Evaluation of SCORE Parenting Skills

EVALUATION OF SCORE PARENTING SKILLS TRAINING ON CAREGIVER KNOWLEDGE AND BEHAVIOR; AND CHILD WELLBEING

This publication is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Sustainable Comprehensive Responses for Vulnerable Children and their Families (SCORE) project and do not necessarily reect the views of USAID or the United States Government.

SCORE’s Parents Skills Training Program: Final Evaluation Report

Contents Executive summary............................................................................................................... 3 Abbreviations and Acronyms ................................................................................................ 6 1

Introduction ..................................................................................................................... 7

2

The SCORE Parenting SkillsTraining Program ................................................................ 7

3

Theory of Change underpinning the Intervention............................................................... 9

4

Objectives and Scope of the Evaluation .......................................................................... 9

5

Methods and Procedures ............................................................................................... 10 5.1

Study Design.......................................................................................................... 10

5.2

Participants and study sites:.................................................................................... 10

5.3

Sample Size: .......................................................................................................... 10

5.4

Outcome Measurements......................................................................................... 12

5.5

Data Collection procedure ...................................................................................... 13

6

Results ......................................................................................................................... 14 6.1

Socio-demographic characteristics of the caregivers ................................................ 14

6.2

Participation in SCORE’s Parenting skills training program ................................... 16

6.3

Participants' Perceptions of the SCORE parenting skills training program ............. 17

6.4

Knowledge of 'Correct' parenting practices .............................................................. 18

6.5

Parenting styles and parent behavior....................................................................... 20

6.6 Effect of SCORE parenting skills training program on parenting styles and parent behavior .......................................................................................................................... 22 6.7

Parenting behavior and skills training programme. .............................................. 24

6.8

Parenting Skills training and child welfare ............................................................ 26

6.9

Improvements in Parenting practices following the training program ......................... 29

7

Discusion of findings ..................................................................................................... 32

8

Ethical consideration ..................................................................................................... 34

9

Limitations .................................................................................................................... 35

10

Conclusion ................................................................................................................ 35

11

Recommendations .................................................................................................... 35

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SCORE’s Parents Skills Training Program: Final Evaluation Report

Executive summary This report presents results of the evaluation of SCORE’s parenting skills training program. Sustainable Comprehensive Responses (SCORE) for Vulnerable Children and their families is a seven-year, USAID-funded project implemented by consortium of partners led by AVSI Foundation. AVSI is a not-for-profit NGO started in 1972 in Italy and in Uganda since 1984. AVSI works for the promotion of the dignity of the human person through education.

SCORE’s Parenting skills training was conducted over a period of 3 years from May 2013 and May 2016 and approximately 4032 caregivers were trained in 35 districts. The training contained five modules intended to encourage positive, responsible parenting.

This group-based training was conducted at a community level in the 35 districts; with approximately 20-25 caregivers per group trained over a period of 2-3 months. The trainees were parents/guardians of children below 18 years of age. The parenting skills training was expected to increase parenting knowledge, to improve parent behavior and parenting styles, to improve parent-child relationships and ultimately improve child wellbeing.

Evaluation Objective: The evaluation addressed four key questions: Does Parenting Skills Training lead to increased knowledge of correct parenting practices? Does it lead to improved parenting behavior? Does the training improve parent-child relationship? Does it ultimately result into improved child wellbeing?

Methods The evaluation utilized a comparison-group design. Both primary and secondary data was collected and analyzed. Primary data was collected from a randomly selected household-based sample of caregivers who received training in 10 SCORE intervention sub-counties in 10 districts. In addition, one randomly selected child aged 10-17 years was interviewed in each of the selected households. For the comparison group, we selected a comparable sample of caregivers and children from sub-counties where there were no SCORE interventions within the same districts. Care was taken to select subcounties for the control group that were distant from the implementation areas to reduce bias from potential spill-over effects of the training to the non-participants. Overall, 697 caregivers (337 in intervention group and 360 in control group) were selected and interviewed in the survey.

Focus group discussions (FGDs) and Key Informant Interviews (KIIs) were also conducted with selected participants for in-depth investigation of the impact of the 3

SCORE’s Parents Skills Training Program: Final Evaluation Report

training on parenting behavior and parenting styles and effect on child welfare among other performance indicators.. The data collection was conducted between June and September 2016. Written and verbal consent was obtained from survey and FGDs/ KIIs participants, respectively.

Findings Overall, caregivers who were trained were significantly more knowledgeable about the correct (expected) parenting.. However, there were some differences between what is considered ‘correct’ parenting practice and what the caregivers thought was appropriate regarding disciplining a child, and in dealing with troublesome children. These contrasting views partly reflect the differences in cultural and social norms and values towards child upbringing.

Controlling for socio-demographic characteristics such as gender, location, and income levels, participants in the intervention group were about 2times more likely to practice supportive parenting (p=0.001) and 1.5 times less likely to practice coercive parenting behavior (p=0.002). One r significant influence on parenting behavior was the level of education of the caregiver: care-givers with secondary school level of education were more likely to display supportive parenting behavior compared to those with no formal education.

Data also reveals improved parent-child relationships a result of parenting skills training.

This is reflected in terms of caregivers reporting to be devoting more time for their children and having better communication with children at home. Also significant improvements were reported in regard to parents and guardians understanding their roles better, and having a better understanding of their responsibilities towards the wellbeing of the children and other family members. Children (10-17years) from the intervention group also reported feeling more confident talking to their parents and freely expressing their needs, which was not common before the training. Caregivers also reported positive changes in the children’s behaviour like being more obedient and participating in household chores.

Regarding child welfare, caregivers in the intervention were significantly more likely to provide for their children in terms of education and child protection aspects. Caregivers in the intervention group were more likely to have their children aged 6 years and above enrolled in school. They were also significantly more likely to consider the opinions of the child in decision making and were less likely to approve the use of physical punishment as a way of disciplining children at home (26% versus 48% in the control group). From the children’s perspectives of their welfare, Children from the intervention group reported to be significantly better in terms of food& nutrition. Children in the intervention group were significantly more likely to have at least two meals a day (90.2% Vs 80.1%: p= 4

SCORE’s Parents Skills Training Program: Final Evaluation Report 0.035) and reported to be more likely to always have enough food (89.5% vs 79%: p=0.025).

There were however no significant differences in health, child protection and education indicators.

Conclusion Both the quantitative and qualitative studies demonstrated that the parenting skills training program had a positive impact in improving parenting behavior and parenting styles and child welfare. Caregivers in the intervention group reported significant improvements in the ways they approach parenting ranging from improved communication between them and the children, providing for the needs of their children, and learning supportive ways of disciplining and raising children overall.

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SCORE’s Parents Skills Training Program: Final Evaluation Report

Abbreviations and Acronyms CPRS

Child-Parent Relationship Scale

FDM

Family Decision-Making Scale

FGDs -

Focused group Discussions

KIIs -

Key informant Interviews

PBI

Parent Behavior Inventory

PSDQ

Parenting Styles and Dimension Questionnaire

SCORE -

Sustainable Comprehensive Responses (SCORE) for Vulnerable Children and their families

USAID

United States Agency for International Development

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SCORE’s Parents Skills Training Program: Final Evaluation Report

1

Introduction

This report presents results of the evaluation of SCORE’s parenting skills training program. Sustainable Comprehensive Responses (SCORE) for Vulnerable Children and their families is a 7-year USAID funded project implemented by a consortium of partners led by AVSI Foundation, with CARE International, TPO Uganda and FHI360. The project sought to improve the wellbeing of critically vulnerable children and their households. The project is implemented in 35 districts in 5 regions of Uganda (North, Central, East, East-Central and South-West) and aims to reach 25,000 households over the period of implementation.

The evaluation is a follow up on the operational research conducted by SCORE in 2015 to examine the impact of the SCORE parenting skills training on caregiver knowledge, attitudes and practices and child wellbeing.

Context: Parents play a critical role in ensuring that children grow physically, emotionally, mentally and socially. Thus good parenting is a key element not only for creating an environment that allows the holistic development of the child, but more so, protecting the rights of the child in general. In addition, it lays a firm foundation for family cohesion and makes an early investment in children which builds human resource capital and contributes to sustainable development of the country. Good parenting further prevents children from developing behavioral difficulties. Supporting parents to develop effective parenting skills is therefore an important part of prevention and early intervention, which safeguards children’s wellbeing.

2

The SCORE Parenting SkillsTraining Program

The parenting skills training centered on promoting the authoritative parenting style as conceptualized by Baumrind (1971) 1. This style of parenting is characterized by warm nurturance, firm discipline, and respect for child autonomy. Throughout the training, parents are taught and encouraged to adopt authoritative parenting practices: listen to their children, place limits, consequences, and expectations on their children's behavior, encourage independence, allow children to express opinions, encourage children to discuss options, administer fair and consistent discipline.

1

Baumrind, D. (1971) ‘Current Patterns on Parental Authority’, Development Psychology Monographs 4: 1-107.

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SCORE’s Parents Skills Training Program: Final Evaluation Report

This group-based training comprised of five modules intended to encourage positive, responsible parenting: •

•

• • •

Module 1: Appreciating the Parenting Responsibility: Which explained the 4 different parenting styles as theorized by Baumrind (1971) (authoritative, authoritarian, permissive, and neglectful) and the responsibilities of a parent.

Module 2: Appreciating your Child: Which discussed how to handle different child personalities, the stages of child growth and development, and how to build children’s self-esteem.

Module3: Parent-Child Relationship: Reviewed the best techniques for parentchild communication and dealing with sibling rivalry.

Module 4: Raising Children with Positive Discipline: Explained positive discipline techniques that can be used in place of corporal punishment.

Module 5: Authoritative Parenting: Taught parents how to live as a positive role model, explains the educative role of the parent, and encourages positive parentparent relationships.

The SCORE parenting skills training was conducted three cohorts over a period of 3 years (May 2013 to May 2016). Approximately 4032 caregivers were trained in 35 districts. The group-based trainings were conducted at a community level in the 35 districts; with approximately 20-25 caregivers per group. Facilitators were fully trained in the use of the SCORE Parenting Skills Facilitators Manual, which outlines the training modules and the activities which should take place in each session. This training manual draws heavily from Nancy Vanpelt’s “Train up a Child; A Guide to Successful Parenting”, and Better Parenting Manual for caregivers and highly vulnerable children (2010) developed by FHI 360 and Pact as part of USAID’s Yekokeb Berhan Programme in Ethiopia.

Overall, the training lasts about 40 hours, so it takes about 2-3 months to complete depending on the length and frequency of sessions. Rather than simply lecturing to caregivers about correct parenting practices, the training is based on the use of Active Learning Methods such as role-plays, discussions, surveys, and quizzes in order to engage them in a more interactive way.

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SCORE’s Parents Skills Training Program: Final Evaluation Report

3

Theory of Change underpinning the Intervention

Figure 1: Theory of change

Parenting Skills Training

4

Increased Parenting Knowledge

Improved Parent Behavior

Improved parent-child relationship

Improved Child Wellbeing

Objectives and Scope of the Evaluation

The evaluation sought to rigorously examine the impact of the SCORE parenting skills training program on caregivers and children. Specifically, the evaluation sought to answer the following questions: 1. Does Parenting Skills Training lead to increased knowledge of correct parenting practices?

