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Transitioning Colombia’s National Positive Parenting Program, Mi Familia, to Virtual Delivery During the COVID-19 Pandemic
Submitted by Juan S. Barco, HRH2030 Colombia Project Director, Chemonics International; Juan P. Angulo, Technical Director, ICBF Families and Communities Directorate; Kattya De Oro, Deputy Technical Director, ICBF Family and Community Directorate; Sonia Moreno, HRH2030 Colombia Social Services Specialist, Chemonics International; Kelley Bunkers, Senior Associate, Maestral International; Sian Long, Senior Associate, Maestral International
In Colombia, four out of every 10 children under the age of 18 have experienced some form of physical, sexual and/or emotional abuse in their childhood. Colombia’s National Development Plan 2018-2022 states the importance of designing services to strengthen parental relationships, promote child development and decrease violence against children, calling for the promotion of family-based care. It prioritizes families with children and adolescents already in the protection system, to reduce secondary separation rates and increase successful family reunification processes.
The Colombian Family Welfare Institute (ICBF) is the country’s main entity responsible for strengthening services for children, adolescents and families. In 2019, ICBF’s Families and Communities Directorate (FCD), the department charged with overseeing programs and services targeting vulnerable families, with support from USAID’s Human Resources for Health (HRH2030) program and Maestral International, designed a comprehensive parenting program called Mi Familia. The program is apsychosocial-based family support program that seeks to strengthen parents’ and caregivers’ ability to parent in positive, developmentally appropriate ways with the end goal of preventing violence and unnecessary separation. Mi Familia is a home-visiting program in which trained Family Support Professionals (or PAFs as per the Spanish acronym) conduct weekly home visits over 9 or 13 weeks, supplemented by four group sessions. Mi Familia is implemented by 40 approved agencies. The goal for 2020 was to reach 64,000 families in all regions of Colombia.
The implementation of Mi Familia began in early 2020. However, in March of 2020, ICBF had to rapidly adapt to a remote delivery method due to the national lockdown caused by COVID-19. ICBF FCD, with support from HRH2030, adapted the in-person curriculum to simple protocols that the PAFs could use to support families over the telephone. PAFs spoke with each family during 20-minute calls, three times a week. PAFs were provided with data for their phones to ensure that the additional work via phones could happen in a timely manner. Mi Familia’s operational structures remained the same, maintaining the same number of PAFs in order to ensure high quality services and personalized attention. In fact, the program’s savings in transportation costs were invested in greater technological resources.
The shift to virtual happened quickly, yet PAFs reported feeling supported and prepared to deliver the virtual model. Technical Assistance Professionals helped to review the virtual guides that were adapted from the in-person manuals. Their input was instrumental in ensuring that implementation would be feasible. There were virtual training sessions provided by the Technical Assistance Professionals, and ongoing discussion groups where PAFs could share their concerns or challenges. These were then communicated to ICBF. Most agreed that the flexibility shown by ICBF and the trust shown in the ability of PAFs to deliver content was an empowering element that contributed to overall success as was mentioned in a focus group discussion. As one PAF noted, "The Technical Assistance Professionals support us, listen to us, and that has helped us a lot to lower the stress not only of work but about ourselves as human beings."
The virtual delivery of Mi Familia formally began in May 2020. At the same time, a monitoring plan was designed to assess the virtual implementation process, using three monitoring tools. The first, a Family Satisfaction Survey, included 10 simple questions on overall levels of satisfaction with the program and specific questions related to content and delivery. ICBF’s call center staff surveyed 282 families between August and October 2020. The second tool was a more detailed questionnaire to selected PAFs regarding content and delivery, focusing on their perceptions of families’ satisfaction and engagement to the program and their successes and challenges. The third tool was a series of six focus group discussions with PAFs and technical support unit staff, focusing on qualitative aspects of the successes and challenges in the transition to virtual delivery.
Findings illustrated that ICBF FCD had transitioned from in-person to virtual delivery of Mi Familia rapidly and effectively. Both families and PAFs felt the information and topics were relevant for parenting roles and helpful for children and adolescents. Indeed, 95.6% of the families surveyed felt satisfied with the program. Additionally, 98.3% of the PAFs surveyed responded that they always or almost always achieved session objectives, and 90.6% reported that families always or almost always understood key lessons and information in the session. A total of 99% of the PAFs felt prepared to answer the family’s questions, and 96.1% of the households confirmed this by reporting that they considered the PAFs able to clarify questions. PAFs proved to be innovative and creative in how they engaged with families and delivered the program.
The research was able to identify a number of important successes, which have been incorporated into ongoing developments of Mi Familia. These include validation of the benefits of evidence-based positive parenting approaches and the recognition of a flexible approach that enabled skilled facilitators to continue to adapt the program needs to individual families.
The virtual delivery clearly illustrated that a blended implementation is possible for a positive parenting program. As such, this would allow government entities to deliver these kinds of programs to regions and populations that historically were not targeted, specifically because they were determined as being hard to reach.
The research also identified a number of important challenges that are being addressed currently in the adaptation of Mi Familia moving forward. These include three core issue: 1)the need to focus further on how to promote children’s and adolescents’ participation in the program; 2)to better understand and address the barriers to male participation; and 3)to develop a greater focus on promoting referrals to other care providers through awareness-raising with PAFs and improved coordination with other ICBF departments and external service providers.
Moving forward, Mi Familia aims to serve 280,000 families throughout the country by the end of 2022. ICBF FCD is confident that a blended model can build on the positive experiences from the virtual program. To do so, it is necessary to strengthen training and supervision, and strengthen the relationship between the PAFs and those professionals engaged in and responsible for making care decisions, such as children’s placement in alternative care or reintegration. Finding ways to strengthen these linkages will be an important step in future implementation.
This blog summarizes a presentation given by Juan S. Barco, Juan-Pablo Angulo, and Kelley Bunkers at the CORE Group’s January 2021 Conference, Unlocking Potential: Prioritizing Child & Adolescent Health in the New Decade.