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Assessment of Community- and Family-Based Alternative Child-Care Services in Ethiopia

Ministry of Women, Children and Youth Affairs

Alternative care assessment report_Ethiopia_long_v1X.indd 1 12/19/2013 5:39:37 PM

DECEMBER 2013

Getnet Tadele (PhD)Desta Ayode

Woldekidan Kifle


Assessment of Community- and Family-Based Alternative

Child-Care Services in Ethiopia

DECEMBER 2013

Getnet Tadele (PhD)Desta Ayode

Woldekidan Kifle

This document was prepared by Dr. Getnet Tadele (Consultant), and Francis Okello (FHI 360), who are responsible for its content. Francis Okello oversaw the project. Desta Ayode (Consultant), Woldekidan Kifle (Consultant) and Meaza Yirga (FHI 360) contributed significantly to the document, as did Ephrem Fikre (FHI 360). The scientific writing skills of Tanya Medrano (FHI 360) and Lisa Dulli (FHI 360) brought the document to fruition and Jill Vitick developed the design layout. FHI 360 would also like to acknowledge the support received from the Federal Democratic Republic of Ethiopia Ministry of Women, Youth and Children Affairs (MoWYCA), who provided inputs to the study design and facilitated FHI 360’s collaboration with research entities. Most importantly, FHI 360 is grateful to the OAK Foundation for providing the funds to make this study possible.

© December 2013 by FHI 360

Ministry of Women, Children and Youth Affairs


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TABLE OF CONTENTS

EXECUTIvE SUMMARY 1

INTRODUCTION 5

1.1. Problem Statement 7

1.2 Objectives of the Study 8

1.3 Definitions of terms 8

METHODOLOGY 11

2.1 Study design 11

2.2 Study setting 11

2.3 Study populations 11

2.4 Research instruments 12

2.5 Sampling 13

2.5.1 Sampling - Quantitative study 13

2.5.2 Sampling – Qualitative Methods 14

2.6 Data collection 15

2.7 Data Analysis 16

2.7.1 Quantitative data analysis 16

2.7.2 Qualitative data analysis 17

FINDINGS/RESULTS 18

3.1 Profile of Agencies Providing Community- and Family-Based Alternative Child-Care Services 18

3.1.1 Magnitude and Distribution of Agencies and Services across Geographic Locations 18

3.1.2 Distribution of Agencies by Ownership, Affinity and Funding Source 24

3.2 Quality Assessment of Community- and Family-Based Alternative Care Services and Agencies 26

3.2.1 Number and capacity of staff involved in the provision of the service 27

3.2.2 Staff Capacity-Development Practices 31

3.2.3 Availability/Application of Procedures/Mechanisms to Ensure Access to Services 33

3.2.4 Availability/Application of Procedures/Mechanisms to Ensure Continuum of Care for OvC 45

3.2.5 Availability/Application of Procedures/Mechanisms to Ensure Safety of Children 53

3.2.6 Availability/Application of Procedures/Mechanisms to Ensure Participation of Children/Families/Communities in Decision Making 55

3.2.7 Availability/Application of Procedures/Mechanisms for Service Quality Assurance 60

3.3 Good Practices: Community Engagement and Integration of Services 66

3.3.1 Empowering Families and Communities to Care for Children 66

3.3.2 Innovative Strategies to Mobilize Community and Resources 67

3.4 Major Challenges for Agencies Providing Community- and Family-Based Alternative Care Services 68

DISCUSSION 77

4.1 Scope and Limitations of the Assessment 77

4.2 Access to Community- and Family-Based Alternative Child-Care Services 78

4.3 Compliance with the National Service Standards or Guidelines 80

4.4 Existence of Continuum of Care for Children without Parental Care 82

CONCLUSION AND RECOMMENDATIONS 84

REFERENCES 88


ACRWC African Charter on the Rights and Welfare of Children

AIDS Acquired immune deficiency syndrome

BOWCYA Bureau of Women, Children and Youth Affairs

FGD Focus group discussion

FHI Family Health International

HIV Human immunodeficiency virus

IDI In-depth interview

KII Key-informant interview

MOLSA Ministry Labour and Social Affairs

MOWA Ministry of Women’s Affairs

MOWCYA Ministry of Women, Children and Youth Affairs

NGAC National Guidelines on Alternative Childcare

NGO Nongovernmental organization

OAU Organization of African Union

OSSA Organization for Social Services for AIDS

OVC Orphans and vulnerable children

PHSC Protection of Human Subjects Committee

SNNPR Southern Nations, Nationalities and Peoples Region

UN United Nations

UNCRC United Nations Convention on the Rights of the Child

UNICEF United Nations Children’s Fund

ACRONYMS


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EXECUTIvE SUMMARY

INTRODUCTION

Ethiopia’s already massive number of orphans and vulnerable children (OVC) is increasing, while the capacity of the extended family, which has been at the forefront of caring for them, is declining [2]. Children without parental care are at a higher risk of discrimination, inadequate care, abuse and a host of unmet development needs. The lack of proper care for a staggering number of these children has been recognized as a severe problem requiring comprehensive and urgent intervention [1],[2]. This problem is exacerbated by a lack of information about the coverage, quality and impact of the various care options available, including formal community- and family-based alternative child-protection services. This assessment was commissioned by FHI 360 to generate evidence about formal community- and family-based alternative child-care services and service-providing agencies in Ethiopia, with a particular focus on magnitude, quality and quality-assurance mechanisms in place.

METHODOLOGY

A cross-sectional, mixed-methods design was used for conducting the assessment. The mixed-methods approach was informed by the overall purpose and objectives of the study. The approach encompasses not only generating quantitative data about the quality of community- and family-based alternative child-care services or the scale and distribution of agencies providing these services, but also an in-depth understanding of perception and experiences of various actors including community members, former beneficiaries and stakeholders. A multi-stage random sampling method was used to draw a sample of 184 agencies from a total of 354 institutions identified in the five geographic locations (Addis Ababa, Afar, Amhara, Oromia, and SNNPR) for the quantitative assessment. Purposive sampling was used to select 324 participants from the same locations for the qualitative assessment.

FINDINGS

The assessment identified the uneven distribution of services and agencies across geographic locations in the country, which currently is skewed in favour of Addis Ababa. Further examination of the relative distribution of services indicates that 90 percent of agencies provide family-preservation services that are meant to support families and prevent the unnecessary separation of children mainly due to poverty. Close to half (45 percent) of the agencies provide reunification services, and 39 percent provide adoption-placement services (almost all inter-country adoption). Only 29 percent of the 39 percent provide domestic adoption-placement services. Few agencies (11 percent) provide foster care. A higher proportion of faith-based institutions are based outside Addis Ababa,


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compared to the other regions. Almost all agencies across the five regions (95 percent) rely on funding from external donors, with only 5 percent of the agencies in the five regions relying primarily on domestic sources.

The assessment also highlighted the widely prevalent gap in compliance to the minimum conditions set in the national standard guidelines. With regard to the capacity of staff involved in providing services, there was a significant shortfall in the availability of staff with specialized qualifications. For example, only 31 percent of agencies reported having one or more psychologists, only 51 percent reported having at least one social worker, and only 48 percent have at least one health worker. The assessment also looked into the availability or application of a range of procedures and mechanisms during pre- and post-service. A large proportion of agencies indicated they have no child-protection policy to guide the conduct of their staff and provision of services (52 percent among adoption-service providers, and 28 percent foster care-service providers), and no written eligibility criteria to inform the screening of children for service eligibility (18 percent in community-based services and 46 percent in reunification services). Further qualitative investigation revealed complaints by community members about screening procedures not being appropriate or not being applied appropriately, which results in constraining access and application of the principle of continuum of care.

The number of agencies providing child-care services in the five regions (384) is small compared to the huge demand. What is more, few of these agencies provide integrated services or have linkages and referral systems to meet the needs of children that their services do not meet. This results in a limited access to continuum of care options for OVC. Only about half (54.3 percent) of the agencies providing community-based child-care services include services for children with special needs (disabilities). This was corroborated in the findings from the qualitative assessment whereby some respondents indicated the underwhelming level of integration of services for children with special needs. They emphasized how children with disabilities are under the radar of care-giving institutions, a situation that is worsened by traditional notions that discriminate against such children. Moreover, emergency placement, which can be a critical service for children whose safety and well-being is undermined or threatened, is provided by only a little over half of the agencies that provide foster care.

With regard to participation, it was found that not all agencies make provisions for children to exercise their right to participate in activities and decisions that affect their lives. The practice of consulting children in decision making was very low, especially among agencies providing community-based child-care services (6.6 percent), but many of them (75 percent) do involve the community in the form of committees of volunteers, including child-right committees and Idir members, particularly during screening of beneficiaries.


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Most agencies have some sort of internal quality-assurance mechanisms to ensure the safety of children and proper implementation of services. Almost all agencies indicated to undertake regular monitoring (follow-up) to track the progress and outcomes of the services they provide through home visits, periodic reports, staff meetings or community conversations. With regard to external quality assurance, three in every four agencies undertake regular, joint monitoring practices with relevant government authorities to review the program.

Agencies providing community-based child-care services indicated that they are overwhelmed by the huge demand for various types of family-preservation services in the community, while family-based alternative child-care service providers are reportedly daunted by the wide misconception and negative attitude towards them in the community.

Different groups of informants involved in the study have suggested measures to help address the challenges facing the organizations and improve the quality and coverage of family-preservation services. These suggestions included improving relationships with communities and community awareness, improving working relations with government and addressing the protracted bureaucratic procedures, improving the capacity of organizations, and addressing the lack of financial and human power; empowering families to be self-sufficient; improving working relationships with other agencies that work on family-preservation services, better follow-up of support; empowering communities to play more active roles, supervision and follow-up of children after placement, and supervision of agencies providing community- and family-based alternative child-care services.

RECOMMENDATIONS

• Ensure application of the principle of continuum of care and prevent the unnecessary separation of children from poverty-stricken or conflict-prone families by expanding the availability of community-based prevention services.

• Improve the capacity of MOWCYA and its substructures to provide adequate support and supervision of agencies providing formal alternative child-care services.

• Strengthen MOWCYA’s information management system and its substructures, and that of agencies providing community- and family-based alternative care services in order to provide the platform for evidence-informed planning and program implementation.

• Improve compliance to quality-standard guidelines (including having a written child-protection policy) by making the guidelines widely available and improving awareness,


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and through regular supervision and support of the service-providing agencies. This will ensure the safety and well-being of children, and meaningful participation in decisions that concern them.

• Promote linkages and referral systems among service-providing agencies and other relevant institutions to provide a continuum of care and emergency placement for at-risk children and ensure access to services for OVC with special needs or disabilities.

• Promote uptake and support for foster care and local adoption by addressing barriers such as fear of being labeled infertile, lack of awareness about the local adoption procedures, reluctance to face the legal process, or fear related to inheritance of property.

• Assess the implications of the new NGO law, which has reconfigured the criteria for defining agencies as local or foreign, and limited the funds local agencies have at their disposal for personnel and administrative costs.

• Promote widely existing informal and generally positive child-care options, mainly kinship care, through provision of guidance, support and supervision to the families that care for OVC in a bid to root out some aspects or practices of these options that undermine well-being of children.

• Protect the safety and well-being of a large number of children that find themselves under informal custody of families (relatives or non-relatives) and are subject to exploitation, violence, abuse and neglect; and explore supporting and engaging community-based organizations like Idir in this regard.

• Provide support and supervision to community-based care initiatives being led by schools, community-based organizations (such as Idirs) and other associations to support OVC.

• Research the state of children under informal care, and implications of formalizing informal/traditional family-based child-care options on the well-being of children, and readiness of families to provide support and care to OVC.

• Sustain existing community mobilization and empowerment efforts.

• Scale up access to community- and family-based alternative child-care services to ensure the safety, well-being and development of OVC by mobilizing communities, improving government engagement, and increasing donor support.

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Children without parental care are more likely to suffer abuse and neglect, face discrimination and exploitation, and have a host of unmet development needs. A large and increasing number of orphan and vulnerable children (OVC) exist worldwide [1][2]. According to UNICEF, the number of single or double orphans has reached 151 million. The causes of parental death in sub-Saharan Africa are diverse, with HIV/AIDS being one of the most prevalent. Other factors contributing to the growing number of orphan and separated children in sub-Saharan Africa include poverty, natural disaster, armed conflict, disability and discrimination [1][4].

Countries in sub-Saharan Africa are ill equipped to meet the needs of OVC and their caregivers [5]. It is a well-documented fact that a large proportion of OVC are being cared for by extended families in a context where only a fraction of these households receive any form of family-preservation support from the government, nongovernmental organizations (NGOs), or the community. As a case in point, only 0.2 percent of the 37 percent of households in Rwanda that cared for orphans were provided with support [2]. A similar situation prevails in Ethiopia. According to the 2011 Ethiopian Demographic and Health Survey (EDHS) about one in every five households has a foster child , one in every ten households has a child with only one living parent, and double orphans were prevalent in 1 in 100 of the households [6]. The increasing number of OVC and the lack of support provided to the extended families have reduced the economic capacity of these households and their ability to care for their children [2]. A rapid review in 2002 revealed that three in every four domestic workers in Addis Ababa were orphans, with the vast majority reporting not to have the freedom to quit their domestic work, without access to education, and play [7][8].

The situation is further complicated by various factors including a lack of adequate information about OVC in Ethiopia, such as their characteristics and the contexts in which they live [5]. Information is also lacking about the coverage, quality and impact of the diverse range of care options put in place by various actors, including formal community- and family-based alternative child-care services [2]. The lack of information undermines the application of continuum of care for those children without parental care.

Institutional care, which is supposed to be the last resort, is offered to children without adequately exploring the availability of other community- or family-based alternative care options. It is evident from the body of literature that institutional care stifles certain aspects of psychosocial development of children [1] and is linked with “attachment disorders and

INTRODUCTION1

1 In the EDHS, foster children are defined as “children under age 18 living in households with neither their mother nor their father present,’ and thus doesn’t make the distinction if they are living with relatives or non-relatives; or if the arrangement is temporary or permanent; a broader definition of orphans is adopted, that is, “children with one or both parents dead”.


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developmental delays in social, behavioural and cognitive functions.” [2] Institutional care seldom ensures the holistic development of the child [9]. Ensuring a healthy growth and development of vulnerable children without removing them from their familial environments is the basis of a growing global interest in community- and family-based alternative child-care options. These options are articulated in the UN Guidelines for the Alternative Care of Children [4], Convention on the Rights of the Child (UNCRC) [10] and African Charter on the Rights and Welfare of the Child (ACRWC) [11].

Recognizing the urgent need for community- and family-based alternative child-care options to address the needs of OVC in Ethiopia, FHI 360 initiated this study. Its goal was to assess the scale and quality of these alternative child-care services in Ethiopia to inform policy makers and practitioners towards evidence-informed policy and programming. The study was informed by Ethiopia’s Alternative Childcare Guidelines (developed in 2009) and the UN Guidelines on Alternative Child Care. This study’s qualitative and quantitative research tools draw heavily on these two guidelines.

Both guidelines contain five childcare options in the continuum of care: community-based care, foster care, adoption, reunification/reintegration and institutional care. Ethiopia’s Alternative Childcare Guidelines in particular promotes the following [12]:

• Quality and effective care and support to OVC that is based on ensuring the best interests of the child

• Minimum conditions on the delivery of alternative child-care services in Ethiopia, which organizations can adopt and apply according to the objective reality of their regions

• A participatory approach of dealing with the care and support for OVC

• A code of ethics and the design for M&E systems to be followed by organizations applying the alternative child-care guidelines

This report is organized into four sections. Section 1 introduces the problem, objectives and methods of the assessment. Sections 2 presents findings of the assessment encompassing characteristics of agencies, state of quality across a range of indicators, including access, safety, participation, continuum of care; and internal and external quality-assurance mechanisms. Section 3 presents the assessments findings and results. Section 4 presents a discussion of the study’s scope, limitations and challenges. The final section provides the conclusions and recommendations drawn from the results.


