Anganwadi workers (AWWs) must be trained to identify and support patients with Neurodevelopmental Disorders (NDDs)
When risk factors associated with NDDs go unmitigated, neurodevelopmental outcomes like increased prevalence of infant mortality, early morbidity, and psychosocial delay and disability are well observed and often cascade into long-term physical and mental illness, as well as poorer school and economic achievement. Additionally, these changes can persist into adulthood and contribute to emotional instability, substance abuse, aggression, obesity, and stress-related disorders increasing the burden of neurodevelopmental disorders.
The impacts from comprehensive ECD interventions are simpler, cheaper and more effective as they have shown to have mitigating effects caused by neuro-morbidities in prenatal and postnatal periods and those at higher risk for developmental delays. Anganwadi workers (AWWs) and helpers who play a crucial role at the grassroots require several critical competencies to effectively facilitate and monitor children’s emerging sensory, motor, cognitive, communication, social and emotional skills.
The challenges faced in Anganwadi Centres are many and so a comprehensive and strategically-designed series of programs to ensure that children attending Anganwadi Centres receive age-appropriate developmental stimulation and monitoring to reach their full potential needs immediate priority. This means that capacity building of AWWs who are visiting homes has to be strengthened. These AWWs should only focus on home visits and the capacity-building programs need to be streamlined to support them in delivering maternal and child care services for prenatal, perinatal, and postnatal follow-up of mothers and infants from conception to 24 months of age.
Prior research in the context of home-based programs offers evidence that interventions focusing on improving mother-child interactions and home environments can lead to significant effects on the child’s cognitive skills. The outcomes are also associated with superior social skills and reduced behavioural problems in school. For Anganwadi workers to provide this level of care directly, increasing their ability to train and mentor parents/caregivers is the only way to address root causes on the scale, in a cost-efficient manner.
By being able to ‘nudge’ health-promoting behaviours, risk factors that contribute to infant mortality, neuromorbities and impaired school readiness can be addressed. This is why Anganwadi workers as the pivot point to enact the behavioural changes required at the family system level are most crucial.
Capacity-building of AWWs should include scalable and sustainable best practices in ECD. Measurement and monitoring child’s development by leveraging digital technologies for measuring long-term impacts will ensure the holistic growth and development of children from birth to 2 years. These programs have to be more parent-focused and delivered in home settings ensuring that children receive the necessary care, nutrition, health support, and early education for their optimal growth and development during the first two years of development.
Prevention is better than cure- Capacity-building programs for AWWs are important to break the intergenerational cycle of malnutrition, illiteracy and poverty that can have implications for reducing the burden of disease in children with NDDs in terms of Disability-Adjusted Life Year (DALY)
(The writer is a Professor of Psychology, at Ashoka University. Views expressed are personal). Concluded.