Global Forum for Universal Caregiver Support

Evidence based parenting programs can be defined as a set of activities or services aimed at improving how parents' approach and execute their role as parents, specifically their parenting knowledge, attitudes, skills, behaviors, and practices.

Programs can be integrated into existing services or delivered as a separate program. Core content of effective parenting include a grounding in social learning theory and attachment principles, and a focus on strengthening parenting skills and sensitivity by providing practical instruction on positive-parent child interaction, use of positive encouragement, techniques for non-violent discipline, problem-solving, social, and emotional coaching, and developmentally responsive supervision.

Parenting programs need to be supported by family-friendly policies that provide caregivers with the care, time, and resources to provide quality childcare.

Providing support for parenting and nurturing caregiving at the population level acts as an accelerator for preventing child trauma and its costly impacts on mental and physical health across the life course. Positive parenting can also buffer the effects of community violence, humanitarian crisis and other negative influences.

Globally, around 1 billion children and adolescents aged 2 to 17 years' experience physical, emotional, or sexual violence every year and 3 in 4 young children aged 2 to 4 years' experience violent discipline on a regular basis. Children with developmental delays or disabilities are at particular risk of parental abuse and neglect. In all cases, the best protective factor is improving a parental relationship.

Experience of abuse and neglect in childhood is linked with the development of a wide range of mental and physical health problems. Between 15 and 23 per cent of children live with a parent who has a mental disorder, which may present a risk for healthy parent-child relationships if parents do not receive appropriate and timely support. Parenting programs are shown to improve caregiver mental health.

Total annual health costs attributable to adverse childhood experiences, were estimated at US$581 billion in Europe and US$748 billion in North America. The annual economic burden of child maltreatment is estimated to be 8% of global GDP. Parenting programs are a fraction of those costs.

Parenting programs are low cost and easily scalable. Countries like the Philippines, South Africa and the United Republic of Tanzania have already scaled up non-commercial programs nationally, for costs like those of a standard childhood vaccination program.

Delivery costs for a package of early years home visiting can cost as little as US$22 per family, depending on context, salaries, scale, and participant incentives. It is likely delivery costs would go down significantly after initial set-up costs and once countries reach scale.

The return on investment for government budgets and societal well-being and other developmental outcomes across the life course is substantial, with research suggesting that every dollar spent on early childhood interventions delivers a 13 per cent per annum return on investment, through better education, economic, health and social outcomes. It is also estimated that a 10 per cent reduction in adverse childhood experiences (abuse, neglect, and dysfunctional parenting) prevalence in Europe and North America could equate to annual savings of 3 million disability-adjusted life years or US$105 billion.

The early years offer one of the greatest entry points for promoting healthy attachment and parent-child relationships. Like vaccines against common childhood illnesses like polio and diphtheria, parenting programs can be delivered in infancy, as part of existing services with booster sessions to provide further support through childhood and adolescence. These interventions help parents develop knowledge and skills for effective communication with their children; for greater confidence in applying positive disciplinary strategies; and for managing their own mental health and well-being. Based on the currently available evidence, an example of a minimum package may to achieve universal quality parenting programs comprise:

• A minimum of five to seven in-person sessions delivered at home or through center-based interventions, engaging with all parents and caregivers of children under age 5
• Reflecting the evolving needs and capacities of children and caregivers, follow-up 'booster' sessions to help parents and children navigate key developmental stages (e.g., middle childhood and adolescence). Booster sessions can be delivered digitally in group settings or in a hybrid of in-person and digital support.

All caregivers (and their children) should benefit from this kind of parenting support, but not all caregivers require the same level or intensity of intervention, and needs may fluctuate and evolve over time. This should be seen as a minimum and scalable package that governments should incorporate within a comprehensive, culturally, and context-specific approach to parenting, including by building community systems to enable peer-to-peer support, engagement of male caregivers and more targeted interventions for caregivers of children with developmental delays and disabilities.