Notes from the Field


First Pres Visits Whole Child El Salvador

The director and two teachers from First Presbyterian Nursery School in Santa Monica, California, paid an inspiring visit to Whole Child in El Salvador. “First Pres” is a renowned L.A.-area preschool that puts into practice many of the principles that our work is based upon; it has trained professionals from around the world in its child-focused approach based in the Reggio Emilia educational philosophy. This visit was in preparation for our planned visit to First Presbyterian with Salvadoran government officials later this fall.

This meeting was an opportunity for our colleagues from First Presbyterian to see firsthand some of the successes and challenges of implementing quality care in the limited-resource settings we work with in El Salvador. Together, we visited early childhood centers that a few years back received support from Whole Child’s training in quality centers, relationship-based care, and improvement of spaces, and it was satisfying to see the ongoing impact of our work. We also visited sites that will receive support through the USAID Protection & Quality of Care for Children Project. Throughout the visit, the First Presbyterian team, Whole Child staff members, center directors, and government representatives all shared ideas on how best to support continued improvements to quality.

First Presbyterian, USAID, and Whole Child staff visit El Salvador childcare centers that have received Whole Child support, along with other partners. (Left) First Pres teachers Virginia Martínez and Anne Berteen and Director David Kelly with Whole Child Founder & CEO Karen Spencer. (Center) Whole Child Chief of Party Wendy McFarren; Virginia Martínez; Directora de Escuela Parvularia Gabriela Mistral; Anne Berteen; Candy Guadalupe Hernández Barahona and Erika Hernández from the El Salvador Ministry of Education; Docente de Escuela Parvularia Gabriela Mistral; David Kelly; Whole Child’s Early Child Care & Development (ECCD) Advisor Pilar Fort, USAID Foreign Service Officer Julie Grier-Villatte; and Whole Child Director of Programs Katherine Neidorf.

Welcoming Our Partners from the USC Suzanne Dworak-Peck School of Social Work

This month the El Salvador team hosted our partners from the USC Suzanne Dworak-Peck School of Social Work, whose five-day residency was a chance for the USC team, Whole Child staff, and our Salvadoran partners working on our USAID Protection & Quality of Care for Children Project to collaborate intensively on the first component of the Project, which is to develop an assessment of El Salvador’s child protection system for and with our government partners.

To date, the USC team has carried out 25 interviews of staff in the judicial systems, legislative assembly, civil society, international organizations, the CONNA and ISNA departments of the Salvadoran government, and UNICEF.  They also visited early childhood and residential care centers, and carried out four focus groups made up of 26 child protection system decision-makers, geographical regional coordinators, and technical personnel. This work builds upon the key research that Whole Child staff has done on the evolution of El Salvador’s child protection system and how it works. All of this will support Whole Child’s capacity to make recommendations to the government to help improve the child protection system.

Meetings on Espíritu Santo Island, El Salvador

The Whole Child International El Salvador Facebook page had an interesting story yesterday about a trip earlier this month, in which…

“…staff from INSA, the Salvadorian government’s department of child and family services, and Whole Child team members met at sunrise for a two-hour drive from San Salvador to the Port of El Triunfo, in Usulután. Our destination was the daycare center of El Jobal located on the island of Espíritu Santo, to speak with educators and community leaders about our USAID project, Protection and Quality of Care for Children.


“We arrived at port at low tide, creating an immediate challenge simply in boarding the boat. But thanks to a community member with a water taxi, we were able to begin a 20-minute ride among incredible landscapes and green mangroves. When we arrived on the Espíritu Santo shore we found the El Jobal center was located in the middle of the island — so our adventure continued on a motorcycle adapted for four people!


“When we finally arrived at the children’s center, we met with the wonderful childcare workers who work day after day for the island’s young children. The conversation regarding the project and next steps was productive and truly gratifying, as community leaders and educators expressed their pleasure in being part of this technical dream which is based on the protection and quality of care for children.


“We are especially grateful for the people in this community and for all the educators at the center for welcoming staff from ISNA and Whole Child, but even more for their commitment to Salvadoran children!”

If you’re on social media, please don’t miss the El Salvador team’s posts, or the ongoing conversation on our English-language pages on Facebook, Instagram, and Twitter.

A Formal Agreement with Our Partners at CONNA

Yesterday we were honored to deepen our partnership with the government of El Salvador, signing a memorandum of cooperation with the National Council for Children and Adolescents (CONNA). This memo commits both organizations to strengthen child protection and to collaborate in reaching El Salvador’s goals in its National Strategy for the Comprehensive Development of Early Childhood.

We’re grateful to have the chance to formalize a collaboration and a professional friendship that has inspired and motivated us at Whole Child for a long time.

Pictured: Zaira Navas, CONNA Executive Director & Sonia Silva, Whole Child El Salvador Country Director

Our Mother’s Day Tradition, #LikeAMotherToMe

Whole Child’s new Mother’s Day tradition — #LikeAMotherToMe — is in its second year! It’s a chance to celebrate the mother-like relationships that reflect the connection we help build between caregivers and vulnerable children. Whether or not people have a biological mother in their lives, but they often have mother-like figures who love them, support them, and champion them.

You can see the posts on Whole Child’s Facebook and Instagram accounts, and in future years don’t forget to add your own “Like a Mother to Me” post, tagging #LikeAMotherToMe and @WeAreWholeChild.

