ECD Endline Evaluation Report

Endline study on Early Childhood Development (ECD) in Sustainable Comprehensive Responses for Vulnerable Children and their Families (SCORE) project

Contents 1.

Executive Summary................................................................................................................................ 3

Abbreviations and Acronyms ......................................................................................................................... 5 2.

Introduction ........................................................................................................................................... 6

3.

Objectives and scope of the Evaluation .................................................................................................. 6

4.

Methods and Procedures ........................................................................................................................ 6 4.1

Study Design .................................................................................................................................. 6

4.2

Participants and study sites: ............................................................................................................ 6

4.3

Sample Size: ................................................................................................................................... 7

4.4

Data Collection procedure.............................................................................................................. 7

4.5

Ethical consideration ...................................................................................................................... 7

5.

Results ................................................................................................................................................... 8 5.1

Socio-demographic characteristics of the caregivers ....................................................................... 8

5.2

Results on the child based thematic growth areas ....................................................................... 9

5.3

Knowledge about ECD: ............................................................................................................... 19

5.4

Childrens particpation in ECD interventions ................................................................................ 21

5.5

Understanding the challenges in ECD facilities ............................................................................ 22

5.6

What should we “take home� o ECD........................................................................................... 23

6.

Discussion of findings .......................................................................................................................... 25

7.

Limitations ........................................................................................................................................... 25

8.

Conclusion ........................................................................................................................................... 25

9.

Recommendations................................................................................................................................ 26

10.

Appendix A1: STUDY TOOLS ....................................................................................................... 27

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List of Tables Table 1 Summary of Interviews by Region and category ................................................................................. 7 Table 2: FGD participants by marital status.................................................................................................... 8 Table 3 FGD participants – number of children ............................................................................................. 9 Table 4 Showing varying participant key messages between baseline and end line......................................... 23

List of Figures Figure 1: Graph showing children interviewed............................................................................................. 9 Figure 2: Graph showing child scores along the different themes at baseline 2016 ................................... 10 Figure 3 Graph showing child scores along the different themes at end line 2017......................................... 10 Figure 4 Additional comparative graphs Communication ............................................................................. 11 Figure 5 Additional comparative graphs Gross Motor ................................................................................. 12 Figure 6 Additional comparative graphs Fine Motor .................................................................................... 14 Figure 7 Additional comparative graphs Problem solving ............................................................................. 15 Figure 8 8Additional comparative graphs Personal social ............................................................................. 17 Figure 9 Graph showing overall scores at baseline and end line .................................................................... 18 Figure 10 Graph showing Knowledge about ECD ....................................................................................... 19 Figure 11 Graph showing Components of ECD .......................................................................................... 20 Figure 12 Graph showing qualities of a good ECD facility ........................................................................... 21 Figure 13 Graph showing challenges of existing ECD Facilities in the community ....................................... 22 Figure 14 Graph showing how to respond/ approach these challenges ........................................................ 23

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1. Executive Summary This report presents results of the end line evaluation of the Sustainable Comprehensive Responses (SCORE) for Vulnerable Children and their families ECD program. SCORE is a seven-year, USAID-funded project implemented by a consortium of partners led by AVSI Foundation.

SCORE’s ECD program was a pilot initiative implemented within the existing activities within 6 of the 23 districts. The ECD program was implemented utilizing the Community Play group (CPG) model that includes children under 6 and their parents meeting weekly in a safe space identified and provided by parents. The CPG is led by a trained care giver/facilitator who on a weekly basis meets the children and parents for about two hours and utilizes various approaches including play, storytelling, games, dance, singing, sports, to be able to cover various themes. The caregiver is provided a community play group guide developed by AVSI which he/she then uses to guide his sessions. Following implementation of the pilot initiative for one year which was preceded by an extensive baseline study, the project conducted an end line study which is duly represented in this report. The report covers; the summary, methodology, findings, ethical considerations, limitations, conclusions, recommendations and an annex with the tools used.

Evaluation Objective: To determine the results of the SCORE ECD program at child, parent/caregiver, and facilitator/community level Methods The evaluation utilized a quantitative and qualitative comparative approach in which primary endline data was collected and analyzed in comparison with data collected at baseline. Primary data was collected from a randomly selected household-based sample of children attending the SCORE weekly community play groups and a purposive sampling of parents/caregivers and CPG facilitators was employed to be able to interview relevant people. All the six districts were AVSI implements ECD were sampled reaching 300 individuals out of whom 75 were children and their 75 parents (65% out of the 115 interviewed at baseline), 150 caregivers/parents and facilitators interviewed through FGDs. The data collection was conducted in December 2018 Findings Both the quantitative and qualitative surveys proved that there is demonstrable knowledge about ECD among parents/caregivers, community leaders and other key stakeholders. Majority of respondents cited and appreciated the AVSI community play group model as the only existing one in their community. They recommended some areas for improvement including, providing food, increasing play and other scholastic materials in addition to improving the infrastructure in some of the CPGs to include adequate water, sanitation and hygiene facilities and inclusive space. Overall children attending the CPGs score fairly well for their age in the thematic areas of communication, gross motor and personal social skills while the areas of fine motor and problem solving require specific focus as more than half of them were below cut off.

