For verification of this paper, please visit on http://www.socialresearchfoundation.com/resonance.php#8

Early childhood development (ECD) has received significant global attention in the last decade[1], with research across low and middle-income countries (LMIC) showing that interventions delivered in the first three years of life are effective in improving ECD outcomes[2]. Despite this, millions of children under five years residing in LMICs are at risk of not reaching their development potential because of poverty, poor health, nutrition, and suboptimal care[3]. India has responded to needs of young children through different approaches[4], largest being the Integrated Child Development Services (ICDS) Scheme[5]. With children up to six years, pregnant and lactating women as its beneficiaries, the strength of ICDS is its ability to reach the remotest areas of the country[6]. The scheme is implemented through platforms called Anganwadi Centres (AWC) managed by Anganwadi Workers (AWW), mandated to support ICDS activities and associated administrative work[7]. An initiative implemented since 2018 in ICDS is Poshan Abhiyaan or National Nutrition Mission which strives to reduce rates of stunting, under-nutrition, anaemia and low birth weight by linking and monitoring different nutrition schemes for children[8]. Any programme involving AWWs has to understand their time utilization, especially since they often deliver multiple programmes9. Research conducted on AWW time use and challenges of their work, using observations, interviews, or both[9–13] has found that they are able to spend only 54% of their time on core responsibilities of pre-school education and home visits with substantial burden of record maintenance[10, 11]. A third of the AWWs feel weighed down because of their involvement in national health programmes and election duties, in addition to routine responsibilities[9]. AWWs also report dissatisfaction with low honorarium, delay in receiving funds, inadequate infrastructure, scarcity of play materials, lack of regular refresher trainings and spending a significant amount of time ensuring that the AWC is clean and has drinking water[10–13]. Key challenges within ICDS include inadequate emphasis on behaviour change activities, infrequent home visits, lack of respect accorded to AWWs and insufficient focus on children in the zero-three years age6 . As a result, ICDS in many parts of the country is being administered more as a “welfare support than (a) developmental activity”4(p.232). Studies in India have found implementation of integrated nutrition and early learning interventions through ICDS feasible[14]. A Scalable Programme Incorporating ECD Interventions (ASPIRE), developed by Sangath in collaboration with UNICEF and Department of Women Development and Child Welfare (DWDCW) Telangana intends to develop, implement, and evaluate a video based intervention integrating nutrition and responsive caregiving in the first 1000 days of life in the south Indian state of Telangana. The intervention will be embedded into ICDS and delivered by AWWs who are already trained on delivering messages via videos using the Common Application Software (CAS), which enables Real Time Monitoring (ICT-RTM) of service delivery under the Poshan Abhiyaan [15]. This study describes the Socio-Economic and Demographic characteristics of the Anganwadi Workers and the Problems encountered by Anganwadi workers at Anganwadi Centres in the study area.

Padmaja Ravula, et al, (2022)[16] Tribal population – especially pregnant and lactating women are susceptible to undernutrition because of low socio-economic, cultural norms and practices regarding dietary habits and practices, market access and availability. Nutrition knowledge, attitudes and practices (KAP) studies offer an opportunity to better understand the socio-cultural-psychological-behavioural determinants of nutrition, providing an evidence for planning knowledge interventions. This paper aims to assess nutrition KAP during pregnancy and lactation in selected locations of Adilabad and KomaramBheem-Asifabad districts of Telangana, India. Methods A cross sectional KAP baseline survey was conducted on 358 individuals in the selected locations during February-March 2020. Tablet based data collection was implemented for pregnant and lactating mothers, and frontline workers (Anganwadi workers, School teachers and Accredited Social Health Activist - ASHA workers). Data was validated, coded and analyzed using STATA. Alongside descriptive statistics, differential weightage method was adopted to generate the knowledge, attitudes and practices scores for the respondents. The nutrition knowledge of pregnant and lactating mothers was inadequate less than 50 percent across all the respondents (table 1). Attitudes translate into practices, however the baseline data revealed that all categories of respondents were not adopting appropriate dietary and nutrition practices. The inadequate knowledge by all categories of respondents indicates a gap in nutrition literacy and education. It is planned to co-design, co-create innovative approaches to improve nutrition knowledge through nutrition messaging for a transformative behavior change about nutrition, healthy diets, dietary behaviors and practices.

