Developed in a partnership between INMED Brasil, ENGIE Foundation and ENGIE Brasil, the program improved the quality of life of children and their communities through participatory education on preventive health, nutrition and hygiene. It treats children with intestinal parasitic infection and anemia, providing biomedical diagnostics, treatment and training to their teachers and families. 63% of the local population live in rural areas and face social vulnerability. Only 20% have access to tap water and 14% don’t have bathrooms at home. The program takes place during a year but its trainings become a legacy for the region where the activities occur.

The main objectives of the program are: 1. Improve the health and quality of life of poor and vulnerable communities, teaching them how to use the whole food (stems, roots, etc.) for their nutrition and to make better choices, spending less money. 2. Fight diseases caused by contaminated water through knowledge, helping people get access to potable water using cheap methods and protect themselves through hygiene habits. 3. Disseminate Promote environmental education to communities, teaching them the value of rivers and lands and helping them to become more conscious about their environment. 4. Promote the adoption of healthy nutritional habits among children and communities, showing the importance of a proper diet and the value of what is produced at home and in the community, creating an economically sustainable strategy for a nutritional deficient diet. 5. Establish partnerships with local government, schools, NGOs and private sector to act on a common goal. The interlinkages among the SDGs and targets are: SDG 2: The project contributes to this SDG by its workshops about nutrition, iron supplementation and educational programs. Results are measured by the improvement in the levels of anemia in the children, the reduction of obesity and malnutrition. SDG 3: SODIS (Solar Disinfection of Water) technique, workshops about hygiene and exams to detect diseases caused by contaminated water. Results can be measured by the number of people who started to drink just potable water after the project and the reductions of diseases caused by parasites. SDG 4: Due to the project, the schools in the region have developed their annual programs taking into account themes related to environmental education. As a result, the workshops could be done and the projects could be developed by the students and their families (for example the creation of gardens). SDG 6: Workshops of the SODIS method of water disinfection using solar energy. SDG 17: Partnership between ENGIE (private sector), INMED (NGO with large experience in social projects) and public sector through government institutions. Some difficulties were faced in the project implementation. Firstly, the project was developed in a remote area of Brazil with low human development index and most of the inhabitants depend on rural subsistence activities or government assistance programs. In addition, working with the government in Brazil is always complicated because of the lack of financial and human resources and the weakness or lack of institutions. However, the project has successfully mobilized people about the importance of the planned activities for citizens’ health, especially for children, who could improve their nutrition by learning how to choose their food properly and passing this knowledge for their families.

Beneficiaries: 32 municipal schools; 4,351 children and almost 10.000 members of their families; 10.000 community members; 311 teachers, community health agents and school canteen workers. Implementers: NGO INMED Brasil (program implementation); ENGIE Foundation and ENGIE Brasil (sponsors). Institutions: Health and Educational Municipal Secretaries, The management team from the school called José Simião highlighted the treatment offered to the students. “Before, the students slept in the classroom, […] the parents […] didn’t understand why they were always so tired. This situation changed after the treatment. Children are more agitated, alert and participative in class. It was a great improvement to the school”.

The main program components are: 1. Research and Evaluation – initial and comparative biomedical exams (height/weight measurement, hemoglobin and feces exams) in children; knowledge tests (initial and comparative); 2. Anthelmintic treatment and iron supplementation; 3. Training for teachers, school canteen workers, community health agents and community members, activities, workshops, actions within the schools and the community like sanitation (sewer, water, trash, etc.). During the two years of interventions, the program has provided useful knowledge for children become agents of positive changes within their families and communities. The project becomes a platform for community mobilization because it approaches a wide variety of health, nutrition and education issues. The health improvement of the children and community members was reached through interventions such as: biomedical diagnosis, treatment with iron supplement and trainings about the importance of healthy eating and good hygiene practices. Effective actions were developed to encourage children and teenagers to embrace good eating habits, showing the importance of eating correctly and the value of what can be produced in their own home and community, in order to create an economically sustainable strategy to avoid a poor diet. Awareness programs at schools are a powerful vector to spread of healthy habits among the population. As part of the program activities, all the students received dental oral health kits (toothbrush, toothpaste, dental floss and liquid soap). According to the local program staff, the students in the region did not have basic sanitation material, especially at schools. Since this theme is being developed throughout the year in all the schools, the program included this activity. The coordinator from the school called Eliseu Barbosa said: “We have children that had no access to these type of information before the program and once they learned about these things, it was important to receive the material”. In partnership with the Health Department (dentists and nurses) from the health posts near the schools, they were present during the distribution, to teach children about personal hygiene.

