Impact of ICDS and Allied Schemes on Women and Children in Haryana (1975–2025): A Critical, Data-Driven Analysis

 

-Ramphal Kataria

“Plateau or Progress? Evaluating the Effectiveness of ICDS and POSHAN Missions in Breaking Stagnation in Child Nutrition and Gender Equity Outcomes (1975–2025)”

Abstract

The Integrated Child Development Services (ICDS), launched nationally in 1975, remains India’s foundational social welfare intervention for early childhood development and maternal welfare. Over five decades it has been complemented by a suite of central and state schemes — supplementary nutrition, fortified-food provision, pre-school (playschool) expansions, maternal health support, girl-child incentive programmes, creches for working mothers, and child protection. This paper traces the evolution of ICDS and allied interventions from 1975 to 2025, using publicly available data (censuses, national and state surveys) and state-level administrative records, including recent reforms under Poshan Abhiyaan and Mission Saksham Anganwadi & Poshan 2.0. I compile time-series tables for indicators such as sex ratio, child and maternal mortality, undernutrition, early childhood education enrolment, and maternal health coverage. Where direct data are unavailable (especially for early years), we rely on proxy estimates, clearly marked. The paper analyses achievements — notable declines in mortality, improved maternal care, expansion of institutional mechanisms — as well as persistent gaps: undernutrition, uneven sex ratio recovery, varied quality of implementation, and lack of longitudinal outcome tracking. Finally, we assess whether recent missions (since 2022) represent genuine system transformation or remain largely policy-paper reforms. The paper concludes with recommendations for strengthening monitoring, data systems, behavioural change, and convergence of health, nutrition, education, and social protection.

Keywords: ICDS, Haryana, Poshan 2.0, sex ratio, under-five mortality, undernutrition, early childhood education, maternal health.

1. Introduction

The first six years of a child’s life — often termed the “window of opportunity” — are critical for physical growth, cognitive development, immunological foundation, and long-term health. Recognizing this, the Government of India launched the Integrated Child Development Services (ICDS) in 1975. The institutional framework — Anganwadi Centres (AWCs) staffed by Anganwadi Workers (AWWs) and Helpers — was designed to deliver a package of services: supplementary nutrition, health checkups and referral, immunization, preschool education (non-formal), nutrition & health education, and linkage to other health services.

For a state like Haryana, historically marked by skewed gender ratios, high child and maternal mortality, malnutrition, and low female literacy, ICDS and related welfare schemes hold prime significance. Over time, as socioeconomic conditions, health systems, and policy frameworks evolved, the scope of child and maternal welfare expanded beyond ICDS’s original design — incorporating fortified foods, maternal supplementation, early education, child protection, girl-child incentives, and digital monitoring under modern missions.

This paper aims to critically evaluate the impact of ICDS and allied programmes in Haryana from 1975 to 2025. It asks — what measurable improvements have occurred in child health, nutrition, gender balance, early education and maternal care? For whom? Where are the gaps? And have recent reforms under Poshan 2.0 and other missions broken the long-standing “plateau,” or do they remain policy pronouncements with limited ground-level traction?

2. Methods, Data Sources & Limitations

2.1 Indicators and Time Points

I selected a set of core indicators aligned to ICDS objectives and extended welfare goals:

Demographic / Gender Indicators: Total sex ratio (females per 1,000 males), child sex ratio (0–6 years).

Mortality Indicators: Under-Five Mortality Rate (U5MR), Infant Mortality Rate (IMR), Maternal Mortality Ratio (MMR).

Nutrition Indicators: Prevalence of stunting, wasting, underweight among children under 5.

Education / Early Childhood Outreach: Preschool / playschool / AWC enrolment (where data exist); primary school enrollment as proxy for long-term educational access.

Maternal Health / Service Coverage: Percentage of mothers receiving 4+ ANC visits, institutional deliveries.

I compare these across three time points:

1975 — approximated using closest available data (Census 1971, early SRS / health reports), marked as estimate or proxy.

2000 — approximate values from Census 2001, NFHS-2 / early SRS or other national health datasets.

2025 — latest available from NFHS-5 (2019–21), SRS 2021–22 reports, state administrative data (2024–25), and other publications.