Dr. D. Suresh, et al, (2020)[17] Integrated Child Development Service (ICDS) scheme is the most important nutritional programme in the field of child welfare. Its effectiveness depends upon the efficiency of its functionaries at grass root level i.e., Anganwadi workers (AWW). AWW assumes a pivotal role due to her close and continuous contact with the beneficiaries children grow and develop amazingly. AWWs was not able to work as per the activities specified in the recommended time as records maintenance consumed a lot of time i.e. three times more than the recommended time. Low honorarium, register work, meeting out of duty hours, short attendance of children and adolescent girls, not adequate space in Anganwadi centre (AWC), no government building for AWC were some of the problems reported by AWW. AWWs were unable to render services as per the recommended time because considerable time was spent in maintaining records and other activities.

Biranchi Narayan Das et al (2018)[11] Antenatal care is the essential health care extended to pregnant women. Complete antenatal health care includes four antenatal visits, 2 TT injections, and consumption of 100 Iron and Folic acid tablets. In Telangana state the proportion of mothers received full ante natal care in rural area is only 37.3%. Hence, the present study conducted with an objective to assess the factors associated with utilization of antenatal care services among rural women in Telangana state.  The study is a community based cross sectional study. It was conducted in villages of MoinabadMandal of Telangana state. Sample size was calculated to 373.Out of 26 villages 20 villages were chosen randomly and from each village 20 houses were selected by stratified random method. Married women delivered at least one child during last five years were included. Pretested questionnaire was administered.  The data were tabulated in MS Excel and analyzed by SPSS. Among 373 participants, 89.3% mothers registered during 1st trimester, 92.8% confirmed their pregnancy in the Government sector, 81.3% mothers had four or more antenatal visits, nearly 87.7% mothers received two doses of TT and 77.2% had taken more than 100 Iron tablets. Awareness should be made by the ASHA workers, ANMs and Anganwadi workers through better education and motivation of the target groups such as young mothers, homemakers, low socio-economic status groups and late registered mothers for better utilization.

Tarun Naik et al (2020)[18] Malnutrition is one of the serious health problems in children. Malnourished children are more prone to frequent illness. This adversely affects their nutritional status, faltering growth and diminished learning ability. India adapted the integrated management of childhood illness strategy aiming to reduce its newborn and infant mortality burden and the main objective of the study was the orientation of anganwadi workers on IMNCI in malnutrition. Subjects and The study was observational and conducted jagdalpur Chhattisgarh. Only those who fully satisfied both the inclusion and exclusion criteria were included in the study. Permission from institutional ethics committee was obtained. Selection criteria in the present study were all children in the Anganwadi in a defined area. PEM cases are more compared to controls, Malnutrition is seen in below 5 years of age group in children and more in cases group than the control group. In cases group it was 360 and control group it was 240.In 0 – 2 months of age malnutrition is more in cases than controls. Anganwadi workers were trained based on IMNCI and asked to educate mothers regarding health, nutrition and care seeking during illness of the children.

Five AWCs were selected from one district randomly. Detailed information about various nutritional activities including growth monitoring, information related to preschool education (PSE), and nutrition and health education (NHED) were collected. Growth chart was present in 96.7% AWCs and accurately plotted by Anganwadi workers (AWWs) in 95.0% AWCs. Weight monitoring of children was done by using Salter scale/spring balance in 75.0% AWCs, followed by weighing pan (18.3%). Overall 18.5% moderately malnourished and 1.5% severely malnourished children were reported. PSE material was available only in 35.0% AWCs. Only in one‐third AWCs, NHED training material was available in adequate quantity. Conclusion: There were gaps in the status of PSE activities in AWCs, which needs to be promptly addressed. The need for PSE should be emphasized to all AWWs. There was also a shortage of supply of PSE and NHED material at the AWCs suggesting need of regular supply of material.

