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SECURED: Our Village, Our children, Our Hopes!

This project aims at improving care for child development practices by using Core Community teams (CCTs) of local council I chairpersons, village health team members, health workers, teachers and local government representatives, psycho-social and nutrition facilitators to lead the process of social mobilization and behaviour change interventions. These facilitators will organize caretakers and other members of the community at village level to discuss about ECD, identify and prioritize key ECD challenges, implement and evaluate specific doable actions for better ECD practices in Central Uganda. Facilitators will use quality improvement techniques--PDSA—and and community action cycles to promote care for child development.

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Next steps to bringing SECURED to life:
  • Working through LCI chairperson, VHTs and local government representatives, we will organize village level meeting in Sebowa zone to introduce the program and prototype it
  • The village identifies volunteers as facilitators and CCT members whom we will orient on care for child development curriculum
  • Conduct two-three week prototype and document progress, lessons learnt and use it to refine the program

A story of SECURED: Our Village, Our Children, Our Hopes

This is a description of SECURED from a futuristic view. It provides insights of what the user experience would be, what parties would be involved in making it real and how different villages adopted it.......
 

Atimango, a 23 year old second time mother living in Asundi—a slum area in an upscale Kampala suburb was invited for her usual village meeting by the Secretary for Children’s affairs on a Friday morning.  Atimango recently lost her first born Okello, who was a lovely boy, to a strange disease that turned his hair brown, peeled off his skin and left him with numerous swellings. She later learnt that this disease that had killed her son was known as acute malnutrition and she was filled with remorse because she realized that it could have been prevented. After this experience, she had withdrawn from her village friends and now spent most of her time at home, with her new baby and husband.
Atimango wondered to herself what could have happened in their village because this village meeting had been emphasized more than any other before. She asked her six neighbours if they had also received the invitation to the meeting, to which they all answered affirmative. This brought her some relief, and together, they all went to the mango tree where they usually held these meetings. To their surprise, almost the entire village was present. From past experiences, these meeting had a very poor turn up. At the back of their minds, Atimango and her friends silently concluded, that the day’s topic of discussion that had brought the whole village together must be a very important one.

Seated at the high table was the Local Council Chairperson, Secretary to Children’s Affairs, VHTs, and Priest from St. Balikudembe, Health Facility In-Charge, Community Development Officer and a Head Teacher of one of the most popular primary schools in the village. The LC chairperson made the opening remarks for the meeting in which he welcomed everyone and thanked them for taking great care of their children. He then went ahead to explain the topic for discussion for that day’s meeting which was—continued health, nutrition and social challenges faced by children zero to five in their village and what the community could do together to address these challenges. He introduced the members at the high table and gave reasons as to why each one of them was there.

The village members (especially mothers like Atimango) were pleasantly amazed and clapped endlessly because it was unusual to see their entire community gather together to discuss some of what they considered the most pressing and relevant issues, threatening the future of their village. They were impressed that their leaders were showing interest in addressing such relevant matters instead of the usual business of asking for money for development projects which they never saw materializing. Lanyero-, an elderly member of the community stood up and thanked the LC chairperson for having come up with this brilliant idea. She later confessed how all her three grandchildren had taken longer than expected to start talking, crawling and walking. She testified that she had tried finding possible reasons for this by asking her daughter-in-law how she cared for the children, but this had only earned her a rebuke to leave the children alone.
Lanyero believed her family wasn’t the only one dealing with such issues and that she spoke on behalf of the others that had chosen to remain silent. She therefore welcomed this movement as a golden opportunity to address these issues. She assured the gathering how this move would reach great heights in allowing their children reach their fullest growth potential within the stipulated time. Some mothers testified how this discussion had come up once in their Village Savings & Loans Association (VSLAs) meeting. However, no one had taken ownership of it, therefore it had slowly died out. Just like Lanyero, they were happy that this time the idea was being raised at village level and all key stakeholders—religious leaders, local government, local council, teachers, village health teams, health workers and community members were engaged.

“In twos, in fours, in fives, today we declare as Asundi village to uphold, to provide care, responsiveness and stimulation—love, play and communication to our children, our hope in order for them to grow and develop to their full potential” they all declared in unison while holding hands. With this, the priest stood up and prayed for Asundi. That God would bless their commitment and Asundi would become one of the greatest villages in Uganda especially in child care development.
While everyone thought the meeting had ended, Atimango fell face down at the center of the gathering holding her baby tightly and crying out loudly: “If only this had happened earlier, I would not have lost my dear Okello, to that strange disease. Being a new mother, I thought I was doing the right thing by leaving Okello in the house each day and going off to fend for the family. I worked so hard and even started feeding him with porridge and matooke at 3 months as he did not like my breast milk”.