2.2 Data Sources

Primary publicly available data sets and documents:

Census of India 1971, 2001, 2011 demographic tables. Census India+2Testbook+2

National Family Health Survey (NFHS-5, 2019–21) — Haryana state fact sheet & national compendium. DHS Program+2DHS Program+2

Nutrition data notes and state-level nutrition burden reports for Haryana (e.g., NITI Aayog’s State/Nutrition profile). NITI Aayog+1

Peer-reviewed and grey-literature studies on child health, nutrition, demographic trends in Haryana. ResearchGate+2sshajournal.com+2

National maternal & child health system reports (e.g., SRS-based MMR / U5MR records for Haryana) from state health bulletins. National Health Systems Resource Centre+1

Media and policy releases for recent demographic data (e.g., sex ratio trends, institutional delivery coverage) where official annual datasets are not yet released. Business Standard+2Business Standard+2

State-level administrative data for 2024–25 (e.g., playschool conversions, creche numbers, program coverage) are drawn from the information provided by the user (Haryana WCD Department) and used as “State WCD Department data (2025)” — marked clearly in the text.

2.3 Estimation, Proxy Use & Data Gaps

For 1975 and 2000, many indicators (nutrition, preschool enrolment, detailed maternal health coverage) are not directly available in public archives or national datasets in a format that can yield state-level estimates. Thus, we employ proxy methods: using national estimates, decade-averaged SRS, or earliest plausible state-level data. These data are clearly marked as “proxy estimate” or “requires archival retrieval.”

For some education indicators (preschool / AWC enrolment in early decades), we marked as data unavailable, because AWCs were being rolled out in phased manner, and systematic enrollment records from 1975 onward are not publicly digitized.

For maternal health coverage (ANC visits, institutional delivery) in 1975–90s, data are nearly absent — we note this and suggest retrospective archival research or field surveys if required for deeper historical analysis.

These limitations affect the precision of long-term trends; yet, they do not undermine the broader qualitative observations regarding direction and magnitude of change when triangulated with multiple sources.

3. Historical Evolution of ICDS & Allied Programmes (1975–2025): A Narrative

3.1 Launch of ICDS and the early decades (1975–1985)

When ICDS was launched in 1975, Haryana — like much of India — suffered from widespread child malnutrition, high infant and maternal mortality, low female literacy, and poor early childhood care infrastructure. The 1971 Census recorded a sex ratio of 875 females per 1,000 males in Haryana. Census India

Initial ICDS roll-out was limited: few AWCs, minimal staff, inconsistent coverage; supplementary nutrition was modest, and preschool education only sporadically functional. In this period, setbacks in developmental infrastructure, poverty, lack of maternal care, and limited social awareness constrained the potential impact of ICDS.

3.2 Expansion and consolidation (1985–2000)

During the 1980s and 1990s, ICDS gradually expanded across rural and urban blocks; more AWCs established; supplementary nutrition became regularized. Some state governments (including Haryana) began recognizing the need for targeting vulnerable groups — pregnant women, lactating mothers, adolescent girls — though the resources were modest.

By 2000, the demographic stress was visible: low child sex ratio, persistent malnutrition, and maternal health deficits. However, the institutional framework had expanded sufficiently to allow greater reach for child and maternal services. This set the foundation for more intensive interventions in the new millennium.

3.3 Intensification and layering (2000–2015)

In 2000s and early 2010s, several overlapping trends shaped ICDS’s evolution:

Greater push for maternal health (through reforms in public health, Janani Suraksha Yojana, institutional deliveries) linked with ICDS nutritional and referral components.

Enhanced focus on child immunization, growth monitoring, and identification of severely malnourished (SAM) children.

Expansion of early childhood education through AWCs; though quality and uniformity remained a challenge.

Emergence of civil society and policy-level emphasis on girl child, gender equity, and child protection, seeking to leverage ICDS / AWCs as outreach nodes.

Growing evidence from NFHS and other surveys highlighting chronic undernutrition, child mortality, and gender imbalance — spurring policy debates and incremental reforms.

3.4 Recent decade (2015–2022): Policy reforms, nutrition push, and pre-school expansion

With rising awareness of the malnutrition burden and gender disparities, the mid-to-late 2010s saw intensified efforts: introduction of fortified foods in many states, nutritional supplementation, adolescent girl outreach, and early childhood education revamps. In Haryana, these trends coincided with state-level innovations — including milk supplementation schemes, improved THR/HCM norms, and emphasis on fortified staples.

The national launch of Poshan Abhiyaan (2018) marked a milestone — with a life-cycle approach to nutrition, convergence across ministries, and push for evidence-based interventions. In parallel, civil society and media attention to skewed sex ratio and female disadvantage increased pressure on states to respond.

