ASC mobilizes people from civil society, volunteers, partners and staff to prevent the recurring hospitalization of children, through post-care support to poor families, donations of food and medicines, legal and nutritional advice, counselling, vocational training and housing improvements to ensure adequate living conditions.
Focus: Children and Youth, Health
Geographic Area of Impact: Brazil
Model: Leveraged Non-Profit
Number of Direct Beneficiaries: 50,000 (1991-2013)
Annual Budget: US$ 2,260,413 (2012)
Percentage Earned Revenue: 6% (2012)
Recognition: Schwab Fellow of the World Economic Forum
According to the UN Development Program, Brazil has one of the highest inequality rates in the world in terms of income distribution between regions and social strata, so health and sanitary conditions vary widely. Brazil's public healthcare system coverage is not extensive, and state-of-the-art facilities are only available to those who can afford them. For the 60% of the population using public healthcare, service is limited to basic immunization and emergency care, and poverty presents daunting challenges. Most diseases are caused by unclean drinking water, inadequate sewage disposal, poor housing conditions and malnutrition. Saúde Criança addresses poverty issues and social conditions at the root of childhood illness.
Innovation and Activities
ASC was created in 1991 to gain insight on child patients in public hospitals. It was found that following treatment of chronic and acute illnesses of children at the Hospital da Lagoa in Rio de Janeiro, poverty often caused over half of the children to be re-admitted; if living standards were not changed, the vicious cycle continued. ASC then created the Family Action Plan (PAF) to determine what assistance each high social risk family needed, based upon five pillars of Health, Professionalization, Housing, Education and Citizenship.
From 2006 to 2013, a sample of 848 PAF families demonstrated a reduction in hospital costs, a 62% reduction in days of hospitalization, an average 38% increase in family income and an overall improvement in child health. Each day a child was not hospitalized meant they were not suffering, the hospital saved money and beds were available for others. Additionally, the clinical health of children improved between the time of admission to the programme and their release.
Its model is transferable to locations where disease is exacerbated by socio-economic factors, and has been replicated in 23 other centres in Brazil. To spread this quality and methodology, ASC's governance was franchised in 2010, with 10 of the 23 institutions now so designated. It is creating replication centres to serve beneficiaries and train/control other institutions in each of the five regions in Brazil. To date more than 50,000 people have been served.
Each ASC unit is connected to a public health unit and staffed by volunteers, social workers, psychologists, nutritionists and lawyers. The staff provides intensive one-on-one health monitoring and assistance to families, mostly single-mother households with an income of under US$ 247/month. It works with families for 24 months, providing customized legal and nutritional advice, medicines and food, psychological counseling, vocational training and housing improvements. This methodology is now used by the Belo Horizonte government, serving around 9,000 people through the programme “Família Cidadã: BH sem miséria”.
As a general practitioner physician working in a large Rio de Janeiro hospital, Vera Cordeiro was shocked by the number re-admissions of children from urban slums. Realizing their health problems were related to social conditions, she founded ASC to “connect the hospital to the home” and provide a treatment that addresses the full range of economic and social causes of illness. She is an Ashoka fellow, Avina leader, Skoll Foundation Social Entrepreneur and member of the Ashoka World Council. From 2005 to 2011 Vera served as a Board Member for PATH: A Catalyst for Global Health. In 2003, Saúde Criança won the prestigious Global Development Network Award for the Most Innovative NGO, and in 2006 was recognized by the Skoll Foundation. For the second consecutive year, in 2013 Saúde Criança was voted the best social organization in Latin America, according to The Global Journal. Of the 100 best NGOs in the world, Saúde Criança was ranked 45th.
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