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Conclusion The end line study provides an overview of the largely positive changes between baseline and end line on 5 main domains of communication, gross motor, fine motor, problem solving and personal – social for children. The end line also provides great insight on how the community perception and knowledge around ECD has significantly improved. This is also further shown through a more refined response elicited by community members on the key challenges around ECD and the possible areas for improvement. Overall, the study found a great improvement in ECD interventions as further detailed in the report. These findings provide a good case for implementing CPGs in low resourced settings as shown through AVSI SCOREs interventions targeting children from vulnerable households and communities.

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Abbreviations and Acronyms ASQ OVC ECD CPGs LC LG CBT CDO WASH FGDs SCORE USAID

Ages and Stages Questionnaire Orphans and other vulnerable Children Early childhood Development Community Play Groups Local Council Local Government Community based Trainer Community Development Officer Water, Sanitation and Hygiene Focused group Discussions Sustainable Comprehensive Responses (SCORE) for Vulnerable Children and their families United States Agency for International Development

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2. Introduction AVSI Foundation through its USAID Funded Sustainable Comprehensive Responses (SCORE) for Vulnerable Children and their families in 20161- incorporated a component of Early Childhood development activities into their program. The main goal of the SCORE ECD activities is to build the capacity of parents and other caregivers to fulfill their parenting obligations and ensure that children under 5 are safe and protected in the community. The ECD activities used within the program are community play groups and ECD center grouped based activities. The implementation is being done in 6 of the 23 implementation districts of SCORE (Amuru, Nwoya, Mukono, Buvuma, Sironko and Busia). At the start of the initiative, SCORE conducted a baseline assessment to provide guidance on how to better model ECD activities to suit the target group and to understand community perceptions around ECD. Following targeted and responsive implementation of the ECD intervention for a year, the project has undertaken an end line study to provide a comparative picture between baseline and end line and to especially provide a picture of the ECD effect on individual children and their parents and communities. Similar to the baseline, the end line study was conducted utilizing; primary data through FGDs, and child interviews (traced from baseline) using the Ages and Stages (ASQ-3) focusing on children at 60 months (5 years).

3. Objectives and scope of the Evaluation The evaluation sought to profile the ECD end line parameters within the 6 districts where SCORE piloted the ECD intervention. Specifically the evaluation responded to the following sub areas and questions:  Knowledge about ECD: What is ECD and what are its components?  Access and Inclusion of existing ECD activities: Are your children participating in the existing ECD activities in your community?  Understanding the challenges in the current ECD facilities in the community: What challenges exist if any in the ECD activities in your community?  Generating areas of interest, lessons and opportunities from the SCORE ECD CPG, gathering ideas for strengthening or improving existing ECD facilities: what can be done to strengthen/ improve existing ECD facilities in your community?

4. Methods and Procedures 4.1 Study Design The study utilized a mixed comparative quantitative and qualitative design. Both quantitative and qualitative data was collected and analyzed.

4.2 Participants and study sites: Primary data was collected from the cohort of households2 that were interviewed at baseline. These households had children participating in CPGs. Similarly, parents and facilitators were purposively 1 2

In 2016, SCORE project was extended for 2 years, and a pilot ECD initiative introduced in the project scope During baseline, these households and children were randomly selected

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sampled to match the exact same parents interviewed last year, even though a few of the participants were randomly selected and had not participated in last year’s FGDs. The study utilized the KIIs and FGD interviewees.

4.3 Sample Size: Structured interviews using the ASQ-3 targeting children 60 months (5 years old3) were conducted with a sample of 75 children and their caregivers/parents (making a total of 150 interviews). Besides the structured questionnaire, 12 focus group discussions were conducted reaching 150 additional parents and facilitators with males (30) and females (120) separately from among caregivers, facilitators who attend/ participate in the SCORE ECD program in each of the 6 districts. The FGDs were conducted in local languages and audio recorded. Table 1 gives a summary of the number of interviews conducted per district for a total of 300 individuals Table 1 Summary of Interviews by Region and category Region

