Leave no child behind: a new way to strengthen child development during the pandemic in Brazil

Every day, early in the morning, home visitors of the Happy Child Program in several municipalities in Brazil used to start their visits at the family homes they assist. Then, throughout the entire day, they performed development activities with children from 0 to 6 years old. As the Covid-19 pandemic arrived, home visitors started to face new challenges. Without being able to do face-to-face visits, they had to create new ways to keep in touch and continue working for the integral development of children.

Since the implementation of social distancing measures, home visits are suspended in many municipalities. In Rondon do Pará, in the state of Pará, Amazon Region, the routine of the home visitors now consists of recording videos and calling the families. Every week, they create videos presenting activities divided by age group and send them to the families.

Clea Nascimento, one of the visitors, created a WhatsApp group with the parents of the families she assists. Through videos, photos, calls, and text messages, she receives feedback on the videos she sends out every week. “The families liked the idea because we didn't stop [the program]. They interact well, are always attentive and sending pictures, videos of the children doing their tasks. We are always encouraging them to keep doing it,” says Clea.

Pollyanna Silva is the mother of 2-year-old Anna Vitoria, one of the children assisted by Clea, who has been receiving activities through video to do at home with her daughter. For her, Anna Vitoria’s development progress is clear: she has already learned colours and new words. “We created a nice activity. We painted pieces of cardboard with different colours and hung it in a string. Then, she had to choose the right one. Now, when she picks up objects, she already knows the colour and keeps asking if she named it right .”

All the activities performed with the children use materials easily found at homes, including egg cartons, bottles, cardboard, and other recycled materials. With those, the visitors create toys and tasks to promote sensory, balance, motor, and cognitive coordination. During the pandemic, this method helped to keep families even more engaged in the Happy Child Program.

Overcoming challenges

Even with the efforts to continue working, another challenge had to be overcome in the municipalities: many families can't receive the activities since they do not have access to the internet or mobile phone. Therefore, to ensure that no one is left behind, the program needed to reinvent itself, and visitors created more ways to adapt to each context.

In Iguaracy, a small town in the Semiarid region of the state of Pernambuco, the team developed an activity notebook, which contains several games and incentives that the family can perform at home with the child. The home visitors deliver the notebook to the families at the end of each month, taking the opportunity to talk to them and find out how the activities are going, guiding the next steps.

Using all the necessary personal protective equipment, such as masks, gloves, and using alcohol gel, visitors respect the distance of 1 meter and do not enter the houses. “This is a way to keep children who do not have access to the Internet developing and doing the activities. We try to make sure that social distancing does not impact the development of the child or the bond we had with them,” says visitor Silmara Bezerra, who has been working on the Program for three years.

Aline Araújo, the mother of Karen Araujo, 5, has been receiving the activities at home. Even without the challenge of internet access, they are dealing with other difficulties. Aline's gestation was complicated. From the beginning, she faced a risky pregnancy and, at three months, discovered that she had contracted Zika. At that time, not much was known about the virus or its consequences to the foetus. The diagnosis only came after Karen was already born: microcephaly.

Now, Karen has been accompanied by the Happy Child Program for three years. Before the pandemic, home visits took place in every two weeks. The microcephaly and cerebral palsy caused motor and cognitive challenges for Karen. However, during the pandemic, she could not continue with her health monitoring routine, including physiotherapy and phonoaudiology speech therapy.

Therefore, for the mother, the tasks offered by the Program have been essential to stimulate the girl so that she could continue developing. “With the activities, we can keep stimulating her without having to stop [because of social distancing]. One has to be creative to propose new activities to children, and in the rush of daily life, parents may not have what it takes for that," says Aline.

Participating in the Happy Child Program and with activities in hand, even during the pandemic, Karen's development is remarkable. In one of the tasks, her mother set up a small clothesline with hanging toys, so that the girl could take them out one by one. "At first she had a lot of difficulties, but now she already raises her arms to get the toys," celebrates Aline. "It was a troubled pregnancy, and just by being born, Karen is a big victory."