused on data collection and completely lack in the capacity building, differential planning and review activities for discussion.  State, District and blocks level different committees are functionally weak. It lacks the joint review action.  Joint review meeting with health, education and Panchayat are few.  The operational coordination exists at village level to some extent. But minimal at higher level leading to less joint planning and review meetings at district and state level.

State has studied the gaps in monitoring system with support of UNICEF to address some of the above described issues of monitoring and evaluation. Hence a Nutrition Surveillance System (NSS) has been established, which used for studying the current data. State uses DLHS/NFHS/SRS evaluation reports for the reference.

State will also appoint data entry operators for data entry at different levels. For that funds of 60 lakh required out of this 30 would be provided from M&E head and remaining 30 lakh from training budget.

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c) State's revised Management and Information System:

State undertook following two important activities to improve Management and Information System of ICDS 1) MPR- All important process, outcome and some impact indicator have been included as per GOI guidelines. 2) A soft ware based Nutrition Surveillance system was established in 2008 with technical & financial support of UNICEF. This system is used by ICDS in differential planning.

d) Nutrition Surveillance System:

Nutrition Surveillance System was initiated with a vision to ensure easy analysis of data, which in spite of being collected and compiled with huge efforts, was getting subjected to data mining from grass root level till the higher levels. MPRs (Monthly Progress Reports) were generated by compiling data collected by the AWWs at the sector, block and district levels. These MPRs were sent to the state headquarters and ministry headquarters at the Government of India level. Thus, valuable data which was collected with so much of efforts (involving lot of paper work and man-hours) was neither analyzed nor used to provide feedback for improving performance of the AWC.

Introduction of NSS made this valuable data useable at different levels by ensuring easy analysis and feedback to improve performance. The analysis through NSS is done in the following ways:

o Area wise analysis (project wise, sector wise and Aanganwadi centre wise), o Indicator wise analysis (nutrition indicators as total malnutrition disaggregated by age and health indicators as Maternal and Child Deaths) and o Time wise analysis through graphs generated at all levels (AWC, Sector, Project, District and State levels) and dual maps generated through GIS which give the time series analysis.

Across the state more than 75% of AWCs are currently reporting through the NSS software and MPRs are being generated accordingly.

e) State's strategy to improve the existing MIS:

State is planning to improve the monitoring and evaluation process at all level through following actions-

1. Across state MIS system will be strengthened by establishing M&E cell at the state and district level which will be equipped with required HR and physical support.  It will strengthen the feedback process, field visit & meetings (district, block and sector) especially. Regularly analyze the information and provide feedback to the districts and blocks.  It will provide technical support for weak block/sector at field level.  Regular compilation of all types of reports. It will provide special focus on weaker sectors/blocks and on girl child status and status of disadvantage sections across state.

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2. Studies by external agencies:  Study on IEC Impact assessment for behavior change communication: As we are spending good amount of money on IEC and does many campaigns and activities but we do not know the impact, and up to what extent IEC is playing a role in behavior changes. Therefore this study would be beneficial for assessing the effectiveness of IEC and the results of this study would be referred in planning of any IEC activities for future.  Assessment of Dietary pattern of children under 6 years of age: For knowing the current dietary practices and patterns by 24 hour recall method and by food frequency method. This study would be very useful for knowing the gaps in the diet. Exploration of eating habits may be helpful to understand the process of achieving dietary change

3. A quarterly survey (linked to VLRM) at all AWC's and Mitanin's will be restructured and strengthened to capture all category of beneficiaries, especially the disadvantaged section (which is already included in new MPR). By this the state will be able to increase the community involvement in service delivery system, so that community can emerge as active subject rather than passive object for ICDS.

4. State will re-enforce its objective, mandatory field visit at the district, block, sectors and village level for to AWCs, sector meetings and block meetings by directorate staff, SPMU staff, DPOs, DWCDOs, CDPOS, Supervisors with 10% targeted joint visit with health/ Panchayat. This will improve quality of all monitoring activities and performance at all level.

5. State level existing monthly magazine for AWWs i.e. 'Angana Ke Gonth' will be improved by adding more learning, reading material, success stories for motivation of CDPO, supervisors and AWW.

6. Performance rating system for AWC and sector has been integrated in new designed MPR format and Nutrition Surveillance System. It will facilitate the AWC's grading, sector grading, and block grading particularly on nutrition, ECE and overall services.

7. Supervisors visit to AWC will be with the objective of supportive supervision. Plan will be ensured across state by developing supervisor's capacity on supportive supervision concept. Similarly for AWW home visit planner and a set of toolkit for supervisors will be used across state.

8. Supervisor sector meeting is very critical for monitoring and feedback. A film on “How to conduct effective meeting” is ready with support of UNICEF. It will be used for training of supervisors and CDPOs to improve quality of the sector meeting.

9. A departmental website will be launched (under construction) which will make departmental activities more transparent and easily available for all.

10. Video Conferencing: Video conferencing has become part of communication advancement and technology in reaching out to others via the modern means and application. Video conferencing is an interactive method of interaction which allows two or more people at the same time at a different place to communicate with video and audio transmissions at the same time with the help of web conferencing. In ICDS we planned videoconferencing with all the district officials twice a week. To review the progress of the program and for effective implementation of the ICDS services

103 Chhattisgarh APIP 2012-13 Department of Women and Child Development

f) Community monitoring mechanism:

The community level monitoring will be ensured in three ways:

1. The existing Mahatari committee will be strengthened through capacity building and continuous feedback.

2. Demonstration of community growth charts and demonstration of preschool education performance card of 3-6 year children will be mandatory in all gram Sabhas, Mahatari committee meetings in VHND, Balbhoj with open discussion by AWW/ANM/ASHA. 3. Under NHRM a village health sanitation committee has been formed across the state in 20639 villages, in which president of parent committee and SHG's are members, while AWW is a special invitee member and Mitanin (ASHA) is a convener, so in close coordination of NRHM state mission these VHSCs will be strengthened for monitoring of the nutritional services and preschool education in village.

4. The WSHGs are strong in state; they will be involved in monitoring the AWW services and to support AWCs to improve their quality.

5. All the PRI (Zila, block and Gram Panchayat) members will be informed about the ICDS and their monitoring responsibilities by using a simply designed booklet on ICDS. 6. A Edu-sat program (in support of SCERT and Education) will be organized for PRI members and WSHGs members for 146 blocks (in two rounds of 50 blocks at once) on following points  Timely opening of AWCs.  PSE – key activities, how to contribute and monitor.  VHND- role and how to contribute.

g) Structured Feedback Mechanism:

The existing NSS system will be improved and utilized for providing structured feedback at block and sector level by establishing the M&E cell at state a systematic monthly feedback mechanism will be ensured for each sector, block and districts

h) Key M&E activities as per the GOI guideline:

Table-52 Key M&E Activities Proposal:

S.no Activity Amount Unit Unit cost Actual allotted (rupees) Requirement 1 For revising MIS and printing of 160 lakhs 50311 1000 503.11000 registers etc lakhs 2 Repairing of weighing scales, data 30 lakhs - - - entry, Software updating, and research studies etc 3 Stationary, format printing etc. 25 lakhs - - -

Total 215 lakhs

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Table-53: Monitoring and Evaluation

No. of No of AWCs No. of No. of Allocation & Estimated Means of operational having projects review Expenditure budgetary verification AWCs (as on revised using IT for meetings during last requirement March 2012) records and MIS held at the year for FY (Rs. registers state level 500 per AWC during past year

42709(AWC) 42709(AWC) 163 08 Allocated 218.00 lakhs UC 1st, 2nd, 219.00 lakhs 3rd and 4th 5979(mini) 5979(mini) quarter Expenditure 205.00 lakhs

k) Training and capacity building:

Training status of functionaries who are in-position and assessment of training backlogs:

i) Regular Training Program:

In state 43,763 AWCs are sanctioned against which 42,169 AWWs are in position and out of which 36,869 are trained and 5,300 are untrained. Looking to the maximum capacity of operational training centers, training could be imparted to 3,500 AWWs and refresher training to 1,000 AWWs who have completed two years of the last training. List of training centers in state is enclosed with this action plan.

Training of AWHs is done through MTT (Mobile Training Team or District Training Team). The trainers of MTT have been trained by NIPCCD. MTT organize training at district/block level with the help of Supervisors of that concern project. In sanctioned 43,763 AWCs, 41,268 AWHs are in position out of which 35,768 are trained and 5,500 are untrained. Taking the stock of capacity of MTT, orientation training could be imparted to maximum 6,000 helpers and refresher training to 8,000 helpers.

Under universalization of ICDS, in third phase of expansion we have sought approval of 8826 AWWs and 4229 mini AWWs. Recruitment and training of chunk of them is complete in the year 2011- 12. Thus in year 2012-13, we anticipate that 2663 AWWs/Mini AWWs would be eligible for induction

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training as per NIPCCD norms. All initiations would be taken to impart 08 days orientation training to all the 2663 new recruits. This will help in early operationalization of AWCs/Mini AWCs.

1617 post of Supervisors are sanctioned against which 1444 Supervisors are in position. Out of 1444 in position 1319 are trained and balances 125 are untrained. Taking the stock of capacity of SRC (presently functioning as MLTC), Job Training could be imparted to 125 Supervisors which is proposed in action plan. There are nearly 500 Supervisors to whom refresher training is required to be given. The same has been proposed in this action plan.

There is no backlog of untrained CDPOs/ ACDPOs in the state. Out of 85/44 CDPOs/ ACDPOs in position all are trained. Thus only refresher training has been proposed for in-position CDPOs/ ACDPOs who have completed 02 years of the last training. In consultation with NIPCCD, refresher training will be imparted to 20 CDPOs/ ACDPOs in the year 2012-13.

ii)Other Training Programme:

In this action plan other training to the tune of Rs. 6.48 lakhs is proposed.

Table-54: Other Training Program:

S. N. Name of Training Amount (Rs.)

1 Impact analysis of the Training 3,00,000.00

2 Training to CDPOs on Micro Planning-Nutrition and 1,02,000.00 Health 3 Training on Time / Stress / Fatigue management 2,46,000.00

Total 6,48,000.00

Quality of training is more important than the quantity. From last so many years training is being impacted by AWTCs and MTTs to workers and helpers. There is no system in place so as to analyze what quality of training is being imparted, to what extent trainees are grasping that is being delivered, what is gap, where is gap and what corrective action is required, what improvement is suggestible etc. A proper study/field work will help to understand grass root reality and take appropriate action to improve the quality of training in the state. The proposal to the tune of Rs.03.00 Lakhs has been submitted in this action plan.

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At the field level CDPO act as prime agency implementing various scheme and programs. To target more sensitive and social issue viz. Nutrition & Health, officers are often less aware of how to plan, how to coordinate, whom to coordinate, how to trace/pool the resources etc. A trained officer act with higher proficiency and skill, as compare to untrained officer. Thus for the training to CDPOs on Micro planning on Nutrition and Health Proposal to the tune of Rs. 1.02 Lakhs has been submitted in this action plan.

Optimum results are obtained when the available staff/officers know how to utilize the available time and resources and how to be stress free while on work. This would undoubtedly maximize the work potential. Thus for the stress / time / fatigue management training proposal to the tune of Rs. 2.46 Lakhs has been submitted in this action plan. iii) Capacity Building and ECE:

Understanding the requirement of capacity building, resource mobilization and equipping of the training centers, for organizing quality training program, proposal to the tune of Rs. 20.94 lakhs is given under Capacity Building. Likewise, under ECE/IEC proposal for providing of printing and training materials to training centers to the tune of Rs. 50.00 lakhs is given in the action plan. iv) Training Calendar:

There are 15 training centers conducting Job and Refresher Training for 27 districts in state. Job and Refresher backlog of each districts differs, thus, training calendar of each districts differs. In some districts emphasis require more on Job training and in some on Refresher training.

As matter of precedence, joint meeting is organized in month of April/May of DPO/Instructors/AWTC/CDPO. They jointly prepare training calendar taking into account stock of training backlog. Hence we have appended with this action plan summary of State training calendar and individual training calendar of each training center shall be send separately in month of May/June 2012. v)MLTC :

As said in pre-Para that at present job of MLTC is done by state run SRC (for which approval has been sought from GOI.) As the SRC has been envisaged apex training institute focusing on theme based training, hence we have submitted request for separate state run one MLTC vide our letter no. 2648 dated 22nd Oct 2010. Proposal is pending at GOI level.

