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Table of Contents
COMMENTARY
Year : 2022  |  Volume : 20  |  Issue : 2  |  Page : 188-192

The Accumulating Evidence-Base Regarding Child Friendly Spaces: Policy and Practice Implications


1 Mailman School of Public Health, Columbia University, New York City, NY; Institute for Global Health and Development, Edinburgh, USA
2 Mailman School of Public Health, Columbia University, New York City, NY, USA

Date of Submission10-Aug-2022
Date of Decision14-Sep-2022
Date of Acceptance14-Sep-2022
Date of Web Publication31-Oct-2022

Correspondence Address:
PhD Alastair Ager
Mailman School of Public Health, Columbia University, New York City, NY
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/intv.intv_12_22

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  Abstract 


For over 25 years child friendly spaces (CFS) have been at the forefront of humanitarian response. Initially there was a weak evidence-base informing this approach, but the last 10 years have seen a substantial increase in research and evaluation in this area. This accumulating evidence has informed the evolution of guidance and training on implementing effective CFS interventions, but there remains uncertainty about the key messages emerging from studies. This commentary summarises the key findings of CFS-related research over the last decade and identifies key implications for policy and practice. There is no basis for discarding the approach, but nor is there for using it as a ubiquitous, prolonged response to diverse needs. The key imperatives are to mainstream quality and contextualisation in the implementation of CFS as a mechanism for emergency response; to structure CFS within a phased intervention strategy incorporating education and community-based approaches; and to further develop resources to support quality, contextualised and phased provision for children.

Keywords: children, child protection, education, evidence, humanitarian response, psychosocial support


How to cite this article:
Ager A, Metzler J. The Accumulating Evidence-Base Regarding Child Friendly Spaces: Policy and Practice Implications. Intervention 2022;20:188-92

How to cite this URL:
Ager A, Metzler J. The Accumulating Evidence-Base Regarding Child Friendly Spaces: Policy and Practice Implications. Intervention [serial online] 2022 [cited 2022 Nov 29];20:188-92. Available from: https://www.interventionjournal.org/text.asp?2022/20/2/188/359985




  An Evolving Approach; A Growing Body of Evidence Top


From their advent in the late 1990s, child friendly spaces (CFS)—or, more broadly, differing forms of ‘safe spaces’—have been at the forefront of humanitarian response. In the face of various forms of crisis, their core rationale concerns enhancement of ‘the protection, psychosocial support, and education of children through structured activities conducted in a safe, supportive context’ (Wessells & Kostelny, 2013). Additional objectives claimed for CFS have included providing an environment ‘where parents and caregivers can leave their children while they collect food and water, rebuild homes or seek new income-generating activities’ (Save the Children, 2008), identifying means to respond to the needs of children with particular vulnerabilities (Save the Children, 2008) and/or serving to ‘mobilise communities for protecting children and supporting their resilience’ (Wessells & Kostelny, 2013).

The launch of the Minimum Standards for Child Protection in Humanitarian Action in 2012 and a standard on Child Friendly Spaces (CPWG, 2012) brought with it inter-agency commitment to establish an appropriate evidence-base to inform these interventions. Prior to this, only 10 evaluations were found in a literature review in this journal considering the impacts of CFS interventions amongst refugee or displaced populations (Ager et al., 2013). Further, while a number of these studies suggested positive impacts of programming, major weaknesses in study design undermined confidence in such claims (e.g. only three studies reported pre-intervention baselines and only two featured any comparison between those who attended or did not attend CFS).

