In 1975 the Government of India initiated an integrated approach for the delivery of health care as well as nutrition and education services for deprived populations at the village level and in urban slums through centres, each of which was run by a local part-time female worker (anganwadi) who was paid an honorarium and had a helper. This national programme, known as the Integrated Child Development Services (ICDS), began with 33 projects but, by March 1986, had expanded to 1611 projects covering 23% of the country's population and representing about 50% of the population in the socioeconomically backward areas. The ICDS can therefore be considered to function as a primary health care programme for preschool children (under 6 years old), pregnant women, and lactating mothers. The present study investigated the impact on the nutritional status of the target population after 3-5 years and after 8 years of ICDS interventions, compared with the nutritional status of non-ICDS (control) groups. The results showed that the ICDS nutrition intervention programmes achieved better coverage of the target population and led to a significant decline in malnutrition among preschool children in the ICDS population, compared with the non-ICDS groups that received nutrition, health care and education through separate programmes. This example may lead other developing countries to introduce integrated programmes with certain modifications to suit local conditions. International agencies and national governments should strive to bring about the integration of nutritional services with primary health care and development programmes for children because of the good results in terms of child survival and child development.
PIP: In response to India's undernutrition of preschoolers, pregnant women and lactating mothers, the Integrated Child Development Services (ICDS) program established better nutrition through primary health care. The project is divided into units which cover a community block either in a rural or tribal village area or an urban slum. Because the ICDS project areas are the poorest areas in the nation, health providers are able to reach those with the greatest nutritional need. The project was established by the government of India in 1975 and has achieved much success. In all the areas of undernutrition, including: deficiencies in protein, caloric intake, vitamin A and iron and folic acid, coverage improved through the supplementary food service. The program was successful in part because nutrient supplements were administered as part of a primary health care package. This integrated approach to nutrition was the impetus for a substantial decrease in malnutrition among preschool children. It is recognized that both community support and self reliance are key factors to success. It is recommended that developing countries, international agencies and national governments should implement such programs based on the success of the Indian experience.