Notes from the Field



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.


Investment in ECE is Essential for Peace

January 16th marked the 26th anniversary of the Chapultepec Peace Accords, which ended a 12-year civil war in El Salvador. Though the Peace Accords are unique to El Salvador, the scope and implications of the agreement to create lasting peace start with investing in our children’s future.

Nearly 26 years after the signing of the peace accords, El Salvador is one of many countries that still faces profound challenges related to violence and child development. Studies have shown that programs that aim to teach youth how to develop the life skills needed to succeed in the labor market keep children off the streets and, as a result, makes them less susceptible to the influence of gangs. Our intervention in child care facilities strives to combat this ongoing issue by providing vulnerable children with the internal resources needed to become educated, productive members of society.

Whole Child’s support of the Salvadoran government’s limited-resource early education (ECE) centers is just one of our major investments in children’s future, but there is still considerable work to be done. Studies show that high-quality ECE is not only important for children’s healthy development, but it has significant economic and social payoffs. Together, by investing in early childhood education, we can build a more peaceful and prosperous future.

Whole Child and Shift: A Dynamic Duo

A primary goal of Whole Child’s new five-year strategy is to replicate our relationship-centered care model in new care settings and new countries. To help do this, we have partnered with a UK-based group called Shift. Shift is an award-winning not-for-profit social design agency that supports the creation and improvement of products and services that have positive social impact. For the past several months our El Salvador team has been working with a team from Shift to develop tools and a framework to scale-up our approach to care-giving, from impacting policy on a governmental scale to working directly with caregivers.

Our team working with Shift staff on current practice for early child care.

The support from Shift is one of our initiatives to grow carefully and systematically as an organization. As we expand, Shift will offer its guidance on how we can support our global partners even more effectively. We relish taking this deep dive into the details of our program processes and working with this award-winning charity to continue to improve the quality of care for vulnerable children.

…Can’t Buy Me Love…

We all know that while toys are nice, the gifts that really matter are the ones that cannot be bought. From the time a child is born to kindergarten, his or her brain develops at a faster rate than any other stage in life, which is why it’s crucial for children to be exposed to cognitively and emotionally nourishing experiences in their earliest years of life.

This holiday season, the team at Whole Child encourages you, whether you’re a parent, caregiver, aunt, uncle or special friend, to spend an uninterrupted afternoon with a child in your life. Activities such as playing at the park together or reading them their favorite book are building blocks to empathy and philanthropy, which are far more meaningful gifts than the latest gizmo.

We hope you share the valuable gift of spending quality time and giving special attention to the children in your life this holiday season!


Our Founder Karen Spencer Among People Magazine’s 25 Women Changing the World

This week, People magazine featured our Founder and CEO, Karen Spencer, as one of its 25 Women Changing the World in 2017. Karen has been a champion for relationship-based care of vulnerable children since founding Whole Child more than 13 years ago. We’re grateful to People for bringing attention to this important issue to their more than 46 million readers worldwide!

Please hop online and give it a read, and don’t forget to pick up a copy of the print version at your local newsstand!

Visit by Duke’s Dr. Hy Huynh

Dr. Hy Huynh, our colleague from Duke University’s Global Health Institute, visited the El Salvador team in the beginning of November to provide support for our National Evaluation of Quality of Childcare (ENCCI) post-evaluation effort. Dr. Huynh reviewed our protocols in the office and got to see firsthand our “logistics machine” through office monitoring and by heading out to the field for two very long days. The days begin before dawn, so that the team can arrive at the evaluation site as parents drop off their children. We take advantage of this moment to get any consent for research that we need, as well as to interview the parents on their own well-being, their family’s make-up and well-being, and their perspective on their children’s well being. After speaking with the parents, we move on to evaluations of the children, quality evaluations of the center, and interviews of the caregivers in the childcare centers to determine their well-being.

Dr. Huynh was able to lend his expertise to different challenges as part of this process as well as help us to document some of our work. Documentation is a special challenge for us as we are extremely careful to respect the children’s rights by protecting their identities and their stories. We very much appreciate his perspective and his efforts across this process.

Karen Spencer Receives the Pikler/Lóczy USA Founders Award

Elsa Chahin and Karen Spencer

Elsa Chahin of Pikler USA presents the Founders Award to Whole Child’s Karen Spencer. Photo courtesy of Pikler USA.

Last Saturday at its “Where Pikler Meets Neuroscience” conference, Pikler/Lóczy USA, pioneers in relationship-based childcare, honored Whole Child founder Karen Spencer with its USA Founders Award.

