In 1975, the Indian government launched the world’s largest community-based programme for child development, the Integrated Child Development Services Scheme (ICDSS). At the foundation of this programme is the concept of early childhood education and care (ECCE), which in turn is delivered by India’s Anganwadi system—a system consisting of a workforce of 1.4 million women. The responsibilities these women take on are immense. They are not only responsible for delivering healthcare support to children at India’s rural grassroots, but also provide psycho-emotional and social development support, including counselling, guidance, immunisation, and data collection.
So how do these women receive their training, and in turn impart health education and awareness to millions of children every year? Do they have everything they need to perform at their level-best, so that the ICDSS is a success? Here’s everything you need to know.
The Challenges Of Working At Grassroots Level
According to statistics, there are over 13.7 lakh Anganwadi centres across India. Each of these centres, which are located in villages, is considered to be the basis of the Indian healthcare system—the frontier where the usually marginalised aspire to better civic amenities. In fact, so crucial is their role that it wouldn’t be wrong to say that Anganwadi women are the frontline workers waging India’s constant and uphill battle against malnutrition and diseases. Not only do these women impart basic nutrition education, but also counsel mothers and women in general about how to use contraceptives. The following are the key responsibilities of every Anganwadi centre:
• Providing non-formal pre-school education.
• Providing basic and supplementary nutrition, as well as nutrition and health education.
• Conducting immunisation drives against major diseases like measles, chicken pox and polio.
• Providing basic medicines and contraceptives at a subsidised government rate (usually free).
• Conducting regular health checkups and collecting grassroots-level data about maternal health, maternal mortality, infant and child development, infant mortality, child mortality, etc.
To be able to take charge of these responsibilities, the Anganwadi workers go through an intensive, though short, training under the guidelines set by the Ministry of Women and Child Development. The training usually lasts 26 days, and involves empowering the workers with a comprehensive knowledge of the government’s Acts, policies, schemes and programmes related to women and child development—and how to deploy them properly for the benefit of a grassroots community. The women are taught modules of key aspects of healthcare delivery, including early childhood care and education, basic nutrition, community mobilisation, health awareness and advocacy, etc.
How The POSHAN Abhiyaan Helps Anganwadi Women
In addition to the above-mentioned training, Anganwadi’s women workers are now also empowered by the Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN) Abhiyaan. Launched in 2018, the POSHAN Abhiyaan has the vision of achieving a malnutrition-free India by 2022 (a target which has certainly been derailed due to the COVID-19 pandemic). Realising that the Anganwadi workers are a key part of the health delivery system in a nation which still faces a huge dearth of doctors and healthcare professionals—as we all clearly realised during the COVID-19 pandemic—a major target of the POSHAN Abhiyaan is to improve the quality and delivery of Anganwadi services by providing further and in-depth training to its huge female workforce.
Since the POSHAN Abhiyaan focuses on providing holistic development and nutrition opportunities to mothers, pregnant women and children (especially between the ages of zero to six years), creating a synergy and equal implementation of various government healthcare and development schemes is a necessity. To make this possible, the POASHAN Abhiyaan launched an Incremental Learning Approach (ILA) to build the capacity of frontline Anganwadi workers. The ILA consists of a number of thematic modules, each of which needs to be mastered before moving on to the next. A further effort is being made to empower Anganwadi workers with digital devices, an effort which may also bridge the rural-urban digital divide. Under this programme, the frontline workers are given practical training on how to use smartphones, especially for data collection and accuracy through the ICDS-CAS software app.
Unequal Pay For Anganwadi Workers?
While all of these training and upskilling details sound impressive on paper, the fact remains that just like India’s Accredited Social Health Activists (ASHA) workers, Anganwadi workers too several obstacles that come in the way of accomplishing their jobs. Working at the grassroots level is anyways difficult because services and amenities don’t reach these rural pockets on time—and often, as during the pandemic, ASHA and Anganwadi workers are left with very little means and even lesser support to do their work effectively and efficiently.
A 2018 report in the Indian Development Review reveals that though Anganwadi workers are charged with the critical task of conducting surveys and data collection, the collected data isn’t properly digitised. This is partially due to immense backlogs which cannot humanly be digitised by the same workforce engaged in other activities, and partially because of a general lack of digital literacy and empowerment among the workers themselves. The POSHAN Abhiyaan has offered Anganwadi workers an additional incentive of ₹500 per month to actively use smartphones to collect real time data, but the implementation of this offer is not on record.
But perhaps the biggest obstacle faced by Anganwadi workers is the unequal rates of pay they receive across the country. Since the pay structure differs from state to state, there are many regions where Anganwadi workers and their helpers aren’t paid enough to keep them motivated to continue their work. For example, the Delhi government revised its Anganwadi worker pay in 2022 from ₹9,678 to ₹12,720 per month—making it the highest pay for this job in the country. In states like Uttar Pradesh, Gujarat and Karnataka, the pay ranges from ₹7,800 to ₹8,000 per month. In Maharashtra, the pay is ₹8,666, while in Kerala, Telangana, Tamil Nadu and Haryana, it’s upwards of ₹10,000 per month.
Without a structured, equal pay system; without digital literacy in a world revolutionised by the internet and digital devices; without a more in-depth training and education themselves: India’s Anganwadi women are working dedicatedly despite so many obstacles to ensure that we do indeed overcome healthcare issues like malnutrition, infant and child health, and maternal health. It’s high time this invisible force of women got the attention they need and deserve.