Short‐ and longer‐term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda

Alastair Ager - ORCID 0000-0002-9474-3563 https://orcid.org/0000-0002-9474-3563Karin Diaconu - ORCID 0000-0002-5810-9725 https://orcid.org/0000-0002-5810-9725Background The establishment of Child Friendly Spaces (CFSs) has become a widespread intervention targeting protection and support for displaced children in humanitarian contexts. There is a lack of evidence of impact of these interventions with respect to both short‐term outcomes and longer‐term developmental trajectories.Methods We collected data from caregivers of Congolese refugee children residing in Rwamwanja Refugee Settlement at three timepoints. To assess short‐term impact of CFSs, we compared indicators assessed shortly after refugees’ arrival (baseline, T1) and endline (T2, three to six months after CFS implementation) amongst 430 CFS attenders and 161 nonattenders. Follow‐up assessments after the end of CFS programming were conducted 18 months post‐baseline (T3) with caregivers of 249 previous CFS attenders and 77 CFS nonattenders.Results In the short‐term, attendance at CFSs was associated with better maintenance of psychosocial well‐being (PSWB; β = 2.093, p < .001, Cohen's d = .347) and greater increases in developmental assets (β = 2.517, p < .001, Cohen's d = .231), with significantly stronger impacts for girls. CFS interventions meeting higher programing quality criteria were associated with greater impact on both PSWB and development assets (β = 2.603 vs. β = 1.793 and β = 2.942 vs. β = 2.337 for attenders at higher and lower‐quality CFSs c.f. nonattenders, respectively). Amongst boys, benefits of program attendance were only indicated for those attending higher‐quality CFS (β = 2.084, p = .006 for PSWB). At follow‐up, however, there were no discernable impacts of prior CFS attendance on any measures. Age and school attendance were the only characteristics that predicted an outcome – developmental assets – at follow‐up.Conclusions Attendance at CFSs – particularly involving higher‐quality programming – supported children's well‐being and development. However, sustained impact beyond active CFS programming was not demonstrated. Intervention goals and strategies in humanitarian contexts need to address the challenge of connecting children to other resources to facilitate developmental progress in conditions of protracted displacement.This research was funded by World Vision International and Elrha's Research for Health in Humanitarian Crises (R2HC) Programme (elrha.org/r2hc), which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. At the time of the award supporting this study, the R2HC program was funded equally by the Wellcome Trust and the UK Department for International Development.https://doi.org/10.1111/jcpp.1306960pubpub1