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  • Title: A coordinated approach to children's health in India.
    Author: Tandon BN.
    Journal: Lancet; 1981 Mar 21; 1(8221):650-3. PubMed ID: 6110873.
    Abstract:
    In 1976 a programme which integrated nutritional, health, and educational services for children, mothers, and pregnant women was set up in India, and these services were delivered to the local people mainly through members of their own community. After 21 months the programme achieved improvements in nutritional status of the children that were not attained by decades of many other separate nutritional, health, and educational programmes. Acceptance of immunisation schemes also improved. The programme was first implemented in 33 communities (blocks). Because of its success its gradually being extended to other blocks. The Integrated Child Development Service, established in India in 1976, was aimed at overcoming the deficiences of previous child health programs. The program integrated nutritional, health, and educational services for children, mothers, and pregnant women, and the services were delivered to the local people primarily through members of their own community. The delivery of services through the Integrated Child Development Service (ICDS) and its impact on nutritional status was assessed by comparing the baseline data with the data collected 21 months after the implementation of ICDS in 15 blocks where both surveys were done. A stratified sample of 17,904 children was registered for the study, and 92% of them were available for baseline and followup study. BCG immunization coverage increased from 11.3% to 49.3% in rural projects, 20.9% to 55.4% in tribal projects, and 47.4% to 74.1% in urban projects. Coverage by diphtheria, pertussis, and tetanus (DPT) immunization increased considerable, but overall coverage remained low since the baseline figure was very low. Distribution of vitamin A and supplementary food increased significantly, and the nutritional status of the children improved considerably. The prevalence of severe malnutrition decreased from an overall figure of about 22% to 11.2% in rural, 5.5% in tribal, and 6.1% in urban projects. Analysis by age-groups showed that services did reach younger children, with resultant improvement in nutritional status. The prevalence of severe malnutrition in children younger than age 3 decreased from 25.5% to 9.7% and that of normal and grade 1 nutritional status increased from 48.2% to 61.3%.
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