Challenges

Uruguay Crece Contigo (UCC) addresses socio-health indicators related to the growth and development of early childhood, pregnant women, and their families. This policy carries out socio-educational actions to promote good practices in families, which improve quality of life and favor comprehensive and adequate child development. It promotes capacity strengthening and protective factors in the beneficiary population and the access to rights for populations in socio-health vulnerability, especially for children under five, pregnant women, and their families.

Uruguay had already shown strong economic growth since 2005, and poverty and indigence figures had been steadily decreasing. However, in 2012, significant problems related to pregnant women and early childhood still persisted: 28% of pregnancies were poorly monitored, 12% of births were premature and 3% presented congenital syphilis (data from CHPR/SIP 2012); 31% of children between 6 and 23 months had childhood anemia, and 10.9% of children under 24 months showed stunted growth. The percentage of children under 4 years living below the poverty line doubled the figure found for the total population (24.9%, ECH 2012). Also regarding health indicators, the situation of early childhood showed figures that did not correspond to the general situation of the country.

Toward a Solution

The purposes of Uruguay Crece Contigo are to:

• Develop and implement universal actions that guarantee adequate care, development, and protection of pregnant women and families throughout the country.
• Accompany the trajectories of families in vulnerable situations, with pregnant women, children under 4 years old with socio-health risk, and families with high indices of critical needs, through focused strategies.
• Promote family access to social protection matrix services through inter-institutional coordination.

During 2022, 9,770 welcome sets were sent to all centers, which include the “Guide for a Good Start”, “Advice for Healthy Motherhood and Fatherhood,” and the “Parenting Guide.” In 2022, a total of 13,100 guides were distributed.

The Family Accompaniment Program serves approximately 4,700 direct beneficiaries each year: 1,300 pregnant women and 3,400 children under 4 years of age with socio-health risk in 3,200 households.

During 2023, Family Action served an average of 69 families with 350 direct beneficiaries. With the incorporation of new teams to the Family Action Program, it is estimated to have an annual coverage of 1,000 families.

Among the community actions is the Mobile Polyclinic, which carried out various urban activities in Montevideo, Canelones, San José, Salto, Flores, and Durazno, and rural activities in Rivera, Flores, Treinta y Tres, Rio Negro, Tacuarembó, Durazno, Lavalleja, and Paysandú, conducting 56 activities. In total, 523 office consultations were performed, having conducted 454 Pap smear tests for women, 34 subdermal contraceptive implants were placed and 14 were removed, and 54 people were vaccinated including adults and children. 55 workshops were conducted, reaching approximately 500 people including children, adolescents, and adults. Regarding the workshops, it is worth highlighting that work began on the Positive Parenting strategy in two locations: Andresito in Flores and Villa el Carmen in Durazno, having successfully completed this process. Starting in June 2024, work began in Unit 5 of the CNR-PPL for Women Deprived of Liberty, performing Pap smears for cervical cancer prevention.

The national strategy Painted Parks has created 40 Painted Parks in all departments of the country, including the installation of breastfeeding-friendly spaces and children’s corners located in territorial offices, including one at the Pereira Rossell Hospital Center.

In 2022, 600 workers from early education centers were trained in the application of the “Conceptual framework for the implementation of good feeding and nutrition practices for children from birth to 6 years”.

UCC is an experience that can be replicated in other countries. It has extensive documented experience, with a methodological design for the implementation, training, and evaluation of the program that can be replicated. All accompaniment modalities have action protocols that guide their implementation. Additionally, the work carried out is registered and monitored through a computer system that has its respective manuals, with the possibility of being replicated. The program includes an induction for new technical teams that begin working in it, providing permanent training, thus having qualified technicians capable of transmitting the experience and knowledge acquired. 

A factor that may condition its implementation in other contexts is the type of social protection system existing in the recipient country. An architecture of welfare and institutions is required to support its sustainability (health system, early childhood care services, etc.). A second condition is whether the State has the capacity to implement the practice, being able to address distances, geographical differences, and socio-identity and cultural aspects of the target population. For a better application, it is also recommended to have health professionals and promoters.