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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 After this experience, she had withdrawn from her village friends and now spent most of her time at home, with her new baby and husband.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

150 comments

Join the conversation:

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Photo of An Old Friend
Team

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.

Photo of Bettina Fliegel
Team

Hi Alex!
The user experience map and the story are great!
A few comments and questions:

What is the current approach to discipline in the villages? Is it punitive?
If so is this something that may be adapted?
One mother remarks that :
“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...
What does she mean regarding reporting to your parents..... Does she mean that the child would report the parents to child protective services? The negative remarks about children's rights - is this because older children threaten parents with the possibility that they, the children, will report them to the police?
Are these communities open to guidance on different ways to discipline children? Is training on Positive Parenting techniques part of the plan?

Health Issues:
Strengthening the village health team as a resource is a great idea.
What other practical solutions can be implemented? How far is the closest clinic? There will be ill children who will need this care. How can the community come together to help themselves access care quickly? a cooperative transport team? allocate funds for taxis if that is the method of transport? Can parents be "on call" to watch neighbor's children if a mother needs to get to a health facility immediately? Planning in advance on how to access advanced care will save lives. This applies also to follow up care. If families simply cannot get there for whatever reason what can the community do as a whole to facilitate this? Can families register for follow up appointments en bloc and travel together? Can one family pick up medication refills for others if they are already going to a clinic?

Siblings -
You mention training children over the age of 5 so that they can participate in Secure. Do you have any specific ideas for their role? Any ideas on how to enrich their development while in this role? Perhaps badges for achieving certain levels of responsibility or participation?
I have seen some children asked to do things that are beyond their abilities and when problems arise they have been beaten. How can this be avoided?

I agree with A-L that "Elements of Play" as an idea is very complementary to yours. Look at their discussion on toy libraries . They use it as a tool to teach caregivers the milestones of normal child development. The toys have corresponding cards that outline how they can be used to enhance specific milestones.

Thoughts?

Photo of An Old Friend
Team

Hi Bettina! Thank you for your detailed feedback and questions. Here is my response to specific questions chronologically:

1) According the respondent, long time ago when they were growing up disciplining a child was a responsibility of everyone so no parent would blame another parent for having disciplined their child. The respondent meant children would report to their parents and not to child protection services. Yes, the respondent meant that now days children and parents often report to police and child protection units in case they feel they (the children) have been abused by other adults. The disciplining described as re-portable is extremities of child abuse like caning them uncontrollably. As per the attached compilation of children's rights in Uganda, it is clear the issue of children's rights is misunderstood by many. Yes, in the care for child development training curriculum that would be used by psycho-social and nutrition facilitators, there is module of children's rights and they would work with CCTs to train parents and communities about appropriate parenting techniques which do not constitute child abuse.

2) There is a health centre in each parish to serve about 5 villages. The VHTs are the closest arm of government health care system and therefore the first point of contact for simple ailments and for primary health care services for mothers and children. All other suggestions you have provided are doable through the community action cycle dialogues and quality improvement approaches. Since it needs collective action, members of the community would have to identify the issues as priority and to take doable actions to improve. I know in Kisoro, Southwest Uganda, communities have a local health saving scheme and transport system for pregnant and lactating mothers. It is now a norm in the communities where it is practiced. So yes, these suggested actions are can be taken up.

3) My idea is to engage older children to share their knowledge and skills on toy making, drawings and generally guide younger children at the safe play spaces and also back at home. Yes, just as we have the SECURED stamp for households, it would be good to have tangible incentives to acknowledge attainment of milestones by children. I have run a guide guide and scouts project where guides helped us in mapping children under 2 years and pregnant women, pass messages on nutrition to caretakers and to take mid upper arm circumference. These activities were done in an incremental manner and after accomplishment of the first package, the guides received badges, books or mathematical sets. We would not want to overload the children with too much work.

4) This idea (SECURED) is more of a sustainable community mobilization strategy to catalyze change for positive child care. I have read the discussion of the toy library and it would be good to have it run in our communities.

Photo of Bettina Fliegel
Team

Thanks for the information Alex. The details that you provided for these aspects of the programming that you hope to implement really bring the idea to life. The scout program sounds great I think that model is a good one for Secure.

As this idea is a comprehensive approach what thoughts do you have for next steps? Can you prototype a specific intervention to get user feedback?

Photo of An Old Friend
Team

Thanks Bettina. So our plan is to start prototyping in Sebowa zone. We have talked to LC I chairperson and his vice chairperson about holding a village meeting and we introduce the program. We would bring local government representatives too to the meeting just as it is outlined in the SECURED story. The the community would pick volunteers that we could train as facilitators for the program. We plan to do this during the refinement phase.

Did you have a specific idea you think we should start with? I believe the discussants brought out issues of diarrhoea more frequently.

Photo of Anne-Laure Fayard
Team

Great conversation here. Alex, it's great to know that you're planning to prototype SECURED in the Sebowa zone. I like your idea of starting with a specific issue as I think this will allow you to show the impact of your idea. Maybe you should start by doing a meeting with people from the Sebowa zone to see what is the main issue for them, e.g. what is the health issues they are faced with.

As for the toy library, I understand that this is only one component to your idea which is more of a program or a service, but what you might want to start thinking is what are the different points of contact that the community members will have with SECURED.

Photo of An Old Friend
Team

Thanks Anne-Laure! We will hold the meeting to confirm the health issues with the larger section of the village as we had already interviewed mothers and the LC chairperson there.

Photo of Uve Kindia
Team

Good thing that was mentioned. Its such a major and vital part of the rebuild

Photo of Ayman Hanafi
Team

Alex ,you have some wonderful stuff here, quite a lot to take in. I can see where you are going and what your goal is. It's difficult to get started because as you've said all people must pull together to make progress. The world to day is very much "every man to himself" and one can't interfere as it's not his business. It would be such an achievement to get people on the same wavelength as back in the days. With your striving enthusiasm, I'm sure you'll make a go of it. Good luck!

Photo of An Old Friend
Team

Thank you team. This idea did not make it to the next round but we will continue refining this implementation model and apply it for other programming within the team!

Photo of Bettina Fliegel
Team

Keep going Alex! You have discovered many things and can begin to prototype some interventions based on your research. Keep us posted as you continue with the local communities.

Photo of Anne-Laure Fayard
Team

Alex, I second Bettina. You have done amazing research and have developed a systematic approach to tackle the issue. You are ready to prototype some interesting parts of your model / service.
Keep working on your idea and let us know how it goes. I hope to read your story as an impact story on this challenge.