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vi) Training need assessment of ICDS Functionaries (Physical) Table-55: Training Need Assessment:

Job Training Refresher Training

S. N. Type of Functionaries Sanctioned In No.of No.of persons who No.of persons Target for No.of persons in- Target for position persons are in-position but who are STRAP 2012- position but not STRAP 2012-13 trained as untrained as on anticipated to 13 received any on March March 2012 join after March Refresher 2012 2012 Training during last 2 yrs

1 CDPO/ACDPO 220/103 85/45 85/45 NIL NIL NIL 20 20

3 Supervisor (Job) 1617 1444 1314 125 NIL 125 500 500

4 AWW 43763 42169 36869 5300 1594 3500 12000 1000

5 AWH 43763 41268 35768 5500 2495 6000 12000 8000

6 Instructors of AWTCs NA NA 25 8 4 12 15 15

7 Instructors of MLTCs NA NA 1 2 NIL 2 2 2

8 Ind. AWW/Mini AWW 6548 5685 3885 1800 863 2663

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VII) AVAILABLE TRAINING RESOURCES IN THE STATE (AWTCS/MLTCS/SRCS) TABLE-56: LIST OF OPERATIONAL TRAINING CENTERS IN CHHATTISGARH Name & Address Name of NGOs/ S. No. Districts of Training Centers Deptt. running the AWTCs

Raipur State Resourse Center (SRC/MLTC) 1. H.No 108 Anand Nagar, Raipur WCD Chhattisgarh Phone: - 0771-2427903

Regional Training Center Near old RTO office, Mungeli Naka, Bilaspur 2. Bilaspur Pin-495001 WCD Chhattisgarh (RTC/AWTC) Phone - 07752-223527

Regional Training Center Dimrapal, Jagdalpur Bastar 3. WCD Chhattisgarh (RTC/AWTC) Bastar

AWTC Mana Camp C/o Mrs. Geeta Mundeja

Raipur Near Police Station, Pin-492015 4. C.G. Bal kalyan Parishad (AWTC) Phone - 0771-2418119

Mo. 98937-65263

AWTC Durg Mrs. Aloka Mitra, 11/256 Karmachari Nagar, Sikolabhata, Durg Pin-491001 Durg 5. C.G. Bal kalyan Parishad (AWTC) Phone - 0788-5010184

Mo. 98274-60583

AWTC Pendra Mrs. Satpathi, Near Gorella Thana, Pendra Pin-495119 Bilaspur 6. C.G. Bal kalyan Parishad (AWTC) Phone - 07751-250629

Mo. 94241-59899

AWTC Dharmjaigarh Patrapara, Dharmjaigarh Raigarh 7. C.G. Bal kalyan Parishad (AWTC) Pin-496116 Mo. 94062-37309 AWTC Jagdalpur Bastar 8. C/o G.S.Pandagre, Near Nirmal School, C.G. Bal kalyan Parishad (AWTC) Jagdalpur Pin-494001

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Name & Address Name of NGOs/ S. No. Districts of Training Centers Deptt. running the AWTCs

Mo. 94242-82789

AWTC Rajnandgaon Near Maharashtra Mandal, Baldev Bag, Rajnandgaon Rajnandgaon Nehru Yuvak Kalyan Parishad 9. Phone - 07744-244826 / 507562 (AWTC) Mo. 93013-72021

AWTC, Mahasamund Mahasamund Mrs. Pramila Shukla, Station Road, 10. Vanita Mahila Samaj, (AWTC) Mahasamund Pin-493445 Mo. 99261-60333 Lohara Road, Brahman Samaj ke samne, Kawardha Punana ITI ke samne, Kabirdham. Himachal Institute of Rural 11. (AWTC) Development Mo. 94073 98380

Korba C/o. N.G.O., Korba, Po. Jaytipali. (AWTC) Social Revival Group of urban, 12 Mo. 98266-80190 rural and tribal

Opposite Ashirwad Kirana Dukan, Near Korea Mishra Complex, Schoolpara, (AWTC) Manav Sansadhan Sanskriti Vikas 13 Baikunthpur, Korea. Parishad

Mo. 98261-42836

Jurgum Bhandar, Sanna Road, Jashpur Jashpurnagar, Po. Jashpur 14 (AWTC) C.G. Bal kalyan Parishad Mo. 93298 98427

Saraswati Kunj, Darripara,

Sarguja Ambikapur-497001 Manav Sansadhan Sanskriti Vikas 15 (AWTC) Parishad Phone no. 07774-222590

Mamta Nagar, Dantewada Panchsheel Colony, 16 (AWTC) Srijan Samajik Sanstha Rajnandgaon

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viii) Location of Training Centers in the State

LEGENDS NGO AWTC

Govt. run RTC

Govt. run SRC

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ix) Detailed Training Calendar:

Table-57: Training Road Map

Functionary Line of action proposed to be adopted Anganwadi Worker Job/Refresher There are 13 NGO run AWTCs and 02 state run RTCs through which job and refresher training of AWWs are being organized. In year 2011-12, only 10 NGO run AWTC could function, owing to non completion of necessary formality as per State Grant Rules. In year 2012-13 we expect all 13 NGO run AWTC to function. Supervisor Job/Induction In state there are no NGO run MLTC but training of supervisors are being conducted at state run SRC (State Resource Center-apex training institute Refresher of department).

CDPOs/ACDPOs Job According to the plan / schedule of the NIPCCD. Refresher

Helpers Orientation MTT will conduct orientation & refresher training for AWH. Supervisors of concern projects will also be involved in this training. Trainers of MTT Refresher were trained by NIPCCD.

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Summary of State Training Calendar

Table- 58: Summary of State Training Calendar:

Name of the Number of functionaries proposed to be deputed for training functionary April to June 2012 Oct. to Dec 2012 Jan. to March 2013 Grand Total July to Sept. 2012 CDPO/ Job ------ACDPO Ref 0 -- 1/10 1/10 2/20 Induction 0 0 0 0 0 Supervisor Ref 0 7/175 6/150 7/175 20/500 Job 3/75 1/25 1/25 0 5/125 Job 20/700 25/875 25/875 30/1050 100/3500 AWW Ref 5/200 5/200 5/200 10/400 25/1000 Induction 30/600 30/600 40/800 33/663 133/2663 Job 30/1500 50/2500 20/1000 20/1000 120/6000 Helper Ref 40/2000 40/2000 40/2000 40/2000 160/8000

. Number of batches is proposed according to maximum training capacity of these training centers. Training calendar of each AWTC shall be submitted after joint review meeting of DPO/CDPO/Instructors of AWTC in month of May/June.

113 Chhattisgarh APIP 2012-13 Department of Women and Child Development

x) Training Structure

Relevance of training can be understood from the fact that, it converts 'raw', or inadequately equipped service providers into functionally competent, beneficiary focused and sensitized data sensitive and committed role performers.

Table-59: Training Structure

Participants Type of Training Venue

CDPOs/ACDPOs 1. Job Training NIPCCD

2. Refresher Training NIPCCD

______

Supervisors 1. Job Training SRC

2. Refresher Training SRC

______

Training of DTT/ MTT 1. Job Training NIPCCD

2. Refresher Training NIPCCD

______

AWWs 1. Job Training RWTCs / AWTCs

SRC – State Resource Centre (Function as MLTC) RWTC – Regional2. Women Refresher Training Training Center (FunctionRWTCs as AWTC) / AWTCs AWTC – Anganwadi Training Centre DTT/MTT______– District or Mobile Training Team______

Helpers 1. Orientation training District / Block HQ

2. Refresher Training District / Block HQ

114 Chhattisgarh APIP 2012-13 Department of Women and Child Development

xi) Capacity Building In year 2011-12 furniture/ equipment for newly sanctioned AWTC (non recurring item) could not be procured for want of approval from GOI, thus we have proposed the same in current action plan. This apart we also propose up gradation of old/existing training centers by making them resourceful, providing latest training equipment.

Table-60: Training Equipment:

S.N. Training Tool Users Per Unit Cost Total Cost Justification

1 2 3 4 5 6

1 2 Laptop State Training 76000/- 152000/- For multimedia Cell at presentation at State (Higher Directorate Level TOT Laptop & Configuration LCD is indispensable with all requirement. accessories)

2 01 LCD/DLP State Training 150000/- 150000/- Cell at (Higher Projector Directorate Configuration & advance version)

3 16 OHP Projector All 16 15000/- 240000/- No training is Training imaginable without Centers this equipment.

4 01 Digital State Training 30000/- 30000/- For documentation Camera / Handy Cell at and records cam Directorate photographs /video plays vital role.

5 01 Digital State Training 290000/- 290000/- For distributing Photocopier Cell at documents during (Higher /Ratio-graph Directorate training sessions. Configuration& advance version)

6 16 TV set 29” 16 Training 17000/- 272000/- Display of Training Centers films & material

115 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S.N. Training Tool Users Per Unit Cost Total Cost Justification

7 16 DVD 16 Training 5000/- 80000/- Display of Training Centers films & material

8 Public Address 16 Training 55000/- 880000/- To organize class System Centers room training

Total 20,94,000/-

xii) ECE/ICE

Under training component one of the areas which require focus, is to develop training material that could serve as "Tools" at the project and sector level.

Under ECE / IEC State plans to initiate following activities in year 2012-13

o Revision of Guidebooks for Supervisors & AWWs, which could be used for training. o Development of training kit for trainers - including film, quickies and spots. o Printing of books on success stories, achievements, initiatives and innovations, for distribution during training session. o Develop / procure training material / tool / kit.

In this proposal state plan to design / develop training material / kit which could be used as training tool. A lump-sum provision of Rs. 50.00 lakhs is anticipated under this head. The material / kit would be designed or develop in a way that, it could be used not only in training centers but also by AWWs. After receiving in principal approval, appropriate DPR would be submitted to GOI and work shall be proceed accordingly.

116 Chhattisgarh APIP 2012-13 Department of Women and Child Development

xiii) Physical and Financial performance of the State in the year 2008-09

Table-61: Physical and Financial performance of the State in the year 2008-09:

Functionary Job Training Refresher Training Fund Position Target Achievement Target Achievement Recd. Spent Anganwadi Worker 4515 2812 1600 989 206.81 237.3 Induction training of AWW 5500 4965 0 0 Induction training of Mini AWW 700 498 0 0 Supervisors 0 0 450 359 Anganwadi Helper 7000 5533 5000 5000 Total 17715 13808 7050 6348 206.81 237.3 Percentage of Achievement 78 90 115

140

120 115 100 100 100 100 90 78 80 60

40

20

0 Job Training Ref. Training Fund Flow

o Overall achievement in the training was more than 80%, despite of the fact that we had Vidhan Sabha Election and Lok Sabha Election in the year 2008-09.

117 Chhattisgarh APIP 2012-13 Department of Women and Child Development xiv) Physical and Financial performance of the State in the year 2009-10

Table-62: Physical and Financial performance of the State in the year 2009-10:

Functionary Job Training Refresher Training Fund Position Target Achievement Target Achievement Recd. Spent Anganwadi Worker 5005 3454 3960 3188 325.20 329.56 Induction training of AWW 2000 1845 N/A N/A Supervisors 750 0 475 374 Anganwadi Helper 5100 2600 9800 9100 Total 12855 7899 14235 12662 Percentage of Achievement 62 89 101.34

Graphical Representation

120 100 101.34 100 100 100 89

80 62 60 Target Achievement 40

20

0 JTC RTC Fund Flow

o Overall achievement in the training was more than 75%. Recruitment of 3rd phase of AWW/AWH could not complete in year 2009-10, leading to shortfall in JTC and Induction of newly recruits.

118 Chhattisgarh APIP 2012-13 Department of Women and Child Development

xv)Physical and Financial performance of the State

in the year 2010-11

Table-63: Physical and Financial performance of the State in the year 2010-11:

Job Training Refresher Training Fund Position Functionary Target Achievement Target Achievement Recd. Spent

CDPO/ACDPO 0 0 18 11

Anganwadi Worker 3675 3348 5400 5182

Induction training of AWW 13060 9490 0 0 342.37 442.12 Supervisors (Ind./Job) 750 677 375 90

Anganwadi Helper 5000 2514 7500 0

Total 22485 16029 13293 5283

Percentage of Achievement 71 40 129

140 129

120 100 100 100 100 80 71 Target 60 40 40 Achievement 20 0

Job Training Ref. Training Fund Utilization

xvi) Physical and Financial performance of the State in the year 2011-12:

SOE and QPR of year 2011-12 are under preparation. Thus after getting actual figures of training and expenditure, performance can be evaluated. A separate sheet of performance shall be sent to GOI after finalization of SOE and QPR.

