Leyvraz M, Wirth JP, Woodruff BA, Sankar R, Sodani PR, Sharma ND, Aaron GJ

October 2016 – PLOS ONE

The Integrated Child Development Services (ICDS) in the State of Telangana, India, freely provides a fortified complementary food product, Bal Amrutham, as a take-home ration to children 6–35 months of age. To assess the coverage, utilization, barriers, and drivers of the program, a two-stage, stratified cross-sectional cluster survey was conducted in randomly selected catchment areas of ICDS centers in Telangana. A total of 1,077 children 0-35 months were randomly selected and enrolled in the survey. The coverage of the fortified take-home ration was found to be high among the target population. Nearly all caregivers (93.7%) had heard of Bal Amrutham and 86.8% had already received the product for the target child. Among the children surveyed, 57.2% consumed the product regularly. The ICDS program’s services were not found to be a barrier to product coverage. In fact, the ICDS program was found to be widely available, accessible, accepted, and utilized by the population in both urban and rural catchment areas, as well as among poor and non-poor households. However, two barriers to optimal coverage were found: the irregular supply of the product to the beneficiaries and the intra-household sharing of the product. Although sharing was common, the product was estimated to provide the target children with significant proportions of the daily requirements of macro- and micronutrients.

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