Thanks to all those who shared, and the mother figures who nurtured, supported, and inspired them. And hats off to Nat Hovee who is so gifted at helping tell Whole Child’s story.

Like a Mother to Me Montage

15th Anniversary Message from Our Founder Karen Spencer

Today our founder Karen Spencer sent the following message to all of Whole Child’s partners, supporters, and other friends to recognize a pretty wonderful milestone:

To all our friends and supporters,

I founded Whole Child International on this day 15 years ago with the goal of bringing love and connection to vulnerable children everywhere. As I look back on all these years, I think of the children whose lives Whole Child has impacted and also about the many people who have made it all possible.

Speaking on behalf of our whole team, we are forever in the debt of so many people. I am thinking especially of our champions within development banks and those within government ministries, of our fellow foreign aid partners, and of so many champions in foundations who have worked to bring funds and support to us over the years. And last but not least, we are truly indebted to those many individuals who have chosen to provide us with the funds and other support we’ve needed, often digging deep into their own pockets so that Whole Child could carry on, grow, and aspire to reach more children in more countries around the world.

To all of you who have made our work possible over these last 15 years, thank you.

What better way to spend our 15th anniversary than with our growing team!

Again, thank you for your support, and for celebrating this milestone with us!

Best always,


Rolling Up Our Sleeves on the QCUALS Measurement Tool

Last week, Whole Child’s program and evaluation teams and our partners at Duke University rolled up our sleeves for a five-day working session on WCI-QCUALS, our tool for measuring quality of care in limited-resource childcare centers. The team spent the week pulling apart the elements of the tool and analyzing each of them for user-friendliness. User-friendless is especially important for something designed to be used by highly burdened staff and supervisors of early childcare and development and residential childcare centers in some of the world’s most resource-deprived places.

Since our founding nearly 15 years ago, Whole Child has believed passionately that one of the key obstacles to the improvement of quality of childcare is how to measure it. We are concerned that as interest in improving quality of care continues to grow, the focus in investment will remain on buildings and materials — when science tells us the most important factor for children’s emotional well-being is the quality of the relationships in their lives. From the beginning, this factor proved difficult to measure, but we were faced with another crucial challenge as well: the predominance of tools designed for care centers in developed nations to measure centers in under-developed countries.

(Factors that might “fail” a center in the United States, such as a dirt floor or unreliable electricity, are far less important in a neighborhood where these things are commonplace. It is important to focus on things like the caregiver’s ability to connect with a child while changing her diaper — which is of primary importance no matter where you are.)

In 2012, we started working with the Center for Health Policy and Inequalities Research (CHPIR) at Duke University’s Global Health Institute, which shared our passion for measurement and the importance of relationship in children’s long-term well-being. We worked together to fine-tune the tool and turn it into a smartphone/tablet app. Together, in 2014, we piloted use of the tool on a nationwide scale, measuring 213 centers in the “National Evaluation of Quality of Childcare in El Salvador” as part of our project partially funded by the Inter-American Development Bank, “Improving the Quality of Care in Early Childhood.”

Last week’s arrival in San Salvador marked the beginning of the second phase of our development of the tool, which we look forward to using as a key measurement tool in our USAID project. It is designed for use in a variety of settings, including early child care and development (ECCD) centers, residential care centers, centers for previously trafficked children, and many more. When completed, there will be multiple versions, including one that centers can use for self-assessment, and one for governments to monitor centers they operate and supervise. Crucially, we have always intended to make the tool free to use, as the cost of measurement tools is very often a prohibitive factor in situations where they are most important.

We were deeply grateful to have our faithful friends at Duke working alongside our own team — led by CHPIR Director Kate Whetten, Research Associate Hy Huynh, and Research Analyst Andrew Weinhold. The team brings invaluable experience assessing quality of care through their numerous NIH-funded studies.

Pictured: (Top) Whole Child and Duke staff working together on QCUALS. (Bottom) Longtime collaborators Kate Whetten and Karen Spencer, respectively Director, Center for Health Policy and Inequalities Research, Duke University; Whole Child Founder & CEO.

Integrating the Whole Child USAID Project across El Salvador’s Community of Care

Last month, the Whole Child International El Salvador program staff met with around 200 members of the country’s 14 Departmental Shared Care Networks, or RAC for its acronym in Spanish, to begin the process of collaboration on our USAID Project’s various elements. The RAC is coordinated by the Salvadoran Institute for the Comprehensive Care for Children and Adolescents (ISNA), one of our key government partners.

Our team led a series of presentations and workshops illustrating how the Project will work, sharing all three components of the project and how the members of the RAC are integrated into these actions. Our presentation met with enthusiasm among these partners, many of whom worked with us from the beginning to develop the program.

The delegations identified significant areas where our project reinforces other national-level work of another key partner, the National Council for Children and Adolescents (CONNA), the government institution guarantor of child protection through the development and oversight of child policy and regulations, in particular on matters of positive parenting with pregnant adolescents and adolescent mothers.

This meeting was an important initial dialogue that will ensure we have the access we need across the system of care, and engage all the stakeholders we need to get the job done.

