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Semillas de Apego – Psycho-social accompaniment for principal caregivers to protect young children affected by violence and displacement

It might be thought that in early childhood boys and girls are too young to understand and sense the impact of conflict and community violence. But the opposite is true: there is strong evidence that violence, both direct and indirect, has short-, medium-, and long-term impacts on their wellbeing and development.  Semillas de Apego is a psychological group support program to protect and promote the development of girls and boys who were affected by the violence in Colombia. The program takes an innovative approach, incorporating strategies that promote main caregivers’ mental health, safe and healthy emotional bonds’ principles, early childhood development, and positive childrearing practices using a group approach that suits the needs of the population affected by the conflict. This project seeks to design and implement a scale-up strategy to take the program to other regions badly affected by violence. Other expected breakthroughs include the anticipated discovery of the project’s replication potential and the learning of lessons on how to implement solutions to mitigate the consequences of violence on children.

Problematic

Tumaco, the municipality where the program is being implemented, is plagued by extreme poverty, violence, and forced displacement issues. In 2017 it registered 243 murders, or 116.6 every 100,000 inhabitants, which is more than five times higher than the national average. Moreover, Tumaco is the municipality with the largest number of illegal plantations in Colombia, half its dwellers live under unsatisfied basic needs conditions, and 23% are unemployed (UNODC, 2017; DANE, 2011; United Nations, 2017). As a consequence of this extremely adverse and violent environment, mothers, fathers, and other main caregivers have significant emotional health issues, which in turn affect their ability to build safe emotional bonds with the children. On top of the traumatic exposure to violence, this situation also creates obstacles that prevent girls and boys from developing to their full potential. Therefore, it is of the utmost importance to be innovative and fully aware of the need to develop programs to mitigate the terrible effects of violence. It is also paramount to generate evidence to make it possible to implement it in other communities that may need it.

Solution

Strong and healthy emotional ties with their caregivers can mitigate the effects of children’s exposure to violence. Semillas de Apego aims to promote such ties by providing psycho-social group support and orientation to mothers, fathers, and caregivers. To this end, it has designed and evaluated a 4-month curriculum based on the same principles of Psychotherapy for Parents and Children developed by the UCSF’s Child Trauma Program and adapted to the context and needs of Colombian communities living in a situation of violence.

The program focuses on restoring the main caregiver’s emotional resources and on promoting healthy attachment, as well as on developing local capabilities to generate resilience and protection from the toxic stress caused by contexts of extreme adversity. The program is completely managed by community actors who receive training and permanent support to ensure the quality of its implementation and to mitigate the risks of burnout that typically affects teams working with victims of violence.

This project aims to generate evidence on the cost-effectiveness of Semillas de Apego and on designing and implementing its scale-up program. With this in mind, the program has been structured into two phases. The first one will conduct a new evaluation of the implementation and cost of Semillas de Apego in Tumaco in the period 2018-2019 in order to build the scale-up plan. This process will take advantage of the information collected by the monitoring and evaluation system and supplement it with additional information provided by interviews to key stakeholders. In addition, it will work together with the 

Instituto Colombiano de Bienestar Familiar (Colombian Institute for Family Wellbeing) to ensure that the scaling-up plan is viable and in line with the country’s public policy guidelines. The program’s strengths and opportunities will be carefully analyzed to ensure that in the future it will be prepared to adapt to new contexts and communities without losing its essence and effectiveness. The project’s second phase focuses on the implementation at scale of Semillas de Apego in Tumaco plus 2 or 3 additional Colombian municipalities plagued by violence and armed conflict. This phase will help validate and improve its scaling up strategies.

 

Evaluation and Impact

Semillas de Apego has undergone a two-stage experimental impact evaluation – the first, short-term phase was conducted when the intervention ended, and the second, medium-term assessment, 8 months later – conducted within the framework of the first four groups in Tumaco. This study, which took place between January 2018 and November 2019, included nearly 1,400 families. Areas covered by this evaluation included: mental health of the main caregivers and their children, quality of their emotional ties, childrearing practices, and girls’ and boys’ cognitive and socio-emotional development. The impact assessment is a key tool to help design and implement evidence-based public policies. This evaluation was the product of a partnership between the Universidad de los Andes, the Child Trauma Research Program of the University of California, San Francisco, Genesis Foundation (now United Way Colombia) and the Éxito Foundation, all of which share an interest in designing and validating a new, cost-effective model of implementation for Semillas de Apego. Other groups joined later: FEMSA Foundation, The Coca-Cola Company, and the collective impact vehicle Primero lo Primero (First Things First, formed by the foundations Mario Santo Domingo, Carulla AeioTu, Pies Descalzos, Dividendo por Colombia, and Genesis). The project also received the Grand Challenges Canada’s Saving Brains research grant.  

Basic data

Target population
Caregivers
Girls and Boys (3-5) years
Area
Caregiver development
Cognitive development
Language development
Protection and security
Socio-emotional development
Development of the family environment
Allies
Universidad de los Andes, Child Trauma Research Program de la Universidad de California, San Francisco, United Way Colombia, BID: Fondo de Innovación en Desarrollo Infantil temprano
Place
Colombia
Start date
Fecha de finalización
State
Intermediate stage
Type of Intervention
Psychosocial care and stimulation
Delivery mode
Group sessions