This is an especially meaningful award for Karen and all of us, because the childcare philosophies of Emmi Pikler and the Pikler Institute in Budapest, Hungary, played a big part in the original founding of Whole Child in 2004. Those who have seen Karen give her full presentation have seen a video from Pikler that originally inspired her quest to bring relationship-based care to all children — a beautiful moment between a caregiver and a child, taking advantage of an everyday moment to deepen their relationship and meet the child’s developmental needs for attention, trust, and love.

Congratulations to Karen, and thanks to Pikler/Lóczy USA for its partnership, support, and inspiration.

2017 Gala Celebrates Whole Child’s First 13 Years

Whole Child International hosted our inaugural Gala last Thursday night in Los Angeles at the Beverly Wilshire hotel. It was an elegant, fitting tribute to our achievements thus far, and a great chance for our team to get together with donors, friends, and other supporters both old and new. It also raised awareness and much needed funding for our program, and for that we thank all the attendees who bought seats and tables and “raised their paddle” during the auction — as well as so many who gave in honor of the event.

For more information, including photos of our hosts Earl and Countess Spencer, Master of Ceremonies Sir Ken Robinson, and musical guests Anthony Kiedis and Josh Klinghoffer of the Red Hot Chili Peppers, please visit our dedicated web page about the gala, and don’t forget to like us on Facebook for the latest news.

In addition, we owe a great deal of gratitude to the evening’s sponsors: the Annenberg Foundation, Crane & Co., Christie’s, and Jo Loves. 


Countess Spencer addresses the Whole Child International 2017 Gala

Founder & CEO Karen Spencer addresses Whole Child International’s inaugural gala.

First Set of Post-Intervention Evaluation Data Almost Complete

Our research effort in El Salvador has three main focuses:

  1. What quality of care do children receive?
  2. How are children developing physically and holistically (cognitively, linguistically, physically, socio-emotionally)?
  3. How are the caregivers of vulnerable children doing, both in childcare centers and at home?

We gathered all of this information (and more!) as part of our National Evaluation of Quality of Childcare (ENCCI) baseline assessment with Duke University, the University of Central America, University of South Carolina, and the University of Pittsburgh.

We are currently gathering post-evaluation data. After weeks criss-crossing El Salvador, our evaluation teams have just finalized the quality assessments of the childcare centers.

We don’t have the results yet, and have much to do before the end of the year, but this is a big research milestone!

Whole Child’s Program Director Celebrated at Johns Hopkins

We’d all like to congratulate our Program Director, Meghan López, for winning the prestigious Global Achievement Award from her alma mater, Johns Hopkins. Meghan joined Whole Child International in 2011, and since then has been a driving force behind the development, implementation, and evaluation of our program. She’s led our teams in both Nicaragua and El Salvador, persisting through earthquakes, hurricanes, challenges, and growth. Meghan is also adjunct faculty at Johns Hopkins, where she mentors Masters-level nurse practitioner students.

Felicitaciones, Meghan! We’re glad the rest of the world sees you as we do.

Please read more here about Meghan and her fellow awardees.


Meghan poses with the Dean of the Johns Hopkins School of Nursing, Patricia Davidson, and her well-earned award.

Our “Logistics Machine” in El Salvador

Now fully in the midst of post-evaluation of care centers, Whole Child El Salvador is a logistics machine! Every day from 5 a.m. when the first teams hit the road, to 6:30 a.m. when teams arrive at the first evaluation site of the day, to the evening between 5:00 to 7:00 pm when the teams roll back into the office, we track our personnel’s movements around the country by Whatsapp chat groups and GPS points. This system allows us to reroute the teams when care centers are closed or for security reasons, and keeps the office up-to-the-minute on progress in the field.

We have scheduling and planning spreadsheets to track where the teams are and will be; we have spreadsheets that track the teams’ progress in the various evaluation tools in the various sites; we have spreadsheets that determine what has been sent by the El Salvador team and received by our colleagues at Duke University, and more! Every week the Whole Child El Salvador evaluation team and the office at Duke Global Health Institute coordinate for the research coordination call. This call is a moment’s pause to make sure everything is on track and troubleshoot anywhere needed. It’s a busy moment in the El Salvador office — but the results will be important to guide our ongoing work in El Salvador and worldwide to improve quality of care for vulnerable children!

The Evaluation Team Begins Post-Evaluation in El Salvador

Today our evaluation team is back out in the field as we began post-evaluation to measure the impact of our work to improve quality of care of vulnerable children in El Salvador. The evaluation is a collaboration of Duke University’s Global Health Institute and teams at the University of South Carolina and the University of Central America. The effort uses WCI-QCUALS, a comprehensive measurement tool we developed to assess limited-resource childcare settings in the developing world, comparing what we find against the original baseline study completed last year.