Outreach Visits to Private Residential Care Centers

The project presentation meetings laid the groundwork for a series of visits to private residential care centers now informed about the project and its scope. Certain components of our project in particular meet ongoing needs the residential centers have identified, such as monitoring of children reunited into families and other forms of support, and these shared goals have encouraged these private centers to become active partners in the project.

These information sharing visits are a crucial opportunity for our team to get to know more closely the challenges of the centers and benefit from the experience and perspectives of the personnel on the front lines.

Two ISNA Staff Members Take Up Residency in Whole Child’s Office in El Salvador

We’re moving forward on multiple fronts in our project in El Salvador. One goal we have been able to realize is the seconding of two staff members from ISNA, the Salvadoran government’s Institute for the Comprehensive Development of Children and Adolescents. These two members, Lorena Santos and Hazzel Romero, will spend two years in our office in San Salvador, where our staff of 19 can learn from them and vice-versa.

Lorena and Hazzel are technical specialists in child protection and limited-resource childcare, respectively. They will be accompanying the technical teams of early childhood care centers and protection centers in the processes of training and strengthening their skills and abilities (mentoring) related to guaranteeing quality care practices in different environments. They are also playing an important role in mapping out the child protection system in the research phase of the project.

Our project is specifically about creating capacity in the Salvadoran government to implement best practices and policies in childcare, across its system of care from residential centers to childcare centers to foster and other alternative care. So, there’s nothing more effective than working as closely as possible with the permanent staff who will be guiding and implementing these practices and policies long after Whole Child has completed its work and gone to other countries of need.

Hazzel & Lorena meet with CEO & Founder Karen Spencer, January 2019

The Connection Between Our Project and the Border Crisis (Part 5 of 5)

This is the fifth of a five-post blog series. Part 1 introduced our USAID-funded “Protection and Quality of Care for Children Project” and Part 2, Part 3, and Part 4 described its three principal components. This post will serve to put it all into a wider context.

While the Protection and Quality of Care for Children Project was not timed or designed to respond directly to the ongoing migration crisis that became BREAKING NEWS in mid-2018 with the separations of children from their parents, the project’s focus on child protection, quality caregiving, and early childhood development does help ameliorate root causes of the crisis — violence and poverty — and it helps respond to consequences of the crisis — child separation and family dislocation.

For example, as described in the previous posts, the project will use an evidence-based approach to prevent children from becoming victims of violence — or perpetrators of it — by strengthening:

  • the child protection and social service workforce;
  • case management, so more children are placed in safer care settings;
  • the system for monitoring children’s well-being;
  • the care system’s capacity to respond to reported cases of violence, abuse, and neglect; and
  • the capacity of caregivers and parents to practice positive parenting and relationship-centered care that builds children’s socio-emotional health and resilience.

The project will generate policy and technical recommendations based on concrete experiences of children and youth within El Salvador’s child protection system and incorporating proven best practices in other countries and institutional settings.

This system and capacity strengthening will also help the government continue and improve its efforts to reunify, and support migrant children and youth returning to El Salvador due to deportation or the dangers and difficulties of migration.

The project will also help prevent family breakdown by expanding access to quality early childhood education and daycare that enables vulnerable families, including women-headed households, to earn income and break the cycle of poverty that drives irregular migration.

For the next five years, we’ll be talking about this program in these pages. We hope you’ll keep reading as we conduct this program, assess its impact, and hopefully demonstrate the potential of these ideas for making a real, lasting, and meaningful impact on the lives of some of the world’s most vulnerable children — benefits that reach across Salvadoran society and indeed help ensure a more peaceful and secure American continent for us all.


Family-Based Care Practices (Part 4 of 5)

This is the fourth of a five-post blog series introducing our USAID-funded “Protection and Quality of Care for Children Project” and its three principal components, and putting it all into a wider context. (Jump back to Part 1, Part 2, or Part 3.)

The Project’s third component focuses on supporting the ongoing transition from residential to family care for vulnerable children in El Salvador.

The number of children in residential care decreased from 6,000 in 2009 to an estimated 1,500 in 2017. In 2017, for instance, 250 institutionalized children were reintegrated with families. Much good work has been done to date on the care transition, but challenges remain. To help the government address these challenges and achieve a lasting re-orientation of the residential care sector toward family and community-based care, our Project will:

  • promote and develop the desire for change within the residential care sector.
  • support the development of the legal and policy reform necessary to permit residential care institutions to take on social casework such as family reunification, reintegration, and preservation; and coordinate with judges, local child rights boards and social service staff in the transition process.
  • demonstrate how existing residential care professionals can be re-trained and re-deployed to do case management, supervision, training in parenting, and family support;
  • pilot foster and kinship care approaches modeled on prior work done by NGOs and others;
  • strengthen the system to monitor the well-being and safety of children placed in family-based care.

These activities will be informed by the assessment of the government’s de-institutionalization program that we will conduct under the first component of the project.



That’s the “Protection and Quality of Care for Children Project” in a nutshell! Please stay tuned for Part 5 of this series, which will explain the connection between the project and the humanitarian crisis on the U.S.-Mexico border. (Jump to Part 4 — “The Connection between Our Project and the Border Crisis.”)


Training and Mentoring (Part 3 of 5)

This is the third of a five-post blog series introducing our USAID-funded “Protection and Quality of Care for Children Project” exploring its three principal components, and putting it all into a wider context. (Jump back to Part 1 here and Part 2 here.)