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1.1. PROBLEM STATEMENT

The absence of proper care for a staggering number of children devoid of parental care has been recognized as a severe problem requiring comprehensive and urgent intervention. Notwithstanding the prevalence of hundreds of agencies (governmental, nongovernmental and faith-based) operating in the country providing a gamut of community- and family-based alternative child-care services, only piecemeal information about these agencies and their work is available. The state of formal community- and family-based alternative child-care services at the national level remains unexamined and little understood [2]. In the context of such a dearth of data, it is imperative to have valid and reliable quantitative and qualitative data on the magnitude and characteristics of these institutions as well as the quality of services they provide.

This data will help make informed policy and program decisions to promote the continuum of care for children deprived of their family environment or parental care, and address issues that undermine their best interests. This is particularly important in Ethiopia, where there is a growing number of OVC, but little interest among child-care agencies in community- and family-based alternative care. These agencies seem inclined more towards residential care and inter-country adoption. [9]

The existing research in alternative child care dwells on residential care and development challenges facing institutionalized children. Community- and family-based alternative child-care services, formal or informal options, or the agencies providing these services are emerging, but are the least researched topics in the field. Currently, comprehensive research that encompasses a wide range of formal community- and family-based child-care services is nonexistent in Ethiopia. Little evidence is available on the extent to which the standards on alternative child-care services are implemented and supervised. It is therefore high time to conduct this study to assess the current status of formal community- and family-based child-care services in the country.

An earlier study conducted on child-care institutions by FHI 360 suggested that a quarter of child-care institutions in Ethiopia had no practical experience in implementing alternative child-care services, and the majority of those practicing alternative care mainly depend on the inter-country adoption as the only alternative placement, along with residential care. These drawbacks were mainly attributed to limited experiences and the dearth of practical information on the existing family-based alternative child-care services. [9] Even for these services, there is little comprehensive data on the best practices achieved and the challenges encountered by these organizations. This study attempts to address such gaps and generate data on the magnitude of agencies providing formal community- and


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family-based alternative child-care service in five geographic locations in the country (Addis Ababa, Afar, Amhara, Oromia and SNNP regions); the quality of services they provide; and the quality-assurance mechanisms used. Data from this assessment would help bridge the documentation gap in the sector and contribute to expanding an evidence-based plan of action and policy decisions pertaining to the continuum of child-care options in Ethiopia.

1.2 OBJECTIVES OF THE STUDY

The goal of this study was to describe the existence and quality of formal community- and family-based alternative child-care services in Ethiopia and to inform action planning to address the identified gaps in services.

The study aimed to address the following four specific objectives:

• To identify, list and quantify all formal forms of community and family-based alternative child-care services offered in the five studied regions in Ethiopia at the time of study implementation, per type

• To describe the extent and quality of alternative child-care services (including the extent to which they function within the continuum of alternative child care, qualifications of staff and service-delivery standards used) and gaps to be addressed

• To investigate existing quality-assurance mechanisms and tools, and their use in monitoring family-based alternative child-care services

• To inform the development of practical recommendations to address the identified gaps

1.3 DEFINITIONS OF TERMS

The definitions for the following terms are extracted from the National Alternative Childcare Guidelines (2009), the UN Guidelines for the Alternative Care of Children (2009) and other relevant literature [2].

Access procedures and mechanisms encompass mechanisms and procedures that are put in place to ensure that various formal community- and family-based alternative child-care service alternatives are available to OVC; and to identify and recruit appropriate targets (children and families), including eligibility criteria that serve as a crucial gate-keeping strategy.


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Adoption is the formal, permanent transfer of parental rights to a family other than a child’s biological parents and the formal assumption by the adopting parent(s) of all parenting duties for the child.

Agencies are the public or private bodies that organize alternative care for children. In this study, the term is used interchangeably with institution and organization.

Community-based care refers to a variety of community-initiated and/or community-led interventions that are provided within a child’s own community and within a family or family-like setting. These include family-strengthening, psychosocial support, empowerment, economic development and cash assistance. The term is interchangeably used with the term family-preservation services (FPS).

Domestic adoption is an adoption that involves adoptive parents and a child of the same nationality and the same country of residence.

Family-based alternative child-care services refer, in this study, to forms of care that are characterized by family environment or parental care and include adoption, foster care and reunification.

Formal care refers to all care provided in a family environment that has been ordered by a competent administrative body or judicial authority, and all care that is provided in a residential environment, including private facilities.

Foster care situations are those in which children are placed by a competent authority in the domestic environment of a family other than the children’s own parents for the purpose of alternative care. That family must be selected, qualified, approved and supervised for providing such care.

Informal care is any private arrangement (not ordered by an administrative or judicial authority or a duly accredited body) in which a child is looked after on an ongoing or indefinite basis by relatives, friends (informal kinship care) or others in their individual capacity, at the initiative of the child, his/her parents or other person.

Inter-country adoption is an adoption that involves a change in the child’s habitual country of residence, whatever the nationality of the adopting parents.

Kinship care is family-based care within the child’s extended family or with close friends of the family known to the child, whether formal or informal in nature.


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Mechanisms and procedures encompass laws, policies, rules, regulations, practices and conditions.

Mechanisms and procedures for continuum of care refers to mechanisms and procedures that comply or contribute to the realization of the principle of continuum of care by the preference of caring for children within their families and communities, an emphasis on prevention of unnecessary separation of children from their families, and a recognition of institutional care as a last resort when options for community- and family-based alternative care are exhausted.

Orphans and Vulnerable Children (OVC) are children whose survival and development is jeopardized by certain circumstances and are therefore in need of alternative child-care services. Among others, OVC include: single and double orphans; street children; abandoned children whose parents /families are untraceable; children with disabilities and trafficked children; children exposed to the worst forms of child labour; children infected or affected by HIV/AIDS; victims of sexual abuse and exploitation; displaced children; non-orphan children whose parents are not able to support the child due to illness, injury or detention; child mothers; children in conflict with law; households headed by a child; separated children; refugee children; and other target children, depending on the local definition of vulnerability.

Participation mechanisms and procedures include mechanisms and procedures that are meant to ensure that children, families and communities exercise their rights to participate in activities and express their views in decisions that affect their lives, including the planning and implementation of services.

Quality-assurance mechanism and procedures encompass mechanisms and procedures that are meant to promote or guarantee the proper planning and implementation of services by service-providing agencies. These procedures can be internal (the agency concerned plays a central role) or external (the relevant government authority assumes a critical role)

Safety mechanisms and procedures refer to mechanisms and procedures put in place to ensure the protection of children from all sorts of violence, abuse, neglect and exploitation during pre- and post-placement in formal community- and family-based alternative care services.

Service quality refers to the extent to which the community- and family-based alternative child-care services provided by the agency fulfil the minimum standards outlined in the Alternative Child Care Guidelines.


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METHODOLOGY

2.1 STUDY DESIGN

A cross-sectional assessment using mixed methods was carried out. The selection was informed by the overall purpose and objectives of the study to generate:

• Quantitative data about the quality of community- and family-based alternative child-care services or the scale and distribution of agencies providing these services

• Qualitative data to provide an in-depth understanding of the perception and experiences of various actors including community members, former beneficiaries and stakeholders towards community- and family-based alternative child-care services

Ethical clearance for the assessment was obtained from the Ministry of Women Children and Youth Affairs (MOWCYA) and FHI 360’s Committee for Protection of Human Subjects (PHSC).

2.2 STUDY SETTING

The assessment was conducted within the setting of five selected regions in the country: Addis Ababa, Afar, Amhara, Oromia and Southern Nations, Nationalities and Peoples Region (SNNPR). The selection of study sites was made in consultation with key informants (KIs) in the MOWCYA. The five regions were selected purposively to capture the diversity of geographic location, population size and culture in the country. Addis Ababa, being the capital city and administrative and business hub of the country, is where the majority of the agencies providing formal community- and family-based alternative child-care services are concentrated. Oromia, Amhara and SNNPR comprise the most populous regions and represent the agrarian societies in the rest of the country. The SNNPR is the most diverse region in the country, comprising over 50 ethnic groups. Afar, representing pastoralist societies in the country, is one of the least populous and underdeveloped regions.

2.3 STUDY POPULATIONS

The populations for the quantitative assessment were child-care agencies spread across the five selected regions providing different types of formal community- and family-based alternative child-care services, including foster care, adoption, kinship care, reunification and family-preservation services (FPS). The source populations for the qualitative study included the following diverse categories:

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• Former beneficiaries. This includes adults or youth who, due to their orphanhood or vulnerability status in the past, received either community- and family-based alternative child-care services.

• Guardians, caregivers or parents. This refers to host, foster or adopting families of OVC or parents of vulnerable children who received either community- or family-based alternative child care.

• Community representatives. This refers to those who are well aware of the state of OVC in the community, alternative family-based child-care services and other agencies providing services. These include leaders of local government and heads of religious and religious organizations.

• Heads of child-focused organizations. This refers to representatives (heads) of agencies involved in family-based child-care services.

• Key Informants. This refers to representatives and experts from relevant government and nongovernment institutions (the authorities or regulatory bodies). These informants were selected on the basis of knowledge and experience of working with agencies providing family-based alternative child-care services.

2.4 RESEARCH INSTRUMENTS

The development of research instruments was informed mainly by the National Alternative Childcare Guidelines and the National Standard Service Delivery Guidelines for OVC developed by Ministry of Women Affairs (MOWA) in 2009 and in 2010, respectively. The rationale for using these guidelines in the process of designing the questionnaire is based on the fact that the guidelines contain a set of minimum conditions to maintain the quality of services in alternative child care and are currently serving as official regulatory instruments. The UN Guidelines for the Alternative Care of Children is the other international document consulted for this purpose.

Structured and semi-structured data-collection tools were developed. Structured questionnaire were employed to gather data on quantitative indicators and covered a whole range of issues about the characteristics of agencies and the quality of services they provide. Semi-structured interviews and discussion guides were designed to generate a wide range of qualitative information dealing with experiences and perception of participants about agencies and the quality of services they provide.

METHODOLOGY CONTINUED


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TABLE 1 - Category of participants and research tools used for the study

NO. RESEARCH INSTRUMENT CATEGORY OF PARTICIPANTS SAMPLE

1 Quantitative instrument (Structured Questionnaire)

Heads of childcare organizations 184

2 Key informant interview Relevant authorities or regulatory bodies 25

3 In-depth individual interview Representatives of childcare agencies (heads or senior staffs)

65

4 Focus group discussion guide Community Representatives Parents/caretakers

110111

5 Case studies Former beneficiaries (youths and adults who received alternative care)

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Total 508

The tools were reviewed by relevant FHI 360 staff and pre-tested in and around Addis Ababa with some volunteer child-care organizations. The tools were further refined in accordance with feedback obtained from the pre-test. Some of the amendments include omitting vague and ambiguous questions, adding new questions based on ideas that emerged during the pilot test, clarifying concepts related to community- and family-based alternative child care and rearranging the order of questions.

2.5 SAMPLING

2.5.1 SAMPLING - QUANTITATIVE STUDY

Multi-stage sampling was employed to draw samples for the quantitative assessment. The agencies providing formal community- and family-based alternative child-care services made up the unit of analysis. A sampling frame of agencies providing formal community- and family-based alternative child-care services in the country was constructed. A consultative meeting was held with staff from FHI 360, MOWCYA and other relevant stakeholders from selected regions to inform the sampling process. Because the study focused on formal community- and family-based alternative child care, only organizations recognized by the Federal Charities and Societies Agency or MOWCYA were included in this list.


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The sampling frame comprises a total of 354 institutions spread across the five regions. The highest administrative structures in the country, namely federal regions, were used for stratifying the population into diverse but representative strata. Establishing strata by region was instrumental for the purpose of this study, as these administrative divisions coincide with cultural or language diversity in the country and such stratification allowed capturing this diversity. Of the 11 administrative structures (nine regions and two special administrations) in the country, purposive sampling was used to select five regions, Addis Ababa, Oromia, Amhara, SNNPR and Afar, from which samples were drawn. The regions are starkly distinct from each other in terms of population and geographic size, main means of livelihood, culture and language, and their level of development.

In the absence of information about the prevalence of agencies providing the various community- and family-based alternative child-care services, the prevalence rate was set to be 0.5 to yield the maximum sample size. Hence, a sample size of 184 was determined with 95 percent confidence level, and 5 percent confidence limit. The sample size was distributed proportionally across the regions, and a stratified random sampling technique was used to draw the agencies participating in the national assessment.

2.5.2 SAMPLING – QUALITATIVE METHODS

Individuals for the focus group discussion (FGD), in-depth interviews (IDIs), and key informant interviews (KIIs) were selected using purposive sampling. The selection of informants was done in consultation with the regional Bureaus of Women, Children and Youth Affairs. Besides, the criterion of conceptual saturation was used, by carefully looking


TABLE 2 - Sampling frame and distribution of sample agencies across geographic locations

REGIONS POPULATION SAMPLE PERCENTAGE

Addis Ababa 150 78 42

Amhara 131 68 37

SNNPR 39 20 11

Oromia 23 12 6

Afar 11 6 3

TOTAL 354 184 100


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into the recurrence of information generated from participants, to decide when to stop the data collection. Accordingly, a total of 324 informants took part in FGDs, IDIs, KIIs and case studies as presented below.

2.6 DATA COLLECTION

Dara were collected from October 31 to November 30, 2012. The overall process involved a set of activities that include training for data collectors, pilot testing the instruments, deploying the data collectors and gathering data in the field. Twenty data collectors and five supervisors, who had a second degree in social sciences and experience in data collection, were recruited and took part in the data collection. Data collectors and supervisors received three days intensive training (orientation). The training mainly included a review of the objectives of the study, data-collection procedures, basic concepts in quantitative and qualitative research methods, basic interview techniques, ethical considerations and reviewing the data-collection tools to ensure clarity and accuracy of interview guides and the survey questionnaire.

Quantitative data were gathered from agencies involved in family-based alternative child-care services through self-administered and structured questionnaires. The heads of the agencies or relevant or senior staff filled out the form with the assistance of the trained data collectors who were responsible for delivering, clarifying and collecting the completed

SAMPLE PER REGION

DATA COLLECTION METHODS AND TOOLS

ADDIS ABABA AMHARA OROMIA SNNPR AFAR

In-depth Individual interview with representatives of childcare agencies

10 11 20 16 8

Key Informants Interview with regulatory bodies

2 2 3 4 3

Number of FGDs with community representatives

2 2 3 4 4

Number of FGDs with Parents and caretakers

5 5 5 5 5

Case Study guide for former beneficiaries 3 2 3 2 3

Table 3 - Method, number and type of interviews conducted


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form. Focal persons from the regional Bureaus of Women, Children and Youth Affairs were informed by circular letter and through consultative meetings. Their cooperation and facilitation helped to secure a high response rate.

2.7 DATA ANALYSIS

Qualitative and quantitative data were analysed concurrently, and the qualitative and quan-titative results were compared with each other to ensure rigor, depth and scope of analysis by seeking convergence and complementarity of data across method and data sources.

2.7.1 QUANTITATIVE DATA ANALYSIS

The quantitative data analysis was predominantly descriptive as its aim was to determine the magnitude and distribution of agencies, and the quality of community-and family-based alternative child-care service that they provide. It also had a comparative and relational component, whereby the variables pertaining to the magnitude and distribution of agencies and the quality of services were compared across different categories. The quantitative data analysis followed three phases:

• Ensuring data integrity by testing whether responses furnished by participants were applicable. This involved checking the validity of data to see if there were any inconsistencies across responses in the dataset, to detect erroneous entries introduced at data collection or capturing stages and account for missing responses. This was done both manually and using SPSS.

• Conducting descriptive analysis. This was done by running frequency tables and measures of central tendency, such as average and dispersion for relevant questions pertaining to quality and coverage.

