The Child Pastorate Programme (Pastoral da Criança - PC), implemented by the Catholic Church of Brazil, started in 1983 and is still ongoing. The PC works in 32,265 communities located in 3,403 municipalities (62 percent of the total), in 5,140 parishes (63 percent of the total), and in 261 dioceses (100 percent) of all 27 states of the nation. The PC is primarily concentrated in areas of high incidence of poverty, where child mortality rates and malnutrition are above the national average.
Between October 1999 and September 2000, total programme funds amounted to US$ 6,905,721 (17,264,302 Reales; exchange rate of 2.5 Reales per US$ 1) from the following sources:
In addition, the programme benefits from logistical support from the dioceses and parishes and the participation of 129,725 volunteers, 6,295 regional and local coordinators and training staff.
Objectives of the programme
The programme’s overall objective is the promotion of social justice and greater equality based on the Christian faith and fraternity. Its specific objectives are to:
By the second half of 2001, the programme had achieved the following:
Health and nutrition
Communication and training
The programme has managed to become the bridge between the local and institutional levels. Each diocese now undertakes its own planning, but benefits from information provided in reports from the central level. While there is a strong sense of ownership at the community level, and many community leaders state that they could continue activities even without the support of the programme, decision-making is not yet in the hands of the community. For example, income generating initiatives, a component that could well be placed under the direction of the community, still requires the guidance and approval of the diocese or parish.
Strengths, weaknesses, opportunities, constraints/threats (SWOC)
The programme has had a very positive impact on the section of the Brazilian population vulnerable to poor health and nutrition. It has achieved coordination at different levels in civil society organizations and state institutions, states, municipalities, private initiatives and non-governmental organizations (NGOs). This has facilitated a process of ownership and empowerment at the levels where the programme is active. The involvement of the Ministry of Health has been a determining factor as well as the ownership of the programme at the local level. Activities can, and are likely to, continue without the assistance of the PC.
The Republic of Brazil, a South American country with a surface area of 8,511,965 km2, borders Argentina, Bolivia, Colombia, Guyana, Peru, Paraguay, Uruguay and Venezuela, and the Atlantic Ocean to the east. The country is comprised of 27 states and a Federal District, organized in five regions. It has a population density of 2.95 inhabitants per km2, and its official language is Portuguese. The population distributed in these regions is characterized by contrasts, customs, beliefs, inequalities, and heterogeneity that has evolved over the last decades amidst industrial growth and urbanization.
Brazil’s population in the year 2000 was about 168 million (UNDP, 2000). The growth rate is about 1.4 percent annually, of which 80 percent in urban areas and 20 percent in rural areas, approximately. Currently there is a decline in the birth rate, reflected in a reduction in the number of those in the 0 to 14-year-old group.
The country is characterized by socio-economic conditions of a medium to high average income, with a GDP average annual growth rate of 4.5 percent in the year 1999-2000 (World Bank, 2000). Poverty is more an urban problem than a rural one due to the concentration of inhabitants in these areas. Economic development accelerated during the 1980s, and paved the way for a reformulation of government policies. Trade treaties with other countries gave Brazil a competitive edge in the international trade arena which led to an improved economic environment. Constitutional reform in 1988 also presented the country with new challenges in the face of a broader democratic opening.
In a country of contrasts, poverty has increased, with serious social and economic inequalities. The roots of this inequality lie in the limitations of a development process based on import substitution and on protections for industry which led to an urban industrial economy unable to eliminate poverty and misery. The most vulnerable groups that have been sidelined from the benefits of industrialization are the landless workers, small landowners and marginalized urban workers. According to a study by the Planning Ministry’s Institute of Applied Economic Research (IPEA), 53.1 million Brazilians live in poverty: 34.1 percent of the Brazilian population lives on less than half the basic wage (US$ 36 per month). Of these, 22.6 million – almost 14.5 percent of the population – are destitute. This situation, characterized by social exclusion and vulnerability, has led to the development of government policies on poverty reduction implemented through programmes promoting basic social rights. These are supported by the NGOs working in the country, and the Catholic Church.
Indicators of mortality and morbidity demonstrate improvements in health over the past 30 years, but the Ministry of Health continues to cope with insufficient financial means. This has resulted in gaps in health coverage. Distribution of available financial resources remains unsatisfactory: for every dollar spent on prevention and health promotion, US$ 25 are spent on tertiary care.