The second component of the project focuses on building the capacity of ISNA, the Salvadoran government’s ministry of child services, and its training school to plan, deliver, and sustain a comprehensive national training and mentoring program which will help improve the quality of care and developmental outcomes among El Salvador’s most vulnerable children.

Training and mentoring focus on the range of people involved in planning and delivering quality care: the caregivers themselves, their mentor-supervisors, technical leaders, academics, policymakers, members of the judiciary involved in child welfare and protection, and, of course, parents.

Training content focuses on key topics related to best policy and practice in child development, childcare, and child protection including the neuroscience of early child development and the buffering effect of nurturing care relationships that create resilience to the toxic stress of an environment of extreme violence. The mentoring component involves one-on-one follow-up on the results of our assessments of residential care centers and support for early childhood caregivers in the early childhood care and development (ECCD) centers.  It is a key step towards improvement of care after the initial assessments are carried out in Part 1.

Five best practices for quality childcare in limited-resource settings are at the core of all training and mentoring:

  • Responsive relationship-centered caregiving.
  • Continuous primary care.
  • Small groups.
  • Freedom of movement; and
  • Individuality and identity.

Prior work by Whole Child and partners in El Salvador demonstrated that a key challenge to improving care quality is to effectively improve communication between supervisors and caregivers. Therefore, training of supervisors and directors will include a substantial focus on best practice in mentoring — developing capacity to support behavior change in respectful and productive ways which helps ensure best care practices are maintained.

The training program will not only increase the use of best caregiving practices, but it will strengthen the critical mass of practitioners and policymakers equipped to champion national care reform more broadly by, for example, strengthening the social service workforce, carefully moving children from institutional care to family-based care, and strengthening systems to monitor their care in families — which will be the subject of our next blog post.

The next post will explore the third component of this project, “Family-Based Care Practices” — a series of interventions that will help residential care centers expand their social services and train care center staff to provide desperately needed case management in a country that has far too few social workers to respond to its citizens’ child protection needs. (Jump to Part 4 — “Family-Based Care Practices.”)


Assessing and Mapping (Part 2 of 5)

This is the second of a five-post blog series introducing our USAID-funded “Protection and Quality of Care for Children Project” exploring its three principal components, and putting it all into a wider context. (Jump back to Part 1 here.)

This post focuses on the first of the project’s three main components: strengthening systems to support children without adequate family care.

This component focuses on supporting Salvadoran government’s efforts to take stock of its efforts to date to care for, protect, and promote the healthy development of the country’s most vulnerable children.  The results of this assessment will be used to refine care and protection policies and practices.

Fundamental to this process is getting a bird’s-eye view of the social-service workforce in El Salvador and assessing the overall quality of social work.  The main activity under this component involves mapping social workers’ roles and responsibility for case management and supervision which will entail, among other things:

  • assessing child protection and case management skills;
  • assessing curricula for university social-work degrees;
  • collecting data on reports of abuse and neglect, cases investigated, and their disposition; and,
  • determining caseloads and turnover.

These activities will result in the identification of gaps in financial, human, technical, and procedural capacity and make recommendations to address such gaps, and it will guide the project’s third component which includes support for innovative approaches to utilize the current childcare and social-service workforce to expand family-based care.

Another important activity under this component involves assessing the implementation to date of El Salvador’s deinstitutionalization policy. The assessment will be done under the direction of, and in collaboration with, ISNA, the Salvadoran government’s ministry for children.  The assessment will address, among other things, the quality of case records, the status and well-being of deinstitutionalized children, and, the quality of family-based care received by formerly institutionalized children.

Finally, under this component there will be an assessment of the quality of care in El Salvador’s remaining public and NGO-run residential care centers, of which there are approximately 30. The assessment will identify how each center can improve quality of care and children’s developmental outcomes through operational changes, training, and mentoring (the project’s second component), and will gauge their readiness or capacity to provide social-work-related services (the project’s third component).

Please keep reading this series of posts to learn more about the other components of this project and how they will help children in El Salvador.  (Jump to Part 3 — “Training and Mentoring.”)


The Protection and Quality of Care for Children Project (Part 1 of 5)

This is the first of a five-post blog series introducing Whole Child’s new project in El Salvador.  Today, we begin with an overview of the initiative. The next three posts will introduce you to the project’s three main components. The final post in the series will be a post explaining the connection between the project and the ongoing migration crisis at the US/Mexico border.

On November 13, 2018 in San Salvador, the U.S. Government, through the U.S. Agency for International Development (USAID), and Whole Child International formally launched the Protection and Quality of Care for Children project.  The project, a $7.4 million investment over five years — $4.9 million from USAID and $2.5 million from Whole Child International — will support the Salvadoran government to further strengthen its capacity to provide care, protection, and development for vulnerable children and their families.

The collaboration involves supporting government efforts to assess key aspects of the national child protection system including social-service workforce capacity, case management, the quality of residential care, and transitions from institutional to family-based care.  Assessment results will be used to refine and implement national policies and practices to improve children’s well-being and safety. Safety of children is a preeminent concern given the levels of violence in El Salvador. Through the training of care center workers and by working directly with families, the project will help ensure that children receive developmental support in safe, nurturing environments.