• Conducting comparisons across and within groups through selected statistical tests. This was done by running cross-tabulation of dependent variables across possible explanatory variables. Whenever there were adequate data, this was followed by tests of statistical independence such as chi-square to see if differences among categories was statistically significant.

IBM SPSS Statistics 21 was used to undertake the statistical analysis. Tables, graphs and narrations were used to present data. While analysing the data, it was found useful to compare data between Addis Ababa and the other four regions because of the unique characteristics of Addis Ababa: it is the business and administrative hub of the country and



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comprises two-fifths of the total agencies in the five regions. Another reason that prompted the merging of the other regions into one, apart from their relative similarity with each other as compared to Addis Ababa, is the fact that the number of agencies in all the other regions but Amhara was relatively small to allow meaningful individual cross-region comparison.

2.7.2 QUALITATIVE DATA ANALYSIS

The qualitative data analysis was entirely descriptive as its purpose was to gain in-depth insight about the nature and status of services, as well as the perceptions and experiences of children and targeted communities. It has a relational aspect as it involves comparing perceptions and experiences of different respondent groups about alternative forms of care. The qualitative data were analysed systematically, and the process involved two main phases.

Coding and organization of gathered data were done using themes drawn from the study protocol, and also generated from the data from recurring themes that were significant to the study. The latter was achieved through an iterative process or re-reading. The focus of the analysis revolved around the different forms of alternative child-care options. The researchers, in consultation with relevant FHI 360 staff, developed themes that shed light on issues of interest to the research, such as quality of services. Having identified themes, the researchers then looked for patterns and linkages across information that was gathered from different sources and different data-collection methods.


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In this section major findings from the quantitative and qualitative components of the assessment are presented to provide insight into the situation of formal community- and family-based alternative child-care services encompassing the study’s five diverse locations.

3.1 PROFILE OF AGENCIES PROVIDING COMMUNITY- AND FAMILY-BASED ALTERNATIVE CHILD-CARE SERVICES

This section focuses on the characteristics of agencies providing child-care services and attempts to identify, list and quantify all formal forms of community- and family-based alternative child-care services per type in the five studied regions at the time of study implementation. The section highlights the distribution of agencies and services across geographic location, ownership, affiliation and source of funding categories.

3.1.1 MAGNITUDE AND DISTRIBUTION OF AGENCIES AND SERVICES ACROSS GEO-GRAPHIC LOCATIONS

The following table depicts the magnitude and distribution of the institutions operating across the five regions.

Overall, the assessment depicted the skewed geographical distribution of organizations providing formal family- and community-based child-care services in the five regions, with Addis Ababa alone claiming 42 percent of these institutions. The second highest proportion of institutions was found in the Amhara regional state, accounting for over one-third of the institutions (37 percent). SNNPR had a little over one-tenth of the institutions, with Oromia and Afar comprising about 6 and 3 percent, respectively.

Findings from the qualitative assessment conducted across the country also highlighted the uneven distribution of institutions providing community- and family-based alternative

FINDINGS/RESULTS

REGIONS POPULATION PERCENTAGE

Addis Ababa 150 42

Amhara 131 37

SNNPR 39 11

Oromia 23 6

Afar 11 3

Total 354 100

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Table 4 - Magnitude and distribution of agencies across geographic locations


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FINDINGS/RESULTS

ADDIS ABABA(N=78)%

OTHER REGIONS(N=104)%

TOTAL (N=182)%

Community-based care services for highly vulnerable children 88.5 92.3 90.7

Family-based alternative care services for children without parental care

Adoption total 48.7 31.7 39.0

Inter-country adoption only 81.6 57.6 70.4

Provide both local and international adoption 18.4 42.4 29.6

Foster care 9.0 10.6 9.9

Reunification 37.2 50.0 44.5

Table 5 - Proportion of agencies offering different types of services, by location

child-care services across the regions. A similar imbalance was also reported between urban and rural parts of the regions. Many participants of the qualitative assessment underlined the lack of equity in accessing these services. They reported that most if not all agencies providing formal family-based alternative care are concentrated in urban centres, leaving the majority of needy children in rural areas with little access to these services.

The main problem is that only the OVC found in urban areas and conducive environment can get the child-care services. But as you know our society is pastoralist and they live in rural and remote areas where the child-care service providers could not reach. So majority of OVC who need care do not have access. We were begging the organizations to expand their coverage, but they could not still expand their coverage to include hard to reach areas.

-50-year-old male religious leader, Afar

…much remains to be done. There are communities in marginal areas that live under terrible life situations. Because of their remote location they do not get such services. … Most organizations do not prefer to go to more remote rural areas and work there. Even some of them do not have an office here. They permanently live in Addis Ababa.

-64-year-old male local leader, SNNPR


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Community-Based Care

The distribution of services depict that 90.7 percent of agencies provide community-based FPS, with the proportion for Addis Ababa slightly lower than the combined average for the other regions.

The agencies reported providing various types of FPS. Overall economic strengthening and educational support were the most popular services, reported by 87.3 percent and 85.5 percent of the institutions, respectively. The second most popular categories of services include provision of health care, parenting skills and competencies, food/nutrition and psychosocial support. Other relatively less common forms of FPS include the provision of legal protection and shelter and care. Across regions, the provision of services such as health care and legal protection was significantly higher in the regions than in Addis Ababa.

Family-Based Alternative Care

In terms of family-based alternative care services, reunification was the most prevalent service reportedly provided by about half of the agencies. Foster-care placement was reportedly provided by 11 percent of the institutions. Adoption placement was the second

FINDINGS/RESULTS CONTINUED

TYPE

ADDIS ABABA(N=69)%


TOTAL (N=165)%

Economic strengthening 88.4 86.5 87.3

Parenting skills and competencies 60.9 52.1 55.8

Conflict management skills 13.0 14.6 13.9

Food/Nutrition 52.2 60.4 57.0

Shelter and care 27.5 31.3 29.7

Health care 60.9 76.0 69.7

Education 85.5 85.4 85.5

Psychosocial support 53.6 60.4 57.6

Legal protection 17.4 32.3 26.1

Life skills/vocational training for OVC 4.3 3.1 3.6

Table 6 - Proportion of agencies offering different family preservation/strengthening services provided


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most popular family-based alternative care service provided by close to two-fifths of the institutions, with a higher proportion in Addis Ababa than the combined proportion for the other regions. The vast majority of the organizations provided inter-country adoption alone. It was only the remaining 29.6 percent that combined inter-country and domestic adoption. No institutions provided domestic adoption placement alone.

The qualitative assessment highlighted demand-side factors that could help explain the relatively high prevalence of agencies that provide inter-country adoption-placement services. The assessment found a widespread perception in the general public that inter-country adoption is favoured over domestic adoption, as it is considered beneficial to the children.

Generally, the assumption that “if I let my child go abroad, he will be rich and he will support me… I will address my economic problems” has become pervasive in the community. People equate with DV (diversity Visa lottery). As those who go abroad often become economically better off, families also expect to be financially rewarded in the future from sending their children…

-54 year old religious leader, Sodo

Likewise, many of the KIs stated that some of the major misperceptions associated with inter-country adoption included the notion that the child invariably receives better care and would, as an adult, support the family in the future. A KI from South Wollo said:

On one occasion the Woreda court approved the real biological parents of a child as if they are the aunt and uncle of the child. And then the process of inter- country adoption was started by one of the service providers. But when we did some fact-finding investigation, we came to know that the so-called aunt and uncle of the child were actually identified as the real mother and father of the child. From this you can see the attitude of our community. This is because of the [undue sensitization] service providers conduct in the community about the advantages of inter- country adoption.

Community representatives who participated in the FGDs across the studied regions also recognized the role of a growing number of local agencies that facilitate inter-country adoption as one of the reasons for the popularity and positive perception towards this form of care. The practice of formal domestic adoption was reported to be rare in all the regions. Many people were said to be keen to avoid the legal procedures of formalizing the relationship and the status of the child. This is mainly related to the issue of inheritance: a formally adopted child is entitled to claim inheritance just as a biological child would. Even when the potential adoptive parents want to go this route, close family members apply


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pressure against it. Most respondents underscored that they are not aware of formal/legal adoption of children by local community members. This, according to some informants, is a deliberate move by adopting parents who want to avoid the risk of inheritance issues.

Except those who have no children and the capacity to raise children, people have not developed the culture of raising someone’s child. They are suspicious. They do not want them to inherit like their biological children. This, apart from capacity constraint, is the main factor deterring local adoption.

-FGD participant, 54-year-old male religious leader, Sodo, SNNPR)

The practice of domestic adoption is not commonly practiced in our community because we do not consider the problem as our own problem and we do not consider these children as our citizens. In addition, there is also lack of awareness of the community towards domestic adoption in terms of benefits to the children, community and the country at large.

-FGD participant, Amhara

Similarly, many KIs asserted that issues related to the inheritance rights of formally adopted children explain the low uptake of formal domestic adoption in the country. A quote from one of the KI from the Afar region depicts how inhibited people are to formalize local adoptions.

There is a good culture in Afar society; they support their nephews and niece more than their own children. They do not leave children without support. So, requesting such willingly adopting family to enter a formal agreement creates doubt on the family and affects their normal love for the child.

The sentiment is shared even by a respondent from staff of Afar BOWCYA, as follows:

If I had the opportunity/power, I would have blocked formal adoption in my region. I would have worked on having these OVC adopted in other families so they receive socialization and family love without insisting the adopting family sign any formal adoption agreement since it will only create some bad feelings on the part of the adopting family. As you know Allah gives us children without any agreement and feeling responsible is already there by default. So, I would create and strengthen that feeling on the families.

Overall, IDI informants reported that cultural barriers (fear of being labelled for infertility), lack of awareness about the local adoption procedures and reluctance to face the legal process,


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fear of inheritance matters, the community’s lack of awareness and limited economic capacity to raise additional children as some of the challenges that hamper domestic adoption.

Discussion with community representatives illuminated that informal forms of adoption are common. This practice seems to be entrenched in the culture of the Ethiopian society and perhaps, compared to other forms of family-based alternative care, accounts for the lions-share of care for OVC. Practices like Gudifecha, which is popular in the Oromia region, are good examples. Many families have provided care and support to the children of their extended families, raising them to be good and successful citizens. The practice was also said to be popular due to cultural beliefs, such as adopting or caring for an abandoned child helps with fertility.

Gudifecha/local adoption is widely practiced in our surrounding. Such practice is taken up either by those who don’t have children or those who are passionate. A person with warm heart never passes when seeing abandoned child. When children are found abandoned they are first taken to police. Some women, who haven’t given birth, believe that when they adopt a child of other people, they will be blessed with their own (biological) child. Due to this, some people may adopt a child. These are people who adopt a child through legal procedures with facilitation of Women, Children and Youth Affairs.

There are also some other encouraging developments in domestic adoption and community ownership of OVC issues, as the following story depicts:

Adoption, key informant accounts of initiatives to promote local adoption, SNNPRIn our zone there is a good start in local/domestic adoption practice. So far three people adopted children. To encourage these people and the community we gave them awards in the presence of religious and community leaders. We also closed down six agencies which were solely working on inter-country adoption. About 120 children who were under the custody of these organizations were reunited with their biological and extended families after conducting family tracing and awareness creation activities. During reunification, we raise awareness by inviting some members of the Kebele in a ceremonial way. We do this to make the community aware that bringing up children in their own country is better than placing them for international adoption. As a result, even those parents whose children already went abroad also began to request that their children return. I think there are lots of changes. Surprisingly local adoption has also increased though it is still minimal. Some individuals are expressing their willingness to adopt children in a legal and procedurally acceptable way. It is promising but still a lot remains to be done. In government organizations, government employees also contribute money. For instance, we developed draft document proposing that every organization shall provide long term support to at least 15 to 20 children. We also shared the document with various offices to discuss and comment. It is expected to include government employees at all levels.


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3.1.2 DISTRIBUTION OF AGENCIES BY OWNERSHIP, AFFINITY AND FUNDING SOURCE

COMMUNITY-BASED CARE SERVICES

FAMILY-BASED ALTERNATIVE CARE SERVICES

FAMILY-BASED ALTERNATIVE CARE SERVICES (continued)

FPS ADOPTION FOSTER CARE REUNIFICATION

ADDIS ABABA(N=69) %

OTHER REGIONS(N=96) %

TOTAL (N=165)%

ADDIS ABABA(N=69) %


TOTAL (N=165)%

ADDIS ABABA(N=69) %


TOTAL (N=165)%

ADDIS ABABA(N=69) %


TOTAL (N=165)%

Ownership

Local NGO 63.8 80.2 73.3 44.7 87.9 64.8 85.7 54.5 66.7 75.9 88.5 84.0

Foreign NGO 36.2 19.8 26.7 55.3 12.1 35.2 14.3 45.5 33.3 24.1 11.5 16.0

Affiliation

Faith-based 14.5 36.5 27.3 5.3 9.1 7.0 0.0 36.4 22.2 17.2 15.4 16.0

Non-faith-based 85.5 63.5 72.7 94.7 90.9 93.0 100.0 63.6 77.8 82.8 84.6 84.0

Funding source

External 95.7 95.8 95.7 100.0 90.6 95.7 100.0 100.0 100.0 96.6 90.2 92.5

Domestic 4.3 4.2 4.3 0.0 9.4 4.3 100.0 100.0 100.0 3.4 9.8 7.5

Stark differences prevail in the distribution of institutions that provide community-based care services for highly vulnerable children and family-based alternative care services for children without parental care in Addis Ababa and other regions across ownership and affiliation. Proportionally, for every international organization, there were three local institutions. Compared to the combined proportion of other regions, Addis Ababa has a higher proportion of foreign/international institutions and a lower proportion of faith-based organizations. In contrast, the distribution of institutions across funding source was at a par across regions, and a staggering 95.7 percent of the agencies rely on external funding. Various groups of participants in the qualitative assessment underscored the pervasive reliance on external support coupled with low fund-raising capacity locally as a major threat undermining the sustainability of support and care for OVC. (See Section 3.4, Major Challenges for Agencies Providing Community- and Family-Based Alternative Care Services.)

Family-Based Alternative Care Services

Adoption: As depicted in the above table, 64.8 percent of organizations that provide adoption services were local institutions, and 35.2 were international ones. The proportion of international organizations was far higher in Addis Ababa than in other regions. The

TABLE 7 - Distribution of institutions by ownership, affinity and source of funding


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COMMUNITY-BASED CARE SERVICES

FAMILY-BASED ALTERNATIVE CARE SERVICES



ADDIS ABABA(N=69) %


TOTAL (N=165)%

ADDIS ABABA(N=69) %


TOTAL (N=165)%

ADDIS ABABA(N=69) %


TOTAL (N=165)%

ADDIS ABABA(N=69) %


TOTAL (N=165)%

Ownership

Local NGO 63.8 80.2 73.3 44.7 87.9 64.8 85.7 54.5 66.7 75.9 88.5 84.0

Foreign NGO 36.2 19.8 26.7 55.3 12.1 35.2 14.3 45.5 33.3 24.1 11.5 16.0

Affiliation

Faith-based 14.5 36.5 27.3 5.3 9.1 7.0 0.0 36.4 22.2 17.2 15.4 16.0

Non-faith-based 85.5 63.5 72.7 94.7 90.9 93.0 100.0 63.6 77.8 82.8 84.6 84.0

Funding source

External 95.7 95.8 95.7 100.0 90.6 95.7 100.0 100.0 100.0 96.6 90.2 92.5

Domestic 4.3 4.2 4.3 0.0 9.4 4.3 100.0 100.0 100.0 3.4 9.8 7.5

spread of the institutions across affiliation seems at a par in Addis Ababa and the other regions. With respect to funding sources, an overwhelming proportion of the institutions rely on external funding. All the institutions in Addis Ababa reportedly depend on external funding sources. The proportion in the other regions was comparably high, with 90.6 percent of institutions claiming to depend on external funding.