Gary Newton Joins Whole Child International as Senior Director for Policy

Whole Child International is pleased to announce that Gary Newton has joined our team as Senior Director for Policy. Gary will lead the development of a policy framework to guide our programmatic and geographic expansion.

Whole Child International occupies a niche within the international development community: we focus on the needs and plight of poor and vulnerable children stuck in institutions. While awaiting placement in families, children have the right to the best care possible within the well-known constraints of the institutional setting. Whole Child promotes changes in procedure and practice that improve the quality of caregiving, strengthen attachments, and enrich the emotional environment for children. Whole Child does not promote the institutionalization of children. We help prepare children who live in institutions to live within families.

Whole Child has implemented programs in residential and early childcare settings in Central America – a challenging care environment due to limited resources, widespread displacement, pervasive poverty, and some of the world’s highest rates of violence.

Whole Child is on the cusp of modest growth. Over the next five years, Whole Child will build on thirteen years’ experience working with governments and within the residential care sector to support transitions from institutional to family-based care. We will work on transitions with new partners in Africa and Asia and current partners in Central America. As we expand into family-based care, we will continue our focus on sustainability, increasing government capacity, and leveraging existing alternative care resources to create change.

Gary will consult widely with colleagues in the sector to ensure our policies and programs complement those of our partners and contribute to the global goal of ensuring that as many children as possible are cared for in a family, whether it be their own or an alternative.

Gary served as a Foreign Service Officer with USAID for 25 years, including 16 years in Africa. His positions included USAID Director in Namibia and U.S. Government Special Advisor for Orphans and Vulnerable Children. He teaches a course on vulnerable children at Georgetown University at the School of Foreign Service in the Global Human Development Program, and serves on the board of three organizations that focus on child welfare and protection and public health.

What’s Inspiring Our Team This Week

Working for sustainability is hard. Many times we would love to go into a childcare center and fix everything all at once, but it’s essential to go slowly with our partners and make sure they know the why and the how of the practices and principles that we recommend.

Some days, this process seems like it will take a very long time. And then there are the days it all clicks. Today, in a visit to one of the childcare centers in the heart of San Salvador, on the edge of one of the largest markets and in an area with strong gang presence, it clicked! This childcare center unfortunately does not have any green area, and for security reasons the children must stay indoors nearly all day. Working with caregivers to make the childcare experience full of joy, discovery, and fun in these conditions has been a challenge, but the caregivers have worked tirelessly with our technical team, learning new strategies for positive reorientation and ways to communicate and interact with the kids.

After reaching a number of quality benchmarks, through the generosity of the Mawardi Foundation, we were able to introduce new toys and materials into this center. While the space for the older kids was instantly transformed, the space for the babies was harder to implement. The caregivers have been cautious about creating an environment where children under one year old could be on the floor, moving and playing, while the caregivers were elsewhere in the room. But today when we walked in for technical assistance we found a new kind of quiet filled with the sounds of children discovering, playing, and interacting. The caregivers were moving around doing necessary tasks, pausing constantly to marvel at their charges who could now set new challenges for themselves and achieve those successes.

Pictures from that visit are up on our office bulletin board in El Salvador as our inspiration this week!

A Visit from Dr. Tomas Matza, Ethnographer

From the beginning, Whole Child International has dedicated significant time, resources, and funding to doing research and evaluation of the work that we do. This has been essential to demonstrate results and impact, but it also guides our program development. For instance, if we find that some results are not as effective or as well sustained as we had hoped, through evaluation we can carefully analyze and pull apart the pieces of our program to determine where we need to grow further.

As part of our research in El Salvador, Dr. Tomas Matza, an anthropologist and ethnographer from the University of Pittsburgh, has been providing invaluable insight into the caregiver experience prior to, throughout, and after our work improving the quality of care in their centers. We work intensively with the caregivers, providing them training followed by on-site hands-on coaching and mentoring in applying what they have learned, so it’s invaluable to carefully understand what helps the caregivers — and therefore  the lives of the children they care for.

Tomas first visited in June 2015, and he is back in-country working with the team of local ethnographers as part of the post-intervention assessment. He is also meeting with government officials to learn more about their experience in our university certificate program, and how this has changed their perspective and practice. We are looking forward to the new insights gained from this process.