119 Chhattisgarh APIP 2012-13 Department of Women and Child Development xvii) Financial Requirements of Funds (Regular Training) 2012-13: Table-64: Financial Requirements of Funds (Regular Training) 2012-13

Type of Training Cost 2012-13 Functionaries / Per April to June July to Sept. Oct. to Dec. Jan. to March Total Type of Training Batch No. of Cost No. of Cost No. of Cost No. of Cost No. Cost Batches Batches Batches Batches of Batc hes Supervisor Induction 0.490 0 0.000 0 0.000 0 0.000 0 0.000 0 0.000 Refresher 0.538 0 0.000 7 3.766 6 3.228 7 3.766 20 10.76 0 Job 1.400 3 4.200 1 1.400 1 1.400 0 0.000 5 7.000 Fixed cost * 12.095 2 24.190 0.000 0.000 0.000 2 24.19 0 Refresher 0.375 5 1.875 5 1.875 5 1.875 10 3.750 25 9.375 Fixed cost (13 12.27 0.000 0.000 0.000 0.000 13 159.5 AWTC) Recurring 10 Fixed cost (8 1.25 0.000 0.000 0.000 0.000 8 10.00 AWTC) 0 Non Recurring Job 1.25 20 25.000 25 31.250 25 31.250 30 37.500 100 125.0 00 Helper Orientation 0.508 30 15.240 50 25.400 20 10.160 20 10.160 120 60.96 0 Refresher 0.390 40 15.600 40 15.600 40 15.600 40 15.600 160 62.40 0 Induction Trg. 0.27 30 8.100 30 8.100 40 10.80 33 8.91 133 35.91 0

Total 130.00 94.21 158.00 87.39 137.00 74.31 140.00 79.69 586 505.1 05

Approval of one MLTC is pending at GOI level. We have incorporated fixed cost of two MLTC (01 SRC and 01 Govt. run MLTC) in above table We have received sanction of addl. 08 AWTC vide GOI's letter no. 1-34/2003-TR-I Vol. II, dt. 28th November 2007. We have not received Approval for non-recurring fixed cost. This is proposed in current action plan

120 Chhattisgarh APIP 2012-13 Department of Women and Child Development xviii) Financial Requirements of Funds (Other Trainings) 2012-13:

Table-65: Financial requirements of funds for other trainings 2012-13:

S. Functionary / Type of Cost 2012-13 N. Training Per April to June July to Sept. Oct. to Dec. Jan. to March Total Batch No. of Cost No. of Cost No. of Cost No. of Cost No. of Cost batch batch batch batch batch 1 Impact Analysis of the 3.000 0 0.000 0 0.000 1 3.000 0 0.000 1 3.000 Training 2 Training to CDPOs on Micro Planning- Nutrition and 0.255 1 0.255 1 0.000 1 0.255 1 0.255 4 1.020 Health 3 Training on Time /Stress Management/Fatigue 1.230 0 0.000 0 0.000 1 1.230 1 1.230 2 2.460 management Total 1.00 0.26 1.00 0.00 3.00 4.49 2.00 1.485 7.00 6.480

SUMMARY (Rs. In Lakhs) Table-66: Training Summary:

S.N. Item Requirement of Funds (2012-2013)

1 Regular Training of ICDS functionaries 505.105

2 Other Training Programs 6.480

3 Capacity Building of Training Centers 20.940

4 ECE/IEC 50.000

Total 582.525

121 Chhattisgarh APIP 2012-13 Department of Women and Child Development

l) Convergence with line departments:

i) Existing mechanism for convergence and coordination with line departments:

Two important activities due to good coordination and convergence among ICDSHealth- Panchayat are (i) VHND and (ii) Shishu Sanrkshan Mah. VHND is such an activity which enforces the village level coordination among ICDS-Health-Panchayat- WSHGs. Shishu Sanrakshan Mah is result of state level coordination cum convergence among ICDS-Health-UNICEF-MI and joint planning at district and block. The district level coordination joint meeting is held in most of the districts regularly.

ii) Status of joint planning with health at district, block and village level:

The SCERT and Sarv Shiksha Abhiyan had great contribution in improving the quality of the PSE. The ICDS-Education-SSA-SCERT jointly developed the ECCE policy and jointly planed training of AWW and supervisors on PSE kit.

iii) Joint visits /review with health and other departments:

Although the regular meeting among these key stake holders at state level are not so good. The current status of meetings in last two years with key departments is as follows:

Table: 67: Convergence:

Department State level District level Block level Gram/Village level

Health Not Regular Not Regular Not Regular Regular-VHND

PHE Not Regular Not Regular Not Regular Regular-VHND

Panchayat Not Regular Regular through Regular through Regular-VHND mandatory general mandatory general assembly and WCD assembly and WCD committee meetings committee meetings Education Regular Regular Regular Regular

It's clear that the coordination at state and district level needs improvement. The state will follow and implement the GOI guideline letter no 16-8/2010 Dated 30.3.2011 in this regard, in lieu to that state will form state, district, block, sector and village level coordination and monitoring committees

122 Chhattisgarh APIP 2012-13 Department of Women and Child Development

j) Community participation and involvement of PRIs: i) Nawa Jatan

Undernourish- ment under the age of two results in life-long consequences, including increased risk of death, disease, and poor cognitive development; lower school performance; reduced productivity; and increased risk of chronic disease later in life (Allen, 2001; Barker, 1998). Reduced cognitive ability—measurable in lower scores on IQ tests—leads to reduced productivity and earnings in adulthood.

However, not all approaches are effective against all types of under nutrition. Investments in the interventions that address the right kinds of under nutrition will maximize impact on preventing child deaths, or reducing loss of national productivity.

To address the problem of malnutrition in Chhattisgarh, especially among the underprivileged children of the society. Chhattisgarh state (with as high as nearly 50% population of malnourished children) has developed a multi-pronged mandate 'Nava Jatan' – a result oriented scheme of community based management of malnourished children. A scheme that encourages & rewards activities of redressing Child Malnutrition, in every nook and corner of the state.

Nava Jatan scheme was launched by Honorable Chief Minister on 24th January 2012 at Kondagaon district. The scheme aims at ensuring positive effect of change in the malnourished child status through psycho-social behavioral change, ultimately reducing malnourishment in the state. Anganwadi workers along with Self Help Groups, Mahila Mandals, Mitanins, voluntary institutions, public representatives, parents etc. will be directly involved in the Suposhan Abhiyan. It is envisaged that this will help to break the chain of tragic child deaths due to the malady and also subsequently bring down the figures for such cases in the state, so that all children can have a health future without any pangs of societal guilt.

ii) Basic Features of the Scheme:  With the active involvement and participation of SHGs/Mahila Mandal/Corporate organization, endeavoring to tame malnutrition mustering larger community support. With this nearly 10,000 severely malnourished children would be targeted in span of 06 months.  Training of AWWs/Supervisors/Suposhan Mitra/Family/Member of Gram Panchayat, on how to deal with underweight children through Community Based Management Practices.  Identifying severely malnourished children and ensuring them services (advice/medicine/referral/camp in selected area) under "Mukhyamantri Bal Sandarbha Yojna". Referring severe cases to nearby Nutrition Rehabilitation Centers.  Volunteer Suposhan Mitra would be identified in selected Gram Panchaya with greater number of malnourished children, so as to target closely malnourished children dwelling therein.  Span of one round under this mission is 06 months and rigorous monitoring would be done every month with the help of software. Such 6 months rounds will 123 be continue Chhattisgarh for next 2 -APIP3 years. 2012 -13 Department of Women and Child Development

 Provision of Reward and Recognition to different level of supervisory staff:

Stakeholder Reward/Recognition (result based) AWH Rs. 500/- AWW Rs. 1000/- Supervisor Rs. 2500/- CDPO Rs. 5000/- DPO Rs. 11000/- Gram Panchayat Rs. 1,00,000/- Suposhan Mitra Rs. 2000/- District Collectors Felicitation by Honorable CM

Same way we are rewarding SHGs and V.S.M and NGOs

iii) Expected Outcomes:

 Reduce in numbers of malnourished children.  Fall in infant and child mortality rate caused due to malnutrition.  Good exposure to family and community of undernourished children, to learn community based management practice (CBMP) for checking malnutrition, to which now they can use in lifetime.  Capacity building of field functionaries' viz. AWH/AWWs/Supervisor, on community based management of malnourished children.  Instituting practice/system of referral to NRCs.  Strengthening of ICDS services at root level. iv) Existing mechanism for community participation:

The role of PRI is very important in the implementation of ICDS program. PRIs are involved in a number of ways to support ICDS program activities. For example, AWWs and AWHs are selected by CDPOs on the recommendations of Gram Sabha. Selection of the site for construction of AWC building is also done by Gram Sabha. In fact, Gram Sabha provides land to the department of WCD for construction of the AWC building. Involvement of PRI, however, depends to a large extent on the rapport between the AWW/ Supervisor of the area and the PRI members and, therefore, varies from village to village.

The PRIs extend support to AWW for mobilization of community support, motivating mothers to attend health check up, immunization sessions, conducting Mangal Diwas, observing special days e,g. Breast Feeding Day, etc. Village Health and Sanitation Committees have been formed in all the villages of the state. These committees are part of Village Panchayat and are responsible for planning and implementation of health and nutrition related activities. The scope for PRI involvement in a larger and intensive way so that the program is owned by the peoples’ institutions is as yet limited.

124 Chhattisgarh APIP 2012-13 Department of Women and Child Development

 Recruitment of AWWs/AWHs:

Currently the selection power is given to Gram Panchayat for AWW/AWH selection. The Supervisor collects the panel of applicant as per the state guideline of AWW/AWH selection. They submit it to GP, who approve it as per guideline and send it to Janapad Panchayat (Block Panchayat) for the selection. The Janapad Panchayats “Women and Child Development Committee”, whose secretary is CDPO, does the selection as per the guideline. If this process takes more time than the stated then power has been given to collector to do selection as per the guidelines in support of CDPO.

 Supplementary food distribution

The SNP production and distribution responsibility has been given to WSHGs, so in most of the places WSHGs members with self motivation, do support SNP distribution on THR day

 Regularity of opening of AWCs and Observance of VHNDs

At AWC level a Mahatari committee has been formed and same time in state more than 72000 SHGs are formed at AWC level. These committees and groups have been given one of the key responsibilities to keep check over regular opening of the AWCs as well as participation in VHND to monitor and ensuring the services like ANC/Immunization/SNP distribution etc

 Immunization

In state more than 60000 women community health volunteers (Mitanin, now ASHA) are working on hamlet basis, most of them are member of the WSHGs also, so the support of the community on VHND is very effective. They do support SSM also.

 Construction of AWCs

In state good number of AWCs construction have been given to Panchayats

 Mobilization of community support to AWC

In state God Bharai, BAL Bhoj, Annaprashan are the key community processes organized regularly at AWCs, where community involve directly and practice the actions in facilitation of AWW and WSHGs.

125 Chhattisgarh APIP 2012-13 Department of Women and Child Development

A Community process by community for community at AWCs-BALBHOJ  Women SHGs are formed in AWCs. They collect a hand full of rice, fruits and other eatable from various families, pool them and organize Bal Bhoj for children in AWCs.  Bal Bhoj arrangements vary from week to fortnight and a month in different villages. This arrangement is managed and controlled by the members of SHGs. Bal Bhojan so arranged also ensures better supervision of the ICDS Nutrition program .  The representatives of PRIs i.e. Gram Panchayat's are now seen actively participating and coming forward to encourage this practice in area where SHGs are not able to arrange Bal Bhoj.  The "Bal-Bhoj Day" is arranged on such day that, health and other related activities could merge/converge on the same day  On the day of Bal-Bhoj, we can see community proactively involving and serving nutritious food to the children and we find Anganwadi Worker engaged

in weighing the children, pregnant and lactating mothers with the active participation of the member of SHGs.  Other than Nutrition and Health Day, on the same day, we promote ANM/LHV doing Immunization in the Anganwadi Centers.  Thus Bal-Bhoj has made AWCs a "Convergence Point", where on, the same day and same point services of various departments and involvement of community go hand in hand. Public celebrate Bal Bhoj programme with a sense of social service

In Goud Bharai function the newly identified pregnant women are being felicitated by a coconut and the key messages of ANC has been provided to her in presence of other women. In BAL Bhoj all the children eat community donated food, once in a month in which AWW demonstrate the correct IYCF practices and growth chart. The Annprashan is organised at AWC in support of community. These activities promote the essential ANC behavior, the timely initiation complimentary feeding, correct and appropriate complimentary feeding etc.