In an unexpected turn of events, Ongom- Atimango’s husband joined her and together they wept bitterly. “Fathers of Asundi, do not be like me who left the care of Okello to my wife alone. I also thought I was doing the right thing in the interest of Okello by working hard and leaving the house at 6am when he and the mother were still asleep and only returning at 11.30pm when they were asleep again”. “Today I commit to spend most of my time with this son of mine [picks the child from Atimango]. I will teach him to sing, dance, make toys and I will mentor him as a young man. I will also provide a safe shelter where he and other children from the neighborhood can freely play and enjoy their right to childhood”. Ongom was picked from the center of the gathering by other fathers who came carrying their own babies as a solidarity statement that they too would spend more time with their children and not leave it all to their mothers.

Likewise, the mothers picked up Atimango and held her close. The meeting ended in a celebration of solidarity with tears of joy. It was fully adjourned and the members agreed to return after two weeks to identify leaders of this new project that would support them to better understand how to take care of their children using the locally available resources. Families left hand in hand, singing and dancing to their beloved Ochailop’s new song- “Baillando”, a popular hit in the village.

After the two weeks had elapsed, the community converged at the same venue. This time the agenda for the meeting was to identify members and leaders of the (Child Care Team) CCT. The secretary for children’s affairs provided information on the number of households with pregnant women and children under 5 years in Asundi. The LCI chairperson was elected to chair the CCT and he would be assisted by Mr. Otto, the head of VHTs in the village.

Children older than 5 years were also present at the meeting and declared their interest in helping their younger siblings grow healthier. These children said they would provide psycho-social support to their siblings by organizing activities over the weekends in the open safe place, where they would play with them and make for them toys from locally available materials. They would also bring their art work from school and share with the younger children. This way through learning from the older siblings, the younger children would gain more physical and motor developmental milestones.

During the meeting, the newly elected leaders together with the members of the CCT and VHTs came up with an operational plan for the program. This included a training manual for the CCT and VHT teams, meeting time, children’s play and stimulation activities, monitoring and evaluation of the activities among others. The operational plan also included clear roles of all CCT members, VHTs, elders, older children, parents, religious leaders and local government representatives. This was reiterated to the members of the community to ensure that they held the leaders accountable.

After the leaders had been elected, the LC 1 chairperson introduced a team from a local NGO called YEN. These were going to facilitate psycho-social and nutrition training for the VHT and CCT teams that had just been elected. He mentioned that they would be using an adapted UNICEF and WHO curriculum on Care for Child Development. Part of the criteria for being selected as part of these teams, was that the individual had to be female, warm, nurturing and loving to young children, friendly, kind, non-discriminatory, reliable and trustworthy. Individuals that showcased knowledge and understandings of local beliefs and norms and issues of children’s rights, were also selected. Some of the priorities areas to be covered in the training included; importance of play to children, children’s rights, infant and young child feeding practices, and health and safety issues. Upon completion of the training, those that participated would be given certificates. This would take place at a commissioning ceremony in the presence of the entire community.

One month down the road, on a cool Sunday afternoon, the facilitators were commissioned at a colorful ceremony and everyone rejoiced and welcomed them. The following day, armed with enthusiasm from the support they had received the previous day at their commissioning, the VHTs and CCTs set out to work. They conducted a mapping of children 0-5 years in the community, assessed caring practices and health situation of different households. They also conducted a needs assessments and designed a template for monitoring and evaluating their activities, all the while adopting a more qualitative than quantitative approach.

They then set a schedule for rolling out the activities they had learnt during their training. This plan included weekly discussions in designated places within the communities with mothers and fathers for at most 90 minutes to understand the social, health and nutrition issues they were facing and how these affected child care. Teaching parents how to make playing items for their children using local materials. The facilitators used UNICEF and WHO “Counsel the family on Care for Child Development Counselling Cards”, which basically are pictorial illustrations of milestones of child growth, from birth up to five years; play and communication considerations for parents to engage with the child of specific age category.

To sustain the program, the facilitators and CCTs trained and engaged parents and elder children in designing the intervention. The facilitators organized small group activities where different families got opportunities to learn from each other. The facilitators also supported parents and caregivers in understanding the changes they saw in their children right from birth.  The community cooperated and generously contributed materials for the program to make the Early Childhood Development (ECD) kit complete which further encouraged and motivated the VHTs and CCTs in their work.

The people of Asundi wholly embraced the new practices they were learning, in that, whenever they gathered e.g. at the VSLA group meetings, they always spared a few minutes to share experiences on child care. Besides meeting in the designated spaces within the community, the facilitators and CCTs also conducted home visits to witness how families interacted with their children back at home. They also observed the hygiene and sanitation, food preparation and feeding practices, shelter and play areas and child health records among others. Such visits always encouraged the families to work hard so that the VHTs and CCTs would leave behind a good report.

Once a family had satisfied the VHTs and CCT teams requirements and attained the specific ECD milestones for their children, they earned a “SECURED” quality stamp. The “SECURED” stamp was placed on the front door of the house and was recognizable to the entire village. Neighbors always congratulated families that earned this stamp, because it represented a family that was caring and loving towards their children.