The results of the program demonstrate its success: 1. The number of partnerships, including local government and other institutions; 2. Educational messages disseminated among the population that can be proved through testimonials, exams and treatments done. Parents and caretakers were mobilized to be more aware to health and nutrition. At the same time, they improved their knowledge on those themes, allowing them to make better choices for their families. 3. The comparative data shows that there was a general improvement on the nutrition and health status of children and young people, especially on the anemic levels. The number of children authorized by their parents to take the iron supplementation was 3,105. This treatment can explain the great reduction (43%) on the level of anemic children. 4. Promotion the adoption of healthy nutritional habits, among children and other community members, showing the importance of a proper diet and the value of what is produced at home and in the community, creating an economically sustainable strategy for a nutritional deficient diet. 5. 33 workshops for 900 parents and family members; 6. • Trainings for 205 teachers on the themes of Sanitary Education, Nutrition, Water and Health 7. • 199 Community Health Agents trained in sanitary education, hygiene, nutrition and SODIS; 8. • 120 Cafeteria workers trained in sanitary education, hygiene, nutrition and SODIS; 9. • Total of 108 hours of trainings and workshops; 10. • Around 230 hours of educational activities in the classrooms; 11. • 4 events for the communities; 12. • Over 2,000 children did biomedical exams (height/weight; feces and anemia); 13. • Almost 4,000 children received treatment for anemia; 14. • Improvement of 40% in the level of anemia among children; 15. • Improvement of 63% on the knowledge of students about the program themes; 16. • Improvement of 81% in the knowledge of teachers about the program themes; 17. • Increase in access to potable water at homes, through the SODIS method; 18. • Donation of 4,500 oral hygiene kits for children in partnership with Johnson & Johnson®; 19. • Distribution of 1,180 educational games for schools, on the following themes: “nutrition”, “Preventing Zika and Dengue” (two common diseases in Brasil that are transmitted by mosquitoes), as well as memory card games on nutrition; 20. • Over 1,500 parents and other family members received information and health services through the program activities on health, nutrition and prevention 21. In 2017, with the nutrition training, new topics were added to the action plan elaborated by each school. 22. The school Antonio Ursulina Alves did a partnership with a local Family Health program in which the local dentist came to the school to talk to children about the importance of proper oral hygiene and worked with the students on how to brush their teeth properly. 23. The school Manoel Dias Filho made available a space for the students to develop physical activities. 24. There was a workshop on garden in small spaces, with the distribution of seedlings and the promotion of physical exercise. 25. The school José Firmino da Cunha developed activities on suspended gardens

ENGIE has a broad initiative of sponsorship of social programs worldwide. There is a dedicated team in Brazil to develop social programs in the country in partnership with NGOs and communities that will have a positive impact in the life of people living around its enterprises. ENGIE invests on social programs that bring positive impacts on education, health, sports and culture in many places that are not totally covered by the state government and where people struggle to live in poor conditions. Great part of this social investment is done through Foundation ENGIE, an international organization that has been mobilizing energies to help the weakest and most vulnerable. Its primary focus has been children and young people in need, giving them the confidence to grow by supporting projects that promote inclusion through culture, education, health or sport. Support for children is in keeping with the Foundation’s philosophy: children will build the world of tomorrow, so giving them the energy to act is vital to the future of the planet. The program could be better developed if there were more support from the government, not just with money but also with professional and materials used. This support is a requirement done by Foundation ENGIE in the localities of the project, but if this support were expanded, the project could have attended more people in less time and better use its resources to improve its results. The SODIS method, for example, is an easy and efficient way to filter water, which can be done with no other material than a bottle of water. Therefore, it depends just on NGOs to go on schools and communities to teach children. This action can have great results in reducing the ingestion of parasites from non-potable water. Limitations: The deficiency in vehicle logistic support provided by the local partner, the municipality, to access the more distant schools in rural areas.

This program highlights sustainable ways of living as it encourages communities to consume local and natural products, as fruits, vegetables, among others. This is better for the environment, for the local farms and for their own health, while even rescue their traditional ways of living, as they consume regional fruits and prepare traditional food. In addition, the program helps to rescue the senses of community, as parents go to schools to learn together how to provide better nutrition for their kids and families. The social outcome is a healthier community that is capable of making partnerships with governments and other organizations to improve their quality of life. Thus, many doctors, nurses and dentists are volunteers to the program, being happy to help kids acquiring healthy habits like brush their teeth frequently, wash hands, consume potable water, among others. The economic factor, beyond the stimulus provided for the local consumption, that improves local economy and generates more jobs locally, is also an improvement in familiar economy, as parents spend less money buying fruits and vegetables then they would on snacks. Beyond that, the workshops help parents to consume the whole fruit, making other uses to tales, leaves and other parts, that can be consumed in soups, juices, teas and other recipes that are easy for the parents to cook at home and make better use of the nutrients. This program can be replicated anywhere in the world, as it uses just simple blood and biometric tests, and learning material to teach the beneficiaries. ENGIE has already implanted this program all around the country, benefitting around 45 thousand children, especially in rural and remote areas. The costs of the program can be reduced with partnerships. For example, in some municipalities, J&J provided hygiene products and exams for the kids, reducing costs. The benefits are spread all over the community as the knowledge is passed from one to another, so it is a really transforming project. Teachers are qualified to continue the activities after the project is finished. Also, children became transformative agents and they will spread the knowledge to their families and establish it on their lives now and in the future. The cost of this project was around 58 thousand dollars for each year. Taking in account that more than 4,000 children were benefit by the program, over one year, only less than 15 dollars was spent with every child, what characterizes a high cost benefits relation for the project. The spent of this project with each SDG is: SDG 2: 17 % (workshops and supplementation mostly) SDG 3: 18 % (workshops and exams mostly) SDG 4: 11% (workshops mostly) SDG 6: There is no specified value for this SDG as the SODIS method is free for usage. It depends only of the professionals hired to teach it to the communities. SDG 17: 43% (this amount is used by the NGO to hire professionals who work on the workshops and other actions, contributing to all other SDG described above