A state drive is ongoing since last two years in state, named as Malnutrition Free Campaign, in which community support is immense. State is trying to make Malnutrition as community priority. For this in last year in February month of 2011, Women and Child Development Minister Ms. Lata Usendy has led herself a 40 km Pad Yatra (Walk) on Malnutrition in remote area of the Tribal District Baster. More than 50000 villagers accompanied her during the walk. It received huge response from the community. It was first ever such a unique Walk program in history of state.

In state the breast feeding week, nutrition week, ICDS day, Children's Day, Health Day, Women's day etc every year , these all celebrated for community in support of community.

126 Chhattisgarh APIP 2012-13 Department of Women and Child Development v) AWCs participated in Gram Sabha meeting during last year:

In state every year since more than 7 years, government run a village level drive “Gram Suraj Abhiyan” in which a Gram Sabha is organized in each village in facilitation of a Team formed for each village. In this every AWW participates compulsorily in Gram Sabha for Gram Suraj Abhiyan. They put detail of the status of ICDS services in Gram Sabha, and explain problem to get support from community and PRI.

vi)AWCs received support from the Panchayat/Community based organizations (SHGs, Mahila Mandals, Mother's committee etc)/NGOs:

In state the SNP production work is given to WSHGs and the recruitment of AWW is given to Gram Panchayat, So all AWCs are very close to PRIs and SHGS. Every year state drives a Gram Suraj Abhiyan , in which in every village AWW do represent the status of ICDS in the village.

In all the districts it's a regular process where either General assembly or WCD Committee of Zila Panchayat does review the progress of ICDS services and functioning. vii) Percent of monthly Gram sabha meetings attended by AWWs: Department and Panchayat and Rural Development mandate that AWWs attend meetings of Village Health and Sanitation Committee. This committee is one of the several committees of Village Panchayat and looks after health and nutritional related activities in the village; Data on percent of Gram Sabha meetings attended by AWWs is not available.

k) Financial Management and Funds Flow Mechanism: i)Existing Mechanism of funds flow:

In all 18 districts 16 DPOs and 2 DWCDOs are posted. They all are drawing and disbursing officers at district level. Similarly all 163 CDPOs are block level drawing and disbursing officers. The most of the fund is given through two routs:

1. State to District - like salary of DWCDO/DPO, fund for PSE kit, fund for SNP (DPO/DWCDO do payment to NAN and to SHGs) etc 2. State to block- salary of CDPO, ACDPO, office staff, supervisors, honorarium of AWW/AWH of AWC and mini AWC, fund for IEC activities, fund for contingency fund for Mukhya Mantari BAL Sandarbh Yojana, fund for KSY ii) Steps taken for timely payment of honorarium:

In state since last two years the honorarium of AWW/AWH for 12 month is given to CDPO. On the basis of monthly pay data given by supervisors (endorsed by Gram Panchayat) every month the honoraries of AWW/AWH directly gets transfered to their corresponding bank account through office staff. Hence the timely disbursement of honorarium is ensured.

127 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Innovative activities

1. Study on IEC Impact assessment for behavior change communication.

Objective:

 To assess status of implementation of IEC activities in relation to the State/District IEC plan of past years  To assess the media habits and effectiveness of media used among different groups.  To assess level of awareness created by IEC among different target groups. To study changes in behavior as far as attitudes towards ICDS services concerned in the time frame of last years  To recommend cost effective IEC strategies for future

Background and rational:

As we are spending good amount of money on IEC and does many campaigns and activities but we do not know the impact, and up to what extent IEC is playing a role in behavior changes.

Therefore this study would be beneficial for assessing the effectiveness of IEC and the results of this study would be referred in planning of any IEC activities for future.

Methodology:

The external agency would be hired for doing this study. Conduct survey to assess level of awareness created by IEC among target audience. Area would be Bastar and Sarguja region tribal area and mid part of Chhattisgarh.

Estimated Budget:

Rupees 5 lakhs under monitoring and evaluation head.

Time Line:

For the period of 2 months

Note: This activity would come under Monitoring and Evaluation component.

128 Chhattisgarh APIP 2012-13 Department of Women and Child Development

2. Film Development on following topics

Objective:

To create awareness among society and ICDS workers, 10 short films would be developed on the following topics:

 Breast feeding (Immediate, Exclusive and Continuous)  Complementary Feeding  Food diversity and feeding frequency  Feeding during and after illness  Malnutrition Management  Feeding for undernourished children  Adequate Nutrition for Women  Early Childhood education awareness  Age wise milestones of preschool education  Micronutrient supplementation

Methodology:

Short film would be developed by the experts and shown on television and in other occasions like during breast feeding week, poshan aahar week etc.

Estimated Budget:

Estimated budget is around 10 lakh rupees under IEC head.

Expected Outcome:

 Developed breastfeeding and complementary feeding education for women, their partners and other significant family members during the prenatal, postnatal periods  Encouraged family members to be actively involved throughout the Child developmental years  Increase society awareness of ICDS Services  Increase the number of AWCs children for PSE and other services  Better management of malnourished children

Note: This activity would come under IEC component.

129 Chhattisgarh APIP 2012-13 Department of Women and Child Development

3. Assessment of Dietary pattern of children under 6 years of age

Objective:  For knowing the current dietary practices and patterns by 24 hour recall method and by food frequency method.  This study would be very useful for knowing the gaps in the diet. Exploration of eating habits may be helpful to understand the process of achieving dietary change.

Background and Rational:

Food-consumption studies of rural communities in remote areas are important for two reasons:  First, a large proportion of the food consumed in such areas is home-produced or gathered or purchased locally; therefore, diets are usually monotonous and simple because they are dictated by what foods are available in the home or local markets and the prices of those foods.  Second, because health care, educational facilities, and other services are limited or nonexistent in some areas, dietary intake data can be used to document particular situations for which programs and services to improve conditions can be developed, introduced, monitored, and evaluated.

Methodology:

In general the procedure for measuring energy and nutrient intake involves:

 A report of all food consumed by an individual  Identification of the foods such that an appropriate item can be chosen from standard food tables.  Quantification of the portion size of each food item  Determination of the frequency with which each food is eaten  Calculation of the nutrient intake (portion size (g) x frequency x the nutrient content per g)  Approach would be random sample survey of the community

Estimated Budget:

Estimated budget would be 10 lakh rupees under Monitoring and Evaluation head.

Note: This activity would come under Monitoring and Evaluation component

130 Chhattisgarh APIP 2012-13 Department of Women and Child Development

4. Baseline survey of Malnutrition as “ Wajan Tyohaar”

Objective: To collect the baseline data of nutritional status of children under 5 years of the state.

Methodology: On 6th of June 2012 wajan tyohaar celebrated. On this particular day weighing was done across the state by the AWWs of all the children under 5 years of age and plotting also be done for counselling the families of underweight children. This drive will give us the exact picture of malnutrition of the state. And accordingly we will plan the interventions.

Estimated Budget: 28 lakhs under IEC head.

Expected outcome: This drive will give us the exact picture of malnutrition of the state. And accordingly we will plan the interventions. Database prepared for further planning of malnutrition interventions and policy making.

Results: On 6th June 2012 approximately 25 lakh below 5 years children were weighed across the state. It’s a huge success of the program. Now data entry process in going on. Till date (19th June 2012) data of 3 lakh children entered in the website which is a big sample size. On the basis of this sample size nutritional status of the children is as follows:

Nutritional Status of Children Under 5 years of age

Normal children Moderate Underweight Severe Underweight

60.94% 27.98% 11.08%

Note: This activity would come under IEC component.

131 Chhattisgarh APIP 2012-13 Department of Women and Child Development

5. Exposure Visit to Maharashtra

Objective:

For seeing the best practices of ICDS in Maharashtra specially the ECCE and Nutrition component.

Methodology:

Observation and face to face interaction

Estimated Budget:

Estimated budget requirement is 2-3 lakhs under Monitoring and Evaluation head

Expected Outcome:

This visit would be beneficial in following ways:  Exposure visit is an important part of in which the team gets an opportunity to observe and learn from the other community’s development activities  The purpose of this exposure visit is to learn from the experience of others by direct interaction  To adopt and implement innovative approaches  To learn from experiences of different agencies and partners.

Note: This activity would come under Monitoring and Evaluation component.

6. Video Conferencing

Video conferencing has become part of communication advancement and technology in reaching out to others via the modern means and application. Video conferencing is an interactive method of interaction which allows two or more people at the same time at a different place to communicate with video and audio transmissions at the same time with the help of web conferencing. In ICDS we planned videoconferencing with all the district officials twice a week. To review the progress of the program and for effective implementation of the ICDS services

132 Chhattisgarh APIP 2012-13 Department of Women and Child Development

7. Preschool Education Certification

Objective:

Ensuring PSE Child development card for every 3-6 year children in each AWCs for quality PSE and monitoring.

Background and rational:

Currently we are unable to the know progress of each child individually on social, mental, emotional and psychological developments. A tool like age wise PSE progress card for each child should be provided so the AWW will be able to monitor each child for PSE and put her effort accordingly for each child.

Estimated Budget:

Estimated budget would be 15 lakhs rupees from under IEC component

Expected outcome:

Provision of progress cards. Based on year wise developmental milestones of the children and to review the progress of each child quarterly and discussed with the families of the children. When children enter to the primary school these cards would be referred for admission. The Idea is to assess the age wise development of the children e.g.  For Children between 3 to 4 years  For Children between 4 to 6 years

Note: This activity would come under IEC component

133 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Critical needs for additional HR support or technical assistance

Additional Funds Requirement for following Innovative activities:

8. Nawa Jatan

Objective: To address the problem of malnutrition in Chhattisgarh, especially among the underprivileged children of the society. Chhattisgarh state (with as high as nearly 50% population of malnourished children) has developed a multi-pronged mandate 'Nava Jatan' – a result oriented scheme of community based management of malnourished children. A scheme that encourages & rewards activities of redressing Child Malnutrition, in every nook and corner of the state.

Methodology: Nava Jatan scheme was launched by Honorable Chief Minister on 24th January 2012 at Kondagaon district. The scheme aims at ensuring positive effect of change in the malnourished child status through psycho-social behavioral change, ultimately reducing malnourishment in the state. Anganwadi workers along with Self Help Groups, Mahila Mandals, Mitanins, voluntary institutions, public representatives, parents etc. will be directly involved in the Suposhan Abhiyan. It is envisaged that this will help to break the chain of tragic child deaths due to the malady and also subsequently bring down the figures for such cases in the state, so that all children can have a health future without any pangs of societal guilt.

Basic Features of the Scheme:

 With the active involvement and participation of SHGs/Mahila Mandal/Corporate organization, endeavoring to tame malnutrition mustering larger community support. With this nearly 10,000 severely malnourished children would be targeted in span of 06 months.  Training of AWWs/Supervisors/Suposhan Mitra/Family/Member of Gram Panchayat, on how to deal with underweight children through Community Based Management Practices.  Identifying severely malnourished children and ensuring them services (advice/medicine/referral/camp in selected area) under "Mukhyamantri Bal Sandarbha Yojna". Referring severe cases to nearby Nutrition Rehabilitation Centers.  Volunteer Suposhan Mitra would be identified in selected Gram Panchaya with greater number of malnourished children, so as to target closely malnourished children dwelling therein. Span of one round under this mission is 06 months and rigorous monitoring would be done every month with the help of software. Such 6 months be continuing for next 2-3 years.  Provision of Reward and Recognition to different level of supervisory staff:

134 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Stakeholder Reward/Recognition (result based) AWH Rs. 500/- AWW Rs. 1000/- Supervisor Rs. 2500/- CDPO Rs. 5000/- DPO Rs. 11000/- Gram Panchayat Rs. 1,00,000/- Suposhan Mitra Rs. 2000/- District Felicitation by Collectors Honorable CM

 Same way we are rewarding SHGs and V.S.M and NGOs

Expected Outcomes:

 Reduce in numbers of malnourished children.  Fall in infant and child mortality rate caused due to malnutrition.  Good exposure to family and community of undernourished children, to learn community based management practice (CBMP) for checking malnutrition, to which now they can use in lifetime.  Capacity building of field functionaries' viz. AWH/AWWs/Supervisor, on community based management of malnourished children.  Instituting practice/system of referral to NRCs.  Strengthening of ICDS services at root level.

