Institute of Early Childhood (IPREDE)

I’m Sulivan Mota, a pediatrician with a degree from the Federal University of Ceara (UFC) and a Master's and a Ph.D. degree from the Federal University of Rio de Janeiro (UFRJ). I’m a professor at UFC and have been working to promote children's health my entire life. I’m the founder of the Maternity School Assis Chateaubriand's (MEAC) Milk Bank (the first one in our region) and Neonatology Unity, and cofounder of both Walter Cantídio Hospital’s (HUWC) Pediatric Integrated Ambulatory and the Early Stimulation Nucleus (NUTEP). In 2006, I became president of the Institute of Early Childhood (IPREDE) that since 1986 acts to prevent and treat malnutrition in children of our state and has grown to be a comprehensive institute for child and family care. IPREDE became a reference in Early Childhood with a focus on children’s development, women’s empowerment, and social inclusion for families in poverty.

I’m committed to solving issues related to nutrition and development in early childhood, focused on poor and vulnerable families, through a broad range of services and activities available to them at our Institute. IPREDE’s project proposes a comprehensive approach to early childhood matters, by not only providing medical care and food distribution, but by also empowering families, especially mothers, and fostering child development in its many aspects. We identify the individual needs of each child and family and give them all the support needed to promote their full development: from psychomotricity groups, speech therapist and psychologist appointments, to specialized autism care at a unique facility. Through these services, mothers can become empowered to enter the labor market, kids will have higher chances of fully developing their body, brain, and emotions, and families will find a way out of poverty.

IPREDE was founded in 1986 when the chronic malnutrition rate in our state was 30% (according to the National Survey of Health and Nutrition). Today, that rate fell to 7% and the mortality rate is at its lowest, which enabled our Institute to grow and address other issues in our community. Nowadays, IPREDE is a comprehensive institute that works not only in nutrition and child development but also to help families leave poverty and gain self-sustainability through mother’s empowerment and insertion in the labor market. In our state, Ceará, 42% of the population lives under the poverty line, while in Brazil this number is equal to 25,3% (IBGE, 2019). While poverty has many causes, our target population is mainly constituted by single moms with low educational background and no or little job experience, which are aggravating factors that can trap these families in poverty. To break the poverty cycle, we assist mothers and children in their personal development and work to give the families self-sustainability, changing their present through new opportunities for the mothers, and their future by allowing their children to fully develop.

IPREDE acts on nutrition and development in early childhood, with a set of actions planned to serve children and their families. It all starts at the Welcoming room, where we welcome child and mother with activities such as movies, plays, music, and storytelling. They’re then directed to services that fit their particular needs, such as the ambulatory, where they can be accompanied by doctors, nurses, nutritionists, psychologists, speech therapists, and physiotherapists; nutritional services, where besides individual appointments, they can take part in educational activities and counseling; the mediation space, with activities focused on strengthening the bond between mother and son; the Conviver group, where mothers and psychologists work together to build a space of self-reflection and empowerment for women; the Mom Collaborator project and professionalizing courses, created to prepare mothers to enter the labor market; daily food and milk distribution, etc. Last year, we opened CONECTA, our new center 100% focused on assisting children in the autism spectrum with a multidisciplinary specialized team to perform many of the services previously described with the proper attention and care needed.

We’re located in a poor region with a high inequality and violence rate in Brazil, with many families living in extreme poverty, without access to the sewage system, and depending on government aid and public services to survive. Also, many of the mothers we serve are victims of domestic violence, have a low educational background (73,9% of them didn’t finish High School), self-declare as black or brown (82,6%), are unemployed (69%) or never worked (15%), are single moms (67%), and present some level of food insecurity in their houses (79%). Their children often suffer from malnutrition and inadequate levels of child development and growth for their age. At IPREDE, we seek to improve their nutrition through milk and food distribution and nutritionist appointments; to empower woman to enter the labor market through professionalizing courses and group talks with psychologists; and, above all, to help children to develop their full potential and break the poverty cycle through addressing their specific development and growth issues, and by building a stronger bond between families. (The data presented was collected in research performed at IPREDE in 2017).

IPREDE assists families with children from 0 to 6 years old with inadequate levels of development and growth, experiencing adverse situations and toxic stress, and living in poverty and vulnerable communities. We act to create new opportunities for the children to fully develop and for their moms and families to become empowered and prepared to face the world and the labor market, breaking the poverty cycle and creating a brighter future for them.

IPREDE was founded in 1986 by a group of professionals moved by the conditions of children living in poverty and malnutrition in Fortaleza. At the time, the malnutrition rate was 30% (it is now at 7%), and our Institute was created with the sole purpose of solving this issue by aiding families with food distribution and nutritional services. As the rates fell rapidly, IPREDE saw the opportunity of addressing other problems in our community, while continuing the successful work on nutrition. Through partnerships, we were able to assist more people and in more aspects of their lives. From the start, I acted as a volunteer at the institute, both as a professor and doctor, until I became the president in 2006. My goal was to develop partnerships with universities to disseminate the importance of investments and care in early childhood. Now we have partners around the world researching early childhood and supporting our Institute, and have become an important center for early childhood in Brazil. In 2019, we founded CONECTA to assist up to 180 children in the autism spectrum. We are an ever-evolving institute, and we will continue to expand our activities to meet the needs of our community.

