“If a family has only one egg at a particular moment and two children to feed, how does one make sure that the egg goes to both the kids? In such situations, we suggest – make an omelette and feed them both,” says Piyasree Mukherjee, CEO of Foundation for Mother & Child Health India.
It’s practical solutions like this with which FMCH is reaching out to the underprivileged to provide full access to preventative health and balanced nutrition.
Explaining the urgency to focus on the healthcare of women and children in the country, Mukherjee says: “There are many families where the entire egg would preferably be given to the male child. We aim to change that, too. The focus is to cook nutritious food at low cost.”
Mukherjee should know, considering that she holds over 16 years’ experience in the non-profit space in India and has been working with FMCH since 2011. SheThePeople.TV spoke with Mukherjee about FMCH, healthcare in rural areas, the need to prioritise nutrition of children, and more.
What led you to become the CEO at FMCH?
I started working at FMCH about eight years back, when it was a small organisation. As the organisation grew, I kind of grew with it. I walked into FMCH at the time when nobody was speaking about nutrition. For me, it has been an absolutely amazing journey here in terms of learning.
The regional teams have been heavily occupied with regular weigh-ins of children and conducting pre-natal check-ups for the past couple of weeks. Do you think there’s a lack of structure and system when we talk about these precautionary check-ups in rural areas?
There isn’t a lack of structure. What lacks is the strengthening of this structure which is already in place. So there are prenatal check-ups that can be done at any health post or primary healthcare centres. But the problem is that some of the people offering these services, or in-charge of these services, choose not to do their jobs properly — they’re either irregular or unavailable. That needs to be sorted.
While the country has a huge network, we need to focus on making the network stronger so everyone in the distant of corners can have access to facilities
Accessibility is another issue. For instance, it’s difficult to get to a health centre if it’s very far. Anganwadi workers for example, they work so much and authorities need to think about how to unburden the load there, too.
People on the ground really want to make the difference, but there isn’t always that support
While access to healthcare is an issue in remote corners of the country, there’s also a considerable lack of awareness in these areas. How does FMCH manage to deal with that?
Our entire program is based on helping a community understand this. We work in partnership with the government, locally with the ICDS department. Now for the people who are residing in urban slums, it’s important to understand that whether or not they know what services they have around them, how do they access those services, and, more importantly, whether the people providing the services are well trained or not.
If I talk about the existing system, there’s one ICDS centre for every 1,000 population. However, there are several layers of barriers that deter people from accessing services at these centres. For instance, people from down south do not know Hindi or local languages elsewhere. How do we enable this reach, which is already available to them, to make it more comprehensible? At FMCH, we work towards strengthening areas where we can directly reach the people on ground level, whether it is counselling on the importance of breastfeeding or workshops and demonstrations on complementary feeding.
We are working together with local support groups, local mahila mandal leaders, which help build support into the community
Tell us about FMCH’s nutrition course. What does it aim to offer?
According to the NHFSIV data that came out in 2016, it showed that only 8 per cent children were taking adequate complementary feeds in urban Maharashtra. Now the challenge is to make people understand that complementary feeding has to be age appropriate. The nutrition course was designed to help families understand that. We believe only providing awareness isn’t enough, awareness doesn’t help in behaviour. For example, I know biting nails is not appropriate. But what stops me from biting my nails is when I understand how it impacts my body.
The nutrition course is an eight-week session. Through this course, we have broken down knowledge of nutrients, their role in growing our bodies and using them into small actionable pieces. We also address where we get access to significant ingredients. The idea is to understand local ingredients, where you get them from and their actual practical demonstration. We show a few recipes. We then see how one can use those ingredients. It’s how we use the information about nutrition available to us that matters.
Despite schemes like ‘Ayushman Bharat’, which is claimed to be the world’s largest health protection scheme, there’s still a lot of improvement to look after when it comes to the health condition of women and children in rural areas. What do you have to say about that?
In theory, this policy sounds very good. However, it’s too early for me to comment on the actual implementation of the scheme. It’s only been a few years.
What do you suggest the government, authorities and citizens can do collectively to combat the problem of malnutrition?
First of all, we as a country need to understand what malnutrition really is. People think that absolute hunger is what it is. When we talk about balanced diet, there are these four food groups in place. Now most people don’t have access to such diets and routine. There’s a double burden of over nutrition and undernutrition, which we need to tackle extensively.
Another factor to consider is how our environment is becoming extremely toxic. It’s shocking to see how junk is replacing real meals on a daily basis. We will not be able to combat such issues if we don’t understand why the environment around us has become toxic.
Also, if every fourth child in India is stunted, look where we’ll head to. The future generation will not have the power to be productive at work, something our country and economy will eventually suffer from
How does the team at FMCH come together in enabling smooth operations?
We have a fairly flat organisation to begin with. Our layers are simple and our on-ground team belongs to communities we are working with. The strength lies in our shared vision.
If we talk about a setup that is resource poor, think about a community member who shares a toilet with you or takes water from the same tap, if that person is talking about a certain improvement, that has a fairly large effect on people. We follow global protocols and we make sure the process is not complicated.
The news of India readying a new cadre of certified midwives to improve maternal-infant care is doing the rounds. Do you think this is a positive approach towards improving the quality of maternal care in areas which do not have necessary facilities.?
Absolutely. Traditional birth attendants are what midwives are. They are there everywhere. In a place like Bhiwandi, for example, the local hospital has 70 beds and the population is 12 lakh. Not everyone can approach a private hospital, so eventually there are several home births. Certified, trained midwives will make there’s a safe birth in areas which lack facilities as yet.
People assume that pregnancy is really a happy time for a mother, which really is not the case. There’s a lot women and their bodies go through while they’re pregnant and, mostly, there’s not much support and assistance that they receive. The midwives will make the whole process of pregnancy and birth convenient in such areas
What is your next approach at FMCH?
We are actually launching our next phase of intervention at Bhiwandi.
What keeps you committed to your service towards the healthcare of children and women in this country?
For one, I’m a woman. I have always worked towards what is going to keep our country going. I work in this area because I believe in it. I believe we can achieve a lot when, to a great extent, we work towards reducing the burden of healthcare expense in the country.
There are severe diseases and health ailments we can aim to prevent through nutrition interventions and, in the long run, it will help make a positive impact and raise healthier future generations in our country.