Budget Provision:

Approximately 20,000 children targeted in 188 gram panchayats by 50 NGOs, 200 Suposhan Mitras and 200 local women SHGs. State government will spend more than 2 crore rupees for Nawa Jatan. The targeted areas are preferable the gram panchayats which are having highest number of malnourished children and in the tribal areas across the state. Such rounds will be continued till 2015. State requirement for the financial year 2012-13 budget for one round is as follows:

Target Children Unit Cost Period Cost Incentives Total Cost and other expenses

20,000 @ 10 rupees per 180 days or 6 360 lakhs 140 500 lakhs malnourished child months per day

135 Chhattisgarh APIP 2012-13 Department of Women and Child Development

9. Preschool Education mentor for each block

Objective: 220 Pre School Education mentors for each block. To ensure quality PSE activities by Aanganwadi worker in all blocks. And for effective implementation of ECCE policy.

Background and Rational:

In this context, the pre-school component of the ICDS program assumes significance and was found to be very weak at the grassroots level. In the absence of any other government planning for this age group (3 to 6 years) there is a need to build a better understanding of the content and other parameters of the program. State responsibility for pre-school lies only with ICDS, which has a limited pre-school component. All other pre-school initiatives are in the private sector, which excludes the vast majority of children. Therefore for strengthening ECCE we need some more manpower for intensive support to the AWWs.

Methodology: One PSE mentor in each block. Therefore 220 PSE block mentors required. Individuals with post graduation in child development or equivalent would be eligible for the post. They would be hired through HR agency. These mentors will support AWWs for effective implementation of preschool education. They will support AWW for full on job support, at least for two days in a month, along with supervisor linked to this process essentially to avoid the gap. And will submit the progress report each month to the district.

Budget Provision:

Sl. Interventions/ Activities Unit Financial No. (₨ Lakhs)

1 220 PSE mentor for each block @15000 per month per 396 mentor (including travel, mobile and other allowances)

136 Chhattisgarh APIP 2012-13 Department of Women and Child Development

10. Development of Monitoring and Evaluation Cell

Objective:

Monitoring and evaluation activities need strengthening through the collection of timely, relevant, accessible, high-quality information, ⎯ and this information needs to be used to improve program functioning by shifting the focus from inputs to results, informing decisions and creating accountability for performance. And to address the need of additional HR support for technical assistance

Methodology:

Therefore for strengthening monitoring and evaluation in ICDS we planned to develop M&E cell in the Directorate and this would be a two year process in the year 2012-13 we will develop a State cell and in the next financial year 2013-14 district cells would be formulated.

State cell would be having 4-5 persons team, 1 would be from DWCD, 1 from developmental partner, 1 from SRC and 2 data entry operators will be hired. NSS software would also be designed according to new MIS.

Estimated Budget:

Estimated budget requirement for the same is as follows: Interventions/ Activities Target Unit Norms Timeline (date) Physical Financial (₨Lakh)

Establishment of M&E cell at State level & District level

Human Resource- 3State Data entry 3 3.6 operator @ 10000 per month per person

Human Resource- 27 district Data entry 27 25.92 operator @ 8000 per month per person

Human Resource- 220 project Data entry 220 158.4 operator @ 6000 per month per person

Total 187.92

Note: This activity would come under Monitoring and Evaluation component

137 Chhattisgarh APIP 2012-13 Department of Women and Child Development

SECTION 4: SUMMARY OF ACTION PLAN Physical Targets and Financial Estimates Table: 68 Summary of Action Plan

Physical Targets and Financial Estimates

S. Program Intervention/ Activities Unit/ Norm/ In Time Physic Financial N. Components Sanctioned Position Line/ al Reall (Rs. Lakhs) ocati on

1 2 3 4 5 6 7 8

1 Human Filling of vacancies Targets Resources State level 25 15 100%

District level 121 65 100%

Block level 1354 761 100%

Sector level (Supervisors) 1617 1444 100%

AWC level

AWW 43763 42153 100%

AWH 43763 41044 100%

Mini AWW 6548 5767 100%

Salary of ICDS staff

State 18 15 80

District 121 65 450

Block 2971 2207 7200

138 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S. Program Intervention/ Activities Unit/ Norm/ In Time Physic Financial N. Components Sanctioned Position Line/ al Reall (Rs. Lakhs) ocati on

1 2 3 4 5 6 7 8

Sector (Supervisors) 1617 1444

AWC (Honorarium and AWW 43763 AWW 42428 25220 TA of AWW, AWH and AWH 43763 AWH 41240 Mini AWW) Mini AWW Mini AWW 6548 5810

Total- 94074 Total- 89478

SUB- TOTAL-1

32950

2. Administrative Rent/ Vehicle/Contingency cost Rent

State - -

District - -

Block For 50 approximately 80 buildings

AWC For @200Rs/R 600 Approximately ural AWC/ 19500 AWC Month

@750Rs/U rban AWC/ Month

Total 650

Maintenance of already constructed buildings

139 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S. Program Intervention/ Activities Unit/ Norm/ In Time Physic Financial N. Components Sanctioned Position Line/ al Reall (Rs. Lakhs) ocati on

1 2 3 4 5 6 7 8

CDPO Office 150 @30000 & 50 @ 40,000

DPO office 25 @40,000 10

AWC 17000 @2400 408

Total 468

Hiring of vehicles

State 1 1.62 1.62

District 9 1.62 14.58

Block 130 1.62 210.60

Total 226.8

Vehicle hiring is for next coming 9 months July 2012 to April 2013

POL

State 2 1.2 2.4

District 16 1.2 19.2

Block 95 1.25 118.75

Total 140.35

Contingency

State level 1 15.20 15.20 15.20

District level 25 1 1.3 32.5

Block level 220 0.4 0.6 132

140 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S. Program Intervention/ Activities Unit/ Norm/ In Time Physic Financial N. Components Sanctioned Position Line/ al Reall (Rs. Lakhs) ocati on

1 2 3 4 5 6 7 8

AWC 43763 600 300 131.28

Mini AWC 6548 300 300 19.65

Total 396.62* 330.62 330.63

*Remaining 66 lakh rupees would be used for providing computers to newly sanctioned DPO and CDPO offices

SUB-TOTAL- 2 1815.78

3. Supplementary Children 6 months- 3 11.90 lakh 1200 14280 Nutrition yrs

Children 3 years to 6 9.50 lakh 1200 11400 years

P & L women 4.99 lakh 1500 7494

Severe malnourished 1.80 lakh 1800 2970 children

SUB- TOTAL -3 36144

4. Procurement Supply of material & equipment

PSE kit 43763 (AWCs) @ 1000 437.63

6548(M AWCs) @ 250 16.37

Medicine kit 43763 (AWCs) @ 600 50311 262.578

6548 (M AWCs) @ 300 19.644

Computers/ Printers/ UPS and Photocopier & Fax

State level -

141 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S. Program Intervention/ Activities Unit/ Norm/ In Time Physic Financial N. Components Sanctioned Position Line/ al Reall (Rs. Lakhs) ocati on

1 2 3 4 5 6 7 8

District level 9 (9*4) 150000 13.5

Block level 57 (57*4) 150000 85.5

*2 computers, one photocopier and one fax machine would be provide

Almirah/Storagebox/Utensils,equipment, etc

State level

District level 9 100000 9

Block level 57 100000 57

AWC level 5000* 36

SUB- TOTAL – 4 937.22

*Provision of providing utensils, furniture etc to the newly sanctioned AWCs. Here we mentioned only those AWCs which were left last year to provide the same. Therefore we made the provision this year 2012-13.

5. Training and Regular training 505.105 capacity (induction/ job/ building Refresher

Other Trainings 6.480

Training and Capacity building of 20.940 capacity training centers building ECE/ICE for training 50.00

SUB – TOTAL- 5 582.525

6. IEC

Printing of Angana Ke Gonth 40

142 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S. Program Intervention/ Activities Unit/ Norm/ In Time Physic Financial N. Components Sanctioned Position Line/ al Reall (Rs. Lakhs) ocati on

1 2 3 4 5 6 7 8

State level activities like organization of 20 Rajyotsav, campaigns, state level workshops (Programs/Discussions etc)

Advertisement through Electronic media, 74 print media and hoardings

Organization of various workshops / 121 programs, Vajan Tyohaar, District level activities etc Printing of Broachers, Posters, and other 172 IEC materials, Timetable for all AWCs, Nawachaar and Printing of Progress Cards etc Preparation and Distribution of film CDs 10

SUB - TOTAL- 6 43763 @ 1000 437

7. Monitoring & Evaluation

For revising MIS and printing of registers 140* etc

Repairing of weighing scales, data entry, 30 Software updating, and research studies etc

Stationary, format printing etc. 25

Data entry at different levels 30

*As GOI revised its MIS system, therefore it’s mandatory to provide new registers to each AWWs. A set of 11 register for each worker. And the cost of 1 set of 11 register is rupees 1000. Therefore the estimated budget requirement for this activity is 500 lakh but we have only 140 lakh rupees that can only provide registers to 14000 AWWs, So for rest 36000 AWWs we require additional 360 lakh rupees. The request for the same would be made to GOI

143 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S. Program Intervention/ Activities Unit/ Norm/ In Time Physic Financial N. Components Sanctioned Position Line/ al Reall (Rs. Lakhs) ocati on

1 2 3 4 5 6 7 8

SUB-TOTAL-7 43763 @500 225 6548 @100

8 Others Uniform to AWW/AWH 94074 @ 400 376.2

Flexi Fund for the AWCs 50311 @ 1000 503.11

New badges for 94074 @ 25 23.51 AWWs/AWHs

SUB- TOTAL-8 902.92

Total 73994.74

9 Additional requirement for printing of new registers for revised MIS 360

10 Additional requirement for Nawa Jatan Scheme 500

11 Additional requirement for Pre School Education mentor for each block 396

12 Establishment of M&E cell at State level & District level 187.92

GRAND TOTAL 75438.66

144 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Annexure 1 List of Addresses and Telephone numbers

S.N Name of Name of E mail ID Mobile Office District District & Number phone Official DPO number

1. Mr.Didar Singh Sarguja [email protected] 9425254328 07774- Marawi 224017 2. Mr.A.P.Kispotta Rajnandgaon [email protected] 9425251742 07744- 225188 3. Mr.Suresh Singh Bilaspur [email protected] 9425530001 07752- 230359 4. Mr.Tikvendra Jashpur [email protected] 9425262447 07763- Jatvar 223810 5. Mr.Chandravesh Koria [email protected] 9407684308 07836- Sisodia 232569 6. Mrs. Prafull Bastar [email protected] 9425260098 07836- Dubey 232569 7. Mr. Anand Tiwari Kawardha [email protected] 9425523941 07741- 232241 8. Miss Priyanka Mahasamund [email protected] 9406230578 07723- Thakur 224352 9. Mr. Ashok Raigarh [email protected] 9893943474 07762- Pandey 225429 10. Mr. L.R.Kachhap Durg [email protected] 9425532850 0788- 2323704 11. Mr.Varun Nagesh Dhamtari [email protected] 9424286946 07722- 232353 12. Mr.Rajendra Korba [email protected] 9826387847 07759- Kashyap 226618 13. Ms. Shail Thakur Kanker [email protected] 9827986652 07868- 241289 14. Mrs. Anita Janjgir [email protected] 9425231058 07817- Agarwal 223339 15. Mr.Ajay Sharma Dantewada [email protected] 9424669017 07856- 252863 16. Mr.S.K.Chaubey Raipur [email protected] 9425558451 0771- 2426194 17. Mr.Muktanand Narayanpur [email protected] 9407933930 07781- Khute 252943 18. Mr.Ramesh Sahu Bijapur [email protected] 9406402971 07853- 220346

145 Chhattisgarh APIP 2012-13 Department of Women and Child Development

S.N Name of Name of E mail ID Mobile Office District District & Number phone Official DPO number

19. Mr.Vipin Jain Kondagaon [email protected] 9425246975 07786- 243690 20. Mrs.I Toppo Balodabazaar [email protected] 9424181874 07727- 223445 21. Mrs.Renu Prakash Mungeli [email protected] 9926422577

22. Mrs.M.Tirki Balrampur [email protected] 7898356769

23. Deputy Collector Sukma 7587094366

24. Mr.M.K.Khalko Surajpur [email protected] 9754587416

25. Mr.Hemram Rana Balod 9424105980 07749- 222658 26. Mr. B.D.Patel Bemetara [email protected] 9425253528 07824- 222122 27. Mr.A.K.Biswal Gariyaband [email protected] 9406017120 07706- 241456

146 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Annexure 2 State Nutrition Policy

It is known and proven universal fact that to reduce infant mortality the control on malnutrition is best way for developing countries. Indian constitution also states in article 47 in state directive principals that it will be state's primary duty to improve the nutritional and life status of their people. In background of these two facts, in lieu to National Nutrition Work Plan 1995 and objective of the Tenth Plan (2002- 2007), state has defined its Nutrition Policy in 2004, which has been envisaged on both short and long term strategies to combat malnutrition

The interdepartmental and inter region integrated work system have been envisaged in the state nutrition policy. Community based work; public education and behaviour change communication at family level have been chosen as key strategy for change in public behaviour and nutritional status. The coordination and support among government, society, non government organization, community and people will be ensured. The pregnant women, lactating mothers, adolescent girls, old age people, deprived people, handicapped, industrial/ mining employee, landless labour and their family, migrant people and their family have been targeted under the state nutrition policy.