Photo of Kyaw Tun Sein
Team

Amazing effort Alex! I am new to this open ideo community but I am becoming to see how awesome it is! I really hope your idea wins! =)

Photo of An Old Friend
Team

Welcome on board Sein. I hope you enjoy this community, it is great!

Photo of Bettina Fliegel
Team

Alex
Have a look at this TED talk for inspiration. It highlights work that was initiated by one teacher in the poorest Congressional district in the USA, in the Bronx, NY. It addresses the issues of childhood obesity, food poverty, loss of jobs, and economic insecurity in this community.
It made me pause and wonder as to how teachers and their students can work together to find solutions in communities.
http://www.ted.com/talks/stephen_ritz_a_teacher_growing_green_in_the_south_bronx?language=en
https://www.youtube.com/watch?v=VgGL6mz3dBY

Photo of An Old Friend
Team

Thank you Bettina! This is inspirational. Ronald and Jamiru are working on school feeding and gardening project. They are reaching out to private schools--primary and secondary to train them how to set up school gardens, grow vegetables, make menus and teach nutrition education. We are also planning to set up urban gardening project in Kampala; we have a draft book we are writing on urban gardening; today Ronald and I were discussing about urban aquaculture project too. So there is quite a lot these youth are dreaming about and hopefully one day the projects will come to life!

Thanks, Alex

Photo of Anne-Laure Fayard
Team

Alex, check this idea: https://openideo.com/challenge/zero-to-five/ideas/element-of-play-supporting-vulnerable-children-to-develop-and-thrive-through-play
I can see it as a nice complement to yours - as a resource for the community. Thoughts?

Photo of An Old Friend
Team

Hi Anne-Laure. I have already built in this idea as part of SECURED. As indicated in the earlier response to Bettina, it would be good to prototype the proposed idea through SECURED during the refinement phase. What do you think?

We could reach out to the team and seek their views on doing collaboration.

Thanks,
Alex

Photo of An Old Friend
Team

Team, I have updated the idea and included the user experience map. Thanks to Michael for his support. Thanks for the feedback!

Photo of Anne-Laure Fayard
Team

Checking this soon.

Photo of Anne-Laure Fayard
Team

I just had a look at the use map (as well as looked at the insights for the research attached). The design is great but it is not easy to read the different elements or at least I haven't found a way to zoom in.

Photo of An Old Friend
Team

Thanks Anne-Laure for the feedback. Let me work with Michael to improve the size. I could also send it to your gmail.

Photo of Anne-Laure Fayard
Team

Maybe you could attach it as a document so that people can download and increase the zoom.

Photo of An Old Friend
Team

I have attached it as Secured final (see final 1). Thanks!

Photo of Dana Ilmari Polojärvi
Team

I had the same difficulty Anne-Laure had, and I couldn't find the attachment.

Photo of An Old Friend
Team

I am sorry Dana. Have you tried downloading it from the attachment (file 1)?

Photo of Dana Ilmari Polojärvi
Team

Thanks Alex, I found it.

Photo of An Old Friend
Team

Great! Michael is also modifying the size so I can post it on the main idea page.

Photo of An Old Friend
Team

Wouldn't this be great for teaching behaviour change for child care:
http://www.lifebuzz.com/monkeys-get-bananas/

Photo of An Old Friend
Team

My friend thinks the story in attached to this idea should be turned into a local drama and aired on radio and TV to mobilize more people for better child care practices. What do you think?

Photo of An Old Friend
Team

I have updated the idea and included a story depicting how the program would run and benefit the community! Check it out. Thanks!

Photo of Bettina Fliegel
Team

Alex, great story. Can you indicate at the beginning of the story that it is a story and not something that has happened/observed? I was confused about that when I read it. I thought it was an Update from your meetings. It might just make it clearer to folk that are just coming to the project and reading it for the first time.

Photo of An Old Friend
Team

Thanks Bettina. Let me edit the update.

Photo of An Old Friend
Team

Thank you my great team: Dana, Bettina, Anne-Laure for the great pieces of thoughts. Let me get back to the Creative Lab to analyse all the comments and come up with the visuals.

Photo of Anne-Laure Fayard
Team

Alex, I've just went through the scenario and it is super useful to understand better the impact and the process! I'll read again and write more if I have any questions or suggestions!

Photo of An Old Friend
Team

Here is the link to the ecological diagram:

https://clarityrising.wordpress.com/
http://quizlet.com/26197727/human-development-chapter-1-flash-cards/

Photo of An Old Friend
Team

Here are some of the concerns one of the leaders had regarding the proposed program:

• “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?”

All in all the respondent said she would recommend the community led child development program to the villages in her community because already people in her neighborhood practice it though it’s on a small scale.

Photo of Dana Ilmari Polojärvi
Team

As I've been reading through all this fascinating research and development, I'm struck by the fact that we're trying to build a network of conversations that want us to return to an older way (one of the respondents above actually says the goal is to bring back a way of interaction she remembered from childhood). Are there traditional models from the local sociological history we could be looking to that might make this transformation more natural? Perhaps I missed that part of the research phase?

Photo of An Old Friend
Team

From the discussions especially with the elderly LC chairpersons, they spoke of how the elders in their time helped instill behaviours into young children through story telling, role playing and providing counsel to their parents. There was a council at village level responsible for managing family conflicts and institutionalizing culture. I also learnt that at the moment the local council has a secretary for children, who represents issues around child welfare and health in the council. The council is composed of 12 different members including VHT representative.

Photo of An Old Friend
Team

Since Village Health Teams are recommended to mobilize community members for community led ECD, I am sharing link to comprehensive profiling of these structures as done by USAID's APC project in 2013: http://www.advancingpartners.org/sites/default/files/landscape/countries/profiles/country_profile_uganda.pdf

Photo of Dana Ilmari Polojärvi
Team

Alex, Thanks for this helpful link. How do you see the VHT interacting with the core concept we're working on here?

Photo of An Old Friend
Team

The VHTs will play the direct health service provision to children and caretakers. They would support in provide basic services like deworming, vitamin A supplements, treatment of mild malaria, mild pneumonia, passing on messages and counsel caretakers on care, nutrition and stimulation for children. They are the ones who take basic information on children and mothers in each village. I see them being part of the psychosocial and nutrition facilitators!

Photo of Anne-Laure Fayard
Team

Alex,

I went through all the different updates: amazingly rich and useful.
What I'm gathering is that some parents and community leaders see the potential benefits of the community led program, they also stressed the difficulty to implement it in the current socio-cultural context which seems to be quite individualistic. I noticed several references to the children's rights. Can you tell me more about this? There was also a point about the distinction between the poor and the rich.

