ABSTRACT
In October 2016, Brazil launched the Criança Feliz (Happy Child) home visiting program, a national effort to reach the most vulnerable pregnant women and young children living in extreme poverty. This chapter describes the journey leading to the scaling up of Criança Feliz (CF), with an emphasis on the political will, leadership, and skills that enabled that scaling. While the program has successfully expanded within a short time, reaching significant coverage within three years, the challenges of implementation remain daunting. To what extent the program will attain and sustain a large effect size has yet to play out. Successfully scaling up a program like CF requires the mobilization of necessary financial, human, and informational resources to sustain an expanded program, much of which requires political leadership and will. This chapter presents the case study of how Brazil built the political will necessary to successfully scale up CF, focusing in particular on five key political factors that the literature has identified as critical to scaling: strong leadership, constituency-building, supportive policies and funding, a strong workforce, and capacity for ongoing monitoring and evaluation. The chapter closes with lessons learned and discussion of the challenges ahead as CF continues to expand.
