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Closing remarks for the Panel
on Healthy Mothers, Healthy Babies
Dr. Ms. Zilda Arns Neumann, 67, paediatrician
specialized in public health, founder and national coordinator
of the Child Pastorate – Brazil
Ladies and gentlemen,
I
share with Mark Malloch Brown, from UNDP, Virginia Quiroga,
from Bolivia, Vinod Paul and Doyin Oluwole, from WHO,
Nabeela Ali, from Pakistan’s programme for Saving
Newborn Lives, Miriam Labok, from UNICEF, and Anne Tinker,
our facilitator, my enormous concern about finding ways
to further reduce mother and child mortality in the
world.
The
Pakistani programme that sends health staff door-to-door
reminds me of the strategy used by the Child Pastorate
in Brazil over the past nineteen years.
Brazil
spreads over 8 million square Kilometers, and its population
is 170 million people.
It
is the ninth largest economy in the world, well known
for its Carnival, soccer, the Amazon rainforest, its
warm people and for the peaceful coexistence between
Christians, Jews, Muslims, and atheists.
However,
social inequality still affects millions of people.
30%
of Brazilian families with children aged 0 to 6 still
live on a per capita income of less than two dollars
a day.
In
the 32 thousand poor communities that have been monitored
by this social arm of the Catholic Church in Brazil,
the child mortality rate has been reduced to 13 per
1000 live births, compared to the national average of
34.6 per 1000 live births.
The
neonatal mortality rate is 20 per thousand live births,
according to the Ministry of Health, and represent half
of the infant deaths in Brazil.
And
as pointed out by Dr. Oluwole of WHO, one third of deaths
of children under one year of age are due to complications
related to delivery or during the first days of life.
These
deaths are needless and preventable, whether in Africa,
Pakistan, or Brazil.
In
1982, a United Nations Conference was held in Geneva,
when world leaders discussed poverty and peace.
At
that occasion, James Grant, then UNICEF Executive Director,
persuaded my brother, the Cardinal Archbishop of São
Paulo, Dom Paulo Evaristo Arns, that the Church could
save millions of children from death due to diarrhoea,
pneumonia, and perinatal causes if it could teach mothers
how to prepare oral rehydration solution.
As
a paediatrician and public health specialist, I felt
that poor mothers lacked the information, solidarity,
and a bridge to a better quality of life.
The
Child Pastorate methodology is based on Saint John’s
Gospel which speaks of the miracle of multiplication
of five pieces of bread and two fishes to feed 5,000
hungry people.
Therefore,
groups of families and communities were organized, in
which community leaders volunteered to work moved by
the feeling of fraternity.
They
received training in six areas: support to pregnant
women’s nutrition, breastfeeding, nutritional surveillance
of children younger than 6, vaccination, oral rehydration
and infant education.
A
solidarity network was thus built to multiply knowledge
and support.
The project was tested in the city of Florestópolis,
Paraná state, where the child mortality rate
was 127 per 1000 live births.
One
year later, this figure had been reduced to 28 per 1000.
This
result encouraged UNICEF to send religious leaders from
other countries to visit this network of human solidarity.
Today
we reach over 32,000 communities in 3,555 municipalities,
where more than 153 thousand volunteers monitor more
than 76,800 pregnant women and over 1,6 million children.
The
national average is 12 children per community leader.
More
than 90% of the community leaders are women.
The
advocacy and partnership that is so critical for a good
system that assures Healthy Mothers and Healthy Babies
starts, in my view, with the empowerment of families
and communities.
It
is still possible to reduce child mortality, malnutrition,
and family violence when we have a strong community-based
foundation.
In
Brazil, the data collected from all the communities
are turned into indicators and sent back to the volunteer
leaders, so that they can see what percentage of the
goals is achieved every quarter, compared to the regional
and national goals.
The
programme orientation is easy to understand and can
be multiplied in large scale, even in communities with
a high illiteracy rate.
The nutritional status of pregnant women is regularly
evaluated, and guidance provided on breastfeeding.
At
present, 6% of newborns have low birthweight, and 80%
of babies are exclusively breastfed for at least four
months.
It
seems to me that the keys to success around the world
are: motivated by feelings of solidarity; ongoing training
of agents; good quality educational materials; participation
of community leaders as agents of social change; and
coordination, training, and monitoring teams working
at local level.
The
Child Pastorate is presently working in 14 countries
in 3 continents:
In
Latin America: Paraguay, Bolivia, Peru, Venezuela, Argentina,
Chile, Colombia, and Ecuador,
In
Africa: Angola, Mozambique, Guinea-Bissau, and
In
Asia: East Timor.
The
work is also starting to be implemented in Mexico and
the Philippines.
Religious
leaders around the world have been and continue to advocate
for conditions and programmes that will improve the
health of their peoples.
I am sure that with the collaboration of all of the
UN agencies, NGOs, religious organizations, and others
present at this Special Session for Children, that we
can achieve dramatic results in the next decade.
Thank
you for the opportunity to make the closing remarks
for this session.
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