Category: News

Adapting competence development to multicultural healthcare teams: a qualitative study of the International Caregiver Development Programme (ICDP) in nursing homes

Link to the journal with published article

Link to read more about this study

Abstract

Background

Enhancing holistic, biopsychosocial and person-centred care for older persons depends on developing competence in psychosocial care. To decrease the theory-practice-gap in person-centred care, there is a need for research to investigate adaptions of competence development within person-centred care that enables knowledge integration and reflexivity to practice. More research is needed on competence development in person-centred care that is tailored to the nursing home context.

Methods

This study aimed to explore how group leaders in International Caregiver Development Programme (ICDP) facilitated competence development within psychosocial care for multicultural healthcare teams in nursing homes. The qualitative design included five participatory observation sessions during the supervision of ICDP group leaders, one focus group interview conducted after the completion of ICDP, and the group leaders’ written logs and reflections from the ICDP group meetings. The data were analysed using thematic analysis.

Results

Three main themes were developed from the analysis:1) Creating the right atmosphere, consisting of (a) creating safety for openness, (b) highlighting mastery in practice and (c) helping ICDP participants to be mentally attuned; 2) Making the ICDP understandable, encompassing (a) transitioning to a reflective mode and (b) adapting the language level; and 3) Creating an inclusive and active learning environment, with (a) facilitating collective participation and (b) supporting the groups’ engagement as subthemes.

Conclusions

Study findings suggest that interventions for psychosocial competence development require adjustments based on healthcare workers’ need for security, a sense of mastery, present-moment awareness, reflection on practice, appropriate language level, commitment and motivation. Such adaptations may be crucial for healthcare workers’ ability to integrate knowledge, reflexivity and sensitivity into person-centred practice. ICDP appears to be flexible and adaptable to a nursing context. Further research is needed on the ICDP in relation to professional confidence, sick leave and sustainability.

New assessment of the evidence level for ICDP gives a score of 4 out of 5 possible, and it is classified as having satisfactory documentation of effectiveness.

Through the International Child Development Programme (ICDP), parents can receive support in their caregiving role. The measure is considered to have satisfactory documentation of its effect in the latest knowledge summary in Ungsinn magazine. 

Link to the evaluation

Summary

Background:  This article is a knowledge summary on the effects of the International Child Development Programme (ICDP) initiative in Norway. The article is a revision of two previous descriptions of the same initiative in Ungsinn (Reedtz, 2014; Reedtz & Lauritzen, 2017). ICDP is a parent guidance program that seeks to support children’s psychosocial development by strengthening caregivers’ competence in their caregiving for children. The initiative is a low-threshold, time-limited and structured guidance initiative for caregivers of children aged 0–18 years and was developed by Karsten Hundeide and Henning Rye. The initiative owner in Norway is Bufdir and ICDP Norway. ICDP is implemented in arenas in the families’ local environment and in prison if the caregiver(s) is incarcerated.

Method: This knowledge summary is based on a systematic literature search in the databases Embase, Medline, PsycINFO, Norart, Cochrane, Cristin, Nora, Scopus and Swemed. Five articles based on partly the same sample met the inclusion criteria.

Results: The results include a summary of the description of the intervention, included effect studies, research methodological quality and implementation quality. The ICDP’s objectives, intervention arenas, design and methods are described. A total of six studies were included in this knowledge summary. Overall, there was no effect for most outcome variables that were measured across the included studies. For all positive findings, the effects of the intervention in the studies were consistently small. However, the results of the last study document that the parents’ perceived coping and regulation of the child’s emotions were strengthened after the intervention was implemented. The intervention has good routines for quality assurance of the implementation and a comprehensive strategy for spreading the intervention.

Conclusion: Based on Ungsinn’s criteria, ICDP is classified at evidence level 4 – Measures with satisfactory documentation of effect.

Link to the article

 

Read the English translation here and the original report in French here.

Taken from the report below are some of the testimonials from caregivers and facilitators:

“The ICDP program allowed me to listen to the children because before the training I didn’t listen to my children. The training has allowed me to devote time to my children, something I did not do before this training. I talk better with my children after this training.”

” This program allowed me to review my behavior with children, it led me to no longer judge children, but to try to understand the other in his or her vocations, empathy.”

“A wonderful experience, another knowledge acquired and the satisfaction of helping parents to take better care of their children and finally the satisfaction of contributing to the construction of a healthier, educated and less violent society.”

“I have acquired knowledge, skills, and attitudes that allow me to strengthen my relationships with my nephews and nieces, my Sunday School children, and children in general. I also learned skills to train parents on the ICDP approach.”

