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                  enGender Impact: The World Bank’s Gender Impact Evaluation Database



   Improving Child Nutrition Outcomes in India: Can the Integrated Child Development
                          Services Program Be More Effective?
      Author(s)            Monica Das Gupta, Michael Lokshin, Michele Gragnolati, Oleksiy Ivanschenko
      Contact              mlokshin@worldbank.org

      Country              India

  Organizing Theme         Health

       Status              Completed

Intervention Category      Nutrition

       Sector              Health, Nutrition & Population
                           Levels of child malnutrition in India fell only slowly during the 1990s, despite significant
                           economic growth and substantial public spending on the Integrated Child Development
                           Services (ICDS) program, of which the major component is supplementary feeding for
                           malnourished children. To begin to unravel this puzzle, we assess the program’s placement
                           and its outcomes, using NFHS data from 1992 and 1998. We find that program placement
                           is clearly regressive across states. The states with the greatest need for the program ⎯ the
      Abstract
                           poor Northern states with high levels of child malnutrition and nearly half India’s
                           population ⎯ have the lowest program coverage, and the lowest budgetary allocations from
                           the central government. Program placement within a state is more progressive: poorer and
                           larger villages have a higher probability of having an ICDS centre, as do those with other
                           development programs or community associations. We also find little evidence of program
                           impact on child nutrition status in villages with ICDS centers.
 Gender Connection         Gender Informed Analysis

  Gender Outcomes          Gender disaggregated nutrition

     IE Design             Propensity Score Matching
                           The program aims to provide child growth monitoring, supplementary feeding and pre-
                           school education to young children, along with basic health services to young children,
    Intervention
                           pregnant women and lactating mothers. ICDS centers are established in villages in select
                           administrative blocks, mostly in rural and tribal areas.
 Intervention Period       The program started in 1975 and continued through the time the paper was written.

  Sample population        The sample is comprised of about 90,000 households from 26 states in India.
                           The study compares households who received the programs to similar households that did
Comparison conditions
                           not receive the program.
   Unit of analysis        Individual Level

  Evaluation Period        1992-1999


   Last updated: 14 August 2013                                                                      1
                   enGender Impact: The World Bank’s Gender Impact Evaluation Database


                            Overall, the program had no significant impact on nutritional outcomes. It did have a
                            positive impact on boys' stunting in 1992. For girls there was no significant impact. There
        Results             was actually a significant negative impact in the poor Northern states. Program placement
                            was very regressive across states, the states with the greatest need have the lowest program
                            coverage. Program placement within states is more progressive.
                            A number of monitoring studies suggested that the program had many implementation
Primary study limitations
                            problems. The study uses repeated cross-sections instead of panel data
    Funding Source
                            Ivaschenko, O., Lokshin, M., Gupta, M. D., & Gragnolati, M. (2005). Improving Child
      Reference(s)          Nutrition Outcomes in India: Can the Integrated Child Development Services Program Be
                            More Effective?. World Bank Policy Research Working Paper Series No. 3647
    Link to Studies
                            https://openknowledge.worldbank.org/handle/10986/8301
       Microdata




    Last updated: 14 August 2013                                                                       2