Effectiveness of a parenting programme to reduce violence in a cash transfer system in the Philippines: RCT with follow-up

Abstract

Background: Parenting interventions and conditional cash transfer (CCT) programmes are promising strategies to reduce the risk of violence against children, but evidence of the effectiveness of combining such programmes is lacking for families in low-and middle-income countries with children over two years of age. This study examined the effectiveness of a locally adapted parenting programme delivered as part of a government CCT system to low-income families with children aged two to six years in Metro Manila, Philippines. Methods: Participants were randomly assigned (1:1) to either a 12-session group-based parenting programme or treatment-as-usual services ( N = 120). Participation in either service was required among the conditions for receiving cash grants. Baseline assessments were conducted in July 2017 with one-month post-intervention assessments in January-February 2018 and 12-month follow-up in January-February 2019. All assessments were parent-report (ClinicalTrials.gov: NCT03205449). Findings: One-month post-intervention assessments indicated moderate intervention effects for primary outcomes of reduced overall child maltreatment ( d = -0.50 [-0.86, -0.13]), emotional abuse ( d = -0.59 [-0.95; -0.22]), physical abuse (IRR = 0.51 [0.27; 0.74]), and neglect (IRR = 0.52 [0.18; 0.85]). There were also significant effects for reduced dysfunctional parenting, child behaviour problems, and intimate partner violence, and increased parental efficacy and positive parenting. Reduced overall maltreatment, emotional abuse, and neglect effects were sustained at one-year follow-up. Interpretation: Findings suggest that a culturally adapted parenting intervention delivered as part of a CCT programme may be effective in sustaining reductions in violence against children in low-and middleincome countries.

The Apapacho Violence Prevention Parenting Program: Conceptual Foundations and Pathways to Scale

“…We found six recent reviews and meta-analyses of parenting programs for caregivers of young children to prevent violence and child behavior problems [ 43 , 44 , 45 , 46 , 47 , 48 ]. Furthermore, we found 17 recent randomized controlled trials of 11 parenting programs implemented in LMICs targeted toward young children, which were effective in reducing VAC, key drivers of VAC, and child behavior problems (see Table 2 ) [ 15 , 23 , 24 , 25 , 26 , 28 , 29 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ].…”

“Before I was like a Tarzan. But now, I take a pause”: mixed methods feasibility study of the Naungan Kasih parenting program to prevent violence against children in Malaysia

“…The Parenting for Lifelong Health program for young children was originally developed by integrating common evidence-based program components within the local cultural context in South Africa [ 21 ]. Subsequent testing in randomized controlled trials in South Africa, Thailand, and Philippines demonstrated positive impacts on reduced violence against children and child behavior problems, improved caregiver mental health and positive parenting, and reduced intimate partner violence, the latter in the Philippines [ 22 , 23 ]. Similarly, the Parenting for Lifelong Health program for parents and adolescents was developed in rural South Africa and then tested in a cluster randomized controlled trial showing positive effects across a range of family outcomes [ 20 ].…”

The development, reliability, and validity of the Facilitator Assessment Tool: An implementation fidelity measure used in Parenting for Lifelong Health for Young Children

“…Parenting for Lifelong Health (PLH) programmes are now being implemented in over 25 countries in Africa, Asia, and Southeastern Europe. To date, four randomised controlled trials (RCTs) have examined the effectiveness of PLH-YC-two in South Africa, one in the Philippines, and one in Thailand (Gardner et al, forthcoming;Lachman et al, 2017Lachman et al, , 2021Ward et al, 2020). These studies found improved positive parenting and child behaviour, while reducing family violence.…”