Parenting for Lifelong Health

Reducing violence against children & improving child well-being in South Africa through evidence-based parenting programmes

Violence against Children in South Africa

High rates of child maltreatment

56% physical abuse

35% emotional abuse (Meinck 2016)

Caregivers main source of maltreatment

Physical discipline normative (Dawes 2006)

Impact of violence against children

Immediate:

Poor nutrition & physical health

Low cognitive stimulation

Delayed development

Behavioural problems & poor educational performance

Long-term:

Juvenile delinquency, substance abuse, crime

Mental health problems

Intimate partner violence

Intergenerational transfer of abuse

Cycle of violence

Good news...

Parenting programmes are effective

Reduce risk of abuse (Barlow et al, 2006)

Reduce child behaviour problems (Furlong et al, 2012)

Reduce maternal depression (Barlow et al, 2009)

They work in many contexts

Diverse populations (Lundahl et al, 2005)

Poor families (Leijten et al, 2013)

Depressed parents (Gardner et al, 2016)

Best evidence:

Early stage of development (0 to 9)

Less evidence on programmes for adolescents (10 to 18)

On the agenda

Global agenda

Donor community, WHO and UNICEF

South African Government Policy

Children’s Amendment Act 2005, Chapter 8:

Prevention and Early Intervention

DSD Integrated Parenting Framework, 2012

White Paper on Families, 2013

Strategic Plan for Prevention and Early Intervention (2013-2017)

Integrated Programme of Action Addressing Violence

Against Women and Children (2013-2018)

National Development Plan 2030

Parenting programmes & violence prevention

Changing knowledge & attitudes is not enough SKILLS

Common evidence-based approaches

Attachment, Behaviour, Cognitive Development

Collaborative approach to problem-solving

Developmentally appropriate activities

Culturally sensitive forms of communication

Positive parenting skills

Effective supervision and parent-child communication

Nonviolent discipline strategies

Self-management, care, and stress relief

Parenting programmes in LMICs

Most parenting programmes developed in HICs (USA/Australia)

– highly effective

Limited evidence in LMICs (Knerr et al 2013; Mejia et al 2012)

Can be transported across cultures and contexts (Gardner 2015; Leijten 2016)

So what is the problem???

Costs of established programmes

Prohibitive licensing fees

Accreditation processes

Resistance to changing evidence-based models

Generalisability of evidence-based approaches

Complex family structures (multiple caregivers)

Traditional parenting practices and values

Capacity to deliver programmes at scale

Limited professional expertise

Integrating within existing service delivery system

Additional barriers to implementation due to context

Parenting for Lifelong Health:

Research, policy & practice working together

COLLABORATIVE

APPROACH

Aims of Parenting for Lifelong Health

Develop & test programmes for children ages 0 to 18 years

Adapted for low resource settings in LMICs

Establish evidence of programme effectiveness using rigorous

evaluation methods:

Improving parent-child relationships and child well-being

Reducing risk of child maltreatment

Make programmes affordable, scalable, and freely available

Support high-quality & fidelity implementation

PLH parenting programmes

PLH for Babies (prenatal to 6 months old)

Thula Sana

PLH for Toddlers (12 to 60 months old)

Mikhulu Book Sharing

PLH for Young Children (2-9 years old)

Sinovuyo Caring Families Programme for Young Children

PLH for Adolescents (10-18 years)

Sinovuyo Caring Families Programme for Parents and Teens

All developed and tested in South Africa

Training & implementation support (CWBSA)

Way forward

Overcoming challenges for scale-up

Strategic partnerships, buy-in and long-term commitment

Ownership, coordination and management

Sustainable allocation of financial and human resources

(balance quality & reach)

Implementation plans with realistic timeframes

Integration in existing service delivery structures

Utilise current service providers

Complement existing services and other initiatives

Flexible to fit multiple delivery systems

(e.g. family strengthening, health, education)

Accreditation

Way forward & measuring success

Investment in evidence generation and use

Pre-post outcome questionnaires

Process monitoring tools

Pooling of implementation & capacity building data

Responding to adaptation needs

E.g. domestic violence victims & family reintegration

Optimisation research (cost-effective components)

Contact

Clowns Without Borders South Africa

184 Main Road, Lakeside

Cape Town 7946

info@cwbsa.org

+27 21 788 3202

www.cwbsa.org

PLH Capacity building and dissemination organisation