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Running head: CAPSTONE INTEGRATIVE PROJECT 1

Capstone Integrative Project Final Solution Assessment

Learner’s Name

Capella University

Human Services Capstone for Master’s Learners

Capstone Integrative Project Final Solution Assessment

August, 2018

CAPSTONE INTEGRATIVE PROJECT 2

Capstone Integrative Project Final Solution Assessment

As revealed by United Nations Children’s Fund’s (UNICEF) Progress for Children

report, a child today has a greater chance of survival than he or she did at the beginning of the

millennium. With various programs in place to address child abuse and neglect, UNICEF is

ensuring that inequities are addressed. The work and effort of UNICEF’s humanitarian workers

has reduced inequities related to education, gender, and health among disenfranchised young

populations and ensured progress for them. These workers are often confronted with challenging

work environments, which places them at risk of psychological distress (UNICEF, 2015). A

framework to strengthen resilience among the workers will be recommended to mitigate this

distress. Despite the efforts UNICEF has made to alleviate child abuse and neglect, the

implementation of its programs suffers from certain weaknesses. These weaknesses can be

addressed through inter-organizational collaborations.

UNICEF’s Strengths and Weaknesses

Over the years, UNICEF’s reach has broadened to include millions of children around the

world whose lives have been affected by poverty, conflict, and disasters. It has evolved from its

emergency beginnings, when it came into existence in the aftermath of World War II and

delivered emergency assistance to children in need. At present, UNICEF is working in

emergency and non-emergency settings to enhance the well-being of children (Young, 2011).

The following are examples of the strengths and weaknesses of UNICEF’s program

implementation:

Strengths

• Over the course of a decade, UNICEF’s program promoting exclusive breastfeeding in the

first six months of life bore fruit, with significant progress in several countries throughout

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Africa, Asia, and Latin America. Ghana rose from a mere 7% in 1990 to 63% in 2008

(Young, 2011).

• By 2012, the number of out-of-school children reduced from 104 million to 58 million

(UNICEF, 2015).

• Until 2015, a 53% reduction in child mortality rates was recorded. A majority of the burden

of these deaths is borne by Africa and Asia (UNICEF, 2015).

• Since 2001, there has been a 58% reduction in new HIV infections among the 0–14 year age

group (UNICEF, 2015).

• Since the early 2000s, UNICEF and the Centers for Disease Control and Prevention have

been working with other partners to conduct a series of regional workshops on the use of

home fortification interventions to improve programs for infant and young child feeding,

focusing primarily on micronutrient powders (Jefferds, Irizarry, Timmer, & Tripp, 2013).

• Diarrhea is the second leading cause of death among children under the age of five and is

responsible for the death of around 760,000 children every year. To address the reduction of

such fatalities, UNICEF and WHO came up with a 7-point diarrhea control and prevention

strategy (Ali et al., 2017).

Weaknesses

• Despite the reduction in the rate of stunting, rural children are still two times more likely to

be stunted than urban children (UNICEF, 2015).

• As a result of existing disparities based on gender, disability, and other social indicators, the

poorest children remain five times more likely to be out of school than the richest children

(UNICEF, 2015).

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• The poorest children are almost two times more likely to die before the age of five than the

richest children (UNICEF, 2015).

• A study conducted to test the strategy’s robustness revealed that there exist gaps between

knowledge and awareness around links between immunization and diarrhea prevention,

exclusive breastfeeding and diarrhea prevention, continued breastfeeding during diarrhea,

and the use of zinc in the treatment of diarrhea (Ali et al., 2017).

• A majority of the mothers who were a part of the study were aware of the use of oral

rehydration solution (ORS) in the treatment of diarrhea. Despite that, only a third of the

children received ORS during the illness. This was a result of unavailability of ORS in the

local market and unawareness of the exact terminology used for the product. Another

dimension that was found to link awareness with use of ORS and zinc is the training and

health human resource capacity of facility-level staff and of frontline health workers (Ali et

al., 2017).