Outlined Challenges

Technical reasons of malnourishment in state are as follows

1. Protein Energy Malnutrition 2. Higher Low Birth Weight Children. 3. Anaemia in Children, Adolescent girls and Women (pregnant and lactating) 4. Iodine deficiency and related complications. 5. Deficiency of Vitamin A; 6. Nutritional unbalance in urban area.

The other components which contribute to malnourishment are:

1. Food habit, lively hood and nutritional security 2. Equity- 3. Lack of attention on AGs

In state nutrition policy following points are the important strategies have been included-

1. Prevention of Malnutrition: Primary Investment

A. Strengthening of ICDS  Education for Nutritional food  Motivating the Growth Monitoring  Quality implementation of Health Nutrition Day in AWCs.

147 Chhattisgarh APIP 2012-13 Department of Women and Child Development

 Ensuring the availability of IFA tablets and ORS at Aanganwadi Workers.

C. Life Cycle Contact

D. Implementation of essential nutrition activities.

2. Strengthening the interdepartmental coordination with Health department.

3. Synergy among different food and nutrition program

4. Adolescent girls.

5. Capacity Building for Health and Nutrition Education

6. Behaviour Change Communication

7. Participatory governance

8. Gender Disparity issues

9. Nutrition related issues for urban population and old age people.

10. Partnership for change

11. Follow up and monitoring.

Till now as per the state nutrition policy work plan following activities have been done in last two years.

1. The new SNP (Ready to Eat -RTE) arrangements through WSHGs across state started.

2. The capacity building of AWW/supervisors/ CDPOs has been done on IYCF interventions, Local herbal based treatment in support of AYUSH department, on home based newborn care and management of illnesses among 0-2 month children as per standard IMNCI guideline, on Preschool Education on specially design kit by SCERT being ongoing across state in support of Education

3. Establishment of Nutrition Surveillance System (NSS).

4. A state level drive “SHISHU SANRAKSHAN MAH”, twice in a year is ongoing since 2007.

5. The Bal Bhoj, God Bharai, Annaprashan are some of the activities which is improving community participation and behaviour of the family.

6. For the treatment of severely malnourish children Chief Minister Bal Sandarbh Sewa have been initiated.

148 Chhattisgarh APIP 2012-13 Department of Women and Child Development

7. For the cross learning and knowledge management a magazine ANGANA KE GONTH have been started for all AWWs.

8. The BCC kit material which is Chhattisgarh relevant has been prepared in support of UNICEF. The kit covers most of the points raised in nutrition policy for diet/food behaviour.

As per the work plan of State Nutrition Policy the following actions are yet to complete, which were not carried out due to lack of fund and time.

These all activities will be included in the current annual plan

 The state nutrition mission headed by Chief Minister to observe the follow up of defined strategy.  A State Advisory Committee will be formed which will be headed by Chief Secretary.  Special provision of IFA tablets for Adolescent girls.  The joint effort of AWW, ANM and Mitanin (ASHA) ensuring the benefit of different programs to pregnant women.  Organising the non training actions  Like joint visit of ICDS and health  Implementation of result based reward and prize system  Organizing the Health Mela and cross learning visits  Developing the communication resource for the users  Communicating the nutrition related expectation/ priorities/ key points of program to all administrative levels.  A state level nutrition communication policy would be formulated. In implementation of BCC local culture and folk based activities (Kala Jattha, Nukkad drama, Puppet show, Pandwani, Karma and other folk dance/songs) are required to be included in BCC effort. The radio, TV, slogan writing, exhibition, film show, poster, chart etc mediums are yet to be used for communication.  The needful literature and resource material required to be developed.  Special curriculum for the capacity building of joint review on program by CDPO and BMO.  The nutrition and health will be made a compulsory point for discussion and planning in Gram Sabhas.  Special nutrition package for handicapped children.  Those like Panchayat, health committee, AWW, ANM, Mitanin etc, who will demonstrate the exemplary work in nutrition field, will be awarded.  To organise a comprehensive survey on those important indicators this affects the nutritional status.

149 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Annexure 3 Nutrition Surveillance Management Information System & Geographic Information System

Background & Purpose of ICDS Nutritional Status analysis:

Chhattisgarh has a population of over 20.0 million (census 2001), out of this population 3.5 million (census 2001) is children (in the 0-6 age group). Under nutrition amongst Children is high this in turn has resulted into high Infant mortality rate. It was felt to have a regular monitoring system for ICDS functions & Nutritional Status of Children for the huge ICDS set-up spread across the State. The challenge was to make under nutrition visible at appropriate level for action plan through regular data analysis. Even though huge data was gathered every month from each of the ICDS Projects' Anganwadi Centres (AWCs), the data was not analysed by the people who were implementing the projects at district and project level. Presently Chhattisgarh is having total 20289 AWW centers & another 9148 new AWW centers are coming. The state is having 150 Blocks/Projects. After implementation of level 2, not only each AWCs's performance can be monitored, but at the same time project level MPR gets generated by the system automatically. Many information (data fields) which otherwise gets lost, can now be viewed which gives a good insight of both micro and macro level performance of ICDS system in a project.

The system also reduces repetitive workload at different levels of ICDS by automatically generating MPR from collated AWC data. Regular validation of collated data is carried out automatically. Various indicators are generated by the system for performance analysis. NSS aims at developing the Capacity of the selected ICDS functionaries (District Program Officers and UNICEF District Extenders) and further to CDPO's, ICDS Supervisors & AWWs so that:-

The Nutrition Surveillance System is an initiative to develop a system for the state of Chhattisgarh to analyse Project level & AWC level data of ICDS at level-1 & level-2 (explained below)

At Level 1, monitoring is done by analysing Monthly Progress Report (MPR) of ICDS Projects where quality of data is evaluated and performance of each project is analysed.

 Data fields are clearly understood  Every month, the data is meaningfully analysed to locate areas of inefficiencies (such as low weighing percentage) along with high undernutrition pockets, for subsequent action plan.  Data is transmitted electronically for timely action (a child in Grade IV Nutritional Status is likely to expire without timely medical intervention, while severity of his nutritional status report gathers dust in a district office).  After implementation of Level-2, a bulk work load at project level is reduced.

During intensive training sessions of Nutrition Surveillance at Kolkatta by Technical Support Institution (TSI) Riddhi Management Services has done capacity building of ICDS functionaries in data analysis, locating areas of high under nutrition and subsequently this will also help in implementing evidence based action plans for corrective actions.

150 Chhattisgarh APIP 2012-13 Department of Women and Child Development

16 DPOs and 16 Unicef District Extenders were trained by TSI on computer basics and word processor, use of Microsoft excel, working on spread sheet with ICDS's AWC level data after this training they were able to analyse the specific fields of ICDS supervisors' compilation sheet (Annexure III) and generate charts, they also learned how the customized automated system generates the standard, GOI specified ICDS MPR. At the end of the training session customized CD of all 150 projects, customized CD of all 16 Districts & customized CD of the state were handed over to Extenders for installation at respective project, and district. After this training, the customized software was installed in all the District Program Offices across the state, and trainings to CDPO's & Project functionaries was provided by District Extenders & DPOs.

Steps taken towards systematic approach in implementing MIS in ICDS  Training on Nutrition Surveillance System & its working to all CDPO's, & ICDS Supervisors at District Level.  Training on Filling of MPR to AWW's at Project/Block or ICDS Sector Level.  RMSPL provided all project maps showing village boundary along with designed format. All the data, as required, was incorporated in the map & the format was filled up and sent back to RMSPL well in advance prior to commencement of Level-2 Training.  Data Entry to Office Staff and Report Generation  Sharing different indicators with ICDS CDPO's and Supervisors for corrective actions at District Meetings and at Project Level Meetings.  Data Validation and Field visits by District Extenders and ICDS functionaries to AWC's.  Convergence with allied Govt. Departments and NGO's i.e., Health Department, Education Department, Panchayat Department, CARE etc.

Now the System is fully functional at District Level i.e., The Form 3 compilation done at the project level after receiving Form 2 from all reporting AWCs is provided to District and the data is fed into the Nutrition Surveillance System of each projects, which generates district level reports which are further utilized by the state. This has helped the reporting system and is now accepted and owned by the projects and district functionaries of ICDS, which is turn, will ensure better services to the community and reduce IMR and MMR.

The lateral part i.e. GIS (Geographic Information System) as a part of Nutrition Surveillance Program will give a clear picture of ICDS services and status of various indicators in 3 levels – (i) At AWC level, (ii) Project Level and (iii) District level. This will help to all the functionaries and planning remedial actions Project wise, Sector wise, and Anganwadi centre wise. This GIS will also help Project ICDS functionaries to analyse lacuna areas and plan accordingly and work on lacunas, which could be checked with the help of GIS plotting in coming months. No extra work is to be done to prepare GIS reports; all the indicators can be plotted on maps after the data is entered in the Nutrition Surveillance Software. The State MIS cell can also prepare reports of all the projects on the basis of data of individual projects with the help of simple commands.

The GIS will help the projects in acceptability of nutrition surveillance system as their own project areas can be analyzed by themselves and AWCs will be checked and routine visits to lacking AWCs could be planned and this will show in the consecutive months GIS reports of Project level.

151 Chhattisgarh APIP 2012-13 Department of Women and Child Development

The GIS will also help District Authorities to present certain indicators in their meetings and show patterns of change which took place after strategic interventions by the project functionaries. Poor performing AWC's will be identified in different categories/indicator wise and specific actions could be planned by the projects themselves. Many other benefits of GIS are there and which will enhance the capacity of Project level team and District.

Individual Districts Achievements: Implementation of NSS at field level:

 The detail information of malnourished children from NSS; were utilized by the 2 blocks ( Durgukondal & Antagarh) of district Kanker for Chief minister referral services for children since last year.  During Kuposhan Mukti Abhiyan (Malnutrition elimination rally) which was started on 6th june 2009, malnourished children were adopted by the people of community. For this purpose children's name was provided by NSS data completely from 2 projects of Kabirdham & 1 project of Rajnandgaon & all projects of Bastar. Projects were Kunda & Saharanpur of Kabirdham & Rajnandgaon rural of district Rajnandgaon.  Last year in Dhamtari, during review meeting, indicators which shows data for nutritional status of children, revealed that supervisors & AWWs are not trained in new WHO growth standards, so training was planned & given accordingly in block Nagari of District Dhamtari & also in block Durgukondal & Koyalibeda of District Kanker.  In district Koriya, DPO took very innovative approach for the improvising his district's reporting with the help of NSS. As first of all, he made systems connected through internet for regular & on time reporting of MPRs at project and district level. He started to take review meetings not only at district but also at project & sector levels.  NSS data are utilized in District innovative plans of Raigarh, Bilaspur, Dhamtari, and Bastar & Kanker for availability details of resources, infrastructure like AWC buildings, toilet, drinking water facilities etc.  In district Durg, a cluster of 25 AWWs was formed for the quality reporting of MPRs from field level in a project Balod. With the help of NSS data, supervisors of Balod used to call meeting of this cluster & discuss the mistakes in MPR & workers of this cluster used to train weak anganwadi workers. In this way they improved their reporting at field level. This complete system was supervised by DPO.  There are some projects where entry & analysis of MPR data is completely done through software from all over the state. Out of 156 projects 40 projects MPR data feeding is completely undertaken by the supervisors and 116 projects are practicing data feeding with joint support of supervisors as well as computer operators or clerks; which is not a big success but shows government functionaries interest of becoming more computer friendly in a short period of span & with lack of systems as well as human resource availability.

