Photos by Sudharak Olwe | Text by Priya Pathiyan
An airy room with plenty of floor space, scrupulously scrubbed clean. Everything from windows and doors to utensils neatly labelled. A row of identical bags with a child’s name tacked on each one hanging across one wall. A curtained-off area in the corner for playing hide-and-seek. In an adjoining room, a lady cooks a hot meal for the children, with mothers expected to arrive any minute. This is the typical scene every morning in almost 1.4 million Anganwadis across India.
These rural childcare centres were first introduced as far back as 1975 as part of the Integrated Child Development Services programme to combat child hunger and malnutrition. These centres provide supplementary nutrition, non-formal pre-school education, nutrition and health education and counselling, immunisation, health check-ups and referral services in conjunction with public health systems. The Anganwadi workers are the ones who make regular home visits in surrounding villages, keeping meticulous records of the health of adolescent girls, expectant mothers and children under the age of six years. They are the ones who spot those who need facility-based care and recommend admission to the district’s Nutrition Rehabilitation Centres.
The soft tinkle of glass bangles punctuates the hard discussions between the 27 women gathered in the Anganwadi centre on the outskirts of Rajnandgaon in Chhattisgarh. These Anganwadi Workers (AWWs), clad in red synthetic saris, come from surrounding villages, many of which fall in the Naxal Red Corridor. They report on the number of children who are in the red zone of Severe Acute Malnutrition (SAM) and which ones have moved to the less life-threatening Medium Acute Malnutrition category.
Mala Shahu, AWW from Junglepur, explains, “In most areas where food is scarce, the villagers depend on the mid-day meal we serve at Anganwadis. Where possible, we also provide Take Home Ration as well as Ready to Eat packets so that malnourished children can continue to have a wholesome diet through the day. Even a single egg daily can make a big difference, but at Rs 7 each, they are often beyond the reach of the villagers.”
Supervisors oversee the work of the AWWs and Anganwadi Helpers (AWHs), and themselves report to the Child Development Project Officer (CDPO). The workings of these centres are very carefully planned, with one day dedicated to weighing of babies, another to distributing iron pills to anaemic women, among other activities.
Mulko Beck, who has been working as a supervisor for 25 years, with the last four in the Manpur area of Chhattisgarh, points out, “It’s important that we involve the village panchayat and the men in these efforts. The most successful cases have come from places where the AWWs could make a connection and get everyone to work as a team. Else, 60 per cent of the tribals in our villages are still superstitious, which comes in the way of proper nutrition and medical care for women and children.” AWWs across the country work to dispel myths and educate the poor and disenfranchised about hygiene, progressive practices, their rights and access to medical care that they can avail of.
Despite this efficient and credible network exercising influence on such a large scale, the state of nutrition in India is still quite dismal. There are a number of reasons for this. While no one can fault the enthusiasm of the ladies who manage this grassroots system by sheer dint of will (they have to travel long distances into dangerous areas sometimes, and don’t even get a travel allowance), better training could go a long way. Not all women are adept at managing the numbers recorded in their registers. Some of them are not properly trained to check the weight of babies or to track the progress of a SAM child accurately. When new measuring equipment is sanctioned and delivered, there is often a gap between it being available and it being used as it can be daunting for some of the AWWs to master new technology.
Another aspect is the lack of monetary incentive for many women that belong to this workforce. In many states, they are awaiting revision of their pay in the hope of increments that will reward their dedication. Like Arpana Das, 31, who has been a Supervisor in Kharupetia, inside Assam’s Darrang district for the last eight years. Though young and enthusiastic, she is rather disillusioned at the moment, as she is among 986 other women who have not been paid their monthly salary of Rs 8,500 for the last six months. Despite being awarded Best District Supervisor in 2017, her job hasn’t been regularised by the State Government, despite an ultimatum being provided by the Centre. Jasmine Ara Begum, Supervisor in Khowang in the district of Dibrugarh, is vocal about how dire the situation is: “We work on the field against all odds, building a rapport with communities that are otherwise closed to outside interference, and don’t even get a salary to reward us for our hard work, nor reimbursements for travel or overtime. Not everyone has the cushion of a family who will support this and many capable women will start looking for other work.”
Low morale is another factor that affects the work of the Anganwadis. Often, when the state governments are unable to provide food, the AWWs are further demotivated with the feeling of helplessness in the face of the acute hunger and disappointment of the villagers who depend upon them. Dimbeshwari Hazarika, AWW at the Kalaigaon Anganwadi in a makeshift thatched hut in Assam’s Bodoland Territorial District, observes, “We haven’t been able to serve food for the last two months. The population here is mostly Tea Garden Labourers (TGL), who are migrants from Bihar or from local tribal communities. They are very poor and unable to feed their children and even we don’t have any rations to cook with for a large part of the year. Seeing the children so hungry is really heart-breaking and leaves us feeling so helpless.” Hazarika uses the time with the children in a constructive way, trying to teach the pre-schoolers some educational games and songs to keep them distracted.
There are many issues, but there is also an incredible collective will that keeps the Anganwadi women focused on what needs to be done. The community-based network has great potential for creating change and is also poised to step into a more modern avatar. Already, a few states have started to digitise the voluminous records and others plan to follow suit by introducing the ICDS-CAS scheme, which will involve training the AWWs to feed data into an integrated system via their mobile phones. It’s an ambitious plan to make an already efficient system even more useful, as the data collected can then be analysed and utilised better.