PURPOSE:
To present the implementation and expansion of the Thula Sana model in Uruguay, led by midwives, as a primary prevention strategy against violence starting in early childhood.

DISCUSSION:
The Thula Sana model is based on home or virtual visits from 35 weeks of gestation through the first six months of life, promoting secure attachment through sensitive interactions and respectful caregiving. Midwives lead the intervention in close connection with families, addressing topics such as crying and soothing, breastfeeding, safe sleep, and early stimulation. Since 2024, the model has been redesigned to expand its reach through three key pillars: community engagement (training local agents and educators), integration into public policies (as in the “1000 Days of Equality” program in the department of Canelones), and the development of academic knowledge in partnership with Universidad de la Republica. This territorial, intersectoral, and relationship-centered approach transforms the role of midwifery by integrating health, rights, and community action.

EVIDENCE WHERE RELEVANT:
Between 2019 and 2023, 91 families across various regions of Uruguay were accompanied by midwife-led teams. The program demonstrated high levels of satisfaction and strong adherence among participants. It proved feasible, accepted, and potentially scalable. Integration with public policy frameworks has supported its ongoing institutionalization.

KEY MESSAGE:
Midwives play a key role in promoting healthy early bonding and preventing violence through sensitive, community-based, and transformative care models grounded in rights and reproductive justice. Spanish - other (including three-minute presentation competition)