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High Coverage and Utilization of Fortified Take-Home Rations among Children 6-35 Months of Age Provided through the
Magali Leyvraz1, James P Wirth2, Bradley A Woodruff2
1Global Alliance for Improved Nutrition, Geneva, Switzerland.
Insights
The Integrated Child Development Services (ICDS) program in Telangana provides Bal Amrutham, a fortified food, to young children. Coverage is high, but irregular supply and sharing hinder optimal utilization, despite the product meeting nutritional needs.
Area of Science:
- Public Health Nutrition
- Child Health Interventions
- Food Fortification Programs
Background:
- The Integrated Child Development Services (ICDS) program in Telangana, India, offers Bal Amrutham, a fortified complementary food, as take-home ration for children aged 6-35 months.
- Assessing program coverage, utilization, and associated barriers is crucial for understanding the impact of nutritional interventions.
Purpose of the Study:
- To estimate the coverage and utilization of the Bal Amrutham fortified food product.
- To identify barriers and drivers affecting the coverage and utilization of Bal Amrutham.
- To evaluate the role of ICDS services in the program's reach.
Main Methods:
- A two-stage, stratified cross-sectional cluster survey was conducted in randomly selected ICDS catchment areas.
- 1,077 children under 36 months were enrolled, with caregivers providing data via a validated questionnaire.
- Data collected focused on nutrition program coverage, including Bal Amrutham receipt and consumption.
Main Results:
- High awareness (93.7%) and receipt (86.8%) of Bal Amrutham were observed among caregivers.
- Regular consumption of Bal Amrutham was reported for 57.2% of surveyed children.
- ICDS services were accessible and utilized across urban/rural and poor/non-poor households; irregular supply and intra-household sharing were key barriers.
Conclusions:
- Bal Amrutham demonstrates wide availability, acceptance, and consumption within the target population served by ICDS.
- Improving the supply chain is essential to further increase the coverage of this vital fortified food product.
- Despite sharing, Bal Amrutham significantly contributes to the macro- and micronutrient intake of recipient children.
Abstract:
The Integrated Child Development Services (ICDS) in the State of Telangana, India, freely provides a fortified complementary food product, Bal Amrutham, as a take-home ration to children 6-35 months of age. In order to understand the potential for impact of any intervention, it is essential to assess coverage and utilization of the program and to address the barriers to its coverage and utilization. A two-stage, stratified cross-sectional cluster survey was conducted to estimate the coverage and utilization of Bal Amrutham and to identify their barriers and drivers. In randomly selected catchment areas of ICDS centers, children under 36 months of age were randomly selected. A questionnaire, constructed from different validated and standard modules and designed to collect coverage data on nutrition programs, was administered to caregivers. A total of 1,077 children were enrolled in the survey. The coverage of the fortified take-home ration was found to be high among the target population. Nearly all caregivers (93.7%) had heard of Bal Amrutham and 86.8% had already received the product for the target child. Among the children surveyed, 57.2% consumed the product regularly. The ICDS program's services were not found to be a barrier to product coverage. In fact, the ICDS program was found to be widely available, accessible, accepted, and utilized by the population in both urban and rural catchment areas, as well as among poor and non-poor households. However, two barriers to optimal coverage were found: the irregular supply of the product to the beneficiaries and the intra-household sharing of the product. Although sharing was common, the product was estimated to provide the target children with significant proportions of the daily requirements of macro- and micronutrients. Bal Amrutham is widely available, accepted, and consumed among the target population in the catchment areas of ICDS centers. The coverage of the product could be further increased by improving the supply chain.
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