Parenting for Lifelong Health for Young Children

Parenting for Lifelong Health for Young Children (PLH for Young Children) is a group-based parenting programme that aims to establish and sustain nurturing relationships between parents and caregivers and their children ages 2-9 years, and thereby prevent and reduce the risk of violence against children and maltreatment at home and in the community. Grounded in social learning theory and behavioural change techniques, it aims to strengthen parenting skills and behaviours that help parents and caregivers provide adequate support and care to their children. By building positive relations and promoting alternatives to violent discipline, the programme also contributes to the prevention and treatment of disruptive child behaviours, and the reduction of parental stress and depression.

The programme has been or is currently being implemented in several countries, including Czech Republic, Democratic Republic of Congo, Eswatini, Kenya, Malawi, Moldova, Montenegro, North Macedonia, Philippines, Romania, South Africa, South Sudan, Thailand and Uganda.

PLH for Young Children is delivered by community-based facilitators who actively engage parents and caregivers in building positive parenting skills to improve parent-child relationships and reduce harsh discipline. It uses participatory, non-didactic methods such as group discussions, illustrated stories of parent-child interaction, role-plays to practice parenting skills, home activities assignments, and collective problem-solving. There are currently 8- and 12-session tested versions available for use by implementing agencies. Prototype adaptations have also been developed and are in the process of being tested for families with children ages 1.5 to 5 years in Kenya (in Kiswahili), and for parents and caregivers of children ages 1 to 12 years being reintegrated from residential care facilities into their family setting in Uganda.

PLH for Young Children was first tested in a feasibility pilot with 68 low-income isiXhosa parents and their children in a low-income township in Cape Town, South Africa. The study found that parents who received the programme engaged in more positive parenting strategies when compared to those who did not receive the programme. Due to these promising results, a larger study with 296 parents and children was conducted from 2014-2016 in the same setting to determine programme effectiveness. This study found that parents and caregivers who received the programme (when compared to controls) reported increases in positive parenting and decreases in harsh parenting and child conduct problems immediately after the programme was completed. At the one-year follow-up, those who received the programme also reported more non-violent discipline than parents who did not receive the programme. Data from video observations of parents and children interacting during structured tasks showed that those who received the programme had greater positive parenting behaviour immediately after the programme as well as a year later.

PLH for Young Children has been adapted and tested in a randomised controlled trial funded by the UBS Optimus Foundation and UNICEF Philippines in Metro Manila with 120 low-income families who were part of a government conditional cash transfer programme. In comparison to controls who were receiving a government programme, the study found positive programme effects for reduced child maltreatment, including physical and emotional abuse, and neglect, reduced dysfunctional parenting, reduced child behaviour problems, reduced endorsement of corporal punishment, increased daily positive parenting, and improved parental self-efficacy at 1-month follow-up.

An 8-session version of PLH for Young Children was recently adapted and tested in an RCT with 120 families in Udon Thani, Thailand, in collaboration with UNICEF Thailand and the Thai Ministry of Public Health. Parents and caregivers receiving the programme reported reduced overall child maltreatment in comparison to controls at both immediate and 3-months follow-up. Observational assessments also found reduced harsh parenting at 3-months follow up. Results also indicated increased positive parenting, monitoring, and parental efficacy, as well as reduced parental mental health problems and child behaviour problems.

PLH for Young Children is also being tested as part of a 4-year EU Horizon2020-funded study using the Multiphase Optimisation Strategy Framework in South-Eastern Europe (Macedonia, Moldova, and Romania), this study, known as RISE, aims to test programme components in order to optimise it based on effectiveness, cost-effectiveness, and scalability. Results from this study will be ready in 2022. Please see the project website for further information: http://www.rise-plh.eu/

Development and evaluation of PLH for Young Children has been funded by the World Health Organization. Ilifa Labantwana, Rand Merchant Bank Fund, the ApexHi Charitable Trust, the John Fell Fund, the Clarendon Fund, the UBS Optimus Foundation, UNICEF Thailand, UNICEF Philippines, UNICEF Montenegro, the European Research Council (ERC) [FP7/2007-2013/ ERC grant agreement n°313421], the European Union’s Horizon 2020 research and innovation fund (grant agreement No.771468), Research England, UKRI GCRF Accelerating Achievement for Africa's Adolescents Hub (Grant Ref: ES/S008101/1), and the National Research Foundation of South Africa (Grant No.: 118571).

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Lachman, J. M., Cluver, L., Ward, C. L., Hutchings, J., Mlotshwa, S., Wessels, I., & Gardner, F. (2017). Randomized controlled trial of a parenting program to reduce the risk of child maltreatment in South Africa. Child abuse & neglect, 72, 338-351. Link

Lachman, J. M., Sherr, L., Cluver, L., Ward, C. L., Hutchings, J., & Gardner, F. (2016). Integrating evidence and context to develop a parenting program for low-income families in South Africa. Journal of Child and Family Studies, 25(7), 2337-2352. doi: 10.1007/s10826-016-0389-6 Link

Wessels, I., Lester, S., & Ward, C. (2016). Engagement in parenting programmes: Exploring facilitators of and barriers to participation. Institute for Security Studies: Policy Brief #82 Link