Notes from the Field
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.
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.”)
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.”)
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.”)
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:
- 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.
- 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.
- 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.”)
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:
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.
Children experienced a 46% increase in height and 34% increase in weight with no changes to nutrition.
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).
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)
- 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.
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:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
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.
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.
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.
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.
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.
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.
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
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.
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