Macheo believes it right to approach the complex family situations of vulnerable children we seek to help in a holistic and broad way: what are the challenges? What is causing these challenges? What can be done to address root causes? Who is best placed to provide these services? And how do we know in the end whether the solutions worked?
We are greatly influenced by the school of thought, called “effective altruism”, and try to implement that in our daily practice.
Macheo is assisting the most needy children, we do not believe that one solution will address the complexity of the families in an adequate way. Therefor we aim to apply specific solutions to each situation, hoping to create a better foundation for the children’s development in this way. Children are being referred to us through different people in the surroundings of the child. These can be well-wishers, a parent, a teacher or Government employees from – for example – the children’s office. We also identify directly through our own observations in the community.
In Macheo’s unique Family Needs Based Method we promise a funding partner impact on a holistic level of children’s well-being. This leads to a focus on what is being achieved, more than on whether we delivered the agreed inputs (interventions). We understand that the flexibility we need for truly working based on the (unpredictable) needs of the client require a lot of trust from our funding partners. We appreciate this trust very much.
This model also follows the 3 steps of Diagnosis – Service Delivery – Evaluation. At the bottom of this page you can find a detailed explanation.
This is all captured in Macheo’s Theory of Change, which can be found here
The diagnosis is done by Macheo’s Area Social Workers. For this they use the Child Status Index tool. This is a verified tool that looks at children’s well-being holistically.
The Child Status Index covers:
To complement the Child Status Index we also look at root causes, which might cause low well-being in one or more of the domains of the Child Status Index. The root causes on family level are:
The root causes on a societal level are:
Based on the needs identified the Area Social Workers will make referrals to usually multiple services that are deemed necessary for the children.
An Area Social Worker can refer internally or externally. An internal referral is a referral to one of Macheo’s colleagues to provide the services. We only provide ourselves if there is no other accessible, effective and/or affordable other service provider. Other service providers are the Government of Kenya, other organizations or adress the needs through community mobilization.
1. CHILD CARE & PROTECTION
1 – a Provide temporary residential care: This is always the last option, when all other options have failed.
We admit children into the centre for protection and care. Some children are abandoned, neglected and are victims of different forms of abuse. These children are usually placed into Macheo for care and protection by the sub-county children’s officer, Thika.
The centre can sustain up to a maximum of 40 children who are divided into 5 houses that have a mother each. In general, we have over 350 admitted children who were reintegrated back to their families, went for (domestic) adoption, or are now living with foster families.
Family visits to the centre are encouraged in order for them to reintroduce themselves to their child and enhance a bond. When it is considered safe, the children also go for supervised home visits to their families. Macheo counselors gradually prepare the child to be ready to go back to their family soon after admission for residential care.
It is our goal that on average a child will spend only 6 months in our residential care. While in our care we focus on 3 crucial aspects: work with the family and child to make it possible for children to return home safely, healing of trauma, and -of course- provide the children with a safe and stimulating environment for the period they live under our care.
The purpose of our residential care is to return a child back to a loving family in the community.
1 – b Family reintegration: We believe children are best cared for in loving and stable families.
Reintegrated children are children who were once in the residential care and were successfully placed back to their families. There is co-operation between the centre and their families, we support the families the best way we can so that they are stable enough to be able to accommodate their children. Once reintegrated, Macheo’s social workers do regular follow ups to ensure they are safe and progressing well.
If the reintegrated children have siblings who need our care we also intervene and enroll them into our program.
The focus shifts towards family care, to enable long term safe connection with the family.
1 – c1 Alternative family care: The alternative family care intervention involves placement of children into a safe family. This therefore could be through adoption whereby Macheo involves a registered adoption agency. It also involves tracing of reliable family members and direct placing of the children to these families instead of having them admitted in an institution.
1 – c2 Foster care: in accordance with the policies of the Kenyan government, and in close cooperation with the relevant authorities, we aim to advocate for more people to become foster parents. Macheo organizes meetings to give more information and helps interested prospective foster parents with the necessary procedures.
1 – d Baby house: The staff in the baby house cares for babies who are abandoned and rescued from trafficking and other forms of abuse.
The core purpose of our activities here is to enable the babies to trust, bond and love. Without this ability we believe all their future human connections can be damaged.
These children are mostly below one year old. They have caregivers and a nurse who care for them around the clock. We take them through the clinical check-ups and all the necessities a child of this age needs to the point where they are healthy and old enough to be reintegrated to their families, go for (domestic) adoption or can be placed in foster families. Babies stay on average 6 months.
