Evaluating the longer-term mental health, developmental and systems impact of Child Friendly Spaces in humanitarian emergencies

Grant awarded: £323,309

Lead organisation: World Vision International

Partnering organisations: Columbia University, Columbia University Middle East Research Center (CUMERC), Save the Children, Makerere University, Unicef, Plan International

Project length: April 2014–December 2016 (COMPLETE)

Study locations: Uganda; Jordan; Asia-Pacific Region

Principal Investigator: Kevin Savage, World Vision International


The overall objective of this research was to improve outcomes for children in humanitarian crises by strengthening the evidence base on the impact of Child Friendly Space interventions (CFS). Although CFS are already widely used, it is acknowledged that there is very little evidence to support their use. Research into CFS has therefore been identified as a matter of high priority. If significant lasting impact is found, there may be a case for increasing their widespread use in the immediate stages of a crisis.

Progress and outcomes achieved:

The research successfully documented the longer-term outcomes and impacts of CFS in three locations – Uganda (Congolese refugees), Jordan (Syrian refugees), and Nepal (earthquake affected people). These longitudinal studies examined the trajectory of children’s mental health, well-being, protection and development as well as the sustained impact of CFS on strengthening formal and informal systems essential for children’s support and protection. Over 800 children and 400 caregivers were interviewed at baseline, endline and follow-up.

Key findings:

The study results imply that CFS can be an effective intervention, but the extent that is so depends significantly on contextual factors including the quality of programming. Innovation in how CFS is delivered is required for its impact to be sustained.

The short-term impacts of CFS programmes were often found to be more utilized by and more impactful for younger children (6-12 years), but less so for older children (13-16 years). The measured effect of CFS on caregivers’ stress, sense of protection for their children and awareness of support structures for their protection were mixed depending on study location. Indications of impact in these domains were identified in Uganda and Nepal, but there was little evidence in Jordan that CFS had an impact in reducing either perceived protection concerns or caregiver stresses.

All three studies indicated that most of the short-term effects attributable to CFS attendance dissipated in the longer-term. However, there was some evidence that attending CFS did insulate children from the impacts of worsening settlement conditions in Uganda.  In Nepal as well as Uganda, there was some evidence to suggest that CFS strengthened awareness of community-based mechanisms which assist in the protection of children, although significant barriers remained including the building of trust amongst children and ensuring access to key services.

 Key outputs:

  • Toolkit for monitoring and evaluating CFS produced (funded separately), along with 11 video clips and a video explanation of the Nepal research to explain key sections of the documents and give practical examples and advice
  • Policy synthesis briefing produced
  • Presentation of the research findings at the IASC Interagency MHPSS Reference Group; annual meeting of the Alliance for Child Protection in Humanitarian Action; amongst others
  • Each of the three studies (in Uganda, Jordan and Nepal) has been written up for peer-reviewed academic papers – publication pending
  • In-depth lessons learned, practical guidance and tools from the evaluation are available in a companion document which was prepared by the research team in close partnership with Save the Children. It is titled ‘Tools and guidance for monitoring and evaluating CFS’ and can be downloaded at this link.

Next steps:

World Vision International will continue to work with the IASC Interagency MHPSS Reference Group, the Alliance for Child Protection in Humanitarian Action and others to share the findings from this project. World Vision plans to adapt CFS interventions and test  its effectiveness through a further RCT.


Elrha is a registered charity in England and Wales (1177110).

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