Promising Practices Program

Administering Organization

Horn of Africa

Program Name

Families Together Program (FTP)

Program Objectives and Unique Needs Addressed

The Families Together Program (FTP) is a home visitation program provided by Horn of Africa, a community-based organization providing services to Somali and East African refugees who reside in the greater San Diego area. The program is an affiliate program of Healthy Families America (HFA), a national initiative that aims to reduce child abuse and foster healthy, happy and successful families.

The first year of program implementation focused on developing an infrastructure for measuring these outcomes. The overarching goals of the Families Together program include the following:

  • Reduce the incidence of child abuse and neglect
  • Enhance parents' abilities to create stable, nurturing home environments 
  • Promote child health and development 
  • Help develop positive parent-child interactions 
  • Help ensure that families' social and medical needs are met 
  • Ensure families are satisfied with program services 
  • Increase school readiness

History and Rationale for Developing Program:

San Diego is a major resettlement site for individuals fleeing various forms of hardship, and refugees from Somalia are among the most recent arrivals. Over the last several years, the number of refugees resettling in San Diego has grown to more than 20,000, creating the largest African community in California and the second largest in the nation. The well-being of children and families in this ever-growing population is directly affected by their lack of access to health care and unfamiliarity with the American health and education systems. Although resettlement agencies provide a variety of programs to assist refugees, education on navigating these systems is very limited.

In 2005, in an effort to bridge the gap to accessing services, Horn of Africa conducted focus groups that revealed that access to culturally-responsive early health and education services was a high priority. After a review of the literature, the organization and their partnering agencies decided that the development of the Healthy Families America (HFA) home visitation program would be the most appropriate intervention to reach the target population: East African refugee families with young children ages birth through five years. Such a program was essential to breaking down the cultural, language, and other barriers to access and education faced by refugee families.

Program Description

The Families Together Program is unique in that it is the only Healthy Families America site in the nation that works exclusively with East African refugee and immigrant families. With a focus specifically on the Somali refugee community, the Horn of Africa strives to help refugees with the acculturation and integration process to the U.S. in an effort to successfully empower families to have a new life in America while preserving and celebrating their East African/Somali culture and heritage.

The services are conducted through home visits by East African women (for cultural reasons it would be inappropriate for a home visitor to be male) thus allowing for a level of cultural and linguistic competency that would not otherwise be possible. Through these home visits, each family receives an assessment that helps identify their needs and strengths. The assessment includes supported referrals to medical, educational, and social services, school readiness and overall family well-being, one-on one parenting instruction, and facilitated parent-child interactions. In addition to direct services, the program includes thorough comprehensive training, supervision and technical assistance as well as strengthened linkages with established local organizations.

One of the program's most successful components has been the establishment of monthly meetings with participating mothers to provide education seminars and facilitate connections with other families. The meetings are an hour long and attendance is typically 15-20 participants per meeting. The program hosts guest speakers from community agencies and organizations throughout San Diego to present valuable information to the group on topics such as networking, discipline, developmental screenings, immunizations, Cesarean Sections and child birth, child care licenses, woman's health, nutrition, and early childhood literacy. The monthly group meetings serve as an integral part of the program that connect participating families with both important services in the community and with other Somali refugee women.

Horn of Africa partners include the County of San Diego/Health and Human Services Agency, Women, Infants, and Children (WIC), Social Advocates for Youth (SAY) San Diego, Start Smart, and the City Heights Wellness Center.

Resource Materials Used in Program

The Families Together program provides support services to Somali families either expecting a child or with a child ages birth to five. Working with the Maternal, Child, and Family Health Services Branch of the County of San Diego Health and Human Services Agency and Social Advocates for Youth (SAY) San Diego, the program developed a curriculum culturally tailored for this population. The curriculum provides detailed information on health topics such as women's health, child development, immunizations, as well as systems level help for those new to the United States. Each new family is assigned to a Family Support Worker (FSW) who meets with them weekly to review the culturally-tailored curriculum, provide referrals to needed resources, interpret information, and support families throughout their participation.

Groups Served by Program

East African families with children ages birth to five.

Program Funding

The California Endowment, the First Five Commission of San Diego, and the Annie E. Casey Foundation

Program Staffing and Required Staff Training

Overall, five Horn of Africa staff work with the Families Together Program, either full or part time.

Program Evaluation

Funding for the Families Together Program provided for an outside entity to formally evaluate the program's first year. The company LeCroy and Milligan Associates, Inc. was chosen to conduct the evaluation and consulted with BRYCS when choosing measures to use. The following aspects of the program were analyzed:

  • Documentation of the planning and development process, with an emphasis on the cultural relevance of the program
  • Program description 
  • Implementation, including the challenges of adapting the program for this unique population 
  • Demographic data on numbers and characteristics of families served 
  • Participant satisfaction with the program 
  • The program's effectiveness in reaching outcomes

The evaluation provided both qualitative and quantitative approaches to assessing the program's first year. The qualitative methods consisted of in-depth interviews with program administration staff and Family Support Workers. These interviews provided a historical account of the program development, initial recruitment, and perceptions of challenges and success stories. The quantitative approach used screening tools, assessments of appropriate child development and parent-child interaction, immunization schedules, and satisfaction surveys. To read the full program evaluation, see

Program Outcomes

Key findings revealed that participants had positive feelings about their Family Support Worker. Most respondents felt the FSW was knowledgeable (94%), understanding (94%), helpful (89%), respectful (89%), and supportive (89%). However, some respondents also reported that their FSW was firm (67%), smothering (56%), and scattered (22%).

Eighty-nine percent of respondents felt that as a result of participating in the Families Together program, they knew more about their baby's growth and development, taking care of their baby, well-baby visits, and immunizations. Respondents also felt they knew more about talking to other parents with young babies (83%), coping with problems and stress in their daily lives (78%), resources in the community (78%), and parenting information (72%). Overall, 100% of respondents were very satisfied with the program. The most cited aspects of the program respondents liked best were home visits (89%), parent groups (83%), and the cultural sensitivity of the program (78%). Anecdotally, many individual families have had successful breakthroughs as well. For example, several families have obtained better, more suitable housing, learned American systems, overcome fears of Cesarean Sections, and have seen noticeable increases in communication with their children.

Additional Comments

One of the key challenges for this program was gaining fathers' involvement, but since March 2007 program staff has been making progress in this area. Overall, most families require more services than those typically provided by social service agencies.

Program Contact

Abdi Mohamoud and Safiya Abdirahman
(619) 583-0532

Program Dates

This program began in Spring 2006 and is still operating as of September 2008.