As part of our Ebola response we were asked to help prepare a brief that summarises key considerations for involving children in the Ebola response in Sierra Leone and Liberia. The details have been collated from suggestions and insights shared by:

• Children for Health
• Other experts in children’s participation
• Jenny Kowalczuk, a consultant who works with Children for Health to create and curate our core content
• James Vincent, consultant in child and youth engagement, based in Freetown, Sierra Leone

These considerations are broadly relevant to the recovery response and further investigations into local specificities is needed.

Positive drivers

Children…

• are curious and have an appetite for learning
• are willing to do things when they see they are fun and useful
• care for other children
• have extensive networks with other children through play
• are natural influencers at home, at play and in the community
• develop important lifeskills they can use in the future, when they engage with campaigns relevant to their circumstances
• understand their own circumstances better than anyone
• can participate in health campaigns in ways designed to be appropriate for their age
• have time to learn and campaign
• are willing and able to co-create interventions to address issues that affect them
• have a right to participate in decisions that affect their lives

Rationale for children’s participation

• Governments and leading organisations agree that effective school health programmes use a lifeskills approach.
• A lifeskills approach to health education includes listening to children, mobilising children and linking their learning to the realities of their lives.
• Children, their energy, optimism, appetite for learning and willingness to try new ideas are often forgotten when communities address issues of development and change.
• Adults are engaged in an exhausting battle to control Ebola and keep families safe. Children are left to rely on themselves and each other.
• Children have a major stake in the future – it belongs to them. They will have the energy and motivation to support the recovery of their communities when the epidemic subsides.

Risks to children from their participation in the recovery response

• Children may also feel weary and unwilling to engage in activities about Ebola.
• Children may be suspicious and lacking motivation to accept new initiatives.
• Where basic needs are not met and basic services are lacking, stakeholders may resent time and energy spent on any “extras” that are not essential to survival and basic services functioning
• Psycho-social support for children may be seen as a ‘luxury’ item.
• Children do not have authority so their ability to influence may be reduced
• Children may be ridiculed or put down by other children and adults for sharing new ideas.
• Children advocating of good health behaviours (such as washing hands with soap) might be seen to undermine the roles health workers and youth workers.
• Children advocating good health behaviour may be seen to undermine the authority of community leaders such as elders and chiefs in their communities.
• If recruited in a discriminatory way, child leaders may become inappropriately authoritarian or coercive when ‘working’ with other children.
• Children could face risks if they take part in outreach activities.
• Children involved with an outside ‘project’ not accountable to family or community may lead to problems in the family and recriminations from those they depend on most for love and support.
• Family members may not value the children’s activity and restrict time for outside activities requiring them instead to spend time on domestic duties. This might be especially true for girls.

Other possible barriers to children’s participation

• Promoting high quality children’s participation in health requires skills and sensitivity.
• Facilitating participatory health education requires preparation and training that is not available.
• Using a participatory approach is ‘vague’ and sometimes hard for people to grasp.
• Children’s clubs need careful supervision.
• Adult leaders of children’s clubs need training for clubs to be effective and this might not be available.
• In the past, children (especially boys) have been recruited for military purposes. Recruiting children for health and social campaigning could be perceived as inappropriate especially if health is seen as a political bargaining tool.

Recommendations

Delivery

• There are several types of formal and informal children’s groups active in communities such as faith groups, girls clubs, and school health clubs.
• The Ebola recovery phase can build upon the pre-existing positive platforms as part of the overall social mobilisation effort.
• Clear boundaries should be set and communicated on how children are recruited into formal and informal activities and what their specific role is in health and social campaigning.
• Radio and other media can help create awareness, deliver content and make children’s recruitment into health campaigning clear, open and transparent.

Open access materials & resources

• A hub of fun, stimulating activities can be collected.
• Activities can be distributed to those wishing to revive children’s groups and those working to address psycho-social well-being, health campaigning and lifeskills.
• Activities could focus on addressing lifeskills, child protection issues, grief and loss, healthy behaviours (hygiene, nutrition, malaria etc.) and having fun.
• Activities would target children aged 10-14 and be aligned to similar youth-focussed work.
• Youth focussed work can inform the content and delivery of participatory activities for children aged 10-14.

Sustainability

• Integrate children’s participatory approaches into the formal pre and in-service teacher education programmes.
• Offer leadership training for all child focussed informal groups (scouts, faith based groups, children’s rights clubs, etc.)
• Integrate children’s activities in the everyday life of schools and communities in a way that shows respect for the authority of other experts and community leaders.
• Leaders of participatory programmes such as school principals and other faith or youth leaders should be encouraged to work in partnership with other community stakeholders such as parents, elders and leaders. Efforts should be made to win their support for children’s activities from the start so the work done with children is seen as an investment for the community .
• Develop training to focus being on how to work with children using a life skills approach in fun and participatory ways so they can be mobilised to help with health education and the Ebola recovery phase^.

Outcome focused

• Children’s participation and the associated activities offer a grass-roots approach to achieving goals such as better health and well-being in families and the community (includes psycho-social well-being).
• Children’s participation in the Ebola recovery response positions the ideas and desires of children as a constructive way of helping their community and their country. It harnesses the energy of children in a positive and strategic way.
• Positive engagement with supportive teachers and youth leaders will mitigate some of the risks to children associated with inappropriate role modelling.
• Children’s participation in the recovery response will providing foundation in life skills and leadership skills that will build capacity for the future – especially if the children’s clubs can be formally linked to youth groups. Developing these skills and building capacity in this way will help address the multitude of problems facing communities in the aftermath of the Ebola crisis.

We would welcome your ideas, experiences and responses to this brief.