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Utilization of Integrated Child Development Services (ICDS) and its linkages with undernutrition in India
Shri K Singh1, Alka Chauhan2, Harold Alderman2
1International Institute for Population Sciences, Mumbai, India.
Insights
Increased utilization of the Integrated Child Development Services (ICDS) program correlated with a reduction in underweight children in India. ICDS contributed modestly but significantly to addressing child malnutrition.
Area of Science:
- Public Health
- Nutrition Science
- Developmental Pediatrics
Background:
- Maternal and child malnutrition remains a significant public health challenge in India.
- The POSHAN Abhiyaan, a national nutrition mission, aims to combat malnutrition, with the Integrated Child Development Services (ICDS) program as a central component.
- Understanding the impact of ICDS utilization on child underweight is crucial for effective nutrition interventions.
Purpose of the Study:
- To examine the association between the utilization of the Integrated Child Development Services (ICDS) program and the prevalence of underweight among children aged 6-59 months in India.
- To assess changes in ICDS utilization and underweight prevalence at national and state levels between 2015-2016 and 2019-2021.
- To quantify the contribution of ICDS improvements to the reduction in child underweight.
Main Methods:
- Utilized data from the National Family Health Survey (NFHS-4 and NFHS-5) covering 2015-2016 and 2019-2021.
- Employed descriptive analyses to track ICDS utilization and underweight prevalence trends.
- Applied multivariable logistic regressions and difference-in-differences (DID) models to analyze factors associated with ICDS utilization and its impact on underweight, controlling for various characteristics.
Main Results:
- ICDS utilization rose from 58% in 2015-2016 to 71% in 2019-2021.
- The prevalence of underweight among children aged 6-59 months decreased from 37% to 32% during the same period.
- Decomposition of DID models indicated that enhanced ICDS utilization explained 9%-12% of the reduction in underweight children, with variations across states and demographic groups.
Conclusions:
- The Integrated Child Development Services (ICDS) program has shown a positive association with reduced child underweight in India.
- While modest, the contribution of ICDS to alleviating child malnutrition is meaningful and warrants continued focus and improvement.
- Further research into state-specific factors influencing ICDS effectiveness can optimize national nutrition strategies.
Abstract:
The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6-59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS-4 [2015-2016] and NFHS-5 [2019-2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference-in-differences (DID) approach. Utilization of ICDS increased from 58% in 2015-2016 to 71% in 2019-2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%-12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6-59 months in this period.
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