Programa Criança Feliz
Scaling up home visitation services for families in need across Brazil
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The Programa Criança Feliz (PCF) is a federal government initiative to expand integral services for young children.
Through home visits to families with children from zero to six years old, this program provides them with important guidelines to strengthen family and community ties and stimulate child development.
- Government Agencies Engaged:
- Culture, Education, Health, Social Services
- Implementing Agency:
- The Ministry of Citizenship coordinates Programa Criança Feliz (PCF) activities through its Special Secretariat for Social Development. Home visiting initiatives are carried out by state and municipal level governments, with civil society organizations providing technical support. Other government ministries engaged include health, education, culture and human rights.
- Funding Source:
- From 2017 through 2019 the federal government allocated US$143 million to the project annually. Funds were transferred to states through the National Social Assistance Fund, Ministry of Citizenship. Additionally, each municipality receives a monthly amount of US$20 per person.
- Scale:
- Nationwide. Currently, around 50% of municipalities across the country have joined PCF and begun home visits to families.
- Area:
- Parents+
- Location:
- 2 622 municipalities, Brazil
- Reach:
- Families: 662 747 Children aged 0-3: 666 337 Municipalities with Criança Feliz in place: 4 195 (out of 5 570) Home Visitors: 19 008 Supervisors: 3 468 (as of 30 October, 2019)
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Summary of Intervention/Programme
Established in October 2016, the Programa Criança Feliz (PCF) is a direct result of the adoption of the Legal Framework for Early Childhood, a law aimed at promoting the full development of children under six in Brazil. The approval of the Legal Framework paved the way for the Presidential Decree creating the programme. In both cases, political leadership was key, with significant involvement of the Parliamentary Front for Early Childhood. One of its leading figures and an author of the bill creating the framework, Osmar Terra, became Minister for Social Development and made PCF a priority.
“Income transfers coupled with a program that strengthens parental capacities, can have a very significant impact on the structural causes of poverty.” — Cecilia Vaca Jones, Program Director, Bernard van Leer Foundation
The PCF develops and recommends actions and policies in the areas of social assistance, health, education, culture and human rights, to support and promote comprehensive early childhood development, taking into account the unique family and environmental contexts in which babies and toddlers grow and thrive. The programme reaches families with children up to three years of age through the federal income transfer programme ‘Bolsa Família’, the federal Single Registry for Social Programmes, and the Continuous Provision Benefit for children up to six years of age with disabilities. The three programmes target families in need of financial assistance or other support or risk of financial instability. From here, the families with pregnant women or children under three years are identified by municipalities to be part of the PCF.
The PCF utilises home visitors to visit participating households to strengthen families’ understanding of child development, and encourage families to engage in playful responsive caregiving with their child. They also support pregnant women and their families in preparing for the birth of their child, through sharing strategies to understand pregnancy and childbirth.
What worked well
Intersectoral collaboration from the beginning
The PCF built intersectoral steering committees and technical groups, alongside a coordinating body at the federal, state and municipal levels of government. The national level is responsible for coordinating and supporting states, and formulating workforce training strategies. States are responsible for implementation in their municipalities, raising awareness, mobilising and training municipal supervisors, and monitoring. Municipalities are responsible for implementing the programme at the local level: training home visitors, planning visits, supervising the field work, and monitoring and assessing the visits. While the intersectoral collaboration has not always worked smoothly, the common focus allowed for stakeholders at all levels to make decisions and take action together.
The PCF also worked collaboratively with existing parenting programmes in Brazil, such that financial and manpower resources are pooled to comprehensively serve the target families, while ensuring not overlaps.
The strength of quality home visitation
Quality home visiting services form a crucial pillar of the PCF’s success. Importantly, the team used the WHO’s Care for Child Development as a basis for training, adapted it to ensure training is expansive, including fathers and other caregivers, and is sensitive to the cultural variations within Brazil. A handbook was additionally developed at the national level for home visitors.
Home visitors must have at least high school degrees. In a cascading capacity-building strategy, they are trained by municipal-level supervisors, who in turn are trained by the so-called state-level multipliers – in both cases, these supervisors require college degrees, and the state-level multipliers are trained by the national technicians.
Home visitors observe not just the child, but also the family environment, relationships and other vulnerabilities. The visits utilize playthings made with local materials and visitors have a deep respect for the traditions of beneficiary populations, such as those in indigenous villages and quilombola communities. Each visit lasts between 40 to 60 minutes and take place on a weekly, fortnightly or monthly basis, depending on the individual.
It must be noted that further evaluation is needed to evaluate the quality and impact of the home visitation programme and PCF in general.
What didn't work well
Although the PCF had rapid uptake by municipalities, a major challenge today is to ensure its coverage expansion to all Brazilian states and municipalities. The expansion of the PCF coverage to families enrolled in the Federal Government’s Single Registry for Social Programs should facilitate this process. With this change, it is estimated that an additional 370,000 individuals can be included into the PCF.
Another challenge faced by the program include the amount of resources transferred by the federal government, which did not cover all programme expenditures. This meant that due to the lack of manpower and physical resources, some municipalities were not able to deliver PCF at the quality expected. In addition, frequent changes within state and municipal government administrations meant that training, capacity building and delivery was interrupted in some states. Lastly, there is a strong need to expand the monitoring and evaluation capacities of PCF, as it is essential to identify the drivers of success within the programme and to ensure implementation with quality.
For PCF to ensure political support and financial resources for the coming years, it is necessary to constantly invest in informing and mobilising institutions, families and society at large for everyone to recognise the importance of promoting early childhood development.