Development of self-help groups for caregivers of children with disabilities in Kilifi, Kenya: Process evaluation

Abstract

Background Caring for a child with disabilities in a resource-poor setting brings many challenges to the caregiver. We examined the development of self-help groups for caregivers in a rural part of Kenya. Objectives To conduct a process evaluation on the development of self-help groups during a 10-month set-up period, focusing on implementation and mechanisms associated with their functional status. Methods Using a realist evaluation design, we set up 20 self-help groups for 254 caregivers. An evaluation was conducted to investigate implementation and mechanisms of impact. Implementation focused on caregiver registration, community group support and monitoring visit compliance. Data were collected from group registers, records of meetings and field notes. Mechanisms of impact employed a framework of strengths–weaknesses–opportunities–threats to review the groups at the end of the 10-month set-up period. Results Recruitment resulted in registration of 254 participants to 18 groups – two groups disbanded early. Post-evaluation included 11 active and 7 inactive groups. Compliance with the monitoring visits was consistent across the active groups. All groups engaged in ‘merry-go-round’ activities. The active groups were characterised by strong leadership and at least one successful income generation project; the inactive had inconsistent leadership and had dishonest behaviour both within the group and/or externally in the community. Mediators associated with functional status included the following: available literacy and numeracy skills, regular meetings with consistent attendance by the members, viable income generating projects, geographical proximity of membership and strong leadership for managing threats. Conclusion Self-help groups have the potential to progress in resource-poor settings. However, critical to group progression are literacy and numeracy skills amongst the members, their geographical proximity, regular meetings of the group, viable income generating projects and strong leadership.

Identification of Components Associated with the Operation of Mutual Aid Groups: A Scoping Review

“…On the other hand, income-generating activities allowed the groups to grow. Providing learning opportunities for asset and money management as a precursor to income-generating projects was a critical component of capacity development (Gona et al 2020). Similarly, for Yip (2002) it is essential in mags to carry out processes related to the guidelines to achieve adequate employment.…”

“…Similarly, for Yip (2002) it is essential in mags to carry out processes related to the guidelines to achieve adequate employment. According to empowerment theory, this could correspond to greater control and awareness of the sociopolitical context in which groups operate (Gona et al, 2020;Kieffer, 1984;Zimmerman, 2000;Zimmerman & Rappaport, 1988). Compared to the identity component, Markowitz (2015) mentions that when people with mental illness integrate into significant groups and engage in productive activities.…”

Empowering caregivers of children with learning and developmental disabilities: from situation analysis to community-based inclusive development in Kilifi, Kenya

“…There were significant gains in the caregiver's social support networks; they viewed their child's disability as less severe, and their caregiving role as less problematic. Mechanisms of "handling goods and money" and "social ties and support" were determined to underpin the outcomes (Bunning et al, 2020, Gona, 2020.…”

“…The groups were encouraged to start up various income generation activities, including "merry-go-round" (where group members contribute small sums of money or food items at each meeting, which are allocated to two or three individuals for family use and income development by rotation so each member has a turn as a beneficiary); farming; and livestock rearing. At the end of the set-up phase, 11 groups remained comprising 154 caregiversnine groups having dissolved variously due to drought conditions, in-group tensions and fraudulent activity in the local community (Bunning et al, 2020, Gona, 2020.…”