we have chosen five municipalities as pilot municipalities of the Healthy Municipalities Project
They are located in "Central Agreste" region (the Agreste region lies between the coastal rainforest region and instate semiarid lands of Northeast
We took into consideration the economic situation
the existence or lack of similar projects and the willingness of the municipality to collaborate
These 5 municipalities are between 110 to 130km from the state capital of Recife
All have agriculture and livestock farming as the major industry
The total population of these 5 municipalities is 97,295 (in the year 2000) and their Human Development Index is 0.588 (in 2000)
Their HDI is practically at the level considered for low-income countries (0.554 in the 2000 Human Development Report)
which has previously have worked with Healthy Municipalities aided by the Ministry of Health
is also integrated as one of the pilot municipalities of the project
We then selected pilot communities in each municipality
we chose one life cycle as a theme for each municipality through interviews and existing information
we selected one community from each pilot municipality - the community with an accumulation of social capital relevant to the selected life cycle
we selected the youth life cycle theme in Bonito
We selected one pilot community where there were a large number of youth groups
Figure5 : Localization of Pilot Municipalities
In the concept of Healthy Municipalities, health would be improved not only through improvements to health care services, but also by the effects of various factors in everyday life (q.v. Figure 2)
We call this the "Idea of Comprehensive Health"
we should not treat health and life within only a few sectors such as health care
education or industries; we should treat them more widely and cross-sectionally
the framework of the life cycle comes to the fore
Thinking in terms of life cycle phases such as children
we can treat health and life in a more comprehensive fashion
Our Healthy Municipalities Project proposes the life cycle framework and performs trial runs of specific policy-making and intersectoral cooperation
This is just a gateway of activities and it is possible for each pilot municipality to alter or amplify the life cycle themes later on
The life cycle themes of each municipality are cited below
Barra de Guabiraba The life cycle theme : adult men
Camocim de São Felix The life cycle theme : adult women and children
Sairé The life cycle theme : elderly
São Joaquim do Monte The life cycle theme : adult women and children
Itambé The life cycle theme : infants
municipality and community development takes a long time
All precedent cases of municipality and community building generally show that there are no concrete outcomes at first
but they become gradually clear in the process of 3 to 5 years
Particularly when involving the development of human resources and social capital (capacity development)
it is important to support development with patience as well as considerable time and effort
in supporting "municipality and community development" through a technical cooperation project that calls for certain results within limited time
the Healthy Municipalities Project has chosen as its objective the creation and implementation of "mechanisms" that may be developed and concretized during the project period
"Mechanisms" are social devices that permit continuity in the collaborated activities of residents and local government
There are three different levels on which where these activities are implemented
Figure6 : Mechanism of Healthy Municipalities
residents freely discuss and take an active part in the undertakings
Facilitators have the role of encouraging community gatherings and leading meetings
"Facilitators" work in cooperation with "supervisors" (mentioned later) to promote community activities
always seeking to have new members participate in them
The participation of "collaborators of healthy municipalities" who help facilitators and supervisors is also indispensable
there is EAPPPS (Center for Healthy Public Policy Articulation and Promotion) for the integration and coordination of public policies giving priority to health and life
Supervisors coordinate and link activities from the micro and mid levels here
these include the intersectoral adjustment of public policies that reflect the concerns of the residents
the training of the human resources necessary for Healthy Municipalities
implementation and evaluation of community activities
the coordination of federal and state government programs or projects to meet the community's needs
participation in the development planning of municipalities
On the macro level (group of adjacent municipalities)
there arise discussions on broad-based common issues that can be more effectively resolved together than by an individual municipality
as the referral center for "Healthy Municipalities"
the UFPE trains the necessary human resources for the "mechanisms" and lend technical support to the activities
The UFPE also hosts the network of healthy municipalities and diffuses the "mechanisms" to other regions
the state government has introduced "Healthy Municipalities" in its development strategy and offers information on various public programs or projects to the EAPPPS of each municipality to support the planning of healthy public policies
In the course of the discussions on the intervention method of the Healthy Municipalities Project in communities
the central issue was how a community becomes empowered (how is it possible to improve the autonomy of the community effectively)
There are two fundamental problems in this region
people who live in Northeast region of Brazil have historically leaned heavily upon the hope of assistance from patrons
the notion of autonomy within the community is fragile
it is desirable for the community to solve their problems themselves through the empowerment process
but there is difficulty in achieving this with community efforts alone due to the serious problems stemming from poverty
Dealing with these two problems simultaneously is daunting
we need to take a different path from conventional ways
we have developed a method that seeks to make the best use of Existing Potentials (utilizing the abilities of one person who is good at making things
etc.) in the community to set up goals that can be accomplished by the community itself
We believe that their autonomy can be enhanced by achieving these goals
(The traditional approach has been a "cause-seeking approach" that analyzes the cause of problems to be solved.) The development of project method is based on the SOJO (System-Oriented Joyful Operation) model developed by Japanese researcher Toshihiro IWANAGA and others
people feel a sense of accomplishment through the implementation of small actions through joint efforts
boosting their self-respect and lending continuity for further actions with confidence
This name derives from the image of bamboo: Flexibility - flexible application of the method is one aspect; the firm roots of bamboo - a sound base in reality and also symbolizes the collaboration of Brazil with the Orient
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