In die Grondslagfase is Lewensvaardighede een van drie leerprogramme wat deur die Departement van Onderwys voorgeskryf en verder in die Nasionale Kurrikulumverklaring uiteengesit word. Lewensvaardighede fokus op die ontwikkellng van lewenswaardes en stel die ontwikkeling van verantwoordelike en gedissiplineerde landsburgers. van Suid-Afrika ten doe!. Teen die agtergrond van die bogenoemde oorkoepelende uitkoms van Lewensvaardigheidsopvoeding, was die doel van die studie om antwoorde op die volgende navorsingsvrae te ViFld: • Wat is Grondslagfase-onderwysers se houding teenoor Lewensvaardigheidsopvoeding? • Is daar 'n verband. tussen sekere biografiese veranderlikes en Grondslagfaseonderwysers se houding teenoor Lewensvaardigheidsopvoeding? • Hoeveel tyd bestee Grondslagfase-onderwysers daagliks aan die onderrig van leerders se lewensvaardighede? • Verskil die daaglikse tydsbesteding aan die onderrig van Lewensvaardighede, Gesyferdheid en Geletterdheid betekenisvol van mekaar? • Is daar faktore wat Lewensvaardigheidsopvoeding in die Grondslagfase belemmer? • Watter aanbevelings kan gemaak word om die onderrig van Lewensvaardighede in die Grondslagfase te bevorder? Ten einde bogenoemde vrae te beantwoord is 'n gekombineerde (kwantitatiewe en kwalitatiewe) navorsingsmetode geTmplementeer. Data is deur middel van 'n gestruktureerde vraelys by 'n steekproef van Grondslagfase-onderwysers in die Potchefstroom en Klerksdorpskooldistrikte van die Noordwes Provinsie ingesamel en die inllgting is statrsties geanaliseer: Die kwantitatiewe fase van die ondersoek is opgevolg deur 'n kwalitatiewe fase waartydens onderhoude met Grondslagfase-onderwysers gevoer is. Voortspruitend uit die kwantitatiewe en kwalitatiewe resultate, is die volgende gevolgtrekkings gemaak, wat in diepte in die verhandeling bespreek sal word: • Grondslagfase-onderwysers se houding teenoor Lewensvaardigheidsopvoeding is oor die algemeen oorwegend positief. • Daar is 'n verband tussen sekere biografiese veranderlikes en Grondslagfaseonderwysers se houding teenoor Lewensvaardigheidsopvoeding. • Die meerderheid van die Grondslagfase-onderwysers bestee tussen 25% en 35% van hulle daaglikse tyd aan die onderrig van Lewensvaardighede. • Die tyd wat 'Grondslagfase-onderwysers daagliks aan die onderrig' van Lewensvaardighede, Gesyferdheid en Geletterdheid bestee, verskil betekenisvol van mekaar. Die meeste tyd word daagliks aan die onderrig van Geletterdheid bestee, gevolg deurGesyferdheiden Lewensvaardighede. • Daar is bepaalde faktore wat die suksesvolle. aanbieding van Lewensvaardighede -in die GroRdslagfase belemmer. Op grond van die bevindinge van die ondersoek, is bepaalde aanbevelings aan die hand gedoen om die onderrig van Lewensvaardighede in die Grondslagfase te bevorder. / Life Skills, as prescribed by the Department of education, is one of three learning programmes in the Foundation Phase as reflected in the Nationa1 Curriculum Statement. Life Skills focuses on the development of values for life and has as a goal, the development of responsible and disciplined citizens for South-Africa. Against the-background of the above mentioned super ordinate outcome of Life Skills education the aim of the study was to find answers to the following research questions: • What is the attitude of Foundation Phase teachers towards the teaching of Life Skills? • Is there a connection between specific biographical variables and the Foundation Phase teacher's attitude towards Life Skills? • How much time do Foundation Phase teachers spend daily on teaching Life Skills to learners? • Is there a significant difference on the time spent daily on die teaching of Life Skills, Numeracy and Literacy? • Are there factors that hinder the teaching of Life Skills in the Foundation Phase? • What recommendations can be made to promote the teaching of Life Skills in the Foundation Phase? In order to answer the above questions, a mixed research method (quantitative and qualitative) was implemented. Data were gathered by means of a structured questionnaire from a random sample of Foundation Phase teachers in the Potchefstroom and Klerksdorp school districts of the North West Province, and the information was analysed statistically. The quantitative phase of the investigation was followed bya qualitative phase during which personal interviews with Foundation Phase teachers were conducted. Originating from the quantitative and qualitative results, the following recommendations were made that will be intensiv.ely discussed in the dissertation: • The attitude of Foundation Phase teachers towards Life Skills education are in general positive. • There is a correlation between some biographical variables and the Foundation Phase teachers' attitude towards Life Skills education. I • The majority of the Foundation Phase teachers spend between 25% and 35% of their daily time on the education of Life Skills. • The daily .input that Foundation Phase teachers spend on the teaching of Life Skills, Numeracy and Literacy differ meaningfully from each other. Most of the time is spent on the teaching of Literacy, followed by Numeracy and Life Skills. • There are specific factors that hinder the successful presentation of life Skills in the Foundation Phase. Based on the results of the investigation, specific recommendations were made to promote the teaching of Life Skills in the Foundation Phase. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2010.