Hence, I think that more than just the program content and structure, you also need to think about the different stakeholders and how to change people's culture / mentalities.

Reading your description" we want to organize core community teams (CCTs) of local council I chairpersons, village health team members, health workers, school teachers and local government representatives to lead the process of social mobilization and behaviour change interventions among caretakers for improved early child development practices" I wondered exactly how it would look like, what would be the programming like: what kind of activities? what would be the role of the different actors you mentioned? what would the parents "gain"? and the children? In particular, parents insisted on diseases but I was not sure how the program would help.

Maybe using all the research you did, you could develop a few personas: for 2 different parents. You will then think about how these 2 parents currently take care of their children and what are the issues they are facing. E.g. one of this mother worried because her child has the flue and can't be breastfed. Then tell the story of how with the new program this would be changed. See for example the "let's imagine part in this idea we posted on a previous challenge" https://openideo.com/challenge/womens-safety/funded-impact/bindis-community-concierges-to-inform-connect-and-empower
Meena's post is also a great example: https://openideo.com/challenge/e-waste/concepting/neighbourhood-e-waste-champion
As you describe the activities of the program, you can also start thinking about the different actors involved. It will also help people understand what your idea will include and achieve.

In terms of piloting the program and changing mentalities, you might want to do a small pilot in one of the communities you visited (or in several in parallel) and tried to show quick wins and benefits and with the words of mouth this might create interests among other parents.

Thanks!

al

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Team

Hello Anne-Laure! Thank you for this important feedback. You are so right about piloting the program as per the findings we obtained from the community. The team plans to start doing that in two different settings--slum and typical village setting on Monday. I am currently engrossed on developing the persona to better describe how they benefit from this proposed program.

My thoughts though were to first identify the hardware in form of the organizational structure i.e. CCTs to lead the process of changing attitudes, behaviours related to ECD i.e. the software. You may have noticed people seem not to understand ECD very well but they have child growth and development challenges, which they can solve using locally available resources...

Thanks for being a great team member, Anne-Laure!

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Alex, glad you found the feedback useful. I think you did a great ground work. It seems that as you develop the content of the first pilot focusing on the challenges such as health, discussed in your meetings would be key.
Can you explain me what is exactly the "child's rights" that several people mentioned as being something that people might invoke? Is it a law protecting children that led to individualistic and protective interpretations and behaviors. I'd love to understand better as it seems key to the adoption of your program. Thanks!

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One more question: have you also found some local organizations who play a role in these communities. It reminded me a conversation I had with a friend in another challenge https://openideo.com/challenge/womens-safety/research/learning-from-an-expert-in-the-field
She told me a story about her work in DC where she had a local NGO working with them. They were trusted by the community and its members were already visiting people regularly. You mentioned religious leaders. Are there religious organizations with which you could work? Just a thought...

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Hello Anne-Laure! Thanks for the continued feedback. From day 1 when we first pretested our tool, we got taken back when Local Council I kept on talking about children's rights. So we interviewed someone responsible for children's protection in local government. From this expert's opinion, it seems there is misunderstanding of what constitutes children's rights. It also seems individuals largely consider punishing children as a form of promoting ECD. That's why I suggest education of caretakers of ECD would make part of the software piece of the program.

We are yet to find out which agencies exist in these areas. This is easy to do. We will have feedback next week.

Here is the link to collection of Ugandan Laws around children. It could help us better understand the urgement these individuals are making. From my own perception, these laws are in fact promoting better caring practices for children.
http://www.unicef.org/uganda/collection_of_children_laws_finale_110711.pdf

Some quotes from the document:

Neglecting to provide food e.t.c for children (s. 157):
It is unlawful for a parent or guardian or a person in charge of a child of tender years, (who has the ability to maintain the child), to refuse or neglect to provide sufficient food, clothes, beddings and other necessities for such child, so as thereby to injure the health of the child.

The Constitution also provides for the specific protection of children (Article 34). The Constitution provides for the following specific rights of children:
1. The right to know and be cared for by their parents or other people
2. The right to basic education which must be provided by the Government and the parents of the child;
3. The right not to be denied medical treatment or any other social or economic benefits
4. Protection from all exploitation (being taken advantage of)
5. Children who are below the age of 16 years must not be employed or do work that is
harmful to their health or that interferes with their education
6. A child offender shall not be detained with adults
7. Orphans and other vulnerable children must be specially protected by the laws of Uganda.

Children’s Rights:

The right to stay with parents (s. 4)
A child has the right to stay with their parents or guardians, unless this would not be in their
best interests
Duty to maintain a child (s. 5)
Every parent, guardian or any person with custody of a child has the duty to maintain that
child. This duty gives a child the right to:
• Education and guidance
• Immunisation
• Adequate diet
• Clothing
• Shelter
• Medical attention
Any person who has custody of a child shall protect the child from discrimination, violence, abuse and neglect.

The right to leisure, cultural and artistic activities (s. 4(a) First Schedule)
The child has the right to leisure and to participate in sports and
other cultural and artistic activities, which are not harmful to its
development.

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Anne-Laure, I have read your post on the findings from interviews with the expert. I must say what she said is in line with my thoughts for this idea. Being culturally sensitive, thinking long term solutions, motivating clients to take action and finding the right coalitions to support the clients open, discuss their own challenges, find solutions to them, implement and monitor the priority solution, and to celebrate their successes together.

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Thanks Alex for the explanation regarding children's rights. Interesting to see how it has been interpreted.

I'm glad (and not surprised :-) ) that the interview resonated with you.

I read about this program: http://www.providencetalks.org/participate/
which made me think of your approach. I also wondered if starting with a pilot focusing on a specific problem, in that case number of words, but in your case, it could be health and / or growth, might not be a good way. It will allow you to have quick wins and evaluate better the success of the program. You can then add other themes and activities.

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Alex, you should check this idea https://openideo.com/challenge/zero-to-five/ideas/super-mamas-for-low-income-communities
I can see the concept of super mamas being integrated in the community education program.

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Alex and Anne-Laure, I'm impressed by this idea of the super-mama. It would be wonderful to have someone in any community who is able to lend that welcome bit of advice in a way that is culturally acceptable and who can reframe ideas for new comers (like the the maid in the shocking video above). There're some additional benefits that I can see arising from that addition to the plan. First, as you're interacting at the village level, getting a feel for the roles people play in neighborhoods, you might be able to identify some of the local caregivers, I'm thinking especially of older people who might otherwise be drifting on the margins. Additional training in identifying group dynamics and intervention might help some of these people take on advisory roles as they see interactions in the community develop. In a sense we'd be designing fail safes into the system, caretakers of caretakers, so to speak, who can identify problems and bring them forward. So much conflict stems from unspoken pain. These super mamas (and papas) might be able to help identify that pain and bring it out. I mention older people as a target group for involvement, as they are often less involved in community (because their children are adults now), but they are often also close watchers of community interactions (I'm also reminded of the youth mentor challenge: https://openideo.com/challenge/youth-mentor/brief.html).

