Understanding Policy Convergence Through The Structural overlaps of ICDS And NRHM.

Abstract

The objective of this research is to study the overlaps of the Integrated Child and Development Services Scheme and the National Rural Health Mission in the existing health system of India in order to understand the larger context of policy convergence in India. The ICDS Scheme run by the Ministry of Women and Child Development was envisaged as a convergence of nutrition, health and education programmes with the aim of having a better, overall impact of these services. Services from ante and post natal care to pre-primary education were being delivered with the help of Auxiliary Nurse/ Midwives and Anganwadi Workers under the scheme until 2005. In the light of the scheme failing to produce desirable results, the National Rural Health Mission was launched in April 2005, along with the flagship programme for appointing Accredited Social Health Activists, under the Ministry of Health and Family Welfare. With this, there was an attempt to take a step further in the direction of inter-sectorial convergence. The ICDS cluster was born out of the realisation that the problems of health and nutrition cannot be solved in isolation. NRHM too categorically identifies intersectorial convergence as incremental to the success of these initiatives in its implementation guidelines but provides no clear indications detailing how to achieve this convergence. Moreover, neither one of the programmes has the onus of ensuring convergence as proposed. As a result, even though there is some convergence at the top bureaucratic levels in differential degrees the effects fail to ripple down to the field level and the system is ineffectual in the present form. This lack of coordination between MoWCD, MoHFW and other health mechanisms has been identified as the key reason behind India's poor nutritional status. There is a thus need for understanding the various aspects of convergence in the selected policies and identifying the mechanisms throughout the structures furthering or hindering the achievement of goals and that is the focus on this research.