Foster care: The distribution of institutions that provide foster care across ownership categories was 2:1 in favour of local institutions. Unlike agencies providing community-based care and adoption services, the proportion of local institutions engaged in foster-care placement was higher in Addis Ababa than in the other regions. Other regions have a higher proportion of faith-based organizations. When it comes to funding, all institutions across regions depend on external funding.

Reunification: Patterns of the distribution of institutions that provide reunification services show that Addis Ababa has a higher proportion of foreign institutions. Unlike other services, the proportion of faith-based organizations was a bit higher than it is in the other regions. The distribution across funding source was more or less equivalent across regions.

TABLE 7 - Distribution of institutions by ownership, affinity and source of funding


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NUMBER AND QUALIFICATION OF STAFF TYPE OF SERVICE TYPE OF SERVICE (continued) GEOGRAPHIC LOCATION

STAFF FPS ADOPTION FOSTER CARE REUNIFICATION REGIONS TOTAL

TOTAL (N=165)%

AVERAGESTAFF NO.

TOTAL (N=71)%

AVERAGE STAFF NO.

TOTAL (N=18)%

AVERAGE STAFF NO.

TOTAL(N=81)%

AVERAGE STAFF NO.

ADDIS ABABA(N=78)%

OTHER REGIONS (N=104)%

TOTAL (N=182)%

AVERAGE STAFF NO.

Program staff 98.2 18.0 95.8 22.3 94.4 35.0 96.3 23.4 94.9 99.0 97.3 17.9

Admin. support staff 95.8 11.2 94.4 8.3 88.9 21.6 96.3 14.9 94.9 97.1 96.2 11.1

Educational level

High school Certificate 70.9 10.3 80.3 12.7 88.9 19.4 80.2 11.7 76.9 65.4 70.3 11.0

Diploma 94.5 7.4 95.8 6.0 88.9 16.2 95.1 9.1 92.3 95.2 94.0 7.18

First degree 93.3 5.7 85.9 3.7 88.9 6.8 87.7 6.9 88.5 89.4 89.0 5.6

Second degree or above 37.0 2.2 31.0 2.7 44.4 4.9 39.5 2.8 53.8 21.2 35.2 2.1

Under high school 52.7 9.8 62.0 8.9 61.1 17.1 64.2 12.2 60.3 48.1 53.3 9.5

Specialized qualifications

Social work 53.3 2.8 53.5 1.9 61.1 2.3 64.2 3.0 57.7 46.2 51.1 2.7

Psychologist 32.7 1.5 33.8 1.3 50.0 1.5 44.4 1.6 34.6 28.8 31.3 1.6

Health worker 49.7 3.5 56.3 3.1 55.6 5.3 56.8 4.1 59.0 40.4 48.4 3.5

Lawyer 18.8 1.2 32.4 1.0 50.0 1.1 23.5 1.47 26.9 12.5 18.7 1.2

Economics, management, business administration, accounting

17.0 1.0 14.1 1.0 16.7 1.0 14.8 1.0 3.8 26.0 16.5 1.0

TABLE 8 - Number and capacity of staff

3.2 QUALITY ASSESSMENT OF COMMUNITY- AND FAMILY-BASED ALTERNATIVE CARE SERVICES AND AGENCIES

The provision of formal community- and family-based alternative child-care services encompasses a range of procedures and tools that need to be employed appropriately before, during and after providing the services to ensure the access, safety, well-being and development of children [12]. This section describes the extent and quality of existing alternative child-care services and the gaps that need to be addressed.


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NUMBER AND QUALIFICATION OF STAFF TYPE OF SERVICE TYPE OF SERVICE (continued) GEOGRAPHIC LOCATION

STAFF FPS ADOPTION FOSTER CARE REUNIFICATION REGIONS TOTAL

TOTAL (N=165)%

AVERAGESTAFF NO.

TOTAL (N=71)%

AVERAGE STAFF NO.

TOTAL (N=18)%

AVERAGE STAFF NO.

TOTAL(N=81)%

AVERAGE STAFF NO.

ADDIS ABABA(N=78)%


TOTAL (N=182)%

AVERAGE STAFF NO.

Program staff 98.2 18.0 95.8 22.3 94.4 35.0 96.3 23.4 94.9 99.0 97.3 17.9

Admin. support staff 95.8 11.2 94.4 8.3 88.9 21.6 96.3 14.9 94.9 97.1 96.2 11.1

Educational level

High school Certificate 70.9 10.3 80.3 12.7 88.9 19.4 80.2 11.7 76.9 65.4 70.3 11.0

Diploma 94.5 7.4 95.8 6.0 88.9 16.2 95.1 9.1 92.3 95.2 94.0 7.18

First degree 93.3 5.7 85.9 3.7 88.9 6.8 87.7 6.9 88.5 89.4 89.0 5.6

Second degree or above 37.0 2.2 31.0 2.7 44.4 4.9 39.5 2.8 53.8 21.2 35.2 2.1

Under high school 52.7 9.8 62.0 8.9 61.1 17.1 64.2 12.2 60.3 48.1 53.3 9.5

Specialized qualifications

Social work 53.3 2.8 53.5 1.9 61.1 2.3 64.2 3.0 57.7 46.2 51.1 2.7

Psychologist 32.7 1.5 33.8 1.3 50.0 1.5 44.4 1.6 34.6 28.8 31.3 1.6

Health worker 49.7 3.5 56.3 3.1 55.6 5.3 56.8 4.1 59.0 40.4 48.4 3.5

Lawyer 18.8 1.2 32.4 1.0 50.0 1.1 23.5 1.47 26.9 12.5 18.7 1.2

Economics, management, business administration, accounting

17.0 1.0 14.1 1.0 16.7 1.0 14.8 1.0 3.8 26.0 16.5 1.0

TABLE 8 - Number and capacity of staff

3.2.1 NUMBER AND CAPACITY OF STAFF INVOLVED IN THE PROVISION OF THE SERVICE

It is important that the child-care institutions shall have adequate and competent program and administrative staff members who are cognizant of the number and needs of target children. Providing community- and family-based alternative child-care services requires the involvement of a specialized staff, including social workers, psychologists and health workers. [12] The assessment examined the agencies’ human resources. The quality of services provided is closely related to the availability of an adequate number and mix of qualified personnel having the appropriate skills and qualification. This section assesses personnel capacity of these institutions


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Community-Based Care Services

On average agencies that provide child-care service have 18 program staff members, but some organizations reported having over 100. The average reported number of administrative staff was 11. Examination of the level of staff qualification revealed that a large proportion of the agencies employ staff members with low qualifications. Eighty-seven (52.7 percent) institutions have on average 10 staff members whose qualifications are below high school. Furthermore, 117 (70.9 percent) institutions have on average 10 staff members with only a high school certificate. One in every three agencies (33.3 percent) also reported that they consider shortage of qualified personnel as one of the major challenges they face in providing service to OVC or their caregivers.

On the other hand, most agencies reported to have staff members who have diploma or degree qualifications. A significant proportion of the organizations (94.5 percent) reported to have on average seven staff members with a diploma, 93.3 percent of the institutions reported to have about six with a first degree, and 37 percent of the institutions reported having on average two with a second degree or above. Reports on staff members with specialized qualifications shows 53.3 percent of institutions have three social workers, 32.7 percent of institutions have fewer than two psychologists, 49.7 percent of institutions have fewer than four health workers, 18.8 percent of institutions have 1.2 lawyers, and 17.0 percent of institutions have one business and administration staff, on average.


On average agencies providing adoption-placement services have 22 program staff members. The average reported number of administrative staff members was eight. The range was between none and 45. With respect to staff qualifications, a significant proportion of the agencies employ staff with low qualifications. That is, 62.0 percent of institutions have on average nine staff members that have qualifications below high school. Furthermore, 80.3 percent of institutions have on average 13 staff members with only a high school certificate.

On the other hand, a large proportion of the organizations (95.8 percent) also reported to have on average six staff members with a diploma, 85.9 percent have about six staff members with a first degree, and 31.0 percent on average have three staff members with a second degree or above. The presence of staff with specialized qualifications shows that 53.5 percent of institutions have two social workers, 33.8 percent institutions have fewer than two psychologists, 56.3 percent have three health workers, 32.4 percent have one



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lawyer, and 14.1 percent have one business and administration staff member, on average. Thirteen percent of the agencies highlighted the shortage of qualified personnel as the major challenge undermining adoption-placement services.

The results show that 61.1 percent of the agencies providing foster-placement services have on average 17 staff members that have qualifications below high school. Furthermore, 88.9 percent of the institutions have on average 19 staff members with only a high school certificate.

On the other hand, 88.9 percent reported to have on average 16 staff members with a diploma, 88.9 percent have about seven members staff with a first degree, and 44.4 percent on average have five staff members with a second degree or above. With respect to staff with specialized qualifications, 61.1 percent of institutions have two social workers, 50 percent have fewer than two psychologists, 55.5 percent have five health workers, 50 percent have one lawyer, and 16.7 percent have one business and administration staff member, on average.

The table above depicts the wide practice of employing staff with minimal qualifications. When it comes to availability of staff members with specialized qualifications, 64.2 percent of institutions have three social workers, 44.4 percent have either one or two psychologists, 56.8 percent have four health workers, 23.4 percent have one lawyer, and 14.8 percent have one business and administration staff member, on average. Three in every 10 agencies also reported that they consider shortage of qualified personnel as one of the major challenges they are facing in providing reunification services.

In the qualitative assessment, informants indicated that issues related to personnel (including lack of capacity, lack of motivation, high work load and high staff turnover) undermine the quality of care. Social workers running child sponsorship programs, for instance, are overburdened with different responsibilities. The program involves various activities such as education, health, psychosocial support and income-generating activities for families. Every child needs regular follow-up about how they are faring in education, health and psychosocial situations, which is documented for communication purpose with their sponsors and the organization. Because of this, most community social workers often complain that the workload eventually compromises the quality of the services.

Additionally, working with children requires strong passion and commitment, as the focus is human development. Some managers of child-care organizations admitted some of their unskilled staff members lack the level of passion and commitment needed to



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work with children. This affects their relationship with the children and the quality of the psychosocial services. High staff turnover has been reported as a common problem for most organizations, especially when the organization loses those who have served for many years and have accumulated knowledge and skills. Staff turnover is often attributed to dissatisfaction in salaries and benefits and the massive workload.


TABLE 9 - Staff capacity development practices employed by agencies

COMMUNITY-BASED CARE SERVICES FAMILY-BASED ALTERNATIVE CARE SERVICES


ADDIS ABABA(N=69) %


TOTAL (N=165)%

ADDIS ABABA(N=38) %


TOTAL (N=71)%

ADDIS ABABA(N=7) %


TOTAL (N=18)%

ADDIS ABABA(N=29) %


TOTAL (N=81)%

System/strategy to improve staff capacity 80.9 82.3 81.7 78.4 72.7 75.7 71.4 100.0 88.9 86.2 80.8 82.7

Type of strategy

ADDIS ABABA(N=55) %


TOTAL (N=134)%

ADDIS ABABA(N=29) %


TOTAL (N=53)%

ADDIS ABABA(N=5) %


TOTAL (N=16)%

ADDIS ABABA(N=25) %


TOTAL (N=67)%

Conduct periodic capacity &performance assessment 65.5 46.8 54.5 55.2 62.5 58.5 100.0 63.6 75.0% 56.0 54.8 55.2

Provide on the job training 87.3 91.1 89.6 75.9 87.5 81.1 100.0 100.0 100.0 100.0 92.9 95.5

Organize experience sharing visits 69.1 50.6 58.2 58.6 70.8 64.2 80.0 81.8 81.3 60.0 59.5 59.7

Organize short courses or workshops 58.2 36.7 45.5 51.7 45.8 49.1 80.0 54.5 62.5 68.0 42.9 52.2

Educational scholarships 9.1 15.2 12.7 6.9 12.5 9.4 0.0 18.2 12.5 4.0 16.7 11.9


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TABLE 9 - Staff capacity development practices employed by agencies



ADDIS ABABA(N=69) %


TOTAL (N=165)%

ADDIS ABABA(N=38) %


TOTAL (N=71)%

ADDIS ABABA(N=7) %


TOTAL (N=18)%

ADDIS ABABA(N=29) %


TOTAL (N=81)%

System/strategy to improve staff capacity 80.9 82.3 81.7 78.4 72.7 75.7 71.4 100.0 88.9 86.2 80.8 82.7

Type of strategy

ADDIS ABABA(N=55) %


TOTAL (N=134)%

ADDIS ABABA(N=29) %


TOTAL (N=53)%

ADDIS ABABA(N=5) %


TOTAL (N=16)%

ADDIS ABABA(N=25) %


TOTAL (N=67)%

Conduct periodic capacity &performance assessment 65.5 46.8 54.5 55.2 62.5 58.5 100.0 63.6 75.0% 56.0 54.8 55.2

Provide on the job training 87.3 91.1 89.6 75.9 87.5 81.1 100.0 100.0 100.0 100.0 92.9 95.5

Organize experience sharing visits 69.1 50.6 58.2 58.6 70.8 64.2 80.0 81.8 81.3 60.0 59.5 59.7

Organize short courses or workshops 58.2 36.7 45.5 51.7 45.8 49.1 80.0 54.5 62.5 68.0 42.9 52.2

Educational scholarships 9.1 15.2 12.7 6.9 12.5 9.4 0.0 18.2 12.5 4.0 16.7 11.9

3.2.2 STAFF CAPACITY-DEVELOPMENT PRACTICES

Child-care agencies are expected to avail opportunities for their personnel to improve their capacity to deliver services to target children in a child-friendly and sensitive manner [12]. Representatives of institutions were asked to share the practice in their respective institutions in this regard. These are detailed in the following table.


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Over four-fifths of the organizations in Addis Ababa and other regions reported having a strategy/system to upgrade staff competency with the distribution across regions being more or less at a par. Such systems and strategies included conducting periodic capacity and performance assessments, providing on-the-job training, organizing experience-sharing visits, organizing short courses and workshops. Provision of partial or full scholarships to allow staff to pursue advanced studies was another reported strategy. Differences in the application of these strategies were evident across regions. Compared to Addis Ababa, provision of scholarship and on the job training was a bit more common among institutions in the other regions. On the other hand, conducting periodic capacity and performance assessments, organizing experience-sharing visits, and organizing short courses and workshops were more popular in Addis Ababa than in the other regions.


Among adoption-service agencies, 75.7 percent of the organizations reported having a strategy or system to upgrade staff competency. The distribution across regions is more or less at a par. Differences in the application of these strategies were evident across regions. More institutions in Addis Ababa claimed to organize short courses and workshops than the other regions. In contrast, institutions in other regions fare better than Addis Ababa in regard to providing scholarships and on-the-job training, conducting periodic capacity and performance assessments, and organizing experience-sharing visits.

Among agencies providing foster-care services, about nine in every 10 agencies reported having a strategy or system to upgrade staff competency. There were noticeable differences in the application of different strategies across regions. While more institutions in Addis Ababa claimed to organize short courses and workshops than other regions, a higher proportion of institutions in other regions provide educational scholarships.



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In relation to reunification service, 82.7 percent claimed to have a strategy or system to upgrade staff competency. Once again, a higher proportion of institutions in Addis Ababa claimed to organize short courses and workshops and provide on-the-job training, whereas institutions in other regions fared better with regard to educational scholarships.

3.2.3 AVAILABILITY/APPLICATION OF PROCEDURES/MECHANISMS TO ENSURE ACCESS TO SERVICES

The assessment examined the issue of access to formal community- and family-based alternative child-care services. The assessment examined the extent to which child-care agencies apply certain procedures or tools to screen target children and host families to confirm eligibility; document relevant information; and assess the condition of host families prior to, during or after placement. Procedures related to recruiting target children are important to avoid unnecessarily separating families and to ensure that the most needy and vulnerable children have access to child-care services. [12][4] The following sections present the findings across the different types of community- and family-based alternative child-care services.

