HUMAN DEVELOPMENT USING “LOCAL KNOWLEDGE”: UTILIZING COMMUNIY ACTORS IN BASIC LITERACY AND PERSONALIZED HEALTHCARE INITIATIVES
A CASE FROM THE SOUTH: Mauà, Brazil
Basic health and education are essential elements
of human development and municipalities have an important role to
play in providing the services that respond to particular development
needs of the community. The city of Mauá has introduced innovative
policies that aim at improving the basic educational standards and
health conditions of its poorest citizens. Both programmes have placed
great emphasis on training local residents to play an active role
in assessing local needs as well as in providing services. The involvement
of citizens living in the poorest neighbourhoods, who acknowledge
the cultural values of the area, and have easier access to needed
information, has been essential in ensuring the success of the policies
implemented.
Background
The city of Mauá has a population of approximately 375,000
inhabitants and has been growing at an astonishing rate during the
last forty years. A great number of immigrants, especially from north-eastern
Brazil, have settled down in Mauá often in precarious conditions.
For the city’s informal settlements and poor neighbourhoods,
low income is highly correlated with the education level and the dangerous
health conditions. Approximately 8.6% of the population over 15 are
completely illiterate and a large number of them are considered to
be functionally illiterate. Similarly, and despite important progress
in recent years, infant mortality rate remains high at 22 per 1000.
1) Literacy Campaign
The main objectives of the literacy programme are as follows:
- To establish a widespread literacy campaign that will eventually
reach the estimated 18,420 illiterate youth and adults. The long-term
objective is to eliminate illiteracy in the city of Mauá.
- To motivate participants to continue their development of the
basic literacy skills
- To encourage different social actors - from the public and private
sector as well as from community organisations - to cooperate in
the implementation of the initiative.
Identification process
Targeting a programme at the illiterate population is not an easy
task. Traditional publicity campaigns are ineffective when trying
to reach people who are unable to read. The programme has therefore
relied almost exclusively on the support of “Social Educators”
and community organisations.
Social Educators: “Social Educators” are,
in most cases, residents of the poor neighbourhoods with at least
a secondary education diploma. They are trained by the municipality
to participate in the programme both as teachers of basic literacy
and as agents of communication with potential participants. “Social
Educators” visit the poor neighbourhoods to publicize the literacy
campaign, and to encourage its residents to participate in the literacy
campaign. “Social educators” in the districts have direct
contact with poor families, and they are able to identify the needs
of the local communities.
Community organisations: NGOs, churches and other community-based
organisations are also involved in promoting the literacy campaign
and in providing information on how to participate. There are in fact
64 information sites spread throughout the city located within community
organisations.
Financing the programme
Although a small grant of approximately US$ 75 a month is provided,
the work of social educators is considered to be essentially voluntary.
The grants are funded by the municipal government, and in some cases
by community organisations or private enterprises where social educators
are working. Community organisations, churches and trade unions provide
most of the classrooms and donate most of the teaching materials.
The municipality, in collaboration with the Secretariat of Education,
is in charge of training the educators.
Coordination: Partnerships with civil society organizations
(CSOs)
The Municipal Literacy Forum, a coordinating institution, is composed
of the representatives of all institutions involved in the programme.
Two representatives from a municipality and two representatives from
civil society (one representing the teachers’ trade union and
the other representing the local chamber of commerce) administer the
program. Participation of all sectors in the society is crucial to
make sure the programme has a widespread support.
“Social Educators”, who are supervised and trained by
professional schoolteachers, carry out the teaching. In selecting
“Social Educators” from the local community, the municipality
intends to encourage a participatory model of education, where the
student's own social and cultural background is considered. Because
the learning process requires an active interest from the student's
side, the material being taught should be accessible and in the context
of his/her everyday experiences.
Impact
Since the program started in 1997, the literacy campaign has expanded
at a considerable pace. There are currently 70 established literacy
centres and approximately 2, 500 students involved in the initiative.
The active role of trade unions, as well as the support of industrial
management, has recently resulted in the establishment of classrooms
within a few factories, where illiterate workers may also benefit
from the programme. Thus, expanding the target of the program made
the campaign more valuable and understandable in the community. Another
important indication of success is the large number of students (so
far 1,150) who have registered for school after completing the literacy
course. These students have not only learned to read and write, but
have also developed an interest in continuing their education beyond
basic literacy.
2) Family Health Programme
The Family Health Programme seeks to address the following issues:
- Some areas of the city have no public health facilities and very
poor sanitary conditions.
- The lack of proper medical assistance as well as the inappropriate
hygienic conditions in some neighbourhoods lead to the spread of
preventable diseases.
Characteristics of the programme
The programme intends to provide personalised health assistance through
door-to-door service. In this manner, health provision and medical assistance
become more efficient, given the financial constraints and the impossibility
to set up a public hospital in each neighbourhood, and also more capable
of responding to individuals and the community's need. For this purpose,
Health Teams have been set up within most poor neighbourhoods. Each
Health Team, which covers approximately 600 families, includes 1 doctor,
1 nurse, 2 nurse assistants, 4 to 6 community health assistants, 1 dentist,
1 dentist assistant.
Identification process
The process of identifying the needs of the local communities is carried
out by the Community Health Assistants: The community health assistants
are residents of the poor neighbourhoods who are trained by the local
professionals in basic healthcare. They regularly visit families in
local neighbourhood to assess the impacts that changes in social and
economic conditions may have on their health. They, therefore, monitor
the health conditions of the neighbourhood as well as those of individual
families, spotting local needs and carrying out an important prevention
campaign. They are also in charge of identifying issues that should
be discussed in health education workshops.
Impact
The project was initially implemented in the area of Jardim Oratorio,
one of the areas characterized by the most deteriorated health facilities.
After the implementation in February 1998, the programme has rapidly
expanded despite of its financial constraints. The programme was intended
to cover 50% of the population via this personalised door-to-door
health service. At the moment there are 16 established “health
teams” with 72 community health assistants benefiting 10,082
families. The introduction of the community health assistants has
been crucial in improving the capacity of health institutions to respond
to local needs. The system of door-to-door health provision, especially
in neighbourhoods lacking proper healthcare infrastructure, has become
common practice in many Brazilian municipalities and has had positive
results in reducing the infant mortality rate.
The experience of Mauá provides an instructive example of using
local knowledge both in the process of identifying beneficiaries as
well as in implementing social programmes. “Social Educators”
and Community Health Assistants are playing a central role in the
city’s social policy. Their intervention is less likely to be
seen as a disruption of community life and their knowledge of local
habits makes them a crucial link between the population and the city
authorities.
We thank Sr. Marco Arroyo, from the Prefeitura de Mauá,
for providing us with information on this project.
For more information,
please contact:
Sr. Marco Arroyo
Secretaria de Administracion
Preifetura de Mauà, Brasil
phone: +11 7632 7504
Email:administracao@maua.sp.gov.br
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