As a result of these problems, during the 1980s a series of reforms was begun aimed at decentralization, with increased autonomy for the states, to allow the poorest population groups better access to health services and thus to increase coverage. The new United Health System has evolved, according to demands and priorities, and information systems that help to evaluate both the results and the costs for achieving them.
The implementation of such health policies has resulted in more than 90 percent of births being attended by a physician, a decline in the infant mortality rate in the last five years to 38 per thousand live births55, and an improvement in antenatal care. Another aspect that increases the health sector workload is the emergence of communicable diseases such as AIDS, which necessarily changes the characteristics of prevention within health programmes.
In 1997 low birth weight incidence was 7.8 per 1,000 live births (PAHO, 2000) 56, but this national figure hides serious regional disparities, the north and northeast having the highest incidence of low birth weight. A study done in 1996 in 1,300 municipalities in 17 states revealed a national malnutrition level of 41 percent in children between 6 and 24 months, based on weight-for-age. Children under five years of age, school children, and women are at risk for anaemia due to iron deficiency, and over 25 percent of children under five have vitamin A deficiency. The maternal mortality rate is still high at 213 per 100,000 live births. The main causes of food insecurity are: lack of access, lack of purchasing power, lack of access to means of production, especially among those that have no land, lack of public services, and lack of access to quality information. On the other hand, the increase in food importation and an inadequate food system threaten cultural values rich in terms of nutrition. Along with problems of undernutrition, development has caused more recent problems of obesity and poor eating habits, affecting certain age groups.
In 1982, the Archbishop of Saõ Paolo and the Executive Director of the United Nations Children’s Fund (UNICEF) agreed that the Church could help save the lives of thousands of children in Brazil who died of preventable diseases.
The programme began under the leadership of the Child Pastorate (Pastoral da Criança - PC). In 1983, the Child Pastorate initiated its activities in the city of Floristópolis, in the State of Paraná, southern Brazil, where infant mortality was highest: 127 per 1,000 live births as compared to the national average of 73. It started in 29 communities, aiming at a wide area of coverage.
UNICEF’s technical and financial support at that time was of paramount importance. Preliminary activities included the preparation of a methodology, the design of materials and strategies for working in the communities, and the structuring of a local community-based information system.
The initial actions agreed upon between UNICEF and the Child Pastorate included young child growth monitoring, oral re-hydration, breastfeeding promotion, immunization, and health education. Early referral of the seriously ill to health services was added later. Between 1984 and 1987, geographical coverage was expanded from 29 to 200 communities. UNICEF continued to support the programme, and other financial and technical organizations added their support, as did the federal government via the Ministry of Health. Between 1988 and 1994, the geographical coverage reached 19,000 communities, and between 1994 and 2000, coverage was expanded to 32,265 communities in all 27 states. Volunteers have formed the backbone of the programme, and between 95 percent to 98 percent of the trained personnel have been women. The average annual rate of growth has been 1,738 communities per year since the Programme’s inception. The strategy was implemented via a methodology that developed the volunteers’ technical knowledge, solidarity, and training in the Christian faith.
Activities involving the beneficiary families included:
The programme began with five basic health care activities:
The activities are documented as part of the monitoring process in the “health notebook”, which currently has 27 items that the leaders must fill out each month.
The main basic items include:
These activities have been reinforced with complementary projects such as income generation, literacy training for young people and adults, participation in the social arena, community mental health, roundtable talks, the Child Alive project, family planning, senior citizen groups and social communication.
The basic organization of the Child Pastorate consists of a central coordination office where all the guidelines pertaining to health and other aspects originate. The organizational and programming structure for health is put into practice by the diocese, parishes, and communities working together. In their respective areas of influence and, with a certain degree of autonomy, they can decide on some issues, especially raising additional funds to support the programme, coordinating among other organizations and organizing other events geared to strengthening the work of the Child Pastorate.
It is important to look at the evolution of the PC in terms of interinstitutional involvement. At the beginning, UNICEF was fully involved during the years 1982-1987; soon after, in the years 1988-1994, other international cooperation organizations joined on a more regular basis, as well as the federal government through the Ministry of Health. Since 1995, the programme has been working on bringing in state authorities, as well as municipalities where high health risks exist. The positive aspects of the programme have generated the need to involve a greater number of institutions, both governmental and international cooperation.
The Ministry of Health is the government institution that has participated most actively, both at the financial and technical levels, and currently has professional personnel assigned to work in the programme’s operative leadership. The Ministry of Education has been very active as far as literacy training for adults is concerned. Clearly, one of the PC’s most successful aspects has been that of coordination. The need to coordinate, and the efforts to do so, have been of great benefit to the programme’s target population.
