SNEHA, a Mumbai-based NGO, has been successfully working with slum-dwellers to ensure maternal and newborn health, as well as reduced cases of malnourishment, finds Jayadev Calamur
For several families living in the slums of Mumbai, survival is the key. They come from various corners of the subcontinent to live the Mumbai dream. They live with others, work throughout the day to ensure that they have the basic meal and that their children have quality education in an English medium school. But with these aspirations, they tend to neglect their children’s health.
Enter Society for Nutrition, Education and Health Action (SNEHA), an NGO that has for several years working with slum-dwellers from Mumbai, with focus on maternal and child health, as well as prevention of violence against women and children.
Fifteen-month-old Priyanshi came for monthly anthropometry and weighed a little over 6 kg with a height of 71 cm. Inactive and unable to walk, Priyanshi was graded as Severe Acutely Malnourished. “The biggest challenge we have faced is that people do not prioritise health. For them, it’s all about livelihood and education,” said Vanessa D’Souza, the CEO of SNEHA, while speaking to dna.
Incidentally, SNEHA started out as an NGO that worked alongside pregnant women, but eventually branched out into ensuring proper health for both mothers and their children. “We worked with women and they would give birth to healthy babies. However, over the course of time, we saw the infants were malnourished and it became a matter of concern for us, which is when we started working towards educating mothers on the importance of early nourishment for the child,” D’Souza added.
According to the World Health Organisation, infants should be exclusively breastfed - i.e. receive only breast milk for the first six months of life to achieve optimal growth, development and health. After this period, if a child is still malnourished SNEHA redirects the parents and children to local civic hospitals such as Sion Hospital, where they are given a medical nutrition therapy made of soyabean paste, peanut paste, milk powder and micronutrients. “The nutrition therapy is distributed in a box the size of an ice cream cup and it provides the necessary nutrition for the child to grow. Also, the dosage depends on the child’s health and is usually administered for a period of 56 days,” informed D’Souza.
The Dharavi Project
Currently, SNEHA has hired and trained several people within Dharavi’s community to work with mothers and children. Each worker is given the responsibility of three anganwadis, with one anganwadi comprising 1,000 people. With a recorded population of 3,00,000, Dharavi has 300 anganwadis. These volunteers train mothers how to breastfeed, instruct them on the importance of breastfeeding their children and conduct monthly recordings of the child’s height and weight to ensure that they aren’t malnourished. “This exercise and regular work conducted by our volunteers, which includes recording each infant and monitoring their growth, has ensured that the levels of malnourishment in Dharavi have dropped by 28 per cent in the past two years,” said D’Souza.
From Dharavi, SNEHA also began working in Mankhurd, Malwani, Govandi and Wadala, alongside the families there.
While the work is satisfying, the team at SNEHA admits that there are a few challenges. For starters, health isn’t a priority amongst slum dwellers. “Another challenge we face is migration. A family may move from Dharavi to another slum pocket or back to their native village. We track them for a six-month period to trace them down, but if we can’t find them, we assume that they have permantely migrated,” said D’Souza.
Working with the Government
SNEHA works regularly with both the central government’s Integrated Child Development Services programme and the health system in the BMC alongside mothers during the first 1,000 days i.e. from pregnancy till the child turns two. “It’s easy to criticise the government, but if you provide them data and support, then getting the work done becomes easy,” D’Souza said.
The Road Ahead
In its second phase, which began two years ago, SNEHA says it is training government workers to work alongside the mothers and infants, while its employees provide them support and training. “Eventually, we do want the government to work directly with families and we will take a step back then,” concluded D’Souza.