3.5 2022–2025: Mission Saksham Anganwadi & Poshan 2.0, renewed reforms, and state-level mobilization

In August 2022, the Government of India issued guidelines for Mission Saksham Anganwadi & Poshan 2.0 — a paradigm shift in ICDS implementation. Major elements include:

Emphasis on dietary diversity, millets, fortified staples, and micronutrient-rich nutrition.

Strengthening of Take-Home Ration (THR) / Hot Cooked Meal (HCM) norms.

ICT-enabled tracking (Poshan Tracker) for last-mile delivery and beneficiary monitoring.

Integration with maternal health, early childhood education, and community mobilisation.

At the state level, Haryana expanded pre-school infrastructure: user-provided data indicates 4,000 AWCs upgraded to playschools and 50,309 children enrolled in 2024–25. Creche expansion, fortified milk supplementation, and enhanced nutritional norms reflect renewed administrative commitment.

This period thus represents a critical juncture — potentially a transition from decades of incremental change to mission-mode systemic reform.

4. Results: Trends in Key Indicators (1975 / 2000 / 2025)

Below are consolidated tables summarizing the key indicator values across the three time points. Cells marked “(estimate/proxy)” reflect approximate values derived from closest available data; “Data unavailable / archival retrieval needed” marks areas where published data are not accessible and require further investigation.

Table 1: Sex Ratio & Child Sex Ratio — Haryana (1975 / 2000 / 2025)

Year / Indicator	Total Sex Ratio (females per 1,000 males)	Child Sex Ratio (0–6 yrs, females per 1,000 males)
1975 (proxy)	~ 875¹	~ 898²
2000 (proxy, Census 2001)	861³	819³
**2025 (latest state-wide data / administrative + census 2011 + press 2024–25) **	~ 879–915⁴	~ 830–910⁵

Notes / sources:

1. 1971 Census sex ratio for Haryana was 875. Census India

2. 1971 child sex ratio was recorded around 898 (for Haryana), used as proxy for 1975 baseline — archival SRS / state data retrieval recommended for precision. (Estimate / proxy)

3. Census 2001 reported total sex ratio 861 and child sex ratio 819 for Haryana. Testbook+1

4. 2011 Census recorded sex ratio 879; recent state-level monitoring and media reports (2023–25) indicate modest improvements, especially in sex ratio at birth (SRB) in many districts. Testbook+2Business Standard+2

5. 2011 child sex ratio was 834; some districts report birth-ratio improvements under intensified monitoring post-2022 reforms, though full data for 2025 not yet consolidated — indicates potential range 830–910 depending on district. Embibe+2International Journal of Research+2

Table 2: Mortality Indicators (Under-5, Infant, Maternal) — Haryana (1975 / 2000 / 2025)

Indicator	1975	2000	2025 (latest)
Under-Five Mortality Rate (per 1,000 live births)	~ 120–150 (estimate / proxy)	~ 70–90 (estimate)	~ 31 (SRS 2022)⁶
Infant Mortality Rate (IMR, per 1,000)	~ 90–120 (estimate / proxy)	~ 60–80 (estimate)	~ 27–33 (recent SRS/NFHS)⁷
Maternal Mortality Ratio (MMR, per 100,000 live births)	~ 400–600 (historical estimate)	~ 200–400 (estimate)	~ 89–106 (2020–22 SRS / state health reports)⁸

Notes / sources:

1. Recent SRS (2022) reports U5MR for Haryana at ~31 per 1,000 live births. State NHM & health bulletins confirm decline. National Health Systems Resource Centre+1

2. NFHS-5 and SRS infant mortality estimates place IMR for Haryana in low 30s. DHS Program+1

3. According to state health reports and SRS 2016–18 bulletins, Haryana’s MMR declined from ~153 (2007–09) to ~91 (2016–18). Recent improvements reported further to 89 (2022), though still slightly above national average. National Health Systems Resource Centre+1

Interpretation: There has been a dramatic decline in child and maternal mortality over the past five decades, reflecting improvements in institutional deliveries, immunization, maternal and child care — areas where ICDS and allied health interventions intersect.

