WITH the state government directing that growth monitoring of infants for assessment of malnutrition be resumed after being suspended for four months during the lockdown, the Integrated Child Development Services (ICDS) programme commissioner has asked the administration of all districts to stop entrusting anganwadi workers with surveys and other work related to the Covid-19 pandemic. The anganwadi worker women, however, continue to face difficulties in undertaking the growth monitoring work with parents even in green zones reportedly unwilling to hand over babies to them for weighing.
In a letter to all collectors and commissioners of urban local bodies, Maharashtra’s ICDS Commissioner Indra Mallo has said work on growth monitoring will now resume. Especially in regions that witness instances of malnutrition and malnutrition-related deaths of babies, growth monitoring of infants is central to assessing the extent of prevalence of moderate acute malnutrition and severe acute malnutrition. “There are several complaints that the door-to-door growth monitoring work is not progressing because families won’t hand over the baby even for a few minutes to an anganwadi worker who has no protective gear but a mask. In Wardha for example, many of our women tried to resume the growth monitoring work but there is obviously a problem,” said Shubha Shamim of the Maharashtra State Anganwadi Workers Joint Action Committee. “We have demanded that this work remain stalled for another two months given the current circumstances.” In some areas, anganwadi women have said they are willing to go door to door and provide referrals to the nearest health centre for babies that have visibly lost weight over the period of the lockdown. “Babies who are clearly malnourished can then be weighed by a doctor in a PPE,” Shamim said.
Since the imposition of the lockdown in March, anganwadi workers who function under the ICDS programme have been taken with doing door to door surveys in villages to identify residents with symptoms of the disease, anybody with a travel history and anybody who may have been in contact with a patient. While anganwadis have remained closed, the anganwadi workers were also directed to supply grocery kits in place of hot cooked meals to beneficiaries under the ICDS programme, including lactating mothers, pregnant women and children up to the age of six years. “This has impacted the main work of the anganwadi workers,” the ICDS commissioner’s letter concedes. Having received the ‘incentive’ payment of Rs 1,000 only once during the course of the lockdown, the anganwadi workers are also not keen to continue doing survey work.
Across parts of rural Maharashtra, there have been demands from anganwadi workers that they be provided protective gear including masks and hand sanitisers. Devidas Jige, an All India Trade Union Congress leader in Jalna, said there was one instance in the district of a nurse who was doing survey work along with anganwadi workers testing positive for Covid-19. “Anganwadi workers have been given survey work but no protective equipment at all,” Jige told The Indian Express. “We don’t want to stop their work but are advising the women to exercise extreme precaution while going door to door.”
There is also some ambiguity in whether anganwadis in green zones should be re-opened to provide pre-primary educational services and the hot cooked meals under different schemes for pregnant women and lactating mothers. “Some supervisors are interpreting the order to ask anganwadi workers to keep anganwadis open for four hours, but all kinds of passersby end up stopping by the anganwadi and the women are hardly equipped to deal with that risk,” Shamim said.