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Session Submission Summary

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

Tue, April 16, 8:00 to 9:30am, Hyatt Regency, Floor: Atrium (Level 2), Waterfront D

Group Submission Type: Highlighted Paper Session

Proposal

This panel is the second in a series of three proposed panels relating to the Nurturing Care Framework (NCF) released by WHO and UNICEF in 2018. The NCF recognizes the critical importance of the enabling environment that surrounds a child, and the role that multiple sectors play to protect, nourish, and stimulate optimal development. The framework builds on the growing body of literature displaying the importance of high quality inputs from multiple sectors for children’s optimal development, and advocates for inter-sectoral collaboration (Black et al., 2016). One of the most common collaborations that has been growing with the launch of the NCF is the integration of early stimulation and responsive caregiving programs with newborn and child health initiatives.
Inter-sectoral programs offer many efficiencies and opportunities for strengthening existing services, but they also present added complexity for program delivery as well as for program monitoring and evaluation. Incorporating actors from multiple sectors brings additional perspectives and outcomes of interest. For example, a health sector program might focus on improving child development through the reduction of stunting, whereas an early stimulation program might conceptualize improved child development as stronger cognitive outcomes. In this way, two groups can propose to be working towards the same goal of improved child development but the activities undertaken and the outcomes measured differ substantially. Therefore when such programs come together, the way child development is defined and measured needs to be expanded or modified for both groups.
In addition, inter-sectoral programs often involve adding workload or changing responsibilities for existing service providers. One shortcoming that has been identified within the expansion of community health worker networks is that they can become overburdened with too many responsibilities, which reduces effectiveness (DiGirolamo, Stansbery, & Lung’aho, 2014). This shift in working practices makes implementation fidelity critical to monitor. Further, health systems have many different levels of health works who vary in their professional and educational backgrounds, as well as the extent to which they interact with young children and families. Program implementers must gain an understanding of which cadre of health worker is the most appropriate to deliver messages to the target beneficiaries.
This panel will showcase examples of how organizations are establishing monitoring frameworks and conducting evaluations that meet the needs of both child health and early stimulation practitioners in different contexts around the world. All groups have used mixed methods approaches to answer the complex questions about integrated program functioning. PATH focuses on integration of ECD interventions, messages, and activities into national health system “touch-points”, and will share results from assessments conducted in Mozambique, Kenya and Zambia. ChildFund will share the results of sub-national mixed method evaluations in Kenya and Zambia. Save the Children will present information from mixed method studies of program implementation and effectiveness in Ghana and Bhutan. Finally, World Vision will discuss results from a national evaluation of a holistic child development approach recently implemented in Armenia.

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Chair

Individual Presentations