Utilization and Satisfaction of Services Provided for Children under the Integrated Child Development Services Scheme in a Block of West Bengal, India

Rajesh De, Mandira Roy, Jadab Chandra Sardar, Himel Mondal
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 Methods: This descriptive cross-sectional study was conducted from August 2016 to November 2018, and simple random sampling was used to select ICDS centres. The centres’ were evaluated for determining the rate of utilization of the services. For evaluating satisfaction, a face and content-validated, pre-tested questionnaire was used. The first part of questionnaire was for collecting the socio-demographic profile of mothers. The second part was concerned about determining satisfaction regarding various services provided by centers to children below 6 years of age on a 5-point Likert scale. About 10% of children enrolled in each ICDS centre were selected, and their mothers were surveyed for satisfaction regarding supplementary nutrition services, informal education, immunization, and other health-related services and infrastructures. The data were expressed in number and percentages and the test of association between categorical variables was done using a chi-square test. The GraphPad Prism 6.01 (GraphPad Software, USA) was used for statistical test.
 Results: Among the surveyed 62 ICDS centres, service utilization rates were 98.04% for immunization, 90.56% for supplementary nutrition, 82.52% for informal education, 40.27% for health check-ups, and 13.32% for referral services regarding different health problems. A total of 89.63% of the mothers were satisfied with the supplementary nutrition, 83.46% with immunization and health-related services, 77.42% with informal education, and 56.5% with infrastructures.
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Abstract

Background: The Integrated Child Development Services (ICDS) scheme is a community-based program in India for the betterment of health and nutrition of children aged 0-6, pregnant and lactating mothers, and women aged 15-44 years. This study aimed to investigate the pattern of the utilization of services and the level of satisfaction of mothers regarding the services provided to their children in a block of West Bengal, India. Methods: This descriptive cross-sectional study was conducted from August 2016 to November 2018, and simple random sampling was used to select ICDS centres. The centres’ were evaluated for determining the rate of utilization of the services. For evaluating satisfaction, a face and content-validated, pre-tested questionnaire was used. The first part of questionnaire was for collecting the socio-demographic profile of mothers. The second part was concerned about determining satisfaction regarding various services provided by centers to children below 6 years of age on a 5-point Likert scale. About 10% of children enrolled in each ICDS centre were selected, and their mothers were surveyed for satisfaction regarding supplementary nutrition services, informal education, immunization, and other health-related services and infrastructures. The data were expressed in number and percentages and the test of association between categorical variables was done using a chi-square test. The GraphPad Prism 6.01 (GraphPad Software, USA) was used for statistical test. Results: Among the surveyed 62 ICDS centres, service utilization rates were 98.04% for immunization, 90.56% for supplementary nutrition, 82.52% for informal education, 40.27% for health check-ups, and 13.32% for referral services regarding different health problems. A total of 89.63% of the mothers were satisfied with the supplementary nutrition, 83.46% with immunization and health-related services, 77.42% with informal education, and 56.5% with infrastructures. Conclusion: Using supplementary nutrition and informal education exceeded expectations, but immunization, other health-related services, and referral services need improvement to achieve the program's goal. ICDS center infrastructure needs improvement, and a holistic approach is necessary to meet the satisfaction of mothers regarding different services.
印度西孟加拉邦一个街区儿童综合发展服务计划下为儿童提供的服务的利用和满意度
背景:儿童综合发展服务(ICDS)计划是印度一个以社区为基础的方案,旨在改善0-6岁儿童、孕妇和哺乳期母亲以及15-44岁妇女的健康和营养。本研究旨在调查印度西孟加拉邦一个街区的服务利用模式和母亲对为其子女提供的服务的满意度。方法:本研究于2016年8月至2018年11月进行描述性横断面研究,采用简单随机抽样选择ICDS中心。对这些中心进行了评价,以确定服务的利用率。为了评估满意度,使用了面部和内容验证的预测试问卷。问卷的第一部分是收集母亲的社会人口概况。第二部分是关于以5分李克特量表确定中心为6岁以下儿童提供的各种服务的满意度。在每个ICDS中心登记的儿童中,约有10%被选中,他们的母亲对补充营养服务、非正规教育、免疫接种和其他与健康有关的服务和基础设施的满意度进行了调查。数据以数字和百分比表示,分类变量间的相关性检验采用卡方检验。使用GraphPad Prism 6.01软件(GraphPad Software, USA)进行统计检验。 结果:在调查的62个ICDS中心中,免疫服务使用率为98.04%,补充营养服务使用率为90.56%,非正规教育服务使用率为82.52%,健康检查服务使用率为40.27%,不同健康问题转诊服务使用率为13.32%。89.63%的母亲对补充营养满意,83.46%的母亲对免疫接种和健康相关服务满意,77.42%的母亲对非正规教育满意,56.5%的母亲对基础设施满意;结论:补充营养和非正式教育的使用超出了预期,但免疫、其他健康相关服务和转诊服务需要改进,以实现该计划的目标。ICDS中心的基础设施需要改善,需要一个整体的方法来满足母亲对不同服务的满意度。
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