In die Grondslagfase is Lewensvaardighede een van drie leerprogramme wat deur die Departement van Onderwys voorgeskryf en verder in die Nasionale Kurrikulumverklaring uiteengesit word. Lewensvaardighede fokus op die ontwikkellng van lewenswaardes en stel die ontwikkeling van verantwoordelike en gedissiplineerde landsburgers. van Suid-Afrika ten doe!. Teen die agtergrond van die bogenoemde oorkoepelende uitkoms van Lewensvaardigheidsopvoeding, was die doel van die studie om antwoorde op die volgende navorsingsvrae te ViFld: • Wat is Grondslagfase-onderwysers se houding teenoor Lewensvaardigheidsopvoeding? • Is daar 'n verband. tussen sekere biografiese veranderlikes en Grondslagfaseonderwysers se houding teenoor Lewensvaardigheidsopvoeding? • Hoeveel tyd bestee Grondslagfase-onderwysers daagliks aan die onderrig van leerders se lewensvaardighede? • Verskil die daaglikse tydsbesteding aan die onderrig van Lewensvaardighede, Gesyferdheid en Geletterdheid betekenisvol van mekaar? • Is daar faktore wat Lewensvaardigheidsopvoeding in die Grondslagfase belemmer? • Watter aanbevelings kan gemaak word om die onderrig van Lewensvaardighede in die Grondslagfase te bevorder? Ten einde bogenoemde vrae te beantwoord is 'n gekombineerde (kwantitatiewe en kwalitatiewe) navorsingsmetode geTmplementeer. Data is deur middel van 'n gestruktureerde vraelys by 'n steekproef van Grondslagfase-onderwysers in die Potchefstroom en Klerksdorpskooldistrikte van die Noordwes Provinsie ingesamel en die inllgting is statrsties geanaliseer: Die kwantitatiewe fase van die ondersoek is opgevolg deur 'n kwalitatiewe fase waartydens onderhoude met Grondslagfase-onderwysers gevoer is. Voortspruitend uit die kwantitatiewe en kwalitatiewe resultate, is die volgende gevolgtrekkings gemaak, wat in diepte in die verhandeling bespreek sal word: • Grondslagfase-onderwysers se houding teenoor Lewensvaardigheidsopvoeding is oor die algemeen oorwegend positief. • Daar is 'n verband tussen sekere biografiese veranderlikes en Grondslagfaseonderwysers se houding teenoor Lewensvaardigheidsopvoeding. • Die meerderheid van die Grondslagfase-onderwysers bestee tussen 25% en 35% van hulle daaglikse tyd aan die onderrig van Lewensvaardighede. • Die tyd wat 'Grondslagfase-onderwysers daagliks aan die onderrig' van Lewensvaardighede, Gesyferdheid en Geletterdheid bestee, verskil betekenisvol van mekaar. Die meeste tyd word daagliks aan die onderrig van Geletterdheid bestee, gevolg deurGesyferdheiden Lewensvaardighede. • Daar is bepaalde faktore wat die suksesvolle. aanbieding van Lewensvaardighede -in die GroRdslagfase belemmer. Op grond van die bevindinge van die ondersoek, is bepaalde aanbevelings aan die hand gedoen om die onderrig van Lewensvaardighede in die Grondslagfase te bevorder. / Life Skills, as prescribed by the Department of education, is one of three learning programmes in the Foundation Phase as reflected in the Nationa1 Curriculum Statement. Life Skills focuses on the development of values for life and has as a goal, the development of responsible and disciplined citizens for South-Africa. Against the-background of the above mentioned super ordinate outcome of Life Skills education the aim of the study was to find answers to the following research questions: • What is the attitude of Foundation Phase teachers towards the teaching of Life Skills? • Is there a connection between specific biographical variables and the Foundation Phase teacher's attitude towards Life Skills? • How much time do Foundation Phase teachers spend daily on teaching Life Skills to learners? • Is there a significant difference on the time spent daily on die teaching of Life Skills, Numeracy and Literacy? • Are there factors that hinder the teaching of Life Skills in the Foundation Phase? • What recommendations can be made to promote the teaching of Life Skills in the Foundation Phase? In order to answer the above questions, a mixed research method (quantitative and qualitative) was implemented. Data were gathered by means of a structured questionnaire from a random sample of Foundation Phase teachers in the Potchefstroom and Klerksdorp school districts of the