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Thanks Dana. I tried to indicate the roles for grandparents, VHTs, teachers, community leaders in the draft story. For a community driven program to succeed, I believe the community has got to select people they trust, respect and have enthusiasm to lead the process. For instance, VHTs are selected by the community based on these criteria. As for ECD, it is recommended female volunteers take the lead. We will see what the community decides as we prototype but we are taking the ideas.

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Shocking Video of Ugandan House Maid Torturing Baby To Near Death: https://www.youtube.com/watch?v=3CM_SaBfJRI

The child was simply not taking the food that the maid was giving her, this sparked anger from the maid and what followed was torture. I believe this is the classical abuse of children's rights as spoken about by the respondents in our interviews.

What if this maid was trained and understood the what responsive feeding means? What if she understood that she did not have to force the child to eat? What if she knew the value of interactive feeding? What if she knew psycho-social needs of such a young rapidly growing child?

What did the parents of the child do wrong to the maid that sparked off such hatred for the child? The maid was brought from the village in southwestern Uganda and has been working for these parents for only 26 days. What did the parents teach her about child care? I understand the couple itself is young. Would it have been a different scenario if the parents had received appropriate training on ECD?

I see this maid has been remanded to Luzira prison and will be charged with child abuse and intent to murder. There is a lot of all abuses towards her and yes they are justified but can we learn something out of this and use it to help us refine this idea?

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Team

A related video has been produced in memory of Ryan who lost his life when it was run recklessly by City Authority's law enforcers after denying the child his rights to feeding;

SAVE A CHILD: https://www.youtube.com/watch?v=N7XgoeHvDj0

VERSE 1

When you are born as a child it’s a blessing to the world… like having an angel sent from above, with love and peace to share with mankind. It’s the beauty of life breathing with a smile…like there’s no tomorrow before good turns bad.

Verse 2

This is a story of a Ugandan child, who’s been denied the rights of the human race (ah ah aha)… Let me talk about the street kids…These are our children who need love and affection. Show them the ability of helping and honesty coz it’s so sad for a four year old begging and hustling the streets! And as a result, he’ll end up gang banging and messing his life. The cry is so loud to you and me… stand up and save a child.

Chorus

Child defilement (ah,ah,ah)

Child labour (ah,ah,ah,ah)

Child molesting (ah,ah,ah)

Child sacrifice (ah,ah)

We’ve got to fight hand in hand to wipe out these evils to save a child

(Voice over)

The plight of children with disabilities should not be left to be theirs alone, but should be seen as a national issue which needs not only government attention but also action from the civil society… All children have a right to education, good nutrition, good health care, Love and protection from Mother Uganda… etc.

Edited by James Scott

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Team

Alex, this is a shocking video: I just could not watch it all.
I'm curious to know how the video was done: did the parents put a webcam because they were not trusting the maid.
I think you highlight other important questions regarding the maid and the parents: how much knowledge the maid had? how was she herself treated to hate that poor kid so much? ... beyond all your questions, what if there was a place where she could go with the kid to play, interact, and also get advice, rather than staying at home?

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This happened two days ago. The parents did not trust her so they put up a secret camera in the sitting room. They uploaded the video on U-tube!

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At least they had a good intuition!

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Alex, I wonder if it's possible that we're also dealing class-based violence? Perhaps some of the anger that leads to the abuse of children's rights your respondents are revealing stems from the loss of community that happens when some members have more money than others. Of course this would be divisive. If you take a girl from village life then move her to a new area where new kinds of stresses come out, you may find lots of psychological hurt emerging that could lead to this kind of behavior. Of course it's not a justification, just a potential thing to deal with in the training. How do we remember we're a community when we don't all have the same things?

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Team

We are not sure of what triggered the lady to act that way but at this point all the points you make are possible!

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Team

Today's interviews with representatives from Kira Town Council seem to point strongly the need to enter the communities through the local government. It seems people have also misunderstood the issue of children's rights. Community Development Officers who also act as child probation/protection officers with direct links to the communities. Since they are well respected in the communities and lead social development, it would be good to work with them and health service providers for this idea. Interesting findings!

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Team

HI Alex. Loving reading about conversations with local leaders.
Did your team speak with the leaders specifically about a program for small children? The leaders appear to be focusing on negative behaviors of teenagers in their locales. Can you give the leaders more concrete examples of what programming you envision for the villages? Might it be helpful to share an experience map with them? Has your team fleshed out a few ideas for programming examples?
You mention that the leaders the team spoke with yesterday are officials in a slum area. How many people live in his parish? Can you describe the current situation there in regards to parents and work? Do both parents usually work outside the home and if so who currently cares for small children etc.? Are older siblings involved in caring for small children?
Looking forward to learning more!

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Hi Bettina! Since yesterday was more of pre-test of the tool, we have adjusted how the questions are asked and provided more specific explanations related to ECD.

I will post the findings from today later today or tomorrow. They should provide us with more information. But yes older siblings are involved in caring for small children!

More to follow...

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Hi Alex, Seeing Bettina's cool idea of sharing the experience map me me realize that it might be helpful if we could see a visualization of the network you're trying to build. A network of interaction map would let us see the key stakeholders in their relationship to one another.

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Yes I agree that would be very helpful as the project unfolds.
Maybe a flow chart using colors to identify specific groups. Also maybe a legend? So example - a chart on the corner of the flow chart of map that says - VHT = Village Health Team. Might make it easier to get a sense of the big picture. We can also then give feedback on how to focus on certain areas either to start with or perhaps that need clarification?
What do you think Dana?

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Hi all,

I think there are 2 important things here: mapping the different stakeholders (children, family, local governments, doctors, schools, etc.) and their connections; and mapping the experience journey of children and their family as they interact with the service offered by VHT. A map also of the VHT's team journey might be worth it. This second map focuses less on the system, and more on the experience. Yet, going through the different touch points of the experience will help define the system. Check out this map designed by ideo.org: https://s3.amazonaws.com/oi2-openideo-rwd-prod/attachments/2c911d636249657916fa23d17adb57358385faeb.pdf

For the system view, check: http://www.servicedesigntools.org/tools/28

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Team

Hi all. A-L this is well laid out. I think at this point in the project this is key.

