Improving curriculum and teaching methods to influence policy and increase the quality of ECDE provision for children with disabilities in Malawi.

Lead Research Organisation: University of Birmingham
Department Name: Education

Abstract

The University of Birmingham (UoB) and Sightsavers International have invited researchers and academics from leading institutions working in the areas of early childhood development and education (ECDE) and special educational needs and disability (SEND), educational psychology, applied anthropology, and epidemiology in Malawi, the UK and the USA to co-design and conduct an innovative three-year study. This study will provide the ESRC, DfID, the Malawi Government and its partners in education with a better understanding of the complex dynamics that can enable or inhibit quality ECDE for CWDs. The Malawi Government has prioritised ECDE as part of its Growth and Development Strategy II (2012-16) to increase equity of access and improve the quality of early childhood services which are currently reaching just over one third of children aged three to five years.

This research programme, which aims to address the widespread need for equitable and quality ECDE services in Malawi, will establish advanced level collaboration between UoB - a research institution specialising in the education of children with disabilities (CWDs) - and Sightsavers, a UK-based charity that supports the educational inclusion of CWDs in sub-Saharan Africa and South Asia. They will collaborate with the University of Malawi (Chancellor College), Arizona State University, and a UK-based research organisation specialising in applied anthropology in global health research (Anthrologica). Non-academic stakeholders will include the Malawi Ministry of Gender, Children and Social Welfare (MoGCSW) and the Ministry of Education, Science and Technology (MoEST), Save the Children, and the Association of Early Childhood Development in Malawi (AECDM), the main agency responsible for the delivery of ECDE training to all caregivers in Malawi.

The research questions and mixed method study design were developed in consultation with the partners, and will be further refined at the study outset during an inception workshop. A study group will be formed of representatives from a wide range of governmental, academic and non-governmental stakeholders, including people with disabilities, who will guide and oversee the implementation of the activities. The study will be subject to ethical approval at the Universities of Birmingham and Malawi, and will adhere to best practice in acquiring informed consent from all participants.

The research will be based on a socio-cultural model that situates learning within a cultural context in which family, peers and schooling are regarded as key in responding to children with early developmental delays and disabilities in rural settings. We will focus on daily family routines of families with CWDs to identify ways of understanding the whole family ecology and how it intersects with the community and its institutions. Further, we will explore how community-based childcare centres (CBCCs) can provide 'institutional' support to help meet family goals that support their children, and try to reduce stress levels which are often high in these families, particularly for the main carer. We will design and implement a community participation framework which will provide CBCC caregivers with the required skills and knowledge to adapt their own teaching practices to help develop children's skills (e.g. language and communication; self-help; cognitive; fine motor; gross motor; social; and emotional) in sustainable ways. The team will disseminate study outputs through existing networks and partnerships at local and international levels, and investigate opportunities to extend and deepen those connections on the basis of this work.

Planned Impact

The research consortium will produce high-quality research findings in order to influence a range of audiences and policy makers in Malawi and internationally over the three years. The research partners are in an excellent position to maximise impact by ensuring that the findings influence key decision makers at the Ministry of Gender, Children and Community Development (MoGCSW) and the Ministry of Education, Science and Technology (MoEST) at national and district level in Malawi. This is guaranteed by the long-standing relationship the consortium has with international agencies working in education and disability (e.g. Catholic Relief Services, CBM, Handicap International, UNICEF), the strong academic networks in Malawi and internationally, and previous, as well as ongoing, research into education (e.g. Sightsavers Innovative Fund to support research into 'Early Childhood Development and Education of Children with Visual Impairment; ESRC Knowledge Exchange Opportunity - 'Making Educational Research Count for Children with Disabilities in Malawi, Kenya and Uganda', and other areas (Social inclusion, Eye Health, Neglected Tropical Diseases).

The ultimate beneficiaries of the research are children with disabilities and their families living in Malawi and similar settings. The research consortium expect these groups to benefit directly from the interventions offered during the study and through policy and programme changes which promote their inclusion and participation in formal and informal ECDE.

