1. Get Healthy, Give Healthy CRY 2015 ARE CHILDREN GETTING A HEALTHY START? A study on early childhood in urban slums

2. Overview of the Study – Nutritional status among children in the age group of 1 to 5 years – Immunization status and Supplementation history – ICDS service and its utilization by children – Knowledge and practice of primary care giver about ICDS service provisions

3. Methodology Geographical Area: 15 slums across 5 metropolitans Respondent : Primary caregiver for children between 1 to 6 years Design: Household survey Sample Size: 1260 parents Tools: Questionnaire Nutritional Assessment as per WHO guidelines Data Analysis using statistical package(SPSS/STATA) Caregivers of Children under the age of 1 year not included

4. The Study Team The team comprising of 60 volunteers came from various disciplines. They were either college goers or young professionals who believe that ‘what we can do, we must do’ to bring about change in the lives of children To quote one of the volunteers involved in the study ‘After the first few days, I felt so comfortable moving around in the community, there was an inner curiosity to see and know more of this unknown world that existed alongside ‘my world’. From being shocked, I gradually started wondering about how these children still managed to enjoy and stay happy’

5. Area and Respondent Profile Slums Covered in Bangalore: 5 Sample Covered : 258 Profile of Respondents:The respondents comprised of a mix of migrants from neighbouring states, locals and are primarily from the lower socio- economic group. They have varied religious and linguistic backgrounds. Most of them are employed in the unorganized sector and are daily wage earners.

6. Nutritional Status of Children

7. Malnutrition in urban slums is far more than regular urban spaces on an average. * Data from Chennai and Kolkata is not included in the calculation of stunted..

8. One in three children underweight in slums of Bangalore. *CRY Volunteers in Bangalore have been working on malnutrition in these areas since 2011

10. Birth of every fourth child is unregistered in Slums of Bangalore

11. Basic inputs- child health

12. * This is only for some form of vaccination

15. Anganwadi-Enrolment & Services

16. ICDS Access and Coverage Enrolment in AWCs Bangalore stood at 47%. 50% of parents were aware of the right age of AWC enrolment

17. Growth monitoring- National picture

18. Regularity of Growth Monitoring Only two-thirds (66%) of the parents surveyed in Bangalore said that the AWC does regular growth-monitoring.

19. Growth Monitoring Feedback to parents Around 74% of the parents in Bangalore reported that AWCs do not give regular and proactive feedback

20. Feedback to parents of malnourished children 89% of the parents were NOT INFORMED that their ward is underweight Indicative of low parental engagement as well as outreach

21. AWCs –Other Service Indicators- Bangalore slums

23. Perceptions of Parents on Space and friendly environment in AWC/Preschools

24. Recommendations

25. Early Childhood Care and Development (ECCD) policy and programmes to be contextualised to urban settings Entitlement for children (0-6 years) to be guaranteed by law Improving the information and knowledge of parents on ECCD National ECCE Policy 2013 to be strengthened – States to expedite its implementation Basic Minimum Standards for ECCE across institutions Convergence between ICDS and Health services

26. Recommendations for ICDS Strengthening the service delivery of all 6 services of Anganwadi Intervention to Improve the nutritional Status among 1- 6: Quality, Quantity and regularity – Growth Monitoring process to be strengthened and broad based: Monitor Height – Need for Improvement in early Identification and management cases of malnutrition – Strengthening the component of Nutritional Counselling by AWW Improve community outreach and engagement by AWW to strengthen awareness Strengthen community ownership of ICDS to improve services Realistic Assessment of the Anganwadi Workers workload and Capacities wrt to expected outcome

27. Thank You