Improvement in reporting from tribal districts:

Along with urban & rural projects, tribal projects reporting status have been improved since last 3 years. In tribal districts like Bastar, Dantewada, Narayanpur & Jashpur where AWCs reporting was not expected

152 Chhattisgarh APIP 2012-13 Department of Women and Child Development earlier, now 87 % of reports of AWCs are coming through NSS in Bastar while 80% from dantewada,85% from Jashpur directly through NSS.

Utilization of NSS data by Collectors & CEOs on Review meetings:

 In district Kanker, at the initial stage of NSS implementation, it was found through the evaluation of data by NSS that AWC building details & some other information were not filled in F2 format; so CEO Jila pachayat took action on this by giving supervisors training on correct feeding of data in AWC level MPRs by him. After that regular monitoring of quality reporting by AWCs was ensured by supervisors & CDPOs along with DPOs and NSS became an important part of every month's review meeting.  In district Dhamtari, when the review meeting of the department was taken by Collector in the month of February 2010. With the backing of the analysis report generated through the software; It was realized that Monthly progress reports were not improving qualitatively then Collector gave instruction to the department to conduct training of all CDPOs & supervisors & stop data entry done by operators so that supervisors start feeding of data in the software & become able to rectify the errors & analyze data properly for their own use.  With the great concern in the department, upper collector of district Raipur who is IOC of the department also; has shown her interest towards the software because of the availability of SAM children's detail in NSS. With the help of the software generated list of severe acute malnourished children she is preparing a plan of action for the reduction of malnutrition in one of a tribal project “Gariyaband” of district Raipur. In this project she has taken 80 SAM children& planned to organize 1 day camp to provide health checkups & referral services by pediatrician & follow up camps & scaling of the project in a long run.  In Sarguja district, a nutrition cell was formed by Collector in which functionaries of different departments like health, ICDS, PHE, PRI & education were the stakeholders. This Group especially unites for malnutrition reduction. The key process & impact indicators, generated by NSS were the focused issues of this cell, on which they used to organize meetings every month and on the basis of the major findings collector set milestones for next month.

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Annexure 4 Guidelines for Supplementary Nutrition Program

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Annexure 5 Mechanism for redressal of grievances

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Annexure 6 Development partners

UNICEF

UNICEF Nutrition Program works closely with Department of Woman and Child Development in the following areas:

 Support to preparation of Annual ICDS Program Implementation Plan through technical support.  Strengthening ICDS training infrastructure and capacity through standardization of content and methodology of training as well as capacity building of faculty at the training centers.  Phasing out of support to Nutritional Surveillance System and supporting the roll out of Revised ICDS MIS.  Support roll out of SABLA program in the 5 selected districts in the State through conduction of TOTs, development of materials and monitoring support.  Demonstration of Child Friendly Anganwadi Centers with elements of 'Building as Learning Aid' and documenting the experience to facilitate scale up.

UNICEF Nutrition Program also works closely with the Department of Health and Family Welfare, in coordination with Department of Woman and Child Development in the following areas:

 Roll out of Community IYCF strategy in selected districts  Operationalization and quality implementation of Nutritional Rehabilitation Centers  Implementation of Biannual Vitamin A Supplementation and Deworming program - Shishu Sanrakshan Maah in the State, through planning and monitoring support  Weekly IFA supplementation Program roll out  Strengthening Iodine Deficiency Control Program in the State

Strengthening implementation of Village Health Nutrition and Sanitation Days in the State through planning and monitoring support in 9 High Focus Districts of the State: Sarguja, Korba, Jashpur, Rajnandgaon, Bilaspur, Kankar, Bastar, Bijapur and Narayanpur; through placement of District and Block Consultant

166 Chhattisgarh APIP 2012-13 Department of Women and Child Development

CARE

Early Childhood Development Project – CARE India

ECD(Early Childhood Development) Project, a pilot, is being implemented in Janjgir and Korba districts of CG, to support achieving the goals of GoI run ICDS project. ICDS is dedicated for holistic development of children from 0 to 6 years and for this, six services are provided through AWCs- SNP, PSE, Immunization, Health Checkups, Referrals, NHEd.

Objectives of ECD project-

1. To strengthen the ECCD component of ICDS with a view to ensure health and psycho-social well being of children less than 6 years of age.

2. To promote understanding, skills and capabilities of workers/stakeholders, family and community members to meet the psychological, physical & social development needs of the children below the age of six years during each sub-stage of early childhood years (prenatal, birth to 3 years, 3-6 years).

3. To enhance the skills and competences of functionaries in effective implementation of ECD component of ICDS.

The 5x5 model-

Interventions -Food and Nutrition, Health, Child Development, Child Rights & protection, Economic Development

Levels-Child, Family, Child care settings, Community, Policy

Target groups- Pregnant and lactating women, special focus on children below 3 years, 3-6 years children

Strategies- Community Mobilization, Capacity Building, Institutionalizing MIS, Monitoring, Review & Reporting system, Partnership with institutions, organizations for advocacy, transparency and behavior change, Synergy with other Government initiatives.

167 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Annexure 7 Last 3 Years Financial Expenditure: 2009-10

Annual Statement of Expenditure for ICDS Scheme ICDS (General)

Name of the State /UT -- Chhattisgarh Financial Year - 2009-2010 PART -A ALLOCATION OF FUNDS IN STATE'S ANNUAL BUDGET FOR THE CURRENT YEAR

Central State

1- ICDS(General) Scheme Rs. 18348.69 Lakhs 2038.76 Lakhs

2- S.N.P. Rs. 16350.00 Lakhs 16350.00 Lakhs

UTILIZATION CERTIFICATE Certified that out of the total amount of Rs.- 14068.71 Lakhs released under Integrated Child Development Services Scheme (General) during 2009 -2010 to the State/UT of Chhattisgarh by Government of India, a sum of Rs. 14051.58 Lakhs has been utilized as per schematic norms and for the same purpose for which the amount was released. The excess expenditure incurred by the State as on 31.03.2010 is Rs. 2609.87 lakhs.

Join Director Join Director(Finance) Commissioner

Woman & Child Development Women & Child Women & Child Chhattisgarh Development Development

Chhattisgarh Chhattisgarh

168 Chhattisgarh APIP 2012-13 Department of Women and Child Development

PART -B Rs in Lakhs 1 Funds released during previous financial year Rs. 8992.46 2 Expenditure incurred in previous financial year Rs. 12051.94 3 Unutilized balance of previous financial year (1-2) Rs. 0 4 Excess expenditure incurred in previous financial year (2-1) Rs. 2627 5 Funds released in the current year Rs. 14068.71 6 Net amount of funds available (col 5 -col4) 11441.71 or (col.5 - col.3) as applicable Rs. 7 Expenditure during the year Rs. 14051.58 8 Unutilized Balance (col.6 - col. 7) Rs. 9 Excess expenditure (col. 7- col. 6) Rs. 2609.87 10 State Share available Rs. 2038.76

11 State Share spent Rs. 1561.29

FORMAT -V Period from 1 April 09 to 31 March 10 Financial Year 2009 - 2010

Process Indicators _ ICDS (including SNP)

Budget Provision, Releases & Expenditure

1. Provision in the Budget of the State Central State (i) For ICDS Rs 18348.69 Lakh 2038.76 Lakhs (ii) For SNP Rs. 16350.00 Lakhs 16350.00 Lakhs 2. Funds released by GOI to State (With dates) Rs. in lakhs

169 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Quarter Details ICDS SNP Q1 F.No. 4-1/2009-CD-II (23-04-09) 1519.54 3118.22 Q2 F.No. 4-1/2009-CD-II (27-08-09) 2136.18 3641.04 Q3 F.No. 4-1(3)/2009-CD-II (20-11-09) 1713.86 4443.23 Q4 F.No. 4-1(3)/2009-CD-II (02-02-10) 2092.1 2866.22 Total 14068.71 7461.68

3. Funds released by State to the Department (With date)

Quarter Details ICDS SNP Q1 2 Apr. 2009 20387.45 32800

Q2

Q3

Q4

Total 20387.45 32800 4. Funds released by Department to the Directorate (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 2 Apr. 2009 20387.45 32800

Q2

Q3

Q4

Total 20387.45 32800

170 Chhattisgarh APIP 2012-13 Department of Women and Child Development

5. Funds released by Directorate to Disstricts/Blocks (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 1 Apr. to 30 June 2009 8965.83 12435.00

Q2 1 July to 30 Sep. 2009 4398.91

Q3 1 Oct. to 31 Dec. 2009 462.35 10753.00

Q4 1 Jan. to 31 Mar. 2010 3541.51 1467.00

Total 17368.6 24655.00

6. Expenditure

Quarter Details ICDS SNP Q1 1 Apr. to 30 June 2009 2188.75 2394.84

Q2 1 July to 30 Sep. 2009 3511.63 4419.96

Q3 1 Oct. to 31 Dec. 2009 4031.25 4484.48

Q4 1 Jan. to 31 Mar. 2010 5881.24 10025.39

Total 15612.87 21324.67

Joint Director

Woman & Child Development

Chhattisgarh

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2010-2011

Annual Statement of Expenditure for ICDS Scheme ICDS (General)

Name of the State /UT -- Chhattisgarh Financial Year - 2010-2011 PART -A ALLOCATION OF FUNDS IN STATE'S ANNUAL BUDGET FOR THE CURRENT YEAR

Central State

1- ICDS(General) Scheme Rs. 21426.41 Lakhs 2380.71 Lakhs 2- S.N.P. Rs. 18600.00 Lakhs 18600.00 Lakhs

UTILIZATION CERTIFICATE

Certified that out of the total amount of Rs.- 11717.917 Lakhs released under Integrated Child Development Services Scheme (General) during 2010 -2011 to the State/UT of Chhattisgarh by Government of India, a sum of Rs. 15796.62 Lakhs has been utilized as per schematic norms and for the same purpose for which the amount was released. The excess expenditure incurred by the State as on 31.03.2011 is Rs. - 6688.56 lakhs.

Joint Director Joint Director(Finance) Commissioner

Woman & Child Development Women & Child Women & Child

Chhattisgarh Development Development

Chhattisgarh Chhattisgarh

176 Chhattisgarh APIP 2012-13 Department of Women and Child Development

PART -B Rs in Lakh

FORMAT -V Period from 1 April 10 to 31 March 11 Financial Year 2010- 2011 Process Indicators _ ICDS (including SNP)

Budget Provision, Releases & Expenditure 4. Provision in the Budget of the State Central State (i) For ICDS Rs. 21426.41 Lakhs 2380.71 Lakhs (ii) For S.N.P. Rs. 18600.00 Lakhs 18600.00 Lakhs

5. Funds released by GOI to State (With dates) Rs. in lakhs

Quarter Details ICDS SNP Q1 F.No. 4-1/2009-CD-II (13-05-10) 3318.2 3659.47

Q2 F.No. 4-1/2009-CD-II (07-07-10) 3318.2 3659.48

Q3 F.No. 4-3/2009-CD-II (24-02-11) 5081.517 0 Q4

Total 11717.917 7318.95 6. Funds released by State to the Department (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 2 Apr. 2010 23807.12 37200

Q2

Q3

Q4

Total 23807.12 37200

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4.Funds released by Department to the Directorate (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 2 Apr. 2010 23807.12 37200

Q2

Q3

Q4

Total 23807.12 37200

5. Funds released by Directorate to Districts/Blocks (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 1 Apr. to 30 June 2010 15169.87 24390.00

Q2 1 July to 30 Sep. 2010 548.55 0

Q3 1 Oct. to 31 Dec. 2010 595.48 3043.00

Q4 1 Jan. to 31 Mar. 2011 3011.41

Total 19325.31 27433.00

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6. Expenditure

Quarter Details ICDS SNP Q1 1 Apr. to 30 June 2010 2634.02 3139.33

Q2 1 July to 30 Sep. 2010 3767.57 6606.26

Q3 1 Oct. to 31 Dec. 2010 3878.8 6845.43

Q4 1 Jan. to 31 Mar. 2011 7271.41 9347.14

Total 17551.8 25938.16

Joint Director

Woman & Child Development

Chhattisgarh

179 Chhattisgarh APIP 2012-13 Department of Women and Child Development

180 Chhattisgarh APIP 2012-13 Department of Women and Child Development

2011-12 QUARTERLY REPORT

STATEMENT OF EXPENDITURE FOR ICDS SCHEME ICDS (GENERAL)

Name of the State - Chhattisgarh

Financial Year- 2011-12

Quarter III (1 Oct. to 31 Dec. 2011)

PART- A ALLOCATION OF FUNDS IN STATE'S ANNUAL BUDGET FOR THE CURRENT YEAR

Central State

1- ICDS (General) Scheme Rs. 32829.26 Lakhs 3647.69 Lakhs

2- S.N.P. Rs. 18600.00 Lakhs 18600.00 Lakhs

UTILIZATION CERTIFICATE

Certified that out of the total amount of Rs. 11913.28 Lakhs released under Integrated Child Development Services Scheme (General) during 2011-2012 to the State/UT of Chhattisgarh by Government of India, a sum of Rs. 11415.52 Lakhs has been utilized as per schematic norms and for the same purpose for which the amount was released. Out of this, Rs. 3742.54 Lakhs was utilized in the current quarter ( III rd ).

