The municipal health program for early childhood is a joint initiative of the Ministry of Health and JDC-Ashalim. The program is aimed at improving the availability of health care services for children in the first years of life, specifically those living in poverty. The program was launched as a pilot in two cities: Ramlah and Lod. Commissioned by the Ministry of Health and JDC-Ashalim, the Myers-JDC-Brookdale Institute conducted a formative evaluation of the program development process in 2018-2019, from the initial planning stage up to the stage of implementation. The formative evaluation showed that the collaboration between the Ministry of Health and JDC-Ashalim in the development of the program achieved several important objectives, including recruiting of professionals, getting them involved in the promotion of a collaborative venture in the field of health and development in early childhood, identifying an issue to be addressed, and developing a pilot program to address it. Along with those achievements, the formative evaluation indicated that various challenges had yet to be addressed, including the collaboration with the health plans, the incorporation of the pilot program as part of the municipal services, and the promotion of a real change in the work routines of the parties involved.
In September 2019, the SHVILIM service was launched as a pilot in the city of Ramlah with the aim of providing therapeutic, counseling, and preventive services in response to the emotional problems of children in the first years of life and their parents. The Myers-JDC-Brookdale Institute was commissioned by the Ministry of Health and JDC-Ashalim to conduct a formative evaluation study (hereinafter: the study) of the service.
The goals of this study were: to describe the SHVILIM service and to examine its outputs; to assess the satisfaction of parents and professionals with the service; to evaluate its perceived impact and its value for the children, the parents, and the professionals involved; to examine its effect on the promotion of municipal work routines and practices, the identification of issues that are relevant to the incorporation of the service as an integral part of the municipal services in the city of Ramlah, and the expansion of the service to other localities in Israel.
The following research tools were used in this study: analysis of administrative data on the 173 children referred to the service; 21 interviews with the professionals involved; and a survey among 46 parents of children referred to the service.
The service had many achievements, specifically responding to the emotional needs of children in the first years of life and their parents, and establishing collaborations between the various service providing entities in the city. The parents expressed satisfaction with the service: 82% of the parents said that they were very satisfied and 73% said that they would highly recommend it. The parents were particularly satisfied with the professionalism and attitudes of the therapists but less satisfied with the availability of the service in between appointments, the attitude of the administrative staff, and the process of appointment scheduling. Most of the parents felt that the service was very helpful: 90% said that it helped them cope as parents with the problem that led to the referral to the service; 64% said that the service helped their children cope with the problem that led to the referral; 62% said that it helped their children cope at home; and 55% said that it helped their children cope in the educational setting.
In the interviews with the professionals involved it was found that while some of them felt that the service was helpful in enhancing the professional skills of the therapists, other interviewees, associated with the referring entities, felt that the service was not particularly helpful in that respect. The latter noted that training and guidance of the professionals involved could strengthen the ties and collaboration between the various service providing entities in the city. The initial contact with the Tipat Halav family health centers as well as the division of work between the service providing entities were mentioned as positive aspects of the pilot program. At the same time, it was noted that the establishment of new collaborations between the relevant entities in the city was a challenge yet to be addressed and that the health plans were not sufficiently involved. Feedback provided by the service to the referring entities could facilitate information sharing, coordination of expectations, and cooperation. However, the rather limited feedback actually provided, created the impression that no service was provided – a situation that was liable to undermine the trust in the professionalism of the service.
The interviews with the relevant professionals indicated that the service was highly available, especially in comparison with the standard child development services provided by the Ministry of Health. At the same time, the study revealed some barriers to availability, including long waiting times, limited opening hours, and the failure to provide the service in Arabic. The interviews indicated that to ensure the successful incorporation of the service in the city of Ramlah and its expansion to other localities in Israel, the services provided should be expanded, public awareness of the service should be increased, collaboration between the service providing entities should be strengthened, and attention should be focused on the operation and management of the service.
Conclusions and Insights
The SHVILIM service provides a response to the emotional needs of children in the first years of life, thereby enhancing their and their parents’ psychological health and well-being. At the initial stage of introduction and incorporation of the service, special attention should be given to waiting times and opening hours as well as to the provision of the service in Arabic.
Recommendations and Action Items
- Conduct periodic assessments of the satisfaction with the service and the waiting times for appointment;
- Undertake a marketing effort to increase awareness of the service among parents and professionals;
- Dedicate efforts to ensure the provision of the service in Arabic and the recruitment of Arabic speaking therapists;
- Take action to strengthen the collaboration between the service providing entities and to improve the feedback provided by the service to the referring entities.
 Centers that provide health and medical services for pregnant women, infants and children, and their families.
Citing suggestion: Artom, T. (2022). Municipal Health Program for Early Childhood: A Formative Evaluation of the SHVILIM Service in the City of Ramlah. RR-887-22. Myers-JDC-Brookdale Institute. (Hebrew)