FGDs

District Female

Central North East

Buvuma Mukono Amuru Nwoya Busia Sironko

Total

Male 18 18 28 7 35 14 120

0 1 6 5 10 8 30

Survey Interviews Caregivers Children F/M Female Male 16 7 9 8 2 6 12 6 6 0 0 0 20 11 9 19 8 11 75 34 41

Source: Fieldwork data 4.4 Data Collection procedure Structured interviews using the ASQ-3 (60 months) were conducted with caregivers and children in selected households within the community play group facilities/areas by a team of trained enumerators. In addition, the team conducted FGDs with a sub-sample of parents and facilitators to elicit in-depth information relating to the effect of the ECD. 4.5 Ethical consideration Both verbal and written consent was sought from all the respondents; caregivers also on behalf of their children under 5 years for the ASQ-3 questionnaire and from individuals in the FGD and the KIIs. During the study, the team did not encounter any individuals who declined to participate, instead several individuals wanted to participate even if the sample sizes and specific sub targets 3

Since these were the same children interviewed last year at the start of their 60 months, most of them were th st found a year later at the end of their 60 month or a little above – at the start of their 61 month

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were already found. The interviews were conducted in the local languages, Luo, Luganda and Lugishu except in very few cases where the respondents were preferred to be interviewed in English.

The confidentiality of the respondents has been maintained throughout the data management analysis and report writing.

5. Results The structured ASQ-3 (60 months) evaluation questions were analyzed quantitatively, while the FGDs were analyzed using the qualitative analysis model. Quantitative analysis reports from the ASQ-3 (60 months) shows the differences among children and among the domains; communication, gross motor, fine motor, problem solving, personal social and overall. These were further compared to the baseline data to establish the parameters that changed.

5.1 Socio-demographic characteristics of the caregivers Below are tables summarizing the socio-demographic characteristics of FGD participants respondents interviewed in the end line study.

Majority of the caregivers were married (81%), followed by those single (17%), and 2% separated.

The average number of children per participant was 5.

Table 2: FGD participants by marital status Marital Status

Count

Married Single Separated Total

122 26 2 150

Source: computations from survey data 2, 2%

FGD particpants marital status

26, 17%

122, 81% Married

Single

Separated

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Table 3 FGD participants – number of children Variable Number children

Mean (SD)

Min

Max

5

3

7

of

Source: computations from survey data Figure 1: Graph showing children interviewed

Total children interviewed by gender 80 70

# of children

60 50 40 30 20 10 0 Total # Interviewed # Female Interviewed # Male Interviewed

Amuru 12 6 6

Busia 20 11 9

Buvuma 16 7 9

Mukono 8 2 6

Sironko 19 8 11

Total 75 34 41

75 children were interviewed. 45% of the children interviewed were female and 55% were male.

Busia District registered the highest number of female (11) while Sironko district registered the highest number of male(11) interviewed. Mukono district registered the least number of female interviewed (2). The least number of male interviewed were from Amuru and Mukono district (6 each respectively).

5.2 Results on the child based thematic growth areas Utilizing the ASQ-3, 75 children and their caretakers were interviewed using child interview techniques following the consent of their caregivers. Children’s growth was assessed and graded into three categories; above cut off, below cut off and close to cutoff along five main themes; communication, gross motor, fine motor, problem solving and personal –social. Below are graphs showing child scores along the different themes comparing generally baseline against end line.

Additional graphs are provided comparing baseline and endline for each of the domains across the 9

three categories on above cut off (most desirable), followed by close to cut off (fair) and below cut off (least desirable).

Figure 2: Graph showing child scores along the different themes at baseline 2016

%ge of children

Baseline combined theme score and results (%) 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Communication

Gross Motor

Fine Motor

74% 10% 16%

78% 10% 11%

40% 43% 17%

Above cuttoff Below cuttoff Close cuttoff

Problem Solving 27% 46% 27%

Personal -Social 67% 15% 18%

Figure 3 Graph showing child scores along the different themes at end line 2017

Endline combined theme score and results (%) %ge of children

120% 100% 80% 60% 40% 20% 0%

Communicati on Endline Above cuttoff 92% Endline Below cuttoff 4% Endline Close cuttoff 4%

Gross Motor

Fine Motor

100% 0% 0%

84% 9% 7%

Problem Solving 76% 8% 16%

Personal Social 96% 3% 1%

A key similarity with an even better improvement is the gross motor skills area that had the best scores with 78% of children scoring above cutoff point at baseline and currently all children are at 100% above cut off point. This has been the areas with the greatest improvement.

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The next area, registering the greatest change has been on personal social where 96% scored above cut off compared to 67% at baseline. Only 3% were now below cut off as compared to 15% at baseline. Similarly, the thematic area on communication had 92% above cut off compared to 74% at baseline. Only 4% are still below cut off compared to 10% at baseline.