(a) Sources of data The present study was planned to evaluate the performance of Anganwadi Centers under ICDS in Telangana. The study has been conducted in sample districts from three regions of Telangana state of India by adopting two-stage stratified random sampling procedure. A list of Anganwadi centers covered by Women Development and Child Welfare Department, in urban as well as rural areas, was obtained from the Directorate, Department of Women Development and Child Welfare, Government of Telangana, Hyderabad. As a first stage, one district from each of the three regions was selected on the basis of the highest number of AWCs are available. The districts selected were Nalgonda, Bhadradri-Kothagudem, and Khammam. At the second stage, from each district 5% of the AWCs located in urban and rural areas were selected, and one child beneficiary from three different age groups was chosen as sample respondents. (b) Sample Design Sample Design Multistage Stratified Random Sampling Method 1st State: Districts; Criteria - Highest number of AWCs - 3 2nd Stage: Mandals; Criteria - Highest number of AWCs - 3 3rd Stage: Villages; Criteria - Highest number of AWCs - 15 4th Stage: Sample Respondents (AWWs) - 5% of AWCs in 3 districts - 283 (c) Period of study Secondary data has been collected for a period of ten years i.e., ten calendar years from 2010 to 2020, while primary data has been collected from respondents for a period of one year i.e., 2021. (d) Statistical techniques chosen Simple mathematical computations like ratios, percentages and growth rates are used to assess the data that had been collected; and also used Chi-Square Test for Hypotheses testing. (e) Limitations of the Study: Our research study is confined only to selected sample districts. Secondary data is also collected and limited for a restricted period of time. Information collected through pre-structured schedule is purely based on memory of the respondents. Thus, the conclusions and results can be applied with caution for the policy purpose.

6(a) Sources of data

The present study was planned to evaluate the performance of Anganwadi Centers under ICDS in Telangana. The study has been conducted in sample districts from three regions of Telangana state of India by adopting two-stage stratified random sampling procedure. A list of Anganwadi centers covered by Women Development and Child Welfare Department, in urban as well as rural areas, was obtained from the Directorate, Department of Women Development and Child Welfare, Government of Telangana, Hyderabad.

As a first stage, one district from each of the three regions was selected on the basis of the highest number of AWCs are available. The districts selected were Nalgonda, Bhadradri-Kothagudem, and Khammam.

At the second stage, from each district 5% of the AWCs located in urban and rural areas were selected, and one child beneficiary from three different age groups was chosen as sample respondents.

6(b) Sample Design

Sample Design

Multistage Stratified Random Sampling Method

1^st State:     Districts; Criteria - Highest number of AWCs - 3

2^nd Stage:   Mandals; Criteria - Highest number of AWCs - 3

3^rd Stage:   Villages; Criteria - Highest number of AWCs - 15

4^th Stage:   Sample Respondents (AWWs) - 5% of AWCs in 3 districts - 283

 Sample Respondents (AWBs) - 3 child beneficiaries from each AWC - 849

6(c) Period of study

Secondary data has been collected for a period of ten years i.e., ten calendar years from 2010 to 2020, while primary data has been collected from respondents for a period of one year i.e., 2021.

6(d) Statistical techniques chosen

Simple mathematical computations like ratios, percentages and growth rates are used to assess the data that had been collected; and also used Chi-Square Test for Hypotheses testing.

6(e) Limitations of the Study:

Our research study is confined only to selected sample districts. Secondary data is also collected and limited for a restricted period of time. Information collected through pre-structured schedule is purely based on memory of the respondents. Thus, the conclusions and results can be applied with caution for the policy purpose.

Socio-Economic Characteristics of Anganwadi Workers in Bhadradri Kothagudem, Nalgonda and Nizamabad Districts of Telangana:

This section is filled with the analysis related to socio-economic status of sample Anganwadi Workers among the three sample districts. The data furnished in each table shows that the total number of Anganwadi Centers in the three sample districts of the state of Telangana recorded are 5653 of which, 5 percent of them were chosen as sample Anganwadi Centers and Anganwadi Workers. Number of sample Anganwadi Centers (5%) are coming to 283. Since we selected one Anganwadi Worker from each sample Anganwadi Center, it is coming to 283 Anganwadi Workers as sample size in this research work. Out of 283 Anganwadi Workers, 103 Workers were drawn from Bhadradri Kothagudem district, 105 Workers were drawn from Nalgonda district and the remaining 75 Anganwadi Workers drawn from Nizamabad district.

