A Study to Assess the Logistics and Skills of Rural Anganwadi Worker for IMNCI Strategy in Ahmedabad District

Introduction: IMNCI is an integrated approach to decrease morbidity and mortality amongst children between 0-5 years. Training to pre-service level during medical, nursing-education and anganwadi worker (AWW) is the first fundamental stage of IMNCI. This study was conducted to evaluate the skills of AWWs trained under the IMNCI program and to identify the problems in implementation of IMNCI program in rural areas. Methodology: A cross sectional study was carried out including 38 anganwadi workers (AWWs) of sanand Taluka, of Ahmedabad district selected by random sampling technique during the period from June 2014 to September 2014. Results: Most of the AWWs were ?40 years of age. Out of 38 AWWs, 24% AWWs underwent IMNCI training between 1 to 2 years duration and 25 (66%) AWWs underwent training between 2 to 5 years period from the date of interview. All AWWs were equipped with weighing scales but were not having supplies like, chloroquine (86%) ORS (10%), Cotrimoxazole (52%) and IFA (10%).Out of 35 (92%) AWWs who had maintained the register, only 8 (21%) AWWs had completed them. Lack of motivation and supervision with overburden due to other programs and inadequate stocks of drugs were major difficulties found in this program. Breast-feeding problems were identified by 53% AWWs. Only 21% AWWs had checked immunization cards. The performance score is poor for 1/3rd of anganwadi workers for identification of danger signs in IMNCI program. Conclusion: The study identified a number of programme related and external constraints and by taking care of these problems we might improve implementation and skills of anganwadi worker for IMNCI strategy.