At baseline, the two domains that were found with the worst scores were; fine motor skills had 40% of children above cutoff and problem solving with only 27% of children above cutoff. At end line, while these are among the areas with least performance, they registered significant improvements with fine motor skills at 84% from 40% of children above cutoff and problem solving now at 76% from 27% of children above cutoff. The project team worked hardest on these areas to ensure that children could attain the above cut off in these domain and indeed it has resulted into an enormous change.

Figure 4 Additional comparative graphs Communication

Communicaton close to cut off

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

92% 74%

%

%

Communication Above cut off

Communication

Baseline Above cut off

74%

Endline Above cuttoff

92%

Basline Close cuttoff Endline Close cuttoff

Communication below cut off 12%

10%

10%

%

8% 6% 4%

4%

2% 0% Baseline Below cuttoff Endline Below cuttoff

18% 16% 14% 12% 10% 8% 6% 4% 2% 0%

Communication 10% 11 4%

16%

4%

Communication 16% 4%

Figure 5 Additional comparative graphs Gross Motor

Gross Motor Above cut off 120% 100%

%

80% 60% 40% 20% 0%

Baseline Above cut off Endline Above cuttoff

Gross Motor 78% 100%

12

Gross Motor Close to cutoff 12%

%

Gross Motor below cut off

10%

10%

8%

8%

6%

%

12%

6%

4%

4%

2%

2%

0%

0% Baseline Below cuttoff Endline Below cuttoff

Gross Motor 10% 0%

13

Basline Close cuttoff

Gross Motor 11%

Endline Close cuttoff

0%

Figure 6 Additional comparative graphs Fine Motor

Fine Motor Close to cutoff

Fine Motor Above cut off 90%

18%

80%

16% 14%

70%

12%

60%

10%

%

%

50%

8%

40%

6%

30%

4%

20%

2%

10% 0% Baseline Above cut off Endline Above cuttoff

0% Fine Motor

Basline Close cuttoff Endline Close cuttoff

40% 84%

14

Fine Motor 17% 7%

Fine Motor below cut off

%

50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0%

Fine Motor 43% 9%

Baseline Below cuttoff Endline Below cuttoff

Figure 7 Additional comparative graphs Problem solving

Problem Solving Above cut off 80% 70% 60%

%

50% 40% 30% 20% 10% 0% Baseline Above cut off Endline Above cuttoff

Problem Solving 27% 76%

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Problem Solving Close to cutoff

Problem Solving below cut off 50%

30% 25%

45% 20%

40% %

35%

%

30% 25%

15% 10%

20% 5%

15% 10% 5% 0%

Baseline Below cuttoff Endline Below cuttoff

0% Basline Close cuttoff Problem Solving Endline Close 46% cuttoff

8%

16

Problem Solving 27% 16%

Figure 8 8Additional comparative graphs Personal social

Personal Social Above cut off

Personal Social Close to cutoff

120%

20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0%

100%

60%

%

%

80%

40% 20%

0%

Personal -Social

Baseline Above cut off Endline Above cuttoff

Basline Close cuttoff Endline Close cuttoff

67% 96%

Personal Social below cut off 16% 14% 12%

%

10% 8% 6% 4% 2% 0% Baseline Below cuttoff Endline Below cuttoff

17 Personal -Social 15% 3%

Personal -Social 18% 1%

The last area of assessment was based on additional eight overall parameters including; hearing, talking, understanding things, walking and running, family history on hearing, vision, behavior and other medical problems. The following graph shows the baseline and the end line findings for all children with an attempt to compare what changed between baseline and end line. Changes in some parameters are related to the integrated service approach that the SCORE CPGs took on – often ensuring that health and other critical services are provided to respond to the gaps found at baseline and any emerging challenges that children experienced during the year.

Figure 9 Graph showing overall scores at baseline and end line

Additional evaluation areas of concern 3%

Other Concerns

24%

7% 12%

Concerns about behavior

21%

Any medical problems Concerns about vision

10% 0%

Family history of hearing impairment

35%

23%

17%

Walks, runs, and climbs like other children

99% 98%

Others understand most of what your child says

99% 97%

Understand most of what your child says

99% 98%

Talks like other Children his age

99% 97% 100% 97%

Hear Well 0% Endline -Yes

20%

40%

60%

80%

100%

120%

Baseline - YES

Overall, there has been a change in all domains towards the positive for particular aspects that could change even though most changes have been minimal. Overall, other concerns have reduced form 24% to 3% showing perhaps an increase in attention for children needs. Concerns about behavior have also changed from 12% at baseline to 7%. Children with medical problems have changed from 35% to 21% making the link with the program effort to extend health outreach services to CPGs. The main area that worsened and requires specific follow up and immediate intervention is on concerns about vision which worsened from 10% to 23%.

