Prasad Vandana
Public Health Resource Society, New Delhi, India
BMJ Paediatr Open. 2025 Sep 2;9(1):e003857. doi: 10.1136/bmjpo-2025-003857.
This article reviews the current status of the Integrated Child Development Services (ICDS) Scheme, India; the largest Early Childhood Care and Development (ECCD) programme in the world, at 50 years of its existence. While there has been substantial advance of this scheme in terms of coverage and quality, its thrust has remained on providing supplementary nutrition and much more needs to be done to achieve truly universal and comprehensive ECCD services. The major issues besetting favourable outcomes relate to inadequate investments resulting in poor infrastructure, inadequately remunerated and capacitated ICDS workers and an overcentralisation resulting in a critical lack of community engagement and contextual adaptation. Social legislation is likely to be required to promote the rights of very young children through the reinvigoration of this scheme.
本文回顾了印度综合儿童发展服务（ICDS）计划的现状；该计划是世界上最大的幼儿保育与发展（ECCD）项目，迄今已实施50年。尽管该计划在覆盖范围和质量方面取得了显著进展，但其重点仍在于提供补充营养，要实现真正普及和全面的ECCD服务，还有很多工作要做。影响良好成果的主要问题包括投资不足导致基础设施薄弱、ICDS工作人员薪酬过低且能力不足，以及过度集权导致严重缺乏社区参与和因地制宜的调整。可能需要通过重振该计划来推动社会立法，以促进幼儿的权利。
