ABSTRACT
Background: There is considerable evidence suggesting that parenting programmes reduce violence against children (VAC). Based on this evidence, there have been calls for implementation of parenting programmes at scale. However, most of the existing evidence on implementation quality and scale-up comes from high-income countries and very little research ascertains the perspectives and experiences of programme implementers from low-income settings. Objective(s): To explore the views and experiences of implementers from six non-profit organisations who delivered Parenting for Lifelong Health for Teens (PLH-Teens) programme at scale in Tanzania in 2020 and 2021. Method(s): This paper employed a qualitative research design involving 44 in-depth interviews and 12 focus group discussions (FGDs) with facilitators, coaches, and local implementing partners (LIPs). Data were collected on implementers' experiences of delivering the programme at scale by exploring topics including programme delivery, training and support they received and details around programme logistics. All interviews and FGDs were audio-recorded with the permission of the participants. With the aid of NVIVO 12 qualitative analysis software, thematic analysis was used to synthesise the interview and FGD data. Result(s): Thematic analyses of the interviews and FGDs revealed three themes: 1) implementers' reflections on factors promoting scale-up;2) implementers motivation for implementation of the programme;and 3) barriers to scale up. Implementers described factors that promoted successful scale up as: planning and working closely with community organisations, which enhanced trust and buy-in;delivering the programme through role plays;and delivery by skilled implementers. Implementers were motivated to deliver the programme at scale for reasons such as prestige/respect, financial incentives, and acquiring skills for their own parenting. This study highlights barriers to programme scale-up as: conflicting demands on staff time;beneficiaries' initial doubt of the programme's value;COVID-19 related disruptions;and logistical challenges that affected how both implementers and parents/caregivers engaged with the programme. Despite these obstacles, implementers remained flexible in scheduling and adapting the programme to ensure successful completion. Conclusion(s): This paper highlights the perspectives of staff implementing a parenting programme aiming to reduce VAC at scale. The study suggests that several factors support staff in delivering the programme whereas other factors hindered successful implementation. It is important for all programme stakeholders to understand these factors and find ways of addressing them for desired programme impact. The study also reveals that the successful delivery of parenting programme should allow for flexibility in modes of delivery by allowing for necessary adaptations and adjustments.