A child is admitted to hospital with acute respiratory problems and diagnosed with pneumonia.They are treated and sent home. The problem is that “home” is a favela in Rio de Janeiro, with poor sanitation and overcrowded rooms, and a family unable to afford proper meals. The child falls ill again and is readmitted to hospital. Their school attendance starts to suffer, as do grades, thus reducing their long-term prospects and locking them into a povertytrap.
But there is a way of breaking the cycle. To tackle ill health, poverty and social exclusion, we must treat the causes and not just the symptoms.
One example of this approach is my own organisation, Associação Saúde Criança (ASC) – a Brazilian NGO that promotes the well-being of children. We help to create tailored-made family action plans, whereby families agree to certain commitments and targets related to five areas: health, housing, income generation, citizenship and education. To successfully complete the programme, families must meet a minimum standard in each area.
ASC also gives direct support to families, for example by providing basic and special food items, medicines, clothes, toys, etc. Indirect support is provided through educational talks, courses and guidance, vocational courses aim to help them find work. This integrated approach helps to break the vicious cycle of poverty and poor health. The objective is not only to improve the health of the child but also the well-being and social inclusion of the entire family.
The programme’s impact evaluation has shown that not only does the health of children significantly improve, but the economic well-being of the families improved substantially. Improvements were seen across all five target areas.Days spent in hospital were down (by 90% from the start to the end of the programme); school attendance was up (from 10% at the start to almost 92% three to five years after completion); family incomes almost doubled and employment rates increased; home ownership rates of participating families went from 25% to 50%; and household access to benefits went from 6.6 % to 20.8%.
Poverty, ill health and social exclusion are all mutually reinforcing, and can’t be treated in isolation. The methodology used in ACS’s programmes is, in the words of Nobel Peace Prize Laureate Muhammad Yunus, “a powerful way to deliver social inclusion to less fortunate people”. By taking a holistic approach and targeting the most vulnerable in society, we can permanently help the very poor families to live with dignity.
Author: Vera Cordeiro is founder and Chief Executive Officer of Saúde Criança in Brazil. Social Entrepreneur: Schwab Foundation for Social Entrepreneurship.
Image: Children are seen playing in a Favela in Rio de Janeiro REUTERS/Sergio Moraes