By September 2000, the Child Pastorate had received support from the following institutions: Ministry of Health, the Electricity Company and its subscribers, Ministry of Education, Globo TV network/UNICEF, the Van Leer Foundation, Mission Austria, German Technical and Social Cooperation, Munich School Sisters, Adveniat, Misereor57, Agricultural Cooperative Development International, Canadian International Development Agency, International Lions Club and Panamerican Health Organization.
One of the PC’s tasks since the beginning has been fundraising, at first through coordination with various international cooperation organizations, followed by support from the federal government, until finally securing funding from the states and municipalities. This means that from the time that the programme first defined its principles, it had to seek funding sources in order to implement its activities. Once funding was secured, the technical and planning structures were developed by personnel of the PC and technical support organizations, including UNICEF.
Between October 1999 and September 2000, total programme funds amounted to US$ 6,905,721 (17,264,302 reales, at an exchange rate of 2.5 reales per US$ 1) from the following sources:
The above does not include the cost of logistical resources provided by the dioceses and parishes, as well as the participation of 129,725 volunteers and 6,295 regional and local coordination and training teams.
The technical support has been provided by other organizations, including:
The programme’s substantial impact is largely credited to the volunteer workforce that does not merely complete its routine work but rather sees it as a commitment to help its neighbour, without regard to race, religion or ideology. The programme’s impact in overall terms is clear, having operated from 1983 through the second half of 2001.
Impact on health and nutrition
National coverage of children 0-6
Infant mortality rate
Deaths of children aged 1 to 6-years (per 1000 children of same age)
Pregnant women vaccinated against tetanus
Malnourished pregnant women
Low birth weight (< 2,500 g)
Children exclusively breastfed until 4 months of age
Children with vaccination scheme completed
Children with diarrhoea
Children with diarrhoea given home-made rehydration
Nutritional monitoring of children under 6:
Source: Child Pastorate, coverage update for second half of 2001. Curitiba, Brazil.
Communication and training impact:
Impact on community organization:
Guidance from the Child Pastorate and the Catholic Church has, since the beginning, given the programme important momentum even though overall community participation is still minimal, limited to seeking external funds to strengthen the work of the Child Pastorate. In some cases, community leaders have met in small groups and proposed initiatives for income generation projects that are still in the planning phase (based on direct observations made in the field in Curitiba and Francisco Beltrão).
Clearly the programme has contributed to improving the health and nutrition of the target population and has supported the efforts of government authorities, in this case the Ministry of Health and the Ministry of Education. These in turn recognize the important role the programme has played nationwide and the national and international recognition it has enjoyed, to the extent that the Government of Brazil proposed it as a candidate for the 2001 Nobel Peace Prize. It is also relevant to note that other health authorities in Latin America and Africa have followed the example of Brazil and started similar activities in their respective countries, adapting them to the national and local circumstances. The programme ought to continue the crucial phase of analysis and review so that it can shape new scenarios for the short, medium and long term in order to strengthen the actions linked to health, and above all to visualize a broader form of community participation that would promote greater sustainability of the programme at its different levels.
Decision-making at the strategic and technical operational levels has always been carried out by the PC using a democratic process of consultation and consensus building among different institutions and organizations. However, it is only in the area of funding that some decisions may be made by the dioceses. The institutions and organizations provide technical support in the design of main strategies. The strategic and technical work designed by the programme’s middle and higher levels is in line with the existing local organizational platform. The Child Pastorate community leaders receive guidance and training from the area coordinators of the parish and of the dioceses, these leaders are the basis of the work and success of the PC.
The implementation of actions at the local level relies on the community leaders who in turn are monitored by the respective area coordinators and parish coordinators on two occasions: once during the monthly visits the community leaders make to the families under their care, and the other when they are trained by the coordinators. The philosophy of the programme lies in the principle of working with poor and very poor families in parts of Brazil where infant mortality and malnutrition are above the national average. The majority of community leaders themselves come from these same communities and their commitment draws upon three vital aspects: the Christian faith, love for children, and solidarity.
In practice, a good part of what is programmed is accomplished. Nevertheless, some of the shortcomings of the work include aspects of monitoring, follow-up and local capabilities. For example, the reports that should be sent each month to the central office are not always filled out completely. In a random sample, two forms in a row were not properly filled out. Some community leaders are illiterate themselves and what motivates them is the desire to do something on behalf of children and their neighbours. The risk is that often the person helping to fill out the forms is not trained either. These are obviously situations that concern coordinators at the all levels and for which they are seeking solutions.
