Ramani Sudha, Sridhar Rama, Shende Sushma, Manjarekar Shreya, Patil Sonali, Pantvaidya Shanti, Fernandez Armida, Jayaraman Anuja
SNEHA (Society for Nutrition, Education and Health Action), Mumbai, Maharashtra, India.
J Family Med Prim Care. 2021 Oct;10(10):3600-3605. doi: 10.4103/jfmpc.jfmpc_2526_20. Epub 2021 Nov 5.
The National Nutrition Mission (POSHAN Abhiyaan) intends to "converge" nutrition-related program components across sectors (nutrition, health, water, and sanitation). In this study, we have examined the perspectives of Anganwadi workers (AWWs), the frontline workers of the Integrated Child Development Services, on working in convergence with the public health sector.
This exploratory qualitative study was done between June 2018 and June 2019 in two urban informal settlements in Mumbai. We conducted in-depth interviews with 26 AWWs and their supervisors, purposively sampled and diversified in terms of age, education, and years of experience. We used the software NVivo version 12 to aid analysis.
Most AWWs acknowledged that a convergent framework of action between "nutrition" and "health" was likely to be beneficial to the community. However, they also shared that cross-sector convergence was currently limited due to technical unfamiliarity with "health-sector" issues in the frontline, discomfort with data sharing, and lack of meaningful incentives for joint work. Broader organizational challenges such as poor infrastructure and lack of supervision, as well as challenges in the urban context (migration and cultural barriers) further hindered joint activities.
The findings indicate that critical structural gaps in the urban setup of ICDS need to be addressed and AWWs need to be better familiarized with the changing roles expected from them under . To work better with the health sector, the work timings of AWWs need to be aligned with those of the health sector and meaningful financial incentives need to be put in place for cross-sector activities.
国家营养使命（“POSHAN Abhiyaan”）旨在整合各部门（营养、健康、水和卫生设施）与营养相关的项目组成部分。在本研究中，我们调查了综合儿童发展服务的一线工作人员——anganwadi工作人员（AWWs）对于与公共卫生部门协同工作的看法。
这项探索性定性研究于2018年6月至2019年6月在孟买的两个城市非正式定居点进行。我们对26名AWWs及其主管进行了深入访谈，根据年龄、教育程度和工作经验进行了有目的的抽样和多样化选择。我们使用NVivo 12版软件辅助分析。
大多数AWWs承认，“营养”和“健康”之间的协同行动框架可能对社区有益。然而，他们也表示，由于一线人员对“卫生部门”问题技术不熟悉、对数据共享感到不适以及缺乏联合工作的有意义激励措施，目前跨部门融合有限。更广泛的组织挑战，如基础设施差和缺乏监督，以及城市环境中的挑战（移民和文化障碍）进一步阻碍了联合活动。
研究结果表明，需要解决综合儿童发展服务城市设置中的关键结构性差距，AWWs需要更好地熟悉在……下对他们期望的不断变化的角色。为了更好地与卫生部门合作，AWWs的工作时间需要与卫生部门的时间一致，并且需要为跨部门活动制定有意义的经济激励措施。
