Social protection policy in promoting human development outcomes: the cash transfer programme for orphans and vulnerable children in Kiambu, Kenya

Magister Artium (Development Studies) - MA(DVS)Cash transfers, integral in social protection, have increasingly been viewed as a viable measure of promoting human development outcomes in low and middle income countries in the face of persistent poverty exacerbated by the HIV/AIDS pandemic. Sub-Saharan Africa has been the worst hit by the HIV/AIDS pandemic with almost two thirds of the world’s HIV/AIDS patients living in the region. By 2005, 12 million children were orphaned by the disease while 2 million more below 15 years of age were estimated to be infected (UNICEF, 2005:2). To address the plight of orphans and vulnerable children in Kenya the government together with various international development agencies launched the Cash Transfer Programme for Orphans and Vulnerable Children (CT-OVC) in 2004 to provide for the basic needs of OVC and promote their human development. With the capability approach as its theoretical framework, this research seeks to determine the value attached by recipients of the CT-OVC to capabilities in the four broad dimensions of social life, health, education and play. It also seeks to gauge the extent of attainment of functionings in the four dimensions, and the association between participation in the programme and one’s functionings in the key dimensions. The research is conducted through a quasi-experimental design which compares recipients of the cash transfer to non-recipients and mixed methods are used to collect and analyse data. Results show that OVC consider capabilities in the dimensions of social life, education, health and play to be of high value in their lives. Children in the recipient group appear to have attained functionings in the four dimensions to a higher degree than their counterparts in the comparison group. There is also an association between participation in the CT-OVC programme and attainment of functionings in all four dimensions. Perceptions from participants explore further opportunities created or expanded through the CT-OVC as well as participants’ suggestions on the programm

A community engagement approach for an integrated early childhood development intervention: a case study of an urban informal settlement with Kenyans and embedded refugees

Background: Community engagement is crucial for the design and implementation of community-based early childhood development (ECD) programmes. This paper aims to share key components and learnings of a community engagement process for an integrated ECD intervention. The lessons shared are drawn from a case study of urban informal settlement with embedded refugees in Nairobi, Kenya. Methods: We conducted three stakeholder meetings with representatives from the Ministry of Health at County and Sub-County, actors in the ECD sector, and United Nations agency in refugee management, a transect walk across fve villages (Ngando, Muslim, Congo, Riruta and Kivumbini); and, six debrief meetings by staf from the implementing organization. The specifc steps and key activities undertaken, the challenges faced and benefts accrued from the community engagement process are highlighted drawing from the implementation team’s perspective. Results: Context relevant, well-planned community engagement approaches can be integrated into the fve broad components of stakeholder engagement, formative research, identifcation of local resources, integration into local lives, and shared control/leadership with the local community. These can yield meaningful stakeholder buy-in, com‑ munity support and trust, which are crucial for enabling ECD programme sustainability. Conclusion: Our experiences underscore that intervention research on ECD programmes in urban informal settle‑ ments requires a well-planned and custom-tailored community engagement model that is sensitive to the needs of each sub-group within the community to avoid unintentionally leaving anyone out

Supporting Child Development Through Parenting Interventions in Low- to Middle-Income Countries: An Updated Systematic Review

Background: Over 250 million children in low- and middle-income countries are at risk of not achieving their fullest developmental potential due to co-occurring risks such as poor nutrition and inadequate learning opportunities. Early intervention programs integrating the aspects of nurturing care, that is, good health, adequate nutrition, safety and security, responsive caregiving, and learning opportunities, may ameliorate against the negative impact of these adverse conditions. Methods: This meta-analytic review updates the evidence base of parenting interventions comprising stimulation and responsive caregiving components on developmental outcomes for children under age 2 years in low- and middle-income countries. It also describes and assesses the moderation effects of population characteristics and implementation features on the intervention effectiveness. Studies were identified based on previous systematic reviews and an updated literature search in eight databases and the gray literature up to December 2020. A random-effect model was used to explore the pooled effect sizes accounted for by the intervention for developmental outcome of cognition, language, motor, and social-emotional capacities. Exploratory moderation analyses were also conducted. Results: Twenty-one randomized controlled trials representing over 10,400 children from 12 low- and middle-income countries and regions across three continents (Africa, Latin America, and Asia) were identified. The interventions showed overall small-to-moderate effects on children\u27s cognitive development (ES = 0.44; 95% CI = [0.30, 0.57]); language development (ES = 0.33; 95% CI = [0.18, 0.49]); and motor skills (ES = 0.21; 95% CI = [0.10, 0.32]). The overall effect on social-emotional development was non-significant (ES = 0.17; 95% CI = [−0.01, 0.34]). Effect sizes (ES) varied significantly across the studies. Parenting programs that targeted vulnerable groups, including rural communities and caregivers with lower education levels, had more significant effects on children\u27s development. Group sessions (vs. individual visits) and high program dose (≥12 sessions) were also associated with stronger effects on child development. Further research is needed to determine the effectiveness of the workforce and training on programmatic outcomes. Conclusion: The findings indicate that parenting interventions that encourage nurturing care are effective in improving the early development of children, especially among vulnerable populations. We discuss opportunities to strengthen the implementation of research-based parenting interventions in such contexts

Mental Health during COVID-19 Pandemic among Caregivers of Young Children in Kenya’s Urban Informal Settlements. A Cross-Sectional Telephone Survey

The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants. Survey instruments included the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, COVID-19 Anxiety Scale, and questions on the perceived COVID-19 effects on caregiver wellbeing and livelihood. Data were analyzed using descriptive statistics, and univariate and multivariate analysis. Caregivers perceived COVID-19 as a threatening condition (94.54%), affecting employment and income activities (\u3e80%). Caregivers experienced discrimination (15.27%) and violence (12.6%) during the pandemic. Levels of depression (34%), general anxiety (20%), and COVID-19 related anxiety (14%) were highly prevalent. There were significant associations between mental health outcomes and economic and socio-demographic factors, violence and discrimination experiences, residency, and perceptions of COVID-19 as a threatening condition. Caregivers high burden of mental health problems highlights the urgent need to provide accessible mental health support. Innovative and multi-sectoral approaches will be required to maximize reach to underserved communities in informal settlements and tackle the root causes of mental health problems in this population