2. Does Parenting Skills Training lead to improved parenting behavior?

3. Does parenting skill training improve parent-child relationship?

4. Does Parenting Skills Training ultimately lead to improved child wellbeing?

We hypothesize that the SCORE parenting program results into improved parenting knowledge and behaviors, which in turn results into improvement in parent-child relationship and consequently improved child wellbeing.

Improved parenting knowledge and behaviour and parenting styles are manifested in form of authoritative and supportive parenting practices as opposed to authoritarian/coercive and permissive parenting practices. Improvements in parent -child relationship is reflected in terms of communication and interaction between the child and parent, understanding the child’s needs including unique talents/challenges and promoting equity (fairness) for all children in the family. Child wellbeing is a broad concept, but for this evaluation, it focused on the areas of provisions of basic necessities

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SCORE’s Parents Skills Training Program: Final Evaluation Report

such as adequate food, beddings, clothing, education materials and healthcare. It also included psycho-social support and care by the parents/guardians 5

Methods and Procedures

5.1 Study Design

We utilized a comparison-group design 2 to compare the parenting knowledge and practices of parents that earlier received the intervention (SCORE parenting skills training program) versus those that never received the intervention (control group). In addition, we compared the parent-child relationship and the wellbeing of children between the two groups. Both quantitative and qualitative data were collected between June and September 2016.

5.2 Participants and study sites: Primary data was collected from a randomly selected household-based sample of caregivers who received training in 10 SCORE intervention sub-counties in 10 districts. 3 In addition, one randomly selected child was interviewed in each of the selected households. For the comparison group, we selected a comparable sample of caregivers and children from sub-counties where there were no SCORE interventions within the same districts. Annex A1 shows the districts and sub-counties that were selected for the study.

5.3 Sample Size: Structured interviews were conducted with a sample of 697 caregivers (337 in the intervention and 360 control group) out of the planned 704, giving a coverage rate of 99.0%. In addition, a total of 329 children between the ages 10-17 years from both the intervention group (186) and control group (143) were interviewed. These children were selected from the same households where the caregivers from the intervention group were recruited. The child selected for interview was identified randomly from among those within the age category using the Kish-grid. The sample size calculation was based on the number of 4,032 participants in the parents’ skills training programme and determined using standard formulae for sample size calculations.

The sampling procedure was in three stages. In the first stage, the 35 intervention districts were stratified into five regions or strata. Within each region (stratum), two 2

A comparison group design is also called a quasi-experimental design.

The districts include: Buikwe, Luweero, Wakiso, Kampala, Mayuge, Bududa, Amuru, Nwoya, Bushenyi and Rukungiri

3

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SCORE’s Parents Skills Training Program: Final Evaluation Report

districts were randomly selected using computer generated random numbers in Microsoft Excel.

To determine the distribution of the 352 sample of caregivers across the strata (regions), we used the respective sample weights, which is the number of caregivers trained in each strata as a proportion of overall total population in the 10 selected districts (N=1864). The sample size for each selected district was determined by dividing up the strata sample proportionately based on the total number of the caregivers in the 2 selected districts per strata. In each district, one sub-county was purposively selected based on the total number of caregivers.

Besides the household survey, we conducted 17 focus group discussions (FGDs) with males (7) and females (10) separately from among caregivers who attended the SCORE parenting skills training program. In each district, 2-4 FGDs were held involving 6-10 participants. The FDGs were conducted in local languages and audio recorded. In addition, 17 key informant interviews (KIIs) were conducted with stakeholders (implementing partners and local leaders) who were involved in the organization and conducting of the trainings. Table 1 gives a summary of the type and number of interviews conducted per district.

Table 1: Summary of Interviews by Region Region

Central Eastern Northern South-West Total

District

Buikwe Kampala Luweero Wakiso Bududa Mayuge Amuru Nwoya Bushenyi Rukungiri

FGDs 4

1 2 1 2 2 2 2 2 2 2 18

KIIs

1 2 1 3 2 2 1 1 2 2 17

Survey Interviews Intervention Control Caregivers Children Caregivers Children 36 11 39 17 47 26 48 7 43 18 49 20 88 39 89 31 12 9 12 11 30 22 30 14 15 12 15 5 19 17 26 7 13 8 15 9 34 25 37 22 337 187 360 143

Note: Only female FGD were conducted in Buikwe and Luweero, and both male and female were done in other districts

Source: Fieldwork data

4

Only female FGD were conducted in Buikwe and Luweero, and both male and female were done in other districts

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SCORE’s Parents Skills Training Program: Final Evaluation Report

5.4 Outcome Measurements The evaluation sought to examine the impact of the parenting skills training program on: (i) parenting knowledge, (ii) parenting behavior, (iii) parent-child relationship, and (iv) child wellbeing. These outcomes were measured as described below: •

Parenting Knowledge: Parenting knowledge was assessed using five items adapted from the Knowledge of Effective Parenting Scale (KEPS) (Morawska, Sanders & Winter, 2007).

•

Parenting Behavior/Practices: Parenting behavior/practices were assessed using 15 items from the Parenting Styles and Dimension Questionnaire (PSDQ) (Robinson et. al 2001), which was developed to measure parent’s adherence to the parenting styles (see Baumrind 1966). The PSDQ includes measures of authoritative, authoritarian, and permissive parenting. Participants rated responses to each item using a five-point scale from “never” to “always” (coded 0 to 2). In addition, we assed parenting behavior using 20 items from the The Parent Behaviour Inventory (PBI). A self-report measure, the PBI reflects two dimensions of parenting behaviour. One is hostile/coercive “behaviour which expresses negative effect or indifference toward the child” and could include using physical punishment, threat or coercion to influence child behaviour (e.g., “I grab or handle my child roughly”) (Lovejoy et al., 1999, p.535). The second is supportive/engaged parenting which reflects parental acceptance of a child through signs of affection, instrumental and–emotional support and shared activities (e.g., “I have pleasant conversations with my child”) (Lovejoy et al., 1999, p.535). Total scores for the respective subscales of this measure were calculated. Higher scores indicate better forms of parenting for authoritative parenting behaviours and worst forms for authoritarian or permissive types of parenting behaviours. .

•

Parent-Child Relationship: We assessed parent-child relationship using 15 items from the Child-Parent Relationship Scale (CPRS) (Pianta, 1992). The CPRS assesses parent’s perceptions of the relationships they have with their children.

The measure has two subscales; a conflict subscale( assesses the extent, to which a parent feels that the relationship with their child is characterized by negativity), and a closeness subscale which measures the degree to which a parent feels that the relationship with their child is characterized by open communication, warmth and affection (Driscoll & Pianta, 2011). A total score for each subscale was calculated. Higher scores for the closeness subscale indicate a positive parent-child relationship. Higher scores on the conflict subscale in contrast indicate a poorer parent-child relationship.

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SCORE’s Parents Skills Training Program: Final Evaluation Report

•

Perceived parent-child relationships: We also assessed the children perceived relationship with their parents using six items from a modified version of Epstein and McPartland's (1977) Family Decision-Making Scale (FDM). The measure included three items to assess children perceptions of parental control and power assertion in their relationships.

It should be noted that this construct does not represent the positive aspects of parental control, such as monitoring and supervision. Rather, it measures the amount of parental autocratic domination of the relationship. It also included three items to measure the perceived opportunities available for participating in decision making with parents

•

Child wellbeing: We assessed several indicators of child wellbeing, including school attendance, and self-report of violence (Binary). In addition, we assessed the social and emotional wellbeing of children using the strengths and Difficulties Questionnaire (SDQ).

•

Caregiver Demographics: We elicited information relating to age, marital status, level of education, living arrangement, number of children, relationship with index child, location etc.

•

Children demographics: Age, sex, disability status, relationship to household head.

5.5 Data Collection procedure Structured interviews were conducted with caregivers and children in selected households in both the intervention and control areas by a team of trained enumerators.

In addition, we conducted FGDs and in-depth interviews with a sub-sample of caregivers 5 from the intervention group to elicit in-depth information relating to parenting knowledge and practices, parent-child relationship and how these have contributed to the well-being of children. KIIs were conducted mostly with local implementing partners to solicit their views on the relevancy and perceived/observed impact of the training, on parenting and child welfare.

5

Conducted FGDs with female and male caregivers separately to examine any gender differences when exposed to same training. This is because the child-parent relationships and interactions differ between male and female caregivers

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SCORE’s Parents Skills Training Program: Final Evaluation Report

6

Results

The evaluation questions were assessed using quantitative and qualitative data from the survey; and from the FGDs and KIIs respectively. Quantitative analysis reports the percentage differences between intervention and control group (bivariate analysis) and the multivariate regression results to examine the effect of the training on parents’ behavior, and the child well-being while controlling for co-founding factors such as socio-demographic and economic status of the caregivers. The FGD and KII data is used to triangulate the results obtained from the survey data and for in-depth assessment of the evaluation questions.

6.1 Socio-demographic characteristics of the caregivers A summary of the socio-demographic characteristics of the caregivers interviewed in the survey is given in Table .1.

Table1: Socio-demographic Characteristics of the Caregivers Variable

Intervention

Control

Overall

Age

(n=337)

(n=360)

(n=697)

16- 30

34 (10.1%)

133 (36.9%)

167 (24.0%)

30-40

101 (30.0%)

106 (29.4%)

207 (29.7%)

40-50

88 (26.1%)

67 (18.6%)

155 (22.2%)

50-60

68 (20.2%)

26 (7.2%)

94 (13.5%)

Above 60

46 (13.7%)

28 (7.8%)

74 (10.6%)

Catholics

157 (46.6%)

144 (40.0%)

301 (43.2%)

Protestants

104 (30.9%)

97 (26.9%)

201 (28.8%)

Muslims

25 (7.4%)

65 (18.1%)

90 (12.9%)

Born again/Pentecostal

45 (13.4%)

48 (13.3%)

93 (13.3%)

Other

6 (1.8%)

6 (1.7%)

12 (1.7%)

None

90 (26.7%)

59 (16.4%)

149 (21.4%)

Primary

184 (54.6%)

178 (49.4%)

362 (51.9%)

Secondary

61 (18.1%)

105 (29.2%)

166 (23.8%)

Post-Secondary

2 (0.6%)

18 (5.0%)

20 (2.9%)

Religion

Education

Marital status Married& living with spouse Married not living with spouse2 Not married, living with partner

170 (50.5%)

206 (57.2%)

376 (54.0%)

10 (3.0%)

26 (7.2%)

36 (5.2%)

3 (0.9%)

27 (7.5%)

30 (4.3%)

In relationship not living with

8 (2.4%)

2 (0.6%)

10 (1.4%)

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SCORE’s Parents Skills Training Program: Final Evaluation Report partner Single

10 (3.0%)

10 (2.8%)

20 (2.9%)

Divorced/Separated

36 (10.7%)

48 (13.3%)

84 (12.1%)

Widower/Widow

100 (29.7%)

41 (11.4%)

141 (20.2%)

Female

273 (81.0%)

318 (88.3%)

591 (84.8%)

Male

64 (19.0%)

42 (11.7%)

106 (15.2%)

Female

182 (54.0%)

145 (40.3%)

327 (46.9%)

Male

155 (46.0%)

215 (59.7%)

370 (53.1%)

Gender of Caregiver

Gender of Household head

Source: Authors' computations from the survey data

Majority of the caregivers were married, about 25% had secondary level education or above and the majority (85%) were female. These trends were similar between the intervention and control group. Majority of the caregivers interviewed were females and in the child bearing age of 18-49 years. Most of the caregivers were either Catholics (43%) or Anglican (29%) which is comparable to country's recent census statistics where 39.3% and 32.0% of Ugandans are Catholics and Anglicans respectively (UBOS, 2015).