Analysis in the following is presented by taking objectives as the base. Information furnished in the first table is related with the first objective and second table is concerned with second objective so on and so forth. Here, in this seminar paper, analysis is confined only at aggregate level but not included the district-wise analysis.

Table 1: Socio-Economic Characteristics of Anganwadi Workers in the Study Area

Source: Field Study

*Figures in the bracket represent percentages.

Information furnished in the table is related to socio-economic characteristics of Anganwadi Workers. We covered age, education, social status, marital status, religion, type of family, family members and family income under socio-economic characteristics.

Results reveal that in the study, out of 283 sample Anganwadi Workers, about 84 Percent of them fall in the age group of between 41-50 years, but only 16 percent Anganwadi Workers age was recorded between 18-35 years.  We can say that higher-aged Anganwadi Workers may perform better than the lower-aged workers. The results of a study (1) reveal that the higher-aged Anganwadi Workers perform better. This may be because relatively lower-aged Anganwadi Workers suffer from family hazard more and they may suffer from lack of job satisfaction which decreases the level of perfection in their activities for Anganwadi Centers. For younger Anganwadi workers, the opportunity cost for this job is higher than that for older. So, older serve their services more minutely than younger ones.

As regards educational qualification is concerned, about 72 percent of Anganwadi Workers were having up to Intermediate as education qualification and the remaining about 28 percent of them are having Degree as their educational qualification. Though minimum qualification required is only SSC but persons with higher education are working as Anganwadi workers.

If we look into the social status of them, the highest number (148) of the Anganwadi Workers belong to the Scheduled Caste which is accounting to about 53 percent and the next highest number (75) of them or about 27 percent belonged to Backward Classes whereas only 60 sample Anganwadi Workers or about 22 percent belonged to Other Caste. Our results are in consonance with a study by D Suresh (2).

With regard to marital status position, about 84 Percent of Anganwadi Workers are (238) married and about 10 Percent or 30 Anganwadi Workers are un-married or single women workers. These figures are in consonance with the figures of the Evaluation Report, 2011 on ICDS, New-Delhi. One more important observation is that married worker may inversely and unmarried worker may directly correlate with performance. Here also comes the concept of family disturbance in the form of dependence (like child caring). So, due to the freeness from dependence unmarried workers pay more attention to their duties. Therefore, in several cases family hazards appear as an important obstacle against better performance of Anganwadi Centers. So, it may be considered as a derivative factor for low performance of the programme.

Religion results show that out of the 283 sample Anganwadi workers, the majority of them i.e. 243 (85.86%) belong to Hindu religion whereas 34 (12.01%) are Muslims and the rest of the one person belonged to Christian religion.

Regarding the type of family details, it reveals that majority of the sample Anganwadi workers have joint families whereas minority portion of them have nuclear families. At the aggregate level, 176 (62.19%) of the sample Anganwadi workers have joint families whereas 107 (37.80%) of them have nuclear families.

As regards to family members information exhibits that at aggregate level, in all the sample districts together, most of the Anganwadi Workers have a 4-member family. On the whole, 283 Anganwadi worker families, 154 worker families (54%) are having four family members followed by 68 Workers families are having more than 5 members and more, 51 Workers are with 3 members and 10 Anganwadi Workers are with 2 members as family members.

Income earned per month results reveal that out of 283 Anganwadi Workers, the highest number (105) of the sample Anganwadi Workers, whose income per month ranges between Rs. 15,000/- to Rs.20,000/- share is 37.10% among all the other income group people in the study area. Anganwadi Workers who fall in the income group between of Rs. 20,000/- to Rs. 25,000/- are 79 and which is accounting to 27.19% followed by 54 Anganwadi Workers whose income range is between Rs 10,000 to Rs 15,000 and their share is 19.08% and with above Rs 25,000 income per month 45 Workers with 15.90% share stands in the highest income position relative to other Workers in other income groups in the study area.

Table 4: Problems faced by Anganwadi Workers

Source: Field Study

*Figures in the bracket represent percentages.

