A childcare worker in an anganwadi is a vital part of a village - ensuring the health and growth of rural children. A young development professional observes the consequences when there is no worker for months.
The single room anganwadi (rural child care centre), in the campus of a primary school in Banskhedi village, has no toilet, no kitchen, no flooring, not even a fan, never mind any electricity connection. It is in one of the most interior parts of the Bamori administrative block in the Guna district.
To observe “Village Health, Sanitation and Nutrition Day” (VHSND) a team from the Women and Child Development (WCD) department paid a visit to this anganwadi. They wanted to check how it was functioning since the anganwadi worker (AWW) had not come into work for many months and had yet to be replaced.
Because these anganwadi workers play a very important role in ensuring the health and growth of children, what happens when she is absent from the village daycare centre for a long period?
Hemlata Joshi, the auxiliary midwife nurse (ANM), performing her regular VHSND duties in the porch of the anganwadi room at a scorching 43 degrees in June, greeted the WCD team. Inside the anganwadi, Bhabuti Bai Rajat, the accredited social health activist (ASHA), was assisting Draupti Bai, the anganwadi helper in preparing lunch for the children.
But since there was no LPG cylinder or stove, the food had to be prepared by Draupti Bai inside the anganwadi on a chulha causing a lot of smoke in the room. Sunita Kakoriya, the supervisor from the WCD department, advised her not to cook inside the room as the smoke is harmful to the children.
It was just another instruction that Draupti Bai has received in the past few months from the officials. In the absence of the anganwadi worker, she had been hoping that the department would appoint a new AWW soon and would reduce her plight.
Since the AWW went ‘missing’, the daily duties of the anganwadi worker have fallen on Draupti Bai, who – like most anganwadi helpers – is not literate as she only assists the AWW.
Not knowing how to read and write, she is forced to visit several nearby anganwadis to get help from other anganwadi workers to fill out the forms for schemes, such as PMMVY – the maternity programme, Ladli Lakshmi Yojana for the girl child. She also needs help for data entry to the ANMOL, a tracking mobile application of the Ministry of Health & Family Welfare.
She also maintains attendance and immunisation records of the children with the midwife’s help.
But sometimes things fall through the cracks.
The WCD team learnt that for several weeks the Banskhedi anganwadi had not received pre-cooked food, mandatory supplementary nutrition packs or take-home rations for pregnant and lactating women.
Since the anganwadi worker (AWW) had not been showing up for work anymore the authorities were not notified of these shortages.
Several times Draupti Bai has asked the AWW to return to work to no avail. She even asked the department to appoint a new AWW, but no one came.
The team from WCD asked the villagers why the AWW, called Ojha, had stopped coming into work and if it were possible for her to return. But they learnt she was a victim of domestic violence, abused daily by her addicted husband. She was at a safe location, but did not intend to resume her job.
She had not responded to any communication from the WCD authorities for months. Supervisor Sunita Kakoriya said that Ojha was a sincere anganwadi worker. However, after several notices went unanswered, the department was forced to begin the process of her official removal.
While the officials were preparing the panch-nama, the official process for the AWW’s removal, I observed some of the beneficiaries visiting the anganwadi for the VHSND.
Sumita Bai had brought her 3-month-old granddaughter Divyanshi for immunisation at the anganwadi. At a glance the department officials could tell that Divyanshi was malnourished. Divyanshi’s weight turned out to be just 3.75 kg which is way below the acceptable range of 4.5-5.5 kg for her age and quite uncommon as she was the first child.
Supervisor Sunita Kakoriya called for Divyanshi’s mother, Manisha, for urgent counselling. Speaking to the mother, Kakoriya could attribute the reason for the child’s poor growth to inadequate breastfeeding. She told Manisha the importance of breastfeeding a child for at least 20 minutes. In Manisha’s defence, there was no one to counsel her as the AWW was not available for months and it is the AWW who generally gives such advice to the women.
Rajkumari and her daughter Priyanshi were sitting beside Manisha and were listening to the discussion. Priyanshi’s appearance belied her age. A 9-month-old child, she looked more like a 4-month-old baby.
Priyanshi weighed 5 kg. Rajkumari told us that when Priyanshi was born she weighed just 0.5 kg and had to be admitted to the community health centre. Rajkumari also received counselling on nutritious dietary requirements, feeding practices and oral rehydration solutions.
These egregious situations brought our attention to how consequential the role of an anganwadi worker is on the ground in such interior areas that are seldom visited by district officials.
Thankfully, the panch-nama has now been completed by the WCD officials and a new AWW will soon be appointed at the Banskhedi anganwadi.
Both Divyanshi and Priyanshi have been immediately referred to the Nutrition and Rehabilitation Centre, Bamori. A vehicle will be sent to bring them and their mothers to the Bamori centre where they will receive medical counselling and a healthy diet for 14 days.
But the prolonged absence of this village AWW shows how vital they are.
An AWW serves as the last-mile delivery person for India’s social development programmes that bring valuable change at the grassroots level. She is the primary interface of the rural community and is critical for community outreach and the upliftment of rural areas.
But reduced manpower, coupled with limited resources and infrastructural challenges, can considerably deteriorate the outcomes of important community programmes.
The lead image at the top shows Hemlata Joshi, the auxiliary midwife at the Banskhedi anganwadi, wishing her colleague would return to work (Photo by Pratyush Sharma).
Pratyush Sharma is an Aspirational District Fellow with Transform Rural India Foundation, working in Guna district, Madhya Pradesh.
