4. In which ways is the initiative creative and innovative?
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According to the strategy previously planned, after the closing of the studies and the consolidated document with its premises, objectives and definitions of the governing structure and actions to be taken, the ATITUDE Program was created in September 2011 and regulated in 2013 by State Governor Decree, conditioned to the public policies of High Complexity Special Social Protection, in conjunction with Pact for Life – aiming at developing conditions for the independence, self-care, and the users’ family and social ties, as well as contributing to the exercise of citizenship, contributing to the prevention and reduction of violence/crime rates.
Still in 2011, with articulated actions among the 14 state secretariats, the organizational structure of the program was conceived and the positions involved were defined. There were also articulations with the municipalities, NGOs, and society in general, comprehending a network of solidarity between the programs and actions developed by all those entities.
Over the same period there is the inclusion of the program among the priority goals of the government, moving on to an effective implementation of the actions of the program to assist municipalities with a higher rate of CVLI (Intentional Lethal Violent Crime). Initially, the work was carried out on the scenes of crack consumption, with professionals of Social Assistance doing their job within the users’ territory, with their needs identified. Such methodology helped format the program’s direct action plan split into four modalities, generating the need to work on the streets, as well as specialized sheltering centers.
Thus, for the effective implementation of the assistance to drug users, more specifically, crack users, actions begin to be taken through a mobile and territorialized service, offering in a continued and programmed way on streets, squares, under overdrives, communities, intended to build a connection with users to safeguard their rights, reduce risks of damage associated to the consumption of crack and other drugs. This modality is established as Atitude nas Ruas.
Related to this process, the Center for shelter and Support is created and set to be open 24/7, with a multidisciplinary team that ensures immediate, humanizing sheltering and primary care, making use of a tactful approach, with low demand, with actions well thought out based on user demand. There are also actions of Intensive Sheltering, this one working 24 hours a day, in a home care fashion, where users stay from 2 to 6 months, depending on the seriousness of the case, aiming at outlining a new plan for life. And to complete the modalities of the program’s interventions, the Social Rent/Dormitory action was created, through house renting for an average of six months, with possible extension, for serve the target audience that cannot return to their community due to impending threats, or for not even having where to get back to for being a street dweller.
In 2013, the program becomes the permanent policy of care for crack users in the State, with improved sheltering of the target population, and support from the World Bank is sought through public policy development credit operation, known as Development Policy Loan, reinforcing the execution of strategy through raising and strengthening of budgets for the program’s actions.
Nowadays, reaching out to the Recife Metropolitan Area, besides the municipalities of Caruaru, Floresta and other surrounding municipalities, through 5 centers, located in Recife, Jaboatão dos Guararapes, Cabode Santo Agostinho, Caruaru and Floresta, and managing resurces worth around R$ 12 thousand, annually, the program involves more than 100 professionals working directly close to the drug users and their family, interacting with managers and coordinators, who monitor and assess the ongoing of the program and its results.
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5. Who implemented the initiative and what is the size of the population affected by this initiative?
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In 2010, the State Governor, in light of the scenarios/studies, made a commitment with the population to fight the problem of growing crack consumption in Pernambuco. From this perspective, he deliberates the articulation of 14 Secretariats (Human Rights and Social Development; Education; Health; Social Defense; Labor, Qualification and Entrepreneurship; Municipalities; Children and Youth; Sports; Regional and Social Articulation; Culture; Women; Staff; Management and Planning; and Press Office), besides the Judiciary Power and the Military and Civilian Police Forces with the intent of building the main premises and actively collaborate with the implementation and execution of a program aimed solely at drug users and their families.
In response to the request, together with representatives from said sectors, the Chamber of Crack Enforcement is created through Decree NO. 35065/2010. With weekly meetings, these agents take part, uninterruptedly, in the process of making and monitoring public policies on drugs, in which the ATITUDE Program is inserted. In this phase, there is the participation of other actors such as City Halls, NGOs, social organizations, the organized civil society and universities.