Table 2 provides additional socioeconomic characteristics of the households selected for the survey. Average family size did not differ much between the control and intervention group, and is slightly lower than the national average of 5.2 persons per household. The reported average monthly income for the intervention and control was UGX 138,280/= (USD 43) and UGX 174,980 (USD 55) respectively.

Table 2: Socio-demographic features of the sampled households Variable Age of caretaker Age of household head Household income (monthly) Number of children

Intervention

Overall

Control

Mean (SD)

Min

Max

Mean (SD)

Min

Max

Mean (SD)

Min

Max

46.1 (13.0)

23

90

37.8 (13.8)

16

90

41.8 (14.0)

16

90

48.1 (12.9)

23

90

41.8 (13.1)

20

90

44.8 (13.4)

20

90

101,970 (138,286)

0

1,300 ,000

134,617 (174,982)

0

1,500 ,000

118,832 (159,033)

0

1,500,00 0

4.2(2.1)

1

12

3.5(2.0)

1

12

3.8 (2.1)

1

12

Source: computations from survey data

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SCORE’s Parents Skills Training Program: Final Evaluation Report

6.2

Participation in SCORE’s Parenting skills training program

Percentages of the caregivers who took part in each of the training modules were computed. Majority of the caregivers trained attended all the five modules as shown in Figure 2. Except in western region (Bushenyi and Rukungiri districts) where there was about 15% reported missing the first module and about the same number did not complete module five, attendance in the other regions was consistent and fairly high across all five modules.

Figure2: Level of Participation in score parenting training modules by region (%) 100.0 98.0 96.0 94.0 92.0 90.0 88.0 86.0 84.0 82.0 80.0

Central Module 1

S/Western Module 2

Eastern Module 3

Northern Module 4

Overall Module 5

Source: Own computations from the Survey data Despite, in South-Western and Eastern regions where participation in some modules was lower than in other regions, the overall attendance was generally high at 90% and above. Given this level of participation in the training across the 10 districts assessed, caregivers in the intervention group can be considered to have benefited equally from the training and therefore can be looked at as a homogeneous group with respect to their level of exposure to the training. Thus, from a statistical and program implementation point of view, the entire group of caregivers trained can be compared against those who did not receive the training.

Reports from the focus group discussions with the caregivers trained show that participants found the modules to be relevant and informative on how to ensure proper up-bringing of children and providing for their general wellbeing. These views are reflected in the reported improvements achieved following the training which are given in section 8.9.

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SCORE’s Parents Skills Training Program: Final Evaluation Report

Parents were asked about their experience of the parenting skills training and its effects.

Particularly, they were asked about aspects of the training they found helpful and why, and the extent to which they had observed changes in their own and their children behavior as a result of the training. Results are reported below:

6.3

Participants' Perceptions of the SCORE parenting skills training program

During the FGDs, the relevancy of the training and the benefits to the caregivers was explored from the participants’ view point. Overall, participants perceived the parenting skills training to be relevant and beneficial in terms of the way it improved their parenting skills. The parenting skills training centered on equipping parents with effective parenting skills; including skills related to managing difficult or defiant behavior on the part of children, and handling difficult children. One of the implementers interviewed explaining the purpose of the trained commented:

It was mainly to help the beneficiaries who were parents to better manage their children. Because we realized that vulnerable households are characterized with a lot of problems. And the parents used to tell us they had a lot of problems with children. Many Children could not listen; were not going to school and were involved in……. So it was from this background that the SCORE project came up with the parenting skills education (Key informant, Mayuge District) Responses from the FGDs showed that parents learned several things from the training to help them appreciate their parenting role and develop and use effective parenting strategies. These included: the principles of positive parenting, how to deal with children’s problem behavior, how to communicate in a positive way with children, how to build/maintain strong and nurturing relationships with their children among others. In the FGDs, caregivers who attended the training gave their experiences of what they had learned from the training such as:

We were taught how to handle different behavior of children (FGD with caregivers, Bushenyi district).

We also learned how to care for kids, to protect them from bad moods, share with them their thoughts, befriend them, understand them when they do mistakes and correct them with love (FGD with caregivers, Bushenyi district).

They also introduced games so we can learn to play with kids, they showed us how we can play with our children through throwing it to a friend who would still throw it to another, jumping ropes.

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SCORE’s Parents Skills Training Program: Final Evaluation Report

we studied about the way to handle a child, take care of her, we also studied how to bring up a child, even the feeding of the children, We learnt about relationship of the parents that take care of that child their way of leaving, if parents corporate with each other well, the child grows up well which is not the case when parents are not cooperating… (FGD with female caregivers, Luwero).

The trainings for the different groups were preceded by a pre-training assessment to determine participants’ knowledge on parenting before the training. The trainings were largely participatory and involved a lot of role plays, group discussions and video sessions.

However, some Key informants expressed concerns regarding the training manual. The SCORE parenting skills training manual was written in English and no language translations were done. The informants felt the manual should have been translated into the various local languages to enable effectively delivery of the training.

The main problem, the manual we were given was in English and yet most of our people never went to school. In our class we never had a parent that had reached S.4. So for you to be effective in your trainings you needed to sit down and revise these manuals extensively and try to master what these manuals required for you to be able to go and translate to the class very well. Actually in my manual I wrote Lusoga in it. But doing that would take me a lot of time to do it. You needed to first of all revise or else you would go and teach them in English and these people would not understand it. So it was important for these manuals to be translated into Lusoga. (Key informant, Mayuge District) In addition, many parents would have liked the course to have gone on longer and expressed a need for more support after the training, saying that it was easy to slip back into old ways. Further, some parents felt the course would have been more effective if their partners had attended.

… Many women think they left out the men. It’s like SCORE is not so concerned about men yet much of the family responsibility is theirs. For a child to grow up well, they should be raised and guided by both parents. But we always leave the men behind (FGD with female caregivers, Wakiso).

6.4 Knowledge of 'Correct' parenting practices

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SCORE’s Parents Skills Training Program: Final Evaluation Report

Caregivers in both the intervention and control group were interviewed on a range of questions to assess their knowledge of generally acceptable parenting practices.

Caregivers responded to five questions which have been validated and used in studies in other settings to assess knowledge of appropriate parenting Practices. Figure 3 shows that overall, caregivers who were trained (intervention group) were more likely to provide correct parenting practices responses, thereby depicting better knowledge of ‘correct’ parenting practices. Differences in knowledge of expected (‘correct’) parenting practices were significant with regard to Qn.1 regarding cuddling and hugging to express love towards children (p=0.061); Qn. 4 about approaches to child upbringing (p=0.038) and Qn.5 on how to appropriately deal with a troublesome child (p=0.021).

This difference in knowledge of expected parenting could be attributed to the knowledge gained during the SCORE's parenting Skills training program. Details on the five questions and expected responses are shown in annex A2. Results disaggregated by region follow a similar trend and are shown in Annex A3.

Figure 3: Caregivers knowledge of “correct” Parenting (%)

100.0 80.0

70.3

76.6

60.0 40.0 20.0

50.0 52.0

57.2 49.4

42.8 45.7

38.1 25.6

30.0

Control

18.1

Intervention

0.0 Showing Love Disciplining Understading Child & Compassion children Child upbringing behaviour

Source: Own computations from survey data

19

Handling troublesome child

Overall

SCORE’s Parents Skills Training Program: Final Evaluation Report

From Figure 3, it is clear that most caregivers had largely different opinions regarding disciplining a child (Q2) and dealing with troublesome children (Q5). For example, by and large, a number of caregivers felt it was appropriate, while disciplining a child, to ensure he/she feels some bit of pain or discomfort (35% versus 22% for expected response)Similarly, most caregivers reported that when a child is jumping on a chair, a parent should explain to her again, why jumping on the chair is dangerous (61%) rather than the expected response of simply telling the child to stop jumping on the chair and do it outside (34%) . (Annex A3). This finding suggests that parents combine a mix of behaviors - being on the good side of the scale on one hand, and on the other being on the negative side of the scale. However based on the findings from this study, majority of the parents apply the positive (authoritative) parenting styles.

6.5 Parenting styles and parent behavior Using a set of indicators which depict parenting styles we compare the proportion of desired and undesirable responses between the control and intervention group. We hypothesized that: (i) caregivers intervention were more likely practice authoritative/supportive parenting compared to those in the control group, (ii) caregivers in the intervention were less likely to display coercive and permissive parenting practices.

Caregivers were interviewed responding to a range of questions to assess their parenting style using the Parenting Styles and Dimension Questionnaire (PSDQ). Table 3 shows the mean scores between the control and intervention group.

Table 3: Mean scores for supportive, coercive and permissive parenting behavior Intervention Control Group t-statistic P-value Group (n=337) (n=360) Mean SD Mean SD -4.43 0.000 Supportive 8.7 2.29 8.0 2.55 Parenting Coercive 3.8 2.03 4.4 2.32 4.12 0.000 Parenting Permissive 2.23 1.53 2.25 1.77 0.10 0.920 parenting Source: Own computations from survey data

20

SCORE’s Parents Skills Training Program: Final Evaluation Report

Table 3 shows that caregivers who had been trained (intervention group) were more likely to practice supportive (authoritative) parenting (P<0.01) and less likely to practice coercive (authoritarian) parenting (P<0.01), but there was no significant different between the two groups for permissiveness. . These results indicate that the training had influenced caregivers to be more supportive and less coercive when dealing with their children.

Participants in FGDs with caregivers who were trained gave views on what constitutes proper parenting. These included not being so tough no children, even when disciplining them; showing their children love without spoiling them and creating time for children and engaging children in various plays to build the child-parent relationship.

Caregivers reported that the training had changed their approach to parenting in various ways compared to what they were practicing before the training. Views and comments from the FGDs which depict change of parenting styles towards more supportive parenting included:

… we are calm and not tough on them [children] like before. I talk with them and we even make conversation. We are actually becoming friends with them (FGD with female caregivers, Wakiso district) ... First the most important thing I learnt was how to handle children at home. I

didn’t know that it was possible for a father to play with his children. But they taught me that and I have applied it and it has worked for me (FGD with Male caregivers, Mayuge district).

In a typical African traditional setting a father was looked at as a centre of power and authority in the home and to be feared as a way of showing respect. It is interesting to note that male caregivers who were trained mentioned having benefited greatly from the training especially in learning how to interact with their children. There were comments in FGDs with males to demonstrate how the training had taught fathers/male guardians ways to interact with children. A male participant in one for the FGDs commented:

I am proud of SCORE, they taught me how to interact well with my children and now days I can even play with my children. And now days even when I go back home my children run towards me and welcome me home ; which was not the case before SCORE. And sometimes children bring a ball and say, father let us play. I also oblige…go and play with them for some time; unlike before the SCORE’s parenting skills training. (FGD with Male care givers, Mayuge).

21

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

Such views suggest that the training impacted on the caregivers and they were more likely to adopt and practice a more supportive parenting style. These views cut across all the districts visited.

6.6

Effect of SCORE parenting skills training program on parenting styles and parent behavior

We explored the linkage between the parenting styles and behavior displayed by caregivers and the parenting skills training programme while controlling for other sociodemographic and economic characteristics (marital status, family size, gender of household head, gender of caregiver trained, occupation, location, and reported monthly income).

