In Brazil, most of the population (45-55%) consists of children less than 15 years old. Younger children generally represent the largest population in the various Brazilian regions. In 1991, according to population estimates from Brazilian sources (DPS/SESFHDF), there were 233,112 children age 04 years in the Federal District, from which 39,969 were 12-month old (17.15% of this group). The Northern Section of the Federal Health District contains about l0% of this total.
However, there is little in the international and Brazilian literature regarding child growth and development in the first years of life when genetic, environmental, social, and cultural influences are so great. Thus, it is incumbent upon health professionals to take part in multiprofessional, interdisciplinary groups which can develop models for optimizing oral health, especially for children. These groups should operate in realistic social and cultural environments so as to render their outcomes most suitable for use by the proper authorities.
In order to positively influence the oral health of children and simultaneously embrace the philosophy of the Brasilia UNI Program, UNIA: Child Health, the formulation of an operational model for multidisciplinary follow-up of children was deemed appropriate. The plan calls for a cohort of children to be followed from birth to 56 years of age, using dental, psychosocial, and physical parameters, with the active support of the community.
Thus, we intend to formulate a proposal to integrate policy and health services based on a model encompassing field research, health promotion and disease prevention, and a referral system to link the primary, secondary, and tertiary care levels.
The program is being developed with a multiprofessional staff which, initially, will involve the disciplines of Social and Pediatric Dentistry, as well as two non-dental specialties - Pediatrics and Nutrition. Activities begin with a health orientation for pregnant women, preschoolers and school-aged children which is being conducted by ninth-term dental students in community health centers. Emphasis will be placed on the role of primary prevention in oral health, especially health education. Students from dentistry will be joined by those from medicine, nursing and nutrition who are involved in their respective activities within the UNI Project.
In support of the study on newborns, oral and general anthropometric assessments are made along with semiologic analyses. This information is shared with parents, establishing a baseline for future clinical-pediatric follow-up in health centers and reference hospitals.
A socioeconomic investigation is also part of the program, whereby families are visited and asked to complete a survey questionnaire. Observations are made of living conditions, behaviors, values and attitudes which might influence a child's health; when convenient, these are followed by suggestions and general family health education.
As the model is developed, there exists some possibility for immediate application in the public services of the Federal Health District. While the university and health services integrate efforts to bring health promotion to the community, professionals will receive community-oriented scientific training, an understanding of the Brazilian socio-economic and sanitary reality, and some experience in promoting community participation.