SNEHA: A Community-Driven Approach to Urban Public Health

The Society for Nutrition, Education, and Health Action (SNEHA) was founded in 1999 in Mumbai with the goal of addressing critical gaps in urban public health, particularly in informal settlements. Recognizing the limitations of an institutional healthcare model, the organization pioneered a community-based approach to improving maternal and child health, adolescent well-being, and the prevention of gender-based violence. Over the years, SNEHA has expanded its interventions through strategic partnerships with municipal health systems, research institutions, and corporate social responsibility (CSR) initiatives, enabling the organization to influence public health policy and practice at a broader scale.

SNEHA was established by a team of healthcare professionals led by Dr. Armida Fernandez, who had firsthand experience with the challenges faced by vulnerable communities in accessing quality healthcare. The organization initially started with a crisis center for victims of domestic violence and gradually developed programs addressing maternal health, neonatal care, and child nutrition. Over time, its scope expanded to include adolescent health, urban sanitation, and gender equity. These interventions were designed to bridge systemic gaps in healthcare services, with a focus on evidence-based, scalable models that could be replicated in similar urban settings.

A defining feature of SNEHA’s work has been its emphasis on integrating research with practical interventions. The organization has employed data-driven methodologies to assess community health needs and design targeted programs. By conducting baseline and endline surveys, SNEHA has been able to track the effectiveness of its interventions and adapt them to evolving challenges. This approach has also helped the organization build credibility with donors, government agencies, and academic institutions, facilitating long-term funding and policy support.

One of the key challenges faced by SNEHA has been the shortage of trained medical professionals willing to work in informal settlements. To address this, the organization has developed a cadre of trained community health volunteers who act as a bridge between public health facilities and underserved populations. These volunteers conduct home visits, provide counseling, and facilitate access to healthcare services. This model has been instrumental in increasing maternal healthcare utilization, improving childhood immunization rates, and promoting nutrition awareness among urban poor communities.

The organization has also played a crucial role in changing gender norms and addressing gender-based violence through its Prevention of Violence Against Women and Children (PVWC) program. This initiative has combined legal aid, psychosocial support, and community engagement to empower women and adolescents. By working closely with local police stations and the judicial system, SNEHA has helped streamline referral mechanisms for survivors of domestic violence, ensuring they receive timely support and intervention.

As SNEHA expanded, it adopted an "indirect intervention" model to ensure the sustainability of its programs. This involved gradually transitioning the responsibility of health interventions from SNEHA field teams to community volunteers and government frontline workers. By integrating its programs into public health frameworks, the organization has been able to reduce dependency on external funding while maintaining service delivery quality. The shift towards a more decentralized approach has also enabled SNEHA to scale its interventions across multiple cities without significantly increasing its operational costs.

The organization’s ability to foster partnerships has been instrumental in its growth and impact. Collaborations with corporate entities through CSR initiatives have provided financial sustainability, while engagements with academic institutions have facilitated research-driven innovations in public health. SNEHA’s work with municipal health systems has resulted in improved maternal and child health services in urban settlements, with several of its intervention models being adopted into government programs. The organization has also been a strong advocate for policy-level changes, pushing for greater investment in community-based healthcare solutions.

Looking ahead, SNEHA aims to further integrate technology into its programs, leveraging digital tools for data collection, telemedicine, and health education. The organization also plans to deepen its engagement with adolescent health, recognizing the long-term benefits of early intervention in areas such as mental health, nutrition, and reproductive health. As urbanization continues to pose challenges to public health in India, SNEHA’s work stands as a testament to the power of community-driven healthcare models in creating sustainable change for vulnerable populations.