Parenting knowledge, beliefs, attitudes and practices associated - - PowerPoint PPT Presentation

National ECD Community of Practice

23 October 2018

Early Childhood Development

PARENTING PROGRAMME

Dr Marc Aguirre

Parenting

Parenting can be understood as interactions, behaviours, emotions, knowledge, beliefs, attitudes and practices associated with the provision of nurturing care

Parenting

The term ‘parenting’ or ‘parent’ is not limited to biological parents, but extends to any guardian or caregiver providing consistent care to the child.

Brain Development

A child’s socio-emotional, cognitive and language development is most effectively nurtured through loving and stimulating relationships with their parents and family.

In South Africa…

There are approximately 70,000 teachers in ECD centres across the country. There are more than five million primary caregivers of children up to the age of four

2.4 million children

in South Africa are

• rphans, many due to HIV

CHALLENGES

64% of the

country’s children

live in poverty HIGH RATES

• f under-five

mortality, malnutrition and stunting

Half of SA’s children do not have access to formal

early learning opportunities

CHALLENGES Caregivers face enormous stress that impacts their parenting

Cycle of Poverty

Preschool Child

Low IQ, behaviour problems

School

Poor school achievement Behaviour problems

Adult

Low Education Low skilled/no work high fertility Depressed/stressed

Intergenerational transmission of poverty

Poor Stimulation Nutrition and Health National Economy

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Affordable, high-quality, community based ECD programmes & services that target caregivers are critical for children’s: Physical development emotional development Cognitive development

2016 Lancet Early Childhood Development Series

Advancing Early Childhood Development: from Science to Scale 4.2 By 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education

www.thelancet.com/series/ECD2016

www.nurturing-care.org

VISION

A South Africa where every young, vulnerable child gets the best possible start in life

MISSION

Transforming the lives of young children, their households and communities through: Compassion Collaboration Capacity

14

THEORY OF CHANGE

Build Caregiver Capacity

14

Improve Child Outcomes

NURTURING CARE FRAMEWORK

• Preschool and

Household Feeding

• Nutrition Education

Parent Support Groups

• Self-Esteem

building

• Positive

Parenting Home Visits

• Child Protection
• Gender-Based Violence (GBV)
• Referrals
• Play Every Day
• Toy & Book Libraries
• Playgroups
• Health education
• Child Development
• Screenings
• Referrals

Bloemfontein

Limpopo

Polokwane

Moletjie, Seshego, Mmotong Mpumalanga

Mbombela

Free State Gauteng

Johannesburg

Daveyton, Ivory Park Olivenhoutbosch, Watville, Cosmo

Tswane

• Mamelodi

KwaZulu-Natal

Durban

Eastern Cape

Port Elizabeth

Western Cape

Cape Town

7 Provinces

IMPLEMENTATION SITES

94%

• f houses are

informal dwellings

65%

• f households are

receiving social grants

>30%

unemployment, nearly

40%

part-time employment Estimated

25-30%

HIV ANC prevalence

ECD PARENTING APPROACH

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START-UP IMPLEMENTATION RESULTS

Selection, training and support of community Workers Selection & assessment

• f eligible

beneficiaries Structured home visits: services, referrals, and assessments Structured caregiver support group/ play groups Forums Increased knowledge, skills, support and services Improved

• utcomes

for children

Caregiver Knowledge & Skills Development Process

Identification of Vulnerable Households with young OVC Household Screening & Needs Assessment Workshop and establishment of a Parenting Support Group (PSG) Structured Parenting Support Group Meetings, Referrals and Visits Monthly Progress Assessments PSG Leader Development PSG Leader Development

PSG member Profile

Female Female Average age 33 years (Median 30 (15-75 years) Average age 33 years (Median 30 (15-75 years) Average of 1.6 children Average of 1.6 children Unemployed, on grants Unemployed, on grants

Parent Support Groups (PSG)

12-15 members per Group 3 hour sessions twice a month – curriculum-based At a local community centres (halls, ECD centres, libraries, homes) Facilitated by HOPEww Community Worker with support from PSG Leader PSG Leaders are trained in the PSG curriculum ‘Loyalty Card’ Approach. Graduation Certificate and Gift if attend the 10 core sessions. (attrition issues)

Group Sessions

Key Skills Development Areas:

