Lessons from Senegal's Database System for Case Management for Child Protection: A Pilot Project on Web-based and Mobile Technology

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Lessons from Senegal's Database System for Case Management for Child Protection: A Pilot Project on Web-based and Mobile Technology
  See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/263421545 Lessons from Senegal's Database System forCase Management for Child Protection: A PilotProject on Web‐based and Mobile...  Article   in  IDS Bulletin · March 2013 DOI: 10.1111/1759-5436.12018 CITATION 1 READS 22 3 authors , including: Some of the authors of this publication are also working on these related projects: Intersectionality: A key for helping men break out o their patriarchal prisons View projectJerker EdströmInstitute of Development Studies 52   PUBLICATIONS   99   CITATIONS   SEE PROFILE All content following this page was uploaded by Jerker Edström on 12 May 2015. The user has requested enhancement of the downloaded file.  1Introduction The aim of this study was to understand a chosenexample of a real-time monitoring (RTM)intervention in depth, to assess its achievementsand discuss the potential of possible modifications.The method has involved a process of mutuallearning between IDS, UNICEF and partners atmultiple levels; before, during and after a missionto Senegal which took place from 7–16 December2011. The ‘Database System for Case Managementfor Child Protection in Senegal’ was one of several examples selected for in-depth analysisto (in aggregate) provide a baseline assessment,and to extend our knowledge of strategies andmechanisms that appear to have a good chanceof success in achieving key objectives of RTM forthe Most Vulnerable (RTMMV) children. TheSenegal case study was chosen as it focuses onrapid and ongoing monitoring for immediateservice delivery and (thus) complements many other country studies, often focusing on periodic(if frequent) monitoring systems used fortracking trends and/or policy development,rather than monitoring activities on a daily basis. This article is structured into three mainsections, with sub-sections. We start in thisintroductory part, with a conceptual frameworkfor the study, as well as the methodology andlimitations. The main section presents detailedresearch findings, including an overalldescription of the initiative, the quality of themonitoring data generated, considerations of equity and exclusions, the usefulness of themonitoring system to potential users and its value added (including relevance for policy andadvocacy), costs and sustainability. We then closethe article with summative reflections andlessons learned in conclusion. 1.1Framework: child protection, case management and real-time monitoring Several generations of children growing up, overrecent decades in parts of sub-Saharan Africa,have experienced progressively deepeningchallenges with multiple crises, sometimescombining and often posing severe threats totheir long-term welfare. Children’s needs and vulnerabilities are unique and complex and 69 Lessons from Senegal’s DatabaseSystem for Case Management for Child Protection: A Pilot Project onWeb-based and Mobile Technology  Jerker Edström, with Amadou Moreau and Xavier R. Sire 1 Abstract   This case study on the Database System for Case Management for Child Protection in Senegalfocuses on rapid monitoring for immediate use in service delivery and (thus) complements other country studies in this IDS Bulletin . The case provides an exciting initiative with much potential for improving childprotection services, as well as additional information generation with the potential for broader monitoring,advocacy and operations research. The challenges centre on the need for clearer definition and agreementofroles and responsibilities between actors at different levels, as well as coming to an agreed balance ofthesharing ofdata on individual cases with data protection, for confidentiality. The key lesson has been theimportance ofa collaborative process ofdeveloping the system with diverse actors in child protection,coupled with an accompanying consultative process ofdeveloping an inter-sectoral national child protectionstrategy: in other words, a way ofestablishing common standards together. IDS Bulletin Volume 44 Number 2 March 2013 © 2013 The Authors. IDS Bulletin © 2013 Institute ofDevelopment StudiesPublished by Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UKand 350 Main Street, Malden, MA 02148, USA  derive from challenges in multiple dimensions ordomains (such as from health-related, psycho-social, educational, physical or economichardships), as well as due to their dependence onadults and relative lack of autonomy or legalstatus. Hence, children’s needs and vulnerabilities are not only multidimensional,but often also inter-connected. In other words,crises in one area such as poverty, often leads toproblems in others, such as education,experience of violence, crime or ill-health. However, children’s needs and vulnerabilities arenot only unique – or ‘specific’ – in the sense of being different from those of adults (e.g. due todependence and lack of legal majority), but alsodiverse and shifting as children mature and growolder. This time-specific, or ‘time-sensitive’, aspectof children’s vulnerabilities means that crises forindividual children need to be prevented,managed (in relation to the potentially multiplesources of risk and of support) and followed upthrough ongoing support and referral (Edström2007). So, children’s vulnerabilities and theirneeds for protection are both:imultidimensional – thus requiring cross-sectoral support; and iievolving and shifting – thus being ‘time-sensitive’ in terms of support.Individual children have different needs andpriorities at different ages and stages, asrecognised in UNICEF’s promotion of child-centred approaches, which are also  child- developmental . Senegal’s draft National Strategy for Child Protection (République du Sénégal2011) reflects well this multidimensional anddynamic understanding of children’s vulnerabilities. 