In the last 10 years, however, this lack of robust evidence has been substantively addressed. First, an inter-agency global study led by World Vision and Columbia University explicitly sought to address previous design weaknesses with a series of case study impact evaluations in Ethiopia, Uganda, Jordan, Iraq and the DRC (World Vision, 2015). In addition to a meta-analysis of findings across these settings (Hermosilla et al., 2019), there are detailed analyses of findings specific to the former three situations (Hermosilla et al., 2021; Metzler et al., 2019a, 2019b). Subsequently, studies focused on longer-term impacts of CFS interventions on the wellbeing and development of children: in contexts of protracted displacement in Uganda (Metzler et al., 2019b) and Jordan (Hermosilla et al., 2021) and subsequent to response to the earthquake in Nepal (Forthal et al., 2022; Elrha, 2020). Most recently, members of this group have considered the impact of CFS interventions utilising more structured sequential delivery of sessions (Metzler et al., in press). This major body of work directly focused on CFS has been complemented by wider research on structured interventions in humanitarian contexts (Haroz et al., 2020; Panter-Brick et al., 2018; Purgato et al., 2018) and other systematic studies on related interventions such as women and girls safe spaces (WGSS; Stark et al., 2021).

In this period, approaches to the implementation of CFS have significantly evolved, not least in response to evidence emerging from research. The Minimum Standard on Child Friendly Spaces of 2012 marked preliminary inter-agency understanding of what constituted effective and appropriate practice. Subsequently, practitioners have developed more detailed operational guidance (World Vision International and IFRC, 2018a) to ensure quality in implementation, encourage use of a wider range of potential activities and support processes of their contextualisation and sequencing in the form of a comprehensive Toolkit for Child Friendly Spaces in Humanitarian Settings (World Vision International and IFRC, 2018b). In an effort to strengthen community-based child protection systems, the most recent revision of the Child Protection Minimum Standards (2019) incorporated CFS as just one of several group-based strategies that can be used as part of a more comprehensive approach to support child wellbeing and resilience. Given these developments in programming practice and evidence gathering evidence, where does this leave our understanding of CFS as a humanitarian intervention?


  Key Findings Top


Providing Safe Spaces Reduces Some Protection Risks

Among all the wider claims for CFS it is easy to lose sight of a fundamental goal: keeping children safe in a context associated with escalated protection risks, ranging from abuse and neglect to abduction. In some settings—for example, amongst Somali refugee children engaged in activities in a secure, guarded compound just across the border into Ethiopia (Metzler et al., 2019a) or for Syrian children attending a centre in a refugee camp in Domiz in northern Iraq (Lilley et al., 2015)—securing a sense of safety has proved the clearest benefit of attending CFS. The nature of the protection risks is clearly of relevance in terms of the safety that can be feasibly secured, however. Stark et al. (2021), for instance, found WGSS to be appreciated by participants, but no evidence that they reduce their overall exposure to violence in their living situation. A more structured approach to programming activities may promote a greater sense of protection (Metzler et al., in press).

Provision of Structured Activities Protects and Promotes the Social and Emotional WellBeing of Children

A large number of studies have now documented a positive impact on children’s social and emotional wellbeing following CFS attendance. This was the clearest consistent outcome for younger children signalled by Hermosilla et al.’s (2017) meta-analysis across settings, and is indicated by both Metzler et al.’s recent randomised control trial (RCT) in Uganda (in press) and Stark et al.’s systematic review of WGSS (2021). Studies evaluating specific forms of structured activity—such as Mercy Corps programming informed by a profound stress attunement (PSA) approach (Panter-Brick et al., 2018)—have reported similar findings. While promotion (i.e. improvement) of wellbeing is the usual—and appropriate—focus of attention, Metzler et al.’s earlier work in Uganda documented the positive impact of CFS in protecting (i.e. maintaining) existing levels of wellbeing in the face of the escalating challenges of protracted displacement that otherwise were driving down children’s wellness (2019b).