“Showing your love to the child and the child seeing that you put yourself on the same level is something extraordinary for them. These have been experiences extraordinary for them in terms of knowledge and educational practice for children.”

“Improvement of parents’ view of their children’s faults, improvement of relationships with children, change of children’s behavior in a gentle way.”

“The project has brought a big change in the relationship between parents and children and this has improved exchanges and communication between parent and child. So a positive impact on the lives of the families of caregivers.”

“This program has allowed caregivers to take ownership of the program’s themes and to put them into practice wherever they are. It also allowed them to better understand how to educate children, have good communication with children.”

“Several parents who had a sense of anger at children’s shortcomings felt liberated after the children’s redefinition and felt more willing to support children and accept their individuality.”

“We have a caregiver who has a 9-year-old daughter who was interested in cooking but she refused to let her do it; after the training she started cooking with her and today her daughter can cook and knows how to cook a lot of dishes.”

During the past year over 500 people received ICDP training by the Danish ICDP Centre. The participants represent a diversity of professionals, both in the educational and health sectors – Dansk Center for ICDP – http://danskcenterfor-icdp.dk/

Read their about the many and diverse activities of the Danish centre in their Annual report 2025. A few snippets taken from that report:

We developed a lot of new materials, and in 2026, we our focus will be on the dissemination and implementation of these new initiatives – both internally and externally. We continue to work to position ourselves in the education market in Denmark.

It is with great pleasure and pride that we can present this year’s 4 new trainers. Together, they have taught 60 professionals in the ICDP programme. The 4 new trainers are fantastic ambassadors for the ICDP programme.

Psychologists Nete Rysgård and Maja Line Volden (on photo above) are new certified ICDP trainers – and therefore they were celebrated with brunch and flowers. Nete and Maja have trained pedagogical staff, including childminders from Odense Municipality, in ICDP at level 1 with great professionalism and good humour. The evaluations among the participants show that they felt strengthened in their pedagogical core professionalism – and as a side benefit, increased job satisfaction.

Daycare center manager Tina Maria Dalgård Sommer and Pedagogical Consultant Anne Moos have completed their ICDP trainer training in the day leading up to Christmas. Tina teaches her employees in ICDP and will subsequently be responsible for teaching the organization’s employees internally.

Anne Moos is trained by another provider but is now dedicated as a treasured ICDP trainer in the Danish Center for ICDP. She has been employed as an internal ICDP trainer and supervisor in Tønder Municipality.

Psychologist in Odense municipality, Helene Helskov, has been trained as an ICDP master-trainee at level 4. During the spring of 2025, Helene has with great skill and good humor, taught a bunch of committed daycare educators and educators from the daycare area at level 2, so that they are now certified in the art of providing relationship-based guidance. Helene uses her professional background in psychology to create a learning space with a high professional quality.

Network for trainers: All our approx. 40 certified trainees we meet face to face once a year. Where there is a focus on professional upskilling and networking. In addition, the trainees are divided into professional networks. In these networks, they meet regularly online and discuss professional issues and challenges.

Webinats: There has been a lot of interest in the registrations for our free webinar that we regularly hold.

1.The resilience framework and ICDP by associate professor and ICDP trainer Ida Skytte Jakobsen.

2.Relationship-based conflict Work by ICDP trainer Ugur Kevioglu

3.Empathy in Kindergarten by ICDP-Consultant Elise Linder

4.Quality improvement in daycare by Centre manager Anne Linder and ICDP trainer Sebastian Damkjær-Ohlsen

5. Supervision and inspection of the relational environment in Daycare by ICDP trainer Sebastian Damkjær-Ohlsen

News in 2026:

• In 2026, Elise Linder will take over as Center Director and Head of Professional Development for the Danish Center for ICDP. She replaces Anne Linder, who has chosen to enjoy her retirement with very reduced working hours.
• In the coming year, we plan to start a small development project with the aim of using ICDP as a pedagogical mindset for people working in the voluntary sector.
• Collaboration with The house of Song, a national institution that works to spread song among the Danish population. We intend to publish a joint material with a focus on singing and ICDP for the very youngest.
• We are planning a national ICDP conference in Southern Jutland together with Tønder municipality and the publisher Dafolo.

 

THE CHILD GRANT PLUS ICDP BASED PARENTING PROGRAMME IN NEPAL
ECONOMIC EVALUATION AND COST OF FUTURE SCALE UP
October 2025

Authors: This report was prepared by Camilla Nystrand and Jan Klavus.
Other contributors: Hemanta Dangal, Anita Tamang and Disa Sjoblom.