Other key beneficiaries include:

1. Trainers of caregivers who work at community-based childcare centres;
2. Caregivers with different levels of literacy working in urban and rural districts;
3. Specialist teachers who have training in sensory impairment or intellectual impairments;
4. Community-based rehabilitation volunteer workers and Child Protection Officers working for the Community Development Department within MoGCSW and the Ministry of Disability.

The study will have impact on the international core working team of academics, NGOs, policy makers, ECDE trainers and caregivers through their involvement in the research. A purpose built online community will have an impact on all key stakeholders, providing an innovative space where we can share examples of different training practices and innovative intervention programmes at the CBCCs, and communicate via podcasts, webinars and discussion boards. The use of participatory action research methods at the different stages of the study will mean that participants will particularly benefit as they will be asked to draw on their own experiences and beliefs and will be encouraged to pose and answer questions most important to them. In the long-term the organised working groups and online discussions will lead to a body of new knowledge for academics and practitioners working in the field of ECDE and the assessment of young children with disabilities in low income settings.

A large network of stakeholders including International Disability and Development Consortium (IDDC); the International Centre for Evidence in Disability at the London School of Hygiene and Tropical Medicine and Leonard Cheshire Research Centre at UCL will be invited to seminars as part of an ongoing 'research in progress' series at the University of Birmingham. Sightsavers will also plan an annual research seminar which will be recorded and used by the organisation's programme development team in its country offices. The partners will also explore opportunities to communicate with other projects which are involved in 'ECDE and inclusive education' in Malawi to ensure it is up-to-date with their latest findings and developments. Where possible, the consortium will explore opportunities to present findings from our research at national seminars and conferences organised in Malawi.
 
Description The baseline data was collected between December 2016 and May 2017. The intervention training took place over the summer holidays (July-August 2017), when most CBCCs were closed. The end-line data collection started 9 months after the training intervention had been delivered, and took place between May and July 2018. At endline, 44 out of 48 CBCCs (22 CBCCs in each arm) could be found with 2 CBCCs in each arm having been closed and lost to follow up.
The main outcomes, where the intervention was expected to lead to a causal change and therefore measured by the cluster randomised control trial are:
• Percentage of children with developmental age equal to actual age (primary outcome);
• Caregiver satisfaction and motivation?;
• Changes in early childhood centre environmental rating scale.

Data in this study was collected using six tools: two which collected CBCC level data from the lead caregiver or chairman (the CBCC questionnaire and work roster and the CBCC environmental rating scale (observation tool)); one which collected caregiver level data (the caregiver satisfaction and motivation questionnaire); and three which collected child level data (the UNICEF/ Washington Group Child Functioning Module (CFM), the Malawi Development Assessment tool (MDAT) (lan-guage and socio-emotional domains only), and the school readiness scale).
Exploitation Route We are still producing policy briefs for the Malawi government to use as it plans to increase levels of investment into ECD and are exploring opportunities to work with local media agencies and government departments in Malawi to disseminate our briefs. The briefs contain key findings from both the trial and from case studies of children with disabilities collected during the trial. Findings based on children's school readiness and assessment of children's learning environment will be particularly useful in terms of reviewing its policy on the infrastructure and staffing of community-based child centres in Malawi. Findings from the Child Functioning Module (Washington Group Questions) and the Malawi Development Assessment Tool (MDAT) are helpful for the Children's Directorate to use when planning to allocate resources to CBCCs and review the training of caregivers.
Sectors Education,Healthcare