Information furnished in the table shows that the problems encountered by Anganwadi workers like travelling distance from home to centre, mode of transport, lags in payment of honorarium and nature of work, etc. It is clear from the data in table that about 36% of the Anganwadi Workers only are residing at the distance between 2 and 6 kilometers; and the remaining 64% of them are travelling only within the distance of up to 2 kilometers. It means that majority of them are reading nearer to their respective Anganwadi Centers. If Anganwadi workers reside faraway from Anganwadi Center, she may devote more time in their duty since they are free from family matters during the time of service vice-versa.

Due to not having their own transport facility, Anganwadi workers may not reach in time to centre but here about 55% of Anganwadi worker reach by walk and the remaining 45% of them reach by two wheelers. It is to be noted that there is no provision of finance to purchase motor bike so that Anganwadi Workers have to arrange their own mode of transport to reach their respective Centers.

On our enquiry whether Anganwadi worker is satisfied with their nature of work, majority of them i.e., 83% Anganwadi Workers are having moderate and low level of satisfaction and the remaining 17% of them are highly satisfied with their nature of work and work load. The reason for dissatisfaction is that they have to maintain various records of child growth, nutrition status of beneficiaries, take home rations, referral services, pregnant and lactating mothers, health checkup records, Village Health Nutrition Day records, etc. Their work involves daily home visits, a lot of record maintenance or they have to assist other departments. They have been engaged in other departmental works like socio-economic census, National Rural Health Mission works, Nutrition Rehabilitation Center works, Health, etc. They have to maintain Twenty six registrar like, Survey registers, Attendance registers, Pregnant mothers’ registers, Weight growth registers, Inventory registers, Premix registers, Stock registers, etc. These paper works have to be done daily basis, weekly basis and some have to be done monthly basis.

With regard to lags in payment of honorarium, majority Anganwadi Workers are happy for timely payment of honorarium but meager percentage of them expressed unhappiness for lag in honorarium payment. But majority of them felt that they are not given sufficient honorarium for their work and the government exploited them. Most of them expressed that salary which they receive is too less in comparison to the responsibilities assigned to them.

We conducted a Chi Square Test to know whether Null Hypothesis is Rejected or Accepted. Null Hypothesis is “There is no association between the problems faced by Anganwadi worker and their level of satisfaction with their nature of work and work load”

Results are as follows:

Chi-Square = 54.098, df = 1,

Computed value = 54.098 which is higher than table value of 3.841.

Null Hypothesis is rejected

Therefore, there is a significant relationship between problems faced by the Anganwadi Workers and the level of satisfaction of the Anganwadi Workers.

