OUR EVOLUTION
2004
2005
2006
2009
2009
2012
2014 - 2016
2017
2018 - 2023
2023 - 2026
Karen Spencer identifies a gap in child protection for children living in orphanages. She sees an opportunity to have a global impact on development and learning outcomes for these children by focusing on implementation of high-quality, relationship-based care in existing orphanages. She founds Whole Child International to address this problem.
We begin developing our relationship-based caregiving program for use in orphanages with the University of California, Davis; WestEd; the Pikler Institute and other partners. The program is designed to meet children’s emotional and developmental needs with no increase in staff, making it a sustainable solution.
We establish an office in Managua, Nicaragua and begin a six-year program of research and intensive intervention. Our initial efforts serve caregivers in cohorts of 50 to 100, providing workshops and lectures in child-focused, relationship-based care, followed by hands-on mentoring to ensure the best practices are fully applied in the residential care centers. Center administrators also receive special training and assistance in implementing administrative best practices throughout their centers.
Data collected and evaluated by the University of Pittsburgh’s office of child development show that the program made a significant impact on the children in seven orphanages. Key results included an increase in children’s weight-for-age and height-for-age by 34% and 46% respectively. Children who had tested as though intellectually disabled decreased by 62%, and negative behaviors such as aggression, withdrawal, and self-stimulation were reduced by 43%.
2010 KEY DEVELOPMENTS
LESSONS LEARNED
1. Our three-day director training was not sufficient to provide center directors with the depth of knowledge they needed to commit fully to what they had learned, undermining the program’s sustainability and its promise for long-term improvements for children.
2. Government leaders needed training in and understanding of best practices and principles in childcare to build and sustain practices and policies that support children’s optimal development.
3. Local university faculty lacked training in the latest theory and practices, creating a nation of ill-equipped professionals.
4. Best practices in childcare were not only absent in orphanages, but across the larger system as well, including childcare centers and foster care.
5. Finding a quantitative way to measure quality of care in limited-resource care settings was and is crucial to measuring and maintaining improvements.
Based on a full analysis of the successes and challenges of our program, a new vision of our program as a systems-based intervention comes fully into view: relationship-centered care can only be permanently established if it is implemented and sustained across a nation’s entire system. In El Salvador, we scale up our interventions to include the nation’s early-childhood centers as well as residential care centers.
In addition, we begin exploring how we can help residential care centers expand the breadth of their services to include family reunification and support, running small-scale foster programs, with appropriate monitoring. This allows us to leverage the resources within the existing residential-care community while safely reducing the number of children outside of family-based care.
PROGRAM DEVELOPMENTS
Addressing lessons 1&2 — In partnership with prominent universities, we developed a university certificate program on best practices in childcare in limited resource settings.
Addressing lesson 3 — We added capacity building of university faculty as one of our key goals.
Addressing lesson 4 — We broadened our scope to childcare facilities and foster care.
Addressing lesson 5 — We began to develop WCI-QCUALS (Whole Child International Quality Childcare Universal Assessment for Limited-Resource Settings) to measure and guide our own work and provide governments with a tool to quantify, monitor, and maintain quality of care.
While developing the above expanded program components, we continued caregiver training and mentoring in Nicaragua with funding from the Inter-American Development Bank. Our evidenced-based program reached 500 caregivers and improved caregiving for aproximately 3000 children.
We shift our partnership for third-party evaluation from University of Pittsburgh’s Office of Child Development to Duke’s Global Health Institute and further development the WCI-QCUALS care center measurement tool. With a second grant from the Inter-American Development Bank, we begin negotiations with the government of El Salvador to do the first phase of a full-country systemwide implementation.
We begin the first phase of countrywide implementation and deliver our policy-level university certificate program to 72 government officials from 11 Salvadoran ministries, including those in charge of child protection, education, and family services, and all Supreme Court justices from the family court. 65 technical government staff take a second university course, and we reinforce our work training caregivers and their government supervisors by beginning development of a caregiver assessment tool.
We conduct an unprecedented national baseline assessment of 217 early childcare and 11 residential protection centers using the WCI-QCUALS center measurement tool, and begin a pilot project in nine childcare centers.
A considerable donation from philanthropist David Booth enables us to build our team and infrastructure. We conduct a multifaceted strategic planning process, which determines the key ways to cost-effectively and impactfully meet persistent global need among the world’s most vulnerable children.
Whole Child implements our relationship-centered care program system-wide in El Salvador and in two other countries, testing and proving the program’s capacity for global impact by working in three different continents. We further develop, refine, and test the tools necessary to successfully implement systems change in relationship-centered care. We will also begin development of the Whole Child Tool Kit, readying us for the next phase of expansion.
USAID funds the the Quality of Care and Protection project for five years in El Savador. We expand our team and scale up our program across El Salvador’s system of care. We forge a partnership with the USC School of Social Work to conduct monitoring and evaluation and to broaden the social-case work capacities of residential childcare centers.
USAID extends our existing award in El Salvador for another three years. We continue to make strides in improving the quality of care in early childhood development centers for 16,000 low-income families throughout El Salvador; conducting trauma-focused case management training to help government case workers better respond to children and families with extensive trauma histories; and providing parental support to ensure that families experiencing vulnerability are able to meet their basic needs and constructively manage the emotional toll of parenting in adversity.