Next Article in Journal
Emerging from the Shadows: Intrinsic and Extrinsic Factors Facing Community Health Workers in Western Cape, South Africa
Next Article in Special Issue
Health Indicators of Pregnant Women in Tonkolili District, Rural Sierra Leone
Previous Article in Journal
Healthcare Providers’ Knowledge and Attitude Towards Abortions in Thailand: A Pre-Post Evaluation of Trainings on Safe Abortion
Previous Article in Special Issue
Inequalities in Rotavirus Vaccine Uptake in Ethiopia: A Decomposition Analysis
Open AccessArticle

Utilization of Integrated Child Development Services in India: Programmatic Insights from National Family Health Survey, 2016

Institute of Health Management Research, IIHMR University, Jaipur 302029, India
Institute of Economic Growth, Delhi 110007, India
Indian Institute of Technology, Gandhinagar 382355, India
Tata Trusts, Mumbai 400005, India
NITI Aayog, Government of India, New Delhi 110001, India
Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul 02841, Korea
Department of Public Health Sciences, Graduate School, Korea University, Seoul 02841, Korea
Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(9), 3197;
Received: 19 February 2020 / Revised: 10 April 2020 / Accepted: 30 April 2020 / Published: 4 May 2020
The Integrated Child Development Services (ICDS) program launched in India in 1975 is one of the world’s largest flagship programs that aims to improve early childhood care and development via a range of healthcare, nutrition and early education services. The key to success of ICDS is in finding solutions to the historical challenges of geographic and socioeconomic inequalities in access to various services under this umbrella scheme. Using birth history data from the National Family Health Survey (Demographic and Health Survey), 2015–2016, this study presents (a) socioeconomic patterning in service uptake across rural and urban India, and (b) continuum in service utilization at three points (i.e., by mothers during pregnancy, by mothers while breastfeeding and by children aged 0–72 months) in India. We used an intersectional approach and ran a series multilevel logistic regression (random effects) models to understand patterning in utilization among mothers across socioeconomic groups. We also computed the area under the receiver operating characteristic curve (ROC-AUC) based on a logistic regression model to examine concordance between service utilization across three different points. The service utilization (any service) by mothers during pregnancy was about 20 percentage points higher for rural areas (60.5 percent; 95% CI: 60.3; 30.7) than urban areas (38.8 percent; 95% CI: 38.4; 39.1). We also found a lower uptake of services related to health and nutrition education during pregnancy (41.9 percent in rural) and early childcare (preschool) (42.4 percent). One in every two mother–child pairs did not avail any benefits from ICDS in urban areas. Estimates from random effects model revealed higher odds of utilization among schedule caste mothers from middle-class households in rural households. AUC estimates suggested a high concordance between service utilization by mothers and their children (AUC: 0.79 in rural; 0.84 in urban) implying a higher likelihood of continuum if service utilization commences at pregnancy. View Full-Text
Keywords: ICDS; child undernutrition; childcare; India ICDS; child undernutrition; childcare; India
Show Figures

Figure 1

MDPI and ACS Style

Rajpal, S.; Joe, W.; Subramanyam, M.A.; Sankar, R.; Sharma, S.; Kumar, A.; Kim, R.; Subramanian, S.V. Utilization of Integrated Child Development Services in India: Programmatic Insights from National Family Health Survey, 2016. Int. J. Environ. Res. Public Health 2020, 17, 3197.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

Search more from Scilit
Back to TopTop