Emerging Evidence on ECD Parenting Programming Improving Health Outcomes at the Household, Community and Sub-National Systems’ Levels in Kenya and Zambia

• In Event: Highlighted session: Nurturing care framework: building evidence for program implementation and effectiveness_session I

Proposal

Problem and Description of the Project and Interventions: In Eastern and Southern Africa, an estimated 6 million children have been orphaned due to HIV and AIDS. Considering the high prevalence of HIV and AIDS and the vulnerability of children in both Kenya and Zambia, ChildFund International, supported by the Conrad N. Hilton Foundation, implemented a project known as, “Assuring the Essentials of Optimal Development for Infants and Young Children Affected by HIV and AIDS in Kenya and Zambia” from January 2016-July 2018. The interventions aimed to provide technical support to partner community-based organizations (CBOs) that worked directly with communities and sub-national government partners. The intervention sought to identify and build caregivers’ capacities through home visiting sessions and/or through ECD group parenting sessions for caregivers part of existing community groups. These sessions focused on key messages across the components of the Nurturing Care Framework.

Methods: A mixed methods approach was utilized to conduct an endline assessment of the abovementioned interventions. Quantitative data were collected through household surveys and observations with 667 caregivers in Kenya and Zambia. Qualitative data were collected through 20 focus group discussions with caregivers and community stakeholders, 24 in-depth interviews with caregivers, and 49 key informant interviews with county government officials, CBO partners, ChildFund staff, and community stakeholders. Descriptive analyses were conducted of the quantitative household survey data. Chi-square analyses or ANOVAs were also conducted. Qualitative data from the focus group discussions, in-depth interviews, and key informant interviews were examined and common themes extracted.

Results: Findings demonstrate the largely positive impact of the intervention on caregivers’ knowledge, attitudes, and practices (KAP). For example, at endline, 58% of caregivers across both countries reported taking the child for a consultation with a health professional immediately when the child was identified as ill, with 62% of caregivers reporting information on what to do when a child was identified as ill was learned from group and/or home visiting sessions. Findings suggest caregivers continue to experience barriers accessing health services such as long distances, which increased across countries from baseline to endline (51% and 58% respectively). Emerging evidence suggests government health stakeholders’ capacity for integrating stimulation and other ECD content into health interventions was strengthened during the life of the project.

Advice for CIES Audience Based on Results: Implications for designing and evaluating ECD parenting programs will be presented based on the study’s findings and limitations. Further, how impact assessment data and data from country consultations (conducted September-October 2018) were utilized to inform the design of subsequent health-related interventions across levels of the ecological model based will be shared to provide important considerations for stakeholders designing and implementing interventions aiming to improve health outcomes and scale up the health component of the Nurturing Care Framework at the sub-national, community, and household levels.

Authors

• Jennifer Vu, Independent consultant

• Damaris Wambua, ChildFund