Theory of Change: The REAL Father Initiative in Karamoja and Acholi

"Using a theory of change framework to develop a better understanding of how programs achieve change can guide intervention development, adaptation, and scale. Frequently, theories of change are developed by program designers and managers, not with community members and program participants."

This report describes a participatory consultation with young fathers, their wives, mentors, and community members who were involved in the scale-up of an integrated violence prevention project - the Responsible, Engaged and Loving (REAL) Fathers Initiative - in northern Uganda. The process used reflection and dialogue to understand how fathers internalised, enacted, and sustained new behaviours in their relationships, using a theory of change framework to understand the sequence of identified changes. Learnings from this consultation will support future scaling of REAL Fathers in Uganda, facilitate adaptations to new settings, and advance the global understanding of how to work on integrated violence prevention with young men. The report was prepared by the Institute for Reproductive Health (IRH), Georgetown University, under the United States Agency for International Development (USAID)-funded Passages Project.

As detailed at Related Summaries, below, REAL Fathers is an evidence-based, community mentoring programme that works with young fathers (aged 16-25 years) to prevent intimate partner violence (IPV) and violent discipline of young children (aged 1-3 years) and to increase acceptability and use of family planning. REAL Fathers seeks to build young fathers' knowledge and skills for new behaviours, enlisting the support of families and communities. A concurrent, emotion-based public poster campaign reinforces learning from monthly mentoring sessions and messages of community support, culminating in a community celebration to recognise fathers' accomplishments and encourage sustained changes. With funding from USAID, REAL Fathers was developed, piloted, and evaluated in northern Uganda between 2013-2015. It was then adapted, scaled, and evaluated in both Karamoja and the Acholi sub-region of northern Uganda, between 2016-2018.

Consultations in Karamoja took place in March 2020; in Acholi, consultations were held in September 2020. The sessions were held separately with mentors, REAL Fathers, wives of REAL fathers, and community leaders. Additional group and individual consultations were held with stakeholders including early childhood care and development programme coordinators in Karamoja, local government community development staff, and staff with Save the Children and the IRH who previously coordinated REAL Fathers in the sub-region.

The consultations followed a 3-step process: listing, pile sorting with discussion, and ordering with additional reflection questions. Consultation participants listed and the facilitator recorded all the changes they had experienced and/or observed in REAL Fathers families. Once finished, the group categorised each of the changes as related to REAL Fathers or due to other factors (e.g., participation in other projects). During the pile sort, consultation participants discussed their categorisation and came to agreement. They then ordered the changes related to REAL Fathers according to when they were observed, reflecting together on the ordering.

Across consultation participants and settings, it was clear the changes observed did not take place in a linear way. Some fathers adopted changes earlier and others later in the project cycle, and changes were often grouped together (i.e., a phase) with changes within a phase influencing and supporting other changes within the same phase:

The report summarises consultation participants' feedback on all of these phases and changes. To cite only one example, with regard to fulfilling community expectations and norms (phase 3), participants explained that the use of violence and heavy alcohol consumption among young fathers prior to REAL Fathers led to them being unable to fulfill their expected social roles, including being responsible for their families and being active community members. As fathers changed their behaviours and improved their relationships, these young men and their wives were now able to fulfill community expectations and norms. Further, as the relationship between young women and their partners improved, community members witnessed the respect their husbands afforded them and began to treat women with more respect and trust. For example, some women were appointed to leadership roles in their clan and their community, with one Acholi woman who participated tasked with training other young women of their clan on the principles shared in REAL Fathers.

Key messages to emerge from the process include:

• Trusted, well-trained and -supported local mentors are important to young fathers' engagement with REAL Fathers and efforts to change behaviours.
• Creating an emotional connection with fathers - that is, opening their hearts and minds early in the project - allowed men to internalise concepts and imagine new ways of being in relationship.
• Readiness and commitment to REAL Fathers is influenced by fathers' individual behaviour, relationships, and socio-structural factors.
• Engaging multiple family- and community-level relationship supports throughout the project is important to fathers' motivation, retention, transformation, and sustained change.
• Family and community pushback to changing gender roles and responsibilities in the family challenged fathers' willingness to change.
• Applying a tightly focused, contextually-appropriate approach to programming influenced the acceptability of REAL Fathers.

Participant suggestions to improve REAL in future adaptation and scale-up include:

• Include or link to structural (e.g., economic initiatives) and behavioural (e.g., services to prevent heavy and frequent alcohol consumption) programmes to support fathers' engagement, motivation, and commitment.
• Include or link to reproductive health services to ensure access to family planning methods.
• Consider adding female mentors to provide guidance to wives' behaviour change throughout the project period.
• Monitor for and consider how to respond when extended families promote harmful behaviours and prevent fathers' adoption of new behaviours.
• Engage mentors in reflection and training to create a plan for how mentors can provide continued guidance to young fathers and their families, post project.
• Work with fathers and their wives to identify strategies to support men in maintaining their behaviours over time.

The report concludes with tools for elaborating a theory of change for REAL Fathers.