• The study also revealed that health human resources were unaware of standard treatment

protocols of the government and did not receive any formal training on diarrhea prevention,

control, and treatment. Frontline health workers required training on infant and young child

feeding practices, engaging with mothers, and identifying the danger signs of diarrhea (Ali et

al., 2017).

• International and UN agencies failed to protect Palestinian children from violence

perpetrated by Israeli authorities and settlers. This has not, however, affected the reputation

and standing of these organizations. They are rarely questioned about giving into political

pressure, which consequently reduces their stated aims and values.

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• Certain practices (such as the manner in which Palestinian children are treated) keep

concerted critique away. Psychosocial programming is always based on the assumption that

young Palestinians are vulnerable, passive, and in dire need of psychological and emotional

support (Hart & Forte, 2013).

• According to Mearsheimer and Walt, the close and dependent relationship between child

protection organizations and major Western governments has constrained the work of these

organizations accordingly. For instance, UNICEF was reluctant to take a strong public stand

and challenge the Israeli government’s violations as a signatory of the United Nations

Convention on the Rights of the Child and other international legal instruments. According to

several interviewees in the book, this reluctance was primarily attributed to a fear of

alienating donors and those with political influence in the United States, where the pro-Israel

lobby was immensely powerful (Hart & Forte, 2013).

• UNICEF’s possibly toughened resolve to address Israeli violations was highlighted in its

2013 report on the treatment of Palestinian children in the Israeli military justice system.

According to Lyons, instances of conflict within the organization related to the release of the

report and failure to clearly use the word “torture” within the text indicated that this resolve

is far from universal and could possibly be short-lived if donor pressure is strongly exerted

(as cited in Hart & Forte, 2013).

These statements make it evident that despite the programs that are currently in place,

factors such as lack of resources, improperly trained staff, gender inequalities, and disparities

among the rich and the poor do not allow for a reduction in the existing inequalities.

Theoretical Framework for Resilience among Humanitarian Workers

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UNICEF is tirelessly working toward addressing issues such as child mortality, extreme

poverty, stunting, infant and young child feeding, equity in education, and gender inequality. The

extensive data available also projects encouraging outcomes. However, the occurrence of a large

number of disasters results in complex and multiparty disaster relief operations, which leads to

limited information availability and transparency, replication of efforts, insufficient resources

and funding, and issues related to accountability and coordination (Jahre, Pazirandeh, & Van

Wassenhove, 2016).

Additionally, humanitarian workers face chronic stress and trauma while working in the

field. According to research, the longer these workers are deployed, the greater their risk of

burnout and depression. The burnout is apparent because some people suffer from a psychotic

break or even attempt suicide. For others, burnout takes over their passion slowly. Responding to

international disasters or humanitarian crises places humanitarian workers at risk of mental

health problems. In 2012, the Antares Foundation and the Centers for Disease Control and

Prevention carried out a series of research studies that looked at traumatic stress and other mental

health problems among relief workers. These studies revealed that 20 to 25% of the humanitarian

workers in Iraq, Jordan, Uganda, and Sri Lanka exhibited symptoms of post-traumatic stress

disorder. More than 50% of them were depressed, and about half of the total workers

experienced anxiety. One of these studies, which evaluated the mental health of more than 200

international humanitarian workers, revealed that the prevalence of symptoms of depression

doubled post deployment and that signs of anxiety increased at a similar rate (Troutman, 2017).

Apart from dealing with mental health problems, humanitarian workers also face the risk

of violence. As per the Aid Worker Security Database, more than 287 humanitarian workers

were victims of violence in 2015. The victims, mostly national or local staff, constitute more

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than 90% of humanitarian aid workers. Because they earn a fraction of what international

workers do, local or national workers are unable to access mental health care. Studies show that

only a few humanitarian organizations have policies in place that provide mental health care to

their workers. In a 2013 report, the United Nations High Commissioner for Refugees stated that

the lack of mental health support was a serious problem among humanitarian organizations

(Troutman, 2017).

