Learning from Models of ECCD Provision in India Dipa Sinha & Vandana Bhatia (presented to Kusuma Foundation) June 2009 Contents Acknowledgements .................................................................................................................... 2 Acronyms ................................................................................................................................... 3 Abstract ...................................................................................................................................... 5 1. Early Childhood Care and Development in India .................................................................. 6 Background ........................................................................................................................ 6 Importance of ECCD ......................................................................................................... 7 Status of Young Children in India ..................................................................................... 9 Policies and Programmes for Children under Six ............................................................ 11 2. Models of Provision of ECCD in the Government .............................................................. 16 Good Governance and Political Priority – ICDS in Tamil Nadu ..................................... 20 Maharashtra’s Mission against Malnutrition ................................................................... 29 3. Non-government models of ECCD provision...................................................................... 38 Towards Better Health and Nutrition – CINI .................................................................. 39 Every Child in School and Learning Well - Pratham ...................................................... 46 Child Care for ALL – Mobile Crèches ............................................................................ 54 Child Care for Working Mothers – SEWA...................................................................... 62 4. Lessons Learnt and Moving Forward .................................................................................. 69 Gaps in ICDS and Government Experiences ................................................................... 69 Learning from NGO Programmes ................................................................................... 72 Recommendations for Funding Support .......................................................................... 77 References ................................................................................................................................ 79 1 Acknowledgements This report would not have been possible without the support of the organisations whose work has been documented here. All of them generously hosted us by arranging for our field visits and sharing their experiences and documents with us. We thank the staff of all the organisations for helping us in this endeavour and also for all the wonderful work that they are doing for the rights of young children. The report is informed by our work with the Right to Food Campaign and the Commissioners to the Supreme Court of India in the last few years and learning from the various individuals involved in these two places. We would also like to thank the Kusuma Foundation for giving us this opportunity and Dr. Jean-Paul Faguet, Prof. Jean Dreze and Biraj Patnaik for their help and advice at different stages of the project. Dipa Sinha & Vandana Bhatia June 2009 2 Acronyms ABC: Achievement of Babies and Children ANM: Auxiliary Nurse Midwife ARI: Acute Respiratory Illnesses ASAT: Anchal Se Angan Tak ASHA: Accredited Social Health Activist AWH: Anganwadi Helper AWW: Anganwadi Worker BPNI: Breastfeeding Promotion Network of India BVS: Bal Vikas Samiti CBO: Community Based Organisation CDC: Child Development Centre CDPO: Child Development Project Officer CINI: Child in Need Institute CRC: Convention on the Rights of the Child ECCD: Early Child Care and Development ECCE: Early Childhood Care and Education ECE: Early Childhood Education FOCUS: Focus on Children Under Six FORCES: Forum for Crèches and Child Care Services GDP: Gross Domestic Product GHI: Global Hunger Index HBNC: Home Based New born Care HDI: Human Development Index HDR: Human Development Report IDA: International Development Association IFPRI: International Food Policy Research Institute IMNCI: Integrated Management of Neonatal and Childhood Illnesses IMR: Infant Mortality Rate INHP: Integrated Nutrition and Health Programme ISHI: India State Hunger Index JSY: Janini Suraksha Yojana MMR: Maternal Mortality Rate MO: Medical Officer MOHFW: Ministry of Health and Family Welfare NACP: National AIDS Control Programme NCAER: National Council of Applied Economic Research NCERT: National Council of Educational Research and Training NFHS: National Family Health Survey NGO: Non Government Organisation NHD: Nutrition and Health Days NHP: National Health Policy 3 NIPCCD: National Institute of Public Cooperation and Child Development NNM: National Nutrition Mission NNMB: National Nutrition Monitoring Bureau NPA: National Plan of Action NPE: National Policy on Education NRC: Nutrition Rehabilitation Centre NRHM: National Rural Health Mission NSS: National Sample Survey PHC: Primary Health Centre PT MGR NMP: Puratchi Talaivar M.G.R.Nutritious Meal Program RACHNA: Reproductive and Child Health Nutrition and HIV AIDS Programme RCH: Reproductive and Child Health SEWA: Self Employed Women’s Association SHG: Self Help Group SPAC: State Plan of Action for Children SPOA: Special Plan of Action SSA: Sarva Shiksha Abhiyaan TINP: Tamil Nadu Integrated Nutrition Programme UIP: Universal Immunisation Programme UNICEF: United Nations Children’s Fund UPA: United Progressive Alliance USAID: United States Agency for International Development WFP: World Food Programme WHO: World Health Organisation 4 Abstract Young children require care and nurture to grow into healthy and productive citizens. While there is extensive research showing the critical importance of interventions for children under six years, they are still a neglected group in public policy and action in India. In spite of unprecedented economic growth in the last two decades, India’s record in the provision of education and health in general, and especially early childhood care and development, is quite poor. Almost half the children under three years of age are underweight and more than 70% are anaemic. The infant mortality rate stands at 62 per 1000 live births in rural areas. Based on documenting successful efforts towards improving early childhood care and development (ECCD), the present paper builds a case for funding initiatives in the field of early childhood care and development (ECCD) in India. This paper documents six ‘models’ of intervention for ECCD in India. While two of these ‘models’, that of Integrated Child Development Services (ICDS) in Tamil Nadu and the Rajmata Jijau Mother Child Health and Nutrition Mission in Maharashtra are government programmes, the rest – Pratham, Mumbai; Mobile Crèches, Delhi; SEWA, Gujarat and CINI, West Bengal are NGO programmes. The paper also analyses the status of the ICDS, which is the single largest programme for ECCD in India. It is seen that although it has great potential, the ICDS programme is currently not very effective because of low coverage and poor implementation. However, the experiences of the ICDS in Tamil Nadu and Maharashtra show that the ICDS can be made to deliver, with political commitment and better investments. The NGO models show that for high quality, along with the right investments a programme that is providing early child care and development services must include community involvement, have a strong component of workers’ training, sufficient number of workers, a strong and supportive system of monitoring and supervision, understand mothers’ needs and be sufficiently decentralised and flexible to take into account different contexts. Finally, the report recommends that there is a need for further investments in the field of ECCD in India. This funding could be directed towards strengthening the ICDS, enhancing community participation, supporting local monitoring, building ‘models’ of child care, including models of crèches and investing in further research and documentation. 5 1. Early Childhood Care and Development in India Background Young children require care and nurture to grow into healthy and productive citizens. While there is extensive research showing the critical importance of interventions for children under six years, they are still a neglected group in public policy and action in developing countries like India. With high and stagnant levels of malnutrition in South Asia, including India, there is now an increasing focus among researchers, policy makers and development professionals across the world on what needs to be done for children of this age group in a country like India. The present paper builds a case for funding initiatives in the field of early childhood care and development (ECCD) in India. It is seen that India has an extensive network of public programmes to address ECCD needs in the country. However these are largely ineffective and need major overhauling. An analysis of the strengths and weaknesses of the existing programmes and studying successful experiences both within the government and the non- government sectors in India, can throw some light on the strategies that need to be undertaken to ensure