The foundation of the programme is the community leader, who receives training and coaching in order to develop a series of activities divided in two phases.
These activities have been identified through an analysis of the national situation and have been defined and prioritized by the PC technical professionals. Personnel from the Ministry of Health, UNICEF, the Child Pastorate and the entire organizational structure of the PC have participated in the technical teams. The training system has originated from the central level, working down through the coordination levels, to the community leaders. In the end, the implementation of all activities relies upon the community leaders who have received the whole training process for working in the context of the families to which they are assigned.
One of the greatest advances of the PC is its information system, which is based on the community leaders’ monthly reports on statistics for health and children’s growth, for more than 1.6 million children under six, and of more than 77,000 pregnant women in all 27 states. The whole system has been designed from the central PC office, beginning with the community notebook which was proposed at the beginning of the programme by the first community leaders of the Floristopolis municipality. The information system has been designed in such a way that it clearly shows ongoing interaction between all principal players (leaders, community coordination, area and parish coordination, national coordination, state and diocese coordination).
This system of information and monitoring has other functions such as permitting ongoing evaluation of all actions carried out, reflection on those actions, and planning of new actions based on the monthly monitoring report.
Community leaders have a registration tool that covers 27 items organized by categories such as health, nutrition, opportunity and success indicators, immunizations, pregnancies, births, infant and maternal deaths. The information is reported monthly to the central level, where it is analysed and entered into a database that provides information by community, parish, municipality, state, and nationwide. Every three months, feedback is provided to the community leaders with a message of congratulations and encouragement to continue working, sometimes with suggestions or advice for improving the work. Then the community leader during her next group meeting with the mothers does an exercise based on seeing, playing, evaluating, and celebrating as a way of encouraging and moving forward together.
Very occasionally there are some problems with the data received at the central level. When this happens, the central level makes a note and returns them by the same route so that they can be verified. This guarantees that higher quality information is entered into the database.
From the PC national coordination centre, the quarterly data is shared with the health authorities of each state, and is also sent to the national level so the best use can be made of the information. Consequently the programme has an information and monitoring system that comes mostly from the grassroots level, and that – most importantly – works. These actions serve as a type of constant evaluation for the PC, as the observations done at the grassroots level are taken into account so that there is always a decision-making process at the diocese level. The information and monitoring system presently covers more than 32,000 communities where the PC works, in 3,402 municipalities in all the Brazilian states.
The training of community leaders to manage monthly reports started in 1987, almost five years after the programme began. The training of leaders and trainers allows the PC to have an information system of the sentinel site type and it is not, properly speaking, an epidemiological surveillance system. The task of the community leader is to detect main health risks for children and mothers, and make necessary recommendations for halting, diminishing and/or eliminating such risks.
Since the 1980s Brazil has faced serious time social problems. The number of Brazilians living in poverty and extreme poverty is very large, while inequalities of wealth and income reach very high levels. This poverty and inequality has its roots in the development model known as import substitution and protected industrialization that doubtless have been responsible for the expansion of the industrial-urban economy. In this context the 1988 Constitution of Brazil started a new chapter in the life of the Brazilian population. It is from this time that the different sectors responsible for the development of the country proposed profound transformations as well as a push towards a strategy of sectoral decentralization in the nation in order to meet the goals set forth. Much remains to be done, especially in the urban areas of the country, where the majority of the population lives because of the need to migrate to cities in search of employment. As part of this dynamic, mechanisms were set in place that favoured processes of local participation that eventually could face up to the challenges of development.
The governments in power since 1988 have given high priority to social problems but the gains are not yet evident. However, the partnerships governments formed with support organizations such as the Catholic Church have had important results. Today, the Government and NGOs have a series of poverty relief programmes aimed at promoting, consolidating, and guaranteeing basic social rights and equal opportunities especially for vulnerable groups.
In terms of designing centralized nutrition policies, the example of the Ministry of Health is important since it has organizational structures at all levels (central, state, municipal) to coordinate and support multisector actions aimed at improving the nutritional status of the most vulnerable population, in this case children and women. The case of Curitiba’s Secretariat of Health is important; it assigns well trained human resources to the area of nutrition. This has allowed it to maintain a monitoring system of the nutritional situation and the actions performed by the Ministry of Health and the NGOs that contribute to its programmes.