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5.3 Knowledge about ECD: 5.3.1 Knowledge about ECD In comparing participants overall knowledge on ECD, the study found a great change with participants eliciting more refined responses attesting to the increased dialogues held targeting parents and community members to provide important information about ECD. While responses at baseline were reflective of some knowledge on ECD, end line responses were more solid and varied less among respondents Figure 10 Graph showing Knowledge about ECD

Knowledge about ECD

7%

About children’s rights and freedom Knowing who a child is, giving knowledge to children, teaching them to know what is right…

14%

Where children are taught how to be active through games or playing and parents brought…

21%

Helping a child grow well, with proper wellbeing, nuturance, good health/mental health

29%

Taining given to children age 0-5 years to mould them and provide a great stimulated start to…

29% 0%

5%

10%

15%

20%

25%

30%

Respondents indicated that ECD involved molding and training given to children age 0-5 years to help them to start primary with the right stimulation. They mentioned that part of the training involved; knowing their body parts, and knowing how to associate with each other. Respondents also mentioned that it generally meant helping a child to grow well, with proper wellbeing, nurturance, good health/mental health, and actively participative in playing 5.3.2 Knowledge about the components of an ECD intervention With regard to knowledge on the components of an ECD intervention, unlike at baseline where fewer components were mentioned, respondents this time had a wider variety of aspects that they considered as important components of an ECD services. There was also more inclination towards identifying multi-sectoral items, an indication of the programs responsiveness and introduction of the aspect of integration in compliance with the national integrated early childhood development policy and plan. Parents ranked adequate clean WASH facilities, play promotion and available space as well as feeding as main components of an ECD intervention. These are further detailed in the graph below

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Figure 11 Graph showing Components of ECD

Knowledge of ECD Components Availability of furniture

1%

Immunization and provision of birth certificate

1%

Equipment and materials for children with special needs

1%

Scholastic materials

4%

Trained caregivers

4%

Safety including fencing

5%

Regular attendance of children

5% 8%

Availability of enough playing materials Help children self- discover, learn how to speak and share

9%

Physical, Spiritual and psychological growth

9%

Enough space (Shelter, classrooms, storage, kitchen)

11%

Availability of food/feeding

11% 13%

Play grounds and promotion of play, story-telling and‌

16%

Adequate, clean WASH facilities 0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

5.3.3 Knowledge about the qualities of a good ECD intervention Participants indicated that the qualities of a good ECD facilities are various and ranked the presence safe and clean WASH facilities, a caring and loving caregiver/ facilitator and safe, spacious facility with playing space that is secure and with a child friendly as the highest.

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Figure 12 Graph showing qualities of a good ECD facility

Knowledge about ECD: qualities of good ECD facilities Should have first aid kits

1%

Should be nearer and accessible

1%

Should have adequate furniture (desk, tables, chairs,…

1%

Should be registered and regularly monitored

3%

Should enhance spiritual growth of psychosocial growth…

4%

Should bring parents, children, and teachers together

5%

Provide feeding and refreshments

8%

Should have adequate playing materials (toys)

9%

Should have adequate scholastic materials (books, pens,…

9%

Should have adequate classrooms and shades

11%

Should have safe, spacious playing ground

14%

Presence of well trained ,caring, loving, kind, friendly and…

15%

Presence of adequate, clean & safe WASH facilities…

18%

0%

2%

4%

6%

8%

10% 12% 14% 16% 18% 20%

5.4 Childrens particpation in ECD interventions 81% of participants reported that their children were attending ECD facilities around their community. They pointed out towards the AVSI Community Play groups Childrens particpation in ECD activities mainly.

Not all (some) 19%

Yes 81%

Yes

Not all (some)

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5.5 Understanding the challenges in ECD facilities Participants pointed to different challenges including; Inadequate and unsafe classrooms, learning and play space, insufficient training/playing materials, irregular attendance of children and fairly low participation of parents, lack of food and refreshment as main issues. Respondents were also asked to provide some ideas and strategies that could be employed to respond to these challenges and they indicated among others; sensitize parents to support and participate more with their children, providing scholastic materials (uniforms, books, pens), providing more learning/playing materials, constructing a learning space, enrolling all children (no segregation: project or age) and improving WASH facilities (clean water, toilets, rubbish pits, first kits). These are all presented in the graphs below.

