Human Development Using “Local Knowledge”: Utilizing Community 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.

Literacy Campaign

The main objectives of the literacy programme are as follows:

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.

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.

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