‌Families caring for premature infants or children with pediatric cancer face many challenges. While they strive to help their children achieve optimal health outcomes, families from economically disadvantaged neighborhoods face additional social obstacles. This story is the same whether they reside in Brazil or in Baltimore.

Reduced access to maternal education, unemployment, lack of transportation, food insecurity, poor access to health care, and inadequate and unstable housing all increase the risk of adverse outcomes for mothers and their children. However, access to critical social resources can help families overcome these challenges and significantly improve health and quality of life for ill children and their families.

University of Maryland School of Nursing (UMSON) students accompanied Yolanda Ogbolu, UMSON assistant professor and director, Office of Global Health, to Brazil to assess the Saúde Criança Association (ASC), which aims to improve quality of life for impoverished families by addressing the social determinants of health.

Yolanda Ogbolu, PhD ’11, MS ’05, BSN ’04, CRNP-Neonatal, University of Maryland School of Nursing (UMSON) assistant professor and director, Office of Global Health, and three students in UMSON’s Global Health Certificate program spent time in Rio de Janeiro this summer, attempting to better understand these issues. Students Trish Milburn, DNP, CRNP; Oriyomi Dawodo, MS; and Martine Kirwin, BSN, accompanied Ogbolu to Brazil to assess the Saúde Criança Association (ASC), which aims to improve quality of life for impoverished families by addressing the social determinants of health. Ogbolu and the students sought to strengthen the partnership between UMSON and ASC and to explore the possibility of designing a cultural adaptation study model for Baltimore.

Saúde Criança, which means “Healthy Children,” is a 25-year-old program replicated across 31 countries in Africa, Asia, and Latin America; it empowers families to address the social determinants of health for children with chronic diseases. It also builds family capacity by developing a family action plan that leverages family strengths in five key areas: education; global citizenship (psychosocial and legal factors); health (food, medicine, and nutrition); housing; and income generation.

“This program truly addresses the social needs of families with sick children,” Ogbolu said. “Many families of critically ill children in Baltimore and Brazil suffer from similar challenges and could benefit from a culturally adapted model that leverages the strengths of the family to address their social challenges while at the same time providing direct assistance with transportation, housing, education, professional training, and legal issues over an extended period of time. Empowering families for the long term and allowing them to have sustainable transformations that can strengthen their families and brighten their futures is the ultimate outcome.”  

The certificate students spent 10 days learning how ASC helps families improve health outcomes by addressing social factors including breaking away from poverty through professionalism training to develop skills that will allow them to secure a job, legal support, and access to nutrition and medications. The students collected qualitative and quantitative data for a baseline analysis of the program, listened to first-hand accounts from families about how the program helped them overcome challenges, interacted with interprofessional health and public health staff, and used the data that was collected to make recommendations to improve Brazil’s program.

“Since nursing’s inception with Florence Nightingale, who identified the correlation between living conditions and disease, nurses have been striving to provide comprehensive care to the infirmed through evaluating social, political, and economic factors that contribute to or affect health outcomes,” student Milburn said. “These factors not only impact health and care delivery in the United States but on a global level. We anticipated that health care providers in Rio de Janeiro face similar challenges as do practitioners in Baltimore. The successful comprehensive approach that Saúde Criança developed helped inform us on how to develop a similar program and modify it to fit our health care challenges.”

The students will give presentations about their experiences in Brazil on Tuesday, Oct. 17, from 4-6 p.m. at the School of Nursing in Room 730.