ASSESSMENT OF CHILD DEVELOPMENT IN THE COMMUNITY ¨C NEEDS
AND ISSUES
Singhi P,
Postgraduate
Institute of Medical Education And Research, Chandigarh- 160 012, INDIA
The main
objective of assessment of child development in the community is to promote
integrated child development. This is particularly needed in developing
countries where majority live in rural areas, and hospitals are far and
few. Comprehensive coverage of vulnerable age groups, use of local norms,
easy reliable screening tools, family involvement, and follow up action are
needed. The Integrated Child Development services is a large programme in
India that aims to meet these needs. Launched in 1975, it covers over 75%
of community Development Blocks, with 23 million children under 6years of
age. Over 5,00,000 trained community based anganwadi workers with other
supporting staff operate through the anganwadi centre, health system and
the community. Traditionally growth and development assessment has been
done with the help of monitoring charts. Developmental milestones were added on to growth
charts. However it has been found that often monitoring charts focus on
wrong ages and become a ritual and an end by themselves rather than means
to an end. Considerable time is involved in monitoring at the expense of
interaction and counseling and there is minimal family involvement.
Monitoring by itself is not an
intervention ¨C it needs to be followed up with action oriented programmes.
Implementation of socio-culturally appropriate developmental surveillance
with family based education and community participation are required. A
number of training programmes with the help of UNICEF and World Bank
including Udisha are being envisaged o achieve this. The feasibility and
practicality of such programmes and their monitoring and evaluation
needs discussion. Whether the desired outcome is achieved is to be seen.
Are there any indicators for assessing child development in the community?
Considerable research is being undertaken in this direction. An ideal
indicator for integrated child development is yet to be found.