This is a public-sector capacity-building project focused on care reform.  Whole Child has years of experience in El Salvador working in collaboration with government departments responsible for the care of vulnerable children.  ISNA, the government department in charge of the “comprehensive development of children” has been and will be our main partner. We are well prepared — and honored — to continue this partnership.

Given the project’s emphasis on strengthening systems and human capacity, Whole Child is expanding the range and depth of technical support available to the government under the project through an alliance with the USC School of Social Work.

The project in a nutshell focuses on an objective of fundamental importance to El Salvador: Increased capacity of the government of El Salvador to protect and care for children most at risk of being victims or perpetrators of violence.

Project activities are organized around three key results necessary to achieve the objective:

  1. Strengthening systems to support children without adequate family care.  This entails, among other things, supporting government efforts to assess El Salvador’s deinstitutionalization experience to date, assess the quality of public and NGO residential care, and map case management and supervision.
  2. Increasing knowledge and skills in childcare best practices in 200+ public sector Early Childhood Care and Development (ECCD) centers and in the 30 remaining public and private sector residential care centers.  This entails, among other things, training key personnel from ISNA and other government departments, training and mentoring all levels of residential care staff, and training and mentoring field supervisors who oversee care in the ECCD centers.
  3. Institutionalizing family-based-care best practices.  This entails, among other things, developing policies and protocols to enable the transformation of residential care to include family-based care; training ISNA and protection center staff on new case management practices and protocols; and piloting approaches to transition institutional care facilities to focus on family-based care.

The three posts that follow in this series will go into a bit more detail on each of these three project components, and one additional post will put it into the context of the migration “crisis.”  (Jump to Part 2 — “Assessing and Mapping.”)


Part 4: Our Results

This is the fourth of a four-part blog series outlining the philosophy behind our work, and the roadmap going forward. (See also pt. 1, pt. 2, and pt. 3.)

Our program may be growing to support whole countries in their nationwide programs, but the most important measure of our success remains the impact on children in the childcare system and in the childcare settings we work with. Third-party evaluation of our results has shown that it improves* developmental outcomes for vulnerable children, as shown across multiple developmental domains:

Intellectual Development

At baseline, 82% of children scored as though intellectually disabled on the Battelle Development Inventory. In less than two years, only 14% of children scored as though intellectually disabled, which reflects a 62% decrease in children presenting as if they had intellectual disability.

Physical Development

Children experienced a 46% increase in height and 34% increase in weight with no changes to nutrition.

Relationship Development

The social-emotional relationship between caregiver and children improved by 150% as noted by the the Caregiver-Child Social/Emotional and Relationship Rating Scale (CCSERRS).

Behavioral Development

Negative behaviors such as aggression, withdrawal, and self-stimulation were reduced by 43% in children.

The Importance of Measurement

In partnership with Duke University, Whole Child developed WCI-QCUALS (Quality of Care in Limited-Resource Settings), a measurement tool that allows agencies to assess the quality of care in childcare facilities. Third-party evaluation by Duke University confirmed that WCI-QCUALS works better than other standardized tools used in limited-resource childcare settings, and that the outcomes from this tool correlate to children’s well-being.

* As measured in five residential care centers in Managua, Nicaragua. (2012 Groark, C. J., McCall, R. B., McCarthy, S. K., Eichner, J. C., Warner, H. A., Salaway, J. and Palmer, K. (2012) The Effects of a Social-Emotional Intervention on Caregivers and Children in Five Central American Institutions University of Pittsburgh Office of Child Development, Prepared for: Whole Child International and the Inter-American Development Bank under Technical Cooperation ATN/KP-12327-NI; 2013 Groark, CJ; McCall, RB, McCarthy, SK, Eichner, JC,Warner, HA, Salaway, J, Palmer, K, Lopez, ME. (2013). “The Effects of a Social–Emotional Intervention on Caregivers and Children With Disabilities in Two Central American Institutions.” Infants & Young Children. Vol. 26, No. 4, pp. 286–305)


Part 3: Our Before & After

This is the third of a four-part blog series which will outline the philosophy behind our work, and the roadmap going forward. (See also pt. 1, pt. 2, and pt. 4.)


  • Children are kept in large groups by age and “graduate” to new caregivers and peers regularly.
  • Caregivers are overwhelmed and don’t know how to connect in a meaningful way with children, considering the constraints of time and the large number of children for whom they are responsible.
  • Children have no personal space or record of the moments and developments that form their identity.
  • Countries overly rely on residential care (orphanages)


  • Children are placed in family-like small groups where primary caregiver relationships are formed and maintained as long as they are in care.
  • Caregivers are trained to use routine moments to connect with each child and feel confident in their ability to provide what the child needs.
  • Caregivers keep records of developmental milestones; children have cubbies for their own things and a binder of progress and past history to help form an identity.
  • Residential care centers are supported in expanding their programs to include services in family reunification and support, running small-scale foster programs, and appropriate monitoring.

The next installment of this series is Our Results: an overview of the developmental outcomes of children in childcare systems after our intervention.

Part 2: Our Methodology

This is the second of a four-part blog series which will outline the philosophy behind our work, and the roadmap going forward. (See also pt. 1, pt. 3, and pt. 4.)