URL https://onlinelibrary.wiley.com/doi/full/10.1111/cch.12741
 
Description We completed the project on 28 February and have finalised the report writing of the endline data collected after the intervention in Malawi. We have carried out three dissemination events in Malawi in January 2019. Having completed these important activities, we are working on producing planned publications in peer-reviewed journals and short briefs which contain some of the key data for the Ministry of Gender and its partners in Malawi. They are very interested in our findings on disability and developmental delay as well as the intervention we used to train the caregivers. We applied in January 2019 to the invited follow-on call for Raising Learning Outcomes projects to carry out some extra activities on this project which will involve non-academic partners and the Ministry of Gender. Children, Disability and Social Welfare. Unfortunately, we were unsuccessful in winning this additional funding but have been successful in winning an award from the British Academy to do some more work into developing trans-disciplinary partnerships to determine how and why early childhood education works in community based childcare centres as well as in special and mainstream schools for children with disabilities. This project involves Chancellor College, University of Malawi as well as the College of Medicine and The Catholic University, Malawi. The project will come to an end in December 2021. We have published some the qualitative findings in the following early years periodicals: 1) A 1,000 word paper in the Early Years Educator (to be published in March 2019) 2) A 1,000 word paper in International Teacher Magazine (to be published in April 2019)
First Year Of Impact 2019
Sector Education
Impact Types Societal,Policy & public services

 
Description Participation in high level steering group on early childhood development and disability in Malawi
Geographic Reach Africa 
Policy Influence Type Participation in a national consultation
Impact Dr Foster Kholowa, co-investigator at Chancellor College, University of Malawi, was invited to present some of the key findings from the baseline research to a high level Malawi Government steering committee which oversees the implementation of the Early Childhood and Development Policy. Our findings have lead to two changes -1) the content and delivery of Early Childhood and Development training to volunteer nursery teachers by including a module on inclusion of children with disabilities, 2) the inclusion of techniques and advice on on how to better support children with disabilities when implementing the Malawi Government's 'Early Leading Development Standards'. These standards are used in conjunction with the ECD training programme and form the backbone of early years provision in Malawi.
 
Description Early Childhood Education
Amount £23,659,200 (GBP)
Funding ID ECE190049 
Organisation The British Academy 
Sector Academic/University
Country United Kingdom
Start 11/2019 
End 11/2021
 
Title Child engagement and well-being tracking tool 
Description This tool is based on an existing observation tool created by Dr. Ferre Laevers at Leuven University, Brussels. It essentially tracks a child's interactions with other adults as well as gauge levels of involvement and well-being at 15 minute interviews using a five-point scale. It can be used as a stand-alone tracking tool at a school or in combination with a child assessment. Observers require approximately 1 day's training using video clips and case study scenarios. The tool can be applied in highly resourced schools to classrooms in low-resourced settings in rural areas of low income countries. 
Type Of Material Improvements to research infrastructure 
Year Produced 2018 
Provided To Others? Yes  
Impact Both academics and practitioners working in the field of early childhood development and education have shown an interest in using the tool for assessment and monitoring purposes. We are in the process of discussing ways for the tool to be integrated into the Government of Malawi's Early Childhood Development Monitoring toolkit. 
 
Title Child-Based Community Centre Questionnaire and Caregiver Roster 
Description This is a comprehensive survey (approximately 45 minutes to complete) which collects data on key areas - registration details, activities carried out in centres, main barriers, role of parents, record keeping, training of caregivers, areas of the curriculum addressed on a daily and weekly basis. 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact This tool has proved to be extremely useful at gathering vital information about how early childhood centres are functioning as a result of observations and interviews with key personnel working at the children's centres. 
 
Title Child-Based Community Centre Rating Scale and Guidelines 
Description This is an observation tool which should be conducted only on an unscheduled and unannounced visit to a centre. Two observers should allow for 1 and half hours continuously, regardless if the caregiver(S) is present the entire time and should position themselves so that they are a minimal distraction to the class but that they can still see all that is happening with the caregiver(s) and children. Observers make take notes on a separate note pad during the observation time (1hour and a half). But should not answer any questions until the time has ended and they can answer the questions together using the guidelines. For all questions, the observer should consider which answer is the best representation of the entire observation. 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact This tool and guidelines are proving to be extremely useful for the research group to identify areas for human development particularly around caregiver training and responding to children's development and learning. 
 