North West Province, and the information was analysed statistically. The quantitative phase of the investigation was followed bya qualitative phase during which personal interviews with Foundation Phase teachers were conducted. Originating from the quantitative and qualitative results, the following recommendations were made that will be intensiv.ely discussed in the dissertation: • The attitude of Foundation Phase teachers towards Life Skills education are in general positive. • There is a correlation between some biographical variables and the Foundation Phase teachers' attitude towards Life Skills education. I • The majority of the Foundation Phase teachers spend between 25% and 35% of their daily time on the education of Life Skills. • The daily .input that Foundation Phase teachers spend on the teaching of Life Skills, Numeracy and Literacy differ meaningfully from each other. Most of the time is spent on the teaching of Literacy, followed by Numeracy and Life Skills. • There are specific factors that hinder the successful presentation of life Skills in the Foundation Phase. Based on the results of the investigation, specific recommendations were made to promote the teaching of Life Skills in the Foundation Phase. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2010.

This dissertation consists of three essays related to the effects of welfare reform on the intergenerational transmission of welfare participation as well as effects on labor supply and childcare arrangements. States implemented welfare reform at different times from 1992 to 1996, and these policies notably introduced work requirements and other restrictions intended to limit dependency of needy families. One mechanism reforms were intended to address was childhood exposure to a "culture" of ongoing welfare receipt. In Essay 1, I estimate the effect of reform on the transmission of welfare participation for 2961 mother-daughter pairs in the Panel Study of Income Dynamics (PSID) over the period 1968-2013. I find that a mother's welfare participation increased her daughter's odds of participation as an adult by roughly 30 percentage points, but that welfare reform attenuated this transmission by at least 50 percent, or at least 30 percent over the baseline odds of participation. While I find comparable-sized transmission patterns in daughters' adult use of the broader safety net and other outcomes such as educational attainment and income, there is no diminution of transmission after welfare reform. In Essay 2, I estimate behavioral labor supply responses to reforms using experimental data from Connecticut's Jobs First welfare waiver program in 1996. Recent studies have used a distributional analysis of Jobs First suggesting evidence that some individuals reduce hours in order to opt into welfare, an example of behavioral-induced participation. However, estimates obtained by a semi-parametric panel quantile estimator allowing women to vary arbitrarily in preferences and welfare participation costs indicate no evidence of behavioral-induced participation. These findings show that a welfare program imposes an estimated cost up to 10 percent of quarterly earnings, and these costs can be heterogeneous throughout the conditional earnings distribution. Lastly, in Essay 3, I return to PSID data to examine the relationship between welfare spending on childcare assistance and the care arrangements chosen by low-income families. Experimental evidence has shown that formal child care can result in long-term socioeconomic gains for disadvantaged children, and work requirements after welfare reform have necessitated increased demand for child care among single mothers. I find that an increase of a thousand dollars in state-level childcare assistance per child in poverty increases the probability of formal care among low-earnings single-mother families by about 27 to 30 percentage points. When public assistance makes child care more affordable, families within the target population reveal a higher preference for formal care relative to informal, which may be related to perceived quality improvements for child enrichment and development.