The community continued to gather monthly and the CCTs together with the VHT psychosocial and nutrition facilitators shared information on how children in different households were being taken care of. They also highlighted number of households that had already obtained the first “SECURED” stamp as result of fulfilling the minimum care indicators for their children within the stipulated time frame. All the members of families who had obtained the “SECURED” stamp were always called to the front of the gathering for recognition for their efforts and received a hand shake from the LC1 chairman. Members of Asundi were determined to see that every household received the “SECURED” stamp. Health workers were often present at these meetings and provided complementary health services for children and their mothers as needed. Children and mothers requiring more medical attention were always referred to the nearby health facilities. The quality of the program, lessons learnt and strategies for improvements following the PDSA cycle were also discussed. 

Within the first six months of program implementation, Atimango and Ongom’s house was among those that had obtained the first “SECURED” stamp and were working on the child care indicators for the second “SECURED” stamp. By the end of the year, every child in Asundi was receiving maximum care which was evidenced by the “SECURED” stamps on all their door frames and thus, families spent most of their time and money on more productive activities other than treating children due to sickness and malnutrition. Malnutrition soon became totally wiped out in Asundi and the later generations would only learn about it from stories told by the elders.

The village converged for their last meeting that year, in which the LC1 chairman thanked CCTs and VHTs for taking the lead in this social change and behavioral intervention for child care and development. This ended in joyous merry making and feasting.  Nearby villages learnt of Asundi’s success and requested Asundi CCTs and VHTs to go and train their people too. Atimango, her husband, Lanyero and a few other families of Asundi accompanied CCTs and VHTs to the nearby villages and provided testimonials on how SECURED has helped their village SECURE health and nutrition of their children and how it had become a norm for entire village to better care for children.
 

 


Updates: Nov 24

  • Using the findings from the interviews and focus groups and other global ECD related research and programming, I am working on the proposal for moving this idea forward.
  • I will share the updates on the proposal and the user experience map later today.
  • Look forward to your continued great feedback. Many thanks!


Nov. 21: Sharing updates on what is making news in ECD in Uganda

Shocking Video of Ugandan House Maid Torturing Baby To Near Death
 

This story that is going viral on social media and national televions in Uganda, summarizes urgency of need to implement this project and sensitize entire community for collective action for better ECD practices.

See the video https://www.youtube.com/watch?v=3CM_SaBfJRI

Just on Thursday there was another baby who the Capital City Authority law enforcers denied being breastfed by her mother, whom they had detained. As s result, the child was run over by the Authority's car. People are definitely bitter that such a government body that is supposed to promote child survival is being in the news for death of a child instead. See the story as written in BBC: http://www.bbc.com/news/world-africa-30142244

More details to this story and let's brain storm who we can make our community better friendly to early child development: http://www.investigator.co.ug/entertainment/4321-kalema-releases-video-over-kcca-killed-baby.html


Updates--Nov.18: Synthesis of findings from Focus Groups in four villages
The team conducted focus group discussions with mothers, fathers and VHTs in four villages in Kiwatule in Kampala and Kira in Wakiso last week. The synthesis is provided in detail:
 
A healthy child in the eyes of the people:
  • A healthy child  is one who is growing well and rarely falls sick
  • A healthy child is growing well. 
  • Such a child is one who is happy and cries less; some children cry when they are hungry, sleepy, uncomfortable or even unhappy or sad.
  • “I would describe child who is healthy and growing well as one who is social and playful on top of falling sick less”, reported a female respondent.
  • A child who is growing well is one who is healthy and grows systematically in that when it’s time to crawl that child crawl, if it time to stand they do so and so on.
  • One who is lively and plays or interacts with other children
 
Health challenges of children between zero to five years:
  • Diarrhea/dysentery
  • Cough
  • Intestinal worms
  • Malaria
 
Feelings towards elimination of health challenges faced by the children
  • “I would be happy if such health issues disappeared because that would relieve me of the constant worry and fear that my child can fall sick any time”, female respondent in Kira.
  • “Such health issues really disturb children in this special category; and as a parent when your child is sick, you can’t eat or sleep properly. I would therefore be glad if these health issues especially diarrhea and flu disappeared because in my children dysentery is not common”.
  • “We are many but I am sure all of us would be happy if such health issues would disappear because as parents we suffer even more than our children when they are sick”, respondent in Kiwologoma.
  • With happy children we would have happy parents that can focus on their work without worrying about their children getting sick.
  • “I would want to see my children happy and disease free, when they are healthy I get less stressed and sleep well and that means I can be more productive”, reported a respondent.
  • “I would feel very happy if these health issues disappeared and we spent less on treating our children. If we spent less on treating our children then we would concentrate on some other businesses”, respondent reported
  • “I would be the happiest mother if such health issues were eliminated and the money I would use to treat the children would be used for other things like buying food”, says a female respondent.
  • “When my 3 months old baby suffers a lot when he has flu and cant breast feed properly and that hurts me a lot so I would be relaxed if my child would not suffer from such”, lamented a mother.
 
