Integrated Child Developmental Services (ICDS) has played an important role in improving the health and education of children of India [1]. The state of Kerala has better health and socio-economic indicators compared to most other parts of the country. However, there are not many studies assessing the utilization of Anganwadi services in Kerala [2-4]. This study was done in a rural area near Kochi. In the first stage of sampling, we selected four wards randomly. In the selected wards, the investigators visited consecutive houses in all directions from the entry point to the ward. We collected data from 352 households regarding utilization of Anganwadi services in the past 1 year. The information was obtained from an adult member present at the time of visit, preferably a lady.

In our sampling frame, 136 families had children below 6 years, 66 families had adolescent girls (11-19), and 193 women were in reproductive age group out of which 26 were lactating or pregnant. All respondents knew about Anganwadi; 79% were aware of supplementary nutrition provided from there. Respondents had average (71.4%) or good (8.5%) knowledge about services provided to children below 3 years, but not to other age groups.

Only 40 (70%) out of 57 families who had children below 3 years and only 43 (54%) out of 79 families with children between 4-6 years availed the Anganwadi facilities. Just 6 (9%) out of 66 adolescent girls and 5 (19%) out of 26 pregnant/lactating women availed these services. Only 2 out of 193 women in the reproductive age group of 19-45 utilized the ICDS services.

76% of all respondents who availed the facilities were completely satisfied with the services. Of those, who were not satisfied, 64% did not mention any specific reason and 23% felt that the facilities were inadequate. Those who did not avail the facilities did so because they were not interested (50%).

The survey indicates that Anganwadi services for children are under-utilized. Among other age groups, very few utilized ICDS services. There is an urgent need to carry out qualitative studies to know more about the reasons for non-utilization and expectations from these services.

Contributors: PTF: concept, supervision of data collection and wrote the manuscript. He also had a role in data analysis. NP: statistical advice, supervised data entry, and carried out data analysis.

Funding: None; Competing interests: None stated.

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