Figure 13 Graph showing challenges of existing ECD Facilities in the community

Challenges affecting ECD activities 2%

Difficulty in managing children (Children come with bad…

Lack of facilitation/motivation for facilitators

3%

Bad weather (heavy rain)

3% 5%

Too young children - who cant walk to the centre/…

5%

Lack of scholastic materials (Uniforms, books, pens, etc)

6%

ECD Targets project children Poor WASH facilities

8%

Low teacher children ratio

8% 12%

Lack of food and refreshment

12%

Irregular attendance of children and low participation of…

14%

Insufficient fund to buy all necessary training/playing…

23%

Inadequate and unsafe classrooms, learning and play space 0%

5%

22

10%

15%

20%

25%

Figure 14 Graph showing how to respond/ approach these challenges

Improving ECD activities Exchange visits (tours) among children of…

2%

Provide continuous supervision

3%

Place a poster/ sign post for the centre

3%

Early preparation for ECD programs (Involving…

3%

Improvement in the relationship between parents…

5%

Improve safety of children (fencing play spaces)

5%

Enroll and training more facilitators

5%

Provide food and refreshments for children

6%

Additional motivation, allowances, and transport…

6%

Improve WASH facilities (clean water, toilets,…

8%

Enrol all children (no segregation: project or age)

8%

Construct more classrooms (learning space)

11%

Provide more learning/playing materials

12%

Provide scholastic materials (uniforms, books,…

12%

Sensitize parents to support & participate more…

12%

0%

2%

4%

6%

8%

10%

12%

14%

5.6 What should we “take home” o ECD This section was particularly asked to respondent to be able to further ascertain the level of importance they attach to ECD activities, the level of knowledge and importantly any changes that parents have noted about the SCORE ECD Community Play group model. These messages when compared with respondents thoughts at baseline vary significantly with end line responses being more ECD oriented and often eliciting the changes the program brought as opposed to mainly “complaints and requests” captured at baseline. These have been placed in comparative table below

Table 4 Showing varying participant key messages between baseline and end line

End line Baseline  “ECD is very important in caring for  SCORE should engage the DEO to children, parents should send their children supervise/support ECD CPG and centre to ECD”. based facilities  “My child can now relate well with other  Parents are happy about the ECD facilities children. ECD taught them how to play as they engage with their children more and with one another”. feel that their children are much happier 23

 “My child can now count from 1-10. ECD taught her well”.  “My child can now write her name after attending ECD activities”  “My child’s self-esteem is developed. He is not now timid and can now stand in front of his fellow children with confident.

Thanks to ECD”.  “My child can now do what he could not do before joining ECD”  “Parents lets welcome the ECD facilities, support teachers and monitor growth of our children. The facility has really helped my family.”  “ECD is good foundation for children and prepares them for the future”  “ECD creates good relationship between parents and the children and enlightened/empower parents on how to handle their children in terms of care/support of education”.  “ECD has helped & enabled children to share with others and be patient always. It shapes children in terms of behaviour change and discipline”.  “ECD has built good relationship in my family. I can play with my children and there is love”.  “ECD improved general behaviour, skills, general hygiene and health of children in the community. Parents should send their children to ECD.”  “Encourage parents that have not yet discovered the important of ECD to give time and include their children because doing so, will help them learn what to do as parents and how to relate with their children“.  “ECD activities are important in the mental development of children. Parents should not wait for AVSI to provide everything.

They should support the feeding of the children at ECD, creating of local play materials, and support facilitation of teachers”.

     

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Men should be encouraged to participate more in the program and involved in child up bringing Nearly all respondents appreciated AVSI for the support in the area of ECD Parents should be sensitized on hygiene maintenance Increase the number of days to twice a week Consider other ECD activities like tours, hold Christmas and other celebration parties for children Consider setting up an ECD facility in other villages as well like; Turudakatuba Amuru and in Nakisunga

6. Discussion of findings The evaluation sought to establish the ECD end line characteristics at child, parent/caregiver and community level in the 6 districts where AVSI implements the community play group ECD model in comparison to the baseline findings and provide feedback on the effects of the SCORE ECD model At child level using the ASQ-3 that assesses six development themes, overall, the gross motor skills had the highest scores above cut off point at 100%; followed by personal social at 96%; then communication at 92% and fine motor skills at 84% from 40% of children above cutoff and problem solving now at 76% from 27% of children above cutoff. The project was able to turn around the poor scores through activities including; provision of playing materials, training of facilitators/caregivers, direct participation/monitoring of the ECD activities, increasing the number of trained caregivers, designing an ECD guideline which includes specific activities that focus on building gross and motor skills.

Overall, of all the 75 children interviewed; the main area of concern was on vision which worsened from 10% to 23%. There has been a change in all domains towards the positive for particular aspects that could change even though most changes have been minimal. Other concerns have reduced form 24% to 3% showing perhaps an increase in attention for children needs. Concerns about behavior have also changed from 12% at baseline to 7%. Children with medical problems have changed from 35% to 21% At caregiver/parent and community level with regard to knowledge on ECD, respondents have more solid and refined knowledge on what ECD represents, the components and good qualities.