The purpose of this study was to explore the potential connection between emotional awareness and resilience in a young child affected by HIV/AIDS. The study forms part of a broad research project, the Kgolo-Mmogo project, involving a multidisciplinary team of researchers from the University of Pretoria, South Africa and Yale University in the United States of America. The Kgolo-Mmogo project aims to investigate the adaptive functioning of children affected by HIV/AIDS, whilst potentially enhancing resilience. The project involves an assessment of the participating children, which is followed by a structured intervention and post assessment. The conceptual framework for my study was based on existing literature relating to early childhood development, emotional development, as well as children affected by HIV/AIDS and resilience. I followed a qualitative approach, anchored in the interpretivist paradigm. I utilised an instrumental case study research design and conveniently selected the participants, who were involved in the broader Kgolo- Mmogo project at the onset of my study. One five year old girl, her mother and the care workers who facilitated the intervention, participated in my study. I observed eleven intervention sessions, as well as the pre- and post assessment. In addition to observation, documented in the form of field notes, photographs and a research journal, I employed conversational interviews with the care workers, for data collection and member-checking purposes. I also conducted two semi-structured interviews with the mother of the participant. Three main themes emerged subsequent to thematic data analysis. The first theme relates to developmentally appropriate skills that remained constant throughout my study, with the sub-themes associated with the cognitive, emotional and social domain of development. The second theme concerns accelerated emotional functioning in certain areas of development, with the sub-themes being an increased frequency in referring to feelings, and an increased differentiation when referring to feelings and desires. The last theme entails the enhancement of social skills, with the sub-themes relating to the formation of trusting relationships and enhanced communication about experiences. Based on the findings I obtained, I can conclude that the Kgolo-Mmogo intervention seemingly provided some learning opportunities to foster emotional resilience in a young, vulnerable child. Copyright / Dissertation (MEd)--University of Pretoria, 2010. / Educational Psychology / unrestricted

Magister Educationis - Med / The purpose of this study was to investigate the implementation of a Literacy Intervention Programme with Grade One isiXhosa speaking learners in one primary school in the Western Cape. The study was motivated by the persisting low literacy levels in the Foundation Phase which have been reported in the Annual National Assessment (ANA) reports since 2011. The Department of Basic Education (DBE) and the Provincial Departments of Education have designed many intervention programmes to assist teachers in teaching literacy to young learners. These programmes include teacher development workshops and the supply of literacy materials in schools. Schools also have their own intervention programmes to support learners who struggle with reading and writing. Despite these efforts, there is no significant improvement in learners' literacy levels. Therefore, this study investigated how the literacy intervention programme for Grade one was implemented in one township school in Cape Town.

Magister Artium (Psychology) - MA(Psych) / While community health workers possess valuable insight into health care delivery in South Africa, their voices and experiences are seldom sought in the acquisition of knowledge surrounding relevant social concerns. This research aimed to explore community health workers’ perspectives of mother–infant bonding within the first 1000 days of life. The first 1000 days of a child’s life are a delicate yet highly consequential period affecting future physical, cognitive, and socio-emotional growth. The bond between mother and infant within the first 1000 days is especially critical as it is within the bounds of this relationship that a child is fed, cared for, and kept safe. Furthermore, mother–infant bonding lays an essential foundation for future development. However, there is a paucity of contextualized literature, particularly regarding mother–infant bonding in the first 1000 days. In practice, mother–infant interventions are often delivered by community health workers. Through their work, community health workers gain a wealth of knowledge and information about the experiences and practices of bonding within their community. Their insights are a potentially untapped resource which could be used to supplement research and interventions with local, contextualized wisdom. The aim of this research was to explore community health workers’ perspectives of mother–infant bonding within the first 1000 days in Khayelitsha, South Africa. The study utilized a qualitative methodological framework and an exploratory research design. Semi-structured individual interviews were conducted with 15 experienced community health workers, who were purposively selected from a non-governmental organization located in Khayelitsha, South Africa. Data were thematically analysed, and five primary themes emerged from the analysis, namely: (1) the importance of the first 1000 days; (2) the centrality of mother–infant bonding within the first 1000 days; (3) effective approaches to bonding are simple, natural, and free; (4) the inhibitors of mother–infant bonding; and (5) the need for support. Trustworthiness and researcher reflexivity practices were integrated throughout the research process. Ethics considerations were prioritized, and included providing informed consent, ensuring confidentiality and anonymity, and informing participants of their rights as stipulated by the University of the Western Cape Biomedical Research Ethics Committee.