Link to the study: https://resourcecentre.savethechildren.net/pdf/Child_Grant_Plus-Parenting_Nepal_Economic_Evaluation_9_Dec_2025.pdf

Summary
Background: The Child Grant Plus Parenting Programme (CG Plus) is a Save the Children initiative designed to augment the impact of the Nepal government’s Child Grant cash transfer programme for children under five years, introduced in 2009. CG Plus is implemented with parents who receive the cash transfer and aims to strengthen children’s socio-emotional, cognitive, language and motor development while also improving child nutrition practices and household financial management.

Objective: Previous impact evaluations suggest that, compared with the Child Grant alone, CG Plus may lead to substantially greater improvements in child development outcomes. This study aimed to assess the economic impact of CG Plus in terms of its short- and long-term cost-effectiveness, based on the programme’s 2022–2024 impact evaluation. In addition, the study examined the implementation costs of scaling up CG Plus across Nepal.

Methods: Impact evaluation data were collected at three time points: pre-intervention (baseline), mid-term (one year post-baseline), and post-intervention (two years post-baseline). At baseline, 962 parents participated in the study. The short-term cost-effectiveness of CG Plus, compared with the Child Grant only, was assessed as the additional cost required for a one-unit improvement in child development outcomes. For the long-term evaluation, a cost–benefit analysis was conducted to compare the additional costs and benefits of the parenting programme. The main analyses focused on three key outcomes: (1) average net benefits, (2) benefit-cost ratio and (3) cost-effectiveness multiplier.

Results: The short-term evaluation compared the direct effects of the intervention, measured as child development outcomes, to the cost of implementing the intervention. The analysis indicated that additional (intervention) costs of about NPR 6 800 (US$ 48) generated one additional unit on the z-score scale, reflecting the improvement achieved in child development. For the long-term analysis, data from the impact evaluation and national statistics were used to project the potential cost–benefit of CG Plus in terms of human capital development. The average cost per child in the CG Plus was approximately NPR 12 000 (US$ 94). Relative to these costs, the programme was estimated to yield, on average, three additional years of schooling. Over a lifetime, children benefiting from the CG Plus were projected to experience a 7% increase in lifetime earnings. When comparing the intervention and additional schooling costs with the benefits generated of increased earnings, the results suggested a return of roughly US$ 12 to every US$ 1 invested. A cost-effectiveness multiplier analysis further indicated that the Government of Nepal would need to spend an additional NPR 30 000 per child on the Child Grant to achieve the same impact generated by NPR 12 000 invested in CG Plus. In terms of implementation costs, running the CG Plus for three consecutive years cost only one-fifth of the amount required for the Child Grant cash transfer programme. Scaling the intervention to the Madhesh province level was estimated to cost approximately NPR 1 350 (US$ 10) per child.

Conclusions: The economic evaluation of the CG Plus programme provides strong evidence of favourable impacts on both human and economic capital in the short and long term. Even under conservative assumptions—where bserved effects are halved—CG Plus remains a highly costeffective investment compared with the Child Grant alone.

The evaluation of the Child Grant Plus Parenting Programme in Nepal was completed and published in 2025, with very encouraging results.

Link to the study:
https://resourcecentre.savethechildren.net/document/final-evaluation-of-the-child-grant-plus-parenting-programme-in-nepal-2025

Abstract:

The Child Grant Plus (CGPLUS) Parenting Programme is an innovative addition that builds on the success of the national government’s Child Grant cash transfer program in Nepal. By combining Save the Children’s expertise in implementing intensive parenting support, the CGPLUS program was designed to empower parents and caregivers with the skills enabling them to transform everyday moments into opportunities for learning, social-emotional development, and improvements in their wellbeing.

The framework used in the CGPLUS program built on lessons learned form the International Child Development Programme (ICDP) framework. Specific activities guided participating parents through group sessions, home visits, and follow-up support. The goals of the program were to foster nurturing caregiver-child relationships, the use of positive discipline strategies, and improve child nutrition and feeding practices. Animated videos, interactive voice messages, and game-based “brain-building” modules reinforced key lessons between sessions—helping families sustain change far beyond the training room.

Study Overview
This evaluation, conducted across three rounds of data collection between 2022 and 2025, used a quasi-experimental difference-in-differences design to estimate the impact of the CGPLUS programme on a range of caregiver and child outcomes. The study compared results in seven intervention municipalities with six matched comparison municipalities in both rural and urban areas of Madhesh and Karnali provinces. The study followed more than 900 caregiver–child pairs to measure changes in parenting attitudes, behaviors, child feeding and nutrition, and early childhood development outcomes.