2 Responding to these shiftingneeds over time requires an individual (but real-life contextualised) focus as well as an ability torapidly assess and respond to these in real time –that is, before it is ‘too late’ for any given child. Child protection calls for specifically protecting‘ the most  vulnerable’, and not merely ‘ most of  the vulnerable’ children. Many sectoral services(such as maternal and child health, socialprotection, education for all, etc.) can meet mostneeds of most children who are vulnerable, by simply doing their work in an inclusive(especially in terms of ‘vertical’ socioeconomicequity between the poor and better off) andchild-sensitive fashion. However, the children who are the most vulnerable are often precisely those who fall through the nets of even relatively good sectoral programmes. A key challenge for  equity and for eliminating exclusion problems insocial protection, education and health, as wellas for strengthening child protection, is that of   identifying such  individual  vulnerable children andmanaging their complex needs across a range of areas, or sectors, in an integrated fashion. 3 Child-sensitive universal services and protectionschemes must therefore also be complementedby child-specific management and monitoring inreal time (rather than simply issue-specific, suchas HIV- or violence-related). This requires ‘casemanagement’ across services by qualified andofficially mandated social workers and/or otherappropriate civil society actors, supported by effective referral systems across services, sectorsand over time (Roelen  et al. 2012). Early detection or identification of specific casesoften occurs in different sectors (in hospitals, inschools or by the police on the streets) orthrough different community level organisationsor processes. Hence, case management andreferrals need to interface between formal andinformal systems. Referrals and solutions areoften made at community level, but many children still ‘fall under the radar’ (including by leaving their community and migrating intourban areas) and effective protection requiresprofessional risk assessment, objectivity andconfidential management of cases. Even if many actors and institutions may beinvolved in these processes, ideally individualcases of children in need of protection should beoverseen, followed and managed by one identified,qualified and mandated professional (even if supervising others, e.g. volunteers, to make home visits, etc.). Due to its time-sensitive nature, as with addressing crises such as impacts of HIV orchild hunger, child protection can broadly bethought of in terms of ‘stages’, 4 such as: iPrevention and detection; iiManagement, monitoring and support; and iiiFollow-up and evaluation. Figure 1 interrelates the above, time-sensitiveand multidimensional vulnerability of children tothe idea of case management in child protection. Edström et al . Senegal’s Database System for Case Management for Child Protection: Web-based and Mobile Technology  70  1.2Methodology and limitations The Senegal study team involved an IDSResearch Fellow working in close collaboration with an external research consultant andUNICEF professional staff from Headquarters inNew York. The team aimed to evaluate theinitiative under four broad headings: (1) thequality of the information generated; (2) itsinclusivity in terms of reflecting the situation of all members of the targeted vulnerablepopulation; (3) the extent to which it meets thestated information needs of a range of potentialusers; and (4) the extent to which it is actually used for advocacy, operational activities or policy. A strategic combination of methods wereemployed, namely: literature review of documentation provided by UNICEF Senegal,tailored semi-structured interviews, withpurposively selected key informants, as well asfacilitated group discussion on particularquestions and broader debates in two workshops. Certain caveats and limitations remain in themethodology, nevertheless. First, thepositionalities of the team as ‘outsiders’ to theprogramme is a potential limitation, althoughmitigated by the team composition allowing fortriangulating perspectives and the interactiveand dialectical approach to the inquiry, whichprovided ample space for local inputs, includingan end-of-visit consultation and validation workshop, which was designed to directly andtransparently open the team’s preliminary findings and interpretations to validation andrevision. Another important limitation was thefact that the team had no direct access to the database itself (given the confidential nature of itscontents), although this was partially mitigatedby virtual demonstration by the private company Manobi, which had designed the system inSenegal. A related limitation was that of thedifficulty in accessing child ‘beneficiaries’ forboth practical and research ethical reasons.Instead the team met with adults affected by onecase. Finally, the timing of the visit – at a phase when the initiative is transitioning between apilot phase (phase one) and institutionalisation with local authorities and a broader range of partners – implied further challenges in terms of the system’s full functionality, discussed in detailbelow. On the other hand, the latter also provedto be an opportunity for maximising any utility of findings for stakeholders in Senegal. 