Alex - The process of mapping will help you and your team on the ground learn where the idea has strength and where there are weak links at this point.
Visualizing it will help us on the virtual team help you.
The maps will also help you as you engage the stakeholders. Showing it to them will help them help you take next steps, and they might actually have ideas for prototyping.
Thoughts?
(Thanks for those links A-L - I am excited to check them out and learn from them myself!)

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Team

I'd add that as you're considering this mapping process you can be developing an idea of the rules of interaction across the network, thinking about the connections between the stakeholders not just as lines on a map but as lines that code a way of interacting. Some of those interactions might be more fundamental than others, and figuring out how to change the rules by which they connect can be helpful in determining how to leverage the system for better outcomes. For further on this: http://www.donellameadows.org/archives/leverage-points-places-to-intervene-in-a-system/

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Great post, Alex, thank you!

Very pleased to see a group-focused intervention that draws on the experience of parents and communities. Check out our team's idea on delivering group pediatric care here, would love your thoughts and comments: https://openideo.com/challenge/zero-to-five/ideas/we-need-to-deliver-group-pediatric-care

Also great to see the questions that drive the formative part of this project seek to understand what parents and communities consider healthy children and practices that promote health, what their hopes and worries are for their children. Understanding these nuanced, fluid, and plural beliefs and practices will be critical for designing the intervention in context, and for shaping a rigorous M&E framework that tracks not only quantitative measures (e.g. any anthropometrics, should that be a measure of interest), but also qualitative outcomes, such as the affect of the intervention on parenting techniques, and improved knowledge, self-efficacy, and uptake of social support, all of which may be more challenging to evaluate. Along these lines, what would you list as your primary outcome(s) of interest here?

I think long-term participant observation and extended field stays, as you point out, will be crucial for triangulating your findings, and focus group discussions also seem particularly well suited to assess parental and community perceptions of child wellness. A child may be “well” by evidence-based developmental milestones, but if parents do not feel validated in their care, or if they have other etiological concerns about wellbeing, a child may be “well” according to one standard and not another. Implementation research, as you point out, is critical here, fueled by PDSA cycles that engage the community as the drivers of CQI.

Can you also please describe the social marketing techniques you reference.

Thanks again!

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Thank you, David. Your thoughts are good and I will take them into consideration as I refine the idea. I am an enthusiast of community quality improvement and use of social marketing to accelerate social change is what I think would be important in getting the communities to take the lead in addressing the challenges they have for collectively bringing up healthier children.

I do like the idea of participant observation and extended field stays for triangulating the findings and to enhance learning and adaptation. I will include this piece in the update. I will also describe the social marketing approach we intend to use further.

Thanks David!

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Hi all. I am interested in this idea of using a PDSA cycle here. I attended an interesting workshop on PDSA cycle use in medicine this year. One thing that struck me was how one comes to the initial question. The importance of that question from the point of view of different stakeholders. The importance of the team. Who might be included on the team? What info/insights might be gained from the different team members?

Alex - In your post there are many questions being asked of the parents, the community. What questions/question do the parents want to ask of their own community, of themselves, of your team? Where do they want to start? What team would they put together to work on a common problem?

I found this really intriguing when I was at that workshop. I am curious about this process. I find PDSA challenging. (Just really learning about it's potential myself.) Have you had experience with using this process before?

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Hi Bettina! It seems we are thinking alike. I would like us to use Community Driven Quality or Community Action Cycle which use the concept of quality improvement to empower communities to better care for their children. So yes to the application of PDSA cycle.

Through this approach using continuous feedback from community teams or groups, we would learn what is working well or what is not working. The teams would come up with improvements to test, learn from them and continue to act.

I am hopeful this approach would help us come up with change packages which can be adapted across the world to get communities supporting ECD interventions.

In the tool I am working on, I will add a section which has questions which communities have for us and for the other community members.

Thanks for the great contribution.

David, did you have any different thoughts on this?

Thanks,
Alex

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Team

Hi Bettina! Here are some of manuals on community action cycle:

http://www.aidstar-one.com/sites/default/files/GoCommunities_English1.pdf

http://www.accesstohealth.org/toolres/pdfs/access_cmmnh.pdf

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Thanks Alex. I will have a look at the links.

I am curious - What is the first language of the families in these villages?
I read that English and Swahili are the official languages in Uganda but that there are many other indigenous languages. Is this correct? If so, what language do adults speak in the villages you are working with and what language do the children learn in in school?

Also - In your research post - "It Takes A Village" - there were many quotes from Community Health Workers talking about wanting to do more for the children and feeling frustrated as to what they were able to provide. Can you describe the educational background of these workers and what their role is in a village? Do they live in the village? Is there a central health center that they work out of? Do they provide health education and diagnose/treat ailments? Do they have contact and back up with other professionals - nurses/doctors - in larger centralized facilities? In the Women's Safety Challenge I recall reading about a large group of health workers in India who were trained in community work and also in how to communicate with back up. What is the baseline in the villages you are investigating? Will check out your Access to Health PDF above as well!
Thanks!

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Hi Bettina! Uganda has English as the official language. Adults and children here mainly speak Luganda as the local language. Children learn in English language at school.

Community health workers/village health teams are members of the village who are selected by the village members themselves to help them with provision of primary health care. These workers are actually volunteers affiliated and recognized by Ministry of Health. They are affiliated to the local health centres and hospitals that serve the nearby villages. They also provide some basic curative services such as malaria (minor), diarrhoea and ARI treatment using ICCM approach. Each village has an average of five of these volunteers.

They are well trained using Ministry of Health curriculum!

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Alex, do parents speak enough English to help their children with their school work if Luganda is the language spoke at home? What is the literacy rate of parents in the villages - in English? in Luganda?
Why are the health workers volunteers? Do they do other jobs as well? What is the ICCM approach? Thanks for the info.

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Team

Hi Bettina! The practice here is English is used at school but back home children speak local language and English (if parents can speak it). General literacy rate in Uganda is 73%.

I will send you the guidelines on community health workers separately. However, these are not qualified nurses or doctors; http://www.readbag.com/malariaconsortium-inscale-downloads-uganda-vht-strategy-and-operational-guidelines

See write on ICCM: http://www.malariaconsortium.org/userfiles/5-ICCM-in-uganda-background-and-process.pdf
https://www.k4health.org/sites/default/files/ICCM%20Implementation%20Guidelines.pdf

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Hi. Do any children learn in Luganda in primary schools? Seems it would be difficult to learn in a language you are unfamiliar with. I know this is an issue in Haiti.
How far are the local health centers from the villages on average and how does a family get to one? If a child is ill can a family get to a center at all? Who staffs these centers and can they provide urgent life saving care there? I guess what I am trying to find out is what is the system of care? What can actually happen medically in a village, and what are the next steps? Can families access care in a timely fashion when women are having complications during pregnancy, or when a young child is ill - or are these situations handled in the home with poor negative outcomes? Is transportation or a system of transport something you are reviewing as part of your plan?