Assessing Our Progress in El Salvador

Last week, Founder & CEO Karen Spencer and other U.S.-based staff joined our El Salvador team to visit all corners of El Salvador and assess the progress of the work we have been conducting in limited-resource childcare centers. The El Salvador team has done tremendous work in the care centers, and we’re all grateful for our dedicated partners in the centers and across the Salvadoran government as we move forward with our nationwide program.


One of the most visible changes to children’s lives in the care centers is the addition of toys, play structures, and other improvements to the space to encourage imaginative play and enhance caregiving. Since they were added last year, they’ve been a big part of the hands-on support we have provided caregivers. In turn, caregivers have been able to leverage them to engage with children, and empowered to find creative ways to support the development of each child in their care.


We can’t praise the caregivers, their supervisors, and technical staff members enough for their energy, their care, and their resourcefulness as we all work together to improve the care centers as part of our larger nationwide program.




Whole Child Begins Collaboration in China

Whole Child has been thinking about how to evaluate the quality of care that children receive since the founding of the organization. This careful analysis led to a five-year process of literature review, development, testing, and expert review to develop our childcare setting quality measurement tool, WCI-QCUALS — first as a tool on paper and then developed as a smartphone application with Duke University. This month our program director, Meghan Lopez, traveled for 10 days to China to work with our colleagues at One Sky for Children, who share a similar perspective on the importance of quality care and relationship centered care.

She provided a training session focused on an overview of quality in childcare through the lens of existing evidence, specifically looking at limited-resource settings. Meghan shared WCI-QCUALS and worked with One Sky staff to pilot its use.

One of our goals in this partnership is to learn as partners at One Sky use WCI-QCUALS to evaluate their orphanages, childcare programs, and foster care services, in China. From the thoughtful questions during training and the on-site practice assessments, it was exciting to share experiences with our talented colleagues there and to support the important work they do for vulnerable children.


Meghan Lopez and her One Sky colleague, Xiaomin, address the training session in China.


First Caregiver Trainees Graduate in El Salvador

Whole Child’s El Salvador team graduated its first group of 54 caregivers of Salvadoran orphanages and childcare centers on November 18. The caregivers completed eight months of arduous effort and learning in our first monthly workshops on “Improving Practices for Childcare in Groups,” which is the fourth stage in our process which aims to improve the quality of childcare across the country. Whole Child is joined in this effort by the Salvadoran government’s Institute for Children and Adolescents (ISNA), supported by the Inter-American Development Bank (IDB) and the Korean Poverty Reduction Found (KPR). The workshop was a collaboration of experts in integral child development from ISNA, government supervisors, as well as directors and caregivers from nine centers dedicated to childcare in El Salvador.

The workshops covered multiple topics around care and well-being of children, including communication with children, establishing routines in care, establishing a bond with children through everyday activities, the creation of safe and welcoming spaces, observation and child development support.

Each session included reflection and discussions regarding practices and participant experiences. After each session, the Whole Child team provided the caregivers in each center with hands-on support and coaching. We want to thank all 54 caregivers who participated in and learned through these workshops; honoring the commitment, effort, and willpower to make a difference in the life of these children.

Outfitting Childcare Centers with Furniture, Toys, and Materials that Improve Care

On Friday, November 11, we celebrated an important activity in the process of the improvement of quality care in the pilot childcare centers that are the focus of our intervention right now. Our team adapted spaces for children and their caregivers, and put in place furniture, toys, and materials to support the development of Salvadoran boys and girls who are being raised in limited-resource orphanages and other care settings. This effort reinforced what the caregivers learned during the workshops, and the coaching they had received throughout an eight-month period. In total, nine Salvadoran pilot centers benefited from this project.


We installed the toys and materials in the presence of representatives of the Salvadoran government’s Institute for Children and Adolescents (ISNA), community leaders, caregivers, and families, Watching the happiness and enthusiasm of the children with new toys and play spaces was gratifying and joyous for the adults as well.

This effort has been made possible thanks to the Inter-American Development Bank (IDB) and the Korean Poverty Reduction Fund, and through the support of the Youssef and Kamel Mawardi Fund. It’s a pilot effort we’ll be following in many of the other care centers across El Salvador and beyond, so it’s been carefully documented for replication on larger scales.

Beginning a New Program with El Salvador’s Ministry of Education

This Saturday, June 25, Whole Child International will launch a new effort in El Salvador in coordination with the Ministry of Education and our partners at the University of Central America in San Salvador. The program will build upon our existing work in children’s institutions and limited-resource care settings to improve the quality of early childhood development, bringing the care practices at the heart of our work to more children across the country.

