TDH - Terre des hommes

Improved children psychosocial wellbeing

Indicator ID R&E1
Indicator full statement

% girls and boys targeted by Tdh and partners interventions who report an improvement in their psychosocial well-being, in particular their sense of safety, and connectedness. 

Purpose

This indicator measures the effectiveness of interventions in enhancing the psychosocial well-being of children, specifically their sense of safety and connectedness from the perspective of children and young people themselves, also giving an indication of the quality of the intervention. In addition, this indicator provides insights into existing MHPSS needs, and provides an analysis of Tdh’s action according to different ages, genders, regions or types of activities.

Definition

  • Girls and boys, children and youths: children (6-12 years), adolescents (13-17 years) and/or young adults (18-25 years old). In some cases, it may include infants (children - 3-5 years) if tools are available to work with this age group.

  • "Intervention”: structured or semi structured MHPSS activity[1] across Tdh programme (A2J, Migration, Health) or other projects, as focused intervention or mainstreamed and across the IASC MHPSS pyramid.

  • MHPSS interventions: specific activities to reduce distress and suffering, to increase coping mechanisms, prevent mental health deterioration and improve well-being of children and their families.

  • Who report an improvement: subjective information collected from children and youth directly (reflective assessment or comparison b/ what is reported before and after an intervention (see further in the table proposed methodologies to capture “improvement”).

  • Psychosocial well-being: As described in Tdh operational guidance on MHPSS, Tdh adopts a holistic understanding of Mental health and psychosocial well-being, including physical, emotional, social, political, economic, cultural and spiritual dimensions, structured under the 5 well-being pillars and applicable to individual, family and community spheres 1). Safety, security, stability; 2). Bonds and networks; 3). Roles and identities; 4). Justice and rights; 5). Hope and meaning.

[1] Structured interventions refer to a cycle based activity, based on specific curricula (organized by thematic, capacities to be strengthened). It is generally targeting vulnerable children and youths. Groups are “closed”; same children and youths should attend the whole cycle / curricula.

Non structured interventions refer to activities that are not limited in time or linked to a specific number of sessions. Groups are “ open” (children can be different from one session to the other).

How to collect & analyse the data

What do we count?

Girls and boys involved in Tdh (Terre des hommes) interventions or partner interventions (surveyed)
How to calculate the indicator's value

The % is calculated as follows :

  • Numerator (N): The number of girls and boys involved in Tdh (Terre des hommes) interventions or partner interventions who report an improvement in at least two of the well-being pillars: safety and connectedness, within a defined time period among those participating in the assessment exercise.

  • Denominator (D): The total number of girls and boys involved in Tdh or Tdh partners' MHPSS interventions in the same geographic area and reference period, participating in the assessment.

To determine if a child report improved well-being for inclusion in the numerator, consider the following:

  • Identify Main Needs and MHPSS Areas:

    • Assess the status at the beginning of the intervention and define expected changes.

  • Define a Threshold for Improvement:

    • Establish a limit or threshold to declare an improvement. See for example“Tdh well-being data collection toolkits » which includes scoring modalities  for each question

    • As interventions are context -dependent, collaborate with MHPSS specialists and the MEAL (Monitoring, Evaluation, Accountability, and Learning) team to agree on criteria for including a child as an “improved case.”

    • If including a final assessment session is not feasible, consider these options, Work with a representative sample of the group.
Data sources

Data is collected from children themselves.
Data collection methods and tools

  • Data is collected through individual interview or self-adminstrated questionnaire

  • Notes

    • For each Mental Health and Psychosocial Support (MHPSS) intervention, include a pre-post or post-reflective session appropriate to the intervention type.

    • If using specific interventions (e.g., PM+, EASE, BLOOM), refer to validated assessment methodologies for those interventions.

    • For custom curricula, develop an assessment session or use an agreed tool (e.g., Strengths and Difficulties Questionnaire - SDQ) in consultation with the coordination structure.

    • Use Tdh-developed M&E tools for specific methodologies (e.g., Ride On, MoE, S4P).

    • If including a final assessment session is not feasible, consider working with a representative sample of the group. Follow guidance on:
Example of survey questions

  • Utilize a data collection toolkit for MHPSS, which includes a bank of questions that can be contextualized according to the intervention's nature and target audience.

  • Possible tools and questionnaires:
Disaggregation

Gender and Age
Important considerations

Self-developped data collection tools must be reviewed and approved by the Regional Advisor or a technical MHPSS and M&E specialist at Tdh.

Limitations and precautions

Risks:

  1. Risk of Bias and Other Issues Related to Quality:

    • The risk of bias in administering questionnaires to children is high due to social desirability. Children may respond in ways they believe will please project staff or align with expected positive outcomes, which can skew results.

