Systems Testing of the PLH Human-Digital Package within the Health Sector in South Africa

About this project

copy of gpi brand maps south africa yellow
  South Africa
  January 2023 –December 2025
Principal Investigator Professor Catherine Ward (University of Cape Town, South Africa)
Co-Investigators Cindee Bruyns (University of Cape Town, South Africa), Dr Jamie Lachman, Professor Lucie Cluver, Professor Frances Gardner (University of Oxford, UK).
Partners Department of Health, Western Cape Province of South Africa; Clowns Without Borders South Africa; UNICEF South Africa.

Overview

Sequential Multiple Assignment Randomised Trial (SMART) to identify the most optimal and cost-effective system of delivery of the Parenting for Lifelong Health (PLH) human-digital parenting package within the health sector. Benefactors will be parents or caregivers above the age of 18 who show an interest in parenting support.

Context

Most (if not all) parents could benefit from some advice about parenting and keeping children safe; some may need more intensive support. This raises two questions: whether most parents can be reached; and what the optimal combination of support should be, to provide the level of support needed by each parent, in an affordable, cost-effective manner. The GPI is developing and testing digital versions of PLH programmes of varying intensity (in order from least to most intensive): ParentText, ParentApp, and ParentChat. The question now is how best to offer these to parents at the intensity they need within existing government systems.

Objectives

There are two main objectives of this study:

  1. To offer parenting support to all parents attending Department of Health facilities in a designated area in Cape Town.
  2. To test which combination of programmes is most cost-effective at meeting the different needs of parents.
     

Study Setting

This study will take place in five primary health care clinics in Cape Town, South Africa. These clinics serve the majority of South Africans (those without health insurance). Most parents will visit a health facility for their own healthcare, for well-baby checks, vaccinations, or for childhood illnesses, at least once a year, which offers an ideal opportunity to reach parents with support. The wide reach of the setting and the alignment with key health priorities, including preventing child maltreatment and promoting child wellbeing, make this an ideal setting in which to attempt population-wide reach of parents.

Study Significance and Impact

A key challenge in providing support to all parents everywhere, is finding an entry point to reach all parents. Healthcare facilities appear to provide the ideal vehicle, because they are accessed, without stigma, by almost all people at least annually. This study will allow us to test whether they are such a vehicle. Secondly, matching level of need to intensity of intervention is a key issue for many health, educational and social welfare programmes. The results of our study will have applicability far beyond PLH: they will provide guidance to all other programmes that offer digital and stepped-intensity programmes.