Scaling Up Playful Parenting in Zambia

• In Event: Beliefs & Practices on Play in Serbia & Zambia

Proposal

Care for Child Development (CCD) is an intervention model aimed at strengthening the capacity of parents and caregivers to promote children’s wholistic development through responsive care. At the core of CCD is integrating an emphasis on the importance of play and communication into existing services across multiple sectors, including health, nutrition, child protection and sanitation and hygiene. The primary mechanism through which parents/caregivers receive messaging and support to provide early stimulation and responsive care to their children in this project is through home visits by CBVs. Every parent/caregiver-child pair enrolled in the project is placed under the care of a CBV who supports ten households. As such, Zambia’s CCD program entails training community-based volunteers (CBVs) to counsel parents during home visits, and to facilitate group sessions at the local health facility or Insaka (community-based integrated ECD hub). Training and supervision are provided by district health office staff.
The utility of implementation research is especially evident in the context of complex intervention structures such as the one in which Zambia’s playful parenting program is embedded. Findings garnered from key informant interviews, focus group discussions and observations enabled iterative changes inspired by what were often unexpected findings. The data provided opportunities for careful data-driven adaptations, which while simple, enhance the quality and sustainability of the program. For example, growing attrition rates and challenges with adequate supervision opportunities for CBVs prompted adjustments to the quantity and content of sessions, including a reduction in the required number of contact sessions and increased focus on embedding and spending more time on play and communication during home visits. To address knowledge and skill gaps, CBV training was enhanced with a stronger focus on developmental milestones and use of “demonstrations” to build capacity of CBVs to model effective parenting practices. Additionally, qualitative study findings provided important nuanced insights on implementation barriers; prompting the establishment of play corners at the health facilities to broaden reach and support early stimulation of young children through play during long wait-times to see a health care provider.
Additionally, a pilot study of a new UNICEF-developed module—Caring for the Caregiver (CFC) embedded within Zambia’s playful parenting program capacitated front-line workers to provide strengths-based counselling to support caregivers’ parenting confidence, stress management, self-care and conflict-resolution skills. Results from a study of 100 caregivers show improved knowledge and skill amongst frontline workers, and for counselled caregivers, significant reductions in anxiety and depression, and improvements in parenting self-efficacy and problem-solving. Findings also highlighted high demand for the social support afforded by the intervention. As such, peer-to-peer support has been built into supervision reflection meetings at the health facilities, and into the mother-baby play sessions at the Insakas.
Discussion will elaborate on the development of new strategies to support scale-up of UNICEF Zambia’sthis playful parenting program, highlighting how specific research findings informed changes in the content and pedagogical approach adopted for the training and supervision of CBVs, and efforts to embed social support systems into supervision and group counseling to foster caregiver wellbeing and more playful parenting.

Author

• Zewelanji Serpell, UNICEF