2 Findings from the field 2.1Description of the initiative in Senegal UNICEF’s country office in Senegal initiated aprogramme that aims to support child victims of abuse and exploitation, or living in high-risksituations, to reintegrate them with theirfamilies and communities in three prefectures(two in/near Dakar; one in the South), and toprovide them with a protective environment in which to grow and develop. Within this larger IDS Bulletin Volume 44 Number2 March 201371 Internalisation, traumaand adaptive interactionsUpstreamdeterminants;threats andrisk factorsDownstreamimpactsReproduction ofvulnerabilities overtimeRehabilitation,follow-up andservice evaluationSupport, referralsand monitoringPrevention andearly detectionCase management forchild protection Responses in multiple sectors to support child protection effortsOutcomesfor child’swellbeingOnset of crisis for achild Child Context  Figure 1A case management response to child protection over time SourceAuthor’s own. Note: A similarversion also appears in Roelen et al. (2012).  programme, a pilot project was launched todevelop a case management system supported by a tailor-made database system. As this pilot wasin the process of transition, with some ninepartners engaged at the time of the study, theinitiative was limited in terms of scale; bothgeographically and in terms of absolute numbers.With some 300 cases said to be entered in thedatabase (duplication of cases and otherconcerns are discussed further below) and withlittle reliable information available on theoverall scale of children in need of protection inSenegal, little can be said about its overallcoverage. However, it is important to stress thatthis initiative is intended to help with respondingto actual cases identified and to be scaled up, which is also hoped to improve nationalcapacities to monitor scale and trends. The central strategy in this project has been thedevelopment of a database system with theoverall goal to support the case management,monitoring and reintegration process of separated children, children living in high-risksituations, as well as child victims of violenceand/or exploitation. The two stated key objectives of the database system are: ito improve partner coordination andefficient management of the process of reintegrating and monitoring of vulnerablechildren in their families of srcin; and iito speed up and make more efficient thecase management process throughout thedifferent steps of care and protection of children [who are] victims of violence,exploitation or at high-risk. (UNICEF n.d.)The initiative was developed to enable a range of social workers (including civil society actors with varying levels of training) to better meet theneeds of highly vulnerable and at risk childrenthrough the use of a tailored database on theinternet. This was to be supported by mobilephones and PDA handsets for gathering, enteringand transmitting data about specific children atrisk or highly vulnerable and, thus, in need of protection. An interagency child protection datamanagement system was developed with Manobias a tool for case management and referral, tofacilitate the provision of child protection andfamily reintegration services. The intention isthat organisations and services linked to the datasystem are able to share common referralpathways – with clearly defined policies,procedures and levels of access to data – in orderto enable appropriate information sharing,coordination and collaborative case management. The platform was being used primarily by locallevel partners in contact with individual children(e.g. NGOs and some decentralisedgovernmental services), although the intention isto achieve integration and users at more centraland aggregate levels over time. The databasesystem (with its related mobile devices) containsinformation on vulnerable children, the servicesoffered by NGOs and service providers, andcurrent guidelines for practice along the referralpathways. It is designed to facilitate severalaspects of the partners’ work, such as: theidentification and monitoring of vulnerablechildren and those at risk; registering them withthe civil registration systems; monitoring thereintegration process to sustain positiveoutcomes; and mapping, or locating, community resources and social actors who provide relevantservices for child protection. Data on vulnerable children are collected andthen entered on a web-based database, with atailored software application jointly developed by UNICEF and Manobi, the Senegalese serviceoperator. This web-based database allows foruploading child and family assessment forms, as well as more basic initial information on a case.The system was designed with functionalities formobile phones (rapid SMS for alerting andreporting on cases) and smartphones (PDAs) forfield-level data entry and access, which worked inphase one. Functionality with access and data-sharing on cases has encountered somelimitations in terms of file-synchronisation andas a result of increased limitations on data-sharing in the current transition phase (exploredfurther below). 2.2Information management The main users of the database system areNGOs involved in the provision of childprotection services at community levels, as wellas local government services concerned withchild protection. At the time of the study UNICEF oversaw the initiative with Manobi, which was contracted to design, amend and hostthe system, as well as to provide technicalsupport to partners in its use. The oversight andcentral management of the database was Edström et al . Senegal’s Database System for Case Management for Child Protection: Web-based and Mobile Technology  72
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