Why are these children in hospital again?

by THE OLBIOS TEAM

Physician Vera Cordeiro was shocked by the number re-admissions of children from urban slums. She then came up with a treatment plan that addresses the full range of economic and social causes of illness.

THE OLBIOS TEAM

According to the UN Development Program, Brazil has one of the highest inequality rates in the world in terms of income distribution between regions and social strata, so health and sanitary conditions vary widely. Brazil’s public healthcare system coverage is not extensive, and state-of-the-art facilities are only available to those who can afford them. For the 60% of the population using public healthcare, service is limited to basic immunization and emergency care, and poverty presents daunting challenges. Most diseases are caused by unclean drinking water, inadequate sewage disposal, poor housing conditions and malnutrition.

As a pediatric physician working in a large Rio de Janeiro hospital, Vera Cordeiro was shocked by the number re-admissions of children from urban slums. Realizing their health problems were related to their social conditions, she founded the Association Suade Criança (ASC) to connect the hospital to the home and provide a treatment plan that addresses the full range of economic and social causes of illness. According to the UN Development Program, Brazil has one of the highest inequality rates in the world in terms of income distribution between regions and social strata, so health and sanitary conditions vary widely along the same lines. Brazil’s public healthcare system coverage is not extensive, and state-of-the-art facilities are only available to those who can afford them. For the 60% of the population using public healthcare, service is limited to basic immunization and emergency care. Unclean drinking water, inadequate sewage disposal, poor housing conditions and malnutrition cause most diseases in these poor communities. ASC addresses poverty issues and social conditions at the root of childhood illness.

Her initiative started in 1991 by gaining insight on child patients in public hospitals. It was found that following treatment of chronic and acute illnesses in children, poverty often caused over half of the children to be re-admitted. If living standards were not changed, the vicious cycle would simply continue. ASC then created a Family Action Plan to determine what assistance each high-risk family needed, in health but also in housing, work and/or education issues. Implementation resulted in an over 60% reduction in the number of days of re-hospitalization. The reduction was greater in cases where the social influences were more pronounced. Additionally, the clinical health of children improved between the time of admission to the program and their release. In only four years, a sample of six hundred families demonstrated a reduction in hospital costs, an average 35% increase in family income and an overall improvement in child health. Each ASC unit is connected to a public health unit and staffed by volunteers, social workers, psychologists, nutritionists and lawyers. The staff provides intensive one-on-one health monitoring and assistance to families, which are mostly single-mother households with a very low income. It works with families for at least two years, providing customized legal and nutritional advice, medicine, food, psychological counseling, vocational training and housing improvements.