08 November 2022
From curiosity to confidence
An independent evaluation of the Initiative has captured its impact on health policy implementation by frontline workers. The training of government officials and the staff of implementing partners has, for example, generated noticeable behaviour change in health service providers and the way in which they deliver services.  Importantly, it has also helped public health workers to develop more effective ways to cope with their own stress.  Feedback from pre- and post-training assessments has confirmed that knowledge has improved.  Services have been mapped out across the five countries, Standard Operating Procedures (SOPs) have been improved, and referral services that connect children and their caregivers to specialized health care have been enhanced.  ;  With support from the Initiative, public health officials interacted (often for the first time) with cultural mediators, resulting in greater appreciation for their vital work. The Initiative has also increased health professionals’ understanding of the importance of immunization and treatment of mental health issues, as well as raising awareness and understanding of substance abuse among children and adolescents.  ;  National partners now have greater capacity on key issues. In Bosnia and Herzegovina, for example, the International Organization for Migration now follows UNICEF’s protocol on the provision of baby formula milk.  In Italy, UNICEF was able to enhance the capacity of partners on Protection Against Sexual Exploitation and Abuse (PSEA)  and disseminate indicators, tools and protocols to inform work with unaccompanied and separated children, which has strengthened the capacity of frontline staff to work with these children.  The Project also helped to increase the knowledge of public health institutions. In Bosnia and Herzegovina, cantonal health institutes are now better informed on refugee and migrant health conditions.  Targets for this aspect of the ‘RM Child-Health Initiative’ have often been exceeded. In Bulgaria, for example, the Initiative aimed to ensure that 30 health authorities, service providers and other frontline workers (disaggregated by authority) completed UNICEF-supported training on health issues for refugee and migrant children and international best practice. In all, 170 completed this training – more than five times the original target. In Serbia, around twice as many professionals were reached as originally intended, with workshops reaching a wide range of professionals, including educators, trainers, guardians from centres for social work, Commissariat staff, and frontline health staff such as doctors and psychologists.  This training is continuing to reach staff, even though the Initiative itself has come to an end. Training was delivered in a way that was relevant to participants and responsive to their needs. In Greece, for example, the starting point for the training was the existing knowledge and experience of participants, aiming to build their sense of ownership and engagement, and the training built on an assessment of their training needs. The communities participating in the training were also consulted to assess what kind of support to prioritize. This process revealed challenging areas that needed to be added to the training: working with vulnerable children; professional stress and burnout; and the importance of cross-sectoral cooperation. The training was also flexible, incorporating a module on how to deliver training online during the COVID-19 pandemic. In Lesvos, Greece, the needs assessment for the training found that kits for mothers contained breastmilk substitutes. A set of training materials was produced for a wide range of participants, including staff from non-governmental organizations, the state-run health provider and site management organizations as well as volunteers in the camps and other professional in Lesvos, such as teachers. These materials included a ‘truth or myth’ game for use with pregnant or lactating women. The training created a new network of people who have kept in touch, with some asking for more information on how to deal with specific cases. Implementing partners have noticed that training participants have started to collaborate in the camps, with midwives and volunteers, for example, working together. In one camp, there have been no requests for breastmilk substitutes since this initiative.