Table 4: Factors associated with parenting styles and parenting behavior

22

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

Source: computations from Survey data Note ** and *** denote the variable is statistically significant at 5% and 1% level of significance

The estimates in Table 4 show that caretakers who were trained were significantly more likely to display supportive parenting styles and less likely to be coercive in their parenting styles. Likewise, the older caretakers were more likely to be supportive in parenting, just like those with more children in the household. These results could reflect experience in dealing with children and therefore be more supportive than coercive in raising children. There were also significant regional differences regarding whether caretakers were more likely to be supportive, coercive or permissive in their approaches to parenting. Relative to the Central region, caretakers in the Eastern and Western 23

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

regions were less likely to display supportive parenting. While the underlying factors for these differences were not explored in this study, the results reflect that caretakers exhibit significantly different parenting styles and behavior while raising children across the regions, some of which could be associated with differences in cultural and society norms and values.

6.7

Parenting behavior and skills training programme.

Table 5: Regression results showing the influence of parenting skills training on parenting behavior VARIABLES Age Income Primary (no educ) Secondary Post-secondary Number child Unmarried (Married) Northern (central) Eastern Western Male_care Intervention Constant

Observations R-squared

(1) Supportive behavior

(2) Hostile behavior

-0.0162* (0.00917) -1.06e-06 (7.57e-07) 0.417 (0.294) 1.087*** (0.361) 0.821 (0.729) 0.0801 (0.0566) 0.267 (0.261) 0.0264 (0.344) -0.0386 (0.384) -2.370*** (0.343) -0.311 (0.340) 0.537** (0.237) 17.97*** (0.520)

-0.0187** (0.00808) 3.40e-07 (6.67e-07) 0.194 (0.259) 0.362 (0.318) -0.586 (0.643) 0.105** (0.0499) 0.172 (0.230) -1.750*** (0.303) -1.607*** (0.339) 1.028*** (0.302) -0.691** (0.300) -0.368* (0.209) 8.039*** (0.458)

697 0.117

697 0.133

24

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

Physical punishment of Children at home and at School There are significant differences in attitudes using physical punishment as a way of disciplining children as shown in Figure 4. A lot fewer caregivers who participated in the parenting skills training viewed hitting or beating a child as an appropriate means of discipline control at home or at school compared to those who were not trained.

However, caregivers seem to suggest that beating a child at school may be necessary to instill discipline. This could reflect the common tradition of disciplining troublesome children in schools. Use of physical discipline is considered appropriate in this regard, by a sizable segment of parents.

Attitude towards physical punishment of children at home and school

60

53 47

50 40

48 42

38

30

26

20 10 0

Overall (%)

Control (%)

Intervention (%)

Hitting or beating a child is an appropriate means of discipline or control at home Hitting or beating a child is an appropriate means of discipline or control at school

Source: Own computations from survey data During the FGDs, some caregivers also reported that, as a result of the training, they are more skilled in dealing with their childrenâ&#x20AC;&#x2122;s problem behavior. For example, some parents reported they had stopped shouting at their children and using more positive discipline strategies. During one of the discussions with caregivers who trained, a member of the group commented:

25

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

For me before I joined the parenting skills training program I knew that for you to discipline a child you must get a cane and beat up that child for him/her to understand. But according to what we were taught in SCORE it is not good to beat a child because when you do, that child will not understand what you tell him/her. It is better to give counsel to the child and since I learnt that, now there is a very big change in my home (FGD with Male caregivers, Mayuge).

A number of participants in other FGDs reported similar experiences where they now use more promotive disciplinary measures learned during training rather than beating or spanking their children.

6.8

Parenting Skills training and child welfare

Child welfare was defined from the three perspectives: child protection, education, health and dietary intake. The parenting skills training program was expected to lead to caregivers being more concerned and in position to allocate more resources to provide for these welfare dimensions. We hypothesize that caregivers in the intervention group were more likely to provide for the improved welfare of their children as a result of the training. Table 6 shows the proportion of caregivers reporting always providing for their children for a range of welfare indicators. The results show that, except for food provision, caregivers who attended the training were significantly more likely to provide for their children in terms of education, emotional support and considering the opinions of the child in decision making,. There is therefore some evidence that the training impacted caregivers positively, since the same aspects were covered during the training.

Table 6: Caregivers responses to child welfare Welfare indicator

control

p value

intervention

Number

%

Number

%

Providing enough food for the family

303

84.2

245

72.7

0.001

Giving sufficient food to all children in family

305

84.7

254

75.4

0.002

All school-going children being enrolled

310

86.4

303

89.3

0.013

All children going to equally good schools

275

76.4

275

81.6

0.019

Checking on children's performance in school Believe education is an important investment for all children in the family

206

58.9

197

58.5

0.151

350

97.5

329

97.6

0.279

Believe education is important for all children in the home

346

97.4

334

99.1

0.016

Provides adequate beddings for all children

265

93.6

233

69.1

0.007

Provides emotional support to all family members

285

79.2

273

81

0.753

26

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report Considers children's opinions in decision making

165

54.2

231

68.6

0.001

Seeks prompt treatment for all family members

327

91.1

299

88.9

0.541

Source: Own computations from survey data

Using the child questionnaire (annex A5 Part II), we investigated the views of the children aged 10-17 years about their welfare in terms of nutrition, education child protection and health. Table 7 gives the proportion of children from both the intervention and control group who reported always experiencing the conditions depicted in the 28 questions presented to them during the survey.

Significant differences were only observed for food and nutrition indicators (Table 7).

These estimates imply that children in the intervention group were less satisfied with their conditions regarding food intake in the home compared to their counterparts in the control group. This is to be expected given that lacking sufficient food in the home impacts children more severely than adults, and food is perhaps the most important basic need for children during their early development stages. Going hungry is perhaps the most significant deprivation children can ever experience. Surprisingly, children from the intervention group reported significantly lower levels of satisfaction with their current experiences with food and nutrition intake.

There was no significant difference between the two groups with respect to other welfare indicators (child protection, education and health). It is worth noting that majority of the children felt secure and loved in their homes and there were very minimal levels of sexual abuse (>2%), but one in five children still experience physical abuse.

Overall high levels of performance were reported for most of the child welfare indicators explored in the study.

Table 7: Childrenâ&#x20AC;&#x2122;s perspectives on child welfare SN

Welfare Indicator

Intervention (n=187)

Control (n= 143)

p- value

number

%age

number

%age

FOOD &NUTRITION 1

Eating at least two meals a day

129

90.2

149

80.1

0.035

2

128

89.5

147

79.0

0.024

3

Always having enough food Getting equally sufficient amount of food as other children in the home

133

93.0

155

83.8

0.041

4

Going to bed hungry

14

9.8

20

10.8

0.001

5

EDUCATION Being refused to go to school in order to do household work Parent /guardian checks on performance in school

15

10.6

18

9.8

0.175

81

57.9

112

61.5

0.773

6

27

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

9

Going to equal good schools like other children in the home Teachers treating you like other pupils at school Parents /guardians providing the child enough books and pens

SN

Welfare Indicator

10

CHILD PROTECTION Having adequate beddings like other children in the home

7 8

11 12 13 14 15 16 17 18 19 20 21 22 23 24

121

87.7

158

87.3

0.194

122

87.8

162

89.0

0.541

114

82.0

68.1

0.005

Control (n= 143)

124 Intervention (n=187)

p- value

number

%age

number

%age

104

72.3

117

62.9

0.106

130

90.9

167

89.8

0.869

127

88.8

164

88.2

0.587

4

2.8

3

1.6

0.168

31

21.6

43

23.1

0.667

17

11.9

24

12.9

0.924

26

18.2

31

16.8

0.704

112

78.3

132

71.0

0.165

24

16.8

31

16.7

0.769

112

78.3

151

81.2

0.690

104

72.7

134

72.0

0.834

105

73.4

130

69.9

0.328

113

79.0

151

81.2

0.772

114

80.3

140

75.3

0.554

47

33.1

65

35.0

0.268

26

18.2

40

21.5

0.294

Feeling secure in the home Feeling loved and cared for by parent or guardian Being sexually abused by anyone in the family or community Being physically abused by any member of the family or community Being threatened by anyone in this home to make you feel wanted to go and live somewhere else Being treated differently from other children in the household Getting emotional help and support from your family Parents /guardians use corporal punishments when you do wrong things Trusting your parents or guardian Freely expressing your feelings to your parents Participating in family activities such as home chores, parties, visiting relatives, prayers.

Getting enough support from your family when you face challenges Getting good balance of play time at home Child's opinions being considered when taking decisions that affect him/her at home or school HEALTH

25

Falling sick regularly

26

Getting prompt medication when sick

114

79.7

139

74.7

0.303

27

Sleeping under a treated mosquito net Feeling that the parent or guardian is keeping the child in good health

86

60.1

104

55.9

0.744

126

88.1

170

91.5

0.615

28

Source: Own computations from survey data

28

SCORE’s Parents Skills Training Program: Final Evaluation Report

Based on the self-reports from the children regarding their welfare shown in Table 7, one could argue that the intervention made minimal differences in the area of child welfare, especially food and nutrition. However, based on the outcome of the FGDs with caregivers who participated in the training, majority reported that they were sufficiently providing for their children’s needs. These contrasting views underscore the importance of assessing programme effects from the view point of all key stakeholders before firm conclusions can be made. It also shows that children’s views about the level and quality of their own welfare may be different from their caretakers’ perceive.

The study also investigated factors related to child’s emotional symptoms, peer problems, hyperactivity, pro-social and conduct problem (see annex A4). While there were no statistically significant differences between children in the control and intervention groups, children generally reported high levels of positive aspects such as being loved and trusted by peers, having good friends, volunteering to help others and being obedient. There were fewer cases of the negative aspects like being angry and lying to others, often being unhappy or nervous in new situations. Children from the intervention group tended to perform better, suggesting that the parenting skills training their parents/guardians received could have positively impacted on the way children feel and behave.

6.9 Improvements in Parenting practices following the training program The evaluation investigated how the training program had helped participating caregivers to improve their parenting practices. This was in form of their attitude and practices towards: improved provision of food, education and sanitation services, child protection and fair involvement of children in household/family work activities (child labour), skills training and parent-child relationships. Table 8 presents the distribution of perceived improvements in parenting practices following the parenting skills training program.

29

SCORE’s Parents Skills Training Program: Final Evaluation Report

Table 8: Perceived improvements in parenting practices following SCORE’s training

Indicator

Overall (n=342)

Regions Central (n=216)

Southwest (n=45)

Eastern (n=33)

Northern (n=48)

Feeding practices for children

96.5

98.2

95.6

87.9

95.8

Sending children to school

97.1

97.7

100

97

91.7

Health care seeking for children

98.2

98.6

100

97

95.8

Sanitation

98.8

99.1

100

97

97.9

Management of childhood illnesses

97.9

98.6

97.5

93.9

97.9

Timely child immunization

96.8

97.7

100

97

89.6

Providing children opportunity to play

98.5

98.6

100

97

97.9

Teaching children how to relate with others

97.7

97.7

100

100

93.8

Protecting children from abuse

98.5

98.6

97.7

97

100

Not overloading children with work

98.8

99.5

100

100

100

Understanding a child’s behavior

98

99.5

95.5

90.9

97.9

More confident dealing with children

97.4

99.5

97.7

84.9

95.8

Improved parent child relationship Better understanding of child’s needs

98

99.5

97.7

93.9

93.8

98

99.5

95.5

93.9

95.8

Learned helpful ways of interacting with children

98.2

99.5

95.5

93.9

97.9

Feeling less stressed as a parent

97.4

98.6

93.2

97

95.8

Source: Own computations from survey data

Caregivers reported significant improvements in a number of parenting practices, ranging from food and nutrition for the children, education child health and child protection.