A need to reinforce resilience among UNICEF’s humanitarian workers exists due to the

complex nature of their work. In the field of humanitarian relief, there is still no agreement on

the definition of resilience. However, some consensus exists on the fact that psychological

resilience is related to an individual’s ability to adapt after a traumatic event (Brooks et al.,

2015). The existing literature does not focus on resilience in the context of human services.

Theoretical frameworks do not explain the ways in which resilience can be practiced and only

focus on the factors affecting it. They take only the organization’s point of view into account

(Brooks et al., 2015; van Breda, 2016; Arrogante & Aparicio-Zaldivar, 2017).

For instance, Adamson, Beddoe, and Davys’s (2014) framework takes into account the

core characteristics of workers, their personal and professional histories, and their values and

ethics for the cultivation of resilience. Factors such as the connection between stressors and

strengths at home or the workplace and work–life balance underpin the sustainability of

resilience. Key factors to the development of resilience are coping behaviors in addition to casual

support from peers and formal supervision. The framework proposed by van Breda (2016)

concentrates on an organization’s need to develop resilience. The framework is divided into three

components, the first of which focuses on the organization as a system instead of the individuals

who are part of it. The second component addresses the need for resilience among the staff.

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However, an organization is not just a system or a group of individuals; it is also meant to serve

communities. The third component addresses the resilience orientation of the organization’s

delivery of services to the concerned communities. Instead of outsourcing the service delivery,

the organization’s staff should carry out the same, because this will contribute to its resilience.

The organization will become stronger when it pays attention to all three components. It will

strengthen when it is rooted in the social context of the community it is serving and is aware of

the strengths and weaknesses of that community’s social system. van Breda’s framework is not

comprehensive enough to concentrate on the ways in which resilience can be strengthened

among UNICEF’s workers.

Dunkley (2018) provides a practical approach for human services organizations through

which resilience can be strengthened. Her framework shifts its focus toward the humanitarian

workers in these organizations. Implementing Dunkley’s resilience practices in UNICEF will

provide workers with a psychosocial support system before their deployment and until they

resume a normal life. Pre-deployment consultation programs should include trauma awareness

courses in which the workers can develop appropriate responses when confronted with a

traumatic incident. The programs should also include teaching workers how to provide

immediate psychosocial support to their team members in the aftermath of a traumatic event.

Courses containing exercises for stress management will allow workers to identify their stress

cycles. These programs could also teach workers how to protect themselves against the threat of

violence and survive kidnapping and hostage-taking situations. Following the recognition of

risks tied to the workers’ mental health or lifestyle or in the occurrence of requests made by

them, they may require mid-deployment consultations. These consultations may contribute to

increasing motivation and a boost in energy levels. Post-deployment consultations will allow the

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workers to share their experiences and emotions and will also help in recognizing the factors that

lead to trauma or burnout (Dunkley, 2018).

Cultural and Ethical Considerations

UNICEF’s current global presence spans 190 countries. With 21 of its country offices

spread across Europe and Central Asia, the organization is working with and for disadvantaged

children and adolescents through its country-specific programs. There are considerable equity

gaps in this region in terms of the fulfillment of children’s rights. Children who are poor,

disabled, belong to a certain ethnic community, and live in residential institutions or juvenile

detention have a higher chance than others to lose out on opportunities. These children are

bearing the brunt of the world’s biggest refugee and migrant crises, having fled from countries

including Syria, Afghanistan, Iraq, Somalia, and Sudan. UNICEF also has programs in place to

respond to the needs of refugee and migrant women and children in Austria, Germany, Greece,

and Italy (UNICEF, 2015).

UNICEF operates in 24 countries in West and Central Africa. Its diversity is not limited

to culture, beliefs, languages, and lifestyles. It extends to binaries of stability and conflict, of

affluence and poverty. The organization is concentrating its efforts on eight key areas—

immunization, stunting and malnutrition, education, violence, child marriage, birth registration,

sanitation, and open defecation (UNICEF).

