Holistic Approach to Family Restructuring
Country: Brazil
Organization: Associação Saúde Criança Renascer
2) Sector of activity: Healthcare
3) Description of your products or services: Renascer’s objective is to restructure children attended at Lagoa’s hospital and their families in five essential areas: Health, Income Generation, Housing, Education and Citizenship through the development of a “Family Plan”. Each family is followed during two years, about 250 families per month. They are assessed monthly and receive food, and medication until they achieve a set of a very well- defined criteria for “discharge” from the program created by Renascer with help from McKinsey & Co. For the families to be able to sustain themselves, professional training courses are offered. When family members have potential to be entrepreneurs, Renascer helps with acquisition of equipment and materials. Renascer promotes home refurbishing, physiologic support, nutricional support and legal orientation. Data for each family is registered in Renascer ’s Database, to assist program implementation and generation of reports and social impact indicators. One innovation is that the courses and donations of work tools were not enough to embark our students on a path of success and so we created the Competency Development Module in which all of the students of the internal courses should participate,our students have skills in many areas which are unknown to them, due to a lack of opportunities, self- esteem, and training. We target that in this module, with the intention of preparing them to a firmer and more objective attitude in their professional trajectory.
4) Description of the operational model: Our work begins in Triage where a selection of families eligible to the program according to specific criteria occurs. The criteria include: disease, poverty (family income of < US$40 monthly), difficulty in achieving social mobility, family disintegration, and willingness to improve. Once admitted , a “Family Action Plan” is developed and actions are defined for restructuring. They then begin to execute the plan and are given basic and technical support. Family progress is closely evaluated and families who meet the criteria of evolution on each dimension (Family income, Housing, Health Care, Citizenship, and Education), validated by a multidisciplinary team, and confirmed by home visits are discharged so that new families can be helped (the average assistance time is two years) The “Family Action Plan” is comprised of a triage interview, hospital information, home visits and a discussion with the mother to help develop a realistic plan . Every month, the mother comes to Renascer , a volunteer and the mother sit to discuss overall and action plan progress. The volunteer registers the progress and enters it into our database. Programs Offered: Direct Assistance: Food, Medicine/Medical Equipment, Housing Technical Support: Psychological and Psychiatric, Nutritional , Legal , Social Assistance Professionalization: Internal and External Courses, Work Tools Support Programs: Recreation, Workshops
5) Description of the financial model: Renascer has worked to create strategies for sustainability, a key success in Renascer’s history has been maintaining a large base of local support for core programs thus reducing dependence on external funding sources. Renascer counts on the support of Unimed, (sponsor all the medicines the families need), Kinder Institute and L’Oreal (sponsor of Profissionalization program), Queiroz Galvão (sponsor of the housing refurbishing program), UNESCO ( sponsor of food, diapers, school material and medical equipments), Johnson & Johnson (sponsor of educational speeches for mothers and adolescents, plus meals and transportation) Praxair (sponsor of salaries and equipment for the profissionalization of Renascer’s network, and covers Renascer’s monthly buffer fund). Renascer also counts on the help of more than 1000 individual donors. Renascer has developed a revenue-generating project , the Fish Hook Project, it includes an original clothing line, jewelry line and other products bearing the Renascer logo. This project provides up to US$2800 in profit per month. The profit generated is all reinvested in other projects run by Renascer.
Client fees represent this approximate percentage of operational budget: 0%
6) Key operational partnership: Renascer was able to built and maintain many parternerships with companies, institutes and foundations. Since 1995 Renascer counts on the support of Unimed, (sponsor all the medicines the families need), Kinder Institute in Brazil (our sponsor and partner for the profissionalization project, a Swiss-Brazilian institute which sponsors social projects in our country.), L’Oreal (a partner in the profissionalization project offering technical support, as well as training opportunities for students and teachers and providing us with products at a discount rate.), Senac( a technical studies institute in Brazil, i a consultant and a partner in the methodology of our teaching.), Queiroz Galvão (sponsor of the housing refurbishing program), UNESCO ( sponsor of food, diapers, school material and medical equipments), Johnson & Johnson (sponsor of educational speeches for mothers and for adolescents, meals and transportation) Praxair (sponsor of salaries and equipment for the profissionalization of Renascer’s network, and covers Renascer’s monthly buffer fund). Renascer also counts on the help of more than 1000 individual donors and a team of more than 200 volunteers in all areas.
7) Current outreach:
We are at the Mature stage. Renascer was founded in 1991, during that time it has developed a model that can be implemented near any public hospital around the world, since its foundation, Renascer has become recognized both nationally and internationally, winning more than 15 awards for efficiency and transparency, including the Global Development Network’s Most Innovative Development Project Award in Cairo - 2003.
How many clients have benefited from your product/service in total? Over the last year? Since it’s founding, Renascer has directly assisted more than 2000 families totaling more than 7000 children. Currently Renascer supports: 256 families and 919 children. The Child Health Network attends 600 families and 2.400 children monthly, the number of beneficiaries of the model to date is around 20,000 children and their families. Furthermore, Renascer has provided over 1200 work tools and offered professional courses to more than 1900 families members enabling them to generate income.