Similar views came up during the FGDs with caregivers who had participated in the training. Overall, parents reported Increased parenting self-efficacy, better relationships with their children, better emotion regulation, adoption of positive and nurturing behaviour management techniques and improvements in their children's behavior as a result of the training.

Caregivers reported that, as a result of the training, they learned that they have the responsibility to fulfill the needs of their children. One female focus group participant 30

SCORE’s Parents Skills Training Program: Final Evaluation Report

explained: “I understand the role of the father and the mother: both should give more

attention to children and are responsible for the health, education, and balanced food of the children. Others reported that through the training they learned how to take care of their children, which includes being involved with their school.

It (Parenting Skills Training) was relevant because it helped people to realize their potential and responsibilities when it comes to parenting and children upbringing (Key These perspectives were confirmed in interviews with some of the key informants:

informant, Mayuge District) Consequently, parents and guardians who trained seem to be responding better to the needs of their children than before the training. For example, one parent explained that, before the training, he would give his children all kinds of household-based chores, but now, after the training, he gives them tasks that are acceptable for their age.

Another significant improvement reported relates to the child-parent relationship.

Participants identified several behaviors that indicated an improvement in child-parent relationship including: spending more time with children, playing with children, using more explanation and reasoning, and communicating more. Thy also reported reduced less yelling at children, fewer punishments, and forcing children to do certain tasks beyond the child’s ability.

In one of the FGDs with male caregivers, a participant gave his experiences of the changes in his parenting style following the training, explaining that:

For me now days I am proud of myself… The way I talk with my children changed.

My children now days are free to talk to me and tell me their problems. For example, if they are sent away from school because of school fees they now find it easy to come and talk to me: father, we have been sent away from school for school fees. But in the past they used to fear talking to me and telling me their problems and concerns. Many times they used to go speak to their mother first and then their mother could come and talk to me. But now they come to me directly and talk to me because I created a positive atmosphere where they can come and speak to me whenever they want (FGD with Male care givers, Mayuge).

In Northern Uganda, a female participant acknowledged the positive impact the training had had on her approach to parenting stating:

I am proud of SCORE, they taught me how to interact well with my children and now days I can even play with my children. And now days even when I go back 31

SCORE’s Parents Skills Training Program: Final Evaluation Report

home my children run after me to come and welcome me back home which was not the case before SCORE (FGD with female caregivers, Amuru) Similar views emerged during the discussions with male and female caregivers in all the districts visited during the study. For example in Luweero, a female participant gave testimony of the changes she has experienced since the training in terms of planning to care for the family and interacting with her children. She reported that:

Some of us were so rude and harsh, we did not know how to care for children, we would not listen to the child, never had time to chat with the child, you do your own things and she (the child) also does her own things (ok) you don’t know whether the child will eat, but now we learnt how to take care of children, and also the children listen to us, they are free to us as in they are good people they no longer fear us, we cooperate with them well let it be boys or girls (FGD with female caregivers, Luweero).

Caregivers also reported some changes in the way their children behave after the training. These changes could be attributed to the way caregivers now care for the child, providing for their children’s needs and creating time to understand them better. For example, some parents reported that are as result of the training, children became more obedient and were having more effective communication with their parents/guardians. In one of the FGDs in South-western region, a participant commented:

Our children are now obedient, they can fetch water, and do any other work assigned to him (FGD participants, Bushenyi).

Such experiences reflect that the training had improved caregivers parenting practices including better interactions and communications with their children and using more positive discipline strategies.

7

Discusion of findings

The evaluation sought to examine impact of the parenting skills training program on four outcomes: (i) parenting knowledge, (ii) parenting behavior/practices, (iii) parent-child relationship, and (iv) child-wellbeing. In addition, the evaluation assessed caregiver’s participation in the training, their perspectives on the usefulness of the training and changes in parenting practices as a result of the training.

Regarding knowledge of ‘correct’ or appropriate parenting, caregivers in the intervention displayed better knowledge of the ‘correct’ parenting overall. However, there were huge differences between what is considered ‘correct’ parenting practice when disciplining a 32

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

child, and in dealing with troublesome children and what the caregivers interviewed thought was appropriate. These differences between expected (as validated in other studies) and what is likely to be practiced locally reflects the different cultural and social norms and values towards child upbringing. It also underscores the importance of understanding the local context before applying assessment tools developed and applied in other settings.

Results indicate that caregiver who were trained were significantly more likely to practice supportive (authoritative) parenting and less likely to practice coercive (authoritarian) parenting.. Specifically, controlling for socio-demographic factors such as gender, location, income levels, etc, caregivers who were trained were about 1.9 times more likely to practice supportive parenting and 1.5 times less likely to practice coercive parenting. These results suggest that the training program impacted positively on the parenting practices of targeted caregivers. Other significant influences on parenting behaviour were education of the caregiver and location (region). Caregivers with secondary school education were more likely to display supportive parenting behaviour relative to those with no formal education. Likewise, there were differences in displaying supportive or coercive behaviour by caregivers in other regions relative to those in the central region. The regional differences towards parenting behaviour and parenting styles could reflect the differences in cultural and social norms and values regarding child rearing, which tend to be so entrenched across societies.

Data also reveals improvements in parent-child relationships as a result of the parenting skill straining; with parents in the intervention group reporting to devote more time for their children and improved communication with their children.. Another significant improvement was in regard to parents and guardians understanding better their roles and responsibilities towards the well-being of the children and other family members. Across the FGDs parents reported their children feeling more confident talking to them and freely expressing their needs, which was not common before the training. This reported increase in parenting self-efficacy is a component of positive mental health, and is considered important in terms of caring for children. 6 Caregivers also reported positive changes in the childrenâ&#x20AC;&#x2122;s behaviour like being more obedient and participating in household chores. These experiences reported show an improvement in the parent-child relationships.

Changes in child welfare were explored along four dimensions: food and nutrition, education, child protection and health. Both the perspectives of the caregivers and the children (10-17 years old) were captured. Overall, caregivers who trained were more likely to provide for their children in terms of education and child protection aspects. For 6

Stewart-Brown S. Measuring parts most measures do not reach: a necessity for evaluation in mental health promotion. J Mental Health Promotion2002;1:4â&#x20AC;&#x201C;9.

33

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

example caregivers in the intervention were more likely to enroll their children in schools and take all children in equally good schools. They were also significantly more likely to consider the opinions of the child in decision making. A lot fewer caregivers who were trained could approval physical punishment as a way of disciplining children at home (26% versus 48% in the control group). There was however not much differences for healthcare seeking between the intervention and control group.

From the viewpoint of the children interviewed, there were no significant differences with respect to their satisfaction in terms of education, child protection and healthcare.

Statistically significant differences were observed for food and dietary intake. This is perhaps because accessing food is such an important need for children the lack of which directly impacts on their physical and emotional being.

By and large, the training had a positive impact in parenting behavior and parenting styles and the effect on child welfare. Caregivers in the intervention group (those trained) reported significant improvements in the ways they approach parenting ranging from improved communication between them and the children, providing for the needs of their children, and learning ways of disciplining and raising children. They also displayed better knowledge of expected parenting practices. While there were not much statistical differences in terms of child well-being between the control and intervention, a slightly higher proportion of children whose caregivers had had the training, reported experiencing more positive aspects regarding child protection, education and healthcare.

8

Ethical consideration

Written consent was sought from all the caregivers and the children aged 10-17 who interviewed in the study. Where the respondent was not able to read the consent form by himself/herself the local leader working with the research team (or the field supervisor) explained the contents, meaning and implications of the consent. We did not encounter any refusals. The interviews were conducted in the local languages 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. For the case of interviews with children, the caregiver also provided verbal consent to have the child interviewed. Interviews with children were conducted away from the caregiver, to avoid the child being unduly influenced by the parent/caregiver, but within an eyeâ&#x20AC;&#x2122;s view of the caregiver /adult member of the household in order to reassure the child of his/her safety and comfort while talking to the interviewer.

34

SCORE’s Parents Skills Training Program: Final Evaluation Report

9

Limitations

Improvements in child welfare were a key goal of the Parenting skill training program.

However the current evaluation of child welfare issues is based on self-reported accounts of the caregivers and children and not complimented with objectively verifiable measures. For instance there was no data to assess if actual quantities of food rations given to children had changed between the start and end of the training or was different between the intervention and control group. While the methodology used in conducting the FGDs is valid and to a good extent gives insight of effect of the intervention from the caregiver’s perspective, the success stories could not be triangulated with objectively measured quantitative data. Thus the results should be interpreted bearing in mind the context of local communities (values, beliefs and customs) the intervention was implemented.

10 Conclusion By and large, the results of both the quantitative and qualitative analysis showed that SCORE’s parenting skill training program had a positive and significant effect on parenting knowledge and practices and child wellbeing. The caregivers in the intervention group were more likely to practice authoritative parenting styles and display supportive parenting behavior than their counterparts in the control. The caregivers perceived the training to have been very beneficial in improving their parenting skills.

From an evaluation point of view, the seemingly contrasting views between caregivers and children regarding how child welfare was being addressed shows the importance of assessing program effect/impacts from the view points of the key stakeholder before making firm conclusions about the level of impact achieved. In addition understanding the local context within which the program was implemented is important in interpreting and generalizing the results of the program evaluation.

In general, there is evidence that the SCORE’s parenting skills training program did well in achieving the intended objectives and can potentially be replicated in other settings.

11 Recommendations The SCORE parenting skills training program should be replicated in other areas given the wide evidence on the impact of the training on improving parenting practices and child welfare. This evaluation relied on a control-intervention design approach due to lack of a comprehensive baseline survey. The design of similar training programs in future should include a baseline survey to avoid the potential bias of using a control group in evaluation of program impact. Majority of the trainees were female, however, given the pivotal role of men in decision-making regarding family welfare, future trainings should consider including more men to maximize impact.

35

SCORE’s Parents Skills Training Program: Final Evaluation Report

Annex A1: Districts and sub-counties selected for the study Region

District Buikwe Kampala Luweero

Central

Wakiso Bududa Eastern Mayuge Amuru Northern Nwoya Bushenyi South-West Rukungiri

Sub-county/Division Intervention Bukunja Nakawa-Banda Parish Butuntumula Entebbe Bududa Baitambogwe Amuru Alero Nyabubare Ruhinda

Control Buikwe S/C Nakawa – Kyanja Parish Luweero S/C Makindye- Sabagabo & Kakiri S/C Bushiribo Wairasa Labongali Anaka Bumbare Kihanga

Annex A2: Knowledge of correct parenting practices (show Intervention Vs control) Q1: When children receive lots of hugs and cuddles from parents they mostly Become needy and dependent.

Feel loved, secure and wanted. (Expected Answer) Find it harder to separate from their parents.

Are more likely to become interested in the opposite sex early.

Q2: When disciplining a child it is important that a parent Is consistent in their reaction to their child’s misbehavior.

(Expected Answer) Makes sure their child feels a bit of pain or discomfort so they will remember what they have done wrong.

Speaks firmly to their child so they know who is the boss and that you mean business.

Encourages their child to express their negative or angry feelings openly.