Through their response son challenges and opportunities, it also became clearer that they had an improved their knowledge on the content and importance of ECD. This change can be attributed to project interventions including; more dedicated community dialogues on ECD, Involving parents to participate together with the children in ECD activities, home visits/follow-ups done by the social workers, selection of facilitators from the same community where ECD is hosted among others.

7. Limitations Despite an interest in tracing all the 115 children and parents interviewed with the ASQ at baseline, we were only able to find 75 corresponding to 65%. Some of the children had transitioned to primary school – which was a positive finding while others had transferred to other geographical locations and could not be traced (these were less than 3%) 8. Conclusion The results of both the quantitative and qualitative analysis showed various interesting parameters that had changes as a result of the SCORE CPG ECD intervention. The SCORE ECD play group model is appreciated in the community. Findings suggest that the model can be utilized especially in low resource settings to provide the required stimulation activities for young children as evidenced in the significant changes between baseline and end line on different domains. This model also promotes the involvement of parents and communities and as such could provide a better platform

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for increased stimulation, possible structured play opportunities with parents and overall improved relations between children and their caregivers.

9. Recommendations The SCORE ECD community play group model should be further explored and a more refined comparative study conducted including cost and time effectiveness parameters introduced to better understand the effect of this model compared to the ECD center based options. Despite the overall larger gains/improvements made with this model, certain aspects especially related to WASH, safety and adequate play facility should be provided for CPGs to enable them provide even better ECD services

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10. Appendix A1: STUDY TOOLS ANNEX 1: FOCUS GROUP DISCUSSION GUIDE ENDLINE SURVEY ON EARLY CHILDHOOD DEVELOPMENT (ECD) IN THE SUSTAINABLE COMPREHENSIVE RESPONSES (SCORE) PROJECT FOR VULNERABLE CHILDREN AND THEIR FAMILIES Focus Group Discussion Guide Consent Process Consent forms for focus group participants are completed in advance by all those seeking to participate.

Below is a summary of the information in the consent form that focus group organizers and facilitators should use to make sure participants understand the information in the consent form.

Thank you for agreeing to participate. We are very interested to hear your valuable opinion on early childhood development (ECD) in the sustainable comprehensive responses (score) project for vulnerable children and their families 

    

The purpose of this study is to generate end line information on ECD activities. We hope to that the End line study will serve as a plat form for the project to demonstrate the impact of the ECD intervention on the targeted beneficiaries and generate lessons and best practices that future AVSI programs can use when implementing ECD activities.

The information you give us is completely confidential, and we will not associate your name with anything you say in the focus group.

You may refuse to answer any question or withdraw from the study at any time.

We understand how important it is that this information is kept private and confidential. We will ask participants to respect each other’s confidentiality.

If you have any questions now or after you have completed the questionnaire, you can always contact a study team member like me, or you can call the SCORE project team leaders whose names and phone numbers are on the consent form.

Please sign on the consent form to show you agree to participate in this focus group.

Note: Make sure that each participant signs 2 consent forms. One copy should remain with the participant and one copy to be kept by the study team) Materials and supplies for focus groups      

Sign-in sheet Consent forms (one copy for participants, one copy for the team) Pads, Colors, & Pencils for each participant Focus Group Discussion Guide for Facilitator School uniform shirts Notebook for note-taking

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Introduction: 1. Welcome Introduce yourself and the note taker, and send the sign in sheet4 with a few quick demographic questions (participant ID, year of birth, gender, occupation) around to the group while you are introducing the focus group.

Review the following:   

Who we are and what we’re trying to do What will be done with this information Why we asked you to participate

2. Explanation of the process Ask the group if anyone has participated in a focus group before. Explain that focus groups are being used more and more often in human services/Social research.

About focus groups    

We learn from you (positive and negative) Not trying to achieve consensus, we’re gathering information No virtue in long lists: we’re looking for priorities In this project, we are doing both Key informant interview questions and focus group discussions. The reason for using both of these tools is that we can get more in-depth information from a smaller group of people in focus groups as well as key informants. This allows us to triangulate the answers given and helps us explore topics in more detail than we can do with a single tool.

Logistics    

Focus group will last about one hour Feel free to move around Where is the bathroom? Exit?

Help yourself to refreshments

3. Ground Rules Ask the group to suggest some ground rules. After they brainstorm some, make sure the following are on the list.  Everyone should participate.  Information provided in the focus group must be kept confidential  Stay with the group and please don’t have side conversations  Turn off cell phones if possible  Have fun 4. Ask the group if there are any questions before we get started, and address those questions.

