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Helping Empower Youth Brought up in Adversity with their Babies and Young children

Periodic Reporting for period 2 - HEY BABY (Helping Empower Youth Brought up in Adversity with their Babies and Young children)

Reporting period: 2020-11-01 to 2022-04-30

This research project is developing the first known theoretical framework of resilience for adolescent parents and their children in Africa. By creating an empirically generated theory, this research aspires to three major advances in prevention science: 1) We are combining quasi-experimental, data pooling and qualitative methods to identify protective pathways; 2) We are creating the global South’s first multi-country study of parenting support; 3) We are combining pioneering research with adolescent participation and embedded stakeholder engagement. Our research has already directly impacted international and regional policy and programming.
HEY BABY: Examining socio-economic predictors of resilience

This research combines new data from 1000+ adolescent mother-child dyads in South Africa with prior data from pre-conception to pregnancy, which can be used to identify facilitators for promoting resilience for this highly vulnerable group. These quantitative findings are further informed by qualitative research and engagements with adolescent and policy groups.

(1) New tools for data collection were developed, informed by adolescent mothers’ feedback. Standardised scales of child development were adapted to improve contextual relevance and implementation feasibility.

(2) We developed a sampling strategy enabling inclusion of adolescent mothers who both did and did not engage in formal health, education and social services, and leading to recruitment of 1042 adolescent mothers and 1124 of their children.

(3) Data cleaning of complex relational data is building a unique dataset that will allow us to identify services and social protective factors to promote resilience amongst high-risk adolescents and their children in South Africa.

(4) During COVID lockdowns, the team adapted robust data collection methodologies remotely. Following full redesign, training and pilot testing of new tools, remote data collection is now tracing the study dyads in collaboration with 70+ health facilities.

(5) Active engagement with policymakers and implementers at local, national and international levels elicited close collaborations with the Departments of Basic Education and Health and local NGOs, which have been instrumental in supporting pilot and baseline data collection, successful recruitment and identification of key research priorities.

(6) Concerted data cleaning enabled preliminary analysis of baseline data to respond to urgent policy questions, with publication of 6 peer-reviewed papers and multiple high-level presentations.

PLH-SUPER: Testing parenting support for adolescents in severe adversity

Our aim is to investigate the implementation and effectiveness of the PLH parenting interventions when delivered at scale in real-world contexts.

(1) Strong collaborations have been established with implementing partners in 10 African countries, with anonymised secondary data received from Tanzania, South Sudan, the Democratic Republic of Congo, Zimbabwe and Montenegro, expected from Eswatini, Zambia, South Africa and Malawi and further commitments from the Czech Republic, India, Thailand and the Philippines. The research focus has widened from only adolescent parents to families with adolescents and with younger children; and the scope has increased from an estimated 8,000 to an estimated 77,000 sample size, in a larger number of countries, including conflict areas.

(2) The team provided remote capacity-building support to partners to strengthen data collection and management processes.

(3) Country-level ethical clearance has been secured in 8 of the participating countries, with the remainder in progress.

(4) The team has produced 3 academic publications and a study commentary, including a paper in collaboration with CRS/4Children South Sudan and the South Sudan Ministry of Health.

(5) COVID-19 escalated the global demand and scale-up of PLH vastly beyond anticipation. Pivoting in response to this need, we adapted our PLH in-person programmes into an innovative repertoire of open-source materials disseminated in coordinated collaboration with the World Health Organization, UNICEF and 240 NGOs. These resources have been accessed by 210.3 million people in 198 countries and territories and used in 34 national government COVID responses. The research team is developing and testing intensive digital parenting interventions to support parents in settings including impoverished and remote communities, working with policy makers in response to their need – made urgent and visible by the pandemic - for cost-effective development accelerators.

TAG: Citizen social science

Teen Advisory Groups engage with young people to explore their perspectives on adversities and early parenthood and available support to overcome these and foster resilience.

(1) Participatory research with adolescents and young people in South Africa and Kenya generated data about social issues chosen by the young people, captured in arts-based outputs of word association posters, poetry, music, and theatre.

(2) Research activities, co-generated with adolescents and conducted remotely, investigated in real-time how adolescents and young people were affected by the pandemic, with data collection through phone calls, messaging and groups on social media.

(3) Posters were presented at IAS 2021 on lessons learnt from remote research and health service experiences of South African adolescents and healthcare workers during COVID-19. The team are compiling a toolkit on remote methods.

(4) Data generated from COVID-19 activities were included in 2 UNICEF reports and a journal article and submitted to the IAS COVID-19 conference. Papers have been accepted for publication in 3 peer-reviewed journals. Findings from narrative analysis of two TAG member experiences will inform recommendations in a policy brief co-developed with UNICEF ESARA.
WP 1: This research contributes to a globally unique dataset, merging data from 1000+ adolescent parent-child dyads with a dataset from the world’s largest longitudinal cohort study of adolescents living with HIV. This database will be the first known primary research in Africa examining predictors of multi-dimensional adolescent maternal and child outcomes, enabling identification of resilience-promoting factors that will inform social and healthcare policy and programming for high-risk adolescent mothers and their children.

WP 2: The innovative data pooling method - acutely needed in Africa with its poor data sharing globally - enables access to regionally-relevant findings that will inform policy and practice. The study creates the largest pooled dataset of real-world parenting intervention data, complemented by quasi-experimental and experimental data from PLH trials around the world. Findings will provide unique insights into the adoption, adaptation, implementation, effectiveness and sustainment of parenting interventions being delivered at scale across different contexts, with health economists exploring the costing and cost impact, for scale-up viability.

WP 3: Research is co-designed and undertaken in partnership with young people, with the data generated feeding into the design of linked studies, and filling an evidence gap where participatory research is absent. Engaging alongside policymakers in the research synthesis stage, TAG leverages participant voices directly into the policy sphere
HEY BABY Fieldwork team in East London, South Africa