What percentage of your clients is below the poverty line ($2 per day)? 99% Almost all our clients are bellow the poverty line:
According to data published in 2001 by the National
Household Sample Survey from the Brazilian Institute of
Geography and Statistics 32% of the population – 54 million
people – are poor, 49 million people earn less than half of
the monthly minimum wage in Brazil, (approximately US$62
per month), 5 million have no income whatsoever.
As a result, tens of millions of Brazilians live in urban
slums that lack decent housing, clean water, or proper
sanitation. Millions of children’s growth is stunted from
chronic malnutrition. Many diseases - pneumonia,
tuberculosis, rheumatic fever, anemia, mal nutrition, skin
lesions, are caused or exacerbated by extreme poverty.
Children are discharged from hospitals to the same
conditions that produced the disease, and thats where and
when our work enters the picture.
What is the order of magnitude of the potential demand for your products or services? Which
other low-income groups, countries or regions could benefit from it? Try to quantify (number
of clients, market size in currency):
The demand for such a model is striking when considering the levels of poverty in Brazil and the country’s highly skewed distribution of wealth. According to data published in 2001 by the National Household Sample Survey (PNAD) from the Brazilian Institute of Geography and Statistics (IBGE), the wealthiest 10% of the country’s population controls 46% of the total income, while 40% of the poorest have access only to 10.1% of the wealth produced in the country, 32% of the population – 54 million people – are poor, and 49 million people earn less than half of the monthly minimum wage in Brazil, approximately US$62 per month, 5 million people have no income whatsoever.We also believe that Renascer has the potential to be replicated in other countries as well. In July 2000, a group of UN representatives accompanied by Ruth Cardoso (Brazil’s Former First Lady) visited Renascer. During the visit, Graça Machel (Nelson Mandela?s wife) said : “This is the most complete health care model I have ever seen throughout the world” She expressed her desire to implement Renascer?s model in South Africa.
8) Scale-up strategy:
How many low-income individuals do you plan to benefit in three years from now? How are you planning to scale up or replicate your solution? What are the major constraints to scale up?
Renascer is a center of reference that fosters the replication of the program’s model in other parts of the country, its model has already inspired founding 14 programs and four more are in process of founding at other hospitals following quite a similar methodology and forming the Child’s Health Network. Since it’s founding, Renascer has directly assisted more than 2000 families totaling more than 7000 children. Currently Renascer’s supports: 256 families and 919 children. The Child Health Network attends 600 families and 2.400 children monthly, the number of beneficiaries of the model to date is around 20,000 children and their families. Renascer?s long term goal is to have a similar institution attached to each public hospital in the world. To accomplish this Renascer holds workshops, produces replication material describing the steps to found a new institution, maintains a network development program, with training and periodic progress reviews, and offers financial support for the replicated institutions. In the next three to five years our goal is to assist the development of two to four institutions in each year. In order to facilitate the spread of her model beyond Brazil, as well as increase funding resources, Dr. Cordeiro founded the U.S.-based organization Friends of Renascer in New York in 2000. Now with tax-exempt status, Dr. Cordeiro sees a great opportunity for increasing investment in the Child’s Health Network and visibility for the idea.
Which specific areas - and why - in your field would benefit most from investment by corporations, foundations, and other investors:
In our opinion, the area that would mostly benefit from investments is income generation because when families are self sustained they are able to go on with their lives without the help of others.
9) The organization: How does the initiative fit with your overall organization's strategic goals and priorities? How did the initiative start?
In her 20 years working as a pediatrician in Lagoa's Hospital, a public hospital in Rio de Janeiro, Brazil, Dr. Vera Cordeiro perceived that health professionals were faced with the challenge of not only “curing” the child’s illness but the conditions of poverty this child lives in. To address this problem, she created an innovative model which addresses a family’s basic needs through an individualized plan for restructuring the family while at the same time leveraging health care resources. Therefore, the focus of Renascer’s work is poverty alleviation with a hospital-based methodology for attending to the poorest. Renascer targets the most destitute families and give them the ability (job skills, information, self-esteem) to sustain themselves and provide a dignified and healthy environment for their children and the whole family.
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10) On the mosaic diagram, which of these factors is the primary focus of your work?
- Factor: Poor understanding of the human and social capitals of low income communities
- Principle: Leverage the power of communities as both consumers and producers
Contact Information:
Name: Dr. Vera Cordeiro - Founder
Organization: Associação Saúde Criança Renascer
Mailing address: Rua Jardim Botanico 86
Country: Brazil
Email: vera@criancarenascer.org.br
Tel: (55-21)2266-1446
Fax: (55-21)2266-1446
Website: www.criancarenascer.org.br
Organization's legal status: NGO
Number of Employees: 37
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