Utilization of Integrated Child Development Services in India: Programmatic Insights from National Family Health Survey, 2016

Sunil Rajpal, William Joe, Malavika A. Subramanyam, Rajan Sankar, Smriti Sharma, Alok Kumar, Rockli Kim and S. V. Subramanian
Additional contact information
Sunil Rajpal: Institute of Health Management Research, IIHMR University, Jaipur 302029, India
Malavika A. Subramanyam: Indian Institute of Technology, Gandhinagar 382355, India
Rajan Sankar: Tata Trusts, Mumbai 400005, India
Smriti Sharma: Tata Trusts, Mumbai 400005, India
Alok Kumar: NITI Aayog, Government of India, New Delhi 110001, India
Rockli Kim: Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul 02841, Korea
S. V. Subramanian: NITI Aayog, Government of India, New Delhi 110001, India

IJERPH, 2020, vol. 17, issue 9, 1-16

Abstract: The Integrated Child Development Services (ICDS) program launched in India in 1975 is one of the world’s largest flagship programs that aims to improve early childhood care and development via a range of healthcare, nutrition and early education services. The key to success of ICDS is in finding solutions to the historical challenges of geographic and socioeconomic inequalities in access to various services under this umbrella scheme. Using birth history data from the National Family Health Survey (Demographic and Health Survey), 2015–2016, this study presents (a) socioeconomic patterning in service uptake across rural and urban India, and (b) continuum in service utilization at three points (i.e., by mothers during pregnancy, by mothers while breastfeeding and by children aged 0–72 months) in India. We used an intersectional approach and ran a series multilevel logistic regression (random effects) models to understand patterning in utilization among mothers across socioeconomic groups. We also computed the area under the receiver operating characteristic curve (ROC-AUC) based on a logistic regression model to examine concordance between service utilization across three different points. The service utilization (any service) by mothers during pregnancy was about 20 percentage points higher for rural areas (60.5 percent; 95% CI: 60.3; 30.7) than urban areas (38.8 percent; 95% CI: 38.4; 39.1). We also found a lower uptake of services related to health and nutrition education during pregnancy (41.9 percent in rural) and early childcare (preschool) (42.4 percent). One in every two mother–child pairs did not avail any benefits from ICDS in urban areas. Estimates from random effects model revealed higher odds of utilization among schedule caste mothers from middle-class households in rural households. AUC estimates suggested a high concordance between service utilization by mothers and their children (AUC: 0.79 in rural; 0.84 in urban) implying a higher likelihood of continuum if service utilization commences at pregnancy.

Keywords: ICDS; child undernutrition; childcare; India (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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