Parenting for Lifelong Health (PLH)

The Parenting for Lifelong Health (PLH) initiative is focused on the development, evaluation, and dissemination of parenting programs to reduce violence against children and improve child wellbeing in LMICs. As a collaboration among academics, policy makers, and implementing agencies from the World Health Organization, UNICEF, the Universities of Bangor, Cape Town, Oxford, Reading, and Stellenbosch, Clowns Without Borders South Africa and the Mikhulu Trust, it was established to address the need to develop low-cost, evidence-based parenting programs that can be integrated within existing service delivery systems in LMICs (Ward et al., 2014). It was also founded in response to a) the high cost of established evidence-based parenting programs, in terms of licensing fees, accreditation processes, and resistance to changing original models, b) limitations on the generalizability of evidence-based approaches due to complex family structures and traditional parenting practices and values, and c) limited capacity to deliver programs to scale in low-resource settings as a result of limited financial and human resources as well as other implementation barriers due to context (Mikton, 2012). PLH members have developed four prototype programs delivered by community paraprofessionals across the child development spectrum: PLH for Infants (prenatal to six months), PLH for Toddlers (6 to 24 months), PLH for Young Children (2-9 years), and PLH for Parents and Teens (10-17 years). The development of PLH programs is intended to meet the following core criteria for disseminating parenting programs in LMICs:

1. demonstration of effectiveness in reducing risks of violence against children using rigorous evaluation methods (i.e., RCTs);
2. integration of the program within existing service delivery systems utilizing current service providers;
3. feasibility to deliver the program with fidelity and quality by community lay workers;
4. cultural acceptability of the program to target beneficiaries, service providers, and other stakeholders;
5. scalability of the program in terms of affordability, replicability, and sustainability.

Parenting for Lifelong Health for Young Children (PLH 2-9)

PLH 2-9 draws from a long tradition of evidence-based parenting programmes that have been tested in the UK, US, Australia, and Europe (Barlow, Johnston, Kendrick, Polnay, & Stewart-Brown, 2006; Bennett, Barlow, Huband, Smailagic, & Roloff, 2013; Furlong et al., 2013). The PLH 2-9 prototype is the ‘Sinovuyo Caring Families Programme for parents of Young Children,’ a group-training programme delivered by community facilitators and targeting parents and primary caregivers of 2-9 year olds. This programme was developed and tested in South Africa and is now being adapted and tested in a small-scale randomized controlled trial for low-income families in the Philippines and Thailand (Lachman et al., in revision; Lachman et a., 2016a; Lachman et al., 2016b). Programme content includes components common to many evidence-based parenting programmes including developing positive caregiver-child interaction through child-led play and emotional communication, praise and rewards to encourage positive child behaviour, limit setting behaviours such as effective instruction giving and establishing consistent household rules, and non-violent discipline strategies to replace harsh parenting and corporal punishment (Lachman et al., 2016). The programme also includes activities derived from Mindfulness Based Stress Reduction in order to address parental stress (Kabat-Zinn, 2013).

The adapted versions of the PLH program can be downloaded here.

RISE Study Profile General (download link)

Barlow, J., Johnston, I., Kendrick, D., Polnay, L., & Stewart-Brown, S. (2006). Individual and group-based

parenting programmes for the treatment of physical child abuse and neglect. Cochrane Database of Systematic Reviews, 3, 1-20.

Bennett, C., Barlow, J., Huband, N., Smailagic, N., & Roloff, V. (2013). Group-based parenting programs for

improving parenting and psychosocial functioning: A systematic review. Journal of the Society for Social Work and Research, 4(4), 300-332.

Furlong, M., McGilloway, S., Bywater, T., Hutchings, J., Smith, S. M., & Donnelly, M. (2013). Cochrane

Review: Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years (Review). Evidence-Based Child Health: A Cochrane Review Journal, 8(2), 318-692. doi: 10.1002/ebch.1905

Kabat-Zinn, J. (2013). Full catastrophe living (revised edition): Using the wisdom of your body and mind to

face stress, pain, and illness. New York: Bantam Books.

Lachman, J. M., Cluver, L., Ward, C. L., Hutchings, J., Gardner, F., Wessels, I., & Mlotshwa, S. (in revision).

Randomized controlled trial of a parenting program to reduce the risk of child maltreatment in South Africa.

Lachman, J. M., Cluver, L., Kelly, J., Ward, C. L., Hutchings, J., Gardner, F. (2016a). Process evaluation of a

parenting program for low-income families in South Africa. Research on Social Work Practice. doi: 10.1177/1049731516645665

Lachman, J. M., Sherr, L., Cluver, L., Ward, C. L., Hutchings, J., & Gardner, F. (2016b). Integrating evidence

and context to develop a parenting program for low-income families in South Africa. Journal of Child and Family Studies, 25(7), 2337-2352. doi: 10.1007/s10826-016-0389-6

Mikton, C. (2012). Two challenges to importing evidence-based child maltreatment prevention programs

developed in high-income countries to low- and middle-income countries: Generalizability and affordability. In H. Dubowitz (Ed.), World perspectives on child abuse (Vol. 10, pp. 97). Aurora, CO: International Society for the Prevention of Child Abuse and Neglect.

Ward, C. L., Mikton, C., Cluver, L., Cooper, P., Gardner, F., Hutchings, J., . . . Wessels, I. M. (2014).

Parenting for Lifelong Health: From South Africa to other low-and middle-income countries. Early Childhood Matters: Responsive Parenting: A Strategy to Prevent Violence, 49.