Perceptions towards the proposed community led early child development program (SECURED)
  • “This is a good program because most of us grew up in such environments and we were well-disciplined. Those days we considered every adult as father, mother, grandmother, grandfather, aunt or uncle”, explained a respondent
  • The respondent felt their communities would move from the ideology of ‘every man for himself ‘to a cooperative one where each member is concerned about the other.
  • “I would love to see our community raising our children in such an environment because you see different parents raise their children differently but if such a program is practiced then what one parent doesn’t teach her child, another parent can and the child grows up with everything”, encourage a respondent.
  • Respondents recognize that people these days are selfish and greedy in that they don’t want to share. The respondent however say such a program would be a good one and would bring about unity in the community because if they are all to be responsible for bringing up their children well then by all means they have to act as one.
  • The program is perceived as a good one that community members would welcome with one heart for they think their communities would grow to be a big one as a result of the program.
  • The whole community would know the children and who they belong to so that every child would be accounted for.
  • “These days even giving a neighbor’s child food is a tag of war because if the mother finds out you have given her child food she will ask you if you are the one who feeds her child every day or she will say that if you are so sympathetic towards the child then take the child!”
  • “These days because of the bad hearts of people most parents actually tell their children never to eat food from anywhere apart from home and not to talk to strangers”.
  • “When the grownups have personal differences between themselves, they take it out on the children. Due to this you find some parents locking their children in the house”.
 
Motivation for community member engagement in the proposed program
  • Community members would elevate their status if such a program is implemented “Everyone would want to be noticed or known as one who helped the community get rid of challenges that effect early child development. I would therefore be proud to be associated with such a change”, respondent in Kira says.
  • “If I was able to help my community get rid of challenges affecting early child development I would be the happiest mother in the world”, reports a respondent in Sebowa.
  • People feel happy they are part of the great team that contributed to creating a generation of healthier children without many early child development challenges
  • “I would feel very happy if I helped my community get rid of the challenges affecting early child development because it would mean that our children would grow up happy and healthy”, said a respondent in Kiwologoma
  • “I would feel happy if I was able to do something as important as that because that would mean my children and grandchildren would grow up happy and contented”, reported a respondent.
 
Questions and concerns about the proposed community led ECD program:
  • People are concerned that these days people don’t care about one another and that there are a lot of misunderstandings. So one just can’t discipline or feed a neighbor’s child without permission. They are not sure of what they can do to bring back such a practice [of community led ECD].
  • Other respondents reported of how people have a bad mentality in that when others try doing something nice for their children they think they have ulterior motives.
  • There is less trust among people so implementing such a program which requires cooperation among people would be hard.
  • People are selfish and wouldn’t want to share the little they have with others even when they all know that children don’t really eat much.
  • When parents don’t wish to be cooperative then how will the children be cooperative? Imagine scenario where a child goes to the neighbor’s compound to play and are chased away so they don’t get to play with other children.
  • “How shall we bring such a thing back when parents themselves are the ones that raise their children to be disrespectful? A mother will say vulgar words when her child is listening so tomorrow when you find that child uttering the same words who do you blame?”
  • “This program will be very hard to bring back because of the way people these days are wired!”
  • “The government put up children’s rights for a reason but we are misusing them which would affect the implementation of the community led early child development program. How do we bring back such a program?” lamented a respondent.
  • How shall we implement such a program parents don’t associate with each other?
  • How do we make parents adopt the community led early child development program? If we can do that then we will be very happy.
  • Parents don’t have time to attend village meetings or seminars so how do you plan on getting to them?
  • Parents mind their own businesses so how will you change their attitudes?
  • “There is little trust among adults and I wouldn’t blame anyone for that because these days even a father can defile or molest his own child so why should anyone trust a neighbor with their child?”
  • To get this program going would require that you go through the parents because they are the ones that mostly influence their children; my worry is, how will you do that?
What community members would miss if the community led ECD is not implemented (framing the loss):
  • “Children learn some things from doing them with their peers or from watching someone do them. These things would include some that the parent doesn’t do and so our children would miss that if the community led early child development program isn’t implemented”, explained a respondent in Kiwologoma.There would less teamwork between our children since we raise them not to interact with others and even lock them in gates our houses.
  • Community members would miss getting help from their neighbours which could impede development.  Parents who have work would specifically miss out getting support from other members to support their children while they are away.
  • “We would miss out on making friends with different people”, said a respondent
  • “We would miss having a well-disciplined generation”, reported a respondent.
  • The children would miss growing a cooperative community.
  • Children grow up with little or no discipline at all.
  • “We would miss seeing our children grow up to be very social and interactive”, says respondent.
  • “When you talk to your child, they might listen to you but when someone else who is not their parent says the same thing they will listen better”.
  • Children learn very many things when they interact with their peers and from other people, so if the community led child development program is not implemented our child would miss out on a lot of things and this could cripple them for life.
  • We would miss out on having well-disciplined children and future leaders. I think that is why some leaders embezzle funds; they didn’t grow up in a community where they were taught that such a thing is bad. 
 
