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The Integrated Child Development Services (ICDS) scheme is the largest program for promotion of maternal and child health and nutrition not only in India but in the whole world. The scheme was launched in 1975 in pursuance of the National Policy for Children. The scheme has expanded in the last twenty-seven years form 33 projects to 5171 blocks. ICDS is a multi-sectoral program and involves several government departments. The program services are coordinated at the village, block, district, state and central government levels. The primary responsibility for the implementation of the program lies with the Department of Women & Child Development at the Centre and nodal department at the states, which may be Social Welfare, Rural Development, Tribal Welfare or Health Department or an independent Department. The beneficiaries are children below 6 years, pregnant and lactating women and women in the age group of 15 to 44 yrs. The beneficiaries of ICDS are to a large extent identical with those under the Maternal and Child Health Program. The program provides an integrated approach for converging all the basic services for improved childcare, early stimulation and learning, health and nutrition, water and environmental sanitation aimed at the young children, expectant and lactating mothers, other women and adolescent girls in a community. ICDS program is the reflection of the Government of India to effectively improve the nutrition and health status of underprivileged section of the population through direct intervention mechanism. The program covers 27.6 million beneficiaries with supplementary nutrition. The program services and beneficiaries has essentially remained the same since 1975. Recently a review of the scheme was held, sponsored by Government of India, which suggested modifications in the health and nutrition component of ICDS scheme to improve the program implementation and efficiency.

Despite India's substantial progress in human development since its independence in 1947, 5-7% of its children have vitamin A deficiency disorders in selected geographic areas, 53% have iron deficiency anemia, and 9% have goiter. Three micronutrients--vitamin A, iron, and iodine--are among the most important of all the nutrients needed by the body because they are vital for developing normal learning and cognitive functions, immunity, work capacity, and reproductive health. The body cannot synthesize them, so they must be made available through the diet. Deficiencies of these three micronutrients are known to have devastating effects on health.

Iodine is one of the essential micro-elements required for normal human growth and development. Iodine Deficiency Disorders (IDD) are an important public health problem in India. There has been no data on the prevalence of IDD from the Kottayam district, India and hence, the present pilot study was conducted in the year 1999 to assess whether iodine deficiency existed in the district or not and to estimate the iodine content of salt consumed by the population. A total of 1872 children in the age group of 6-12 years were included in the study and were clinically examined. On the spot urine samples were collected from 251 children. A total of 420 salt samples were collected randomly from the families of the children. The total goitre prevalence was found to be 7.05% in the subjects studied. It was found that the percentage of children with urinary iodine excretions of < 2, 2- < 5, 5-9 and 10 microg/dL and above were 6.4%, 6.0%, 20.7%, and 66.9%, respectively. Assessment of the iodine content of salt by the iodometric titration method revealed that 60.6% of the children were consuming salt with an iodine content of 15 p.p.m. and more, which was the stipulated level of salt iodisation. The findings of the present study indicated that the population is in a transitional phase from iodine deficient, as revealed by total goitre rate, to iodine sufficient nutriture, as revealed by the median urinary iodine excretion level of 17.5 microg/dL.