It is important to note here that a large proportion of agencies emphasized the difficulty of coping with the high demand for services as one of the major challenges they face. This demand was particularly severe in the case of agencies providing FPS, 64.8 percent of which reported very high demands. Although not to the same degree, agencies providing adoption-placement services, foster-care service providers, reunification service providers also reported that demands for their services were higher than they were able to meet. In such a context, the availability and application of proper procedures and mechanisms that ensure appropriate access to services becomes all the more important.


Procedures/mechanisms to ensure access to community-based care services



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ACCESS ADDIS ABABA(N=69) %


TOTAL (N=165)%

Eligibility criteria for recruiting target children/families 75.4 87.4 82.3

Assessment tools used to document eligibility

Case study 36.2 35.4 35.8

Baseline/need assessment 75.4 70.8 72.7

Medical records 33.3 14.6 22.4

Feedback from committee 7.2 4.1 5.4

Feedback from relevant government organization 4.3 4.2 4.2

Physical observation/assessment of home or child 4.3 10.4 7.9

Parties involved in recruitment

Joint committee of stakeholders 39.1 50.0 45.5

Relevant government Authority 89.9 83.3 86.1

Head of the organization 33.3 31.3 32.1

Parents/relatives 24.6 12.5 17.6

Children 7.2 6.3 6.7

Child right committees 8.7 5.2 6.7

Volunteer committee or task group 8.6 30.2 21.2

Staff of the organization, social worker, project coordinator, project officer 14.4 7.3 10.3

Idir leaders, Idir members 2.9 2.1 2.4

Targeted groups

OVC in general 75.4 94.8 86.7

Economically disadvantaged families 85.5 89.6 87.9

Conflict-prone families 14.5 16.7 15.8

Families prone to substance abuse 11.6 8.3 9.7

Disabled children 1.5 3.1

HIV infected and affected families (chronically ill parents) 7.2 10.4

TABLE 10 - Procedures/mechanisms to ensure access to community-based care services


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The assessment found that the vast majority (82.3 percent) of the agencies do use written eligibility criteria for recruiting target children or families. Institutions in the regions fare better than the ones in Addis Ababa in this regard, but the lack of written eligibility criteria in the other 17.7 percent of agencies studied implies a lack of transparency, which undermines accountability and introduces confusion and bias when implementing the actual recruitment.

Institutions providing FPS employ various assessment tools in the process of identifying targets. Overall, baseline assessment was by far the most widely reported assessment tool (72.7 percent). Other more commonly reported assessment tools included case studies and the use of medical records, followed by physical observation and feedback from government or community. There were significant differences across regions. The use of medical records as an assessment tool was more common in Addis Ababa than the other regions. Similarly, baseline needs assessments are used more in Addis Ababa than in other regions. On the other hand, physical observation was more common in the regions than in Addis Ababa.

Various groups are involved in deciding how to identify target children and families for FPS. Overall, relevant government authorities (including MOWCYA) were the most commonly

ACCESS ADDIS ABABA(N=69) %


TOTAL (N=165)%

Services

Facilitate free access to health services to OVC 60.9 69.5 65.9

Access to safe and conducive environment for interaction and play 63.8 67.4 65.8

Facilitate access to special educational needs of children with disabilities

40.6 42.1 41.5

Services for children with special needs(with disabilities)1 50.7 56.8 54.3

SERVICES PROVIDED TO OVC WITH SPECIAL NEEDS ADDIS ABABA(N=35) %


TOTAL (N=89)%

Creating Mobility access 37.1 36.2 36.6

Appliance support 51.4 53.2 52.4

Life skills Training 51.4 61.7 57.3

Medical and referral support 8.6 9.3 8.9

TABLE 10 - Procedures/mechanisms to ensure access to community-based care services


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involved group, followed by committees of stakeholders or volunteers (including child-rights committees and Idir members. The third most reported group included staff members of the organization, including the head of the institution, social workers, project coordinators and project officers. Other involved groups included children and the parents and relatives of children. The involvement of committees was more popular in the other regions than in Addis Ababa. Conversely, the practice of involving the staff of the organization was more common in Addis Ababa than in the other regions.

It is worth noting from the above findings that only a small proportion of the institutions claim to involve children and the community in making decisions regarding the identification of targets, and it would be insightful to investigate why.

Most agencies have reported working closely with relevant government institutions to improve OVC’s access to basic services such as health and education. The health institutions and child-care agencies are expected to facilitate and ensure access to formal referral systems and free health services for OVC. Close to two-thirds of the institutions reported engaging in activities to facilitate free access to health services for target OVC. Child-care agencies are also expected to facilitate access to safe and supportive environments for recreation, play and cultural activities, which 65 percent of the agencies stated that they do.

Ensuring access to services for OVC with special needs or disabilities is one of the responsibilities of agencies. Asked whether the organizations integrate children with special needs in their services, only a little over half of the institutions 54.3 percent reported doing so. There was little difference in the situation among agencies in Addis Ababa and other regions. Agencies most commonly reported life-skills training, creating mobility access, and medical or referral services as the services they provided to OVC with special needs.


Procedures/Mechanisms to Ensure Access to Family-Based Alternative Care Services

Agencies providing formal family-based alternative care services also mentioned that they engage in certain activities to ensure that OVC have access to certain much needed services.



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a) Adoption

ADDIS ABABA(N=38) %


TOTAL (N=71)%

Eligibility criteria for recruiting 52.6 75.9 62.7

Sources children are recruited

Directly from orphanages 60.5 25.0 44.3

Directly from poor families 2.6 15.6 8.6

From the street 5.3 18.8 11.4

Assigned by government agency 73.7 75.0 74.3

Source of recruitment of adoptive parents

From adoption agents 63.2 75.8 69.0

Individual applicants contacting adoption agents 34.2 21.2 28.2

From government agency 21.1 45.5 32.4

Searching in the community 2.6 12.1 7.0

Effort made to promote domestic adoption in the community 28.9 71.0 47.8

TYPE OF EFFORT ADDIS ABABA(N=11) %


TOTAL (N=33)%

Sensitizing the community 81.8 86.4 84.8

Appreciating adopting parents 30.0 18.2 21.9

Organizing events 50.0 36.4 40.6

TABLE 11 - Procedures/mechanisms to ensure access to adoption placement services


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Over half of the organizations reported that they have eligibility criteria for identifying children for adoption, as well as how they identify (recruit) adoptive parents for target children. Because of the huge demand for alternative child care, a portion of the agencies engaged in providing adoption-placement services indicated that they promote domestic adoption. A few of the organizations that did not promote domestic adoption reported a lack of demand for local adoption, lack of information about the procedures, lack of experience and absence of qualified staff as reasons why they did not promote it.

According to 74.3 percent of the organizations, the children are assigned to them by government agencies. The second most common identification practice was to get children directly from orphanages (44.3 percent). Less common practices of recruitment included identifying children directly from poor families or from the street.

Significant differences exist in the identification practices of organizations across regions. In Addis Ababa, direct identification from orphanages was much more common than in the other regions. Conversely, direct identification from poor families or from the street were significantly more common practices in the regions than in Addis Ababa.

Organizations also reported how they identify (recruit) adoptive parents for target children. The majority of the organizations (69 percent) claimed to recruit the adoptive parents from adoption agents. Other mechanisms included recruiting from government agency (32.4 percent), and individual applicants contacting the organization (28.2 percent). Significant differences prevail in the practice of adoptive parent recruitment among organizations across regions. The use of adoption agents was more popular in other regions than in Addis Ababa , while recruiting adoptive parents from government agencies was more prevalent in regions other than Addis Ababa. Conversely, the practice of recruitment via individual applicants contacting the office was more common in Addis Ababa than in other regions.

The distribution of practices varies significantly across regions. In Addis Ababa, securing consent for adoption, providing counselling to children, and orienting about the culture and lifestyle of prospective adoptive parents were more reported than in the other regions. On the other hand, medical screening and treatment was more common in the other regions than in Addis Ababa.

As a way to deal with the huge demand for alternative child care, a portion of the agencies engaged in providing adoption-placement services indicated that they strive to promote domestic adoption. This was indicated by 47.8 percent of the organizations while the rest admitted not doing anything in this regard. Significant differences in the proportions of


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organizations engaged in promoting domestic adoption were observed across regions. Whereas 71.0 percent of the organizations in the regions claimed to promote domestic adoption, only 28.9 percent in Addis Ababa were engaged in similar efforts. Activities undertaken to promote domestic adoption included sensitizing the community, showing public appreciation to adopting parents and organizing promotional events. Some organizations that did not promote domestic adoption cited a lack of demand, information, experience and qualified staff as reasons for not promoting this service.

b) Foster Care

Two-third of the organizations indicated having formalized/written eligibility criteria for selecting foster families, but not having written or formalized eligibility criteria does not necessarily mean that they do not apply any criteria. Accordingly, a much higher proportion of organizations (82.4 percent) reported to apply some sort of criteria while selecting foster families (71.4 percent in Addis Ababa, 90.0 percent in other regions). Only two of the 18 agencies providing foster-care services reported they have a strategy to recruit foster families through awareness raising using media and other outlets.

A little over half of the 16 responding institutions that provide foster-care placement indicated that they provide emergency placement services when there is an urgent concern for the safety of children or until long-term placement options materialize. There was little difference in the responses of agencies in Addis Ababa and other regions.

Findings from the qualitative assessment suggest that many community-based organizations and schools are involved in finding emergency-placement services for OVC. Respondents indicated that certain community organizations provide formal or informal emergency foster-placement service in the community with facilitation and supervision of schools and community groups. Some schools were reported to play a key role in the implementation of emergency foster-placement services by linking children who are out of school, or who have dropped out or are on the verge of dropping out due to lack of resources or lack of someone to look after them.

The old man was willing to raise the child. So after we received a copy of the person’s Identity card we made him sign an agreement to raise and educate the child and we gave him the child. Now she finished two academic years. We also closely monitor the child and the family.

-27-year-old male school administrator, Addis Ababa)


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It is also the case that foster families come forward voluntarily via schools to look after OVC, often with an arrangement whereby the agencies provide necessary basic need support to the child.

I know one woman at our office who agreed to raise the child who lost both of his parents due to HIV. The woman wanted only the child’s clothing, feeding and school expense to be covered. The woman receives support from child-care organization and the child is still living with her. Another teacher also facilitated the enrolment of two siblings to an institution after their parents abandoned them for unknown reason. Now the children joined university.

-29-year-old female school administrator, Addis Ababa)

Schools are often obliged to find quick solutions to rescue children who are facing imminent danger of being out of school or worse, and arrangements are not always as formal as they ought to be.

It is not common or we may not do it formally but there are several cases that we arranged similar options to children when they are forced to discontinue their education due to disagreement with extended families.

-45-year-old male teacher, Addis Ababa

Children who are found abandoned on the street are not screened, as these children are considered to require emergency alternative care and support. The experience of the Missionaries of Charity Sisters is one example:

We do not make any kind of assessment because as I have said we work based on referral systems with police, Kebele administrators, health centres, hospitals and WCYAO. Therefore, we provide our services for children referred to us without any additional assessment and recruitment criteria.

-IDI Informant from Missionaries of Charity Sisters, Addis Ababa

c) Reunification



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ADDIS ABABA(N=29) %


TOTAL (N=81)%

Written criteria for establishing eligibility of child to family/relative reunification

47.3 57.0 53.5

Source of recruitment for reunifying with families

From the streets 41.4 61.2 53.8

From orphanages/childcare institutions 51.7 42.9 46.2

Orphan households 3.4 34.7 23.1

From relevant agency (MOWCY, Police, Kebele, Associations) 27.5 9.6 16.0

Conduct case study of the family when reuniting children with biological family

89.7 82.7 85.2

Conduct case study of the family when reuniting children with extended family before placing for kinship care

86.2 76.0 79.7

Keeping record of appropriate background information on every child reunified with the family or kinship caretaker

93.1 96.1 95.0

Searching in the community 2.6 12.1 7.0

Pre-reunification services provided to the target children

Medical check-up and treatment 62.1 64.0 63.3

Appliances for children with disabilities 17.2 14.0 15.2

Facilitate and encourage visit to parent/s or member/s of extended family before reunification

62.1 52.0 55.7

Collect the child's transcript and other educational evidences from schools to enable smooth transition of his/her enrolment after reunification

72.4 56.0 62.0

Provide with materials such as bed, blanket, bed sheets, etc. 75.9 57.1 64.1

Counselling 10.3 21.1 17.2

TABLE 12 - Procedures/mechanisms to ensure access to reunification services


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The practice of recruiting OVCs for reunification varies across regions. Addis Ababa has a higher proportion of organizations recruiting from orphanages/child-care institutions and relevant agencies than the combined proportions for other regions. Conversely, the practice of recruiting children from the streets and orphan households was higher among institutions in other regions than those in Addis Ababa.

In the qualitative assessment, it was found that some agencies target certain hot spots to recruit target children and ensure that they are reconnected with their families. Discussions with community representatives across the country revealed that this service was mainly common in Addis Ababa, where trafficked or migrant children from various parts of the country are assisted to return to their immediate or extended family. It is worth noting that a high degree of collaboration was reported between child-care organizations providing this service, the police, and the community residing near the hot spots, such as bus stations.

I live around the bus station. We find many children who came from the regions/country side. Some of them have run away from their families; others came with relatives or other people who promised them that they would get better living or education in Addis Ababa. Brokers take these children and give them for sexual and labour exploitation. The community police, community volunteers, Iddir leaders and child care organizations have been working together to search and return back such children to their families. Control mechanisms have been set up at different bus stations or check-points (‘Kellas’) to identify from where, with whom and for what purpose the children are travelling.

-42-year-old Idir leader, Addis Ababa

In the qualitative assessment, some agencies, such as the Organization for Social Service for AIDS (OSSA) in Bahirdar, Bethlehem Children’s Home in Adama and Kombolcha Child Care Centre in Kombolcha, claimed to have better experiences in providing reunification services for targeted children along with formal kinship-care services. The process involves tracing their families or relatives and convincing them to accept the children and reintegrate them into their families and communities. Some of these children were first admitted to institutions and received rehabilitation service for some time. However, the findings indicated that efforts made to follow up and monitor the situation of children post-reunification were mostly inadequate.

Procedures/Mechanisms to Ensure Safety of Children in Family-Based Alternative Care Services

a) Adoption

In the case of child-care agencies providing adoption-placement services, about half of them (47.2 percent) indicated to have an internal child-protection policy that provides guidance



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to caregivers on the appropriate provision of service and conduct of their staff. There was a significant difference across regions: the proportion of institutions having such a policy was by far higher in other regions than in Addis Ababa (36.8 percent and 59.4 percent, respectively).

b) Foster Placement

Agencies that provide foster-care placement services indicated that they take various measures to ensure the safety and well-being of children. Seven in every ten agencies that provide foster care-services reported to have an internal child-protection policy. The proportion of institutions having such a policy was much higher in other regions than in Addis Ababa.

Emergency placement is crucial to ensure the safety of children who have been subjected to abuse, neglect, or exploitation — or when there is a concern that they may be. Over half of the agencies indicated that they provide emergency-placement services, with little difference in the proportion of agencies in Addis Ababa and other regions.

Agencies that provide foster-care placement services are also expected to accept grievances and comments on the status of the child placed in a foster family and act on them urgently. The vast majority of agencies providing services for foster-care placement indicated that they make provisions to accept grievances and comments on the status of the child placed in a foster family. The proportion of agencies making this provision was higher in Addis Ababa than in the other regions. About two-fifths of the agencies providing services for foster care claimed to have received grievances, opinions and comments in the past. The distribution across regions was at a par.