1. Daelmans B, Darmstadt GL, Lombardi J, et al. Early Childhood Development: The Foundation of Sustainable Development. The Lancet. 2017; 389 (10064): 9-11. doi: 10.1016/S0140-6736(16)31659-2
2. Jeong J, Franchett EE, Ramos de Oliveira CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. Persson LÅ, ed. PLOS Med. 2021;18(5):e1003602. doi:10.1371/journal.pmed.1003602
3. Lu C, Black MM, Richter LM. Risk of poor development in young children in lowincome and middle-income countries: an estimation and analysis at the global, regional, and country level. Lancet Glob Health. 2016;4(12):e916-e922. doi:10.1016/S2214-109X(16)30266-2
4. Nair MKC, Radhakrishnan R. Early Childhood Development in Deprived Urban Settlements. Indian Pediatr. 2004;41:227-237.
5. Ministry of Women & Child Development, India. Integrated Child Development Services (ICDS) scheme. Published 2009. Accessed November 18, 2021. https://icds-wcd.nic.in/icds.aspx
6. Kapil U. Integrated child development services (ICDS) scheme: A program for holistic development of children in India. Indian J Pediatr. 2002;69(7):597-601. Doi:10.1007/BF02722688
7. National Institute of Public Cooperation and Child Development. Handbook for Anganwadi Workers. Published online 2006. https://www.nipccd.nic.in/file/syllabi/eaw.pdf
8. Poshan Abhiyaan | NITI Aayog. Accessed March 23, 2022. https://www.niti.gov.in/poshan-abhiyaan
9. Desai G, Pandit N. Changing role of Anganwadi workers, A study conducted in Vadodara district. Healthline. 2012;3(1):41-44.
10. Joshi K. Knowledge of Anganwadi workers and their problems in Rural ICDS block. IP Journal of Paediatrics and Nursing Science. 2018;1(1):8-14.
11. Kaur D, Thakur M, Singh A, Saini SK. Workload and perceived constraints of Anganwadi workers. Nursing and Midwifery Research Journal. 2016;12(1):18-24.
12. Sahoo J. Operational Assessment of ICDS Scheme at Grass Root Level in a Rural Area of Eastern India: Time to Introspect. J Clin Diagn Res. 2016;10(12):LC28-LC32. doi:10.7860/JCDR/2016/23059.9041
13. Qadiri F, Manhas S. Nature of Pre-School Education Imparted at Anganwadi Centre. Shodh Samiksha Aur Mulyankan Int Res J. 2009;2(7):135-138.
14. Fernandez-Rao S, Hurley KM, Nair KM, et al. Integrating nutrition and early childdevelopment interventions among infants and preschoolers in rural India: Integrated nutrition and ECD interventions. Ann N Y Acad Sci. 2014;1308(1):218- 231. doi:10.1111/nyas.12278
15. Ministry of Women and Child Development Government of India. Guidelines for implementation of ICT-RTM system. Published online 2018. Accessed November 18, 2021. https://icds-wcd.nic.in/nnm/NNM-Web-Contents/LEFT-MENU/ICT-RTM/Guidelines_for_ICT-RTM_English.pdf
16. Khan Z, Hasan J. A profile of Anganwadi Workers in Jawan .Block of district Aligarh, Uttar Pradesh. Indian Journal of Community Medicine. 1992;17:58-62. 5. Seema TN. Performance of Anganwadi Centers
17. SOCIO-ECONOMIC FACTORS BEHIND UN-SATISFACTORY PERFORMANCE OF ANGANWADI CENTERS UNDER ICDS PROGRAMME IN INDIA Sudeshna Saha1 , Dr. Bikash Saha, EPRA International Journal of Multidisciplinary Research (IJMR) - Peer Reviewed Journal Volume: 7 | Issue: 6 | June 2021|| Journal DOI: 10.36713/epra2013 || SJIF Impact Factor 2021: 8.047 || ISI Value: 1.188 2021 EPRA IJMR | www.eprajournals.com | Journal DOI URL: https://doi.org/10.36713/epra2013 46
18. Dr D Suresh etal., “WORKLOAD AND PROBLEMS OF ANGANWADI WORKERS IN TELANGANA STATE – A STUDY” SPWI JOURNAL FOR SOCIAL WELFARE, (A Multi Disciplinary Peer-Review Bi-Quarterly Social Science Research Journal) Volume : 3 Issue : 1 January-March 2020
19. Nagaraj GM, Muninarayana C, Anil NS, Avishankar S. The profile of Anganwadi Workers and their working conditions in Kolar District. Indian J Practising Doc. 2011;6:7-10.
20. Thakur K, Chauhan HS, Gupta NL, Thakur P, Malla D. A study to assess the knowledge & practices of Anganwadi Workers & availability of infrastructure in ICDS Program, at District Mandi of Himachal Pradesh.
21. Prudhviraj, K.,etal.,(2022). Gopal, B. S., Jahnavi, K., Parusuram, J. B., & Sitarama, A. (2022). “A cross sectional study on assessment of infrastructure and facilities at Anganwadi centres of Vijayawada” International Journal of Health Sciences, 6(S3), 309723107. https://doi.org/10.53730/ijhs.v6nS3.6308 22. Prudhviraj, K., etal (2022). Gopal, B. S., Jahnavi, K., Parusuram, J. B., & Sitarama, A. (2022). A cross sectional study on assessment of infrastructure and facilities at Anganwadi centres of Vijayawada. International Journal of Health Sciences, 6(S3), 309723107. https://doi.org/10.53730/ijhs.v6nS3.6308 International Journal of Health Sciences ISSN 2550-6978 E-ISSN 2550-696X © 2022. Corresponding author: Parasuram, J. B. Manuscript submitted: 18 Dec 2021, Manuscript revised: 27 March 2022, Accepted for publication: 09 April 2022 3097