Monitoring Quality of Reach Up and Learn for Families Affected Conflict and Crisis in the Middle East

• In Event: Roundtable Session (Monday II)
  In Refereed Round-Table Session: Nurturing care: building evidence for program implementation and effectiveness_session II

Proposal

Young children in conflict-affected settings face an accumulation of adversities, which poses both an immediate and long-term threat to their health, cognitive and socio-emotional wellbeing. While consistent, responsive care can buffer children from the negative consequences of war and displacement, and serve to build resiliency, there is a scarcity of evidence-based interventions to support caregivers in conflict and crisis settings. A broad body of research points to the powerful potential of programs that support play, communication and responsive caregiving practices, which have been found to have significant positive effects on children’s developmental outcomes across diverse contexts and service delivery platforms (Britto, et al., 2017). Among the most widely cited example of a parenting program implemented in low and middle income contexts is the Reach Up and Learn program, which is a home visiting program originally designed to promote cognitive stimulation among growth-stunted babies and toddlers in Jamaica. Follow-up studies with participants after 20 years have demonstrated significant, long-term increases (25%) in adult earnings and reductions in violence and improved health (Gertler et al., 2014; Walker, et al., 2010). The Reach Up and Learn model has been adapted for caregivers affected by the Syrian crisis in Jordan, Lebanon and Syria by the International Rescue Committee with the support and guidance of the original creators of the Jamaican home visiting program. The program currently reaches nearly 2,000 children ages 0-3 in the Syria Response region with high quality home visiting services integrated within three different service delivery platforms: early childhood education (preschools) in Lebanon, community health services (CHVs) in Jordan, and protection services in Jordan and Syria. In order to strengthen the quality of the home visiting program, and to further refine and adapt the program to support additional scaling through government systems and partners, the IRC and research partners have been working to develop robust monitoring and evaluation systems that can be integrated across service delivery platforms. This presentation will review the selection process for identifying key measures, the piloting process, and present monitoring and evaluation findings that provide critical insights into the implementation quality of home visiting services across complex crisis-affected contexts.
Methods
Quantitative and qualitative measures were reviewed to identify appropriate and feasible tools for assessing and monitoring the quality of home visiting services, caregiver-child behaviors, caregiver feedback and children’s developmental outcomes. Selected tools, including a home visit quality observation measure and a caregiver questionnaire including items from the Caregiver Reported Early Development Index (CREDI) and a supervision checklist are currently being used to test the feasibility and utility of using these measures in humanitarian contexts.
Results
The presentation will present an analysis of M&E and implementation research from the adapted Reach Up and Learn program in Lebanon, Jordan and Syria and provide guidance for the further development of M&E systems that can be used to promote continuous quality improvement in humanitarian settings.

Authors

• Katie Maeve Murphy, International Rescue Committee

• Katelin Wilton, IRC

• Susan Walker, University of the West Indies, Jamaica

• Alice Wuermli, University of California, Davis

• Hirokazu Yoshikawa, New York University