The programme was born of the need to reduce the high incidence of mortality in areas of poverty and extreme poverty. The Catholic Church has led the campaign since 1982. The programme had the unconditional financial and technical support of UNICEF during its first three years. The involvement of state institutions and other cooperating institutions was quick in coming, giving the programme diversified sources of cooperation and technical support.
The programme has achieved an important balance in terms of local participation versus the sources of funding and technical assistance: the PC has managed to act as the bridge between the local and the institutional levels. The PC acts as a bridging organization in planning as well, since it plays an important role in planning at the central level with other institutions and NGOs, and at the local level. The decentralization process has evolved in such a way that now each diocese does its own planning between the different levels of programme coordination, as well as with the community leaders. On the other hand, the quarterly results that are sent back from the central level are a rich source of information for reflection at each level and for proposing new actions at the community level, which then become part of the plans that they come up with.
In terms of resource management, the process of decentralization allows each diocese to manage resources on its own to strengthen actions supporting health, since the Ministry of Health, through the state and municipal secretariats, provides funding for health activities.
On the other hand, the Association of Friends of the Child Pastorate is a private initiative with a series of fund-raising strategies for providing continuous financial support for the PC from each diocese. Since 1995 the Ministry of Education is in charge of technical and financial support for the adult literacy programme in the PC areas, in which more than 19,000 adults are currently learning to read and write. Additional funds the dioceses obtain through friendly cooperating organizations are used to invest in income-generating projects such as bakeries, vegetable gardens, sewing, cleaning equipment. The income-generating projects have been operating for two years. They are organized with the community leaders to allow them to dedicate part of their time to other projects that support the family budget. However, this experience is still new, and needs periodic revision to define a strategy of broad coverage that would contribute more effectively to the microeconomies of the community families.
The example of groups in Francisco Beltrão and Curitiba is interesting; while leaders recognize that it is a good project, they have not yet found steady markets that would enable continuous production. Families living in project areas are similarly poor, so for example with the bread-baking project, bread had to be sold on credit, with debts being paid up to 60 days later, creating a drain on project capital. In other cases, new projects such as vegetable plots and cleaning products are held back due to the training process, others do not have a market for the products.
What this situation makes clear is that it is necessary to undertake a more rigorous analysis before launching into an income generation project. Such projects, if successful, have the potential of providing a degree of sustainability to the community leaders. The PC has now drafted a planning document for 2002 in which it established the need to guarantee greater food security within the programme and it appears that income generation projects are a mechanism to achieve this.
At the operational level, there is recognition of the difficulties that some mothers face in order to participate more fully in the programme. There are cases of non-participation due to religious issues (some think that because they are non-Catholic, they will not be welcome in the programme), jealous husbands, lack of interest, or because the economic situation is so dismal they are embarrassed to participate. However, there is an expression of solidarity when the coordinator detects such situations and the women participants contribute with food for families in difficulty, while the husbands look for temporary work.
In other cases, the priests inform parishioners during mass about the families’ difficulties, and a food drive is organized immediately for the neediest ones. In other cases, the parishes have signed agreements with the municipalities and give a bag of foodstuffs (rice, flour, oil, tomato paste, sugar and milk, among other things) to the community leaders for distribution. The above examples serve to denote the levels of ownership and solidarity that exist among participants at the various levels. Many of the leaders are of an advanced age while the coordinators are younger. There is great mutual respect among them. The majority (95 percent) of the PC leaders and coordinators are women. The beneficiaries for their part recognize the efforts of the PC: they see their children grow and survive, they learn how to prepare oral rehydration fluid and how to help their own children. In essence, the programme is a success for the beneficiary families.
Evidence indicates that community participation in the PC programme is strong and consolidated as far as carrying out the activities pertaining to health, nutrition and food security. The spiritual aspect linked to the technical one has produced commendable results, so much so that some community leaders interviewed said that were the programme to end, they could carry on by themselves. This is evidence of the work ethic and social outreach that the Programme has promoted since its beginnings. However, community participation in the decision-making process of the PC at the central level is limited. The possibility should be considered of viewing community participation in terms of the support it could give the Programme for income-generating activities, and of finding a more autonomous way for the communities to run them.
Present conditions fully support the Child Pastorate Programme’s continued development. The Programme has achieved prestige and recognition at the national and international levels for the positive effects it has had in its different areas, and this gives it the authority necessary for continuing to function. The level of commitment from the different governments has been favoured the Programme. The technical and financial support from both the Ministry of Health and the Ministry of Education could increase even more.
