Helping India reach nutrition target through community focused initiatives

April 6, 2021   | author: Foundation for Mother & Child Health India (FMCH)

“Healthy mothers and thriving children for a world of unlimited possibilities.”- has been the vision of the nutrition program of Foundation for Mother and Child. This is in line with one of the key messaging of UN Sustainable Development Goals – which is to put an end to all forms of malnutrition.

The World Health Assembly’s Global Nutrition Target is a reduction in stunting in 40% of under-5 stunted children as well as reducing and maintaining wasting to less than 5% by 2025. According to the Comprehensive National Nutrition Survey (CNNS) report published by the Ministry of Health and Family Welfare in 2020, it was found that 35% of under-5 children in India were stunted while 17% were wasted.

Although the malnutrition figures show that India must accelerate its intervention, several foundations and NGOs have been working relentlessly to support the government in their nutrition goal. One such organization is the Foundation for Mother and Child Health (FMCH), which was founded in 2006.   The very first initiative was launched in a slum-redevelopment building in South Mumbai back in 2007.  Subsequently, owing to the support and guidance of a pro bono managing committee and a non-profit organization specializing in capacity building, detailed analysis was undertaken to identify the need of the community. This was followed by the revision of the mission and vision of the organization and consequently develop a more effective program model to best deliver services to FMCH’s identified beneficiaries. Between 2010 and 2013, FMCH expanded into other communities in Mumbai.

Following the strategic plan goal of sustainability and community empowerment, in 2015, FMCH engaged with Rajmata Jijau Nutrition Mission of Maharashtra to introduce the “First 1000 Days” program into existing government programs in areas with high burden of under-nutrition of urban Maharashtra as well as to bring recommendations for long-term policy change. “First 1000 Days” program for children is a community-based innovative from conception to two years of her age.

In 2015, FMCH expanded its services into capacity development for capacity building trainings. FMCH started a training centre where NGOs, educational institutions, medical professionals, and government agencies could be trained, and knowledge was shared on direct or indirect interventions focusing on nutrition. Such capacity building exercises helped spread the messaging and awareness around nutrition more effectively.

The Foundation’s mission is simple but essential – to ensure that families/beneficiaries have access to skills and knowledge related to nutrition that is timely, contextual, and actionable during the critical window. This will enable families to make the right nutritional choices to prevent malnutrition.

More recently, during the COVID-19 pandemic, when the Foundation staff was unable to go to the field, FMCH shifted all its services to digital platforms that enabled it to work remotely. Around the same time, FMCH developed the ‘NuTree App’ for its frontline workers to help them manage their tasks. This was done in collaboration with medical specialists from IIT Bombay, technology experts and by using the insights from the field. The NuTree App navigates cases and supports me-sensitive counselling sessions as it helps with data collection, beneficiary tracking and management, ensuring the Foundation reaches out to all mothers. The app, coupled with strong community relationship, enabled the Foundation to widen its reach even when FMCH could not be physically present on the field. Due to lack of services in several communities, many families have turned to us as the first point of contact.

Today, FMCH continues to be one of the frontrunners working towards ensuring  mother and child health and nutrition in Mumbai and is positioned to make a real paradigm change in the health and nutrition of women and children in India. The two areas where the program operates are – Project Poshan in Kurla, Mumbai and Community Nutrition Initiative in Bhiwandi, Thane.

Over the last 5 years, FMCH has worked with over 40,000 families across low-income slums of Mumbai. FMCH works with families from the time a woman gets pregnant to the time the child turns two years old (about 1,000 days old). Through FMCH’s flagship 1000 days’ initiative, families with pregnant mothers and children below the age of two, or children above 2 years identified with acute malnutrition across slums of Kurla and Bhiwandi, FMCH conducts the following:

  • Structured education sessions on nutrition, pregnancy and childcare for mothers and secondary caregivers
  • Ante-natal care visits, nutrition counselling and post – natal care visits for mothers and families
  • Home-based counselling for the families to ensure all practices of Infant and Young Child Feeding (IYCF) are met – early initiation of breastfeeding, exclusive breastfeeding, initiation of correct complimentary feeding etc.
  • Growth monitoring for the child
  • Training and supportive supervision for the Anganwadi machinery

Over the last five years, through its programmes, the organisation has seen a 48% reduction in wasting in children who have been with regularly with FMCH, improved birth weights to 2.7kgs (from 1.5kgs), and an increase in the breastfeeding rate (up to 70% increase in some of the interventions; 25 PP higher than the national average), all indicators moving children who are malnourished to regain a state of better health.

The projects in each location are carried out for 3 to 5 years. The time depends on the programme goals, size of the target population, social and cultural psychology etc.

There are two aspects of sustainability in the direct implementation work:

  • Mother support groups: Women from the community who have been through the FMCH intervention collectively take ownership of the nutrition and health of the community.
  • Anganwadi machinery: Before FMCH enters any community; it forms a relationship with Integrated Child Development Services (ICDS). Through training and supportive supervision, it is able to ensure the work continues through the anganwadi even after the exit.

The Foundation firmly believes this program will be sustainable   when the community is able to make the right nutrition choices even after the program intervention has ended, Hence capacity building exercises remain a core area of the intervention.

 Shruthi Iyer, the CEO of FMCH says that, “We are committed to prevention of malnutrition by using innovative, local methods that are rooted in empowerment of families. Malnutrition affects our children in irreversible ways. We understand we cannot solve this issue alone and thus work in the intersection of various partnerships to solve this is extremely pressing and complex issue”.  It can be safely said that collective efforts like these will only help India reach its commitment to nutrition.

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