Sub-Saharan Africa (SSA) has a scarcity of research on autism spectrum disorder (ASD) and available early interventions, as most of what is known about the disorder is from highincome countries. Early detection and intervention methods were found to have positive effects on developmental delays and to alleviate symptom severity in children with ASD or at risk of it. There is a need for scalable interventions in low-resource settings, which are characterised by a lack of highly-trained specialists, infrastructure and funding. This study explored the barriers and facilitators to implementing and sustaining a caregiver-coaching ASD early intervention, informed by the principles of the Early Start Denver Model (ESDM), adapted for South Africa and for delivery by non-specialists. The study also identified some changes that could be made to improve intervention adoption and sustainability. Nine multilevel stakeholders involved in the implementation of the caregiver-coaching intervention were purposively sampled, individual in-depth interviews were conducted, transcribed verbatim and thematically analysed. Major implementation facilitators included: ECD worker baseline ASD knowledge and experience; skills gained from the training received and coaching; clear in-session caregiver-coaching structure; value of strong team relationships; clear video illustration of intervention concepts; and the mastery and generalisation of skills by the ECD workers, ECD supervisors and caregivers. Implementation barriers included: the complexity of the intervention and coaching concepts; misalignment of ECD teacher training with the caregiver-coaching approach; logistical challenges; and mismatch of the video content with the South African context. Facilitators to sustain the intervention included: child outcomes; caregiver ‘buy-in;’ and competence; and the need for ongoing live supervision. Barriers to sustaining the intervention included: structural issues of poverty, transportation and unemployment. Positive child and caregiver outcomes could be offset by larger contextual and system-level issues such as poverty and the need for ongoing support, supervision and local coaching materials in South African languages. The results will inform tailoring of the intervention training and supervision approach for a larger pilot study.

Sensory inputs of hearing and vision during early childhood development support the achievement of language, speech and educational milestones. The early detection of sensory impairment is essential for facilitating early childhood development, socio-emotional well-being and academic success, in addition to obtaining sustainable educational development goals. The majority of children with sensory impairment live in low- and middle-income countries where services are often unavailable or inaccessible, because of the absence of systematic screening programmes for children, prohibitive equipment cost, a shortage of trained personnel and centralised service-delivery models. Therefore, research is needed to investigate whether a community-based mobile health (mHealth) supported service-delivery model for hearing and vision screening can increase access to hearing and vision services for children in resource-constrained settings. This study aimed to describe an implemented hearing and vision screening programme and evaluate its success in terms of acceptability (consent return numbers), coverage (number of eligible children screened), referral rates and quality indicators (duration of tests and number of hearing tests conducted under conditions of excessive noise levels). The study also explored the challenges faced during a community-based screening programme and the strategies developed to address these. Four non-professionals were appointed and trained as community health workers (CHWs) to conduct combined sensory screening using mHealth technology (hearScreen application, hearXGroup, South Africa and Peek Acuity application, Peek Vision, United Kingdom) on smartphones at preschools in low-income communities in Cape Town, South Africa. The consent form return rate was 82.0%, and the coverage rate was 94.4%. An average of 501 children were screened each month, at a cost of US$5.63 per child. The number of children who failed hearing and vision screening was 435 (5.4%) and 170 (2.1%), respectively. Failing of hearing tests was associated with longer test times (odds ratio [OR]: 1.022; 95% confidence interval [CI]: 1.021–1.024) and excessive background noise levels at 1 kHz (e.g. OR for left ear: 1.688; 95% CI: 1.198–2.377). Failing of visual screening tests was associated with longer test duration (OR: 1.003; 95% CI: 1.002–1.005) and younger age (OR: 0.629; 95% CI: 0.520–0.761). The study also aimed to describe and compare