All my life’s work, being a pediatrician, professor of Medicine, founding and assisting the pediatric ambulatory and milk bank of MEAC, and creating the Early Stimulation Nucleus – all that led me to IPREDE. It was the place I found I could truly make a difference to early childhood development, acting directly to strengthen the nutrition, growth, and attachment of the children in our region, while also empowering their mothers and families. I tried to solve the problems in early childhood my whole life, through the many places I worked and many initiatives I started. But it was only when I found IPREDE that I believed my actions would have a real and long-lasting impact on people's daily lives. The path to healing the family starts with the child. But for them to succeed and make their way out of poverty and the degrading conditions they live in, IPREDE focuses on mother care and capacitation to help ease the consequences of vulnerability and create opportunities for them to change their lives and escape the poverty cycle. That is how I believe we can change our community and these families’ realities.

IPREDE has been active in Fortaleza for over 30 years and is now solidified as a part of our city and community. We have the experience and infrastructure needed to deal with such serious matters, as well as the support of institutions and community leaderships to improve and expand our current work and develop new projects and ideas. As the head of IPREDE, I devote my life and years of experience to providing the best service we can to the families in our community, always searching for new partnerships to expand our capacity and serve a greater number of people who need us. Recently, we faced two new challenges that proved that our community network of solidarity can achieve great things: the opening of CONECTA, a dedicated center for kids in the autism spectrum, providing them with a range of adequate services, born out of the need of giving special attention to these children already served at IPREDE and opening our doors to new children in need of special care; and the COVID pandemic, that gave birth to our DONATION project, comprising of several actions to help families of 7 vulnerable neighborhoods in Fortaleza, including the distribution of 2600 lunch kits and soups daily, and tons of food and hygiene kits. These challenges proved that we have what it takes to help our children and improve the services we offer them, and to expand our actions beyond our walls to help those in need.

After creating the Integrated Pediatrics Ambulatory of MEAC, my colleagues and I idealized partnerships with community leaders to help improve children's primary care. That was the beginning of the Community Health Agent program, now spread throughout Brazil. Afterward, I participated in the foundation and construction of UFC's Neonatal Unit and ICU. Both initiatives and IPREDE were of fundamental importance to reduce infant mortality in Ceará. Our institute emerged to serve thousands of children suffering from malnutrition. Over time, we expanded our focus, now including mothers and caregivers, aiming to strengthen their skills and improve the living conditions of these families in high vulnerability. However, for them to become agents of transformation and create new opportunities for them and their children, we simultaneously need to recover their self-esteem, satisfaction, and confidence. That demanded expansion: to do so, we needed to assemble a team of professionals, make partnerships with different sectors of the economy, and seek more resources. That was the most urgent and challenging expansion at IPREDE, and I overcame this by chasing partnerships and convincing people through science and data that this work was necessary to take these families permanently out of poverty.

Throughout my journey, I was always opened to new challenges, I was but never alone. I always had a group of friends and colleagues from different areas of knowledge with me. In 1983, I was the coordinator of the scientific initiation program at the University Hospital Walter Cantídio (HUWC) and founded its Integrated Pediatric Clinic. Around the same time, I founded the first Milk Bank in our region and cofounded the Early Treatment Center (NUTEP) at UFC. In 2006, I accepted the challenge of presiding IPREDE, leading a technical and multidisciplinary team, giving scientific support to national (UFC, UNIFOR, and UECE) and international (Harvard, Quebec and, more recently, Rice) partners, to provide the most vulnerable with the best of scientific knowledge. I emphasize that my contribution consists of leading trained professionals through participatory management and, in partnership with the public authorities and the private sector, daily monitoring actions with families, close to the employees who work at the Institution, listening to each of them, and their ideas. I believe that innovative management is essential so that we build credibility, strengthening of actions, and the sustainability of IPREDE.

IPREDE was born out of the need to help kids suffering with malnutrition in Fortaleza, but soon expanded its focus, becoming a comprehensive, one of a kind institute that works simultaneously with child development (in its many aspects) and empowerment and strengthening of the family. In 1997, IPREDE became a center of reference in scientific research in Early Childhood by making partnerships with many universities, being now UFC’s main extension Project. In 2005, IPREDE became a UNESCO’s program. In 2009, IPREDE started offering mothers professionalizing courses, creating opportunities for them to enter the labor market and leave poverty. Our main innovation is the comprehensive approach we take on early childhood. We do not focus only in preparing the children to face the future, but we also think about the present and the self-sustainability of their families. We particularly focus on the empowerment of women, their self-esteem and self-confidence. Another unique aspect of IPREDE is that we do not limit ourselves to our current activities; we truly feel we have a commitment to the community we are a part of. We do not measure forces when it comes to attending its most urgent needs and we are always trying to expand the number of people we serve and the variety of services we offer. A recent example is our DONATION Project, born during the COVID pandemic, where we left out headquarters and went to poor neighborhoods to distribute over 200,000 meals and 398,000 hygiene kits and food baskets in 2 months.