36

Number 67 511 98

Freq (%) 9.61 73.31 14.06

21

3.01

153

21.95

244

35.01

140

20.09

160

22.96

SCORE’s Parents Skills Training Program: Final Evaluation Report Q3: An 11-year-old girl tends to yell and shout at her younger sister, in order to get what she wants. She is most likely to have learned this by: Seeing characters from her favorite TV show yelling at each other.

Listening to loud music, which may have affected her hearing.

Listening to her parents raise their voices at her, when she does not do her chores or do as she’s told.(Expected Answer) It’s probably just part of her nature.

Q4: Of the following approaches to child rearing/raising/upbringing, which one do you prefer to use in your home?

Being strict, rigid and punish the child whenever in wrong Being firm, set limits and goals for the child, use reasoning and encourage independence of the child (Expected Answer) Being relaxed about the child’s conduct, understand his situation, and treat the child like a peer To let the child live his/her own life. All one needs to do is provide food, shelter, clothing and school fees Q5: 305 A child is jumping on the chair. Her mother wants her to stop. Which approach would be most effective?

Telling her to stop jumping on the chair and to jump outside if she would like to jump. (Expected Answer) Saying “[NAME], don’t be so silly”.

Explaining to her again, why jumping on the chair is dangerous.

Asking her to explain why she wants to wreck the chair.

37

50

7.17

5

0.72

355 287

50.93 41.18

95

13.63

371

53.23

225

32.28

6

0.86

238 12

34.15 1.72

424 23

60.83 3.3

SCORE’s Parents Skills Training Program: Final Evaluation Report

Annex A3: Percentage of caregivers with 'correct' Knowledge on acceptable parenting practices

Overall (%)

Central (%)

Northern (%)

Eastern (%)

Western (%)

Mean difference control vs intervention

Correct expected behaviour

Control

Interventio n

Contr ol

Intervention

Control

Intervention

Control

Intervention

Control

Intervention

P-value

Question 1

70.28

76.56

72.8

76.2

89.1

76.7

41

81.8

64.7

74.5

0.0612

Question 2

25.56

18.1

21.9

17.3

37

14

30.8

24.2

27.5

21.3

0.0175

Question 3

50

51.93

44.2

51.4

63

58.1

43.6

30.3

68.6

63.8

0.6113

Question 4

49.44

57.27

47.8

52.3

63

69.8

48.7

60.6

45.1

66

0.0386

Question 5

38.06

29.97

36.6

29.4

34.8

27.9

38.5

9.1

47.1

48.9

0.0245

Overall (passed at least two questions)

42.78

45.7

39.3

43.9

60.9

48.8

30.8

30.3

51

61.7

0.4387

Source: Computations from Survey data Notes: Question 1: When children receive lots of hugs and cuddles from parents they mostly (Ans. Feel loved, secure and wanted) Question 2: When disciplining a child it is important that a parent: (Ans. Is consistent in their reaction to their child’s misbehavior.)

Question 3: .An 11-year-old girl tends to yell and shout at her younger sister, in order to get what she wants. She is most likely to have learned this by: (Ans. Listening to her parents raise their voices at her, when she does not do her chores or do as she’s told).

Question 4: .Of the following approaches to child rearing/raising/upbringing, which one do you prefer to use in your home? (Ans. Being firm, set limits and goals for the child, use reasoning and encourage independence of the child) Question 5: A child is jumping on the chair. Her mother wants her to stop. Which approach would be most effective? (Ans. Telling her to stop jumping on the chair and to jump outside if she would like to jump.)

38

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report Annex A4: SOCIAL AND EMOTIONAL WELL-BEING OF CHILDREN

Indicator EMOTIONAL SYMPTOM SCALE A lot of headaches, Worry a lot Often unhappy Nervous in new situations Having many fears CONDUCT PROBLEM SCALE Getting very angry Usually do as your told Fighting a lot Often accused of lying

Control Intervention p- value Number %age Number %age 54 47.8 84 45.2 0.178 24 16.8 37 19.9 0.472 18 12.6 35 18.8 0.128 31 21.7 39 21 0.876 34 23.8 49 26.3 0.595

Taking things that are not mine from home/school .

HYPERACTIVITY SCALE Being restless Constant fidgeting or squirming Easily distracted Thinking before doing something Able to accomplish tasks/ work given PEER PROBLEM SCALE Usually I am on my own Having one good friend People of my age generally like me Young people pick on me Getting on better with adults than people of my age PRO-SOCIAL SCALE Trying to be nice to other people Sharing with others Helping if someone is hurt Often kind to young children Often volunteer to help others

Source: Computations from Survey data

37 120 8 27

25.9 83.9 5.6 18.9

44 165 10 21

23.7 88.7 5.4 11.3

0.643 0.205 0.931 0.053

10

7

7

3.8

0.19

15

10.5

16

8.6

0.561

7 14

4.9 9.8

12 17

6.5 9.1

0.549 0.841

110

76.9

148

71

0.563

127

88.8

169

90.9

0.54

20 134

14 93.7

23 175

12.4 94.1

0.666 0.886

129 52

90.2 36.4

158 48

85 25.8

0.156 0.039

34

23.8

54

29

0.286

134 132 128 136 129

93.7 92.3 89.5 95.1 90.2

168 175 167 171 169

90.3 94.1 89.8 91.9 90.9

0.268 0.522 0.935 0.254 0.841

39

SCORE’s Parents Skills Training Program: Final Evaluation Report Annex A5: STUDY TOOLS SURVEY QUESTIONAIRE PART I: CAREGIVER QUESTIONNAIRE QUESTIONNAIRE NUMBER |__|__|

INTERVIEWER CODE |__|__||__|__|

Cover Sheet Instructions – Please complete this cover sheet for each household where a questionnaire is administered. Do not leave any spaces blank. When you arrive at the household, ask to speak to the primary caregiver of the children in the household.

Identification 001 Questionnaire number 002 Type of location Circle 003 Region 004 District 005 Sub-county/Division 006 Parish/Ward 007 Village/Cell/Zone 008 Household number (from study sampling list)

Urban Rural

1 2

Interview Log Visit 1

Visit 2

Visit 3

Date (day/month/year) Interviewer Comments Interview comment codes: Interview completed 1; Appointment made for later today 2; Appointment made for another day 3; Refused to continue and no appointment made 4; Other (Specify) 5

009 Interviewer NAME 010 DATE INTERVIEW COMPLETED (DD/MM/YYY) COMMENTS

40

CODE |__|__|

SCORE’s Parents Skills Training Program: Final Evaluation Report SCREENING QUESTION

Is this person in the treatment group or control group? (CIRCLE APPROPRIATELY ):

Control Intervention

0 1

SECTION 1: CAREGIVERS’ SOCIO-DEMOGRAPHIC CHARACTERISTICS First, I have a few questions about you and the children under your care.

NO. 101 102

Question Record caregiver sex Circle How old were you at your last birthday?

(RECORD AGE IN COMPLETE YEARS)

103

Marital Status

104

What is your religion?

Coding Category Female Male

106

1 2

[__ __] years Married, living with spouse 1 Married, not living with spouse 2 Not married, living with partner 3 In a relationship, not living with partner 4 Single, not in a relationship 5 Divorced / separated 6 Widower / Widow 7 Other (Specify) ____________ 98 Orthodox 1 Catholic 2 Protestant 3 Muslim 4 Traditional religion 5 Born again/Pentecostal 6 None / No religion 7 Other (specify): ______________98 Yes 1 No 2 Primary 1 Secondary 2

(CIRCLE ONE ONLY)

105

Skip

Have you ever attended school?

CIRCLE ONE ONLY What is the highest educational qualification you have obtained?

GRADE/FORM/CLASS |__|__| Technical/vocational Cert 3 University/college Diploma 4 University/college Degree 5 Other (Specify)_______98 107

What is your occupation?

108

Estimated monthly household income

109

How many children aged 0-17 years are you responsible for? If the answer is 0,

UGX________________ [__ __] children

41

107

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report NO.

Question terminate the interview and note on cover page.

Coding Category

42

Skip

SCORE’s Parents Skills Training Program: Final Evaluation Report 110

Are you the head of household

111

What is the sex of the household head

112 113

How old is the head of household? (years) In the last six months, have you visited a health facility to receive services (whether due to illness or routine care)?

In the last six months, have you visited a health facility to receive HIV prevention, care or treatment services?

I don’t want to know the results, but have you ever been tested to see if you have the HIV virus?

Have you been tested for HIV within the last six months?

114

115

116

If yes 113

Yes 1 No 2 Female 1 Male 2 [__ __] years Yes No

1 2

Yes No

1 2

Yes No

1 2

Yes No

1 2

SEC2

SECTION 2: PARTICIPATION IN SCORE PARENTING TRAINING (FOR ONLY PARENTS IN THE INTERVENTION GROUP) As part of the SCORE parenting skills training, did you receive training on the following:

Yes

No

The 4 different parenting styles and responsibilities of a parent (module 1)

1

0

202

How to handle different child personalities, the stages of child growth and development, and how to build children’s self-esteem (module 2)

1

0

203

Best techniques for parent-child communication and dealing with sibling rivalry (Module 3)

1

0

204

Positive discipline techniques as opposed to corporal punishment (such as taking away privileges, reward for good behaviors, explaining to the child what they did wrong and why it’s etc) (module 4)

1

0

How to be a good parent (Module 5)

1

0

201

205

ALL CAREGIVERS [BOTH IN THE INTERVENTION AND CONTROL GROUP] 206

Have ever received training about parenting from elsewhere other than SCORE!

43

Yes No

1 2

SCORE’s Parents Skills Training Program: Final Evaluation Report SECTION 3: PARENTS’ KNOWLEDGE TEST Please read each of the following questions carefully and circle the response which you consider would be the most effective action for a parent to take. Please circle only one response for each question.

[READ OUT RESPONSES TO THE RESPONDENT] 301 .When children receive lots of hugs and cuddles from parents they mostly: a) Become needy and dependent. b) Feel loved, secure and wanted. c) Find it harder to separate from their parents. d) Are more likely to become interested in the opposite sex early.

302 .When disciplining a child it is important that a parent: a) Is consistent in their reaction to their child’s misbehavior. b) Makes sure their child feels a bit of pain or discomfort so they will remember what they have done wrong. c) Speaks firmly to their child so they know who is the boss and that you mean business. d) Encourages their child to express their negative or angry feelings openly.

303 .An 11-year-old girl tends to yell and shout at her younger sister, in order to get what she wants. She is most likely to have learned this by: a) Seeing characters from her favorite TV show yelling at each other. b) Listening to loud music, which may have affected her hearing. c) Listening to her parents raise their voices at her, when she does not do her chores or do as she’s told. d) It’s probably just part of her nature.

304 .Of the following approaches to child rearing/raising/upbringing, which one do you prefer to use in your home? a) Being strict, rigid and punish the child whenever in wrong b) Being firm, set limits and goals for the child, use reasoning and encourage independence of the child c) Being relaxed about the child’s conduct, understand his situation, and treat the child like a peer d) To let the child live his/her own life. All one needs to do is provide food, shelter, clothing and school fees 305 A child is jumping on the chair. Her mother wants her to stop. Which approach would be most effective? a) Telling her to stop jumping on the chair and to jump outside if she would like to jump. b) Saying “[NAME], don’t be so silly”. c) Explaining to her again, why jumping on the chair is dangerous. d) Asking her to explain why she wants to wreck the chair.

44

SCORE’s Parents Skills Training Program: Final Evaluation Report SECTION 4: PARENTING STYLES AND DIMENSION QUESTIONNAIRE (PSDQ) I am going to read to you some statements relating to different parenting practices. Kindly indicate how often you use or apply each of the following practices: For each statement, state: “never,’ ‘sometime’ or ‘always’.