How to influence community members to take up Community Led ECD?
  • Every community has a person or people they look up to. So using such people to talk to others is a good thing because when these people say something people listen and try to do what they have said.
  • Local Council (LC) chairperson do the mobilization of the community and organize village meetings where people can get information from these meetings. Therefore, they should be used to reach out to community members
  • “As an expert I would first talk to the mothers and these mothers would tell others. I wouldn’t find someone on the way and talk to them about such a program because they might not take you serious”, advised a respondent.
  • “Personally I would first approach a few mothers and tell them about community led child development, these few would then tell others and the cycle would widen. I would also go to worship places and schools to get peoples’ attention. You would also use mass media like a program on the people’s favorite radio station”, advised another mother.
  • In this community people don’t respect VHTs yet they could be of great help to the people and the community.
  • “If was appointed as someone to ensure everyone in my community knew about community led early child development and contributed to promoting better caring practices for all children zero to five, I would first be an example to the rest so that they look at what I am doing”, respondent in Kiwologoma advises
  • Passing through religious leaders to introduce religion in the children and talk to them as early as possible. Through Sunday schools where children meet, the children can be taught what is right and wrong. They would learn respect as early as possible.
  • “As an expert I would first sit down with adults to educate them. I would also move with the LCs because people listen to them so if they called village meetings people do attend them. Even when the whole community doesn’t attend the few that attend can pass on the information”, says a mother in FGD.
  • VHTs play an important role in the community because they are the first people who villagers go to for help when their children fall sick.
  • As an expert I would go through religious leaders to talk the people because people listen to these leaders more than they listen to any other person.
  • As an expert I would pass through the LCs and wouldn’t refrain from ambushing people who don’t know me.
  • The mothers take most responsibilities and can pass it on to others but fathers are always busy and are not reliable.
  • Churches, schools and mosques would be a good place to go to in order to capture people’s attention; also social groups would not be a bad idea.
  • VHTs and LCs play an important role of mobilizing and uniting people in the community. LCs are trusted people in the community and therefore if you move with them people will know that you are a genuine person. 
 
 
 

Updates: Day Two of discussions with community leaders


Our team set out to discuss with village chairpersons of Sebowa zone in Kiwatule, Kira and Kiwologoma zones in Kira town council. I hereby provide key highlights of the discussions:
 

Health concerns for children:
  • The leaders are mainly concerned about malaria and diarrhoea that continously affect children under 5
    • “Malaria is the most common challenge even when parents get mosquito nets!”  reported the chairman of Kiwologoma. 
  • The leaders in Kiwologoma said diarrhoea is often related to sanitation and hygiene challenges faced by children as many of them are seen playing in dirty water and environment
  • Some of the challenges in Sebowa zone include diarrhea, flue and cough. The diarrhea is due to sanitation because part of the zone is a slum and there is little hygiene.
  • Note: When we were carrying out the interview we noticed that some women were having lunch with their children but there were flies all over the place and to sum it all up a child helped himself right there where they were eating from and they took long to clean it up.
  • “I would be a happy man if I knew that children in my community are not disturbed by such health issues and I am sure the community would be a better and happier one with more development since the money which would be used to treat such issues is spent on developmental things.” 
  • “I would feel very happy as a mother and a leader if these health issues disappeared from my community” the respondent said
     
 
Feelings and awareness of community led early child development
  • The leaders felt the program is good and they would be happy if it was introduced in their communities because they grew up in such environment
    • “As a young child in my generation, if you were found by anyone eating dirty food or fruits, you would be disciplined by either thrashing or some other form of punishment and you wouldn't report to your parents because they would punish you even more!” enlightened the respondent with a smiling face.
  • Smiling, the respondent says she likes the program because she grew up in such a community and it was a good thing.
  • “As a result of such a program, there would be few cases of parents locking their children in the house so as to go to work and thus fewer children would die due to fires because neighbors would be willing to look after the children till the parents get back from work” lamented the respondent. The respondent also said that the children would grow up differently from the way they do now simply because there would be community effort in raising them.
  • Community development officer of Kira town council:
    • It would be a good initiative and i would be very happy if such a program was introduced because if everyone is involved then we get better results inform of better disciplined children.
    •  And I think the community would experience a positive change in the form of raising healthy and bright children which in turn would mean a better community.
    • Such a program would be had to implement because people cannot differentiate between entitlements and responsibilities when it comes to children’s rights.
       


The leaders anticipated their communities experiencing the following changes as a result of the program:
  • Collaboration among the parents and the whole village
  • Well-disciplined and healthy children since every person would have a responsibility on the children.


Worries the leaders had regarding the program:
  • Given the misinterpretation of the children’s rights, it is hard to discipline a child that is not yours.
  • Most parents raise their children with a mentality that no other person has the right to discipline them so it would be hard to change that attitude.
 
