Benefits and experiences of integrating playful parenting into health and nutrition programmes: A comparative study of Uganda and Nepal

• In Event: Evidence from integrated ECD-Health interventions in low- and middle-income country contexts

Proposal

Abstract: The benefits and experiences of integrating playful parenting into health and nutrition programmes: A comparative study of Uganda and Nepal
Background: Despite promising evidence regarding the effectiveness of integrated parenting programs within community healthcare systems for the early development and well-being of children and caregivers, the adoption of integrated approaches for holistic child development faces numerous challenges. Fragmented systems, isolated operations, limited evidence of feasibility, and capacity constraints hinder the implementation of comprehensive integrated services.
To address these challenges, the "Inclusive Playful Parenting for Brighter Childhood" (IPP4BC) project, funded by LEGO, was implemented in Uganda and Nepal, targeting primary caregivers of children under six years old (CU6). This project aims to investigate the implementation processes and impact of integrated Early Childhood Development (ECD) parenting interventions on child and caregiver outcomes.
Methods: The IPP4BC project was implemented in five districts in Nepal and ten districts in Uganda since December 2022. Leveraging existing programs supported by the health and nutrition (H/N) sectors of World Vision (WV), the project team mapped out WV-facilitated/supported interventions, platforms, and delivery workforce targeting CU6, in collaboration with the H/N sectors, to design an integrated parenting package with appropriate resources and delivery mechanisms. The Go Baby Go parenting model was employed to promote early learning, responsive caregiving, and safety and security practices at home. In Nepal, Positive Deviance/HEARTH and Mother Groups, facilitated by community facilitators, were utilized. Uganda employed a timed, targeted counseling (ttC) home visiting model for maternal and newborn child health, nutrition in the first 1000 days, implemented by village health workers.
A quasi-experimental design was adopted to assess the impact of different parenting packages on child and caregiver outcomes. These packages varied in terms of direct/in-person interactions (group sessions, home visits) and indirect approaches (SMS, radio jingles, posters), as well as their duration (6 months, 2 months) and intensity levels (high, medium, low). Child development, caregiver nurturing care practices, and mental health outcomes were compared among the different groups.
A comprehensive process evaluation was conducted to evaluate various aspects of implementation, including fidelity, quality (adaptation, workforce recruitment, training, implementation, and supervision), feasibility (technical and operational), acceptability/satisfaction, and relevance/appropriateness. Key stakeholders, including families, facilitators, mentors, project leadership, faith leaders, and partner organizations, provided valuable insights into these factors. The process evaluation aimed to identify the enablers and barriers in designing, implementing, and monitoring the delivery of integrated packages. It also explored strategies for sustaining and replicating these approaches to reach a larger number of families.
Results: The experiences gained from implementing the project in Nepal and Uganda are expected to provide valuable lessons and insights. These findings will prompt reflection on the experiences and facilitate the exploration of ways to enhance similar programs. The results of the project are anticipated to be available in September/October 2023.

Authors

• Viktorya Sargsyan, World Vision International

• Ana Tenorio, World Vision International