401 402 403 404 405 406 407 408 409 410

411 412 413

414 415

When my child misbehaves, I explain what they did wrong and why it’s bad I give my child reasons why rules should be obeyed.

I show respect for my child's opinions by encouraging my child to express them.

I encourage my child to freely express him/herself even when disagreeing with me I take into account my child's preferences in making plans for the family.

I allow my child to give input into family rules.

I use physical punishment as a way of disciplining my child.

I yell or shout when my child misbehaves.

I scold or criticize when my child's behaviour doesn't meet my expectations.

When your child asks why he/she has to do something do you ever say: “because I said so” or “because I am your parent” instead of giving them a reason?

Do you ever punish your child for disagreeing with you or questioning why they have to do something?

I find it difficult to discipline my child.

Do you ever bribe your child with rewards to make them behave?

When your child causes a commotion or has a tantrum about something, do you give them what they want?

Are you unsure of how to handle your child’s misbehavior?

Are you afraid that disciplining your child will cause them not to like you?

45

Never 0

Sometime 1

Always 2

0 0

1 1

2 2

0

1

2

0

1

2

0 0 0 0

1 1 1 1

2 2 2 2

0

1

2

0

1

2

0 0 0

1 1 1

2 2 2

0 0

1 1

2 2

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report SECTION 5: PARENT BEHAVIOR INVENTORY Please think about each statement carefully. Think about how you and your child generally get Along. Tell us how well the statement describes the way you have usually acted with your child within the past 1 month.

0 not at all true (I do not do this) 1 Moderately/Somewhat True 2. True (I often do this) Not Moderately/ True (I true (I do not Somewhat often do do this) true this) 0 1 2 501 I lose my temper when my child doesn't do something I ask 0 1 2 him/her to do.

502 I have pleasant conversations with my child.

0 1 2 503 I grab or handle my child roughly.

0 1 2 504 I try to teach my child new things.

0 1 2 505 I demand that my child does something (or stop doing something) 0 1 2 right away.

506 My child and I hug each other.

0 1 2 507 I complain about my child's behaviour or tell my child I don't like 0 1 2 what s/he is doing.

508 I laugh with my child about things we find funny.

0 1 2 509 When my child misbehaves, I let him/her know what will happen if 0 1 2 s/he doesn't behave well 510 My child and I spend time playing games, doing crafts, or doing 0 1 2 other activities 511 I listen to my child's feelings and try to understand them.

0 1 2 512 I thank or praise my child.

0 1 2 513 I spank or use physical punishment with my child.

0 1 2 514 I offer to help my child with things s/he is doing.

0 1 2 515 I threaten my child.

0 1 2 516 I comfort my child when s/he seems scared, upset, or unsure.

0 1 2 517 I say mean/unpleasant things to my child that can make him/her 0 1 2 feel bad.

518 I hold or touch my child in an affectionate way 0 1 2 519 When I am disappointed in my child's behaviour, I remind him/her 0 1 2 about what I've done for him/her 520 When my child asks for help or attention, I ignore him/her or 0 1 2 make him/her wait until later.

46

SCORE’s Parents Skills Training Program: Final Evaluation Report SECTION 6: CHILD-PARENT RELATIONSHIP List the names of all children 3-12 years, from oldest to youngest. Using the last digit of the serial number of the questionnaire, find that number along the top row of the table. Follow that number down to the last line where a child is listed. The number that you come to is the number of the child that should be surveyed (as indicated in the number column on the far left). Circle the index child selected or indicate in writing if there are no this age category.

#

Name of eligible individuals 3-12 years listed from oldest to youngest

Age (3-12)

Last digit of questionnaire serial number 1 1 1 2 1 3 3 4 2 5 5 6 4 7 3 8 3 9 2 10 1

1 2 3 4 5 6 7 8 9 10

2 1 1 2 3 4 5 4 4 3 2

3 1 2 1 4 3 6 5 5 4 3

4 1 2 3 1 2 1 6 6 5 4

5 1 1 2 2 1 2 7 7 6 5

6 1 1 1 3 5 3 1 8 7 6

7 1 2 3 4 4 4 2 1 8 7

8 1 2 2 1 3 5 3 2 9 8

9 1 1 1 2 2 3 4 3 1 9

0 1 1 3 3 1 1 5 4 2 1

RECORD THE FIRST NAME OF THE CHILD SELECTD:________________________ We are going to ask you some specific questions relating to you relate with [Name of Index Child] in this section.

Please reflect on the degree to which each of the following statements has applied to your relationship with your child in the past 1 month. Using the scale below, circle the appropriate number for each item.

Child-Parent Relationship Scale (CPRS)

601 602 603 604 605 606 607

I share an affectionate, warm relationship with [NAME INDEX CHILD] [NAME INDEX CHILD] and I always seem to be struggling with each other.

If upset, [NAME INDEX CHILD] will seek comfort from me.

[NAME INDEX CHILD] is uncomfortable with physical affection or touch from me.

[NAME INDEX CHILD] values his/her relationship with me.

When I praise [NAME INDEX CHILD], he/she beams with pride.

[NAME INDEX CHILD] spontaneously shares information about himself/herself.

47

Not True/Not Really (I don’t do this) (1) 1

Not Sure (2)

True/Definitely True

2

(3) 3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

SCORE’s Parents Skills Training Program: Final Evaluation Report

608 609 610 611 612 613 614 615

[NAME INDEX CHILD] easily becomes angry at me.

It is easy to be in tune with what [NAME INDEX CHILD] is feeling.

[NAME INDEX CHILD] remains angry or is resistant after being disciplined.

Dealing with [NAME INDEX CHILD] drains my energy.

When [NAME INDEX CHILD] is in a bad mood, I know we're in for a long and difficult day.

[NAME INDEX CHILD] feelings toward me can be unpredictable or can change suddenly.

[NAME INDEX CHILD] is sneaky or manipulative with me [NAME INDEX CHILD] openly shares his/her feelings and experiences with me.

Not True/Not Really (I don’t do this) (1) 1

Not Sure (2)

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

SECTION 6: ATTITUDE TOWARDS PHYSICAL PUNISHMENT No. Question 701 Do you think that hitting or beating a child is an appropriate means of discipline or control in the home?

702 Do you think that hitting or beating a child is an appropriate means of discipline or control at school?

True/Definitely True (3)

Coding Category Yes No Yes No

Skip 1 2 1 2

SECTION 8: PERCIEVED CHANGES AS A RESULT OF THE PARENTING SKILLS TRAINING (ONLY APPLIES FOR THE INTERVENTION GROUP)

801 802 803 804 805 806 807 808 809 810

In your opinion, do you think the parenting skills training assisted/helped you improve on the following practices: Feeding practices for your child/ren Sending children to school Health care seeking for your child/ren in times of sickness Sanitation in the home Prevention and management of childhood illness (e.g. Malaria) Timely immunization for your child/ren Providing children with opportunities to play Teaching children on how to relate with others Protection of children from abuse/violence Not overloading children with work

48

Yes

No

Cannot tell

0 0 0 0 0 0 0 0 0 0

1 1 1 1 1 1 1 1 1 1

2 2 2 2 2 2 2 2 2 2

SCORE’s Parents Skills Training Program: Final Evaluation Report Indicate the extent to which you agree with the following statements in relation to training Agree/Strongly Not Agree sure 811 The SCORE parenting training increased my understanding of 2 1 my child’s behavior.

812 I am more confident in dealing with my child because of the 2 1 SCORE parenting training 813 I feel my relationship with my child has 2 1 improved as a result of the SCORE parenting training 814 I feel better able to understand my 2 1 child’s needs as a result of the SCORE parenting training 815 I learned helpful ways to interact with my child as a result of 2 1 the SCORE parenting training 816 The SCORE parenting training helped me to feel less stressed 2 1 as a parent

Disagree/Strongly disagree 0 0 0 0 0 0

SECTION 9: CAREGIVER RESPONSIBILITIES AND CHILDCARE (FOR BOTH THE INTERVENTION AND CONTROL GROUP).

SN A 901 902 B

Question

None of the time

DIETRAY INTAKE Do you provide enough food for the family?

Do you always give sufficient amount of food to all children n in the home?

EDUCATION

Sometimes

All of the time

1

2

3

1

2

3

None of the time 1

Sometimes 2

Yes 1 No 2 Yes 1 No 2 All of the time 3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

903

Do all the children who are of school going age (6 – 17 years) enrolled in School?

904

Do you take all the children in this home to equally good schools?

905 906 907 C 908 909 910

911

Do you check on all the children's performance in School?

Do you believe education for your children to be important investment for their future prosperity?

Do you consider education to be important for all the children in your home?

CHILD PROTECTION Do you provide adequate beddings for all the children in your home?

Do you provide emotional help and support to all your family members?

Do you consider the opinions of your children /family members when taking decisions that affect their wellbeing at home or school?

HEALTH Do you always seek prompt medication/treatment for all the children/family members when they fall sick?

These are all the questions I have for you. I very much appreciate your time today. If you have any questions about the survey, please use the contact information on your consent form I am leaving with you.

49

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

PART II: CHILD QUESTIONNAIRE, 10-17 YEARS These questions are to be asked to the child in the absence of an adult care giver and other children. Only the interviewer and the child should be the ones to participate. The child is selected randomly as indicated below.

RECORD Number of Children 10-17 years |___|___|___| Mark this box only if there are no children in the household aged 10-17 years. If box is marked, move to next age group questionnaire.

ď Ż

If there is more than one child aged 10-17 years, use the Kish grid to randomly select one child from this age group and interview that child. If there is no child aged 10-17 years in the household, skip the next section and go to next household.

Kish Grid List the names of all children 10-17 years, from oldest to youngest. Using the last digit of the serial number of the questionnaire, find that number along the top row of the table. Follow that number down to the last line where a child is listed. The number that you come to is the number of the child that should be surveyed (as indicated in the number column on the far left). Circle the index child selected.

#

Name of eligible individuals 10-17 years listed from oldest to youngest

Age (10-17)

Last digit of questionnaire serial number 1 1 1 2 1 3 3 4 2 5 5 6 4 7 3 8 3 9 2 10 1

1 2 3 4 5 6 7 8 9 10

2 1 1 2 3 4 5 4 4 3 2

3 1 2 1 4 3 6 5 5 4 3

4 1 2 3 1 2 1 6 6 5 4

5 1 1 2 2 1 2 7 7 6 5

6 1 1 1 3 5 3 1 8 7 6

7 1 2 3 4 4 4 2 1 8 7

8 1 2 2 1 3 5 3 2 9 8

9 1 1 1 2 2 3 4 3 1 9

INDEX CHILD 10-17 Years Name of Selected Child:_________________________ Ask caregiver for permission to speak with [selected child].

R E S P O N D E N T C O N S E N T / A SS E N T *Make sure that the Informed Parental/Guardian Consent AND Informed Assent forms are signed before proceeding* 50

0 1 1 3 3 1 1 5 4 2 1

SCORE’s Parents Skills Training Program: Final Evaluation Report SECTION 1: INFORMATION ABOUT THE CHILD I have a few questions about [insert child’s name from Kish grid above].

No. Question Coding Category Is [NAME] male or female?

Female 1 101 Male 2 How old are you?

102 [__ __] years

103

Relationship of [NAME] to Household Head

104

Do you have any form of disability?

