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At a glance: Peru

Dilver gets off to a good start

© UNICEF/Peru/2005
Many infants like Dilver (at left) in Lamay, Peru, now benefit from the 'Buen Inicio' (Good Start) initiative.
‘Progress for Children No. 4: A Report Card on Nutrition’ will be launched on 2 May. In the weeks leading up to the launch of this, UNICEF’s latest child-survival progress report, we will feature a series of stories focusing on successful initiatives that can help counter the many threats to children's nutritional status.

LAMAY, Peru, April 2006 – It was summer when Diana and Evaristo met in Lima, Peru. She was 16 years old and he 18. Diana had tended cattle on her parents’ land since she was little, but had decided to leave her home in Lamay, in the Cascabamba district of the Andean region, in search of a new life in the capital. Coming from a parochial environment and quite shy, she was unable to find work. Thus she returned to Lamay after some time.

Soon after, to her great surprise, Diana realized that she was pregnant. She decided to hide the fact from her family. Her large skirts and thinness were the accomplices of her secret, and no one suspected what was happening. But Evaristo, having just returned to Lamay, met Diana again and found out. That was reason enough for them to get married and announce that they were expecting a child.

Ironically, when Evaristo saw Diana again he had thought that she seemed in poor health. As is to be expected from a secret pregnancy, Diana had received no health care. In fact, at that time only a few mothers in the area received any prenatal care.

Two months later, John, now six, was born. Although his parents never knew his weight at birth, they remember the baby was very small, cried a lot and was sick all the time. “We are sure he was malnourished since he was born,” they now say in a knowledgeable but regretful tone.     

Close support for mothers

This knowledge has come as a result of their community benefiting from a child survival and development initiative called ‘Buen Inicio’ or Good Start. The initiative was launched in 1999 to promote early growth and development in excluded communities in the Cusco, Apurímac, Cajamarca, Loreto and Ayacucho departments of Peru.

Despite significant progress made in health and nutrition during the last decades, a large proportion of Peru’s population is economically, socially and culturally excluded. This has an enormous impact on the rights of children to a good start in life and to a sound future. In rural areas, 7 out of 10 Peruvians are poor.

© UNICEF/Peru/2005
Dilver had a healthy weight and height at birth, and at three months old was lively and playful.
Some 1,200 mothers die each year during and after childbirth from pregnancy-related causes. An estimated 18,000 children under five die yearly, more than 80 per cent during the first year of life, often from preventable causes. Twenty five per cent of children under five – some 750,000 children – are stunted. These figures are significantly higher in the rural regions where poverty and a poor environment are constant threats.
Lamay has developed a community-based monitoring system to provide close support to all pregnant women and their children, from pregnancy until the child is three years old. This has been made possible through mechanisms set up by local authorities, health promoters and ‘mother advisors’.

Mood of hope and optimism

 “When Buen Inicio began working in the community, it wasn’t easy for us to accept some of the recommendations from the health promoter because they clashed with our traditions,” says Evaristo. But soon he and Diana, as well as the authorities, began to understand the importance of proper care for pregnant women and how the lack of such care could affect a child’s development.

The couple learned about obstetric care before they had their second child. Evaristo soon became involved in the programme’s monitoring activities and was appointed as a health promoter. Diana took more convincing, as she believed that the education sessions at the monitoring centre were a pretext to take the children away. However, with patience and persistence, Evaristo was able to ease her fears. Ultimately she received the best possible care when she became pregnant a second time.

As a result, the new baby, Dilver, had a healthy weight and height at birth. At barely three months old, he already shows a rare liveliness that surprises everybody. “Soon, this one is going to teach his brother,” says Evaristo proudly.              

The mood in Lamay is now one of hope and optimism. With support from the Cascabamba municipality, the community has received additional resources for the monitoring centre. And the mayor is keenly interested in sharing news about the community’s progress.



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