Participatory evaluation using the Most Significant Change (MSC) methodology
We are representatives from Adroit Consult International, carrying out the documentation of the Most Significant Change stories as part of the
Participatory Evaluation of the Lego Funded Multi-Country Playful Parenting Project on behalf of Child Fund International, Uganda.
Adroit Consult International is a multi-sectoral consulting firm operating in Uganda, and Kampala since 2007. We provide high-level services
including evaluations, project support, capacity building, and success story documentation, among others.
We would like to engage with you in a discussion through a Focus Group Discussion, and also in-depth interviews where applicable,
to document your story with regard to the experience on this project.
Your story may be used for reporting and submitted to Child Fund International, Uganda, who may share it with their donors, and or other
partners, or on their media channels.
Do you (the storyteller):
•
Agree/ give consent for you and/ or your child to take part in this success story documentation process and share information regarding
your experience on this project?
Focus Group Discussion 1. Yes
Interview
1. Yes
2. No
2. No
Film
Photography
1. Yes
1. Yes
2. No
2. No
•
Agree/ give consent to Child Fund and the consultant to publish original materials created by your child (essays, poems, photos or any
artwork)
1. Yes
2. No
•
Agree/ give consent for your name to be used and/or the name of your child?
•
Agree/ give consent for your photographs and/ or that of your child to be taken during the process?
•
Agree/ give consent for any of the above-collected information (photographic, video, interview statements, artwork) to be used in whole
or in part, in the consultant’s/ Child Fund International’s publications, in newspapers, magazines and other print media, on television,
radio, and electronic media (including internet sources and social media0 in theatrical media and/ or in mailings for educational and
awareness campaigns by Child Fund International, in connection with the promotion of Child Fund International’s products, and/ or to
help raise funds for Child Fund International.
1. Yes
2. No
1. Yes
2. No
1. Yes
2. No
This consent is given without expiration, and future uses do not require additional permission from me.
The below signed individual, parent or legal guardian hereby consents to give permission to the above
Signature of responsible individual/ parent/ legal guardian: _____________________________
Date: _________________________________________________
Address: _______________________________________________
The above signed parent/ legal guardian consents to and gives permission to the above statements on behalf of the child named below.
Child’s name: __________________________________________
Child’s Age: _________________
The following is required if the consent form has to be read to the responsible individual/ parent/ legal guardian:
I certify that I have read this consent and release form in full to the responsible individual/ parent/ legal guardian whose signature appears
above
Date: _____________
Name and signature of the Consultant ________________________________________________________