Table 3: Child Undernutrition (Children under 5) — Haryana (1975 / 2000 / 2025)

Nutritional Indicator	1975 (proxy / estimate)	2000 (approx)	2025 (latest, NFHS-5 / state data)
Stunting (%)	Likely > 50% (estimate)	~ 45–50% (approx)	~ 28–34% (state NFHS-5 / nutrition notes)⁹
Wasting (%)	Likely > 20–30% (estimate)	~ 20–25% (approx)	~ 12–19% (recent NFHS / state data)¹⁰
Underweight (%)	Likely > 40–50% (estimate)	~ 35–45% (approx)	~ 32% (NFHS-5 & recent studies)¹¹

Notes / sources:

1. The state-level nutrition data note (NITI) and NFHS-5 show decline in stunting but many districts still have high burden; stunting estimated at 28–34% depending on district. NITI Aayog+1

2. Similarly, wasting has declined but remains a concern, especially with district heterogeneity. NITI Aayog+1

3. Underweight prevalence remains significant, though improved compared to estimated historical levels. National NFHS-5 shows underweight decline; state trend similar. DHS Program+1

Interpretation: While chronic and acute undernutrition have declined over time, they remain persistent public-health challenges. The reductions are evidence of progress, but the high residual burden indicates deep-rooted structural and socio-economic determinants.

Table 4: Early Childhood Education / Preschool & Primary Enrolment — Haryana (1975 / 2000 / 2025)

Indicator	1975	2000	2025 (latest)
Preschool / Anganwadi-Playschool enrolment (0–6 yrs)	Data unavailable — AWC network nascent; no consolidated records	Partial coverage; many AWCs functional but no comprehensive data — archival records needed	50,309 children enrolled in 4,000 playschools (2024–25) (State WCD Dept data)¹²
Primary school gross/net enrollment (proxy for basic education access)	Data sparse / not systematically collected	Improvement over 1990s–2000s (SSA expansion) — but exact 2000 state data not compiled here	Near-universal primary enrolment; per UDISE data (not compiled in this paper) but state reports suggest high enrollment & improving literacy — especially among girls¹³

Notes:

1. User-provided data from Haryana WCD Dept indicates 4,000 AWCs upgraded to playschools and 50,309 children enrolled in 2024–25.

2. Detailed UDISE data (gross enrollment, retention) should be retrieved for long-term trend analysis; not compiled here due to volume and access constraints.

Interpretation: Early childhood institutional care via AWCs / playschools has expanded. The 2024–25 data reflect a major scale-up in preschool outreach. However, lack of consistent historical data (1970s, 1980s, 1990s) makes it difficult to quantify the extent of improvement; archival records or district-level longitudinal data needed for robust assessment. Primary school enrollment has improved, but without longitudinal linkage we cannot isolate effect of early childhood interventions.

Table 5: Maternal Health Service Coverage (ANC & Institutional Delivery) — Haryana (2000 / 2025)

Indicator	2000 (approx / proxy)	2025 (latest: NFHS-5 / health system data)
% mothers receiving at least 4 ANC visits	Estimate: 20–40% (proxy)	58.1% (per NFHS-5)¹⁴
% institutional deliveries	Increasing trend; estimate ~50–70% (mixed urban/rural)	88.6% institutional deliveries (per NHM national data)¹⁵

Notes / sources:

1. NFHS-5 data for India indicates that 58.1% of pregnant women receive 4+ ANC visits; Haryana’s state fact sheet reflects comparable or slightly higher coverage. National Health Mission+1

2. National health mission data show institutional deliveries rising from 78.9% (NFHS-4) to 88.6% (NFHS-5) — reflecting improved maternal care and safe delivery access. National Health Mission+1

Interpretation: Maternal health care coverage has improved substantially in the last two decades. Better antenatal care and high institutional delivery rates contribute to declines in maternal and infant mortality. However, quality of ANC (nutritional counselling, micronutrient supplementation, postnatal care) remains to be strengthened to ensure long-term maternal and child health outcomes.

5. Analysis: What the Evidence Shows — Achievements and Persistent Gaps

5.1 Achievements & Strengths

Dramatic reduction in mortality: The decline in U5MR, IMR, and MMR from estimated 1970s levels to modern low-single-digit (for U5MR per thousand) reflects substantial progress in child and maternal survival. This indicates effective convergence of health, nutrition, and maternal-child programmes, including immunization, institutional deliveries, supplementary nutrition, and improved maternal care.

Institutionalization and scale of delivery platform: ICDS’s AWC network, over decades, has become a widespread institutional backbone for delivering nutritional and pre-school services. In Haryana, recent expansion to 4,000 playschools demonstrates administrative commitment to early childhood care.

Improved maternal health service coverage: ANC coverage and institutional deliveries have increased markedly, aiding maternal and child survival, and improving birth outcomes.

Nutrition improvements (though partial): Declines in stunting, wasting, and underweight indicate gradual improvement in child nutrition — an outcome of enhanced supplementary nutrition, fortified food initiatives, and maternal care.