Methodology
Data were analyzed using a rigorous difference-in-differences approach, controlling for household, caregiver, and community characteristics. Instruments included the Early Parenting and Attitudes Questionnaire (EPAQ), WHO infant and young child feeding indicators, and the Caregiver-Reported Early Development Instruments (CREDI) for developmental outcomes.

Results
The CGPLUS programme was found to have strong, positive results that were both statistically and practically significant across several types of outcomes.

1. Stronger Parenting Attitudes, Behaviors, and Engagement with Children
CGPLUS achieved major success in improving parenting quality. Caregivers in the intervention group demonstrated impressive gains in warmth, affection, and attitudes towards early learning. By endline, nearly every parent in CGPLUS endorsed positive attachment and stimulation behaviors.

Parents benefiting from the CGPLUS programme also reported substantially higher levels of engagement and stimulating activities. Parents in the intervention group reported higher levels of playing with their child, storytelling, and teaching activities, and nearly all positive behaviors were stronger in the intervention group The programme also appears to have had a meaningful impact on parental use of discipline—parents in the intervention group reported lower levels of psychological aggression, and neglect, and marked improvements in their use of positive discipline.

2. Improved Use of Feeding Practices and Evidence of Improved Nutrition
Parents in the CGPLUS intervention reported improved usage of positive infant and child feeding practices, resulting in children benefiting from improved dietary diversity and meal frequency. Indicators related to overall nutritional status remained below international reference averages for children in both intervention and comparison groups. Intervention children were less likely to be stunted or underweight, suggesting that the behaviors and attitude changes encouraged by the CGPLUS programme translated into real changes in child nutrition and growth.

3. Remarkable Developmental Gains
Perhaps the most striking finding was in child development. By endline, CGPLUS children scored more than one full standard deviation higher on overall developmental measures compared to their peers—an exceptional effect size for education and early childhood interventions. The largest improvements were seen in cognitive and social-emotional domains, suggesting that consistent caregiver interaction and play translated into real developmental progress.

Conclusion
The overall finding of the evaluation is that the program was effective at nearly each one of its goals. These impressive findings are likely driven by a very intensive approach to intervention with close monitoring and support for caregivers. Future work should look to build on the success of the program and explore the viability and efficacy of scalability when intensive interventions are not practical.

The ICDP Newsletter with the overview of some of our partners’ projects is available to read.

Photo above shows the trainee facilitators

Update by Adam Nyundo

December 2025

Save the Children Zambia through its Child Sensitive Social Protection project (CSSP) promotes child sensitive social protection using the “cash plus” parenting model to help improve parenting practices and prioritize the rights of children to education, nutrition, and protection. The CSSP “parenting package” comprises of a series of parenting (ICDP eight guidelines of good interactions) and thematic (Importance of education, risk of child labour, nutrition, family budgeting and gender transformation) sessions. The project is leveraging on the Social Cash Transfer programme run by the government of Zambia.

The CSSP parenting sessions are based on the International Child Development Programme (ICDP) principles but contextualized to the local situation. The parenting package aims at improving understanding among parents and caregivers of the positive qualities of care that should and could exist between parents and the child, increased sense of caregiver self-confidence and a better understanding and reaction towards children’s point of view and intentions. The programme also aims at ensuring that child-to-child and child-to-caregiver relations are more positive and differentiated.

Under this package, trained parenting facilitators have been responsible for conducting parenting sessions for households in Kalulushi and Lufwanyama District. A total of 1066 caregivers, representing 1056 households, under the Social Cash Transfer programme were reached.

To ensure sustainability of the CSSP parenting sessions, in 2025, the project trained 22 (6M/16F) staff from the Ministry of Community Development and Social Services from the province as well as the two Districts of Lufwanyama and Kalulushi in the Copperbelt province. This is in addition to the 8 (2M/6F) MCDSS staff who were trained in 2021. The 22 facilitators trainees are currently working with caregivers as partial fulfilment of the award of the facilitator certificate.

