Addressing health challenges through community-based
care in the first 1,000 days of life
Malwani is a high-density settlement in Mumbai's western suburbs of P/N Ward with a low Human Development Index.
Our Healthy Cities Programme (HCP), implemented in Malwani integrates preconception care, planned parenthood, maternal nutrition and mental health, appropriate inter pregnancy spacing intervals, early childhood growth and development and prevention of violence against women and children with a focus on improving the health and nutritional status of children younger than three years of age.
Nurturing Care Model
In Azmi Nagar, the Nurturing Care Model aims to facilitate an environment conducive to optimum growth and development of children by improving their nutritional and developmental status. This family-based intervention tries to establish the association between various maternal factors (anaemia, nutrition, mental health, antenatal care, reproductive health and women facing violence) and child factors (malnutrition, IYCF, immunisation, hygiene and early childhood development) for improving child health status through a continuum of care approach. This model has two intervention centres; each one is a resource centre which provides integrated counselling services and also spreads awareness on healthy diets, care seeking for illness by ensuring access to quality care. We also support health and nutrition systems to help them deliver quality services to the vulnerable informal settlements. The intervention covers approximately 13000 households covering 8393 women and 3002 children.
Community Engagement Model
In the New Collector’s Compound (NCC), the Community Engagement Model (Sustainable Intervention) aims to empower a strong cadre of community barefoot soldiers called Swasthya Sahelis to undertake individual and collective action for sustained maternal and child health indicators in collaboration with health and nutrition system. The intervention centre at NCC engages more than 400 volunteers through various community mobilisation strategies for improved community ownership towards health. The intervention covers approximately 16,750 households.
Child Health and Nutrition
Our intervention is primarily focused on reducing all three forms of malnutrition i.e stunting, wasting and underweight, ensure full immunization of children and improve Infant and Young Child Feeding (IYCF) practices.
Maternal and Newborn Care
We focus on reducing maternal anemia, improve uptake of care services by pregnant and lactating women and ensure appropriate breast feeding practices.
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 identify and counsel cases of domestic violence and child sexual abuse through a counseling team staffed by counselors and a lawyer. We also address issues related to mental health.
Partnership with Systems
To promote uptake of health and nutrition related services we work in close collaboration with public systems for sustainable change.
Creating a cadre of community champions
Volunteers lead solutions to civic and other health and nutrition related local problems, by interfacing with the local public health and nutrition authorities.
Early Childhood Development
Our intervention on early childhood development (ECD) addresses various developmental domains such as expressive and receptive languages, gross and fine movements, relating, play and self-help activities of children from birth to three years of age to enable them to reach their full potential.
Reduction in stunting among children under three years of age
(from 35% to 29%)
Increase in full immunization status among children under three years of age (from 64% to 73%)
Increase in contraceptive prevalence rate among married women of reproductive age
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 earlier spoken with her and her husband about contraception. The CO rushed her to the hospital to meet a gynecologist, who advised an abortion as the the pregnancy would be a risk to Momina's health.
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.
Integrated Child Development Services
Brihanmumbai Municipal Corporation