Though Whole Child’s program has evolved over time, many of our elements have stayed the same. Among these are the “Five Essential Childcare Principles” listed on our “Program” page — these core ideas have remained at the center of our work since 2004. The other key elements on that page remain the same also, but as we have shifted our focus to the comprehensive support of national governments, we have also been able to focus the elements of our program into six key steps for building the capacity to create meaningful, sustainable change:

  1. Local academic community
    • University faculty receive training and mentoring in order to update their academic knowledge.
    • Updating this knowledge at the academic level ensures a pipeline of local professionals with the knowledge and skills they need, in perpetuity.
  2. Government decision-makers
    • attend Whole Child’s university course on best practices in limited-resource settings.
    • receive hands-on support and mentoring to implement the necessary changes across the system of care for children.
  3. Childcare center and residential care directors
    • attend our university certificate program on best practices in childcare in limited-resource settings.
    • receive support and mentoring to implement relationship-centered, evidence-based best practices in centers.
  4. Government supervisors of childcare centers
    • receive two years of training and hands-on support focused on creating capacity to be the leaders on implementation and monitoring of quality in residential care and early-childhood care and development centers.
  5. Children’s Direct Caregivers
    • receive nine months of training to improve quality of care and strengthen relationships with children.
    • receive hands-on support to implement the changes in childcare practices in their centers.
  6. Residential Care Centers
    • in addition to the implementation of best practices described in bullet 3, we work with residential care centers to broaden the scope of their work to include family reunification and support, running small-scale foster programs, & appropriate monitoring.

The next installment of this series, “Our Before & After,” paints a brief picture of what a typical childcare system looks like before we arrive, and what a system looks like after we have completed our work.

Part 1: The Problem & Our Solution

For nearly two years, many of us at Whole Child have been engaged in a strategic planning process aimed at figuring out how to effectively and cost-effectively expand the program we’ve been developing and evaluating for 14 years. It’s provided clarity to help plan for the future, and has fed the development of our current project in El Salvador, recently supported by a $4.9 million USAID award.


This is the first of a four-part blog series which will outline the philosophy behind our work and the roadmap going forward. (See also pt. 2, pt. 3, and pt. 4.)

The problem we’re solving has not changed much since Whole Child was founded in 2004. Millions of vulnerable children around the world suffer from a lack of stable, nurturing relationships in low-quality care settings. This is particularly true for children in developing countries growing up in residential care and those from low-income families who spend the majority of their day in early childcare centers. These children’s developmental needs are often not met, resulting in stunting, high levels of criminality, and other adverse outcomes — reinforcing the cycles of poverty and child abandonment through generations.

Current systems tend to be over-reliant on residential care, but replacing residential care has many obstacles. In particular, residential care is generally funded by individual charities whose resources cannot simply be transferred to family-based systems. In addition, the existing social-workforce is inadequate to respond to child protection needs and supervision of family-based care.

Our solution, in its entirety, and at all levels, focuses on building capacity within and building upon a country’s existing government infrastructure, with decision-makers and supervisors being our main focus. In addition, we train and mentor local academia, center directors, and caregivers. Working in early-childhood centers, residential care centers, and foster care programs, we implement evidence-based best practices in relationship-centered care, establishing such care as a national standard.

Within residential care centers, in addition to the implementation of best practices, we work collaboratively to expand the breadth of their services to include family reunification and support, running small-scale foster programs, and appropriate monitoring. This leverages existing resources within the existing residential-care community while safely reducing the number of children outside of family-based care.

Read on in the series to explore (2) Our Methodology; (3) Our Before & After; and (4) Our Results.


Planning Retreat with ISNA

Hola from El Salvador! Whole Child International staff members recently gathered for a two-day planning workshop at the beautiful Santa Leticia on August 22-23, 2018 with ISNA, the Salvadoran government’s Institute for Integral Development for Children and Adolescents.

This retreat was part of the beginning process of implementation for the Protection and Quality of Care for Children project. The project is a five year, $7.4 million project of which USAID is contributing $4.9 million. The workshop consisted of 14 members of ISNA, including the three members of the senior management team: Carlos Tito Lopez, Deputy Director for Promotion of Children’s Rights; Maria de la Paz Yanes, Deputy Director for Children’s Protection; and Samuel Carias, Deputy Director of the National Network of Shared Assistance.

In addition to the INSA participants, the Founder & CEO of Whole Child International, Karen Spencer, participated in the workshop along with Pete La Raus, the Chief Operating Officer, and Sonia Silva, the Whole Child Country Director in El Salvador. In total, 25 people were actively involved in two days of planning.

The planning focused primarily on the first activity of the project, a comprehensive evaluation of the child protection and childcare system in El Salvador. The project will span five years, but the planning retreat focused on the first year of implementation to build the foundation for future activities. Together, participants established concrete and reliable channels of communication, accountability, and transparency. The two organizations identified major milestones, due dates, key personnel, and resources required. More importantly, the workshop solidified both parties’ commitment to work together to develop and implement the project. Whole Child International intends to have a finalized work plan for the first year coming shortly.

We’re looking forward to building on our previous work with ISNA, and to make the foundation for this and future projects even stronger.

Pictured: our staff and the ISNA team together, and a subset of participants discuss the project.