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Hi All, These comments support my idea that taking an overall systems or complexity approach to this problem as you're doing through the continuing field work might lead to interesting results for other areas that are suffering the same plight. I wonder what the underlying commonalities will prove to be.

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Team

The temptation of pre-designing interventions for communities looks unavoidable but given the diversity and uniqueness in factors that affect child care, this idea makes sense as it aims at empowering communities to take charge of this development!

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Team

Alex, I understand the wariness about pre-designing interventions, but I also think these predesigns can be a useful way of articulating primary underlying rules of interaction (thinking in complexity theory terms). It might be helpful for the team you're working with to identify the key actors in the dilemma and the rules they traditionally use to solve these kinds of problems. Once we see that chain of rules of interaction, we might be able to develop some leverage points for transformation. For info on this see John Holland's Hidden Order or Meadows on systems (http://www.donellameadows.org/systems-thinking-resources/)

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The PPT attached on Bronfenbrenner's Ecological Model explains in details the concept of it takes a village to raise a child on which this idea is built.

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Team

Alex, Could you provide a link to this ecological model?

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Alex, check this idea https://openideo.com/challenge/zero-to-five/ideas/my-community-my-child-building-a-community-network-of-care-for-early-childhood-development
It is very complementary to your idea. There might be interesting learnings in sharing perspectives.

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Team

Thanks Anne-Laure! I will reach out to her and see how we can share ideas.

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Hi Alex! Take a look at this research post I put up. It is similar in tone to what you are suggesting. The work is being done by an organization however the professionals who work there, nurses, etc. are very much a part of the community. They take a holistic approach to human services. I had the opportunity to work with them when I was a doctor in that community. In many ways for me they were my eyes and ears into homes when I needed information on a child's asthma, or food security, issues around behavioral problems etc. They made the home visits and they are very welcome in many of the homes. They were then able to share information with me. They also were advocates for families when need be, calling me to let me know that a child could not tolerate a certain medication for example. They partner with organizations who measure their work/re: impact. Might be a good model to dig into a bit. Albeit in your idea the work would come directly from the community members.
https://openideo.com/challenge/zero-to-five/research/the-value-of-community-trust-when-providing-services-to-it

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Team

Hi Bettina! Glad to read from you again. You have been an inspiration in my journey here.

Your story is inspiring. Let the team here study the proposal you have put forward and see how to incorporate the idea into what we gained during the research phase in order to better define this preliminary idea.

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Team

Hi Alex. Great to hear from you as well. I am going to review your research again. I read it early on and had some questions and wonder if they might have been answered in the comments, since there are so many! Are you working with the team from the innovation center?
What I posted is not meant to be a proposal. I posted it as resource, as what an organization that provides multiple areas of support for children and families., which is what you are proposing. Correct? Does that make sense? (I added my experiences with them to show how awesome I think their approach is. They really partner with the community which I believe is how they are able to accomplish what they do.)

Did you ever connect with Beatrice?

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Yes Bettina, I am working with the team in the Innovation Centre. Actually we registered a legal not for profit "International Youth Empowerment Network(YEN)". Right now the team has a home in the suburbs of Kampala and started work two weeks ago. We have four core team members and four volunteer youth who are working in YEN now. We are taking it one step at time as we keep mobilizing resources to fully implement our dreams!

Yes, I meant the preposition in terms of the ideas you provided and not proposal.

No, Beatrice never responded to my request.

Thanks,Alex!

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Team

Perhaps Alex might add Bettina to his team of ongoing support? We love the idea of a doctor from New York collaborating with a switched-on crew of proactive prototypes in Uganda!

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Team

Thanks Meena. Will do so!

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Team

Hi Bettina. I am glad to have you on the team! How might you help us refine the idea? Thanks

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Thanks Alex. Will give it some thought and post.

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Team

Thank you Bettina! I will update the draft idea today as well.

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Team

Thanks Bettina!

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Team

Hi Alex. I'm noting that you're running 2 profiles (your own & the iYEN one) We're excited about ideas and comments from both – though some folks in our community might get confused. Here's a suggestion I'e picked up along the way – if you want to stay signed in as 2 logins on OpenIDEO, use 2 different browsers (eg. Firefox & Chrome) – noe for each respectively. Then all you need to do is post comments from the correct login & browser. Hope that helps :^)

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Team

Sori about that! Jamiru, Afra and Racheal at YEN are the activity leads for the three ideas that I helped put up for them. The team at YEN is now much more familiar with platform and have taken full charge. Thanks for heads-up.

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Hi Alex,
This project sounds interesting. You clearly feel passionate about it and have done a lot of qualitative research.
I agree with some earlier contributors on two aspects of your proposal:
1. moving forward, you could think about how to effectively engage stakeholders, key to the success of your programme. You might find it interesting to look at how Star Development approach this (link below)
http://www.stardevelopmentgroup.org/
2. you have outlined an enormous amount of focus group research. I would be keen to hear some concrete proposals of how you plan to action your mission statement.
A really great initiative so far. It sounds as though you're being very proactive!
Isabel

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Hi Isabel! Thanks for the feedback. I am working on the proposal to move the program forward. We are using the findings to refine our idea and come up with a more viable one. Thanks for the link, the work by Star Development is interesting and is in line with my direction of thinking for this program. I have learnt something from them.

Keep the great thoughts flowing in!

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It is such a shocking video! I can't believe this happening nowadays! Your project is well structured and have a huge potential! Good luck with progression!

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Team

Thanks Sanjana! Yes, indeed the video and the actions of the maid are shocking. Surprisingly, this happened near the place where our team has been interviewing community members from.

This event brings me to the question to this community: I know the challenge is focused on low income areas but in this scenario where there is a maid of low income background living taking care of a child whose parents are of high income status, how are we supposed to handle this situation?

I think one of the idea that should be posted and taken up is "Training maids on Early Child Development and providing SECURED stamp of quality to those who complete the training!"

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Team

Leigh, great to have you on the team once again. We had a great collaboration in Youth unemployment. Let's take the collaboration to the next level now!

Quinque, welcome on-board. Please share those great ideas to help the team refine this idea!