Photo above from Lutheran Child & Family Services (LCFS-Illinois)

USA – Newsletter Nov/Dec 2025

In 2025, ICDP-USA, founded within the Changing Children’s Worlds Foundation (CCWF), completed its transition into two parallel entities: 

1). ICDP-USA founder and trainer Kimberly Svevo, Ph.D (on photo above), will continue to advance ICDP-USA with new partners and communities as of October 2025.  She will continue to partner and train new “ICDP-Best Start for Families” facilitators to implement and expand community-based ICDP parenting programme support.  She will also partner with and train new “Best Start-All About YOUth” coaches to implement programming for children and youth.  Finally, she will partner with community leaders to offer the ICDP-USA based “ACE Interface: Transforming from Trauma to Resilience & Hope” training, offered to over 100 professionals/community leaders statewide in 2025.   Recently Kimberly represented ICDP-USA in the November and December ICDP-International training conversations, attended by many ICDP programme leaders from around the world.  The topic focus was on the Regulative dialogue, and the conversation and sharing of experiences were rich, informative and inspiring.

2). Lutheran Child & Family Services (LCFS-Illinois) will continue to implement a state-wide strategy to offer the “ICDP-Best Start for Families” as their commitment to increase the number of families served within the Illinois child welfare system.  They will also implement “Best Start-All About YOUth” programming through schools and with foster youth.  In 2024-25, the LCFS Best Start for Families Dept., led by Kimberly Svevo and Rachel Fuentes, trained new professional resource persons state-wide, partly funded by a significant federal grant through the Department of Child and Family Services.  The Best Start for Families Dept. offers ICDP through a range of weekly group services for caregivers, youth and children, and also including individual parent coaching for parents with deeper struggles.  The Best Start for Families (BSFF) Department also provides the All About YOUth  (AAY) Programme for middle school students through the Aurora School District. 

Feedback from caregivers continues to reflect their wonderment in the change of the quality of confidence and joy they find in parenting.

Youth are an important focus for ICDP-USA, and we are exploring exciting new opportunities for 2026!

The need to combine the benefits of supporting caregivers, and their children / youth, are just beginning to be understood.  We hope this continues with all our ICDP partners!

STATISTICS ICDP-USA Overall July 2012- July 2025: 

3,000+          Caregivers Served 

10,000+        Children Supported directly and through Caregivers and Facilitators

825               ICDP-USA Best Start Parenting Programme Facilitators trained

75                 ICDP-USA Best Start for Youth Programme Coaches trained

250               ACE Interface Training Workshop – professional and community leaders

Final note, the ICDP-USA best practice community model consists of an integrated approach.  This occurs when we combine:

1a) Train Professionals/Community Leaders as Parenting Programme Facilitators

1b) Implement Parenting Programmes for Birth & Foster Parents/Extended Families (and coaching where helpful)

1c) Offer Children’s Social/Emotional programming in parallel or through parents at home for children 3-15 years.

2a) Train Youth Coaches/Mentors of All About YOUth Programmes

2b) Implement All About YOUth Programs for Youth (12-21 years)

3)  Provide ACE Interface Training for broad communities of professionals and community leaders.

ICDP principles were implemented in several significant projects for parents carried out in the Antioquia region of Colombia. Recognizing that empathic human care promoted by the ICDP programme is essential for good quality care, the programme was applied once more, but this time it was in the Envigado homes for the elderly.

During 2025, in the municipality of Envigado, Antioquia, Carolina Montoya Montoya and Lucy Osorio Mejía, from the ICDP Colombia team, developed a training and research project for caregivers of older people.

The project strengthened the caring skills of caregivers, professionals, family members, and others who support this population. Caregivers of older adults are facing increasingly greater challenges in their daily work in both family and institutional settings. The purpose was to foster positive, humane and transformative interactions between carers and older people. Comments from some of the participants:

I think these are fundamental issues to address today; there are so many older people.

I really value personal growth I experienced here. We feflect and become aware of our role as caregivers.

The knowledge acquired allows me to communitcate better with the older people I work with.

I learned to empathise with older people.

The team coordinated the ICDP work with the Social Welfare Secretariat of the Mayor’s Office of Envigado. In total, 130 caregivers of older people were trained in the principles of ICDP.

The ICDP booklet for parents was adapted and the pilot project tested the adapted version, leading to the validation, enrichment and adjustment of the booklet called: “Guide for a good interaction that dignifies the Elderly Person”.

With great enthusiasm, Carolina and Lucy prepared this booklet, as a product of this pilot project. The booklet contributes to the care of vulnerable older adults who need loving adults to teach them essential skill.

The booklet is now in its final stages of publication for distribution and sharing with other regions and countries interested in implementing similar initiatives. It is an opportunity to promote collaboration with ICDP teams in different countries around the world that share the same goal: recognizing the value of aging with dignity, respect, and tenderness.

Report by Carolina Montoya Montoya