Our project focuses on families living under the poverty line (84% of them are beneficiaries of the Bolsa Família program), in social vulnerability, and with kids from 0 to 6 years old, the majority suffering from nutritional problems. We apply social technologies to stimulate children's development, and partner with Universities to perform research on early childhood so we can base our actions in scientific knowledge, spread the word about the importance of investment in early childhood, and provide the families with credible information on child development. We aim primarily to improve children’s development and growth, empower their mothers, and consequently take them out of poverty. In this first aspect, we provide the child with medical, nutritional, and psychological care, evaluating and treating any problems they might present. We distribute food and milk and take their measures periodically to follow their evolution. We also have a psychomotricity group focused on helping the children with aggressiveness or other kinds of behavioral problems, and groups focused on strengthening the bond between mother and child. Through these actions, we expect, in the short run, for the kids to have improved health, nutrition, and, therefore, development. In the long run, we expect them to learn better when at school, have higher educational attainment, and better living conditions. On the family and mother aspect, we provide professionalizing courses and psychological follow up to lift their self-esteem and prepare them to enter the labor market. In the short run, we expect them to be able to earn an income and provide for their families. In the long term, a better home environment and higher income will provide her with better health, more access to goods and services, and will benefit the child’s development as well. We fight poverty through two channels: a short-run channel, through the mother entering the labor market and earning an income; and a long run one, by enabling the children to fully develop and to be prepared to face any challenges life may present, such as school, the labor market, etc.

IPREDE assists, directly, 1,200 children and approximately 750 women (mothers and caregivers). With the COVID pandemic, we expanded our actions and started working outside of our institute, distributing 1,000 liters of soup and 3,000 lunch kits daily, and 2,500 lunch baskets and 2,500 hygiene kits, reaching 6,000 people. Recently, we bought the neighboring terrain and plan to double our infrastructure next year. For that reason, in one year we hope to be assisting 1,500 kids and 900 women monthly. In five years, we hope to include fathers in our project as well, so that our family care becomes whole, and to continue expanding our capacity, both in our regular care and the newly opened center dedicated to kids in the autism spectrum. Our wish is to assist 2,500 kids and 1,500 families by 2025.

Within the next year, we hope to ease the consequences of the COVID pandemic in our community and expand our infrastructure to assist more families. Right now, we are working to distribute food baskets, meals, and hygiene kits in poor neighborhoods in our city. But we know this pandemic will have long-lasting effects on our population, so we hope to continue aiding them to overcome these hardships while continuing conducting and expanding our work in our institute. Within a year, we hope to expand from assisting 1,200 kids to 2,500 with our new infrastructure. Within five years, we hope to include the father in our daily care, treating the family, and continue expanding the number of families we assist. We are also focused on expanding our newly opened center, CONECTA, focused on kids in the autism spectrum, from 180 to 300 kids in the next five years, hopefully being able to achieve that in less than two years.

Thankfully, we have been given the neighboring terrain to expand our infrastructure and receive the number of kids we aim to in one year. Currently, we are developing the project and looking for partners to finance the construction of our new building. Now, we have a 7,500 square meters building, and when the construction is finished, we will have 15,000 square meters of infrastructure. That will demand an expansion of our team and equipment to serve the families. The main barrier, therefore, is financial. To expand CONECTA and continue aiding families impacted by the COVID pandemic, we will also need financial support and partnerships that will enable us to continue our work.

As we have been doing for so many years, we will continue to look for partners that will financially help us to achieve our goals. To cut costs and assist the expanded number of families we aim to in the following years, we are focusing on scientific innovations such as telehealth that would help us serve more people with a lower cost. This would significantly lower the financial barrier and would make it easier for us to get the finance we need. To do so, we are currently performing research on how to use this technology efficiently to continue helping the families in our community. In the meanwhile, we will continue to disseminate our Institute’s work and the scientific studies that prove our work is valuable and should be expanded to improve the living conditions of the families in our community.

IPREDE is the largest Extension Program at the Federal University of Ceará (UFC) and has collaborators working as professors of Medicine, Psychology, Pedagogy, Arts - Theater and Music, and Economics. In terms of research, we have partnerships with the State University of Ceará Foundation (FUNECE) and the University of Fortaleza, aiming to partner in programs and projects that foster the constant training of its human resources, the rational use of its infrastructure and the joint development of research and development actions and projects for the mutual interests of the participants. In addition to these institutions, we also have collaboration with Professors from Harvard, the University of Quebec in Montreal, Rice University, and the Chinese Academy of Sciences. We also have a partnership with UNICEF, SESC, Banco do Brasil and Banco do Nordeste. Now, during the Covid-19 pandemic, we are working in partnership with Unibanco Institute - and other local NGOs that somehow contribute to this project - for the production and distribution of food and cleaning supplies for poor communities in Fortaleza.