Government Stakeholder Perspectives on the Scalability of Playful Parenting Programs

• In Event: Scaling up Effective and Cost-effective Early Childhood Interventions in LMICs: Evidence from 7 country contexts

Abstract

Playful Parenting programs have been implemented over the past 2.5 years in four countries by different partners. All are working with the government system in some way, with the aim of transferring the program to the government; moreover, they are scaling to different regions of the country over time. Independent local researchers in each country conducted in-depth interviews with 5 to 12 local and national stakeholders, asking their perspectives about the opportunities and challenges to scaling up these programs.

Findings from the 2021/2022 interviews are as follows:
In Bhutan, Phase II involves scaling out to 10 new districts. This is challenging because the populations are different, and this requires some adaptation of the program. Finances for expansion to new geographies with additional training will have to be taken on more by the government, yet decisions were delayed due to the top-level government shuffle. Scale up requires more advocacy in those new districts and among new government officials, along with evidence for effectiveness of Phase I districts. The Health Assistant workforce is strained because of COVID demands on their time, so another cadre of worker may be needed; and more staff are needed to monitor and supervise health assistants.

Stakeholders in Rwanda were very favorable toward the program but felt it would not be scaled unless something like the National Child Development Agency adopted it with a budget. There was a general concern that the resources required to deliver the program as is, e.g. community workers, are simply not available within the system. Because funding is not available, sustaining and scaling the program as it stands now challenging.

Stakeholders in Serbia were very hopeful and optimistic about the sustainability of the program if legal documentation and regulatory framework could be provided; otherwise, professionals would not want to commit to yet another program that ended prematurely. COVID led to burn-out of the workforce. The application for Phase 2 municipalities was popular, with wide participation across the country. However, only municipalities with a certain level of resources and know-how were eligible to apply; and they had to demonstrate a level of motivation and interest in the program.

Stakeholders in Zambia noted that the structures are present to sustain the program, but that capacity and resources were weak. Financing is also an issue once donors leave. Over the past years, not enough community volunteers were trained to deliver the program, and training tended to focus on health and nutrition rather than play. So training in the new play message needs to improve to develop a workforce that clearly understands the concepts. To expand reach, they will have to reduce intensity. Because of their own scaling constraints, the government may have to collaborate with other implementing organizations across the country.

Specific challenges facing each program as they attempt to scale vertically and horizontally over the coming year will be discussed along with their proposed solutions.

Authors

• Carina Omoeva, FHI 360
  Presenting Author

• Karma Choden

• Ksenija Kristic, University of Belgrade, Faculty of Philosophy

• Michael Tusiime

• Given Hapunda, University of Zambia