Eleventh Five Year Plan

142 Eleventh Five Year Plan(in 2005–06). If Indian mothers enhance earlyinitiation of breastfeeding within one hour, we cansave 250000 babies from death annually by just thisaction; this would reduce the overwhelming shareof neonatal mortality in our IMR.• Exclusive breastfeeding for six months is necessary toavoid unnecessary infections to the baby, developthe baby’s immunity, and ensure growth. Only46% of Indian babies are exclusively breastfed; theremaining half is exposed to unhygienic methodsof feeding (see Annexure 4.1.2).• Solid food six months on. The baby must begin toreceive solid, mushy food at 6 months (i.e. togetherwith breastfeeds) for the baby to continue to growin the way nature intended her to grow. Only 56%of mothers introduce appropriate solid, mushy foodin a timely manner after 6 months. Not surprisingthat NFHS-2 data shows that the proportion ofunderweight children rises from 16% to more than60% between the ages of 6 months and 2 years. Thismalnutrition also affects the mental developmentof the child for life. About 90% of the developmentof the brain takes place before a child reaches theage of two years (see Annexure 4.1.2).4.1.68 The ICDS scheme accordingly needs to berestructured in a manner that addresses some of theweaknesses that have emerged and is suitable foruniversalization. The programme must effectivelyintegrate the different elements that affect nutritionand reflect the different needs of children in differentage groups. For the purpose the programme needs tobe restructured in a Mission Mode with a MissionStructure at the central level and a similar structure atthe State level. The Ministry of Women and ChildDevelopment (MoWCD) will prepare proposals forrestructuring along the following lines so that therestructured programme can become effective on 1April 2008.• 0–3 year old children. Without prejudicing theinterest of the 3–6 year olds, the focus of the entireICDS has to shift to a much greater extent thanbefore to the 0–3-year-olds. The AWWs in allanganwadi centres could focus on children underthree years of age, pregnant, and lactating mothers.The tasks of this AWW would include breastfeedingcounselling, nutrition and health education andcounselling to ensure solid, mushy food is introducedby six months to all infants, growth monitoring,provision of SNP to children in the sixmonths to three years age group and pregnant andlactating mothers, and motivation for ANC, immunization,and related matters.• 3–6 years. At present SNP is provided to children inthe age group of 3–6 years. A major factor adverselyaffecting the success of ICDS is leakages which atleast in part is due to centralized procurement ofready to eat (RTE) foods. Centralized procurementof food has the additional problem of irregular supplyof food in the anganwadis, and thrusting fooditems on beneficiaries irrespective of their taste andpreferences. Very often this leads to non-acceptanceor rejection of the food distributed. The fooddistributed has to be hygienically prepared andculturally acceptable. Some States, for exampleTamil Nadu and Maharashtra, are successfully servinghot cooked meals.• Accordingly, it is necessary that the existing mechanismof fund flow to States for implementation ofthe scheme of ICDS be reviwed and restructuredin the Eleventh Plan. In the vision for the EleventhPlan outlined in Volume I, funds should ideally bereleased directly by the Centre through States todistricts, with DPC and PRI institutions involved.The District Planning process will be strengthenedif Gram Panchayats were involved for local levelprocurement of food items and supervisionof AWWs. The Women and Child Development(WCD) prefers a fund release mechanism involvingState, district, and block level societies workingin Mission mode. The actual restructuring inthe Eleventh Plan would need to keep in viewboth the urgency implicit in the Mission-modeapproach and the convergence aspects that areimplied in the overall Eleventh Plan vision foreffective delivery.• The feeding components present some choices. Oneapproach is to rely on hot cooked meals accordingto local taste and provided at the anganwadicentres. Preparation of meals will be entrusted toSelf-help Groups (SHGs) or Mothers’ Groups, asper decision of the Village Committee. An alternativeapproach is to rely upon RTE micronutrient