1 – e Rescue from abuse & neglect: Through this intervention we help children access the care and protection Government services they need in case of neglect and abuse.
1 – f Prevention of abuse & neglect: To prevent abuse from happening it is crucial that individuals and communities are empowered to be able to recognize abuse, know children’s rights and know how to act when abuse or neglect is suspected. We train the community through seminars that we give in public gatherings or in schools.
2. FACILITATE EMERGENCY FAMILY SUPPORT
Relief aid to families: Macheo provides relief through cash transfer to families in crisis or emergency situations. The families can use this as they seem fit, thus keeping them in their role as decision-makers for their own families. Usually food, medicine and payments of debt are their biggest needs. Without this support, the family may fall deeper into a crisis or deprivation of specific needs. Hopefully this support enables our staff to start working on development and empowerment of the family sooner.
3. INDIVIDUAL SCHOOL SUPPORT AND SCHOOL FEEDING
3 – a Payment of school fees to enable access to school. Macheo focuses mostly on enabling access to Early Childhood Education (ECD) and to secondary dayschools for girls.
3 – b Provision of school uniforms: Wearing a school uniform is compulsory in Kenya. Children who are not attending school due to lack of uniform will be provided a uniform by Macheo. One example of someone who really benefitted from receiving a school uniform can be found here.
3 – c Provision of schooldesks: In many schools there is a big shortage of desks. Macheo provides and distributes desks to public schools to prevent too many children having to share a desk. Schools can also request new children to contribute a desk to the school. In that case lack of desks can even hamper access to school.
3 – d Remedial teaching: The remedial teaching is meant for children who had not gone to school for a long time, for example because they were forced to work or living on the streets. When they decide to go back to school, they usually face large challenges. Not only academically, but also in terms of concentration skills and understanding expected social behaviors. Through this intervention we create the possibility (by making it possible for the teachers) to have extra one on one time after school, so that the child can quickly catch up and creates a good report with his/her teacher.
This in turn will also lead to more investment and understanding from the teacher towards the child.
3 – e School feeding: lunch: By providing school feeding programs we positively impact retention of children in schools, improve access into schools, improve school performance and contribute to higher wellbeing levels in health, food & nutritional status, protection and psychosocial wellbeing of children.
One of Macheo’s goals is to get children into school and retain them until they complete their primary school education. Provision of subsidized food for lunch is one of the feeding interventions that Macheo uses to achieve this objective. This intervention is provided in Government schools where Macheo has introduced the feeding program. Parents who can afford contribute to the costs of the meals.
3 – f School feeding: porridge: Nursery school children are the chief targets of the porridge intervention due to the added nutritional advantages although the upper class children also benefit. The nutritious porridge is inclusive of a balanced diet which is available to all the students in the schools with priority to the most vulnerable cases.
3 – g School feeding: conditional cash transfer: We welcome the government’s ambition to implement a school feeding program in primary schools in the
urban areas, we enable vulnerable children in these areas with a Conditional Cash Transfer, so that they can partake in the government program when it requires a parents contribution. The Conditional Cash Transfer is administered directly to caregivers, every week, through their mobile phones and will be used exclusively for providing school meals for their children. In case there is no government school feeding program (yet), the caregivers will have the flexibility to decide when and how to use these funds to provide meals on school days, both lunch and breakfast, in a way that suits their preferences.
We believe this approach will promote ownership and responsibility to the caregivers, empowering them to make choices that best suit the needs of their children.
A video about the school feeding can be found here.
4. PHYSICAL HEALTH SUPPORT
4 – a Individual health support: We identify simple and complex health cases and directly intervene by helping them access medical services. This includes paying for some of their medical charges and levies. We network with hospitals where we advocate for waivers on charges. In areas where we lack the capacity, we refer clients to other organizations that can provide the same services for cheaper costs for further case management. For more detailed information about Individual Health Support click here.
4 – b Malnourished children health support:
Households in the areas where we work sometimes lack food security. They do not have access to nutritious food at all times of the year. This affects the nutrition and well-being of children as they are not provided with a balanced diet. Our beneficiaries also lack information and knowledge on nutrition. We therefore aim to help the caregivers of hundreds of children provide a balanced diet. The children also go through assessment to ensure that other underlying conditions are detected early and addressed. we have also added a special focus to malnourished pregnant women and women who are breastfeeding. Macheo’s nutritionist also helps many families to provide more nutritious meals at home in cost effective ways. She also trains groups and offers advice to other organizations.