Personal benefits community leaders would gain out of supporting the program:
  • Their status within their communities would rise if they were able to help their communities get rid of challenges affecting early child development.
  • The respondent in Sebowa zone said she would feel very proud and happy that if she was able to help her community get rid of challenges affecting early child development. Having grown up with few of these challenges in her days, the respondent said she would love it if her children and grand children also experienced the same.
    The respondents said that most of these challenges can be got rid of only if there is collaboration between the community members. 
  • The respondents said they would recommend such a program to other communities if it was successfully implemented in their communities first.
  • The respondent in Kira said he would be happy if he was able to help his community get rid of challenges affecting early child development, this mainly would be because happy children mean happy parents and a happy community.
  • Helping the community get rid of the challenges affecting early child development is a hard thing and it’s very crucial so if I was able to do that I would be very happy and feel like one in a million since it’s something that is rarely done.
     
Questions and concerns the leaders have about the proposed program
  • Some of the questions and concerns the respondent had about the community led child development program were;
  • “With the way parents raise their kids nowadays, how would anyone change their mindset?” Most parents these days tell their children right from childhood never to eat food that isn’t prepared from their homes and some even tell their children not set their feet in someone’s compound simply because they have quarrels with that person!
  • “How does someone change the way  a lay man understands children’s rights?” the respondent expressed worry about this because these days you don’t just talk about someone’s child, if you do they will be very rude and ask things like “Do you know how my child sleeps at night? Or do you know the pain I went through giving birth?”
  • There are two worlds in this community, the poor and the rich, the poor don’t go to the rich people’s gates and likewise the rich rarely come to the poor people’s ghetto. So the respondent was concerned how the program would over look such a scenario.
  • The respondent also expressed concern about the way grownups behave. “Most of these people don’t mind about their neighbors and will almost never greet them. So how does the program work when the grownups themselves are not caring about each other?”
  • Parents have a belief that children are their own responsibility and no other person has the right to do their work for them.
  • Children these days only listen to their parents so if any other person tried to talk to them they wouldn’t listen
    Most people misunderstood children’s rights and therefore there is a mentality that if a child is not yours you don’ bother yourself.
  • “How would the program be implemented amidst all this?”    
  • How do you plan on making parents and the general public differentiate between children’s entitlements and their responsibilities?
  • How do we make parents cooperative enough to welcome this program?
                                                                                                                                                        

What communities would miss if this program was not implemented:
  • “My community would miss out on having children grow up in a cooperative environment like we did in our generation” lamented the respondent in Kiwologoma village
  • The respondent in Sebowa zone said her community would miss a lot in the sense that children grow up distant from each other and not cooperative simply because of the way their parents raise them.
  • According to the respondent, he and the community would miss having a developed community because of less cooperation among the community members.
  • "I would miss being regarded as a good leader and the community would miss raising a generation of healthy and well-disciplined children:, said Community Development Officer of Kira Town Council.
 

Description of a child who is growing well
  • A child who is growing well would be one whose hygiene is good, is properly fed and is happy.
  • A community with children who are growing well is a happy community.
  •  In her opinion, the respondent described a child who is growing well as one who rarely falls sick, eats well and is hygienic.
  • The respondent in Kira described a child who is growing well as one who is healthy and falls sick less often.
  • “My community and I would feel very happy and stress free when we have children who are growing well!” said the respondent with a happy face.
 
Influential people to engage in mobilizing communities for the program
  • Respondents recommend going through local government offices so that some of the contentious issues such as children's rights are clarified to avoid confusing ECD and child abuse
  • According to the respondent in Kira if he was appointed as someone to ensure everyone in his community knew about community led child development, he would first go to the government so that they explain to the people exactly what is entailed in the children’s rights then after he would organize village meetings.
  • They also recommend using community leaders like local council I chairpesons in making sure that everyone in the community knew about community led early child development and contributed to promoting better caring practices for all children zero to five years. 
  • They (local council I chairpersons) would hold village meetings and move house to house using the VHTs to reach out to the people.
  • They would also go to places of worship like mosques and churches to get to these people.
  • The respondents said that VHTs have played an important role of mobilizing the community members and people listen to them a lot, they can also reach the people in their homes. So VHTs should be part of the team to mobilize communities for community led ECD.
  • As an expert in her community; to ensure that everyone in her community knew about community led child development and contributed to promoting better caring practices for all children zero to five years, the respondent would first talk to the women because they are the easiest to talk to first.
  • She would then talk to LCs to help her out through organizing village meetings and she would also talk to VHTs to help her because VHTs do a good job of mobilizing people.
  • The places she would go to would be churches, schools and mosques.
  • As an expert I would first get the LCs, town mobilizers, VHTs and caretakers of orphans and vulnerable children on board. These can help with spreading the word around. These would help in mobilizing the community members.


Updates November 11: Interviews with village Local Council
chairpersons


Today we set out to discuss with the people who hold villages (Local Council One chairpersons) in Kiwatule parish, Nakawa division, Kampala.  Local council One chairperson in the Ugandan political system is equivalent to the president of the village ( http://en.wikipedia.org/wiki/Local_Council_(Uganda).