Policy renewal and technical refinement: The 2022 launch of Poshan 2.0 and Saksham Anganwadi brings technical sophistication — dietary diversity, millets, fortified staples, digital tracking, and community mobilization. Haryana’s adoption of these norms (fortified milk supplementation, revamped THR/HCM) suggests potential for improved nutrition outcomes.

5.2 Persistent Challenges and Gaps

Undernutrition remains high: Even as stunting and wasting have declined, substantial proportions of children under five remain undernourished, especially in poorer districts. Chronic malnutrition and micronutrient deficiencies (e.g., anaemia) persist, indicating that supplementation alone is insufficient without sustained dietary diversity, public health, and sanitation interventions.

Gender imbalance and fragile gains: While total sex ratio has improved modestly since 2001, child sex ratio remains fragile. District-level heterogeneity persists, with some districts showing decline or stagnation in sex ratio at birth (SRB). Deep-rooted socio-cultural biases, son preference, and sex-selective practices continue to undermine gains.

Lack of long-term outcome data / cohort tracking: There is no publicly available longitudinal tracking of children who benefited from early ICDS services — making it difficult to link early childhood interventions to long-term educational attainment, health, and social outcomes.

Quality and consistency of delivery vary widely: Many AWCs — particularly in remote or marginalized areas — suffer from poor infrastructure, lack of trained staff, irregular supply of nutritious food, and limited child-friendly learning environment. Implementation quality remains uneven across districts.

Insufficient social protection & empowerment beyond early childhood: While maternal and early-childhood interventions have strengthened, adolescent girls, older children, and women’s socio-economic empowerment (skills development, livelihood support) receive less emphasis, limiting intergenerational transformation.

Behavioural and structural determinants under-addressed: Nutrition, gender bias, early marriage, low female education, socio-economic inequality, sanitation — structural determinants — continue to influence outcomes, but many schemes focus on supply-side delivery rather than demand-side behavioural change or social norms transformation.

6. Do Recent Reforms (2022–2025) Mark a Breakthrough or Remain Policy Papers?

The 2022 launch of Poshan 2.0 and Mission Saksham Anganwadi represents a paradigmatic upgrade: focus on dietary diversity, fortified food, millet integration, ICT-enabled tracking, convergence across sectors, and community-based outreach. Haryana’s adoption of these guidelines — expansion of playschools, fortified milk schemes, improved THR/HCM norms — indicates administrative seriousness.

However, measurable population-level outcomes (e.g., stunting reduction, sex ratio normalization, long-term educational gains) will only show up over time, likely in the next 5–10 years — depending on consistent implementation, funding continuity, frontline capacity, and robust monitoring.

Thus, as of 2025, these reforms are best characterized as “systemic potential” rather than confirmed breakthroughs. Their success will depend on overcoming structural bottlenecks and delivering quality, equitable services at scale.

7. Policy Recommendations

Based on analysis, the following are recommended to strengthen ICDS & allied programmes in Haryana (and similar states):

1. 

1. Establish robust longitudinal data systems:

i. Create a unique child-ID system linking ICDS, health, and education records.

ii. Track cohorts from birth through age 18 to monitor long-term outcomes (health, education, social mobility).

2. Upgrade frontline infrastructure & human resources:

i. Standardize AWC infrastructure: safe buildings, clean water, kitchen/storage for HCM, sanitation.

ii. Professionalize Anganwadi Workers: accredited early childhood education (ECE) training, performance-based incentives, regular capacity building, career progression.

2. Ensure quality and diversity in nutrition:

i. Scale up fortified foods, locally sourced millets, pulses, vegetables, and seasonal produce.

ii. Use technology (supply-chain tracking) to avoid leakages, food spoilage, or expiry.

iii. Integrate nutritional supplementation with health interventions (de-worming, micronutrients, immunization, maternal care).

3. Demand-side and behavioural change interventions:

i. Conduct community mobilization (via panchayats, women’s groups, adolescent clubs) to promote gender equity, raise value of girl child, discourage sex-selective practices.

ii. Leverage education system and media for sustained gender-sensitization campaigns.

4. Expand early childhood education & childcare infrastructure:

i. Scale up creches (especially urban / peri-urban areas) to enable working women participation.

ii. Evaluate the impact of playschools and creches on early learning outcomes, school readiness, and female workforce participation.

5. Strengthen child protection and social welfare:

i. Expand foster-care, adoption, after-care programmes under child-protection mandates.

ii. Provide psychosocial support, education, and livelihood linkage for children leaving institutional care.

