Scaling up Parenting for Lifelong Health in Montenegro: Funded by the European Union

Scaling up Parenting for Lifelong Health in Montenegro: Funded by the European Union A feasibility assessment Author: Amalee McCoy Editing and proofreading: Peter Stonelake Cover photo: Duško Miljanić Design: Pixella Circulation: 70 copies Scaling up Parenting Acknowledgements for Lifelong Health in Montenegro: This feasibility assessment The researcher would like to thank Ida Ferdinandi at UNICEF of the institutionalization, Montenegro for her high level of support and engagement throughout this study. In addition, various UNICEF staff A feasibility assessment scale-up and sustainability at the Country and Regional Offices provided important of Parenting for Lifelong feedback which strengthened this report, namely: Jessica Health for Young Children Katherine Brown, Ivana Ceković, Nada Đurović Martinović, (PLH-YC) in Montenegro Guzal Kamalova, Maja Kovačević, Danilo Smolović and Stevan Stanišić. Special and sincere gratitude is due to Professor was commissioned by the Table of Contents Judy Hutchings (Bangor University), who provided vital UNICEF Montenegro Country insights concerning strategies for quality PLH-YC delivery, Office with support from the drawing from over 40 years of experience in the parenting ACKNOWLEDGEMENTS ...............................................................................................................5 European Union. The research support field, during several online meetings, as well as ACRONYMS .................................................................................................................................5 through her review of the draft report. Many thanks are was conducted by Dr Amalee due to Dr Yulia Shenderovich (University of Oxford), who EXECUTIVE SUMMARY ................................................................................................................6 McCoy, as an independent also provided many helpful comments and suggestions on 1. INTRODUCTION ...................................................................................................................... 10 researcher and consultant with the draft report. Furthermore, the researcher would like PARENTING FOR LIFELONG HEALTH FOR YOUNG CHILDREN ................................................... 12 experience in the adaptation to thank Danilo Leković and Tamara Jurlina, who provided high-quality simultaneous translation support during primary PURPOSE AND OBJECTIVES ...................................................................................................... 13 and empirical evaluation of data collection. Finally, the researcher is very grateful to 2. METHODOLOGY..................................................................................................................... 14 PLH-YC. the individuals and institutions that participated in this STUDY MANAGEMENT............................................................................................................... 14 assessment, for taking the time to share their valuable experiences and candid views. STUDY APPROACH ..................................................................................................................... 14 STUDY PROCESS �� 15 Disclaimer: The contents of this report are the sole 3. IMPLEMENTATION STATUS OF PARENTING FOR responsibility of the researcher and can in no way be taken to reflect the views of UNICEF, the European Union and their LIFELONG HEALTH FOR YOUNG CHILDREN IN MONTENEGRO ............................................. 18 partners. A) OVERVIEW OF IMPLEMENTATION TO DATE ........................................................................... 18 B) PROGRAMME DELIVERY PROCESS ��22 C) PARTICIPANT PROFILES AND EXPERIENCES OF THE PROGRAMME ......................................25 Acronyms D) EXPERIENCES OF PLH-YC FACILITATORS AND SUPERVISORS ...............................................27 E) PROGRAMME IMPACT ...........................................................................................................30 CRC Convention on the Rights of the Child F) PROGRAMME COSTS .............................................................................................................31 4. MOVING FORWARD: INSTITUTIONALIZATION AND SCALING-UP ...........................................38 EU European Union A) SUPPORTIVE LAWS, POLICIES, AND INSTITUTIONS ..............................................................38 B) NATIONAL STRATEGIC PLANNING AND STANDARDIZED GUIDANCE .....................................41 FGD Focus group discussion C) STAFF RECRUITMENT AND CAPACITY BUILDING...................................................................46 HC Healthcare Centre D) PROGRAMME REACH ............................................................................................................49 E) PROGRAMME ADAPTATION AND INNOVATIVE APPROACHES ...............................................50 PLH-YC Parenting for Lifelong Health F) PROGRAMME MONITORING, EVALUATION, AND FURTHER RESEARCH ................................52 or Young Children 5. RECOMMENDATIONS ............................................................................................................54 APPENDIX A. LIST OF PLH-YC FACILITATORS AND SUPERVISORS..............................................57 RCT Randomized controlled trial APPENDIX B. RATES OF PARTICIPANT RECRUITMENT, ENROLMENT, UNICEF United Nations Children’s Fund COMPLETION, AND ATTENDANCE ACROSS SITES ��60 APPENDIX C. ESTIMATED COSTS OF PLH-YC PROGRAMME DELIVERY ��62 WHO World Health Organization APPENDIX D. EXAMPLES OF CASCADE TRAINING MODELS ��64 APPENDIX E. LIST OF RESEARCH PARTICIPANTS.......................................................................66 REFERENCES .............................................................................................................................68 Scaling up Parenting for Lifelong Health in Montenegro: A feasibility assessment 5 Executive summary Introduction In response to the high growing body of scientific literature has shown that A social-learning-theory-based parenting programmes prevalence rates of can effectively diminish rates of violence against children violence against children, and improve a range of related outcomes, such as positive parenting skills, developmentally responsive care with at least one billion and affection, and parental mental health. One of these interventions is Parenting for Lifelong Health for Young children subjected to Children (PLH-YC), a social-learning-theory and group- such harm during the based programme for parents and primary caregivers of children aged 2–9 years which has been designed for past year alone, there has the particular needs of low- and middle-income country contexts. PLH-YC is intended for delivery as a secondary been a surge of global prevention intervention for those families at risk of child interest in evidence-based maltreatment. violence prevention and Purpose and objectives the promotion of nurturing This feasibility assessment was commissioned by relationships between UNICEF with support from the European Union to support the institutionalization, scale-up and sustainability parents/ caregivers and of PLH-YC at the national level in Montenegro. The their children. specific objectives were to: 1. Document evidence of programme implementation progress to date and the effectiveness of PLH-YC both in Montenegro Photo: and internationally; Duško Miljanić / 2. Propose modalities for institutionalizing the UNICEF Montenegro programme in terms of coordination and planning, programme delivery, monitoring and evaluation, drawing on examples from other participants; and an online survey targeting 68 parents Healthcare Centres, kindergartens and NGOs. Six cycles countries; and caregivers who did not successfully complete the of programme delivery were undertaken between 2018 3. Cost the programme, utilizing a costing tool that programme, with seven people responding. The research and early 2021, with a total of 458 parent and caregiver can be customized in the future as variables utilized thematic analysis and a hybrid approach to the participants enrolled across five municipalities: Podgorica, change; and coding of qualitative data. Desk review findings and Nikšić, Bijelo Polje, Berane and Cetinje. 4. Share reflections on a broader strategy for primary research data were integrated to draw key parenting support in Montenegro with a conclusions and propose recommendations for scaling To recruit parents and caregivers, facilitators utilized continuum of services/ programmes. up. organizational websites and social media platforms, existing caseloads and contacts, and cross-sector Methodology PLH-YC programme implementation in referrals. Many facilitators noted that parent group compositions with mixed demographic and risk This assessment adopted a mixed-method approach, Montenegro profiles were an ideal arrangement. Data on participant combining a desk review and primary qualitative and engagement revealed that there were high rates of quantitative research. Primary data collection comprised Since late 2017, UNICEF, the Parenting for Lifelong Health enrolment (96%), completion (89%) and attendance individual

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