It is believed that almost 45% of global deaths related to malnutrition could be prevented by improving WASH conditions and practices

More children in India benefit from supplemental nutrition provided by anganwadi centers than the entire population of Madhya Pradesh. Almost half of children aged 0-6 in India are registered in anganwadis.

Why is it important? What is the opportunity?

According to the National Family Health Survey 5 (2019-21), 35.5% of children, or one in three children in India, suffer from stunting – an indicator of chronic nutritional deficiency. The survey also revealed that diarrhea was more prevalent in rural India compared to urban India.

POSHAN Abhiyaan was launched to improve the nutritional outcomes of children, pregnant and lactating women. In March 2018, Mission POSHAN 2.0 further integrated the supplemental nutrition program, which aims to expand the Integrated Child Development Services (ICDS) program nationwide. The Mission aims to reduce stunting, malnutrition, anemia and low birth weight. One of the interventions of the POSHAN 2.0 Mission is to guarantee water, sanitation and hygiene (WASH) services. While water and sanitation at the community level has received significant public attention and investment through Swachh Bharat Mission and Jal Jeevan Mission, there is a critical need to focus on institutions – schools, health centers and anganwadis.

There are several studies that reveal that improper water, poor sanitation and unhygienic behavior cause growth retardation. Short stature compromises the child’s physical and cognitive growth. The existence of a positive correlation between nutritional status and learning levels suggests that stunting may not only compromise long-term health, but lead to worse educational and learning outcomes.

It is believed that almost 45% of global deaths related to malnutrition could be prevented by improving WASH conditions and practices.

There are around 14 lakh operating anganwadi centers in India where supplemental nutrition is provided to nearly 7.4 million children. Nearly 2 million children benefit from pre-school education at these centres.

Government figures suggest that 88% of operational anganwadis have potable water facilities and almost 80% have toilet facilities. However, there are serious concerns regarding infrastructure adequacy and infrastructure suitability.

Nearly a quarter of Anganwadis in the country operate from rented premises. It is not clear if these are covered and considered. There is a strong case for ensuring that, irrespective of ownership of the building, all operating anganwadis have adequate and appropriate water and sanitation facilities.

A survey carried out by WaterAid India of 1,020 anganwadi centers in March 2021 found that only 7% had adequate WASH facilities and only 2% had adequate and child-friendly facilities.

The absence of guidelines or standards for WASH infrastructure in anganwadis, such as the Swachha Vidyalaya guidelines for schools, leads to the mere availability of a toilet or access to water being considered adequate. Standards need to be created for the number of toilets or handwashing stations or drinking water points per proportion of children. Inadequate infrastructure will lead children to defecate or urinate outdoors.

In addition, it is necessary to ensure that the infrastructure is age-appropriate. The infrastructure must ensure that the taps and door latches are at a suitable height for children.

A common concern with all public or community restrooms concerns the quality of operation and maintenance and the hygienic condition of these facilities. This is also relevant for anganwadis. But are adequate resources made available for maintaining the WASH infrastructure?

Finally, the anganwadi centers offer us a unique opportunity to ensure that, from an early age, children inculcate correct hygiene behaviors in terms of proper hand washing, before and after meals and after using the toilet. The availability of appropriate and adequate infrastructure can ensure that the use of latrines, for example, becomes a habit from an early age. Anganwadi workers can play a critical role in motivating children to practice correct behaviors and this can lead to changes in their behaviors at home.

By focusing on adequate and appropriate WASH in anganwadis and emphasizing correct behaviours, we would not only be investing in our children’s health and well-being, but also helping them to realize their full potential.

The author is Executive Director of WaterAid India

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