Another important partner in this implementation was the Word Bank, through the public policies development credit operation named DPL (Development Policy Loan), as well as international organization Open Society Foundation, which cooperated by bringing internationally renowned specialists for training local professionals and advising with assessment processes.
Management of the ATITUDE Program was initially a responsibility of the High Complexity Management from the Human Rights and Social Development Secretariat. Later, it was turned to the newly created General Management of Policy on Drugs.
Currently, the Program is conducted through partnerships, where management contracts are signed between the State Government and Social Organizations such as the Center for the Prevention of Addiction; the Social Development and teaching Institute; the Brazilian Center for Recycling and Professional Training.
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6. How was the strategy implemented and what resources were mobilized?
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With the envisioning of the program and effective actions already begun in 2011, with its management done by the General Management of Policy on Drugs from the Human Rights and Social Development Secretariat, structured on three important pillars: street approach; 24-hour sheltering; and social rent, as far as human resources and materials are concerned, for the development of their activities, ten vehicles were provided for the Teams of Social Approach on Streets, making up a total of 15 rotary teams, which meant a universe of 45 professionals, each team consisting of a driver, a psychologist or social assistant, and a social educator. Input such as mineral water, condoms, lubricant, juice, coconut water, among others, as well as ludicrous materials such as percussion instruments, circus gadgets, books for storytelling.
Still within this given context, in the sheltering units, be it in the Support Sheltering Center or the Center for Intensive Sheltering, both use a total of 12 houses with cozy environment, equipped with a living room, cafeteria, kitchen, games and TV room, individual and group activities room, dorms, sports courts, swimming pool, and garden. Food items are also necessary for the centers, for an average six meals a day, for 40 users a day, per center, besides hygiene items. Also, drawing and pedagogical materials, goods for cooking workshops, recycling, handicrafts, among others. In addition to that, there are 4 5-passenger vehicles to support the Center for Intensive Sheltering.
The Centers’ teams are composed of about 10 professionals with a degree in psychology, social assistance, physical education, nursery, among others. Plus eight social educators, eight workshop instructors, a technical coordinator, two supervisors for each Support Sheltering Center and a supervisor for each Center for Intensive Sheltering. There is still a supervisor for nutrition, whose objective is to supervise all the centers’ food preparation and storage routine.
In the modality Social Rent, 40 fully furnished houses with residential characteristics are used. The houses accommodate up to 4 people each, with each user receiving a staple food basket. These houses also count on 4 5-passenger vehicles. This crack user autonomy process involves approximately ten specific professionals.
The program also relies on outside consultancy, in the shape of technical support for the praxis developed.
As far as financial resources are concerned, from 2011 to 2014, the program has already handled R$ 51 million. Initially, the resources needed for the execution of the specific activities for the program and its maintenance were allocated annually from the State budget, with the support of investments in partnership with the World Bank. The program’s execution modality happened initially through the “OSCIP” – Public Interest Civil Society Organizations – and today it has been executed by Social Organizations whose Advisory Board is paired up with representatives of the public power.
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7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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The main result of the program is a reduction of violence rate by 8.05% in areas covered by the ATITUDE Program, between 2011/2014. Since its implementation, the ATITUDE has significantly increased the number of crack users included in the social policies of the program according to the specificity of each case. The street approach teams have already carried out 24,500 approaches certifying that the target population is effectively served. This result was achieved through active search and mapping by the roaming teams. The modality immerges into the lives of those individuals, generating a direct result, because the service done on the streets guarantees access to the users’ territory.
Other successful results are those of the Support Sheltering Centers. This practice allowed complete and intensive sheltering to more than 1,600 users, 90% of whom are crack users. Besides, 43,000 overnight services were offered between Sep2011/Jun2014.