the performance of two screening protocols that were used in this preschool hearing screening programme to determine optimal referral criteria that is responsive to available resources. Secondary data analysis was done to compare a protocol using a single-frequency fail criterion (which 2,147 children were screened with between 1 October 2017 and 25 February 2018) with a screening protocol using a two-frequency fail criterion (which 5,782 children were screened with between 26 February 2018 and 30 November 2018). For both protocols, screening was done at a 25 dB hearing level (HL) at 1000, 2000 and 4000 Hz. Both protocols included an immediate rescreen at the frequencies that were failed. The referral rate was 8.7% (n = 186) for the one-frequency fail protocol and 4.3% (n = 250) for the two-frequency fail protocol. Compared to the one-frequency fail protocol, children screened with the two-frequency fail protocol were 52.9% less likely to fail (OR: 0.471; 95% CI: 0.385–0.575). Gender (OR: 0.807; 95% CI: 0.531–1.225) and age (OR: 0.996; 95% CI: 0.708–1.402) had no significant effect on screening outcomes. Maximum permissible ambient noise levels (MPANLs) were exceeded in 44.7% of cases in at least one ear at 1000 Hz across both protocols. There was no significant difference between the protocols for both true positive cases and false positive cases. Protocol (OR: 1.338; 95% CI: 0.854–2.098), gender (OR: 0.807; 95% CI: 0.531–1.225) and age (OR: 0.996; 95% CI: 0.708–1.402) demonstrated no significant effect on the odds of producing true positive results. Average time for conducting the screening was 72.8 s (78.66 SD) for the one-frequency fail protocol and 64.9 s (55.78 SD) for the two-frequency fail protocol. Estimating the prevalence and describing the characteristics of sensory loss in a preschool population in low-income communities are important steps to ensure adequate planning and successful implementation of community-based hearing and vision care in this context. The study therefore also investigated the prevalence and characteristics of hearing and vision loss among preschool children (4 to 7 years) in an underserved South African community after implementing mHealth-supported community-based hearing and vision services. Children who failed hearing and vision screening were seen for follow-up assessments at their preschools. Follow-up assessments were also performed with smartphones and hearing and vision testing applications (hearTest application, hearX Group, South Africa and PeekAcuity app, Peek Vision, United Kingdom). A total of 10,390 children were screened at 298 preschools over 22 months. Of the children screened, 5.6% and 4.4% of children failed hearing and vision screening, respectively. Community-based follow-up hearing tests were done at the preschools on 88.5% (514) of the children, of whom 240 children (54.2% female) presented with hearing loss. A preschool-based follow-up vision test was conducted on 400 children (88.1%). A total of 232 children (46.1% female) had a vision impairment, and a further 32 children passed the test but had obvious signs of ocular morbidity. Logistic regression analysis found that age was a significant predictor of vision loss (p < 0.001): with every 1-year increase in age, participants were 51.4% less likely to have vision loss (OR: 0.49, 95% CI: 0.39–0.60). Age was not a significant predictor for hearing loss (OR: 0.821; 95% CI: 0.667–1.011). Gender was not a significant predictor of hearing loss (OR: 0.850; 95% CI: 0.658–1.099) or vision loss (OR: 1.185; 95% CI: 0.912–1.540). The prevalence of hearing loss at a pure tone average (PTA) of 25 dB HL ranged between 2.3% (240 out of 10,390; assuming none of the non-attenders and children who were unable to be tested had hearing loss) and 3.1% (321 out of 10,390; assuming all the non-attenders and children who were unable to be tested presented with hearing loss). The prevalence of vision loss ranged between 2.2% (232 out of 10,390; assuming none of the non-attenders had vision loss) and 2.8% (286 out of 10,390; assuming all the non-attenders presented with vision loss). Findings of this research project indicate that mHealth-supported CHW-delivered hearing and vision screening in preschools provide a low-cost, efficient and accessible service that can improve the provision of affordable hearing and vision care. This service-delivery model is affordable and scalable, because the same staff, needing minimal training, and the same equipment are used to screen for both vision and hearing. Timely identification of sensory losses is essential to ensure optimal outcomes and can be facilitated through community-based hearing and vision services by trained CHWs using mHealth technology. Future studies should aim to report on outcomes and the uptake and impact of interventions on the children diagnosed with sensory impairments following identification through a decentralised screening programme. / Thesis (PhD (Audiology))--University of Pretoria, 2021. / Sonova AG / Hear the World Foundation / Speech-Language Pathology and Audiology / PhD (Audiology) / Unrestricted