Special Visit from our Board of Directors and Donors

If you were to visit El Salvador, you would find a country full of lush vegetation, stunning beaches, and a dynamic, vibrant, and welcoming culture.  However, El Salvador faces considerable challenges when it comes to caring for vulnerable children amidst an environment riddled with gang violence and influence. A lack of relationship-centered, high-quality care for the most vulnerable children continues to be a major challenge.

This month, Whole Child International welcomed our Board of Directors and key donors to see our work in San Salvador. Our trip focused on providing context about the country and explaining the plight of children growing up in residential centers and those who spend their days in early childhood care centers. As the Board of Directors and donors visited each site, they received a small glimpse into what life is like for children growing up in El Salvador without loving families to surround them.

Prior to visiting the centers, our donors and board members were reminded of typical practices that unknowingly contribute to stifling childhood development. Care centers in El Salvador, like many other countries, emphasize efficiency and cleanliness to maintain order, rather than prioritizing emotional needs. This approach detracts from establishing a more family-like, relationship-centered setting that occurs when children of different ages are grouped together with supervision from a consistent and dedicated caregiver. Visiting several different childcare centers allowed our board and donors to understand these problems and see the benefit of Whole Child’s work firsthand.

In addition to site visits, this trip presented many opportunities to continue building relationships with key government partners, USAID officials, ISNA, and the US Ambassador to El Salvador, Jean Manes. Our visitors also had the chance to visit the beautiful area of Suchitoto, a historical town with stunning mountain views, and enjoyed the lovely hospitality at Hotel Los Almendros de San Lorenzo.

We are so grateful to have such wonderful board members and donors who actively engage with our work! Special “Thank You” to each of them for participating in this experience and offering their input and expertise on how we can continue to strengthen our approach within El Salvador.

Pictured: Five of our board members enjoy El Salvador’s natural beauty; a lunch with key donors; and a stunning view of Suchitoto.


Karen Spencer Receives Honorary Fellowship at University of Northampton

On July 24, 2018, our Founder & CEO Karen Spencer received an Honorary Fellowship from the University of Northampton. This honor acknowledged her impact as a social entrepreneur for her work and dedication at Whole Child International by improving care for vulnerable children around the world.

“To be recognized in this way is a wonderful and humbling personal honor, but I’m also proud that the work of everyone at Whole Child is being recognized in this way by such a fine academic institution as the University of Northampton,” said Karen of this special opportunity.

In 2013, Ashoka chose the University of Northampton to be a “Changemaker Campus” focused on encouraging students to tackle social problems throughout their undergraduate experience, and as part of their growing careers. Karen’s position as an Ashoka Fellow made her especially proud to speak to this graduating class of young changemakers.

Dr. Eunice Lumsden, Head of Early Years at the University of Northampton, was quoted as saying: “Countess Spencer is a true ‘changemaker’ in every sense and a pioneer in her work with the world’s most vulnerable children. Her contribution to enriching the life of others is immense and her knowledge about the importance of a holistic approach to early childhood is outstanding.”

In her remarks addressing the faculty, staff, and 2018 graduating class, Karen thanked the university and shared encouragement with attendees. Karen advised the graduates to pursue their dreams, regardless of possible humble beginnings or any failures along the way. She offered challenging yet important advice by saying, “Embrace your own failures. Within my biggest failures was the knowledge and experience that led to my biggest successes.”

Pictured: Karen Spencer receiving her diploma, and posing with Reverend Richard Coles, Charles Spencer, and Vice Chancellor Nick Petford.


Honoring Mother Figures with the #LikeaMothertoMe Campaign

Celebrating the mother figures in our lives begins with a simple acknowledgement of their value and impact. As part of our ongoing effort to shine a light on the work of surrogate mothers and caregivers of all kinds, Whole Child International created a social media campaign for Mother’s Day 2018 called #LikeaMothertoMe.

The campaign encouraged people to share their favorite stories and memories honoring mother figures and the impact that these special individuals have made on their lives.

Our Founder & CEO Karen Spencer shared her inspiration behind the campaign by saying, “I founded Whole Child from a desire to ensure that the most vulnerable of children could experience love and connection. Whole Child is about the centrality of a mother figure in a child’s life. A relational bond for a child is not a luxury, it is the most basic of human needs.’’

Campaign participants shared photos, videos, and stories of their important mother figures.  Many individuals, from the United States to the United Kingdom, participated in the #LikeaMothertoMe campaign, including special friends of Whole Child, Reverend Richard Coles and Elsa Chahin of Pikler USA. Thank you to all who shared!

A few notable posts. . .

 “The women who meant the most to me … were not necessarily the ones who had achieved the greatest financial or professional success. The ones who had the most impact on me were those who cared the most, who took time out of their day to chat with me, to listen and talk and laugh with me.” – WCI COO, Pete La Raus

 “Being #LikeaMothertoMe can be to your neighbor’s kids, to your best friend’s babies, to the foster kiddos in your church, community, your circle. My momma was always a momma to my friends. To this day, she still feels like home to them!” – Liza Rademacher

A crucial part of our work at Whole Child is celebrating and uplifting the many caregivers who serve as mother figures to the children in their care. Cultivating this type of impactful relationship between a child and a mother figure (or caregiver) is the mission of our organization. Today and every day, we honor those who fill the role of #LikeaMothertoMe.