Kiwatule parish ( http://www.ikimap.com/map/administrative-area-kiwatule-uganda)  is situated in a remote suburb of Kampala. It encounters problems common to slum areas such as unemployment, drug abuse, poor sanitation and associated diseases, prostitution, pet-thieves, high prevalence of HIV/AIDS, etc. 

We wanted to understand the perceptions they have regarding Community Led-Early Child Development. I hereby summarize the key findings from the discussions with the first chairperson of Balintuma zone:


Feelings and awareness of community led early child development
  • The respondent acknowledged that community led early child development is a good program and it would really help the community but he stressed that the issue of children’s rights would hinder its implementation.
  • “Children these days take their parents to police because they discipline them which never happened in our generation!” the respondent lamented. The program would be helpful in changing the community for the better but how to go about it is hard, this because children don’t respect their elders and parents neglect their roles in nurturing their children.

Concerns about the Community Led-ECD or SECURED program
“Abantu bakowu” those are the exact words of the respondent when asked the concerns about the program. This basically means that we live in an “every man for himself” era and that most people don’t really mind about what others are doing and thus it would be hard to implement such a program in his Zone.

The respondent also noted that these days when an elder tries to discipline a child, that child will ask “who are you to tell me what to do?”
Also he expressed concern on how most parents of today don’t like other people batting in when it comes to raising their children. “Omanyi omwana wange bwasula?” [Do you know how my child sleeps?] or “bwoba oyagala okukuba, zzala owuwu! [If you want to discipline a child, produce your own!] ”are some of the responses one gets when s/he tries to talk about or discipline a child. 

Framing the loss
  • Children these days grow up indiscipline because parents don’t want other people helping them in raising their children yet they work and don’t have enough time for their children.
  • “We already have a rotten generation!” exclaimed the respondent. My community wouldn’t miss anything because the program would be hard to implement in the first place….continued the respondent.

Recommendation from the key informant
  • The respondent said he wouldn’t recommend the program to villages in his community because it wouldn’t work there given the attitudes of this generation. He also said if only the government would amend the children’s rights, then maybe the program would work.

Surprise
  • I was surprised by the respondent’s attitude towards the program and the generation. He at one point said that he prays to God to destroy us all such that a new generation is formed just like what happened in the Bible with“Sodom and Gomora ”


Updates November 10: Action packed week:

  • Our team starts collecting data from village leaders (local council I chairpersons), mothers of children 0-5 years, fathers of children 0-5 years, grandmothers, grandfathers, village health teams (VHTs), health workers, community development officers (CDOs), agriculture extensionists and sub county chiefs and chairpersons the coming week
  • We will organize focus group discussions with fathers, mothers, VHTs and health workers while key informant interviews will be held with village and sub county leaders ,CDOs and agriculture extensionists
  • This implementation research will inform how the community will address the challenge of ECD in their villages using the resources they have got through community action cycle (CAC)
  • We will specifically inquire whom the community consider as respected and influential members to form core community mobilization team to propel the concept of it takes a village to raise a child in order to improve child care
  • We will ask the participants to prioritize the challenges on ECD and come up with one to three they want to start with
  • The core team will then guide the community on how to go about it through CAC and other quality improvement approaches.

Project Updates: November 3

Thanks to Bettina and team we are moving on to apply community action cycle and quality improvement approaches to mobilize communities/villages to support ECD in Uganda. We are still brain storming on how best to do this but we have some ideas. We welcome anyone with experience in PDSA and other community led developmental approaches to join the team so we refine the idea.

Attached are links to some of the tools:
http://www.coregroup.org/storage/documents/Diffusion_of_Innovation/PDQ-Manual-Updated-Nigeria.pdf
http://respond-project.org/pages/files/6_pubs/curricula-manuals/COMMPAC-Facilitator-Manual-May2010.pdf
http://www.accesstohealth.org/toolres/pdfs/access_cmmnh.pdf

 

Project Updates: October 30

  • From the comments I have received from the team, it would be great to ask the communities:
    • Imagine someone came to you and was talking about caring for children. What would you think of child care? How would talking about child care make you feel?
    • How does the way communities cared for children long time ago compare with the way children are cared for today?
    • What has changed?
    • What is your view of a peaceful village?
    • How does your village compare with the rest of the villages in this area?
    • How would having healthy children make a difference in your village?
    • How would you encourage communities to work together in bringing up children today?
    • Who would be the main person (s) to in making community members collectively take care of children in this village?
 
  • Understanding of how the community perceive working with health service providers and groups to influence social change on child care may be important. I am exploring how to build on the ideas from others on this challenge to integrate the idea on health service, education and social service delivery to communities. But these services should not get dictated to people as their views of their priorities may differ.

Communities should be at the centre of social change for improved child wellness:


There is evidence from around the globe that communities have all the resources needed for raising healthier, productive and happier children. More often than not, it is more of an issue of triggering the social change within villages. This idea is built with the theory of change that raising up a healthy child is a responsibility of the village and not just parents. If the village is triggered to rise up and support caretakers with different resources for care, children would get all the necessary doses of components of healthy growth.

