Project Lead(s): Alexandra Brentani, Sandra Grisi
Brazil has made remarkable progress with respect to child nutrition and child survival over the past decade, resulting in a drop in infant mortality and a lower prevalence of stunting. However, the country continues to struggle with large socio-economic disparities, particularly in urban areas. Many children growing up in the poor urban settlements are not only exposed to a high burden of adverse environmental exposures, but also lack social and family support. The rates of maternal depression are high, and the ability of children to interact with other adults or other children is often severely limited.
These innovators propose to evaluate the efficacy and cost-effectiveness of two platforms for delivering home visiting programs in the poor urban setting of São Paulo’s western region. The platforms fit within the two current models of healthcare delivery there: a program delivered by a newly trained cadre of Child Development Agents for families receiving the traditional model of healthcare, and a program delivered by Community Health Agents employed by the government as part of the Family Health Strategy. The program will randomly select 600 mother-child pairs to follow a curriculum that is adapted to the local context. The primary intended outcome of the program is improved cognitive development of children ages 9 to 15 months old.