A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

Abstract

Introduction: Proper functioning of Anganwadi Centres (AWCs) are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2) To measure the quantitative gap in coverage of beneficiaries. 3) To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs). Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73%) out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45%) enrolled children were availing food under Supplementary Nutrition Programme (SNP). Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10%) AWCs. Pre-School Education (PSE) materials, mainly in form of charts and posters were available at 47(94%) AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC) and Tetanus Toxoid (TT) to them. Only 955 (33%) out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA) supplementations to pregnant women were available at 25 (50%) AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.