4 – c Provide de-worming:
We sensitize and lobby county public health officials to offer technical knowledge and training to staff and children on hygiene and de-worming. We also seek advice and support for our de-worming programs from the county school health officers. By initiating de-worming at the beginning of every school term, we improve the learning and health of children. We hence buy de-wormers and issue them to thousands of children in public schools.
5. MENTAL HEALTH SUPPORT
5 – a Individual counselling: We offer a helping relationship for the individuals experiencing psychological, social or emotional issues that affect their wellbeing both in the short-term and long-term. Our counseling services to the individual clients are free for the clients.
We cannot intervene in all categories of individual psycho-social needs and sometimes refer clients to external counselors for further case management where more specialist knowledge is needed that Macheo cannot provide, an example is a psychiatrist. A more detailed description of this intervention can be found here.
5 – b Group counselling: Group sessions that offer guidance and life skills are effective in connecting children to explore their issues collectively. This helps prevent psycho-social problems or address them as they emerge. These children are therefore empowered with skills on self-efficacy and resilience. These sessions by our group counselors also offer wider insights to our organization as the children tend to highlight the wider issues affecting them in their community.
6 – ECONOMIC EMPOWERMENT
6 – a Family Economic Empowerment: Empowerment is the true objective of our work. However, this can only be achieved once the people are out of the extreme poverty that overwhelms all the other daily activities.
Macheo supports clients (household heads/income earners/bread winners/household decision makers) with funds or tools to start income generating activities to sustain their families. We therefore help clients to develop business ideas that can work in their local context and give them small grants and tools to start their own businesses. We conduct regular field visits to monitor progress and offer additional training and any necessary business support to these beneficiaries to ensure that their living standards are improving. An example of one of the clients helped is shown in this video.
We also network with employers close to us and mediate beneficiaries into paid and stable employment.
6 – b Youth Employability: Job opportunities for Kenya’s vast population of unemployed youth are hard to come by. This intervention aims to enhance the chances of young people to get (self)employed by teaching them necessary skills to apply succesfully for jobs, how to identify opportunities or how to succesfully start their own business.
The youths are trained in cohorts of 25, so that they can also motivate and encourage each other.
7. LIFE SKILLS TRAINING
7 – a reproductive health & life skills training: In the areas where we work, the school attendance of girls is affected by menses where the children who come from families that cannot afford sanitary pads are forced to stay at home while their male counterparts continue covering the syllabus.
The Government of Kenya has promised and is providing sanitary pads to girls in schools.
We train the girls on the use and disposal of the pads. We sensitize teachers and parents to support girls during this period and encourage them to actively support and support us in our program. We also ensure the boys are involved and engaged by offering them trainings and life skills sessions on male and female reproductive health. We help them understand the process of human growth and development.
We also engage the boys so that they are able to understand the situation girls have to go through and the kind of support they can offer to ensure that they are all learning in equal opportunities. We provide both boys and girls with underwear. We train both on valuable life skills and age appropriate behavior.
7 – b Sports & games in schools: Due to poor knowledge, attitudes and practices related to sports and games, we have to come in and offer direct support intervention and services. We sensitize parents and teachers on the importance of play and in most cases directly intervene by providing sports materials, equipment and personnel to help implement games and sports. We sensitize teachers to allow children to play at the stipulated Physical Education and Games lessons. Together with a partner (Join for Joy) a games manual has been designed that enhances social impact of games and play.
8. ASSIST TEENAGE MOTHERS
We offer numerous services and activities aimed at equipping expectant teen mothers with the skills and knowledge required to successfully prepare and care for their unborn child. They are taught how to care for themselves and their babies, offer support, information and including advocacy health, in all relationships, parenting, social welfare entitlements, education, training and anything else that concerns the mother.
Our objectives towards the teen mothers is to ensure that they; have a healthy pregnancy, have a healthy baby, learn to be a parents and work towards empowerment either in finishing school, skills training or having a business. More background on this intervention can be found here. An inspiring video about this intervention can be watched here.
9. PHYSICAL LIVING & LEARNING CONDITIONS
9 – a Improve physical living conditions: the intervention on improving physical conditions ensures that more children involved in our programs are living in a safe, dry and adequate shelter. In the case that this is not happening, we directly provide items such as clothes, beds, mattresses and bedding or even renovate or construct a house. Community mobilization and participation is a key aspect of this intervention.
