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Healthy Cities Programme

Tackling health challenges through community-based care in the first 1,000 days of life


Mumbai (Malvani)

Our Work


First 1000 days of life (between conception and the child’s second birthday) provide a critical window of opportunity to impact a child's growth and development. The 1000 days are the foundation to future cognitive development, physical growth and immunity.


Our Healthy Cities Program (HCP), implemented in Malwani, addresses preconception care, planned parenthood, maternal health, nutrition, access to appropriate care, appropriate inter pregnancy spacing, limiting methods and prevention of violence against women and children with a focus on improving the health and nutritional status of children younger than six years of age. Malwani is a high-density settlement in Mumbai's western suburbs of P N Ward with a low Human Development Index. As in most urban areas, it was not about not having access to food or even affordability that was the issue, but that there was poor awareness of proper feeding and eating practices.

HCP has 3 intervention centers and each one is a resource center providing information and services, catering to 5000. Households The primary beneficiaries of the intervention are pregnant and lactating mothers, children less than 6 years of age and married women in reproductive age group (MWRA). Indirect beneficiaries are adolescents and men. Community organizers are the field staff who generated awareness on different components through mediums of home visits, group meetings, campaigns and events.

Child Health and Nutrition


Our intervention is primarily focused to reduce malnutrition (Stunting, wasting, underweight), improve full immunization and improve IYCF indicators.

Maternal and Newborn Care


We focus on reducing maternal anemia, improve uptake of care services by pregnant women and lactating women and ensure appropriate breast feeding practices.

Family Planning


We work to increase uptake of family planning services and reduce unmet need for contraception. The main objective of working on family planning is to ensure planned parenthood and promote inter - pregnancy spacing.

Prevention of violence against women and Children


We identity and counsel cases of domestic violence and child sexual abuse through a counseling team manned by counselor and lawyer. We also tackle issues related to mental health. We will try to establish link between domestic violence leading the malnutrition amongst children.

Partnership with Systems


To promote uptake of health and nutrition related services through MCBM and ICDS we work in close collaboration with systems for sustainable change.

Creating a cadre of community champions


Volunteers will lead solutions to civic and other health and nutrition related local problems, by interfacing with health and nutrition authorities.

Engagement of males


Families and husbands play a pivotal role in influencing behaviors, we work with families especially husbands to generate more ownership towards the health of their partners.

Reach and Impact



7%

increase in contraceptive prevalence rate reported (2016-2017)

319

cases of gender-based violence identified
(2016-17)

42%

increase in early registration of pregnancies at health posts (2016-2017)

Notes from the field:
A case for contraceptives


We have observed a large awareness gap among women we work with about using and accessing contraceptives. We share best practices in safe contraceptive usage, and make sure women and their partners seek medical help when necessary.

Momina*, a mother of 3 daughters had wanted to use contraceptives, but her husband had refused. A few months after she had a baby, she started experiencing extreme fatigue - she realised she was 2 months pregnant again. Upon her husband’s suggestion, Momina tried to abort her pregnancy by taking emergency contraceptive pills, but shortly after, she began experiencing heavy bleeding. She immediately contacted the Community Organiser (CO) who had spoken with her and her husband about contraception. The CO rushed her to the hospital to meet a gynecologist, who advised an abortion.

After Momina’s recovery, the Community Organiser spoke with her regarding the importance of seeking professional medical attention rather than self-medicating, and spoke with the couple about the basics of family planning.

Momina faced difficulties convincing her husband to allow her to use contraception, but eventually succeeded. The CO continues to follow up with Momina and provide advice on safe contraception.

*Name changed

Partners


Morgan Stanley

Morgan Stanley

Integrated Child Development Services

Integrated Child Development Services

Municipal Corporation of Greater Mumbai

Municipal Corporation of Greater Mumbai