    • Standalone monitoring and evaluation (M&E) of subjective well-being can be biased and ethically questionable due to factors such as power imbalances and lack of trust if conducted by enumerators.

    • Data collection tools that generate fatigue, are intrusive, or judgmental can negatively impact the quality of responses.  The tool should fit the context and the public.  Please use open ended questions and prompts to allow the child to give you free narrative.  

  2. Risk of Causing Harm:

    • Measuring this indicator must not cause harm to the child. Procedures must ensure that the process is non-intrusive and developmentally appropriate.

    • Asking inappropriate questions in relation to the child's age, culture, or gender can lead to discomfort or distress.

    • There is a risk of disconnection between the MHPSS activities and the expected results, potentially leading to misunderstandings or misinterpretations of the child's well-being.

Precautions :

  1. Staff with Competencies:

    • Data collection should be conducted by staff with psychosocial skills and the ability to communicate effectively with children. This includes establishing a trusting relationship, especially with younger children. It is recommended that project staff (e.g., social workers, facilitators, volunteers) conduct the assessments instead of M&E or enumerators.

  2. Embedding the Measurement in MHPSS Curricula:

    • Well-being measurement should be systematically embedded in the MHPSS intervention curriculum, ideally during dedicated sessions. This can occur at the beginning and end of the program or only at the end, using recall-reflective methods.

  3. Not Measuring for Recreational Activities:

    • The indicator should not be measured for recreational activities where children’s attendance is inconsistent, as this could lead to unreliable data.

  4. Contextualisation :

    • The approach to defining well-being should consider the cultural context, age, gender, and developmental stage of the children. The role of community based MHPSS is to support resources for individuals and families without disrupting cultural beliefs and practices.

  5. Informed Consent, Supervision, Ethical Protocol:

    • Informed consent from the child’s caregiver is mandatory, ensuring it is given voluntarily and is renegotiable. A robust reporting and follow-up mechanism must be in place to address any concerns. Procedures should ensure confidentiality of the child's information.

  6. Age Considerations:

    • It is crucial to be clear about the appropriate minimum age for interviewing children. Consideration must be given to their emotional and cognitive capacity at different ages. For children below 6 (six) years of age, parental involvement in assessing the child's progress is recommended.

What further analysis are we interested in?

Analysis can be centered around 3 main types of changes:

  • Knowledge and skills (for example about risks, existing services or communication abilities).

  • Attitudes, perceptions, and feelings (such as trust towards peers, feelings about role in the community, feeling of belonging).

  • Behavior (such as engagement in projects, social activity).

Note: with this indicator we quantify subjective types of change and must be cautious with the interpretation.  Numbers might give a distorted view of reality, and the analysis process requires triangulation with data collected through open questions and qualitative data collection techniques will be key to enrich our understanding of what happens.

Here below are some guiding questions to guide analysis:

  • Did some locations perform better or show greater change than others?

  • Do certain age groups express different viewpoints?

  • Are there similarities or differences in responses between boys and girls?

  • What insights can we gain from gender and disability perspectives?

  • Is there significant variability in responses or noticeable disparities?

  • Are the overall results predominantly positive or negative?

  • Are there contradictions between answers (e.g., open-ended responses contradicting close-ended ones)?

  • What factors might explain certain trends in the context of the intervention? Is there anything that could have influenced the results?

  • What insights can we derive from the results to inform future response designs?

  • How did results of this indicator link to the type of MHPSS activity (indicator R&E2 MHPSS output) – does children’s wellbeing change differ depending on type of MHPSS activity attended?

Additional guidance

  • Refer to Tdh operational guidance on MHPSS,

  • In the event that a donor or MHPSS experts in your team request specific measurement tools to capture changes in Mental Health and Psychosocial Support (MHPSS) outcomes, please ensure that the selected tools are relevant for use in diverse settings and recommended in the IASC Monitoring and Evaluation Framework for Mental Health and Psychosocial Support in Emergency Settings and means of verification. It is essential to utilize the following means of verification for these tools to ensure robust data collection and analysis:

  • Valid and Reliable Tools: Choose tools that have been validated across various contexts and populations to ensure accuracy and reliability.

  • Standardized Protocols: Adhere to standardized protocols for administering the selected measurement tools to maintain consistency and comparability of data.

  • Cultural Sensitivity: Ensure that the tools are culturally appropriate and relevant for the specific populations being served.

  • Feedback Mechanisms: Implement feedback mechanisms to evaluate the effectiveness and relevance of the tools used in capturing MHPSS outcomes.

  • Sampling : Understanding sampling approaches, Calculating sample size.

This guidance was prepared by Tdh ©
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