The reasons for the expressed grievances included exploitation and neglect. When agencies receive grievances, their most reported reaction is counselling, followed by termination of

TABLE 13 - Procedures/mechanisms to ensure safety of children in implementation of foster placement

ADDIS ABABA(N=7) %


TOTAL (N=18)%

Written internal child protection policy 42.9 90.9 72.2

Provide emergency foster placement 57.1 55.6 56.3

Provisions to accept grievances and comments on the status of the child placed in a foster family care

100.0 80.0 88.2

Received any grievances, opinions, and comments in the past 42.9 40.0 41.2


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the foster care and termination of financial and material support. Furthermore, about three in five the organizations reported that they collaborate with relevant authorities in addressing the grievances. About 30 percent of these institutions reported that they had experiences of terminating foster placement and changing foster families. On average, the reported number of reviewed cases over the last four years was 6.6, with this ranging between 1 and 28. The most common reason for termination of foster-care placement was neglect.

c) Reunification

Agencies reunifying children with their biological families or traceable relatives were asked if they have a written internal child-protection policy that informs service provision and conduct of caregivers in relation to children. About six in every ten agencies indicated having such a policy, with the proportion of agencies being higher in other regions than in Addis Ababa.


TABLE 14 - Procedures/mechanisms to ensure continuum of care for OVC

INDICATOR COMMUNITY-BASED CARE SERVICES FAMILY-BASED ALTERNATIVE CARE SERVICES

FAMILY-BASED ALTERNATIVE CARE SERVICES (continued) TOTAL


ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Major stakeholders

Parents 84.1 57.3 68.5 78.9 60.6 70.4 85.7 54.5 66.7 82.8 61.5 69.1 79.5 55.8 65.9

Schools 78.3 68.8 72.7 52.6 63.6 57.7 85.7 72.7 77.8 89.7 67.3 75.3 70.5 66.3 68.1

Orphanages 49.3 15.6 29.7 84.2 18.2 53.5 57.1 36.4 44.4 48.3 21.2 30.9 53.8 15.4 31.9

MOWCYA 98.6 97.9 98.2 97.4 100.0 98.6 100.0 90.9 94.4 100.0 100.0 100.0 97.4 98.1 97.8

Court 49.3 54.2 52.1 73.7 78.8 76.1 57.1 54.5 55.6 55.2 65.4 61.7 50.0 53.8 52.2

Adoption agencies 31.9 18.8 24.2 65.8 51.5 59.2 42.9 27.3 33.3 44.8 32.7 37.0 35.9 19.2 26.4

Police 58.0 80.2 70.9 57.9 93.9 74.6 57.1 81.8 72.2 82.8 92.3 88.9 56.4 80.8 70.3

Children 81.2 43.8 59.4 68.4 60.6 64.8 85.7 54.5 66.7 69.0 53.8 59.3 73.1 43.3 56.0

Donors 73.9 75.0 74.5 63.2 84.8 73.2 100.0 63.6 77.8 69.0 80.8 76.5 69.2 75.0 72.5


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3.2.4 AVAILABILITY/APPLICATION OF PROCEDURES/MECHANISMS TO ENSURE CON-TINUUM OF CARE FOR OVC

Networking and coordinating with other agencies that target OVC child-care helps provide a continuum of care as per the needs of children through linkages and referral systems.

Organizations reported the major stakeholders with whom they collaborate to implement family-based child-care services. Almost all organizations reported collaborating with MOWCYA. Other frequently reported stakeholders included donors, police, schools, parents, children and courts. Other relatively less reported categories were orphanages and adoption agencies. The prominence of the various stakeholders varies significantly across regions. In Addis Ababa, parents, orphanages, adoption agencies and children were considered major stakeholders more so than in other regions, where police and donors were more likely to be considered the major stakeholders. The distributions of agencies that reckon MOWCYA as a stakeholder were equivalent in Addis Ababa and other regions. See Table 14 for more details.


TABLE 14 - Procedures/mechanisms to ensure continuum of care for OVC




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Major stakeholders

Parents 84.1 57.3 68.5 78.9 60.6 70.4 85.7 54.5 66.7 82.8 61.5 69.1 79.5 55.8 65.9

Schools 78.3 68.8 72.7 52.6 63.6 57.7 85.7 72.7 77.8 89.7 67.3 75.3 70.5 66.3 68.1

Orphanages 49.3 15.6 29.7 84.2 18.2 53.5 57.1 36.4 44.4 48.3 21.2 30.9 53.8 15.4 31.9

MOWCYA 98.6 97.9 98.2 97.4 100.0 98.6 100.0 90.9 94.4 100.0 100.0 100.0 97.4 98.1 97.8

Court 49.3 54.2 52.1 73.7 78.8 76.1 57.1 54.5 55.6 55.2 65.4 61.7 50.0 53.8 52.2

Adoption agencies 31.9 18.8 24.2 65.8 51.5 59.2 42.9 27.3 33.3 44.8 32.7 37.0 35.9 19.2 26.4

Police 58.0 80.2 70.9 57.9 93.9 74.6 57.1 81.8 72.2 82.8 92.3 88.9 56.4 80.8 70.3

Children 81.2 43.8 59.4 68.4 60.6 64.8 85.7 54.5 66.7 69.0 53.8 59.3 73.1 43.3 56.0

Donors 73.9 75.0 74.5 63.2 84.8 73.2 100.0 63.6 77.8 69.0 80.8 76.5 69.2 75.0 72.5


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TABLE 15 - Strategies to facilitate community- and family-base alternative care services

COORDINATION STRATEGIES




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Major stakeholders

Information sharing 94.2 97.9 96.4 94.7 97.0 95.8 100.0 100.0 100.0 89.7 98.1 95.1 93.6 96.2 95.1

Community mobilization

39.1 50.0 45.5 21.1 51.5 35.2 28.6 54.5 44.4 55.2 63.5 60.5 35.9 50.0 44.0

Service mapping 33.3 41.7 38.2 15.8 42.4 28.2 28.6 54.5 44.4 44.8 42.3 43.2 30.8 38.5 35.2

Network building 82.6 49.0 63.0 68.4 48.5 59.2 71.4 45.5 55.6 79.3 55.8 64.2 78.2 46.2 59.9

Linkage and referral system

58.0 59.4 58.8 42.1 63.6 52.1 71.4 54.5 61.1 55.2 65.4 61.7 55.1 58.7 57.1

The most used strategy agencies reported to use to facilitate family-based child-care to OVC was information sharing. Other relatively less reported strategies included network building, linkage and referral system, community mobilization and service mapping. The extent to which some of these strategies were used varied across regions. More agencies in Addis Ababa were applying network building as a strategy to facilitate family-based care than in other regions. In the case of other strategies, including community mobilization and service mapping, other regions fared better than Addis Ababa.

Agencies reported the advantages they associated with any of the strategies to coordinate family-based child-care service. The most cited advantage was the opportunity to share best practices, followed by enhancement in the participation of stakeholders, avoidance of resource duplications, ensuring sustainability/continuity of the service and increased program replication. There were differences in the significance of some of the reported advantages across regions. Agencies in Addis Ababa indicated having advantages such as being better able to ensure the sustainability of programs, increased program replication and


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TABLE 15 - Strategies to facilitate community- and family-base alternative care services

COORDINATION STRATEGIES




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Major stakeholders

Information sharing 94.2 97.9 96.4 94.7 97.0 95.8 100.0 100.0 100.0 89.7 98.1 95.1 93.6 96.2 95.1

Community mobilization

39.1 50.0 45.5 21.1 51.5 35.2 28.6 54.5 44.4 55.2 63.5 60.5 35.9 50.0 44.0

Service mapping 33.3 41.7 38.2 15.8 42.4 28.2 28.6 54.5 44.4 44.8 42.3 43.2 30.8 38.5 35.2

Network building 82.6 49.0 63.0 68.4 48.5 59.2 71.4 45.5 55.6 79.3 55.8 64.2 78.2 46.2 59.9

Linkage and referral system

58.0 59.4 58.8 42.1 63.6 52.1 71.4 54.5 61.1 55.2 65.4 61.7 55.1 58.7 57.1

sharing best practices. In the case of the other advantages of applying strategies, the relative distribution of organizations across regions was similar.

In the qualitative assessment, some agencies emphasized the lack of networking and coordination among service providers. One IDI informant explained the resulting problem as follows:

…One other thing I have noticed in the child welfare sector in this country is the absence of strong network among the service providers and other stakeholders. Due to this reason you see many children who are getting support in one organization also receive similar support from another organization as well. Something has to be done to resolve such problem.

-IDI informant, Addis Ababa


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Procedures/Mechanisms to Ensure Continuum of Care in Community-Based Care

About half of the child-care agencies claimed to facilitate legal protection of OVC and their caregivers by providing linkages or referral systems for legal services when the need arises. Fewer agencies in Addis Ababa reported this support than did agencies in other regions.

In the qualitative assessment, the IDIs stressed the difficulty of providing legal protection for OVC. They explained that when children lose their families, they are taken care of by their


TABLE 16 - Procedures/mechanisms to ensure continuum of care in community-based care

MECHANISMS TO ENSURE CONTINUUM OF CARE ADDIS ABABA(N=69) %


TOTAL (N=165)%

Link and refer to other stakeholders to address the shelter and care needs of OVC families

25.0 37.6 32.0

Linkages or referral systems of service for OVC needing medical treatment/help

58.0 77.9 69.5

Linkages or referral systems for OVC and guardians needing legal services

21.7 70.4 48.0

Link caregivers to appropriate income generation activities (IGA) and small loan/credit based on market demand, skill and interest of caregiver

72.5 80.4 77.0

Linkages or referral systems of service for malnourished children to food sources

47.8 58.7 54.0

Mobilize community resources (labor and material ) to improve shelter and care

21.7 36.5 29.9

TYPE OF RESOURCES MOBILIZED ADDIS ABABA(N=15) %


TOTAL (N=46)%

Material resource 40.0 64.5 56.5

Financial resource 40.0 32.3 34.8

Labour 80.0 67.7 71.7


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relatives under kinship care. In most cases, their parents may have some kind of property; but once their children are being taken care of by their relatives, the parents often hide their property. This complicates the efforts to ensure the inheritance rights of orphaned children

Procedures/Mechanisms to Ensure Continuum of Care in Family-Based Alternative Care

a) Adoption

Agencies providing adoption-placement services network and coordinate with various institutions to ensure post-adoption follow-up. The most reported institution in this regard was the adoption agency, followed by MOWCYA, the child-care institute and relevant local authorities. Significant differences in the type of agencies involved in carrying out post-adoption follow-ups are found across regions. In Addis Ababa, the adoption agency and MOWCYA play a more prominent role compared to the situation in other regions. On the other hand, relevant local authorities were more popular in other regions than in Addis Ababa.

b) Foster Placement

Prior to approving a foster family, about two thirds of agencies providing foster-care placement service request references from relevant authorities about the credibility of the potential foster parents. About two in every three agencies stated that they provide training to foster families on proper child-development and child-care practices. All the organizations providing foster-care service expressed that they undertake follow-ups after placement, although the frequency of follow-up varies. Conducting follow-up is the

TABLE 17 - Procedures/mechanisms to ensure continuum of care in adoption

COLLABORATING PARTIES IN MAKING POST ADOPTION FOLLOW UP

ADDIS ABABA(N=38) %


TOTAL (N=71)%

Adoption Agency(ASPO) 92.1 81.8 87.3

Child care institute 34.2 39.4 36.6

MoWCY 73.7 57.6 66.2

Relevant authority 5.3 24.2 14.1


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main way of ensuring continuum of care of children, and agencies providing foster care placement service have the obligation to follow up how well the children have settled in their new environment and their development.

The majority of the organizations reported preparing status reports of each child following the periodic after-placement follow-ups. Foster families reportedly complied with the principle of notifying the agency responsible for the foster placement in the event of injury, disappearance or other prominent events involving the child. They commonly sent reports about the child’s progress, according to all the foster-care providing institutions. This was reported by 88.2 percent of the agencies. The following table provides more details.

TABLE 18- Procedures/mechanisms to ensure continuum of care in implementation of foster placement

ADDIS ABABA(N=7) %


TOTAL (N=18)%

Provide emergency foster placement 57.1 55.6 56.3

Conduct follow-ups after placement 100.0 100.0 100.0

Receive references from relevant authority about credibility of the potential foster parent/s prior to placing children in foster families

42.9 80.0 64.7

Provide training on child development and childcare for foster families

57.1 70.0 64.7

Receive reports from foster families in the event of injury, disappearance or any other major event in relation to the child

100.0 100.0 100.0


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Foster care, accounts of a former beneficiary, Addis AbabaI joined foster family when I was 14 years old. Foster family program was started by SOS for the first time. It was a challenge to start this kind of life and I decided to flee or to escape for some days from my foster parents. We were given brief awareness and transferred to the foster family within a week. The motive of my foster family was money not caring for me and others placed with them and we felt we were lost. Even we renamed it as guest house because she prepared the food and put it in the bedroom. We eat and leave the tray (plate) there to be picked up after we left. No relationship existed at all. We couldn’t develop sense of belongingness or bond there. Yet there was no supervision from government organizations. We were three including my brother. We made known what was happening to us, and leaders of the organization transferred us to another foster family where we found better care. Here we were handled much better than before; there was bond that lasted to this day. … I developed strong bond with my foster family. For example, I got a job and told the woman that I was leaving. She started crying. I decided to stay with her and travelled back and forth long distance to my work place for seven months. Finally she understood my suffering and let me leave. I still visit her and support her as required. Although it has some shortcomings and challenges, foster care must be encouraged. It made me strong and courageous, characters which I didn’t have before. I used to be nervous but I started to dare to do lots of things which were appropriate after I entered the community. I recommend that such services should be strengthened.

c) Reunification

Continued collaboration with the relevant local and regional authorities or stakeholders for post-reunification follow-ups was reported to be the norm in about two-thirds of the agencies, but varied across regions. The issues that follow-up agencies assess include: educational development of children, the adjustment in the family, peer neighbourhood


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relationship, health status, emotional and spiritual development, physical development, and nutritional status. There were significant differences in the extent to which the different components of post re-unification follow-up are adopted by agencies across regions. For example, educational development was reported to be an aspect of the post-reunification follow-up by more agencies in Addis Ababa than in the other regions.

The practice of conducting post-reunification follow-ups was reported by 71.3 percent of the organizations, the practice being common in the other regions than in Addis Ababa. A little over half of the agencies (52.9 percent) conduct the follow-up at least once every quarter. The practice of providing post-reunification counselling to the child and family was reported by 56.3 percent of the organizations, the regions having a higher proportion of organizations that offer such counselling than Addis Ababa.

TABLE 19 - Procedures/mechanisms to ensure continuum of care of children in implementation of reunification

ADDIS ABABA(N=29) %


TOTAL (N=81)%

Provide post-reunification periodic counselling to the child and the family

41.4 64.7 56.3

Conduct post reunification follow-up 58.6 78.4 71.3

COMPONENTS OF POST REUNIFICATION FOLLOW UP ADDIS ABABA(N=17) %


TOTAL (N=57)%

Health status 64.7 80.0 75.4

Nutritional status 58.8 47.5 50.9

Physical development 58.8 52.5 54.4

Educational development 94.1 85.0 87.7

Adjustment in the family, peer and neighbourhood relationship, etc. 76.5 77.5 77.2

Emotional and spiritual development 70.6 50.0 56.1


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Reunification, accounts from Abebech Gobena child-care and support organization, Addis Ababa I would like to mention one best example of the institution’s child reunification and reintegration practices, which began from scratch with very little information about the child’s parents and families. We continued searching families in remote places and finally managed to trace and reunify the child with his biological parents who are economically well off to care for their child. The child’s families were very happy and satisfied when their child was reunited. He was stolen by unknown person for child labour and exploitation. I have had another pleasant experience with reunification. One woman had stolen two children aged nine and two years in order to use them for begging purpose in this area. She was suddenly noticed by passer-by when the little child cried and the guy scrutinized the reason for crying which finally he learnt that the children were stolen from somewhere by the woman and brought forcefully to this area .And, the passer –by reported to police and she was caught and imprisoned for this crime. We successfully reunified the children with their family.

