Implementers’ experiences of scaling-up a parenting programme to reduce violence against children in Tanzania: Implications for scale-up of evidence-based parenting programmes

Considerable evidence suggests that parenting programmes reduce violence against children (VAC) and point to readiness for scale-up. However, there is limited evidence on implementation quality and scale-up from Low-resource settings. This paper explores the experiences of implementers who delivered Parenting for Lifelong Health for Teens (PLH-Teens) to 75,061 beneficiaries in Tanzania. Implementers of a parenting intervention in Tanzania. This qualitative study involved 44 semi-structured in-depth interviews and 12 focus group discussions (FGDs) conducted with facilitators, coaches, and local implementing partners. The participants were sampled purposively, and all were residents of the three regions (Shinyanga, Kagera and Mbeya) of Tanzania where the scale-up was conducted. Data collection explored topics including scale-up context, preparation for, and actual delivery of the programme and challenges to scale-up. Data were analysed thematically with the aid of NVIVO qualitative analysis software. We delineated four themes as follows : 1) Exploration and preparation for programme scale-up (understanding context for scale-up); 2) Programme acceptability and implementer motivations (e.g. social standing, benefits); 3) Sustainment of the programme at scale: Implementers articulated the importance of government support for the programme and scaling-up; and 4) Challenges to implementation at scale. It is possible to delivery an evidence-based parenting intervention at scale in a low-resource like Tanzania. However, it key to consider the challenges expressed by implementers to sustain the programme at scale. Key learnings for successful scale-up of evidence-based parenting programmes are: a) understanding the context of scale-up; b) collaborating with government and community leadership; c) integrating parenting programmes within existing government structures; and d) addressing challenges that may hamper scale-up and utilisation of hybrid delivery models to enhance reach of the programmes. • Understanding implementation quality is key for successful scale-up of parenting programmes. • Programme implementers highlighted key learnings for scale-up of evidence-based parenting programmes: a) Understanding the context of scale-up and ensuring that implementers are well-trained and motivated; b) Collaborating with government and community leadership and integrating parenting programmes within existing government structures; and c) Addressing implementation challenges.