The association of caregivers' access to Anganwadi Center services with school readiness of their 5-year old children: A secondary cross-sectional analysis of data from Chhattisgarh, India Open Access

Sekar, Swathi (2013)

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Background: School readiness is the component of early childhood development that is focused on early childhood education (ECE) and preparing the child for formal schooling. In India, early childhood care and education (ECCE) is almost entirely provided by the Integrated Child Development Services (ICDS) system through a system of Anganwadi Centers (AWCs). Early Childhood Development (ECD) programs with built-in health components, incorporating family-based services and home visiting programs show promise in improving school readiness.

Objective: Explore whether caregiver's access to AWC services is associated with school readiness scores, including literacy and numeracy scores, of children between 5-5.5 years.

Methods: The target population for this analysis consisted of caregivers with children aged 5-5.5 years, resulting in a sample size of 1248. A stratified two stage clustered sampling procedure was used. These data were analyzed in a cross sectional design. Composite scores for the different components of school readiness (numeracy, literacy and adaptive behavior) were created. Nine variables were selected that exemplify various aspects of health services through Anganwadi centers and were combined into a single score for access to services.

Results: Overall school readiness score ranged from 8 to 70 with an average of 43.4. Certain AWC service such as mothers registering their pregnancy, mothers receiving TT vaccinations, and receiving supplementary nutrition showed associations with improved school readiness in the overall score and the adaptive behavior score. Conversely, some services such as those who had a village health and nutrition day organized in their village or mothers who had a health worker visit her home during her pregnancy, were associated with worse school readiness scores.

Discussion: Our data provide evidence to say that caregiver's access to AWC services is associated with school readiness scores of their 5 year old children. However, while some services had a positive association with school readiness, as expected, others had no association or even more surprisingly, a negative association. This could be due to individuals with lower health indicators seeking out these services, or people in the community being unaware of the AWC services.

Table of Contents

Table of Contents

1. Introduction 1

1.1 Rationale 1

1.2 Problem Statement 2

1.3. Purpose Statement 3

1.4 Acronym List 4

2. Review of the Literature 5

2.1 Background 5

2.2 School Readiness 5

2.3 Early Childhood Development (ECD) 9

2.4 Integrated Child Development Services (ICDS) 13

2.5 CARE's ECD Programming in India 16

3. Methodology 19

3.1 Background to Methodology 19

3.2 Study Area and Population 19

3.3 Sampling Strategy 20

3.4 Data Collection Tools 21

3.5 Data Collection Process 22

3.6 Monitoring and quality assurance 23

3.7 Data Processing 24

3.8 Ethics 24

3.9. Analytical Methodology 24

4. Results 27

5. Discussion 29

5.1 Main findings 29

5.2 Limitations 32

5.3 Recommendations 33

5.4 Public Health Implications 34

Appendix 1: Tables 35

References 40

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