Malnutrition among children in India: exploring the contribution of the integrated child development service scheme

In India, the current nutritional transition illustrates a noteworthy decline in the incidence of undernutrition among children under the age of 5 over the past decade. Decline in under-nutrition may be attributed to the various nutrition interventions. Nevertheless, the provision of nutrition supplementation under Integrated Child Development Services (ICDS) is hypothesized to contribute significantly. This study examines the factors influencing the decrease in undernutrition among children and assesses the contribution of ICDS based on data from the two rounds of the National Family Health Surveys conducted during 2005–2016. The results indicate a noteworthy reduction in the level of stunting and underweight among children. This decline was found to be positively associated with maternal nutrition, while it was negatively associated with utilization of ICDS. Decomposition results portray wealth index, caste and religion as the factors, significantly reducing undernutrition. Propensity Score Matching (PSM) portrays a substantial reduction in the estimated prevalence of stunting among those using ICDS (40%), which would have been 47% otherwise. After matching 7% difference exist in the prevalence of stunting among children using the ICDS in comparison to those who were not using the ICDS. Results indicate that the ICDS in its present form contributes to a considerable reduction in undernutrition among children, despite of selectivity bias in registration with Anganwadi centres. Therefore, the service provisions under ICDS need to be strengthening to break the detrimental cycle of undernutrition through intensification of counseling by prioritized home visits of anganwadi workers and reaching to the critical age-groups including pregnant women and lactating mothers.