Watch how Brazil's Social Mothers programme helps new mothers like Maria best care for their infants and themselves.
By Kent Page
The 2013 Progress Report on Committing to Child Survival: A Promise Renewed shows that major progress has been made in lowering child mortality in all regions of the world and at all levels of national income. Nonetheless, even bigger gains are needed if the world is to meet Millennium Development Goal 4 – reducing under-5 mortality by two thirds by 2015. UNICEF’s Web series on A Promise Renewed focuses on some of the successful and innovative programmes that have helped save the lives of millions of children around the world.
In 2012, Brazil reached Millennium Development Goal 4. Disparities across Brazil mean that work remains to be done, particularly in some impoverished communities and among marginalized groups, including Afro-Brazilians and indigenous people. As demonstrated by the Social Mothers programme, the Stork Network, the Mother Kangaroo programme and Super Child Health Agents, Brazil continues to innovate and make progress in addressing under-5 and maternal health.
In Sobral, Brazil, ‘social mothers’ like Franciane are helping to make a clean sweep in the reduction of under-5 mortality by helping mothers during pregnancy and in the first, most critical, month of a baby’s life. Social mothers do everything from household chores to teaching proper breastfeeding, but perhaps their most important role is in the friendship and trust they provide.
SOBRAL, Brazil, 13 September 2013 – Being armed with just a broom may not seem like the best way to reduce child mortality, but an innovative programme – Mãe Social – is proving how effective this simple approach can be.
It has caught the attention of Brazil’s Minister of Health, Alexandre Padilha, who has come to Sobral to see the programme first-hand, and also of Brazilian President Dilma Rousseff. Together, they are exploring ways to expand the Mãe Social initiative across the country as
Brazil continues its remarkable progress in reducing under-5 mortality rates.
Social mother Franciane de Lima speaks with Maria. By assisting with tasks ranging from bathing little Ana Vitoria to preparing meals, Ms. de Lima enables Maria and other new mothers to rest and remain as healthy as possible.
Franciane de Lima is a mãe social, or social mother. “I’ve got two children of my own, but I’ve also become the social mother to more than 30 babies since I began,” she says. “I’ve also become a close friend to many of the mothers and other children in the families I’ve helped to support.”
Helping in any way
Sobral lies in the dry, dusty interior of Ceará state, the heart of Brazil’s semi-arid northeast region. By midday, it’s already very hot: 42° C. But the heat doesn’t bother Franciane as she knocks at the door of a little green home in a low-income neighbourhood.
Newborn Ana Vitoria gurgles and smiles as her mother, Maria, answers the door. Ana Vitoria reaches out her arms towards Franciane. Maria seems relieved to put her baby in Franciane’s arms, and quickly sits down to rest.
Franciane gently bounces Ana Vitoria in an embrace. “My work is important, because it allows pregnant women to rest and be healthy throughout their pregnancy and during the first month of their baby’s life,” she explains. “My job is to help the mothers in any way I can. I’ve been trained to help teach pregnant women about the importance of breastfeeding, and often I help them to do it when they have difficulties.”
But her job is much more than that, which is where the broom comes in. “Franciane helps me in so many ways,” says Maria. “With Ana Vitoria, I’ve now got five children, and my pregnancy with her was very difficult. Social mothers like Franciane help take so much work away from us so we can rest, sleep and be as healthy as possible.”
“I help pregnant mothers with everything in their home,” Franciane says. “I tell them to lie down and sleep while I sweep the floors, clean the house, wash and dry clothes, prepare food for them and wash their baby. I’ve been trained on healthy foods for pregnant women, so I insist they buy lots of vegetables and fruits so they are strong and healthy.”
Franciane’s uniform is a clean, white t-shirt that has ‘Mãe Social’ printed in bright red letters beneath a four-leaf clover, the logo of the local government agency that sponsors the programme. She wears a blue ‘skort’: “It’s shaped like a skirt because that’s traditional, but underneath it’s like shorts, because that’s more practical for the housework that we do,” Franciane explains. “We get it after we complete our one-week training course to become a social mother, and every year we take additional two-day training courses about breastfeeding, nutrition and hygiene. We are always learning.”
Social mothers are not available to every family in Sobral – the programme is targeted at low-income, vulnerable families.
“I think the most important part of my work is not just allowing pregnant women to rest by doing their household chores, or sharing breastfeeding knowledge,” says Franciane. “I think the most important thing is the friendship, caring and emotional support we can give. People can die if they don’t have friendship and love.”
Franciane says that one mother she cared for was so overwhelmed that the woman punched herself in the stomach while pregnant and said she would never be able to breastfeed her child. “I stayed with her and was able to take some of her stress away by supporting and encouraging her. I am happy today because I know it really worked!” she says. “I helped her breastfeed and take care of her baby, and now she’s a fat, healthy baby. I still visit them regularly, and when I come to their home, her mother says, ‘Look, it’s your second mother coming to see you!’”
Pregnant women from vulnerable families in Sobral not only benefit from the help of social mothers, but also from Brazil’s nationwide community health agent programme. Health agents visit vulnerable families with more in-depth health knowledge and work with them well beyond the first-month of the baby’s life. As with many social mothers, the community health agents are often from vulnerable, lower-income families themselves and really understand the problems they face, as well as the opportunities. As community health agents and social mothers are paid for their work, the programme also provides them with essential work experience, skills and financial support.
Sobral is not only the pioneer of the Social Mothers programme – it has also been awarded UNICEF Brazil’s Municipal Seal of Approval six times. The Seal of Approval is a UNICEF initiative, in partnership with Petrobras and Rede Energia, that aims to strengthen municipal policies promoting the rights of children and adolescents. Launched in Ceará state in 1999, it is awarded to municipalities making progress against specific indicators for health, education and social assistance.
A Promise Renewed is a movement based on shared responsibility for child survival, and is mobilizing and bringing together governments, civil society, the private sector and individuals in the cause of ending preventable child deaths within a generation. The movement seeks to advance Every Woman Every Child — a strategy launched by United Nations Secretary-General Ban Ki-moon to improve the health of women and children — through action and advocacy to accelerate reductions in preventable maternal, newborn and child deaths.
Since its launch, 176 governments have signed the Committing to Child Survival: A Promise Renewed pledge, and thousands of civil society groups and private individuals have mobilized actions and resources in support of the goal. A diverse array of governments are setting bold new targets for maternal, newborn and child survival, while, around the world, civil society is increasingly holding governments accountable for their promises, facilitated by new communication technologies and tools.
A Promise Renewed recognizes that leadership, commitment and accountability are vital if we are to end preventable child deaths. And because child survival is increasingly recognized as a shared responsibility, everyone has a role to play.