Home visiting services scale up in the Amazon basin

Families with young children in Acre and Amazonas – two states in Brazil’s Amazon basin – are receiving home visits as part of the Fostering PIAA (Primeira Infância Acreana e Amazônica) programme – an effort funded by the Foundation and implemented by United Way to incorporate parent coaching activities into existing health services in the region by providing training and support to community health workers.

Supporting parents means working through local-level government

Scaling up home visiting programmes is a challenge in Brazil. The country’s structure of government puts decision-making power with state-level governors and municipal-level mayors, and each state and municipality that decides to offer home visiting then needs to customise the model to fit their financial, geographical and institutional capacities. The challenges in rural, semi-urban and urban areas are all very different.

The Foundation has learned valuable lessons from several years of support for home visiting projects in the Amazon basin – a region with especially difficult logistics, high levels of poverty and rich cultural diversity. In particular, these experiences made clear that it is possible for community health workers, whose main role is to work on preventing diseases such as malaria, to be trained to coach parents in areas such as nutrition, early learning and birth registration.

Ambitions to cover millions of children across Brazil

Initially running in 22 municipalities of Acre and Amazonas, the programme is expected to reach around 72,000 children with home visits, organised by the municipalities themselves with United Way’s support. The ultimate aim is to reach several million children across Brazil as part of the national ‘Criança Feliz’ programme.

The programme helps municipalities to coordinate among the various local governmental departments whose support is needed – health, education, social assistance, human rights, arts and culture – as well as corporate partners, community leaders and local universities. It created practical guides to help officials to identify existing resources they can leverage. The national Ministry of Health is putting over EUR 10 million into the programme.

Community health worker Jocilene Lima of Rio Branco commented:

“The programme has broadened our perspective on child development and health care. Previously we only measured, monitored and intervened as necessary in health-focused developmental milestones. Today we know how children’s wider developmental milestones depend on care, affection and encouragement. The programme certainly contributed to enabling health care agents to promote the appropriate interventions to maximise vulnerable children’s chances to succeed in life.”