Maltreatment, Child Clinical Trial
Official title:
Improving Care and Preventing Maltreatment of Orphans: A Cluster-randomized Controlled Study With Caregivers
Sub-Saharan Africa, with more than 56 million orphans worldwide, is the most affected region
in terms of orphans to be cared for (UNICEF, 2014). The recently developed preventative
approach Interaction Competencies with Children - for Caregivers (ICC-C; Hecker, Mkinga,
Ssenyonga, & Hermenau, 2017) trains the essential interaction skills in working with
children. The focus here is on strengthening a warm, sensitive and reliable relationship
between caregiver and child as well as on non-violent education strategies. In a first pilot
study the feasibility of the approach icould be demonstrated (Hermenau, Kaltenbach, Mkinga, &
Hecker, 2015).
The study applies a two-arm cluster-randomized controlled design. The participating
institutions will be randomly divided into intervention and control bodies. The follow-up
examination should take place three months after the intervention. All caregivers in facility
(N = approx. 150) and 25 randomly selected children (age: 6-12) per facility (N = 200) will
be included in this study.
Sub-Saharan Africa, with more than 56 million orphans worldwide, is the most affected region
in terms of orphans to be cared for (UNICEF, 2014). The few studies investigating children in
African orphanages mostly showed inadequate care (Espié et al., 2011; Hermenau et al., 2011;
Levin & Haines, 2007; Wolff & Fesseha, 1998, 1999). In addition to the lack of trained and
competent caregivers, children are also confronted with violence and abuse in the orphanages
themselves (Hermenau et al., 2011; SOS Children's Villages International & University of
Bedfordshire, 2014). Abuse and neglect in orphanages, in addition to traumatisation, abuse
and neglect in the families of origin, pose a considerable risk for the healthy development
and mental health of children (Hermenau, Goessmann, Rygaard, Landolt, & Hecker, 2017). In
addition to meeting basic needs (e. g. eating, drinking, basic medical care, etc.), sensitive
and non-violent education in orphanages is crucial for the emotional and physical development
of children. However, the focus of previous intervention studies has been on promoting a
sensitive and reliable relationship between caregiver and child. Violence and maltreatment,
on the other hand, received little attention (Hermenau et al., 2017).
The recently developed preventative approach Interaction Competencies with Children - for
Caregivers (ICC-C; Hecker, Mkinga, Ssenyonga, & Hermenau, 2017) trains the essential
interaction skills in working with children. The focus here is on strengthening a warm,
sensitive and reliable relationship between caregiver and child as well as on non-violent
education strategies. In a first pilot study the feasibility of the approach could be
demonstrated (Hermenau, Kaltenbach, Mkinga, & Hecker, 2015).
The study applies a two-arm cluster-randomized controlled design and includes 20 to 25
orphanages. After an initial investigation, the participating institutions will be randomly
divided into intervention and control bodies. The follow-up examination should take place
three months after the intervention. In addition, feasibility data will be assessed in the
intervention facilities only at the beginning and the end of the intervention. All caregivers
in facility (N = approx. 150) and 10-15 randomly selected children (age: 6-12) per facility
(N = 300) will be included in this study. Data of caregivers will be assessed with the help
of self-administered questionnaires, whereas data of children will be assessed with
structured interviews.
There is a clear and pressing humanitarian need for science to address the issue of care
quality and maltreatment prevention in institutional care settings in a practical manner.
Perhaps surprisingly in view of this, so far no evidenced-based prevention measures adapted
for the limited resources in low-income countries have been developed and scientifically
evaluated. This research project can address this need, with a scientifically rigorous
evaluation of a violence and maltreatment prevention program that fosters the active
involvement of local personnel and that considers the limited resources of school settings in
low-income countries. Through these efforts this study may help more orphans to grow-up in a
supportive atmosphere, maintaining their psychological well-being and improving their
performance. This preventative program aims to make a significant impact on the psychological
well-being of orphans in Tanzania.
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N/A |