3.2.5 AVAILABILITY/APPLICATION OF PROCEDURES/MECHANISMS TO ENSURE SAFETY OF CHILDREN

This section examines the extent to which agencies that provide community- and family-based services have put in place certain minimum conditions to ensure the safety of OVC. It is imperative that children receive adequate protection from violence and abuse. One way of ensuring this is through having proper internal policies that uphold the safety and protection of children to be endorsed and observed by all personnel. The instrument is also meant to ensure that the rights of children are not violated in the process of providing child-care services. [4][12]


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Procedures/mechanisms to ensure safety of children in community-based care

Contradictory accounts were obtained in the qualitative assessment regarding the application of child-protection policies. While some maintained the policies were used to ensure the safety of children and quality of services, others pointed to superficial application and lack of awareness.

Some indicated having an internal child-protection policy that governs the behaviour of staff while working with and for children. They stated that the newly recruited staff are given induction on the child-protection policy and they pledge to abide by the rules and regulations embedded in the policy. The following excerpts corroborate this assertion.

… the main purpose of our child-protection policy is to protect the rights of the children and to make the staff aware of this policy and protect every child from all forms of abuses. All staff members of this organization are supposed to take the inductive training on the child-protection policy and should live up to it in order to provide quality service to the children.

-Informant from Selam Children’s Village, Addis Aababa

One of the tools we use for assuring quality is by implementing a child protection policy. Our child-protection policy is very strict. Every employee including volunteers is expected to abide by strict rules and regulations. Otherwise it will affect the quality of services we provide to the children. For instance, when I was employed by this organization, I agreed that I would not do things that harm the children, to provide all the care and support to the children, to be there for them at any time I am needed and to accept those rules and regulations without any precondition…

-Informant from MesereteKiristos Church, Arbaminch

TABLE 20- Procedures/mechanisms to ensure safety of children in community-based care

ADDIS ABABA(N=69) %


TOTAL (N=165)%

Written internal child protection policy 45.6 67.4 58.3

Protect inheritance rights of OVC 18.8 43.8 32.2

Sensitize families on child related laws and right 31.9 76.5 56.0


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In other agencies in this study, the use and application of internal child-protection policies were found to be lacking. In many of the institutions that claimed to have internal child-protection policies, informants claimed lack of awareness and follow-up. They said the policy is developed at leadership level, and the majority of the staff that actually implement the services are not adequately aware of it.

One of the respondents from Amhara region reported, “I don’t know about the details of the child-protection policy of the organization. The child-protection policy was formulated by the head office and sent to us…”

In the qualitative assessment, IDI participants emphasized the lack of awareness of positive child-rearing practices. Some interviewed informants knew some families who follow traditional child-rearing practices and abuse their children, who happen to be enrolled in the child-sponsorship program. As one interviewed informant put it:

Although our staff members are well aware of the basics of child development, there is a huge gap in knowledge of many parents (caregivers) on how to raise their children. A mother of one of our sponsored child burnt her daughter’s body and forced her to inhale pepper smoke. She punished her saying that she disrespected her step-father. The woman also tied her for 2 whole days. When we arrived there, the child was seriously hurt. We took her to the clinic and she got treatment. We pressed charges against the woman and she was brought to the court. She was going to be sentenced, but later on we thought ‘who would take care of the child if her mother was to be jailed’ and also worried that her step father may again victimize the child. Now, the agency is seriously following up the situation.

Child-care agencies are expected to undertake education and raise awareness in the community on issues of child rights and child-related laws to ensure the overall safety and well-being of children.

3.2.6 AVAILABILITY/APPLICATION OF PROCEDURES/MECHANISMS TO ENSURE PARTIC-IPATION OF CHILDREN/FAMILIES/COMMUNITIES IN DECISION MAKING

Agencies must ensure that children exercise their right to participate in activities and decisions that affect their lives. Their views should be taken into account in making a range of decisions relevant to them, including the planning and implementation of services. Agencies are also expected to engage with the local community and make provisions to ensure community’s meaningful participation, as this is critical for the success and sustainability of alternative care programs.


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Procedures/Mechanisms to Ensure Participation of Children/Families in Decision Making in Community-Based Care Services

Decision on the recruitment of target children/families for community-based care is made with the involvement of various groups. About 75 percent of the agencies reported involving the community in the form of committees of stakeholders or volunteers including child-rights committees and Idir members. Only a very small proportion of agencies claimed to involve children (6.6 percent).

The qualitative assessment generated findings that further illuminate the selection process. Reportedly, most of the institutions solicited the local community’s and relevant local government agencies’ participation in selecting beneficiaries. The main collaborators here are Kebele administration, Idirs and schools. It is often common that an ad hoc committee will be set up representing different groups in the community. Their participation was suggested as imperative because service-providing organizations are often new to the community and welcome advice in selecting the right candidates. To sensitize community participants about criteria and offset any inclination of bias, institutions offer sensitization training as pre-engagement in selection.

… This organization selects community volunteers and trains them …. These volunteers go to each selected household to ensure the most destitute OVC or the most eligible children are selected for support. Depending on its assessment, the volunteers make recommendation (one way or the other based on facts).… The Community Committee constituting Youth Association, Women Association, Kebele administration, Police, Attorney, Iddir, and government organization make final recruitment decision and prepare the final target beneficiaries. The (initial eligibility) criteria are prepared by the NGO and we can add the criteria which are not included by the NGO.

-57-year-old male Kebele representative, Ambo, Oromia)

The involvement of the community group depends on the kind of service that is going to be offered. Educational services often warrant the involvement of schools. Family-strengthening services imply that a host of community-based organizations and local government structures will take part. It is also reported that selection and recruitment of beneficiaries follow different phases, where different stakeholders are involved to counter-check if candidates meet criteria.

At the time I was placed for support, I was living with my mother. As I remember, the selection was based on economic situation of families. I did not know the


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decision maker but we were told in the Kebele about the support. I think, it might be the Kebele leader who selected me. When we were told in the Kebele, my mom took me to this project. The manager registered my name and we stayed for some time before receiving the service. I think we waited this time because the agents from child-care organization might be screening or finding the fact about us.… I did not know the reason why I was placed or recruited for the service. As I told you, I thought my family was economically weak. We are simply told by our families that something will be given to us. So, we joined that project simply without knowing the services that we will receive at that time.

-A former beneficiary

Community members also take part in the selection process as they are called upon to testify about the family, economic and social condition of the child prior to enrolment for either type of family-based alternative care.

Community participation, accounts of Mary Joy, Addis Ababa We have come to know that contextualizing the plan and utilizing the resources within the community enables us to be effective, because our major resource lies in the community. Ensuring its participation from the start to the end of the project enables the community to own the project thereby creating an opportunity to easily provide quality services. Our effort on local resource mobilization is the greatest strength. It is the base of our work. Moreover, the response of the community to our organization is promising. Many of the renowned celebrities in the country are sponsoring poor children to get educational, medical and subsistence support while they live with their biological parents or relatives. Starting from the top leadership for example, Ato [president] Girma Woldegiorgis is our ambassador. We are working to that level. At grassroots level we creating similar opportunities. For example, we don’t have expenses for house rent. The government or community covers rent. Overall, we have good response from the community. This is because we have made the community aware of the fact that it is responsible for addressing its problem.

On the other hand, some respondents across the different regions have voiced dissatisfaction with the selection process and questioned the credibility or trustworthiness of the people drawn from the community and tasked with the responsibility of nominating or verifying the eligibility of beneficiary children and families. Perhaps as a response to these grievances, or to avoid any malpractice, some institutions were reported to provide orientation training to the ad-hoc committee that is responsible for nominating or verifying the status of children and families.


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In the worst-case scenario, recruitment of beneficiaries is sometimes done with no participation of the local community. Some agencies were reported to post an announcement with the eligibility criteria and then register beneficiaries on a first-come, first-served basis.

The support given by some NGOs is wanting both in selection procedures and quality… They just post the announcement by their own without making any contact with local government or community structure. They don’t make real assessment of who is poor and severely affected and who is not eligible to get support. They select the target groups on their own. In this case those who are really in need are not recruited and don’t receive the support while those self-sufficient or don’t have problems get support.

-24 year old female Kebele youth representative, Ambo, Oromia

Procedures/Mechanisms to Ensure Participation Children/Families in Decision Making in Family-Based Alternative Care Services

About four in every five agencies providing adoption-placement services indicated that they consider the best interests of the child in making decisions while screening the child for adoption as an alternative form of childcare placement. The distribution across regions was more or less at a par. To this end, the agencies reported to make use of different mechanisms to consider what is most beneficial for the child.

The most reported mechanism was consulting the child, followed by consulting parents or guardians, making a case study about the child, and consulting a professional or counsellor. A relatively less reported mechanism was to exhaustively seek all other viable options. There were significant differences in the application of some of these mechanisms across regions. The following table provides more details.



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Agencies providing foster-care placement services were asked if they implement a set of mechanisms to ensure that the best interests of the child are considered and prevail. Among the mechanisms reported, consulting and involving the child in the process of foster care placement was reported by all agencies.


ADDIS ABABA(N=38) %


TOTAL (N=71)%

Consider best interests of the child in decision making while screening the child for adoption as alternative form of childcare placement

76.3 percent

78.8 percent

77.5 percent

MECHANISMS OF CONSIDERING BEST INTEREST OF THE CHILD

ADDIS ABABA(N=29) %


TOTAL (N=55)%

Making case study about the child 51.7 53.8 52.7

Consulting professional/counsellor 51.7 38.5 45.5

Consulting the child(older child) 75.9 50.0 63.6

Consulting parents/guardians 65.5 50.0 58.2

Exhaustively seeking all other options 10.3 26.9 18.2

TABLE 21 - Procedures/mechanisms to ensure participation of children/families in decision making in adoption placement


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Children are entitled to documentation (a life book) about their background and other relevant information upon completion of a foster agreement, but only 58.8 percent of the agencies reported to have such practice in place. Siblings as much as possible are supposed to be placed with the same foster family unless it undermines the best interests of the child. Almost all agencies reported to make provisions to place siblings with the same foster families. The following table provides more details.

Institutions providing reunification services were asked if they put in place certain mechanisms to ensure best interests of the child. A large proportion of the agencies indicated that they adequately involve children in the process of planning and implementing the reunification. The distribution across regions shows that the proportion of organizations having such practice is higher in Addis Ababa (89.7 percent) than in the other regions (80.4 percent). In line with this, almost all the agencies (97.5 percent) claimed to notify or update children about the findings of the family tracing, with little difference between Addis Ababa and the other regions.

3.2.7 AVAILABILITY/APPLICATION OF PROCEDURES/MECHANISMS FOR SERVICE QUAL-ITY ASSURANCE

3.2.7.1 Internal Service Quality-Assurance Mechanisms

Child-care institutions are expected to undertake monitoring and regular follow-up of the proper implementation of the child-care services in order to ensure the safety and well-being of children, and identify any breakdown in the program and take timely corrective measures [12]. This section presents data about internal service quality-assurance mechanisms to provide insight into existing quality-assurance mechanisms and tools and their use in monitoring family-based alternative child-care services.


ADDIS ABABA(N=7) %


TOTAL (N=18)%

Consult and involve the child in the process of foster care placement 100.0 100.0 100.0

Provide children with documentation ('life book') upon completion of foster agreement

42.9 70.0 58.8

Make provisions to place siblings with the same foster families 100.0 90.0 94.1

TABLE 22- Procedures/mechanisms to ensure participation of children/families in decision making in foster care services


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Agencies providing community-and family-based alternative child-care services were asked if they have a regular monitoring (follow-up) system to track the progress of the services they provide and its outcomes. The practice was common among all agencies across services with at least nine in every ten agencies claiming to conduct such regular monitoring. Home visits were the most mentioned strategy, followed by periodic visits, staff meetings and community conversations. There were differences in the uptake of these strategies across regions. Home visits were more common among agencies in other regions than in Addis Ababa. Conversely, periodic reports, and staff meetings were more prevalent among agencies in Addis Ababa than in other regions. See Table 23 for a detailed breakdown.

3.2.7.2 External Service Quality-Assurance Mechanisms

It is imperative that agencies providing community- and family-based alternative child-care services are accountable to a relevant government authority that has the mandate to inspect all aspects of their operation through various mechanisms.

Three in every four agencies mentioned that they undertake regular, joint monitoring practices with relevant government authorities in reviewing the organization’s family-based child-care program. The proportion of organizations having such a joint monitoring practice was relatively higher in other regions than in Addis Ababa. There was little difference in the distribution of this practice across various alternative care services. A large proportion of the agencies indicated that joint monitoring with government authorities often takes place quarterly. See Table 24 for more detailed information.

Overall three quarters of the organizations claimed to have conducted evaluations of their alternative child-care program. There was little difference in the distribution of responses across services, and across regions. Organizations that indicated to undertake evaluation of their respective family-based care program reported the type of evaluations they conducted. The most reported type was mid-term evaluation, and it was more common among institutions in other regions than in Addis Ababa. End-term evaluations were the second most common type, more common among agencies in Addis Ababa than other regions. Impact evaluation was the least reported type, with little difference in the distribution of agencies across regions.

Examining evaluations indicates that relevant government authorities generally undertake or lead in the evaluations. Two in every three agencies (66.2 percent) reported that they use an internal evaluator for their evaluation; two in every five reported to use donor-driven evaluations. Evaluation by an external evaluator was also reported by a significant proportion of organizations include (30.9 percent). The relative popularity of the various evaluation types differs across regions. See Table 25 for more details.


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TABLE 23 - Procedures/mechanisms for internal quality assurance




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Regular monitoring system

94.2 95.8 95.2 92.1 87.9 90.1 100.0 90.9 94.4 93.1 94.2 93.8 93.6 95.2 94.5

MONITORING STRATEGIES

ADDIS ABABA(N=65)%


TOTAL (N=157)%

ADDIS ABABA(N=35)%


TOTAL (N=64)%

ADDIS ABABA(N=7)%


TOTAL (N=17)%

ADDIS ABABA(N=27)%


TOTAL(N=76)%

ADDIS ABABA(N=73)%


TOTAL(N=172)%

Home visits 80.0 96.7 89.8 57.1 93.1 73.4 100.0 100.0 100.0 77.8 93.9 88.2 75.3 94.9 86.6

Periodic reports 83.1 70.7 75.8 97.1 72.4 85.9 85.7 70.0 76.5 81.5 75.5 77.6 82.2 68.7 74.4

Staff meetings 78.5 65.2 70.7 71.4 65.5 68.8 85.7 60.0 70.6 92.6 69.4 77.6 75.3 62.6 68.0

Community conversation

46.2 37.0 40.8 20.0 34.5 26.6 57.1 70.0 64.7 44.4 46.9 46.1 41.1 36.4 38.4

TABLE 24 - Procedures/mechanisms for external quality assurance




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Regular joint monitoring

63.8 78.1 72.1 68.4 75.8 71.8 71.4 81.8 77.8 69.0 84.6 79.0 65.4 78.8 73.1

Frequency of reports

Monthly 2.9 11.5 7.9 5.3 12.1 8.5 0.0 27.3 16.7 13.8 19.2 17.3 6.4 13.5 10.4

Quarterly 68.1 78.1 73.9 47.4 69.7 57.7 85.7 63.6 72.2 65.5 71.2 69.1 61.5 76.9 70.3

Biannually 2.9 2.1 2.4 7.9 15.2 11.3 0.0 9.1 5.6 0.0 7.7 4.9 6.4 5.8 6.0

Yearly 18.8 2.1 9.1 39.5 3.0 22.5 14.3 0.0 5.6 17.2 0.0 6.2 23.1 1.9 11.0


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TABLE 23 - Procedures/mechanisms for internal quality assurance




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Regular monitoring system

94.2 95.8 95.2 92.1 87.9 90.1 100.0 90.9 94.4 93.1 94.2 93.8 93.6 95.2 94.5

MONITORING STRATEGIES

ADDIS ABABA(N=65)%


TOTAL (N=157)%

ADDIS ABABA(N=35)%


TOTAL (N=64)%

ADDIS ABABA(N=7)%


TOTAL (N=17)%

ADDIS ABABA(N=27)%


TOTAL(N=76)%

ADDIS ABABA(N=73)%


TOTAL(N=172)%

Home visits 80.0 96.7 89.8 57.1 93.1 73.4 100.0 100.0 100.0 77.8 93.9 88.2 75.3 94.9 86.6