The Quality of Interventions Substantially Determines the Likelihood and Magnitude of Impacts

Metzler et al.’s (2019b) study in Uganda was the first to systematically address the impact of the quality of CFS provision, which was operationalised using a quality standards checklist. Younger children attending CFS designated as higher quality showed much greater benefits in psychosocial wellbeing and developmental assets compared to those who had attended lower quality CFS. Boys were particularly sensitive to intervention quality, with the expression of psychosocial impacts observed only with the higher-quality provision. Awareness of this finding encouraged wider moves to strengthen training and supervision for those facilitating CFS activities. Metzler et al.’s more recent RCT study in Uganda (in press) examined impacts associated with programming informed by the training guides and the activity catalogue of the Toolkit for Child Friendly Spaces in Humanitarian Settings (World Vision International and IFRC, 2018a,b). Adolescents attending these CFS over a 12-week period showed significantly less psychological distress compared to wait-list controls, with intervention effects generally much larger than noted in earlier evaluations of less clearly specified CFS programming. Effective contextualisation of programming appears to be particularly crucial for reducing the differential impact of CFS for sub-groups (e.g. by gender, age, ethnicity, etc.) noted in earlier evaluations.

CFS Struggle to Demonstrate Targeted Mobilisation of Community Resources

It was noted earlier that one of the frequent claims for CFS is that they serve to mobilise caregivers and communities towards the care, support and protection of children. That is, they have a wider impact than on children themselves when attending activities. Evidence in support of these impacts is generally lacking, however. For instance, in an analysis of CFS provision across Uganda, Iraq, Jordan and Nepal, Hermosilla et al. (2019) found no site where attenders at CFS showed greater knowledge of community resources relevant to support and protection than non-attenders. However it should be recognised that increases in knowledge observed in non-attenders in Uganda (Metzler et al., 2019a) and reduced protection concerns amongst non-attenders in Jordan (Hermosilla et al., 2021) could have reflected the wider mobilising impact of CFS activities. With CFS activities structured according to the recent Toolkit for Child Friendly Spaces in Humanitarian Settings, Metzler et al. (in press) again found limited evidence of direct impact of CFS on community capacities and communal resources to support wellbeing and protection despite the rich potential to connect with other actors within the resettlement area’s child protection system. Returning to sites where projects supporting CFS have come to a close has typically found infrastructure underutilized or eroded and local facilitators no longer actively engaged in work with children, with stated plans to ‘pass on’ operations to local actors unsuccessful (e.g. Kagaha and Opobo, 2014).

CFS can Promote Educational Attainment but School Attendance is a More Consistent Predictor of Longer-term Development Outcomes

In CFS in Ethiopia, where education activities were prioritised given delays in establishing regular schooling, those attending showed strong gains in functional literacy and numeracy (Metzler et al., 2019a). Generally, however, school attendance emerges from analyses as a more consistent predictor of longer-term positive impacts on development milestones (Hermosilla et al., 2021; Metzler et al., 2019b). This reinforces the position that CFS should be seen as a transitional support to children fostering (rather than substituting for) school enrolment (Burde et al., 2015), particularly as there is a growing evidence-base supporting deployment of classroom-based social emotional learning (SEL) for displaced populations (IRC, 2021).

CFS Attendance has Little Impact on Longer-term Outcomes, though Benefits may Sustain with More Structured, Contextualised Programming

While CFS is generally conceived as a short-term, emergency intervention promoting safety and wellbeing (and reducing suffering and risk), it has been suggested that—by supporting children at a critical period—these interventions can influence children’s longer-term trajectories. A number of studies have now considered the longer-term impacts of having attended CFS. Largely, these establish that there are few benefits that can be attributed to CFS attendance after a period of around 12 months (Hermosilla et al., 2021; Metzler et al., 2019). Most recently, however, with the enhanced rigour of interventions shaped by updated guidance, and with effective contextualisation of activities for different age ranges, Metzler et al. (in press) have found improvements in mental health and reduction in protection concerns associated with CFS attendance to be sustained over 1 year.

Children not Accessing CFS Interventions are at Highest Risk for Poor Longer-Term Outcomes

The children with the poorest psychological wellbeing and fewest developmental assets at follow-up—amongst both displaced Syrian children in Jordan and Congolese children Uganda—were those that had not attended CFS when it was made available as part of the initial emergency response (Hermosilla et al., 2021; Metzler et al., 2019b). This suggests the critical importance of outreach to the most vulnerable children that may have challenges in connecting to available resources in the early months of a crisis.


