Introduction
deaths
LENS, CHILD MALNUTRITION
The early years are crucial to ensure that each child reaches their productive and creative potential in adulthood (A Holistic Early Childhood Development (ECD) fosters the overall growth of a child, with the various domains of child development collectively shaping a child’s development and growth. This includes their physical development (i.e., gross and fine motor skills), brain or cognitive development, language development, socio-emotional development and behavioral development.India’s national Integrated Child Development Service (ICDS) program was initiated in 1975 to tackle child malnutrition and illnesses. ICDS is one of the government’s most extensive and prominent initiatives that offer nutritional supplementation, immunization, height and weight monitoring, and non-formal education to children under six through Anganwadi Centers (AWCs). An Anganwadi Worker (AWW), operating at the grassroots level, is responsible for catering to a thousand population through an Anganwadi Center (AWC), with assistance from the Anganwadi Helper (AWH). However, the recent assessment of the ICDS programs recommended reinforcing the infrastructure, training, and support systems for AWC and staff. The report suggested an adapted curriculum and a framework to oversee the program implementation. Despite the primary emphasis of ICDS being on the early years of life, its efforts primarily revolve around nutritional supplementation and children’s healthcare needs. Unfortunately, the responsive parenting program, vital for fostering early childhood development, is considerably underrepresented within ICDS (In India, 55% of children under 6 months are exclusively breastfed. Although breastfeeding is nearly universal in Maharashtra, only 57% of children under 6 months are exclusively breastfed, as the World Health Organization (WHO) recommends. Encouragingly, 87% of infants are introduced to breastfeeding within the first day of their lives, but it drops to 57% for those who begin breastfeeding within the recommended first hour of life. In the context of child health, the infant mortality rate in Maharashtra in NFHS-4 is estimated at 24 deaths before the age of 1 year per 1,000 live births (Integrating parenting with nutrition interventions blended with traditional community-focused child-rearing approaches for Early Child Development (ECD) are evidence-based practices proven effective for ECD (In this paper, we describe the design, implementation, and evaluation of a complex intervention to strengthen the nurturing environment for young children. The evidence for ECD intervention programs is well established; however, a critical design issue for such complex interventions is adequately addressing the sociocultural context and current childcare practices (This study aims to determine the effectiveness of the integrated responsive parenting and nutrition program on child development outcomes in children under 2 years from rural India. The study also reflects upon the cycle of design, implementation, and evaluation using the lens of the Measurement for Change (