4

Sign in sheet annexed

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5. Introductions  Go around table: Name, what you do for living, number children if any, where you live.

When the Discussion begins, make sure to give people time to think before answering the questions and don’t move too quickly. Use the probes to make sure that all issues are addressed, but move on when you feel you are starting to hear repetitive information.

Focus Group Questions: 1. Let’s start the discussion by exploring your knowledge about Early Childhood Development (ECD).

What is an ECD to you? What are the components? What are the qualities of the good ECD facilities?

2. Are your children participating in the existing ECD Facilities in your community? If not, what are the reasons for not participating?

3. What kind of challenges do you see exist in the current ECD facilities within the community?

4. What can be done to improve/strengthen the current existing ECD Facilities?

5. Can each of you tell us one important message that you would like another person to know about Early Childhood development?

Conclusion: Thank you so much for coming and sharing your thoughts and opinions with us. Your opinions will be a valuable asset to the study. We hope you have found the discussion interesting. If you have additional information that you did not get to say in the focus group, please feel free to write it down on the Pads provided and share with me.

ENDLINE SURVEY ON EARLY CHILDHOOD DEVELOPMENT (ECD) IN THE SUSTAINABLE COMPREHENSIVE RESPONSES (SCORE) PROJECT FOR VULNERABLE CHILDREN AND THEIR FAMILIES Sign in Sheet for Focus Group Discussion Guide District: Participant Year birth ID#

Date: of Sex (F/M)

Occupation

Marital status (married/single, separated/divorced)

1 2 3 4 5 6 7

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Number children any

of if

Annex 2: Consent Form-Focus Group Discussion ENDLINE SURVEY ON EARLY CHILDHOOD DEVELOPMENT (ECD) IN THE SUSTAINABLE COMPREHENSIVE RESPONSES (SCORE) PROJECT FOR VULNERABLE CHILDREN AND THEIR FAMILIES Consent to Participate in Focus Group Discussion You have been asked to participate in a focus group sponsored by AVSI Foundation Uganda. The purpose of this study is to generate End line information on ECD activities. We hope that the End line study will serve as a plat form for the project to demonstrate the impact of the ECD intervention on the targeted beneficiaries and generate lessons and best practices that future AVSI programs can use when implementing ECD activities.

You can choose whether or not to participate in the focus group and stop at any time. Although the focus group will be tape recorded, your responses will remain anonymous and no names will be mentioned in the report.

There is no right or wrong answers to the focus group questions. We want to hear many different viewpoints and would like to hear from everyone. We hope you can be honest even when your responses may not be in agreement with the rest of the group. In respect for each other, we ask that only one individual speak at a time in the group and that responses made by all participants be kept confidential. In case of any further questions after you have completed the questionnaire, you can always contact a study team member like me, or you can call the SCORE Chief of Party Rita Larok on contact: Tel. 0771497551.

I understand this information and agree to participate fully under the conditions stated above: Name:

Sign:

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Annex 3: Consent form Questionnaires ENDLINE SURVEY ON EARLY CHILDHOOD DEVELOPMENT (ECD) IN THE SUSTAINABLE COMPREHENSIVE RESPONSES (SCORE) PROJECT FOR VULNERABLE CHILDREN AND THEIR FAMILIES Consent to Participate in Child Interview You have been asked to participate in a Child interview sponsored by AVSI Foundation Uganda. The purpose of this study is to generate End line information on ECD activities. We hope that the End line study will serve as a plat form for the project to demonstrate the impact of the ECD intervention on the targeted beneficiaries and generate lessons and best practices that future AVSI programs can use when implementing ECD activities.

You can choose whether or not to participate in the interview and stop at any time. Although the focus group will be tape recorded, your responses will remain anonymous and no names will be mentioned in the report.

There is no right or wrong answers to the questions. We want to hear many different viewpoints and would like to hear from everyone. We hope you can be honest even when your responses may not be in agreement with the rest of the group. In respect for each other, we ask that only one individual speak at a time in the group and that responses made by all participants be kept confidential. In case of any further questions after you have completed the questionnaire, you can always contact a study team member like me, or you can call the SCORE Chief of Party Rita Larok on contact: Tel. 0771497551.

I understand this information and agree to participate fully under the conditions stated above: Name:

Sign:

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Annex 4: ASQ-60 Months

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COPYRIGHT Š 2017 | AVSI Foundation Design and production by: Sustainable Comprehensive Responses for Vulnerable Children and their families Activity Published by: AVSI Foundation Plot 1119 Gaba Road, P.O. Box 6785 Kampala, Uganda Email: communication.uganda@avsi.org Website: www.avsi.org Website: http://uganda.avsi.org First Edition: 2017

AVSI Uganda @avsiuganda