title: Operational Assessment of ICDS Scheme at Grass Root Level in a Rural Area of Eastern India: Time to Introspect.
abstract: BACKGROUND
  Integrated Child Development Service (ICDS), a flagship program of Government of India (GoI) for early childhood development hasn't delivered the desired results since its inception four decades ago. This could be due to infrastructural problems, lack of awareness and proper utilization by the local people, inadequate program monitoring and corruption in food supplies, etc. This study is an audit of 36 Anganwadi centres at Khordha district, Odisha, to evaluate the implementation of the ICDS.
  
  
  OBJECTIVE
  To assess operational aspects of ICDS program in a rural area of Odisha, in Eastern India.
  
  
  METHODS
  A total of 36 out of 50 Anganwadi Centres (AWCs) were included in the study. We interviewed the Anganwadi Workers (AWW) and carried out observations on the AWCs using a checklist. We gathered information under three domains manpower resource, material resource and functional aspects of the AWC.
  
  
  RESULTS
  Most of the AWCs were adequately staffed. Most of the AWWs were well educated. However, more than 85% of the AWCs did not have designated building for daily functioning which resulted in issues related to implementation of program. Water, toilet and electricity facilities were almost non-existent. Indoor air pollution posed a serious threat to the health of the children. Lack of play materials; lack of health assessment tools for promoting, monitoring physical and mental development; and multiple de-motivating factors within the work environment, eventually translated into lack of faith among the beneficiaries in the rural community.
  
  
  CONCLUSIONS
  Inadequate infrastructure and logistic supply were the most prominent issues found, which resulted in poor implementation of ICDS program. Strengthening of grass root level facilities based on need assessment, effective monitoring and supervision will definitely help in revamping the ICDS program in rural areas.
authors.affiliation: Senior Resident, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, Odisha, India .
authors.forename: Jyotiranjan
authors.initials: J
authors.lastname: Sahoo
authors.affiliation: Assistant Professor, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, Odisha, India .
authors.forename: Preetam B
authors.initials: PB
authors.lastname: Mahajan
authors.affiliation: Senior Resident, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, Odisha, India .
authors.forename: Sourabh
authors.initials: S
authors.lastname: Paul
authors.affiliation: Professor and Head, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, Odisha, India .
authors.forename: Vikas
authors.initials: V
authors.lastname: Bhatia
authors.affiliation: Junior Resident, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences , Bhubaneswar, Odisha, India .
authors.forename: Abhinash K
authors.initials: AK
authors.lastname: Patra
authors.affiliation: Grade II Staff Nurse, Department of Community and Faimly Medicine, All India Institute of Medical Sciences , Bhubaneswar, Odisha, India .
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Hembram
keywords: Anganwadi worker; Community-based research; Health services; Primary health care services; Research practice and policy issues