Title Malawi Development Assessment Tool (MDAT) 
Description This culturally relevant developmental assessment tool is very useful for measuring children's developmental milestones in relation to their age. We are using two (language and social domains) out of the four domains, assessors carry ask children to carry out a total of 68 tasks which are incrementally more difficult as the assessment progresses. This assessment is conducted in the presence of the main carer who can provide some of the answers to routine-based questions. The assessment takes about 30 minutes. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact The results from assessments are helping to identify children who may have a developmental delay or cognitive impairment. Used in conjunction with the Washington Group Questions and the School Readiness Scale, it can provide the assessor with a comprehensive picture of a child's development in a rural, low-resourced setting in Malawi. 
URL http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000273
 
Title School Readiness Scale 
Description This scale is based on Early Learning Development Standards (ELDS) developed by UNICEF and the Ministry of Gender, Children, Disability and Social Welfare in Malawi. This project has identified literacy (reading and writing), numeracy and problem solving to measure over an academic year. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact There has been no validation of the ELDS in Malawi to date. This scale is helping us to see whether the age related development scales are valid for children in Malawi. 
 
Description Establishing a dialogue on disability for higher impact 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The main outcomes from the two-day workshop were:
- A shared knowledge of 'impact' and the potential of the collective
- Emergence of common overarching themes being addressed across the projects - useful for engaging policy makers and others.
- Greater appreciation of how working together can communicate shared objectives, concepts, methods and evidence base to a larger group of stakeholders internationally and nationally.
- Familiarity with selected tools of dissemination and their potential (and challenges) in helping communicate effectively with a wider audience
Year(s) Of Engagement Activity 2016
URL http://www.theimpactinitiative.net/blog/news-establishing-dialogue-disability-higher-impact
 
Description Impact Initiative Research Scoping Day on Child Poverty 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact This one day conference enabled Dr Anita Soni and Dr Paul Lynch to attend and present at a conference on child poverty. The main audience comprised representatives from UNICEF, Save the Children and IDS, Sussex University. The organizing group at Impact Initiative the is interested in developing links with our project and we will be presenting some of our findings at a Conference in Addis Ababa in October 2017.
Year(s) Of Engagement Activity 2016
URL http://www.theimpactinitiative.net/blog/blog-how-disability-contributes-increased-child-poverty
 
Description International Association of Developmental Pediatrics Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact PROMOTING THE INCLUSION OF CHILDREN WITH DISABILITIES THROUGH THE APADTATION OF ASSESSMENT TOOLS, TEACHING CURRICULA AND METHODS in MALAWI - This three-year project seeks to promote the inclusion of children with disabilities through the assessment tools, as well as the teaching curricula and methods used in a rural area of Southern Malawi. We plan to provide policy makers and actors in the field with a better understanding of the complex dynamics that can enable or inhibit quality early childhood development and education for children with disabilities.
In this presentation I will present the aims of the research project, the methodology and some of the main findings from the baseline assessment of over 800 children between the ages of 2-6 years attending early childhood and care programmes in Malawi.
Methods: A mixed-method study over three years drawing on the bio ecological systems theory as a conceptual framework to explore the interrelatedness between young children with disabilities and their learning environments and other adults. We have developed a set of tools to assess and observe children's development and behaviour in natural settings. We also observe and scale the different levels of interaction between volunteer staff working at community-based child care centre (CBCC) volunteers using a community-based rating scale.
Results: I will outline the different outcome measures we proposed for the research at the outset and present some of the main results from the child assessment data during the first phase of a randomised group cluster trial.
Conclusions: I will briefly the implications of the findings and describe the intervention and the next steps of the research.
Year(s) Of Engagement Activity 2017
URL http://www.idpacongress.org/
 
Description Lessons from a Decade's Research on Poverty: Innovation, Engagement and Impact, ESRC/DFID 10th Anniversary Conference, Pretoria 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact The PI, Paul Lynch, Dr Foster Kholowa (Co-I) and Jenipher Mbukwa co-presented the project as part of a symposium on disability. The attendance comprised representatives from DFID, the ESRC and other third level institutions in the UK, USA and the Global South.
Year(s) Of Engagement Activity 2016
URL http://www.theimpactinitiative.net/sites/default/files/Conference_summary.pdf
 