Senior Policy Director Gary Newton Delivers Commencement Address

On July 28, 2018, Whole Child International Senior Policy Director, Gary Newton, gave the commencement address at the University of Notre Dame’s Eck Institute for Global Health. Graduates received a Master of Science in Global Health. Gary and Dr. Bernard Nahlen, the Institute director, are long time colleagues in the field of international development.

Gary used his speech to shift the focus of graduates who have been mainly immersed in the world of preventable childhood disease to the world of preventable childhood adversity. He used two recent high profile cases of childhood adversity – children lost in a cave in Thailand and children separated from parents at the US-Mexico border – as an entrée into the world of vulnerable children globally. To underscore the point that adversity in early childhood should be a core global health concern, Gary talked about the serious long-term health consequences of toxic stress that children can suffer from separation, neglect and abuse. While we are the cause of toxic stress, Gary said, we are also the prevention and cure — stable, nurturing, responsive caregiving is the antidote to toxic stress. He mentioned that this is what Whole Child International specializes in, attachment-based, relationship-centered care.

Gary concluded by saying:

“For you all on the cusp of great careers in global health, I hope and pray that you use your leadership, wisdom and wherewithal to:

Respond to the humanitarian emergency of children suffering from preventable disease and preventable violence, abuse and neglect.

Protect vulnerable children from collateral damage caused by bad public policy, political indifference and adults behaving badly.

And, enable vulnerable children to enjoy the health, rights and opportunities they are due — and which they require — to thrive and contribute a full measure of talent to family, community and nation.”

Congratulations to graduates for their hard work and accomplishments, and to Gary for delivering such an important and timely commencement address.

Photo by Peter Ringenberg/University of Notre Dame


USAID Awards Whole Child International $4.9 Million for Work Improving El Salvador Childcare System

Whole Child International announces the receipt of a $4.9 million award from USAID to support its program in El Salvador.

The program, known as the Protection & Quality of Care for Children Project, is a five-year collaboration with the government of El Salvador and other partners that will bring high quality, relationship-centered care to an estimated 20,000 children in 252 childcare centers and 54 residential care centers. Efforts will focus on building government ministries’ capacity to manage child protection systems and promote child development through socio-emotional development of vulnerable children. By creating caregiving environments that enable stable, nurturing relationships for every child, regardless of the setting in which they are raised, developmental outcomes will improve.

Whole Child will be responsible for contributing $2.5 million in matching funds over this five-year funding period. The total of $7.4 million will allow full program implementation across the nation and its system of care. With its focus on quality caregiving, the program will train and support multiple levels of stakeholders, from leaders of Salvadoran government ministries, to administrators of centers, to caregiver supervisors, to the caregivers who work with the children every day. Another focus of this project will be assessing deinstitutionalization efforts to date and supporting government efforts to pilot innovative approaches to increase the number of children in family-based care.

Whole Child’s partners at Duke University will evaluate the Protection & Quality of Care for Children Project.


Whole Child & Salvadoran Government Leaders Tour Salvadoran Childcare Centers

Last week, members of the executive team of Whole Child in Los Angeles visited our El Salvador mission. Karen Spencer, founder and CEO, Pete La Raus, COO, and Nadia Ammar, Director of Individual Giving, worked with the El Salvador team and our partners on program implementation and our plans for moving forward.

The delegation visited two childcare centers and three residential child protection centers which are all part of the child protection system overseen by ISNA, the Salvadoran government’s child protection ministry. ISNA’s Executive Director, Elda Tobar Ortiza, accompanied them during the visit along with the deputy directors for the protection and promotion of children’s rights. The team visited Centro de Desarrollo Integral San Rafael (San Rafael Center for Integrated Development); Centro de Bienestar Infantil Santa Anita (Santa Anita Center for infant well-being); Hogar del Niño San Vicente de Paul (Children’s Home San Vicente), Hogar de la Niña Santa Luisa de Marillac (Santa Luisa de Marillac girl’s home); and Hogar Dr. Fray de Jesús Moraga (Dr. Fray de Jesus Moraga home).

During the visit, the representatives from ISNA and Whole Child discussed at length how to continue to improve early childhood care and development (ECCD) as well as how to take the next steps together, affirming the need to continue to improve quality of care and that the care is relevant and appropriate in a variety of different environments and contexts. The Whole Child team also held multiple internal meetings to ensure that we continue to innovate and stay on the cutting edge of childcare and best practices, both in El Salvador and beyond.

Pictured (l-r): Ma de la Paz Yánez (ISNA), Pete La Raus, Nadia Ammar, Karen Spencer, and Sonia Silva (Whole Child), and Elda Tobar (ISNA).


A Royal Visit to Buckingham Palace

Earlier this month, Karen had the honor and privilege of being invited to Buckingham Palace by Her Majesty The Queen to attend the Commonwealth Diaspora Reception. This reception recognized individuals who have made a positive contribution to business, community, and culture. Karen was recognized for her commitment and influence in working to improve the quality of childcare for the world’s most vulnerable children.

This 65-year tradition is an important and symbolic event that unifies influential individuals from nearly every geographical region, religion and culture. The Commonwealth organization embraces diversity among its “52 countries and almost 2.5 billion people.”

Throughout the evening, Karen met dignitaries and leaders from around the world, and was honored to share a moment with the Queen.


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