Joint Director(Finance) Commissioner

Joint Director Women & Child Women & Child

Woman & Child Development Development Development

Chhattisgarh Chhattisgarh Chhattisgarh

181 Chhattisgarh APIP 2012-13 Department of Women and Child Development

PART- B Physical 1. Number of ICDS Projects:

(i) Sanctioned 163 (ii) Operational 163

2. Number of AWCs:

(i) Sanctioned AWCs 43763 (ii) Sanctioned Mini AWCs 6548 (iii) Operational/ Reporting AWCs 41774 (iv) Operational/Reporting Mini AWCs 5654

3. Details of ICDS functionaries:

REGULAR EMPLOYEES I (A) State Cell/ Directorate: -

S. Name of Post No. of Posts Pay band Grade Total Total actual No. Sanctio In pay Quarterly expenditure in a ned position emolume year nts 1 Joint Director 1 1 15600 39100 7600 143645 574578 2 Dy. Director 2 2 15600 39100 6600 139535 1116276 3 Asst. Director 2 2 15600 39100 5400 134603 1076820 4 Accounts Officer 1 1 15600 39100 5400 134603 538410 5 A.S.O. 2 2 9300 34800 4300 108299 866388 6 Stenographer 1 1 5200 20200 2800 63705 254820 7 Data Entry Operator 2 0 5200 20200 2400 62061 0 8 Asst. Grade I 1 1 5200 20200 2800 63705 254820 9 Accountant 2 1 5200 20200 2400 62061 248244 10 Asst. Grade II 1 1 5200 20200 2400 62061 248244 11 Asst. Grade III 1 1 5200 20200 1900 60006 240024 12 Driver 1 1 5200 20200 1900 60006 240024 13 Peon 1 1 4750 7440 1300 30393 121574 Total Expenditure 18 15 - 1124681 5780222

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(B) District Cell: - D

S. Name of Post No. of Posts Pay band Grade Total Total actual No. sanctio In pay Quarterly expenditure in a ned positio emoluments year n 1 Dist. Programme 16 7 15600 39100 6600 139535 3906966 Officer/DD 2 Program Coordinator 7 3 15600 39100 5400 55797 669563 3 Asstt. Program Officer 5 0 15600 39100 5400 55797 0 4 A.S.O. 14 3 9300 34800 4300 44843 538121 5 Superintendent 15 10 9300 34800 4300 44843 1793738 6 Asst. Grade-I 2 0 5200 20200 2800 26679 0 7 Asst. Grade-II 16 11 5200 20200 2400 25627 1127569 8 Asst. Grade-III 16 7 5200 20200 1900 24311 680714 9 Driver 14 7 5200 20200 1900 24311 680714 10 Peon 16 17 4750 7440 1300 12689 862823 Total Expenditure 121 65 10260209

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(C) Project Level:-

S. Name of Post No. of Posts Pay band Grade Total Total actual No. sanctio In pay Quarterly expenditure in ned position emoluments a year 1 CDPO 163 83 9300 34800 4300 108299 35955102 2 ACDPO 103 47 9300 34800 4200 107888 20282850 3 Supervisors 1617 1446 5200 20200 2400 62061 358960824 4 Assistants 157 81 5200 20200 2800 63705 20640420 5 Clerk-typist 287 122 5200 20200 1900 60006 29282928 6 Driver 154 73 5200 20200 1900 60006 17521752 7 Group D 0 0 8 i. Peon 230 232 4750 7440 1300 30393 28205122 9 ii. Chowkidar 152 22 0 - 2500 13152 1157376 (Collector rate) 10 Other, if any (Give 108 101 5200 20200 2400 62061 25072644 details) Asst.Gr.II Total Expenditure 2971 2207 537079018 Note: The above calculations are based on mean of committed liability under salary head.

HONORARY WORKERS

II AWWs/AWHs No. in position Monthly Total honorarium paid in the Honorarium the Quarter (in lakhs)

(i) AWWs 41774 1500 Rs. 1592.93 (ii) Mini AWWs 5654 750 Rs. 117.62 (iii) AWHs 40799 750 Rs. 763.87 Total honorarium(in Quarter)(i) Rs. 2474.42

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PART-C

II (B). FINANCIAL Rs in lakhs

Total ICDS

1 Funds released during previous financial year (2010 - 11) 11717.92 2 Expenditure incurred in previous financial year (2010 - 11) 15796.62 3 Unutilized balance of previous financial year (1-2) 0 4 Excess expenditure incurred in previous financial year(2-1) 6688.57* 5 Funds released during the current financial Quarter 0.00 6 Cumulativ release including current Quarter 11913.28 7 Net Amount of Central funds available (Col.6 + Col.3 OR Col.6 - Col.4 as the 5224.71 case may be) 8 State Share available during the quarter 2379.29 Vhi %& o"kZ 2010&11 ds izkjaHk esa iwoZ o"kZ dk &2609-87 yk[k dk _.kkRed 'ks"k FkkA o"kZ 2010&11 esa izkIr vuqnku ls bl _.kkRed 'ks"k ds lek;kstu mijkar o"kZ 2010&11 ds var esa 6688-57 yk[k dk _.kkRed O;; FkkA

185 Chhattisgarh APIP 2012-13 Department of Women and Child Development

9 (a) Recurring expenditure incurred during the Quarter (Please give amount of Central share only) (90%) Rs in lakhs 9 Cumulativ quarter III upto the quarter III (i) Salary to regular employees (a) State Cell Rs. 12.45 50.17 (b) District Cell Rs. 40.45 148.55 (c) Project Rs. 1073.2 3871.09 Total 1126.1 4069.81 (ii) Honorarium to AWWs/ AWHs (a) AWWs Rs. 1433.64 4257.22 (b) AWHs Rs. 687.48 2081.12 (c) Mini AWWs Rs. 105.88 284.78 Total Rs. 2227 6623.12 (iii) POL Rs. 16.01 42.36 (iv) (a) Hiring of vehicles Nos. Rs. 4.34 5.01 (b) Purchase (NER States) No. Rs. 0 0.00 (v) Contingencies Rs. 92.85 122.50 (vi) Monitoring/Stationery Rs. 0.29 0.76 (vii) Flexi funds (give details) Rs. 144.38 297.47 (viii) Medicine Kits Nos. Rs. 0 0.00 (ix) Pre-school kit Nos. 34937 Rs. 0 0 (x) Uniforms Nos. Rs. 0 0 (xi) Badges Nos. Rs. 0 0 (xii) AWCs in rented(rent component) 0 0 premises Nos. 15365 Rs. 110.03 227.95

(xiii)I.E.C. (Give details) Rs. 21.54 26.54 Total 9 a (I to xiii) Rs. 3742.54 11415.52 b. Non-recurring expediture (give details) 0.00 (i) AWC level Rs. 0 0 (ii) State level Rs. 0 0 (iii) District Cell level Rs. 0 0 (iv) Project level Rs. 0 0 Total 9 b (i to iv) Rs. 0 0

Grand total 9 (a+b) Rs. 0 0 10 186 Funds remaining Chhattisgarh unutilized (alongAPIP 2012 with-13 reasons) Department Rs.of Women and Child Development (col. 7 - col. 9) 11 Excess expenditure (with reasons) Rs. 6190.81 6190.81 (col. 9 - col. 7)

Annual Statement of Expenditure for ICDS Scheme ICDS (General)

Name of the State /UT -- Chhattisgarh Financial Year - 2011-2012 PART -A ALLOCATION OF FUNDS IN STATE'S ANNUAL BUDGET FOR THE CURRENT YEAR

Central State

3- ICDS(General) Scheme Rs. 21426.41 Lakhs 2380.71 Lakhs

4- S.N.P. Rs. 21600.00 Lakhs 21600.00 Lakhs

UTILIZATION CERTIFICATE

Certified that out of the total amount of Rs.------Lakhs released under Integrated Child Development Services Scheme (General) during 2011 -2012 to the State/UT of Chhattisgarh by Government of India, a sum of Rs. ------Lakhs has been utilized as per schematic norms and for the same purpose for which the amount was released. The excess expenditure incurred by the State as on 31.03.2012 is Rs. ------lakhs.

Joint Director Joint Director(Finance) Commissioner

Woman & Child Development Women & Child Women & Child

Chhattisgarh Development Development

Chhattisgarh Chhattisgarh

187 Chhattisgarh APIP 2012-13 Department of Women and Child Development

PART -B Rs in Lakhs 1 Funds released during previous financial year Rs. 8992.46 2 Expenditure incurred in previous financial year Rs. 12051.94 3 Unutilized balance of previous financial year (1-2) Rs. 0 4 Excess expenditure incurred in previous financial year (2-1) Rs. 2627 5 Funds released in the current year Rs. 14068.71 6 Net amount of funds available (col 5 -col4) 11441.71 or (col.5 - col.3) as applicable Rs. 7 Expenditure during the year Rs. 13955.27 8 Unutilized Balance (col.6 - col. 7) Rs. 9 Excess expenditure (col. 7- col. 6) Rs. 2513.56 10 State Share available Rs. 2038.76

11 State Share spent Rs. 1550.59

FORMAT -V Period from 1 April 11 to 31 March 12 Financial Year 2011- 2012

Process Indicators _ ICDS (including SNP)

Budget Provision, Releases & Expenditure

7. Provision in the Budget of the State Central State (iii) For ICDS Rs. 32829.26 Lakhs 3647.69 Lakhs (iv) For S.N.P. Rs. 18600.00 Lakhs 18600.00 Lakhs

8. Funds released by GOI to State (With dates) Rs. in lakhs

188 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Quarter Details ICDS SNP Q1 F.No. 4-1/2009-CD-II (12-05-11) 3102.90 2887.85

Q2 F.No. 4-1/2009-CD-II (23-08-11) 4499.44 4305.77

Q3 F.No. 4-1/2011-CD-II (30-09-11) 4310.94 3831.67 Q4

Total 11913.28 11025.29 9. Funds released by State to the Department (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 4-Apr-11 24726.96 37200.00

Q2

Q3 Dec-11 11750.00 0

Q4

Total 36476.96 37200.00

4. Funds released by Department to the Directorate (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 4-Apr-11 24726.96 37200.00

Q2

Q3 11-Dec 11750.00 0

Q4

Total 36476.96 37200.00

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7. Funds released by Directorate to Disstricts/Blocks (With date) Rs. in lakhs

Quarter Details ICDS SNP Q1 1 Apr. to 30 June 2011 20018.70 13756.00

Q2 1 July to 30 Sep. 2011 375.05 558.98

Q3 1 Oct. to 31 Dec. 2011 544.21 8895.00

Q4 1 Jan. to 31 Mar. 2012 0.00 0.00

Total 20937.96 23209.98 8. Expenditure

Quarter Details ICDS SNP Q1 1 Apr. to 30 June 2011 2833.82 4210.26

Q2 1 July to 30 Sep. 2011 5691.70 7899.79

Q3 1 Oct. to 31 Dec. 2011 4158.38 5548.77

Q4 1 Jan. to 31 Mar. 2012 0 0

Total 12683.90 17658.82

Joint Director

Woman & Child Development

Chhattisgarh

190 Chhattisgarh APIP 2012-13 Department of Women and Child Development

Note: Expenditure till December 2011 is given here as we are in process of preparing expenditure report of the last quarter (Dec to March 2012) will share soon.

191 Chhattisgarh APIP 2012-13 Department of Women and Child Development