Anne-Laure, we had good collaboration during the research phase. Let's close the deal now and bring the idea to life!

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Team

Alex, sorry for the silence. I've been buried with work lately. Yet, I'll have a look this weekend and see how I can help. We will bring the idea to life! :-)

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Team

Thanks for adding me to the team. More soon,

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Team

Let's just do it, Anne-Laure!

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Incredible post Alex! The time and energy you've committed to this already is really inspiring - and it's fascinating to read through the project as it has progressed.

You mention communicating with district central government, which really intrigued me in relation to an area I have been thinking about a lot regarding this Challenge; underlying infrastructure, specifically internet access.
Have you heard about the Google Loon project? You might find it interesting!

http://www.google.com/loon/

Hope this help!

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Team

Thank you Quinque! The community here in OpenIDEO has been very helpful in seeing this idea evolve.

Yes, I take the infrastructural set up seriously because there are very many challenges children 0-5 years are faced with and there have been numerous programs set up to address them. However, not many of them have been successful in the long run. So I believe by working with community and government to understand how best to influence social change for ECD is important. Whereas this idea has focused on the structural piece of this journey, it is time now to better understand on the software piece of ECD. This is what I and the team will focus on this week. Our software piece is focused on educating caretakers and members of CCTs on ECD. We have somehow got some of the issues and we will work with the people to dig deeper into them:

"The role of the Educator is to present to the people in challenging form the issues they themselves have raised in a confused form", Mao Zedong


Oh the Google Project Loon looks incredible and would be helpful in reaching out many people without constant or no internet access at . Thanks for the link.

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Team

Thanks to Bettina, we will promote use of visuals to train caretakers on developmental milestones for their children:

https://openideo.com/challenge/zero-to-five/ideas/enhancing-learning-for-parents-with-visual-guides

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Team

You are awesome and this team is amazing!

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Team

Honestly I am humbled by what I am learning from the local government, local council leaders, village health team members,mothers, fathers and grand mothers regarding the concept of SECURED. Whereas they all agree the proposal is good, they are worried about the misconception of children's rights and the negative attitudes of adults to cooperate with others to help their children. The questions and concerns raised are helping us think further on how best the leaders could get supported to reach out to community and bring people together and talk about the proposed program!!

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Team

Hi Alex,
Great work on all the research and feedback. It's interesting to see how the program is being perceived by the community and what challenges they envisage. I noticed that efforts have been put into communicating with VHTs , LCs, parents and other interested parties, with a view to getting them involved in mobilizing the community. They pointed out concerns about the unwillingness of people to cooperate and crossing boundaries with children that are not expressly in their care. I am curious and wonder if the assistance of teachers would not be helpful in these circumstances. They enjoy advantages such as:
* already sharing a certain level of rapport with parents,
* spending time with the children and actually knowing them to some extent
*being directly involved in the education of the child and
*being in a unique position where they are allowed within boundaries(e.g the discipline of the child) where other parties are not

Discussions could seek to understand the following:
1. What do teachers expect of parents?
2. What do parents expect of teachers?
3. To what extent are parents willing to get involved in the education of their children and what are the constraints that prevent them from doing so?
4. How much do parents value the views/opinions of their children's teachers?

We could look into other questions but I think some of these might provide insights into the viability of teachers as a channel to reaching and mobilizing the community.

Keep up the good work!

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Team

Thanks Ese! During the research phase of this challenge, parents said teachers are role models for their children and would therefore be listened to.

Racheal specifically talked to teachers for the hand washing idea and I am sure we can learn from her. She will post the updates later today. We will consider following up with the questions you shared here depending on what she found out.

Thanks!

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Team

You're welcome. Looking forward to Rachael's updates.

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"Most of these children don’t have manners right from home thus. It’s hard to groom them from here, remember charity begins at home and the parents say that “omwana mukuwadde” so they abandon their children to the teachers when it comes to upbringing of these children", teacher explains.

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Team

"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", mother in Sebowa zone
"We would miss seeing our children grow up to be very social and interactive."

"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.
Personally I think that ensuring everyone in my community knew about community led early child development and contributed to promoting better caring practices for all children zero to five would be hard because we were all raised differently and changing someone’s thinking when they are all grown is very difficult.
We also have to use role models in the community to pass on the information.
VHTs play an important role in the community because they are the first people who we go to for help when our children fall sick", FGD in Sebowa zone!

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Team

"People these days are selfish and greedy if I may say in that they don’t want to share but such a program would be a good one and would bring about unity in the community because if we are all to be responsible about our children then by all means we have to act as one", FGD in Kiwologoma!

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Team

"Children learn some things from doing them with their peers or from watching someone do them. These things would include some that the parent does not do and so our children would miss that if the community led early child development program isn’t implemented", respondent in Kiwologoma!

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Team

I am sharing feedback I received from https://openideo.com/challenge/zero-to-five/ideas/we-need-to-deliver-group-pediatric-care

"Scott Halliday November 17, 2014, 02:17AM"

Hi Alex! I'll try to chime in here with some of our experiences in Achham, Nepal. Note- I love the honesty and openness with which you're updating your experiences on your page.

I think one point to emphasize when forming groups, regardless of whether the goal is to foster dialogue about community involvement in promoting early child development or to deliver group pediatric care, is that no one is trying to step on the toes of parents. The community is not trying to replace the parents. Rather, how can we learn from each other?

In our case, we work with the Government of Nepal, specifically Nepal's network of Community Health Workers (CHWs), referred to locally as Female Community Health Volunteers. These CHWs are a vital link in assessing local patterns of healthcare resort, understanding the healthcare landscape of their communities, and promoting collaboration between program implementers and local women. This also underscores one of our principles, which is to work in a public-private partnership to do this. NGOs and non-profits can achieve success working in isolation or in tandem with other organizations. But working in partnership with the government bolsters those relationships.

I hope that's helpful to you. Please reach out if you have more questions or ideas. Keep up the great work!


"Interesting conversation about community involvement guys.

As to the concerns you raise Alex from your conversation with the leaders you have been having dialogue with one suggestion I have is to go to the community itself. Can you go to a marketplace, a health center, or a church and invite the community to a meeting where you can openly discuss your ideas? In my experience the group that show up to events like these is self selected - they are the ones who will be interested, or at least curious, in the topic you have brought to them. Are there other examples of community cooperation in Uganda? Examples of neighbors helping neighbors, sharing of resources?

