Associação de Diabetes Juvenil - ADJ reports on the status of child health in Brazil over the past 20 years and discusses what types of programmes they and the federal government have developed to quell the obesity, diabetes and Non-communicable Disease (NCD) epidemic faced by families and school aged children. Learn how ADJ is promoting diabetes education for families and making a difference in their quality of life.
Global childhood obesity has increased in the last three decades and has become a major public health problem. The International Obesity Task Force (IOTF), in 2005, estimated that 155 million children worldwide were overweight or obese.1
Childhood obesity in Brazil, demonstrated in the Household Budget Survey (POF) of 2008-2009 and conducted by the Brazilian Institute of Geography and Statistics (IBGE) in partnership with the Ministry of Health Research, showed a significant increase in the number of overweight children in the country, mainly in the age group between five and nine years.
Moreover, the number of overweight children in Brazil more than doubled between 1989 and 2009, from 15% to 34.8%, respectively. The number of obese children has increased by over 300% in the same age group, ranging from 4.1% in 1989 to 16.6% in 2008-2009.2
The federal government of Brazil, pressured to provide solution, considers public schools the cultural nexus or institutional centre point of education and health as well as a space where the protection, care and full development of the school community is established. Brazil’s Ministry of Health and Ministry of Education is responsible for coordinating education and health programmes with the objective of improving the quality of life for children, young adults and families. Once officials recognized the need to improve health education in Brazilian public schools, the federal government instituted the School Health Programme (PSE) in December 2007, established by Presidential Decree No. 6.286/2007. According to the Ministry of Education, public school attendance in Brazil constitutes 26% of the population for basic education, a percentage which represents early childhood education, elementary education, secondary education, vocational education and education for youth and adults.
The PSE was established to promote health and to educate students about health care in general, especially targeting health disparities or vulnerabilities that compromise the full development of children and youth in public schools. The PSE also takes into account varying geographical characteristics and culture, and aims to respect diversity and local customs, when initiating proposals or programmes. Specific actions of the PSE include clinical and psychosocial activities to promote health and prevent disease; promote healthy nutrition, physical activity, sexual and reproductive health education; prevent the use of alcohol, tobacco and other drugs; and promote an environment of peace and nonviolence. Continuing education and professional training are also provided as well as monitoring and evaluating student health and the programme’s progress and impact.
Recently, the Ministry of Health issued the Strategic Action Plan against Non-communicable Diseases (NCDs) in Brazil, 2011-2022. The development of the Strategic Action Plan was fortified with additional intelligence by education and research institutions, various Brazilian government ministries, health NGOs, medical entities, associations with chronic diseases, and others. Brazil’s Strategic Action Plan aims to prepare the country for the next ten years to tackle and stop chronic NCDs including: stroke, heart attack, cancer, diabetes, and chronic respiratory diseases. In Brazil, these conditions represent health problems of the greatest magnitude, corresponding to an estimated 72% cause of death, and hitting the most vulnerable portion of the population hardest — low-income families.
In the last decade, there has been a reduction of about 20% in mortality rates for these diseases, which can be attributed to the expansion of primary care, and the reduction of tobacco consumption since the 1990s, showing important advances in the health of Brazilians.
Between November 2009 and September 2012, Associação de Diabetes Juvenil (ADJ), in partnership with the World Diabetes Foundation (WDF), developed a public school educational programme for the prevention of obesity in children and adolescents, called ‘Nutrition in Action’. Through nutrition education and by encouraging physical activity, ‘Nutrition in Action’ aims to decrease the risk of obesity and NCDs, such as diabetes, and has reached 45,237 students, aged 6-18 years old in 87 public schools in the state of São Paulo. It is noteworthy to report that in one student population of 6,589 surveyed, 16% (1,031) were overweight and 14% (903) were obese, highlighting the problem of childhood obesity in the region.
Additionally, ADJ develops specific activities and programmes for school aged children living with diabetes including initiatives like ‘Day by Day Kids,’ summer camps and counselling groups to promote the exchange of nutrition and health knowledge, thereby encouraging kids to better care for themselves and their diabetes.
Advocacy also plays a significant role in ADJ. Parents involved with ADJ are encouraged to unite and acknowledge the issues related to diabetes and to demand the Brazilian government’s help to assist families struggling to live with and manage diabetes now and in the future. Rights for the child living with diabetes are also very important — ADJ helps to integrate children living with diabetes in schools, teaching the school to deal with diabetes and minimizing uncomfortable situations that school children with diabetes often face. ADJ assigns diabetes educators to clarify basic diabetes care and nutrition in the school, and promotes professional healthcare skills in different regions, with the aim of preparing carers for the specialized needs of people living with diabetes.
1. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1: 11-25.
2. Instituto Brasileiro de Geografia e Estatística. POF 2008-2009: desnutrição cai e peso das crianças brasileiras ultrapassa padrão internacional. http://www.ibge.gov.br