Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica.
World Bank, Washington, DC, United States.
Front Public Health. 2023 Aug 8;11:1151826. doi: 10.3389/fpubh.2023.1151826. eCollection 2023.
Sustainable implementation of early childhood programs requires resources, materials and methods that are adaptable, scalable and feasible for delivery through multiple sectors. Additional or modified program resources may be required to meet emerging needs, as programs go to scale. An active and effective monitoring, evaluation and learning (MEL) process may enable programs to be responsive to demands. The Reach Up: Early Childhood Parenting program, is designed primarily for disadvantaged children under 4 years of age in low- and middle-income countries (LMICs) to promote their development through playful caregiver interactions. The curriculum, training manuals and other materials and resources support implementers in the adaptation of the intervention, implementation, workforce training, monitoring and evaluation. This paper reports on how data collected from key informants drove modifications to program processes, materials and resources.
We conducted in-depth interviews with 14 key informants (including program managers, lead trainers, academics, consultants and workforce personnel) on their experiences with Reach Up across 15 LMICs where the program has been implemented. We also reviewed written records generated from (i) structured small group discussions at a Knowledge Exchange meeting of 31 Reach Up partners and (ii) notes from working groups formed at the meeting and tasked to continue working post-meeting to find solutions to support ongoing implementation. The transcripts from the in-depth interviews and the meeting records were analysed using thematic analysis with a mixture of pre-defined categories and data-driven sub-themes.
The main findings indicated that there was a need to: (i) develop advocacy and communication resources and materials to aid prospective implementers and other stakeholders, to make decisions for implementation, (ii) revise and/or add to the content and format of the curriculum and add content in the training and other supporting manuals and (iii) enhance the training process.
The feedback from the key global partners informed the development of new knowledge materials, resources and processes and modifications to existing program materials and resources. These will help to support advocacy, ongoing implementations, and the process of transitioning the Reach Up early childhood intervention to scale.
可持续实施幼儿计划需要资源、材料和方法，这些资源、材料和方法应具有适应性、可扩展性，并且可以通过多个部门进行实施。随着项目规模的扩大，可能需要额外的或修改后的项目资源来满足新出现的需求。积极有效的监测、评估和学习（MEL）过程可以使项目能够响应需求。“崛起：幼儿养育计划”主要针对 4 岁以下的贫困儿童，旨在通过富有乐趣的照顾者互动促进他们的发展。该课程、培训手册和其他材料和资源支持实施者对干预措施、实施、劳动力培训、监测和评估进行调整。本文报告了如何从关键信息提供者那里收集的数据驱动了计划流程、材料和资源的修改。
我们对来自 15 个低收入和中等收入国家（LMICs）的 14 名关键信息提供者（包括项目管理人员、首席培训师、学者、顾问和劳动力人员）进行了深入访谈，了解他们在实施“崛起：幼儿养育计划”方面的经验。我们还审查了从以下方面生成的书面记录：（i）在由 31 名“崛起：幼儿养育计划”合作伙伴参加的知识交流会议上进行的结构化小组讨论，以及（ii）会议期间工作组的记录，这些工作组负责在会议后继续工作以寻找解决方案来支持持续实施。使用主题分析方法对深入访谈的记录和会议记录进行了分析，该方法结合了预先定义的类别和数据驱动的子主题。
主要发现表明，需要：（i）开发宣传和沟通资源和材料，以帮助潜在的实施者和其他利益相关者做出实施决策，（ii）修改和/或增加课程的内容和格式，并在培训和其他支持手册中添加内容，以及（iii）加强培训过程。
来自全球主要合作伙伴的反馈为新的知识材料、资源和流程的开发以及对现有项目材料和资源的修改提供了信息。这些将有助于支持宣传、持续实施以及将“崛起：幼儿养育计划”干预措施推向规模扩大的过渡过程。