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Team

"I would move down to LCs and also talk to them to help in mobilizing their people. Since this program would be implemented in communities, the LCs, VHTs and other health workers would help a lot.
I wouldn’t go down to the communities personally because wouldn’t listen to me as they would their LCs or even VHTs.
VHTs and LCs play an important role in the community of mobilizing the community and keeping the community aware of anything new at all times. The VHTs also diagnose and treat uncomplicated diseases which reduce on the congestion in health facilities", health inspector

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Team

See the detailed write up on the findings from the key informant interview with local council I chairperson of Balintuma village in Kiwatule parish in Kampala City. I am not surprised that this chairperson perceives resistance from the village members towards the program he perceives as being good. Our team will continue talking with more people from this village to dig out more information and ascertain what this informant is saying!

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Team

Yes. keep visiting and talking politely. Possible fear of the 'unknown'? this can be overcome through cordial dialogue, persuasion and perseverance .

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Team

Thanks John. We plan to do just that. We will talk to mothers and fathers of children 0-5 years and village health volunteers from four villages--two in Kampala and two in neighboring Wakiso district. This will give us better insights on their perceptions.

As the idea indicates social mobilization takes lots of dialogue and we hope we will understand how to get the dialogue moving. For instance, this chairperson seems frustrated that he is not getting the required support from the people he leads. This is a good starting point as he is their leader who is often listened to.

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Team

Ok Alex. By the way are elections nearby? that someone sees a frustarting competition in that course? or watch out if your team ever neglected /failed to observe some 'key protocol' in that county? YOU'D KNOW THIS BETTER as you are in the field. All the best.

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Team

John, national elections are due in 2016! We have heard of some local council I chairpersons losing credibility in villages but we will not settle for less. We are convinced the village has solutions to the ECD challenges and we will triangulate everything to the dot til we understand how best they can support themselves!

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Hi. Please help us to fill our survey question below here. Thank you in advance
Does a parenting kit with simple guidelines on how to practice best parenting skills during first five years of child development milestones (in form of DVDs or printed templates) would provide opportunities to parents in low-income communities accessing parenting skills information?
Please answer YES on NO
If YES why?
And
If NO why?
To see the IDEA follow this link: https://openideo.com/challenge/zero-to-five/ideas/first-five-years-parenting-kit

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Team

Yes, but with variation in uptake. It may be impractical in rural areas...

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Team

Yes. especially to urban communities where a video player + electricity are accessible.
Yes. Provided that content is well planned to attract attention of target parents...
Moms with infants are BUSY...and ...try hard to balance a lot of activities around them. A DVD 'd be a really appealing piece of work really able to pull one from the baby ...
Yes. Provided the LANGUAGE is understandable...

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Team

Thanks for the chance to be on board SECURED.

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Team

i'D Like to learn from experiences out there in Uganda, when it comes to community engagement, parents may be strongly bound to a common interest to see that, say, a village school, dispensary or market succeeds. These service units have direct impact on individual families or households. BUT the salaried staff working in at village level may not demonstrate equal empathy, or enthusiasm to community initiatives, unless there is a 'significant push' from above i.e. higher order government structures. Do you experience a similar gap out there? How best are you handling this?

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Team

John, we are experimenting with urban and rural areas. This will enable us understand the issue you raised about salaried individuals. We will a get a better picture at the end of this week when we conduct the interviews and discussions! Will keep you posted!

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Great. Thanks Alex.

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Congrats on this post being todays Featured Contribution!

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Team

Thank you OpenIDEO management for featuring this idea!

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Team

Hi Alex, lovely idea you've got here. Perhaps our ideas could feed off each other; would be nice to see where that leads. Looking forward to hearing from you.

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Team

Hi Ese! Thank you for checking out the idea. Yes, let's discuss how to make the two ideas feed into each other. Collaboration is great!

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Team

I am excited to have Dr. Bettina join the team. Bettina's research: https://openideo.com/challenge/zero-to-five/research/the-value-of-community-trust-when-providing-services-to-it is falls very well within this idea. How may we marry the two ideas and promote a model that will create lasting solutions to child care in Uganda?

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Team

Sounds great, Alex – and hopefully something that you can start to prototype during our Ideas phase (more tips: http://ideo.pn/pr0t0type) Would also help us if you could answer the questions at the bottom of your Ideas submission form. We're excited to learn more and to hear about what you learn as you begin to test this idea!

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Team

Hi Meena. Thanks for the tips. I have updated the idea and answered all the questions!

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Team

Nice one, Alex. As you evolve your idea + post, it might be a good thought to lead with a really tight description in the Summary section and then get into the details and rationale down in the Description section.

We'd encourage you to think about is how you might update your Summary section (text above the image gallery) to encapsulate what your idea actually entails briefly and clearly.

Here's a template if you need some help, though feel free to come up with your own clarifying sentence structure.

Our idea is a_________________ [campaign/app/service/program/online platform/toolkit/social enterprise/etc.] that tackles the problem of _____________[the issue being addressed ] by __________[what your idea looks like in practice].

See some Summary examples from the Amplify Team on a previous challenge here: https://openideo.com/challenge/womens-safety/shortlist

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Team

Might also be interesting for you to sketch out / visualise the process and upload that to your image gallery? We're excited to see what you come up with!

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Team

We also think your idea could benefit from joining discussions on this idea: https://openideo.com/challenge/zero-to-five/ideas/pre-school-community-led-initiative Given collaboration is the name of the game here at OpenIDEO, we hope you might reach out and collaborate to grow each other's concepts. Innovtaion loves company!

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Team

Thanks Meena. We are working on the suggestions you have made.

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Team

Here's another concept you might join discussions on: https://openideo.com/challenge/zero-to-five/ideas/synergy-between-home-and-school-sustaining-the-environment-that-helps-children-succeed

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Team

Thanks Meena. I will check it out!

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Team

Thank you OpenIDEO community for your useful comments. They are helpful in refining the idea. Looking for more of them!

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Team

Halo Alex.. Am loving your line of though on leveraging on community as a platform of engagement I have a solution that works around schools as communities kindly check out
https://openideo.com/challenge/zero-to-five/ideas/community-empathy-maps ..

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Team

Hi Wekesa! Great idea you got there.

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Team

Hi Alex! Will your research draw on work by Banerjee & Duflo in any way?

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Hi Michael! Could you please share the link to Banerjee and Duflo's reports? I would be happy to learn what they did! Thanks

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Team

Sure -- I highly recommend reading Banerjee and Duflo's book, Poor Economics (it's on Amazon). Lots of their work looks at the behavior of the poor. E.g.:

https://www.minneapolisfed.org/publications_papers/pub_display.cfm?id=4785&
http://economics.mit.edu/faculty/eduflo/papers

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Team

Thanks Michael!