South Asia’s vast geographic, ecological, and cultural diversity make it unique; however,

the region continues to be unstable and vulnerable in social, economic, and environmental terms.

The region is dealing with challenges such as inadequate provision of public facilities, poor

urban governance, lack of effective social protection systems, rise in urban poverty, and gender

inequality. It ranks third highest in terms of violence against children and has the largest number

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of out-of-school children and youth. The incidence of child marriage still remains the highest in

South Asia. Because several countries in the region are plagued by conflict or terrorism, heavy

state expenditure is driven toward defense, leaving limited resources for education, health, and

welfare. UNICEF has been working toward ensuring the provision of basic services such as

education and health care. It has also been working to improve the participation and inclusion of

children and adolescents in the process of development (UNICEF).

With UNICEF’s programs spread across diverse territories and multicultural societies, its

workers often work with individuals who do not speak the language they do or those who come

from different cultures. These individuals might suffer from post-traumatic experiences and were

probably subjected to racism and discrimination (Bø, 2015). It is important for UNICEF’s

workers to work in accordance with the social and cultural needs of these populations. This will

lead to greater satisfaction among the stakeholders, desirable program outcomes, and increased

cost efficiency (Galanti, 2014).

Cultural competence is increasingly assuming importance as a prerequisite for any job

involving personal interaction with diverse groups while also being upheld as a desirable moral

value in the workplace (Harrison & Turner, 2011). Cultural competence can be cultivated by first

creating a clear perception of one’s personal culture and prejudices, followed by developing

sensitivity toward the cultures of others, and then acknowledging these cultural differences. This

is followed by acquiring knowledge and understanding of other cultures, especially their values

and beliefs, and finally applying this knowledge to ensure better outcomes and efficiency

(Galanti, 2014). It is important for humanitarian workers to know the different existing

ideologies surrounding family life, gender roles, and child-rearing practices that form a part of

different societies. Being culturally competent also involves the ability to follow cultural codes

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of respect with regard to age, gender, and position; to create good relationships; and to

communicate despite cultural and linguistic differences. It is important for workers to be aware

of the discrimination faced by ethnic minorities as well as ensure that these minorities receive the

public help they are entitled to. Culturally competent workers need to be aware of the rights of

the specific populations they deal with and should be able to utilize existing resources (Bø,

2015).

Solutions for Improvement

In the context of humanitarian work, critical incidents will continue to occur while

workers will continue to face the risk of violence. In order to make them feel supported by their

organization and help them recover, Dunkley’s resilience framework (2018) should be embedded

into UNICEF’s organizational culture.

For UNICEF to address the gaps in its implementation of various relief programs and

strategies, it needs to improve upon its coordination between the regional actors involved in the

relief process. A 2009 evaluation report of its 7-point diarrhea control and prevention strategy in

four districts of Uttar Pradesh revealed various demand and supply-side issues such as lack of

awareness among mothers about the importance of immunization and the relation between

diarrhea and exclusive breastfeeding. In the study area, 28% of the mothers did not wash their

hands after defecation, and 36% of them did not wash their hands after cleaning their child’s

feces (Ali et al., 2017).

The study also found gaps in knowledge and awareness among the mothers about the link

between exclusive breastfeeding, immunization, and diarrhea prevention and the use of zinc in

diarrhea treatment. UNICEF workers, especially frontline health workers, deal with diverse

populations belonging to different cultures. It is important for them to be trained on how to deal

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with mothers. They must be provided with formal training on breastfeeding, young child feeding

practices, and standard treatment protocols for diseases such as diarrhea (Ali et al., 2017).

According to the study, only a third of the children received ORS during diarrhea due to

its unavailability in the local market and a lack of awareness about the exact terminology used

for the product. The unavailability of ORS was due to challenges in procurement and supply

chain management. Issues related to storage and distribution and transportation of supplies along

with the lack of adequate human resources at district and below district levels can be easily

addressed by better coordination and communication with regional actors. As far as the threats

children face from armed conflicts are concerned, there is need for an approach that will give

them a safe environment to live in. There needs to be greater consistency between global norms

and the reality of action on the ground. The decisions taken in this regard should not be dictated

or influenced by donors or be consequences of political strategy (Hart & Forte, 2013).