BACKGROUND: Evidence supports the importance of Early Childhood Development (ECD) interventions to improve children's health, lifelong productivity, and human capital. However, ECD programs are not scaled sufficiently to reach many of the 250 million young children globally who are not meeting their developmental potential. Practical guidance is limited on how to scale ECD programs effectively. This mixed-method study explored the contextual and implementation determinants of scaling up ECD programs in Zambia, using one large-scale, community-based parenting group program (Scaling Up Early Childhood Development in Zambia (SUpErCDZ) program) as a case study. The goal was to generate recommendations for policymakers and implementers in Zambia and other LMICs. METHODS: This study was guided by the WHO/ExpandNet scale-up framework and the Intervention Scalability Assessment Tool (ISAT). A total of 30 key informant interviews were conducted with program staff, government officials, academic partners, implementing partners of other ECD programs, and donors. Qualitative transcripts were analyzed using thematic analysis according to the framework method. A budget impact analysis (BIA) was conducted using prospectively collected program cost and implementation data supplemented by online sources and interviews with program staff. The total cost of scale-up over five years using three scenarios (low, medium, and high intensity) was modeled. RESULTS: According to government officials, donors, and partners, the most common contextual factors influencing scale-up ECD programs are political commitment, availability of an overarching or multisectoral ECD policy, availability of resources, and integration of ECD programs into existing government structures. In addition, multisectoral collaboration, stakeholders’ engagement, and sociocultural factors emerged as themes essential to scale-up. From the perspective of the program staff, the key facilitators of ECD implementation were stakeholders’ engagement, sociocultural factors (cultural norms and beliefs), adaptation of the intervention to the context, integration into existing government structures, and intervention characteristics. In addition, providing incentives to Community-Based Volunteers (CBVs) emerged as critical to sustainability. The main barriers to implementation identified by the program staff were the use of culturally inappropriate activities within the ECD curriculum, lack of incentives (financial or in-kind) to caregivers and CBVs, and unforeseen contextual circumstances (COVID-19 pandemic and insecurity). The budget impact analysis showed that the total cost and budget for scaling up SUpErCDZ or a similar ECD program depends on the magnitude of the scale-up in terms of geographic breadth and depth (coverage within specific geographic areas). Based on our scale-up scenarios, the estimated cost of scaling up this program over five years ranged between US$1.74M to US$4.3M depending on the breadth (how many provinces) and depth (how many health facilities, CBVs, and caregivers) of implementation. CONCLUSION: Multiple complex and interrelated contextual and implementation factors influence the scaling up of ECD programs in Zambia. To ensure equitable access to ECD programs for children under five in Zambia, policymakers and implementers will need to consider these when planning to scale up ECD interventions in Zambia. / 2025-08-04T00:00:00Z

The critical role of children’s play in the development of peer relationships, social and communicative skills is reviewed and discussed. The difficulties experienced by a pre-school learner in engaging in peer relationships, communicating successfully in a classroom situation and constructively using play materials was explained. This was done through the use of anecdotal records, checklists, questionnaires, photographic evidence and a semi-structured interview with the learner’s parent. A pre-school play programme, using blocks, dough and puppets (BDP Programme) was devised and used to assess its influence on the acquisition of social and communicative skills by a non-social and non-communicative learner. The study found the BDP Programme to be very successful in assisting this learner to develop peer relationships and communicative skills in the peer group and thus played a critical role in the social development of this learner. / Psychology of Education / M. Ed. (Psychology of Education)