Marseille 2007
Marseille 2007
Abstract book
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Abstract #329  -  Four Country Study on Community Child Care Coalitions - mobilizing & strengthening community-led child care in high HIV prevalence context
Session:
  26.14: Posters B (Poster) on Tuesday   in  Chaired by
Authors:
  Presenting Author:   Dr Stefan Germann - World Vision International, South Africa
 
  Additional Authors:  Mr Richard Wamimbi, Mrs Faith Ngoma, Mrs Ann Claxton, Mrs Michele Gaudrault,  
Aim:
WV has supported community-led childcare initiatives. The community care coalition (CCC) is a foundational feature of World Visions programming model for mobilizing and strengthening community-led care for orphans and vulnerable children (OVC), and people chronically/terminally ill. To date, WV facilitates and supports over 3030 such community care mechanism with over 880,000 orphans and vulnerable children being supported by those groups in 16 African countries. To learn from this experience, WV conducted a study from August to November 2006 with the aim to identify the strengths and weaknesses of different types of community care groups (CCG) directly involved in child care - and community care coalitions (CCC) focus on coordination and networking - within different contexts in order to inform and guide World Vision (WV) and partners future programs to mobilize and strengthen community-led care for orphans and vulnerable children.
 
Method / Issue:
The study had a qualitative nature and the information collected was analyzed under five domains of enquiry, namely: 1) Operational context and linkages, 2) WV inputs to community care groups and coalitions, 3) CCC structure, composition, organization and leadership, 4) CCC ownership and sustainability, 5) Enhanced orphans and vulnerable childrens well-being. Two main sources of data were used: i) secondary documentation (National Plan of Action for OVC, project outlines and reports) and ii) the views and opinions of a range of stakeholders, gathered through focus group and key informant interviews using standard interviewing instruments. The instrument for use with children and youth involved a drawing activity as a supplemental means of understanding their perspectives. The study involved a total of 24 CCC/CCG with a distribution of 6 sites in each of the four selected countries (Ethiopia, Mozambique, Uganda and Zambia). The study was led by a study coordinator and each country formed a study team that involved at least one independent researcher, staff from WV Africa regional HIV/AIDS team and staff from the respective country office. Fieldwork in each country consisted of at least 10 days of interviews and focus group discussions. Over 105 Focus Group Discussions (FGD) and 62 Key Informant Interviews (KII) with a total number of 778 study participants (716 in FGD / 62 KII) were involved in the study over the period of August to November 2006. 23 FGD involved orphans and vulnerable children.
 
Results / Comments:
Findings indicate, that community led-child care that was established through strong community mobilization processes, well horizontally and vertically networked, are sustainable mechanisms for enhanced child well being at community level. However, the quality of care, depends largely on the quality of home visitors and frequency and sustained home visits. Home visitors have limited capacities in areas such as HIV/AIDS information, psychosocial care, local level service access advocacy, child rights and protection. There is need to enhance the investment in training and strengthening the skills set of home visitors. The importance, value and impact of home visits cannot be overstated. All children participating in the study stated that even when home visitors are unable to provide any form of material support that they greatly value the visits. It is however important to them to receive such visits at least twice per month and in a sustained manner. The quality and integrity of the home visitors was an additional important point for children to be able to share their concerns. One of the most significant findings of the study is related to the impact of CCC on children. In almost all interviews at community level (home visitors, children, CCC members, local government) across all four countries, respondents stated that since the CCC or CCG started operation in the community, they have experienced a general increase of orphans and vulnerable children accessing education, health services, birth registration and other services and rights that had previously been denied or were out of reach for vulnerable children in the community. This is important and indicates that despite many shortcomings in quality of mobilization, training and capacity building, coordinated community-led care responses have a positive impact on perceived child-well being at community level.
 
Discussion:
The level of investment and quality of the initial community mobilization process is critical to ensure a strong foundation for the CCC to operate as a sustainable, community-owned child and community care entity. CCC membership should be as multi-sectoral as possible and needs to include participation of orphans and vulnerable children and people living with HIV. It is suggested that CCC set up program advisory sub-groups that includes children and PLWH, and provide monitoring support of home visitors quality and are part of home visitors recruiting / vetting panels at community level. WV successfully managed to scale up across 16 countries over 3030 CCC/CCGs. However, it is important to maintain the balance of scale-up with quality implementation. WV needs to enhance its existing investment in training and capacity building of volunteer home visitors. This requires sufficient quality field staff with adequate time to facilitate mobilization efforts, provide quality training and hands-on local level capacity building with CCCs, CCGs and home visitors. For WV National Offices this may require a shift in focus, mainly from seeing the work with CCCs not as a HIV/AIDS project, but as WV key programmatic focus, towards achieving its organizational vision of sustained quality of life for children in the areas where WV presently operates its transformational development programmes. Therefore, an important programming area in for the future is to resource and facilitate a long-term process of organizational capacity building with CCCs with special focus of enhancing ownership and their ability to manage small grants. Once the CCC has grant management capacity, WV should link CCC to existing grant makers and/or set up grant making mechanisms at national level for CCCs to access small grants. CCCs have an important role to ensure horizontal and vertical networking of all stakeholders that need to be engaged in community and child care issues. Whilst CCCs presently operate well on the horizontal level of linking and networking, there is need to strengthen the capacity of CCCs in linking vertically with district and national structures. Some WV office may consider secondment of staff to district and local government entities to support district coordination of care and support for orphans and vulnerable children and through such strategic secondment link existing CCC stronger to district structures.
 
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