Another result: the Centers for Intensive Sheltering, open 24/7, in homecare style, in which users stay 2 to 6 months, depending on the seriousness of each case, have already registered an increase of 6% on the monthly goals. This modality has been developing a new life project, protecting users against situations of life threat, and reestablishing family ties, bringing users back to school, technical courses, and activities aiming at inserting those people back into the job market. The program also generated the development of user autonomy, conditioned to education, health and work. This result has been achieved by the modality Social Rent/Dorm – 22 homes rented for accommodation for six months, offered to the public that cannot return to their community due to a situation of threat, or to a lack of home reference resulting from living on the streets.
Other benefits have been observed: the contribution to the formulation of other public policies, with the effective making of a state law that regulates the criteria for hiring companies that provide outsourced services to the State. Special emphasis is put on Law NO. 15209/2013, which guarantees that at least 2% of those hired companies will come from the program.
Lastly, the guarantee of the right to citizenship, given the fact that many users do not possess any documentation, being unable to exercise basic rights. The program works on rescuing documents or obtaining them for the first time. Since its implementation, the program has already promoted the production of personal documents for more than 1,200 users.
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8. What were the most successful outputs and why was the initiative effective?
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The program is monitored uninterruptedly through the program Pact for Life, by the Technical Chamber of Crack Enforcement, and through co-management with Assemblies and Information Systems.
At the weekly Pact for Life meetings, the care services conducted by the ATITUDE Program the previous week are presented, seeking to observe the most critical areas as regards crack consumption and the more specific demands, always aligning with the main indicator of violence reduction – the CVLI (Intentional Lethal Violent Crime), which counts the number of murders per 100 thousand inhabitants. Soon, the activity allows for analyzing and monitoring, in a critical way, the number of users seen by the program and for planning new actions to be realized in each developing region of the State.
The Technical Chamber of Crack Enforcement, also with weekly meetings, has the intent of planning, coordinating, executing, monitoring and evaluating the actions of enforcement on crack and other drugs in the State of Pernambuco. Fourteen Government Secretariats take part in this process, permanently and systematically, dealing with the theme of drugs across the agendas and actions of the secretariats, in line with the principles and directives of the interdisciplinary actions.
Among the activities developed in the centers of the ATITUDE Program, there is the space of co-management of the Assembly. This is about a moment of internal evaluation, with the presence and active participation of all he technical team, together with the users and their families, generating a rich exchange of knowledge, where users and their families debate critically the centers actions, thus, promoting the exercise of citizenship and stimulating social participation. These are open spaces for debate, inserted in the activities program and that happen systematically twice a month. More than 525 assemblies have taken place in all ATITUDE Program homes.
The information system is done on electronic spreadsheets with the use of data consolidation tools. The compilation of information is done daily and online by the technical team of the centers. The data consists of individual and group care with users, family care, discharges, daily attendance, overnight records, profile of users that access the services, referrals done, records of risk profiles with the account of the threat targets, users coming from correctional facilities and the number of users in debt, etc.
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9. What were the main obstacles encountered and how were they overcome?
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Among the problems dealt with the main one was identifying users that were threatened because of debt to drug traffic, and that prior to the program had no access to protection and care programs, having the service totally turned to questions of health, making it necessary to have a service that would attend to health issues on the streets.
Another problem among the obstacles was the difficulty found in relation to the programs addresses, which were full. The neighborhood around the facility showed discontentment about the installation of the service, increasing the prejudice towards users. Continuous efforts were needed to act and intervene in the community. As a strategy, a few primordial agents from the area were called to discuss the objective of the service being implemented in that community.
Another obstacle encountered was the alignment of the actors involved, regarding the intersectional aspect of the program, which was mostly overcome with the weekly meeting of the Crack Enforcement Chamber, attended by the 14 State Secretariats, representatives of the judiciary power, the Military Police, and municipalities and society representatives.
One more challege faced by the program was related to the care intended for pregnant users of crack, who found themselves socially vulnerable, exposed to violence and prostitution, and had difficulty being fit into one of the care modalities of the program, and presenting issues related to their genre such as the household, children, husband, and on several occasions for being the breadwinner. It was necessary to create a service to cover for these particular cases, besides working on raising their self-esteem and their awareness of valuing and being the masters of their own body, promoting better quality of life and their babies.
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