Primeira Infância Ribeirinha (Riverside Early Childhood) – Integral assistance for girls and boys of the Amazon)
While the word Amazon immediately evokes images of exuberant natural beauty, not everything about the region is wonderful – access to basic services for pregnant women and for girls and boys, for example, is a major challenge. The Primeira Infância Ribeirinha (PIR) program tackles this challenge by organizing visits to communities where integral assistance to pregnant women and children is provided by community and healthcare workers trained on the use of the Home Visit Guide. In their visits to homes, these workers provide medical services and teach good nutrition habits, early childhood stimulation, and safe environment practices. The program adapts strategies whose success merits have been tested in other contexts to apply them for the first time in these vulnerable communities. It also takes advantage of technologies such as mobile devices and tablets to monitor the progress of infant development indicators.
Problematic
Isolation and insufficient availability of basic services pose challenges to Amazon riverside communities that are completely different from those of urban and of many other rural, non-riverbank communities. Their dwellers suffer from high rates of infections (such as diarrhea), while pregnant women fail to get adequate care and the development of healthy boys and girls is not properly monitored. Efforts to improve health services provided to these communities need to be adjusted to meet their specific needs.
Solution
This initiative proves that quality childhood development can gain access even to the most inaccessible sites. This integral assistance program targets boys and girls of 0-6 years living in Amazonian Conservation Units. Under the program, pregnant women and children aged 0-3 get visited at least once every two weeks. Also, each community health worker is trained and instructed to visit 80 families following the protocols of the Home Visit Guide that was written having the needs of the riverside communities in mind. The Guide contains games and activities to teach families about breastfeeding, healthy nutrition, early stimulation, hygiene, and common children’s illnesses. The community workers are encouraged to come up with their own creative solutions, for example using available materials to make toys to stimulate children’s perception of different geometric shapes and colors. The Guide also highlights the importance of conversation, singing and playing with children to strengthen emotional ties and promote their development.
Evaluation and Impact
The families that received the visits have improved early stimulation activities (more playing, reading, and singing) as well as their hygiene and healthy eating habits. The program also seeks to strengthen the community worker’s role. However, it is important to note that the great distances that must be covered to reach some of the most remote communities create high monitoring costs and complex logistics.