Project UFMG Escolas Saudáveis

Belo Horizonte is the capital of the state of Minas Gerais, Brazil's second-most populous state. It is the first planned modern city in Brazil. The Metropolitan Region of Belo Horizonte, called Greater Belo Horizonte, is the 3rd most populous of Brazil. The human development of Belo Horizonte varies greatly by locality, reflecting the city's spatial social inequality and vast socioeconomic inequalities. There are neighbourhoods that had very high human development indexes in 2000 (equal to or greater than the indexes of some Scandinavian countries), but those in the lower range (in line with, for example, North Africa). Carmo/Sion (0.973): greater than Iceland - 0.968; Cruzeiro/Anchieta/Funcionários (0.970): greater than Iceland - 0.968; Grajau/Gutierrez (0.965): greater than Australia - 0.962; Belvedere/Mangabeiras/Comiteco (0.964): greater than Australia – 0.962; Serra/São Lucas (0.953): equal to Japan, Netherlands – 0.953. According to the 2010 IBGE Census, 1,110,034 are White people (46.7%), 995,167 are Pardo (Multiracial) people (41.9%), 241,155 are Black people (10.2%), 25,270 are Asian people (1.1%) and 3,477 Amerindian people (0.1%).

The service sector plays a very important role in the economy of Belo Horizonte, being responsible for 85% of the city's Gross Domestic Product (GDP), with other industry making up most of the remaining 15%. Belo Horizonte has a developed industrial sector, being traditionally a hub of the Brazilian siderurgical and metallurgical industries, as the state of Minas Gerais has always been very rich in minerals, specifically iron ore.

There are also a large number of small enterprises in the technology sector with regional to nationwide success, particularly in the fields of computing and biotechnology. Because of both governmental and private funding in the diversification of its economy, the city has become an international reference in Information Technology and Biotechnology, and is also cited because of the advanced corporate and university research in Biodiesel fuel. The number of jobs in the Information sector has been growing at annual rates above 50%. The Belo Horizonte Metropolitan Area, composed of 33 cities under the capital's direct influence, is home to 16% of the country's biotechnology companies, with annual sales of over R$550 million (source wikipedia: https://en.wikipedia.org/wiki/Belo_Horizonte)

The amazing team implementing the AHI HPS model in Minas Gerais:

In collaboration with the Department of Health and Department of Education of Prefeitura de Belo Horizonte, and Dental School, Federal University of Minas Gerais, Brasil, the Affordable Health Initiative (AHI) Health Promoting School (HPS) model is being implemented in two schools serving a socially deprived area of Belo Horizonte City. Health and education officials, school teachers, school children, their parents and health providers have been engaged in the project in Belo Horizonte City.

School headteachers have enthusiastically welcomed the implementation of the AHI HPS model in schools serving Belo Horizonte City.

UFMG Escolas Saudáveis Project Evaluation

The Affordable Health Research Centre (AHRC) evaluated all AHI projects adopting an implementation research methodology LEARN MORE>.

In partnership with the Federal University of Minas Gerais, the AHRC is assessing the implementation and impact of the AHI HPS model on health and education outcomes in Belo Horizonte city. The intention to run the AHI HPS model was assessed among local stakeholders. The viewpoint of stakeholders, in particular the schoolteachers, in transforming schools in health promoting schools is relevant because individual decisions are often central to the implementation of health promoting school programmes and information about the view of schoolteachers is needed to successfully implement health promotion interventions in school settings at a large scale.

The implementation research conceptual framework adopted in this assessment was described by Proctor et all in 2010 (https://link.springer.com/article/10.1007/s10488-010-0319-7). Implementation research attempts to identify in order to solve a wide range of implementation problem. Implementation research can consider any aspect of implementation, including the factors affecting implementation, the processes of implementation, including how to introduce potential solutions into a health promotion strategy or how to promote their large-scale use and sustainability. Implementation research design is appropriate to understand what, why, and how interventions work in “real world” settings and to test approaches to improve them (https://www.bmj.com/content/347/bmj.f6753.full.print).

The domains proposed to assess the factors affecting the implementation a HPS model were acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, coverage and sustainability. The three first domains listed above were assessed.

ACCEPTABILITY

The acceptability of the AHI HPS model among stakeholders was agreeable. The Department of Health (DoH) and the Department of Education (DoE) of Belo Horizonte City agreed with the implementation of the AHI HPS model and showed great enthusiasm in supporting the initiative. The headteachers of the schools invited to implement the AHI HPS model enthusiastically agreed to run the AHI HPS model in their schools.

APPROPRIATENESS

The AHI HPS model was considered relevant and suitable to be implemented in school settings in Belo Horizonte City as perceived by providers and consumers.

ADOPTION

The adoption of the AHI HPS model among stakeholders was fenomenal. All showed strong interest to support and contribute to the implementation of the AHI HPS model. The Department of Education took the decision to allow school educators to use their time to contribute to delivering the health promotion activities included in the AHI HPS model. The initiative will be implemented initially in two schools and may be implemented in a larger scale following the assessment of the impact of the AHI HPS model in schools running the AHI HPS model.

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