Considering that 32% of the population live with less than 18 dollars per month, what is considered extremely poor, it is easy to understand the high indices of parasitosis and nutritional problems that were encountered on the children exams. One out of every four habitants between 15 and 24 years do not study or work, what proves the high unemployment rates and low education of young adults. On this context, the program accomplished its objective to improve the health of children with iron supplementation; improve access to potable water (with SODIS training), better nutrition trough trainings of teachers, relatives and lunch workers. Participatory education aimed to encourage adequate hygiene, health prevention and good nutrition among students, families and community members. In the long term, the program intended to improve the quality of life of the population through changes in health and nutritional status that breaks the vicious cycle of physical and cognitive compromise of the children, so that they can fulfill their role as agents of positive change in their communities. Between some results, it is possible to emphasize that 1. 38,46% of children have presented improvements in the nutritional diagnosis, changing their BMI (Body Mass Index) ; 2. Almost 1000 students were blood tested to discovered their health state, many for the first time as their families couldn’t afford to take them to doctors and the public facilities weren’t available. These numbers show that the project has changed positively the life of more than 5000 children and 10000 adults in the city of Trairi, who were not adequated assisted by the public government. Now, this community has a chance to improve their quality of life themselves, working together to have a more sustainable and healthy life. There are some testimonials of the closing ceremony of the program. Shool professionals were all very happy with the outcomes: “Children charged the day of the medicine. They avoided attending classes on the day they received the supplement. This was very rewarding for us.” Said Zenaide, a school coordinator.
“The sulfate helped a lot in the reduction of anemia. The students performance got much better after the applications.” Eliza, a school teacher

Links to posted news (2016): http://www.inmed.org.br/noticias/noticia.asp?codigo=529
Program launch http://www.inmed.org.br/noticia.asp?codigo=548 http://www.inmed.org.br/noticias/noticia.asp?codigo=530 Workshop for parents
http://www.inmed.org.br/noticias/noticia.asp?codigo=547 Teacher training http://inmed.org.br/noticia.asp?codigo=551 Testimonial http://www.inmed.org.br/noticias/noticia.asp?codigo=554 Parents workshop http://www.inmed.org.br/noticias/noticia.asp?codigo=553 Training for Health Agents
http://www.inmed.org.br/noticia.asp?codigo=565 Events for the community
http://www.inmed.org.br/noticia.asp?codigo=564 Treatment with Iron Supplement
Links to all posted news (2017): https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1470041586367185/?type=3&theater Educational Activity https://www.facebook.com/inmedbrasil/videos/1462832007088143/ Health related news https://www.facebook.com/inmedbrasil/videos/1462810777090266/ About the program https://www.facebook.com/inmedbrasil/videos/1441459709225373/ - Teacher training https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1485044631533547/?type=3&theater Educational Activities http://www.inmed.org.br/noticias/noticia.asp?codigo=573
Health related news https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1545081172196559/?type=3&theater Educational Activity https://www.facebook.com/inmedbrasil/videos/1516979708340039/ Program Highlight
https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1535054226532587/?type=3&theater Educational Activity https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1517946978243312/?type=3&theater Program Hightlight https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1522659911105352/?type=3&theater Training for Community Health Agents
https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1517943514910325/?type=3&theater Educational Activity https://www.facebook.com/inmedbrasil/videos/1504326419605368/
Health related news https://www.facebook.com/inmedbrasil/videos/1544257855612224/
Educational Activity https://www.facebook.com/inmedbrasil/videos/1550510798320263/
Educational Activity https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1551269788244364/?type=3&theater
Training with Cafeteria workers https://www.facebook.com/inmedbrasil/videos/1560595500645126/
Educational Activity https://www.facebook.com/inmedbrasil/videos/1560598223978187/
Educational Activity https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1587596454611697/?type=3&theater Educational Activity
https://www.facebook.com/inmedbrasil/videos/1569018593136150/
Educational Activity https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1573694399335236/?type=3&theater Educational Activity
https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1581832261854783/?type=3&theater Community Health Agents
https://www.facebook.com/inmedbrasil/photos/a.295495123821843.66314.292818584089497/1573693056002037/?type=3&theater Educational Activity
https://www.facebook.com/inmedbrasil/videos/1573691002668909/ Educational Activity https://www.facebook.com/inmedbrasil/videos/1573686442669365/ Educational Activity https://www.facebook.com/inmedbrasil/videos/1575405699164106/