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Sustaining Community Implementation of a Caregiver-Mediated Intervention- Learnings From the WHO-Caregiver Skills
Koyeli Sengupta1, Disha Zaveri2, Alokananda Rudra2
1Developmental Pediatrics, Autism Services and Research Ummeed Child Development Center, Mantri Pride Building, Lower Parel, Mumbai, 400011, Maharashtra, India. koyeli.sengupta@ummeed.org.
Purpose:
The World Health Organization's Caregivers Skills Training (WHO-CST) program has been culturally adapted and implemented across diverse low-resource regions as options to promote developmentally disabled children's development. However, beyond initial feasibility and acceptability, little is known about the long-term sustainability of the program in lower-middle income countries, such as India. The current study explored stakeholders' experiences of sustaining implementation of the WHO-CST in India.
Methods:
Twenty-eight semi-structured interviews were conducted with organizational heads (n = 9), course facilitators (n = 10), and caregivers of children with developmental disabilities (n = 9). Participants had engaged with the WHO-CST across 10 community-based organizations. Using an iterative and inductive qualitative method, four overarching themes were generated.
Results:
'Bridging the Gap' recognized ways in which stakeholders gained knowledge and skills. 'Always about Logistics and Time' acknowledged the existing implementation hurdles, while sustainability was promoted by 'Support and Investment' in local adaptations and strategic resource allocation. 'Nothing, Nothing was in Vain' revealed that, irrespective of current implementation status, the WHO-CST has positively impacted communities.
Conclusion:
Despite its positive reception, long-term sustainability of the WHO-CST program remains a challenge in India. For the WHO-CST to sustain and have an enduring impact, there is a necessity for phased training approaches, systemic capacity building, integration within large-scale public health systems and enabling policy shifts to enhance long-term viability and accessibility.
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