More than just a preschool: the Anagwadi Center

Anagwadi 

This past week we visited an Anagwadi in Udupi. Anagwadis are part of the primary level of health care and are community based. Their main goals are to: enhance the health and nutrition of children under 6 years, reduce infant mortality, morbidity and malnutrition, decrease school drop out rates, and lay a foundation for physical, mental, and social health. In order to meet these goals the Anagwadi provides a number of services to the community including; supplementary nutrition, health check ups, immunizations, basic preschool education, health and nutrition education for mothers, and referrals for specialists. Most of the work that is done at the Anagwadi and via outreach programs is done by the Anagwadi teacher, a honored and respected woman in the community.

The Anagwadi Center

The Anagwadi facility was clearly a place of learning and enrichment. It appeared well kept and safe and the two staff members; the teacher and the helper controlled the children in a friendly way. I was impressed by the respect the children displayed for the women’s authority and felt that it was clear that the teachers were looking after the best interest if the children. The facility was also academically stimulating. For example, the walls were covered in numerous visual teaching tools such as; images portraying important lifestyle choices associated with good health, the alphabet in Hindi and English, and the numbers 1-15 in the form of easy to remember pictures.

Some of the children at the center. After learning about the mission and organization of the center we were able spend time playing with the children. They showed us a number of songs and dances in Hindi then we taught them the makarina! 

This poster is a visual tool used to teach the children about important aspects of life in the village such as; agriculture, fruits and vegetables, work, and clothing. The children are taught both Hindi and English at the Anagwadi and most learn the local language while at home. 

The children learn their numbers 1-15 by drawing creative and easy to remember pictures. For example, the 5 is drawn as an apple and the 4 is drawn as a popsicle. 

In addition to education, the Anagwadi also provides health care for the children. While at the Anagwadi children are weighed, provided supplementary nutrition, and given the appropriate vaccines. In addition, a doctor visits on a monthly basis and referrals can be given to the community at any time. This is the weighing mechanism for the children. They were all excited to be put in the swing and told that they were a healthy weight!

This is a chart of all of the mothers, pregnant women, and women
of childbearing age in the community. It is the teachers
responsibility to keep tract of the members of the community
so that she can effectively provide healthcare for
the target group. 

I was also impressed by the community outreach coordinated by and through the facility. The food supplements to be distributed to the community were well-organized and kept in dry covered containers. In addition, the services offered to mothers’ pre and post delivery were quite impressive. The surveillance and monitoring of the mothers creates a relationship through which the Anagwadi teachers can relay important health messages to the community. Providing mothers with support during and after pregnancy provides the teachers with the opportunity to relay relevant information about health related to pregnancy and lifestyle, which benefits the community as a whole. Community education seems to be a major goal of the Anagwadi and is carried out through biweekly meetings and information sessions. I would be interested in learning about the attendance rate at these meetings.

These packets are examples of food supplements that would be given to the mothers on a monthly basis. There are certain packages that are given to women that are breastfeeding, women that are pregnant, and children that are malnourished. 

Although this Anagwadi was extremely well outfitted and effective, when we talked about the Anagwadis in other districts there was not the same success. Like many of the notional programs implemented on the community level, success varies greatly based on location and other social factors. There is a lot of effort through the instillation of top down management to try and homogenize success, however there are limits on the effectiveness of “outsider” intervention. I would be interested in testing the efficacy of a teaching movement in which respectable Anagwadi teachers traveled to other districts where there has been less success to teach the Anagwadi workers. The goal of their teaching would be to spread their passion for helping to achieve health in the community. In order for the movement to be successful, they would have to instill the seed of selflessness and pride for their work. If successful the movement would change the mindset of those who are exploiting the system and decrease maleficent behavior. If there was a way to decrease the corruption of the system by individuals through increasing education there might be more success stories in more districts across the country.