Improving parenting at scale through existing health workers

Visits from community health workers have been shown to have positive effects on the health, nutrition, learning and safety of young children in Peru. The Foundation has been working in impoverished rural regions to help municipalities access available national government funds and implement home visiting programmes.

Growing up in the Amazon

Peru’s national government is committed to investing in the country’s children, but the region’s decentralised political structure means local municipalities have the responsibility for deciding what services to offer. Many civil servants lack the technical skills to apply for the available funds and implement the programmes.

Rural, indigineous communities in the Amazonian jungle are challenging places for young children to grow up. Two-thirds of people in the region of Loreto live below Peru’s poverty line, mostly making a living from subsistence farming, hunting or fishing. More than one in four children are chronically malnourished – well above the national average.

Building will and skill in municipalities

The Foundation’s partner Asociation Red INNOVA spent four years gaining experience of providing technical support to five municipalities in the Amazonian jungle regions of Loreto and Junín. Based on the successes demonstrated, more municipalities are now interested in participating and the home visiting model is being scaled up to reach 30,000 children across Loreto and into Ucayali.

The model involves community health workers making visits once or twice a week to pregnant women or mothers with children aged under three, often accompanied by a volunteer mother from the local community. The home visitors provide advice and support on parenting, bringing toys and books and showing the mothers how to interact with their children to help their development.

One mother who benefited from the home visiting services, Linda Ramírez, testifies to the impact on her parenting of learning about:

… the importance of talking to our children and telling them we love them. I realised my parents loved me but they didn’t know the importance of saying it. That’s why now I say nice words to my child, I hug him, I sing songs for him, I kiss him.

Aspirations to scale across the nation

The Bernard van Leer Foundation has invested EUR 1.1 million in scaling home visits in Loreto and Ucayali, with municipal, regional and national governments contributing EUR 5.8 million more over three years. Ultimately, the aim is to help the Peruvian government to reach 700,000 children across the nation.

To work in other regions, other actors will need to be inspired to fill the technical support role of Red INNOVA – whether other NGOs, the Ministry of Social Inclusion or private companies with municipal governments paying for support. Experience so far is that, after initial seed funding, municipalities prove willing to continue investing their own funds to keep the service running.