The Ministry of Education has asked us to coordinate their efforts in training all early-childhood teachers across El Salvador – beginning with 480 specialist early-childhood teachers and community education workers who will then then be charged with training their more than 7,000 colleagues across the country. This exciting new alliance aims to strengthen the professional and social skills of public-sector teachers who currently teach early childhood education and early childhood development. It’s a forward-looking, comprehensive approach to promoting the integral development of children in the country through a human-rights approach as part of a national strategy for building a culture of peace. We are proud to be part of it.

Closing the Baseline in El Salvador

On April 20, Whole Child International closed the baseline of our study of Salvadoran early childhood centers, meaning we have reached the first research-based “diagnosis” of a nationwide early childhood care system anywhere in Latin America!

The investigation started in March 2015 in coordination with Duke University’s Global Health Institute (CHPIR), the University of Central America of El Salvador and the University of Pittsburgh. This process has deployed 24 psychologists in the field daily to evaluate seven orphanages and 154 childcare centers on the national level.

The evaluators have collected demographic data, measured children’s physical well-being and development, monitored the well-being of caregivers, and evaluated the features of the individual centers of care. We used WCI-QCUALS, the tool we developed for measuring limited-resource care settings, which proved to be very sensitive in evaluating and monitoring early childhood care, emphasizing the interaction between caregivers and children.

The baseline has been complemented with qualitative information about the context in 20 selected centers, gathered by four ethnographers, in coordination with the University of Pittsburgh Department of Anthropology.

Once the information has been analyzed, Whole Child will be able to provide the government of El Salvador a thorough and complete diagnosis of the quality of early childhood care to the most vulnerable children in the country, as an important tool for decision-making as we continue to expand our program nationwide to address the conditions found in the study.

Promoting Big Ideas at Both Ends Burning

From April 3-6, our founder and CEO, Karen Spencer, and Program Director Meghan Lopez presented at the Both Ends Burning Second Global Symposium for Achieving Child Permanency Through Innovation. Over four days in Los Angeles, 98 people from 25 countries met to discuss big ideas for protecting vulnerable children. Whole Child was honored to be one of only five nongovernmental organizations presenting success stories as well as new ideas for next steps. It was a great opportunity to meet like-minded colleagues from around the world, and get new perspectives on the need for our program and other ideas from across the spectrum of care for orphans and other vulnerable children.

Whole Child Founder Visits El Salvador to meet with First Lady and Second Lady of El Salvador

Karen Spencer, Whole Child’s founder and CEO, met on February 17 with the First Lady of El Salvador, Doña Margarita Villalta de Sánchez, and Second Lady Elda Gladis Tobar Ortiz, who is executive director of ISNA, the Salvadoran government’s Institute for Integral Development for Children and Adolescents.

Whole Child International works intensively alongside the Salvadoran government on our project, “Improvement of Quality of Care in Early Childhood.” The project brings together multiple stakeholders across El Salvador, funded by the Korean Poverty Reduction Fund and the Inter-American Development Bank (IDB), and implemented alongside the Technical and Planning Secretariat of the Presidency (STPP), and ISNA, the University of Central America in San Salvador, among others.

The visit was also a chance to slow down and spend some time with the entire Whole Child team down here in San Salvador, trading stories and aligning our objectives moving into the next phase of work in El Salvador.

Whole Child Team with Karen Spencer

Dr. Santamaria: from Student to Teacher of Best Practices in Childcare

Whole Child International invited Dr. Ricardo Santamaria, a graduate of our first university certificate course on childcare management, to teach the class on basic health concepts in childcare for our second course on best childcare practices at the University of Central America.

As the Metropolitan District Director of the El Salvador Ministry of Health, Dr. Santamaria perfectly represents the key objective of our training programs — to equip and prepare major stakeholders in developing countries to convey a comprehensive set of best practices in childcare and protection to a much wider population.

Dr. Santamaria at Whole Child / UCA

Dr. Santamaria told the students “a diaper change can become a magical moment,” inspiring students to work toward creating those magical moments for vulnerable children and providing them with nurturing caregiving relationships.

The graduates of the second course will now go on to implement what they learned in childcare centers and orphanages across the nation and will support caregivers in their efforts to provide more stable, nurturing high-quality caregiving relationships for more than 10,000 of the country’s most vulnerable children.

Subscribe today to our mailing list:

By submitting this form, you are granting: Whole Child International, 610 Santa Monica Blvd. #215, Santa Monica, CA, 90401, permission to email you. You may unsubscribe via the link found at the bottom of every email. (See our Email Privacy Policy ( for details.) Emails are serviced by Constant Contact.

Please follow us today on social media: