Innovation summary

Many barriers to care exist for children with developmental disorders, which may be attributed to a lack of awareness among families, lack of support workers and the stigma associated with the conditions. The innovation aims to reduce the burden of intellectual and developmental disorders in children while empowering, organizing and training their families.

Content of the FaNs for Kids Project:

  • Stigma reduction campaigns to empower families
  • mhGAP interventions provided by team of families of the children and community health workers
  • Peer-supervision and training provided by experienced families to new ones
  • Technology used to detect new cases, train and supervise family volunteers and sustain the network

Impact summary

  • FaNs for kids served 70 families with 10 volunteers to cover a rural population of 30,000
  • Children of families receiving the training demonstrated a significant decrease in WHO-DAS global disability score from baseline
  • The cost per family trained in evidence based package of care is 2 USD per month

"The Family Networks project delivers integrated innovations in task-sharing approaches to meet the challenges posed by ground realities in low-income settings, with the aim to improve treatment access in a group that has almost no access to care."

 

-The FaNs for Kids Project

This innovation is funded by Grand Challenges Canada. 

Innovation details

Families of children affected by intellectual and development disorders are trained to form an active, empowered group within the community to:

  • Campaign to reduce stigma associated with the condition
  • Work with community health workers (CHWs) to provide mhGAP interventions to the children
  • Support each other through a “cascade model” in which more experienced families provide peer-supervision and training to newer ones
  • Use electronic and mobile health technology to assist with detection of children with the conditions, for the training and supervision of family volunteers and to sustain the family networks (Interactive Voice Response (IVR) for screening, Avatar Assisted Cascade Training (ACT))

Family Networkers will be supported by governmental and charitable sectors in order to make the project viable and sustainable.

Key drivers

Evidence based intervention

The intervention is based on the WHO Mental Health GAP Action programme intervention guide’s1 section on developmental disorders in children. The intervention guide has been developed through a systematic review of evidence followed by an international consultative and participatory process.

Challenges

Motivation to participate

Difficulty in keeping the family volunteers motivated to take part in the program.

Lack of understanding of technological programs

Participants are having a hard time understanding how to use technology-assisted training programs.

 

Continuation

The innovation can serve as a model for various chronic mental health problems such as schizophrenia, dementia and depression, if the research project proves successful. HDRF is committed to disseminating the innovation to other parts of the country.

Future plans include analyzing the preliminary data to estimate the cost of such an intervention and the elements needed to make this program sustainable. FaNs for Kids is currently being scaled up to reach a population of 1 million.

Partners

Funders

Evaluation methods

The FaNs for Kids programme was evaluated using a pre-post design in 70 families and children with developmental delays.

Cost of implementation

The cost per child identified using the Interactive Voice Response (IVR) system is 7 cents. Direct costs associated with training and supervision of 14 trainers using the Avatar Assisted Cascade Training (ACT) system is 122 USD per month. The cost per family trained in evidence based package of care is 2 USD per month.

Impact details

The impact of the Avatar Assisted Cascade Training was evaluated through a pre-post Knowledge, Attitudes and Practices questionnaire (15 items with a total score of 30). The training led to a significant improvement in scores of family members trained (n = 24) from a baseline of 23.29 ± 3.22 to after training 27.17 ± 2.11 (t = 8.36, P < .001).

Analysis of data collected from families using the program for 6 months (n = 68) indicated that all had received the 8-day training from their designated champions, and there was a significant decrease in WHO-DAS global disability score in their children from baseline: 56.89 ± 22.02 to 50.57 ± 24.62 (95% confidence interval [CI] 3.63 to 9.0; P < .001).

There was also a reduction in parent-reported socio-emotional difficulties scores in the child (19.67 ± 5.24 to 13.40 ± 4.76, 95% CI –7.68 to 4.87; P < .001). The families appeared to be more empowered to engage with services and community resources for their child after the intervention, and had modest improvements in their perceptions of stigma.

For additional details on impact, refer to the research paper attached under "Resources".

References

  1. WHO Organization. (2010) mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialised health settings.

Research

Multimedia
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Country

Pakistan

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