Scaling early child development: what are the barriers and enablers?
Scaling early child development: what are the barriers and enablers?
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DOI：
10.1136/archdischild-2018-315425
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发表时间：
2019-04-01
影响因子：
5.2
通讯作者：
Dua, Tarun
中科院分区：
文献类型：
--
作者：
Cavallera, Vanessa;Tomlinson, Mark;Dua, Tarun
《可持续发展目标》、《妇女、儿童和青少年健康全球战略（2016-2030年）》和《养育照料框架》都包括确保儿童茁壮成长的具体目标。然而，许多支持儿童早期发展（ECD）的项目规模不够大，导致大量儿童得不到帮助。本文是研究幼儿发展规划有效规模的系列文章中的第五篇。这项定性研究探讨了在中低收入国家有意招募的幼儿发展项目执行者中扩大规模的经验。参与者是通过滚雪球抽样的方式从现有的网络中抽样的，特别是通过拯救大脑(R)，加拿大大挑战(R)。世卫组织最近对扩大框架进行的文献综述的发现，为制定半结构化访谈时间表提供了信息。所有的采访都是用英语进行的，通过Skype，录音和逐字转录。访谈采用框架分析法进行分析。框架分析根据标准方案周期确定了六个主要主题：规划和战略选择、项目设计、人力资源、筹资和资源调动、监测和评价、领导和伙伴关系。关键资料提供者还确定了关于扩大规模意味着什么的总体主题。利益相关者没有发现现有的文献和可用的框架有助于指导他们成功地扩大规模。我们的研究表明，与其提出更多的理论指导方针或框架，不如支持利益相关者发展组织领导能力和伙伴关系战略，使他们能够在自己的环境中有效地应用实际的计划周期或系统过程。
The Sustainable Development Goals, Global Strategy for Women's, Children's and Adolescents' Health (2016-2030) and Nurturing Care Framework all include targets to ensure children thrive. However, many projects to support early childhood development (ECD) do not 'scale well' and leave large numbers of children unreached. This paper is the fifth in a series examining effective scaling of ECD programmes. This qualitative study explored experiences of scaling-up among purposively recruited implementers of ECD projects in low-and middle-income countries. Participants were sampled, by means of snowball sampling, from existing networks notably through Saving Brains (R), Grand Challenges Canada (R). Findings of a recent literature review on scaling-up frameworks, by the WHO, informed the development of a semistructured interview schedule. All interviews were conducted in English, via Skype, audio recorded and transcribed verbatim. Interviews were analysed using framework analysis. Framework analysis identified six major themes based on a standard programme cycle: planning and strategic choices, project design, human resources, financing and resource mobilisation, monitoring and evaluation, and leadership and partnerships. Key informants also identified an overarching theme regarding what scaling-up means. Stakeholders have not found existing literature and available frameworks helpful in guiding them to successful scale-up. Our research suggests that rather than proposing yet more theoretical guidelines or frameworks, it would be better to support stakeholders in developing organisational leadership capacity and partnership strategies to enable them to effectively apply a practical programme cycle or systematic process in their own contexts.