6. Cross-sectoral convergence:

i. Integrate ICDS/nutrition programmes with water-sanitation (WASH), public health, sanitation, education, social welfare, and livelihoods to address root determinants of malnutrition, mortality, and gender inequality.

7. Independent monitoring and transparent accountability:

i. Periodic third-party audits and community-level social audits of AWCs and nutrition delivery.

ii. Public dashboards showing coverage, nutritional status, child sex ratio, resource utilization, and grievances redressal status.

8. Research Agenda: Filling Data Gaps & Improving Evidence Base

To deepen understanding and enable evidence-based policy, the following research actions are recommended:

Archival retrieval of 1970s–1990s data: SRS, state health department and ICDS records to build accurate baselines.

Cohort studies: Follow children enrolled in AWCs in early childhood to assess long-term impact on health, cognition, education, and social mobility.

Randomized or phased rollout evaluations: Especially for Poshan 2.0/Nutrition interventions — to estimate causal impact on stunting, anaemia, cognitive development.

Cost-effectiveness analysis: Compare cost per DALY averted across interventions (THR/HCM, fortified foods, milk supplementation, creches, ECE).

Qualitative studies on socio-cultural determinants: Investigate persisting son preference, barriers to utilization of services, social acceptance of girl child, intra-household resource allocation, and community perceptions of AWCs/creches.

9. Conclusion

Over the past five decades, ICDS and allied schemes have established a broad institutional framework for delivering child and maternal welfare in Haryana. The declines in child and maternal mortality, improvements in maternal health service coverage, expansion of early childhood education infrastructure, and partial reduction in undernutrition are concrete signs of progress. The 2022 launch of Poshan 2.0 and state-level reforms represent a renewed commitment to address deeper nutritional and social deficits.

Yet, chronic undernutrition, gender imbalance, structural inequalities, and uneven quality of service delivery continue to limit full realization of ICDS’s promise. The absence of longitudinal outcome data, uneven frontline capacity, and socio-cultural barriers further impede transformational change.

For ICDS and allied missions to truly succeed — to break the long-standing plateau — they must evolve from being supply-driven administrative schemes to rights-based, outcome-oriented, community-anchored systems. This requires sustained political will, robust monitoring, convergent social policies, community pro-female social change, and investment in human and institutional capacity. Only then can the vision of a society where every child — irrespective of gender — has the right to nutrition, health, education and dignity be fully realized.

10. References

1. Census of India. Provisional Population Totals, Series-6, Haryana, 1971. Directorate of Census Operations, Haryana. 1971. Census India

2. Census of India. Provisional Population Totals — Data on Population by Sex and Child Sex Ratio, Haryana, 2001 and 2011. Directorate of Census Operations, Haryana. 2001, 2011. Testbook+1

3. International Institute for Population Sciences (IIPS) & ICF. National Family Health Survey (NFHS-5), India 2019–21: Haryana fact sheet. Mumbai: IIPS. 2021. DHS Program+1

4. NITI Aayog. State/Nutrition Profile – Haryana (Data Note on Nutrition & Health Outcomes, 2022). Government of India & State of Haryana. 2022. NITI Aayog+1

5. Hooda D.S., Sandeep. “Performance and status of child-healthcare indicators in Haryana: A study of NFHS rounds.” SSH Journal, 2024. ResearchGate+1

6. National Health Mission, Haryana. State Health & Family Welfare Bulletin, SRS & Health Indicators Summary, 2022. Government of Haryana. (MMR, U5MR, institutional delivery data) National Health Systems Resource Centre+1

7. Ministry of Health & Family Welfare (MoHFW), Govt of India. “NFHS-5: India report — Key findings on child and maternal health (2021).” 2021. Ministry of Health and Family Welfare+1

8. “Sex Ratio improves in Haryana.” Business Standard, 6 May 2013. Business Standard+1

9. Research on Child Sex Ratio dynamics in Haryana. “Alarming child sex ratio of Haryana.” Research Journal of Humanities and Social Sciences, 2018. ResearchGate+1

Note: For some 1975 and 2000 indicator values (especially nutrition, preschool enrolment, maternal health coverage), publicly accessible state-level disaggregated data remain limited. Estimates have been made using the closest available datasets (census, SRS national surveys) — their limitations are acknowledged in the paper. Use of such estimates is meant only for illustrating long-term trends; archival data retrieval / field studies are necessary for accurate historical baselines.