  Policy and Practice Implications for CFS Top


CFS programming has evolved significantly in the last decade, in no small part in response to the findings of some of the research summarised above. Looking at the accumulated evidence, what are the key messages for policy and practice with CFS going forward? We suggest that there are three key implications of the accumulated evidence. These are as follows:

Mainstream quality and contextualisation in the implementation of CFS as a mechanism for emergency response

The preceding review clearly signals how CFS is used as a first-line response in a diverse range of circumstances addressing a wide range of needs: in response to acute disasters, such as the 2015 Nepal Earthquake; in addressing needs of the conflict-displaced populations, such as those fleeing to Lebanon, Jordan and Iraq; and in response to planned settlement of refugees in contexts of protracted crisis such as in Ethiopia and Uganda. CFS have provided services from informal education and basic psychosocial support to hubs for case management, gender-based violence (GBV) and health referrals and even bases for nutritional feeding programmes. This breadth of application is a potential strength of CFS, but a ‘one size fits all’ mentality is likely to undermine achieving targeted outcomes. The quality of provision—reflected in staff training and supervision—clearly influences impacts. However, there is growing evidence that the contextualisation of programming—shaping activities in response to assessment of need, age, gender, ethnicity, disability status—does too (Dowling and Barry, 2020). In addition to respecting the core ‘do no harm’ principle of not undermining any existing provision, CFS thus needs to be implemented with a very clear commitment to—and resourcing for—both staff training and supervision and shaping activities to suit diverse needs.

Structure CFS within a phased intervention strategy incorporating education and community-based approaches

While CFS have generally brought clear benefits in terms of protection and wellbeing, mobilisation of community resources and longer-term impacts have proved more difficult to secure. Some may conclude that CFS is therefore only appropriate as a short-term emergency intervention. However, it may be better to frame it as a component of a phased intervention approach that works over time to strengthen the community mechanisms needed to support children. During an initial ‘acute’ period of programming, CFS should focus attention on the prompt provision of basic needs and protection, including initiating or supporting existing efforts to identify separated and unaccompanied children. This initial phase of CFS would typically provide a programme of basic recreational activities working to establish healthy attachment between children and facilitators. With safety, routine and relationships established, intervention should move towards a second phase of operation, marked by strong engagement with communities focused on identifying both needs and local resources, which will inform the development of programming. The principle of community engagement has frequently been cited in the context of CFS implementation (Davie et al., 2013; Wessells & Kostelny, 2013), but the track record of CFS in this has been weak, not least because of the challenges of securing this in communities wrestling with adversity and precarity (Wood & Kallestrup, 2021). However, there has been significant advance in the fields of community-based child protection and community-based mental health and psychosocial support (UNICEF, 2020) that can inform this phased development of programming as it moves from predetermined, generalised, rapidly-implemented activities to ones that are grounded, linked with other provision and community-informed and −engaged. Crucially, planning would also explicitly address a final phase of work: planned closure of any established CFS facilities on the basis that other ‘safe spaces’ have been identified (e.g. within schools, health facilities, sports facilities, places of worship, etc.) along with a network of systems to support, care for and protect children.

Further develop resources to support quality, contextualised and phased provision

With evidence supporting the value of well-structured tools and guidance for CFS delivery, it is clear that the agendas above will be much more attainable with investment in inter-agency resources to support them. There are significant resources already available (Davis and Iltus, 2018; Davie et al., 2013; International Rescue Committee, 2016; World Vision International, 2015; World Vision International and IFRC, 2018a,b). However, for CFS to be effective in the above terms, further resources need to be developed to support implementers in tailoring a phased approach to the local context and circumstances of the emergency, including the diversity of the population (de Winter, 2007). More needs to be developed especially around activity planning sensitive to age, gender, ethnicity, religion and marital and disability status, processes of community engagement, linkage with other service provision and arrangements for the closure of programming. There is significant potential to provide such resources more widely, efficiently and effectively using digital channels, including greater use of video training materials and virtual coaching and supervision to complement face-to-face support.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.







 
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