What Sinovuyo changed for me in my home: The thing that change in my home is that my mother did not fight with me. We sit down and talk that what is wrong and what is good and when I do something that is wrong she [my parent] tell me that “No, my child, this is wrong.”
— Sinovuyo Teen Participant (Teen)

 Sinovuyo means "We have happiness" in isiXhosa, the predominant language in the Eastern Cape.

Sinovuyo means "We have happiness" in isiXhosa, the predominant language in the Eastern Cape.

Sinovuyo Teen study

A study to develop,and evaluate a free evidence-based parenting and teen programme, with 10-17 year-olds, to reduce violence inside and outside the home in rural and peri-urban areas of South Africa.

This research study is a collaborative effort between the South African Departments of Social Development and Basic Education, UNICEF, the World Health Organisation, and the Universities of Cape Town and Oxford.

The Sinovuyo Teen Study is part of the World Health Organisation's Parenting for Lifelong Health (PLH), a suite of parenting programmes to reduce violence.

Background

Child abuse rates are high in Sub-Saharan Africa and are exacerbated by family-level stressors such as poverty and HIV/AIDS. Adolescence is a particularly high-risk stage for abuse, with rates of violence victimisation increasing not only within the home, but also in community settings. Yet, to date, there are very few evaluated evidence-based child abuse prevention interventions for children in Sub-Saharan Africa, and no known parenting interventions designed specifically for the needs of AIDS-affected children in the region.

AIMS

This research project aims to develop and evaluate a free parenting programme, Sinovuyo Caring Families – Teen, for 10-17 year olds (also known as the Sinvovuyo Teen programme) which is informed by evidence-based principles, in South Africa. The primary objectives are:

  1. To reduce the risk of child maltreatment in the home

  2. To reduce adolescent externalising behaviour problems

Secondary objectives include to: increase good parenting practices; increase social support; improve mental health, and; improve family capacity to plan for keeping adolescents safer in the community.

 The Sinovuyo Teen Study research site is located in the areas around King William's Town in the Amatole District Municipality of the Eastern Cape in South Africa.

The Sinovuyo Teen Study research site is located in the areas around King William's Town in the Amatole District Municipality of the Eastern Cape in South Africa.

 An elderly caregiver completing one our baseline questionnaires using a tablet

An elderly caregiver completing one our baseline questionnaires using a tablet

METHODOLOGY

The research component of the Sinovuyo Teen Study involves conducting baseline and follow-up interviews with caregivers and their teens, before and after the Sinovuyo Teen programme in order to test its effectiveness. This is done by local Research Assistants who have been trained to use tablets with validated screening tools to collect qualitative and quantitative data. The resulting data is then anonymised and examined using statistical analysis. 

The implementation component of the Sinovuyo Teen programme consists of 13-15 weekly group sessions, which are attended by caregivers and their teenagers.The programme is based on evidence-based parenting principles, which have shown to be effectivesuch as: increasing praise and responses to behaviour problems, home practice, illustrated stories using picture codes, traditional stories, role-play, modelling, interactive exercises, stress reduction, and group problem solving.

Questionnaires & Referral Protocol

This study has employed internationally recognized scales and measures. The questionnaires can be accessed below:

Pre-Post Pilot Questionnaires: Teen (Part I  & Part II); Caregiver (Part I & Part II)

Post-Test Pilot Questionnaires: Teen (Xhosa & English); Caregiver (Xhosa & English)

Randomised Control Trial Questionnaires: Teen Baseline (Part I & Part II); Caregiver Baseline (Part I & Part II)

Note: Given the sensitive nature of themes under discussion, the baseline survey for the teens and the caregivers are undertaken in two parts. Part I of the questionnaire consists of relatively anodyne questions which helps establish trust and mutual comfort between the respondents and the research assistants. This is followed up with Part II of the questionnaire where we broach more difficult topics related to abuse experience, and sexual reproductive health.

During the course of interviews, often our participants disclose distressing information about themselves or their families to our research assistants. Often, we find ourselves legally and morally obligated to help these participants who may otherwise be in imminent danger. When we help a participant or a family, we call it a 'referral case'. Despite the desire to help our informants, our team often faces resource constraints, logistical difficulties, and needs to be mindful of socio-culturally sensitive issues in the community. Based on our experiences, we have developed guidelines for dealing with referral cases and proving follow-up support.

Guidelines for Referral and Follow-up Support: English

 The original manuals have been adapted for implementation for young children, adolescents and HIV-prevalent contexts. To support contextually-relevant implementation and scale-up of Parenting for Lifelong Health, these manuals are also being adapted and translated for implementation in Sotho, Swahili and Creole. Manuals are also available in Xhosa, Tagalog, SeSotho, Kiswahili, Luganda, Afrikaans, French and Arabic.

The original manuals have been adapted for implementation for young children, adolescents and HIV-prevalent contexts. To support contextually-relevant implementation and scale-up of Parenting for Lifelong Health, these manuals are also being adapted and translated for implementation in Sotho, Swahili and Creole. Manuals are also available in Xhosa, Tagalog, SeSotho, Kiswahili, Luganda, Afrikaans, French and Arabic.

Results

The trial results show that the programme is not just widespread but effective. Families taking part in the programme had lower rates of violence against teenagers, better family relationships, better planning by families to protect teenagers from abuse in the community, and less alcohol and drug use by both caregivers and teenagers. Caregivers who had taken part in the programme were less depressed and less stressed by parenting, and had more social support. Families who had taken part in the programme were less likely to run out of money, food and electricity at the end of the month, and had better budgeting and more savings.

For more outcomes see our latest policy brief, Parenting for Lifelong Health: Supporting Families in Low-Resource Settings.

In 2018, Randomised Controlled Trial results were published in BMJ Global Health. 

Current status

Following on from positive results from two pilot pre-post studies (in 2013 and 2014), the team conducted an even larger evaluation of the programme. The evaluation, a cluster Randomised Controlled Trial (cRCT), was conducted with 552 families (1100 participants) across 40 villages. Baseline 1 and Baseline 2 questionnaires was completed in September 2015, and the parenting intervention, which was facilitated by our implementation partners Clowns Without Borders South Africa, was completed in November 2015. A mini-post test data collection was completed in November and December 2015. The team also completed a 6-month post-intervention follow-up in the summer of 2016.

Currently, all data collection related to the project has been completed and we are in process of analysing the data.

Parenting a teenager is never simple, and families living in low-resource countries deserve the best research evidence to help them. Parenting for Lifelong Health programmes are now reaching over 200,000 children and families in the places that need them most.
— Prof. Lucie Cluver

Scale-up

 Countries planning and implementing Sinovuyo Teen scale-up.

Countries planning and implementing Sinovuyo Teen scale-up.

Early results from studies of Sinovuyo Teen (also known as PLH for Teens) and PLH Young Children sparked major interest from international agencies and governments to plan scale-up. This resulted in the adaptation of 8 manuals that are being implemented across 11 countries in Africa. This programme is currently being delivered to around 250,000-300,000 families across the continent. 

Eight manuals including a suite of five original Parenting for Lifelong Health facilitator manuals and family guidebooks that are freely available online.

Funders

STS_Funders

Principal investigators

  • Professor Lucie Cluver, Professor of Child and Family Social Work at the University of Oxford & Honorary Lecturer for the Department of Psychiatry & Mental Health at the University of Cape Town.

  • Dr. Catherine Ward, Professor of Psychology in the Department of Psychology at the University of Cape Town.