How we will engage communities:

By using behavioural economics research techniques such as indirect interviewing techniques, change agents or facilitators of social change, would obtain information that is vital to getting to the heart of the matter from different members of the village. Using this information, the facilitators would work with the villages to design strategies to catalyze villages to stand up and raise their children in a more holistic approach. With  rigorous participatory documentation, monitoring and evaluation, the villages would appreciate how their efforts are making a difference in how children grow. This would emotionally motivate them to work harder to cement such practices.


This intervention would work because it is community driven and uses holistic lens to child health beyond the traditional stand-alone approaches. The use of the existing resources, which the communities themselves prioritize as important in healthy child growth is likely to sustain the interventions.

Questions to ask the communities:

The main questions that the villagers would be asked are:
  • the dreams and hopes they have for their children;
  • the worries caretakers hold deep in their hearts about their children;
  • what if any the caretakers would do differently today in order to secure the future of their children;
  • what community leaders perceive as the most important resources available to support caretakers raise healthier children;
  • what feelings villagers have towards current interventions for children;
  • what do villagers describe as healthy children!

Who will benefit from this idea and where are they located?

Our primary target for this idea are mothers and fathers of children under two years living in central Uganda, East Africa. Mothers and fathers will get opportunities to understand developmental changes occurring in their children in order to better support them. Fathers who are often accused of not caring for children will learn from interactions of other caregivers with their children and try out such interactions with their own children back at home. Parents will learn skills for making toys, communicating and playing with their children in order to improve care for child development. Other siblings will have opportunity to transfer skills and knowledge they have accumulated to support their younger siblings through play, communication and keeping environment safe for them.

The secondary target include community health volunteers, local council I leaders, grandparents, health workers, community development officers, school teachers and other village members who are affected or inflicted by poor health of children. These representatives will have the chance to share own ideologies on caring for children in order to improve developmental and health outcomes in their communities. This way they will have less people spending their money and time on treating sick children. Better still they will have peaceful communities as there will be less conflicts as result of poor child development. Leaders, health workers and even grandparents will raise their status for having helped children thrive.

Our tertiary clients include district leadership and the central government because from this idea they will learn how best to promote the well-being of children under five using the concept of the village! This way they can scale up the idea to other constituencies and help address health and social challenges facing children and parents.

How could you test this idea in a quick and low-cost way right now?

My team would design quick implementation research using behavioural economics/human centred design approaches with villagers in the targeted Central region in Uganda in order to penetrate to their hearts and understand their perceived ways of enhancing the well-being of children using holistic approaches. This would take us about 5 working days to complete [Note: we completed this phase and got very important findings that we are using to refine the idea].

Based on the implementation research findings, our team would design a strategy for social change and social marketing to catalyze the rising up of villagers to better care for children at individual, household and community levels. This we anticipate would take 3 days to complete. [See the user experience map and the SECURED story for implementation strategy that we have drafted for this idea].

Working with the key community role models and other influencers identified from the research, our team would camp in the targeted villagers (starting with one village at a time, learn from it, come up with change package and then spread the changes to other villages using experienced change agents and village champions from the current village to testify to new villages) to catalyze the process of villagers, health facilities and possibly schools to identify doable actions to take up to improve the ways children are cared for, to support mothers and fathers better understand how to care for the children, create child care friendly villages, health centres and schools. The team will mostly use quality improvement approaches of planning, doing, studying and acting (PDSA) and Community Action Cycle (CAC) in order to motivate the villages to identify critical changes, needed to enhance care for child development, planning for interventions to implement them, studying and trying out the changes to see if they are leading to the intended outcome.

The other most important intervention our team would facilitate the villages to do is documentation, monitoring and evaluating interventions put in place to address the bottle necks to child care. This important intervention would fit well with the quality improvement concept and would also motivate the villagers and their role models such as community health volunteers, local council leaders, health workers and teachers as they see how their efforts are making a difference in their communities. The documentation will also enhance motivation of mothers, fathers and entire households, CCTs and facilitators as the SECURED mark (see the user experience map) is based on success in achieving key agreed upon practices.

What kind of help would you need to make your idea real?

Our team is looking for open feedback with the intention of helping us shape up the idea and realize it. The team welcomes all possible partnerships to make our dream come true. We are also looking for design support for the idea.

Is this an idea that you or your organization would like to take forward?

  • Yes. I am ready and interested in testing this idea and making it real in my community.
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Attachments (4)

SECURED_Final.jpg

User experience map

SECURED_Program_Impact.docx

Story of SECURED's impact

collection_of_children_laws_finale_110711.pdf

Collection of Uganda's Children's Laws: Could help us better understand the issue of children's rights

Summary of what we obtained during research phase.docx

Highlights of interviews during the research phase

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Together with colleagues in YEN, we plan to use the SECURED structure to implement SOLVED: Two Legumes, one cereal meal for smart children--https://openideo.com/challenge/zero-to-five/ideas/solve-two-legumes-one-cereal-meal-for-smart-children, which is the refinement phase of this idea.

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