Sustainability by the community alone is still a long way off, given that the central level gives directions about community participation. What would happen if the leaders at the level of area, parish and diocese had full responsibility for running the programme without the support of the Child Pastorate central office? The running of the administrative, managerial, and strategic areas could present certain difficulties at first but these would not be insurmountable, knowing the energy of the key people who could be called on to reinforce the areas or abilities that are lacking. It seems that this aspect has not been analysed yet, since it is not thought that the PC ought to assume a different role within the community development process, either within the programme areas or elsewhere in Brazil.
Without doubt, the importance and priority the programme has accorded to health, nutrition and food security, as well as its ability to unite faith, solidarity and commitment with the technical aspect of development, is certainly a solid combination difficult to undermine. Even government agencies value highly the PC’s activities at the present time, and the partnerships that exist with other technical organizations are a sign that the PC is not alone.
The PC needs to consider establishing a centre for training human resources for income generation projects, and thus encourage and support more autonomous decision-making by leaders who have received such training. The idea would be for a trained and organized group to work on developing such projects that would help produce extra income to supplement the family budget and improve food security. However, there is a critical need for the PC to identify sustainable income generation activities. Given that 80 percent of the target population is urban, and 20 percent rural, it is important for the sustainability of the health project to be sought through income-generation: women engaged in economic activities have more confidence and security and will be able to continue to lend importance to activities that favour health care actions, including weighing babies and recording data.
The PC has managed to demonstrate improvements in the health situation of hundreds of thousands of children, and communication has played a crucial role in the achievements. The PC has not played merely a passive role in informing; it has encouraged mobilization and transformation and has helped people to reflect and form opinions based on that reflection.
At present, debate should continue about the level of community participation within the programme. While there is strong interest in encouraging participation, there is as yet clear direction. It must derive a way to help people to continue to do the technical part (weighing babies, registering them, filling out the forms) without this becoming merely a routine. Planning for the future of PC is essential to avoid loss of interest and energy.
This has been a key and determining factor for the Child Pastorate Programme’s success in Brazil. Since the beginning UNICEF’s support has been vital. Seeking partnerships with the states and municipalities has also been important. The accompaniment of other technical and funding cooperation offices has given additional lustre to the present PC. It remains to be evaluated how the PC promotes new partnerships with organized civil society and the NGOs so as to provide technical and financial support for community leaders in a process of thorough training to design, plan, manage, administer, and market income generation projects that could contribute to the family economy. This will give a boost to the energy the leaders currently have and would lend sustainability to the programme. In general terms, the strategy of pastorate coordination at all levels is an important lesson that could very well be transferred, since it has not been theoretical, but has been done in practice.
Brazil has a long history of decentralization. The PC has known how to negotiate necessary alliances at all levels and this has helped it to strengthen work at the grassroots. Presently, personnel of the Ministry of Health at the state level (Secretariat of Health, Director of Nutrition of the Ministry, Ministry Nutrition Coordinators in Curitiba) have a real commitment to the PC’s activities. As the Secretariat of Health said, “The Pastorate is our best ally in our primary health care work.” This situation should be taken advantage of in the future in order to strengthen relations even more and to explore new areas for joint efforts between the states, the municipalities, and the Child Pastorate.
Barros, Ricardo Paes de, & Henriques Ricardo de Mendonça Rosara. 2001. A estabilidade inaceitável: desigualdade e pobreza no Brasil. Texto para discussão no. 800. IPEA, Rio de Janeiro.
Child Pastorate. 2000. Coverage for second half of 2000. Curitiba, Brazil. Data included from 1988, the year the PC’s monitoring system began.
Child Pastorate. 2001. Coverage update, second half 2001, Curitiba, Brazil.
PAHO (Pan American Health Organization). 2000. Food and Nutrition Programme. Division of Health Promotion and Protection. Based on country information for Brazil.
UNDP. 2000. Human Development Report. United Nations Development Programme, NY, USA (editor’s note).
World Bank, 2002. World Development Indicators, 2002. World Bank, Washington D.C., USA
55 There are regional disparities however: IMR in the northeast is 75 per 1,000 live births, and 25 in the south.
56 Pan American Health Organization, Division of Health Promotion and Protection. Food and Nutrition Programme. Based on country information, 2000.
57 Editor’s note:
(a) Adveniat, Bischofliches Hilfswerk Misereor and Scholar Sisters of Our Lady of Munich are German NGOs.
(b) Bernard Van Leer Foundation (The Netherlands).