Importance of Inter-Organizational Collaboration

According to Tomasini and Van Wassenhove and Thomas and Fritz, partnerships

between humanitarian organizations and businesses are expected to provide learning

opportunities for both parties (as cited in Nurmala, de Leeuw, & Dullaert, 2017). Schulz,

Blecken, Van Wassenhove, and Fikar, Gronalt and Hirsch stated that these learning outcomes

include improvements in the efficiency and capabilities of logistics in humanitarian

organizations. Partnerships with corporations will allow UNICEF to expand its own logistical

capabilities by providing insights into how corporations master the logistics process (as cited in

Nurmala, de Leeuw, & Dullaert, 2017). Muller and Kräussl state that for the business sector,

engagement in humanitarian–business partnerships will allow companies to project their

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corporate responsiveness and corporate social responsibility and thereby improve their

reputations (as cited in Nurmala et al., 2017).

For instance, according to Maon et al. and Van Wassenhove, the five-year partnership

between logistics service provider Thomas Nationwide Transport and World Food Program

called “Moving the World” demonstrated that long-term partnerships can contribute to

increasing the capacity of aid networks and enhance the core competencies of both parties

involved (as cited in Nurmala et al., 2017). A second example, as stated by Rueede and Kreutzer,

is about the partnership between Deutsche Post DHL and United Nations Office for the

Coordination of Humanitarian Affairs that solved the problem of bottlenecks such as damaged

infrastructure and unwanted relief goods at airports as well as improved the effectiveness of

humanitarian distribution networks (as cited in Nurmala et al., 2017). The third example, as

stated by Thomas and Fritz, talks about the partnership between American Red Cross and Abbot

Laboratories that increased the visibility and importance of supply chain management in the

humanitarian context (as cited in Nurmala et al., 2017).

In order to foster inter-organizational collaboration to address the issue of child abuse and

neglect and take steps to ensure its prevention, collaborative activities can be as simple as

informal communications. They can even be formal meetings of statewide professional

associations such as the California Mental Health Directors Association and regional and

national planning councils, which are based on a structure guided by certain policies. Such inter-

agency meetings will act as a platform for communication, negotiation, and strategic planning

(Palinkas et al., 2014). When the organizations involved share their vision and values, a sense of

accountability will be created. The accountability can exist through top-down reporting

requirements such as keeping the funder in the loop when it comes to data regarding a particular

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program. According to Chang et al., collaboration will make room for co-learning, interaction,

and troubleshooting and does not mean simply enforcing requirements on the concerned

stakeholder groups to work with other stakeholder groups (as cited in Green et al., 2016). Inter-

organizational collaborations can help UNICEF strengthen the implementation of its programs

that address the problem of child abuse and neglect. These collaborations will make room for

better logistics, allowing for easy accessibility of the required resources and infrastructure.

Conclusion

UNICEF has made significant progress to reduce inequities among the disenfranchised

populations, a fact that is evident in the organization’s 2015 report. However, the challenges

related to the execution of programs addressing child abuse and neglect still remain. With the

organization’s presence spanning several countries with varying cultures, its humanitarian

workers face unique challenges in different territories. Some settings are riddled with conflict

and others have a dearth of resources, which leads to failure in the implementation of programs

addressing child abuse and neglect. Such situations call for not just the practice of resilience

among the workers, but also inter-organizational collaborations that can improve the

implementation of UNICEF’s programs. As demonstrated by examples in the previous section,

such collaborations have resulted in increased coordination and strengthened communication.

Apart from the suggested improvements for UNICEF, it is also imperative for its workers to have

flexible interpersonal skills; awareness about how collaborations between different organizations

work; and awareness of skills associated with community organizing, planning, development,

and management. This awareness will enable them to make important decisions and the changes

needed to revamp institutional infrastructure in their target areas.

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