Description Presentation to the annual European Society for Disability Research conference in Lausanne 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In this presentation (Let's Grow Together: Lessons from the Field in Malawi) I shared some of the some of the main results from the first stage of the project which used a community-based participatory research (CBPR) approach to gather the different experiences of parents who have children with disabilities in 10 villages. This approach involves a commitment to sharing power and resources and working towards beneficial outcomes for all participants, especially communities. CBPR, as a partnership approach, aims to equitably involve community members, organisational representatives and researchers, who contribute expertise and share decision-making and ownership.
A CBPR training workshop for the volunteer peer researchers from within community-based child care centres community and were trained to take part in interviewing their peers individually and within focus groups about their peers' experiences of early childhood development at the time. This included asking about the challenges, tensions, successes and views related to educational inclusion of their children into the centres. This training stemmed from the CBPR ethical guidelines.
The volunteer peer researchers were able to carry out a total of 9 focus group discussions with parents of children with disabilities and a further 9 recordings with volunteer pre-school teachers at 9 community-based community centres. I will discuss the process of how the transcripts were coded by the research team in collaboration with the peer researchers. Finally, I will reflect on whether we were able to maintain a power-sharing and balance whilst utilising this methodology and make some suggestions pn how it could be used in disability research in the global south.
Year(s) Of Engagement Activity 2017
URL http://alter-asso.org/lausanne-conference-2017/?lang=en
 
Description Run a workshop on School readiness and children with disabilities as part of a conference 'Putting children first: identifying solutions and taking action to tackle poverty and inequality in Africa.' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Supporters
Results and Impact n interactive workshop to explore the complexities of helping children with disabilities to be 'school-ready' in Malawi
'School readiness' is a multi-faceted construct linked to many important developmental outcomes, including academic success, completion of high school, and eventual gainful employment and the ability to contribute to society. Over the past 15 years there has been an increased emphasis by governments, parents, and educators on the promotion of school readiness in young children including those with disabilities. This workshop we will collaboratively explore what tools can be used to measure school readiness without penalising children with disabilities and consider how different actors (parents, teachers and services providers) can view a child with disability in more positive light.Part one: Introduction: Present some key areas for concern -multi-dimensions of risk - children who experience disability, poverty and live in low resource settings (20 mins)

a. Quick review of how many assessment tools look at a child with disability through a deficit

b. Why are these children more likely to drop out of school or not complete full cycle of schooling (risk and resilience)

c. Present dynamic model of 'school-readiness' - looking at the intersectionality of child, school and community and the need for a multi-directional approach to schooling

d. Introduce the project briefly and the a set of commonly used tools in assessing children's readiness for school and being used for the ESRC/DFID RLO project


Part two: In small groups of say 6 participants, give a copy of the model and a list of assessment tools that could be used in low-resource settings in LICs (40 mins)

Groups are invited to do some mapping out of tools they consider to be feasible and effective in building a child's chances of going to primary school and staying at school. Look at the child, family/community and school separately and how they intersection.

Also put in some tools (assessments) that are quite generic so they get a sense of what tools are available (e.g. IDELA. EDI, ECERS, etc.)

Groups come up with different permutations of tools which will lead to a good discussion in Part three.



Part three: Discussion about the strengths and weaknesses of different assessment tools in low income countries (30 mins)

Discuss how the tools and interventions are able to mitigate the chances of children with disabilities not entering primary school and remaining at school .

What are the implications for research in other countries?

Final messages to report to bigger conference group
Year(s) Of Engagement Activity 2017
URL http://www.theimpactinitiative.net/event/event-putting-children-first-identifying-solutions-and-taki...
 
Description Seminar at University of Oxford 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Postgraduate students
Results and Impact Paul Lynch was invited by the Comparative and International Education Society to give a seminar to a mixed audience of students, academics and politicians. The presentation: 'Examining early development and school readiness of children with disabilities in Malawi through a bio-ecological systems theory' discussed some of the main findings from research conducted during the first and second year of the research in Malawi.
Year(s) Of Engagement Activity 2018
 
Description UKfiet Conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Third sector organisations
Results and Impact The session was attended by representatives from academia, INGOS, philanthropic organisations and practitioners supporting the education and development of children in the Global South.
Year(s) Of Engagement Activity 2019