9 – b Improve school facilities: in the most needy schools, we engage and work with stakeholders to construct and repair classrooms, toilets and kitchens. While we provide the funds and are responsible for the tendering and contracting process, the schools identify contractors and own the project during and after construction. We aim to achieve child-friendly learning environments with our classroom construction projects. We do classroom renovations for the schools but sensitize them to source funds from any other concerned parties to do other repairs including desk or staff room repairs. Through provision of the infrastructure, we aim at improving the welfare and well-being of all children in school.
The school community contributes 25% to the costs of improving their facilities.
After all interventions have been finished, the holistic area social worker returns to the case and confirms whether all efforts have had the desired impact. For this he or she repeats the Child Status Index.
The difference between the intake and exit CSI score now becomes visible and shows the improvement in the child’s well-being.
This is the impact Macheo (co-)created!
When we now combine the different unit costs of the interventions we applied we can now also calculate the costs of the impact we created, by doing this we can also work on improving our cost-effectiveness, and not only apply what works, but also help as many children as possible with our scarce resources.
All of the above (diagnosis, service delivery and evalution) comes together in Macheo’s unique approach, which truly allows us to follow the clients needs. We call this the Family Needs Based Method.
We work child-oriented. To provide impartial protection and assistance, we must respond based on needs. This means that we do not offer just one service or intervention but give our clients a central role in allowing them to discover and use their talents and strengths. We explicitly involve the caregivers and children in choosing the intervention(s) that can work best for them.
Experience and research show that the healthy development of children is multi-dimensional. We believe that our solutions should be too. That is why we use a holistic approach: we focus on the situation of a specific child to determine which interventions we offer. To fully integrate this approach into our core, funding should also be needs-oriented. This means, in this methodology, we do not request for financial support for a single intervention but ask the funding partner to trust us with funding based on impact. Because we believe that children’s development is multi-dimensional, we look at 7 aspects of a child’s development:
The steps of diagnosis, service delivery, and evaluation are separated into different departments.
This division of tasks allows employees to specialize in their field, which benefits objectivity and performance. This leads to a greater impact per family helped and more cost efficiency, allowing us to help more children with limited resources. It is our ambition to know what works, in what situation and why it works. We want to know this to improve how we diagnose and what services we need to apply. In this way, we optimize our services so that we can create impact by networking with other service providers.
Our individual interventions taht form part of the Family Needs Based Method are:
All these interventions are explained in more detail under “The service delivery”
Based on our available data, it costs on average about € 270 to help a family move forward sustainably. We would like to give this opportunity to many more families than we currently can.
We select the families via our Macheo method: we do intakes, refer internally or externally, provide the services that Macheo can perform (for internal referrals) and measure the performance of the services provided and the impact on the well-being of the children at exit and follow-up (6 and 18 months).
Our ambition level is even higher. We are now able to promise impact, which is about the children’s complete well-being. In other words: “are the children we have helped now doing well in all aspects of their well-being?”
|Target children whose well-being is fair or good on all (sub-)domains of CSI
|Mid-term (6 months after exit)
|Long-term (18 months after exit
The estimate is based on experience and averages. Some interventions serve the child, and others serve the caregivers to enable them to care for their children better.
The probability that a child or caregiver we encounter will need this intervention is multiplied by the expected cost per intervention. In below table this is reflected in the column most on the right, for which the formula is:
(chance caregiver * cost) + ( chance child * cost * # of children)
We use an average assumption of 3.53 children per caregiver. The costs below per family come to a total of KES 35,858. Given the current very uncertain situation in Kenya, we have calculated in the impact promise with an additional unforeseen cost item of 10%, making the total price KES 39,444.
We have to deal with a number of uncertainties in the financial estimate of the project:
1. The prediction of the number of families to help with this amount
We expect this to be the minimum number of what we promised in the table. We are conservative in our estimates if we manage to go over it – even better!
2. The period from intake to exit
This can vary if the children encounter new challenges while being helped, so the exit is delayed.
3. The financial assumptions
Since we work according to the needs of the families, we have assumed the numbers and nature of the services that families will receive to arrive at the cost per family. The costs of the different services are not the same. If we promise too much here – in other words, if it turns out that we need a higher average amount per family – then we will add money from other donors. We will be transparent about that and consult promptly, but it will not affect the services the children need.
Also, current and future inflation levels are very difficult to predict. Apart from these assumptions on the cost-side, we also had to make an assumption on the expected exchange rate.
4. The estimated number of children per family
Based on our experience and data, we assume 3.53 children per family. Official figures show that the number of children per woman in Kenya is 3.42 for the entire country. There is a lot of spread in the family size of our clients. We often help carers with a lot of children, but also relatively often young parents who have not yet reached the full family size.