Self-Confidence/esteem Positive Parenting Key ECD-associated topics

Parent Support Group Curriculum

SESSION 1: CHILD HEALTH AND WHAT TO DO WHEN A CHILD IS SICK SESSION 2: GOOD NUTRITION FOR CHILDREN SESSION 3: SOCIAL AND EMOTIONAL DEVELOPMENT SESSION 4: EMOTIONAL CONNECTION /BONDING SESSION 5: HIV PREVENTION and PMTCT SESSION 6: A CHILD’S GROWING BODY SESSION 7: PLAY AND DEVELOPMENT SESSION 8: A CHILD’S HEALTHY MIND DEVELOPMENT SESSION 9: BUILDING THE CONFIDENCE OF A CHILD SESSION 10: CHILD SAFETY AND PROTECTION

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Parental stress Assessment

Parent/Caregiver Parent-Child Bond Child Development

MEASURING IMPACT

IMPLEMENTATION APPROACHES

HOUSEHOLD SUPPORT

IMPLEMENTATION APPROACHES

SUPPORT GROUPS: WOMEN’S GROUP

IMPLEMENTATION APPROACHES

PLAY GROUPS

IMPLEMENTATION APPROACHES

SUPPORT GROUPS: MEN’S FORUM

MEASURING IMPACT: PROVEN TOOLS

CAREGIVER WELLBEING CAREGIVER- CHILD BOND CHILD DEVELOPMENT

Parental Stress Assessment

• Used to accurately identify children who may be at risk for developmental

delays (0-5 years)

• Designed to encourage parent involvement and education
• Low-cost, reliable and rigorously tested
• Key domains: communication, gross motor, fine motor, problem solving,

personal/social skills

• Identify a child’s strengths as well as any areas where they may need

support

Ages & Stages Questionnaire (ASQ3)

Child developmental areas that the ASQ will evaluate are:

RESULTS: IMPACT ON CAREGIVERS

Lower levels of caregiver stress related to:

• Higher levels of caregiver sensitivity to the child
• Higher quality of caregiver-child relationship
• Improved child behaviour

42 36

20 25 30 35 40 45

Baseline Follow-up

PSA Score Linear (PSA Score) p<0.001

Baseline Follow-up 42% 36%

Parental Depression Pilot (173 caregivers)

EPDS Validated Scoring (General Population): Females Range Interpretation Tally Percentage 0 - 8 Normal 28 17% 9 -10 Slightly increased risk 15 9% 11 - 14 Increased risk 57 35% ≥ 15 Likely depression 62 38%

RESULTS: CAREGIVER-CHILD RELATIONSHIPS

• Improved emotional connection
• Reduced maltreatment

2 4 6 8

Affection Responsiveness Teaching Encouragement

Baseline Follow-up

Overall: p<0.001 Affection Responsiveness Teaching Encouragement

RESULTS: CHILD DEVELOPMENT

• Improved developmental scores
• Increased referrals

5 10 15 20 25 30

DD baseline DD follow up 3 of 5 areas: p<0.001

The ‘Caregiver Access & Practice’ Checklist Tool

Tracks the following Indicators:

• Attendance

Health

• RTHB: Awareness, Health Checks

and Vaccinations

Nutrition

• Breast Feeding & Balanced Meals

Social Protection

• IDs, Birth Certificates & Grants

Child Protection

• Child Proofing, Supervision, Maltreatment

Nurturing & Stimulation

• Spending time Playing & Reading, and Hugs and saying ‘I love you’

Health

Nutrition Social Protection Child Protection Nurturing & Stimulation

TRANSFERING CAPACITY

Scale up and sustainability

• Affordable, does not require a high level
• f expertise
• Can be operated effectively in a range of

community settings

• Can be integrated into other clinical,

social and community-based care programmes

• PSG members from the community can

be effective facilitators

• Builds bottom up leadership among those

who are often excluded from participation

• Has spill over benefits to the communities

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LESSONS LEARNED FOR SCALING UP

Engage other service providers to deliver a full package of care. This requires staff with ‘connector’ skills. Very mobile populations require innovative retention strategies Home visitors require support from professional staff to ensure proper case management and to address more complex situations, e.g. GBV, CP, etc. Relationships are Key at all levels

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LESSONS LEARNED FOR SCALING UP

Work Loads need to be managed. Increased work loads and scope reduce HV morale and effectiveness and program quality. Data quality verification can be time consuming and can divert resources from

• ther core project functions. Need for data

verifiers on site. Staff motivation is vital to ensure program integrity, data quality and sustainability

Thank You

www.facebook.com/HOPEworldwidesa.org www.hopeworldwidesa.org