For example; having a problem with your sight, walking, speech, epileptic or any other difficulties?

105

Do you have a birth certificate?

106

Are you currently enrolled in school?

107

During the last school week, did you miss any school days for any reason?

What class are you in now?

108

Don’t have Got difficulties in sight Got difficulties in hearing Got difficulties in walking Got difficulties in speech Epileptic Other difficulties Don’t know No response

Skip

1 2 3 4 5 6 7 8 9

Yes

1

Yes

1 If no: 110

Yes

1

No

No

No Primary Secondary

2

2

2 1 2

GRADE/FORM/CLASS |__|__|

Technical/Vocational training 3

109

110 111

Other (Specify)________________98

How would you rate your [Academic] performance at school? Would you say it is excellent, very good, good, average or poor?

Excellent Very good Good Average Poor Don’t know No response

Were you enrolled in school during the previous school year?

What class were you during the previous school year?

Yes

No

1 2 3 4 5 6

7 1 If no: 112 2

Primary 1 Secondary 2 GRADE/FORM/CLASS |__|__|

Technical/Vocational training 3

Other (Specify)________________98

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SCORE’s Parents Skills Training Program: Final Evaluation Report

112 113 114 115 116

Have you been to a health facility to receive services in the past six months (whether due to illness or routine care)?

I don’t want to know the results, but have you ever been tested to see if you have the HIV virus?

Have you been tested for HIV within the last six months?

I don’t want to know the results but do you know the results of the HIV test?

Have you experienced any form of physical violence in the past 12 month at home or school? *Physical violence include: Pushed, Grabbed, or Kicked , Hit, beat, or spanked you with a hand/object/stick

117

Have you experienced any form of emotional/psychological violence in the past 12 month? *psychological violence: called bad names, being made to feel unwanted, or being threatened, insulted, scolded, screamed at loudly and aggressively, called funny names, made you feel shamed/embarrassed, Been bullied

118

Have you experienced any form of sexual violence in the past 12 month?

*sexual violence : unwanted touching in a sexual way (i.e., unwanted touching, kissing, grabbing, or fondling), (2) attempted unwanted intercourse (3) physically forced intercourse and (4) coerced sexual intercourse

SECTION 2: PERCEIVED PARENT-CHILD RELATIONSHIP 201 My parents want me to follow their directions even if I disagree with their reasons.

202 I have to ask my parents' permission to do most things.

203 My parents get upset if I disagree with them when their friends are around.

204 My parents trust me to do what they expect without checking up on me 205 My parents encourage me to give my ideas and opinions even if we might disagree.

206 How much do you take part in making family decisions about yourself

52

Yes No

1 2

Yes No Yes No

1 2 If NO: 116 1 2

Yes No

1 2

Yes No

1 2

Yes No

1 2

Yes No

1 2

True 1 False 0 True 1 False 0 True 1 False 0 True 1 False 0 True 1 False 0 Very much 2 Much 1 Very Little 0 Little 0

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report SECTION 3: SOCIAL AND EMOTIONAL WELL-BEING FOR CHILDREN Children and Adolescents SDQ(S)10-17 Instructions: For each item, Circle: Not True, Somewhat True or Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain.

Emotional symptom scale I get a lot of headaches, stomach-aches, or sickness I worry a lot I am often unhappy, depressed or tearful I am nervous in new situations. I easily lose confidence I have many fears, I am easily scared Conduct problem scale I get very angry and often lose my temper I usually do as I am told I fight a lot. I can make other people do what I want I am often accused of lying I take things that are not mine from home, school or elsewhere Hyperactivity scale I am restless. I cannot stay still for long I am constant fidgeting or squirming I am easily distracted I think before I do thing I finish the work that I am doing Peer Problem scale I am usually on my own I have one good friend or more Other people my age generally like me Other children or young people pick on me I get on better with adults than with people of my age Pro-social Scale I try to be nice to other people I usually share with others I am helpful if someone is hurt, upset or feeling ill I am kind to younger children often I often volunteer to help others

53

Not True

Somewhat True

Certainly True.

0 0 0 0 0

1 1 1 1 1

2 2 2 2 2

0 2 0 0 0

1 1 1 1 1

2 0 2 2 2

0 0 0 2 2

1 1 1 1 1

2 2 2 0 0

0 2 2 0 0

1 1 1 1 1

2 0 0 2 2

0 0 0 0 0

1 1 1 1 1

2 2 2 2 2

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report SECTION 4: GENERAL CHILD-WELFARE SN Question A FOOD AND NUTRITION 1 Do you eat at least two meals a day?

2 Do you always have enough food to eat?

Do you always get equally sufficient amount of food as 3 other children in the home?

4 Do you go to bed hungry?

B EDUCATION Have you ever been refused to go to school in order to do household work (e.g. digging, cooking, selling goods in a 5 market, etc?

Does the parent /guardian check on your performance in 6 School?

Do you go to equally good schools like the other children in 7 the home?

8 Do teachers treat you like other pupils/students at school?

Do your parents/guardians provide you with enough 9 materials (books/pens) for class work?

C CHILD PROTECTION Do you have adequate beddings as other children in your 10 home?

11 Do you feel secure in your home where you live?

12 Do you feel loved and cared for by your parents/guardians Have you ever been sexually abused by anyone in the 13 family or community?

Have you ever been physically abused by any member of 14 the family/ or community?

Have you ever been threatened by anyone in this home to 15 make you feel wanting to go and live somewhere else?

Are you treated differently from the other children in the 16 household?

Do you get the emotional help and support from your 17 family?

Do the parents/guardian use corporal punishment when 18 you do wrong things?

Do you trust your parent/Guardian and can confide in them 19 when you have a problem?

Do you freely express your feelings to your 20 parent/Guardian?

54

None of the time

Sometimes

All of the time

0 0

1 1

2 2

0 0

1 1

2 2

0

1

2

0

1

2

0 0

1 1

2 2

0 0

1 1

2 2

0 0 0

1 1 1

2 2 2

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report SN

Question

Do you participate in family activities such as house 21 chores, parties, prayer, visiting relatives, etc.?

Do you feel you get enough support from your family 22 when you face challenges?

Do you feel you get a good balance of play time and work 23 time at home?

Is your opinion considered when taking decisions that 24 affect your wellbeing at home or school?

D HEALTH 25 Do you regularly fall sick?

Do you get prompt medication/treatment when you fall 26 sick?

27 Do you sleep under a treated mosquito net?

Do you feel that your parent/guardian does his/her best 28 to keep you in good health?

None of the time

Sometimes All of the time

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

0 0

1 1

2 2

0

1

2

These are all the questions I have for you. I very much appreciate your time today. If you have any questions about the survey, please use the contact information on your consent form I am leaving with you.

55

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report FGD GUIDE WITH CAREGIVERS WHO PARTICIPATED IN THE SCORE PARENTING SKILLS TRAINING Date of FGD: Time Start/End

Start

End

FGD Moderator: FGD Note taker Number of participants:

Total:__________

Male_________

Female____

District INTRODUCTION My name is ______________________________________ I am working on behalf of the Department of Social Work and Social Administration. We are interested in learning more about the effectiveness of parenting skills parenting initiative, undertaken as part of SCORE, a United States Agency for International Development (USAID) funded program. The findings from this study will be used by the program and its partners including district governments and our donor to inform implementation of activities going forward.

The discussion will last approximately 1 hours. You participation in this interview is completely voluntary and will not affect the services you receive within this or future programs. In addition, We will protect the information about you and your part in this research to the best of our ability.

Do you have any questions about this study right now? Do you need any clarifications? (pause to let the respondent answer any question/clarify any issues) Please do not hesitate to ask any question or raise any doubt that you may have. I can respond to any question you may have.

QUESTIONS Instruction: Probe for examples or stories to support points made 1.

2.

3.

How do you see your role as a parent, in your childâ&#x20AC;&#x2122;s development?

Have you participated in the SCORE parenting skills training? How many sessions did you attend?

What issues/themes were discussed during the training? Do you think these themes/issues were relevant/useful to you as a parent? Why? a.

Probe: Which themes/topics/aspect did you find most relevant to you as a parent?

4.

5.

Let us talk about the training methodology. Do you think it was effective?

Overall, did you find the training beneficial? In what ways? a. Probe: What is the most important thing you learned in the SCORE parenting training?

6.

What changes, in parenting knowledge, skills and practices, if any, have occurred as a result of participating in the SCORE parenting skills training initiative? Probe: a. What things do you do now that you were not doing before the training? b. What discipline methods are you using with your child/ren? Have these changed, based on the training? c. Has the way you communicate (listen/talk) with your child/ren changed after the SCORE

56

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

d. e.

Parenting training? How? Do you think the training helped you understand and improve your parenting style? (Explain what your parenting style was like before, and how it has changed.)

Probe for any changes in Parent-child interaction, Discipline and Behavior Management, use of effective discipline, nurturing behavior

7.

Did the way you relate with your children changed in any way, as a result of participating in the SCORE parenting skills training? How? 8. Have you observed any changes in children behaviors since you attended the SCORE parenting skills training? Which changes? What do you attribute these changes to?

9. Have you observed any change in the well-being of your children as a result of the SCORE parenting skills training? Which specific/particular changes have your observed? What do you attribute these changes to?

10. Any unintended outcomes as result of the SCORE parenting skills training 11. What themes/aspects would you like to be included in future parenting skills trainings?

Is there anything else you want to share with us?

THANK PARTICIPANTS FOR THEIR INPUTS. REMIND THEM ABOUT CONFIDENTIALITY.

57

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report KEY INFORMANT INTERVIEW GUIDE Date of interview Time Start/End

Start

End

FGD Moderator: FGD Note taker Tittle the informant Name of organization/department District INTRODUCTION My name is ______________________________________ I am working on behalf of the Department of Social Work and Social Administration. We are interested in learning more about the effectiveness of parenting skills parenting initiative, undertaken as part of SCORE, a United States Agency for International Development (USAID) funded program. The findings from this study will be used by the program and its partners including district governments and our donor to inform implementation of activities going forward.

The interview last approximately 1 hours. Your participation in this interview is completely voluntary and will not affect the services you receive within this or future programs. In addition, we will protect the information about you and your part in this research to the best of our ability.

Do you have any questions about this study right now? Do you need any clarifications? (pause to let the respondent answer any question/clarify any issues) Please do not hesitate to ask any question or raise any doubt that you may have. I can respond to any question you may have.

QUESTIONS Instruction: Probe for examples or stories to support points made 1.

2.

3.

How are you involved with the SCORE parenting skills training?

What was the focus of the parenting skills training? What themes/aspects were covered during the training?

Who was targeted for the training? How were they selected?

4.

Overall, do you think the parenting skills training was relevant? Please explain

5.

What changes, in parenting knowledge, skills and practices, if any, have occurred as a result of participating in the SCORE parenting skills training? Probe: Probe for any changes in Parent-child interaction, parent-child communication, discipline and behavior management by caregivers etc

6.

What other positive changes have you observed in among children as a result of the parenting skills training? Probe for changes in the behavior and wellbeing of children.

58

SCOREâ&#x20AC;&#x2122;s Parents Skills Training Program: Final Evaluation Report

7.

Are there any unintended outcomes as result of the SCORE parenting skills training? Please described these.

8.

What themes/aspects would you like to be included in future parenting skills trainings?

Is there anything else you want to share with us?

THANK PARTICIPANTS FOR THEIR INPUTS. REMIND THEM ABOUT CONFIDENTIALITY.

59

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