Periodic reports 83.1 70.7 75.8 97.1 72.4 85.9 85.7 70.0 76.5 81.5 75.5 77.6 82.2 68.7 74.4

Staff meetings 78.5 65.2 70.7 71.4 65.5 68.8 85.7 60.0 70.6 92.6 69.4 77.6 75.3 62.6 68.0

Community conversation

46.2 37.0 40.8 20.0 34.5 26.6 57.1 70.0 64.7 44.4 46.9 46.1 41.1 36.4 38.4

TABLE 24 - Procedures/mechanisms for external quality assurance




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Regular joint monitoring

63.8 78.1 72.1 68.4 75.8 71.8 71.4 81.8 77.8 69.0 84.6 79.0 65.4 78.8 73.1

Frequency of reports

Monthly 2.9 11.5 7.9 5.3 12.1 8.5 0.0 27.3 16.7 13.8 19.2 17.3 6.4 13.5 10.4

Quarterly 68.1 78.1 73.9 47.4 69.7 57.7 85.7 63.6 72.2 65.5 71.2 69.1 61.5 76.9 70.3

Biannually 2.9 2.1 2.4 7.9 15.2 11.3 0.0 9.1 5.6 0.0 7.7 4.9 6.4 5.8 6.0

Yearly 18.8 2.1 9.1 39.5 3.0 22.5 14.3 0.0 5.6 17.2 0.0 6.2 23.1 1.9 11.0


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TABLE 25 - Conducting evaluation of community- and family-based care program



TOTAL


ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Conducted evaluation 79.7 75.0 77.0 65.8 69.7 67.6 71.4 90.9 83.3 89.7 73.1 79.0 76.9 74.0 75.3

FREQUENCY ADDIS ABABA(N=55)%


TOTAL (N=137)%

ADDIS ABABA(N=25)%


TOTAL (N=48)%

ADDIS ABABA(N=5)%


TOTAL (N=15)%

ADDIS ABABA(N=26)%


TOTAL(N=64)%

ADDIS ABABA(N=60)%


TOTAL(N=137)%

Mid-term 58.2 76.1 68.3 40.0 82.6 60.4 40.0 90.0 73.3 53.8 76.3 67.2 56.7 77.6 68.4

End term 70.9 62.0 65.9 76.0 56.5 66.7 60.0 60.0 60.0 65.4 57.9 60.9 70.0 59.2 64.0

Impact evaluation 21.8 18.3 19.8 12.0 21.7 16.7 80.0 20.0 40.0 23.1 15.8 18.8 21.7 18.4 19.9

Profile of evaluators

Government authority 74.5 78.9 77.0% 68.0 78.3 72.9 80.0 80.0 80.0 65.4 73.7 70.3 73.3 76.3 75.0

External evaluator 27.3 36.6 32.5 24.0 34.8 29.2 40.0 30.0 33.3 26.9 34.2 31.3 25.0 35.5 30.9

Internal evaluator 83.6 49.3 64.3 84.0 47.8 66.7 100.0 70.0 80.0 88.5 57.9 70.3 85.0 51.3 66.2

Donor 47.3 38.0 42.1 36.0 34.8 35.4 60.0 60.0 60.0 50.0 42.1 45.3 45.0 39.5 41.9

In the qualitative assessment, informants identified various types of evaluations that were being applied at different levels by different actors. In a few organizations, midterm and terminal evaluations were undertaken either by the organization employing an external consultant or by the relevant government departments. Evaluation by the government depends on the type of agreement signed by the NGO and the signatory government bodies. For projects implemented in three or five years, mid-term and end-term evaluations are often carried out. The mid-term evaluation focuses on the progress of the project in


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TABLE 25 - Conducting evaluation of community- and family-based care program



TOTAL


ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

ADDIS ABABA(N=78)%


TOTAL(N=182)%

Conducted evaluation 79.7 75.0 77.0 65.8 69.7 67.6 71.4 90.9 83.3 89.7 73.1 79.0 76.9 74.0 75.3

FREQUENCY ADDIS ABABA(N=55)%


TOTAL (N=137)%

ADDIS ABABA(N=25)%


TOTAL (N=48)%

ADDIS ABABA(N=5)%


TOTAL (N=15)%

ADDIS ABABA(N=26)%


TOTAL(N=64)%

ADDIS ABABA(N=60)%


TOTAL(N=137)%

Mid-term 58.2 76.1 68.3 40.0 82.6 60.4 40.0 90.0 73.3 53.8 76.3 67.2 56.7 77.6 68.4

End term 70.9 62.0 65.9 76.0 56.5 66.7 60.0 60.0 60.0 65.4 57.9 60.9 70.0 59.2 64.0

Impact evaluation 21.8 18.3 19.8 12.0 21.7 16.7 80.0 20.0 40.0 23.1 15.8 18.8 21.7 18.4 19.9

Profile of evaluators

Government authority 74.5 78.9 77.0% 68.0 78.3 72.9 80.0 80.0 80.0 65.4 73.7 70.3 73.3 76.3 75.0

External evaluator 27.3 36.6 32.5 24.0 34.8 29.2 40.0 30.0 33.3 26.9 34.2 31.3 25.0 35.5 30.9

Internal evaluator 83.6 49.3 64.3 84.0 47.8 66.7 100.0 70.0 80.0 88.5 57.9 70.3 85.0 51.3 66.2

Donor 47.3 38.0 42.1 36.0 34.8 35.4 60.0 60.0 60.0 50.0 42.1 45.3 45.0 39.5 41.9

realizing the planned objectives and taking corrective measures to improve the performance of the project. The end-term evaluation focuses on assessing effectiveness and efficiency, and whether the planned objectives are achieved or not. Some organizations reported having undertaken an impact assessment of the intervention(s). The outputs of the mid-term review and evaluations, and impact assessment provided learning opportunities for the organizations to improve future programming.


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3.3 GOOD PRACTICES: COMMUNITY ENGAGEMENT AND INTEGRATION OF SERVICES

Empowering Families and Communities to Care for Children

3.3.1 EMPOWERING FAMILIES AND COMMUNITIES TO CARE FOR CHILDREN

Organizations reported on the major changes brought about through implementation of their respective family-based child-care services: 96.2 percent claimed that the services improved the lives of target OVC; 79.1 percent reported increased capacity of the family in providing care to the children; and 41.8 percent also stated that the implemented family-based child-care services resulted in improved capacity of community organizations in providing support to OVC.

In the qualitative assessment, community representative respondents and KIs indicated that the support children have been receiving from the various family-based care options including family preservation or foster care have improved the children’s life chances and opportunities for normal childhood. Some participants acknowledged the contribution of some institutions and the concerted effort the institutions make to ensure meaningful change is brought about in the lives of OVC.

KIs also outlined various benefits or impacts of the family-based alternative care services including reduced vulnerability and empowerment of OVC and their respective families and communities. A number of study participants stated that family-based alternative care services have helped children to live in their community and lead a better life; decreased the number of children who receive institutional care; reduced the number of children who live in the streets; reduced the number of complaints on institutional care; and brought love, identity, family affection, social skills, and social values to OVC.

Considerable change has been observed in the lives of children especially in areas of emotional and psychological status, as well as the material support they are receiving from the program. Thus, the program helped not only the children but also empowered the family. In general, psychosocial, educational, health, food and life-skill support were the key support areas in the program. Theses supports brought about change and hope to the lives of the children.

I was recruited for the support when I was in grade four while under the custody of my grandmother. She had nothing. The organization offered me



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school uniforms, personal care items including soap, as well as food or cereals. There was also medical care both for me and the family. Tutorial service was another support introduced at grade 10. With this support my grades improved and encouraged by the result, I started to work better until I reached the current position. I thank the organization for enabling me to reach where I am today.

-A former beneficiary, Ambo

3.3.2 INNOVATIVE STRATEGIES TO MOBILIZE COMMUNITY AND RESOURCES

If approached systematically and supported technically, communities have the capacity to identify OVC and their real needs, identify and mobilize local resources and help these children in a sustainable manner. To this end, some organizations have established voluntary associations and used community-based organizations (such as Iddirs) to increase the community’s awareness of the needs of OVC and the moral obligation to support them.

Their first strategy was to make local communities and community associations and their leaders aware of the need to support OVC and how to best use their resources, and to mobilize the community towards this effort. These associations/community-based organizations are encouraged to generate income and use it for supporting the needy children. As a guiding principle, they are encouraged to revise their rules and regulations to incorporate members’ obligations to contribute a certain amount of extra money for supporting OVC. For example, Iddirs collect and save certain amount of money monthly to support OVC.

We have come to know that contextualizing the plan and utilizing the resources within the community enabled us to be effective, because our major resource lies in the community. The role of local institutions mainly Idirs is so enormous. We are successful in these ventures. Ensuring the participation of the community from the inception to the end of the project enabled them to own the project thereby creating an opportunity to easily provide quality services to the target children.

-IDI informant, Hawasaa

In the school context, community members were organized into committees who collaborated with the school staff to recruit needy children, assess their needs, and monitor



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and ensure that services are up to standard. There were reports of school clubs that are active in this regard in Oromia region. Some agencies mobilized resources from private schools, encouraging the more well-off children to contribute educational materials and money for OVC. This is called the child-to-child program. This is a good practice for two reasons: (1) it teaches children the value of helping others from the early years, and (2) children also teach their family members and others in their immediate area to do the same.

Religious institutions may be useful in raising funds for needy children. As an example, the Ethiopian Orthodox Church in Woldia organized discussions with 99 parish churches involving 50 religious leaders and was able to support 500 children with basic and educational needs. This initiative can be replicated in a wider scale both in the Ethiopian Orthodox Tewahedo Church (EOTC) and other religions. Apart from fund raising, some child-care organizations also targeted religious institutions to play an instrumental role in promoting and sensitizing the community about domestic adoption and kinship care.

The emphasis given to enhance the community’s capacity in tapping local resources, linking their initiatives with other stakeholders and increasing individuals’ commitment to support OVC are good initiatives that child-focused organizations should scale up.

3.4 MAJOR CHALLENGES FOR AGENCIES PROVIDING COMMUNITY- AND FAMILY-BASED ALTERNATIVE CARE SERVICES

Agencies providing community- and family-based alternative child-care services reported what they consider to be major challenges they encounter in the course of providing the services. Despite similarities in the type of challenges they mentioned, there were differences in the relative gravity of the respective challenges. See the table below.

Absence of recorded information was a major challenge for agencies providing family-based alternative care services, according to a large proportion of adoption agencies, a quarter of



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the foster-care agencies and one in every three agencies providing reunification services. This was also the case among relevant government authorities, and the researchers experienced the challenge first hand while compiling a list of community- and family-based alternative child-care service providers, a complicated process that took quite a long time.

Many agencies providing family-based services seem to experience a relatively higher sense of resentment and misconception from the communities they work in as compared to agencies that provide community-based alternative care services. This could be attributed to the relatively smaller number of targets they enroll or, quite possibly, their lack of engagement with the community.

Further investigation in the qualitative assessment revealed similar challenges. With regard to the negative perception of the communities, many community representatives attributed this to the way the agencies operate. Community respondents were critical of the level of engagement the institutions have with the community and their linkage with relevant government bodies, which they feel is nonexistent and is contributing to resentment and lack of accountability.

I did not see as such a strong link between government and organizations. I don’t think organizations involve the Woreda administration in their plan. On the other hand, the government people never came to see what the organizations are doing at school. Both should have a signed agreement. Even the Woreda administration people get information about the organizations’ performance from the school. The organizations prefer to contact schools directly. If they have linkage, it is possible to minimize duplication of resources. Schools are receiving similar kinds of support from a number of organizations.

-27-year-old female supervisor, Addis Ababa



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Community representatives reported also shoddy practices by some institutions including informal hiring of staff, nepotism, and lack of relationships with local/community-based institutions such as youth, women or residential groups. Respondents also admitted they know little about the organizations (but then also seem to accept that the community is not entitled to know the internal processes and resources of the institution). Although the institutions were reported to involve community-based organizations or associations during

FINDINGS/RESULTS CONTINUED TABLE 26 - Major challenges agencies providing community- and family-based alternative care services




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%

OTHER RE-GIONS(N=11)%

TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

Financial and material resources constraint

62.3 49.5 54.9 8.1 40.6 23.2 57.1 30.0 41.2 37.9 46.0 43.0

Shortage of qualified human resource

33.3 33.3 33.3 2.7 25.0 13.0 44.8 22.0 30.4

Bureaucratic procedure

33.3 22.6 27.2 70.3 46.9 59.4 0.0 10.0 5.9 20.7 6.0 11.4

High demand for services

68.1 62.4 64.8 21.6 15.6 18.8 14.3 30.0 23.5 13.8 30.0 24.1

Lack of access to standard guidelines

11.6 17.2 14.8 2.7 6.3 4.3 28.6 0.0 11.8 10.3 14.0 12.7

Misuse of support, dependency,

9.4 17.6 14.2

Beneficiary recruitment problem

3.1 6.6 5.2

Negative community perception

0.0 4.4 2.6 78.4 65.6 72.5 57.1 70.0 64.7 58.6 38.0 45.6

Lack of follow up reports

16.2 21.9 18.8 14.3 20.0 17.6 34.5 16.0 22.8

Absence of recorded information about children

29.7 43.8 36.2 14.3 30.0 23.5 48.3 26.0 34.2


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FINDINGS/RESULTS CONTINUED TABLE 26 - Major challenges agencies providing community- and family-based alternative care services




ADDIS ABABA(N=69)%


TOTAL (N=165)%

ADDIS ABABA(N=38)%


TOTAL (N=71)%

ADDIS ABABA(N=7)%


TOTAL (N=18)%

ADDIS ABABA(N=29)%


TOTAL(N=81)%

Financial and material resources constraint

62.3 49.5 54.9 8.1 40.6 23.2 57.1 30.0 41.2 37.9 46.0 43.0

Shortage of qualified human resource

33.3 33.3 33.3 2.7 25.0 13.0 44.8 22.0 30.4

Bureaucratic procedure

33.3 22.6 27.2 70.3 46.9 59.4 0.0 10.0 5.9 20.7 6.0 11.4

High demand for services

68.1 62.4 64.8 21.6 15.6 18.8 14.3 30.0 23.5 13.8 30.0 24.1

Lack of access to standard guidelines

11.6 17.2 14.8 2.7 6.3 4.3 28.6 0.0 11.8 10.3 14.0 12.7

Misuse of support, dependency,

9.4 17.6 14.2

Beneficiary recruitment problem

3.1 6.6 5.2

Negative community perception

0.0 4.4 2.6 78.4 65.6 72.5 57.1 70.0 64.7 58.6 38.0 45.6

Lack of follow up reports

16.2 21.9 18.8 14.3 20.0 17.6 34.5 16.0 22.8

Absence of recorded information about children

29.7 43.8 36.2 14.3 30.0 23.5 48.3 26.0 34.2

recruitment of targets/beneficiaries, the community seemed to believe it has little say or right to assess issues considered internal to the organization.

We are involved in the selection of OVC who should be included in the care of these organizations. But we do not know about their budget, number of staff, management style, etc., because these are their internal issues.

-50-year-old male religious leader, Afar


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The lack of transparency seems to be a common problem among agencies, more so among those that were said to engage in shoddy practices. The community was said to have little power to change this, and many called upon the government to ensure accountability. Respondents identified the lack of government supervision despite the flourishing number of agencies providing services.

Most of the organizations are not transparent. They do not clearly tell the community the services they render and their objectives. They are not accessible to the people because if they disclose their activities and objectives to the community, it can monitor them. This may prevent them from embezzling resources. So, the government should handle this problem.

-54-year-old male Idir leader, Sodo

According to a 48-year-old man who is a member of the Woreda forum, the lack of transparency on the part of agencies is deliberate and is meant to avoid any scrutiny or dis-courage demand for service in the community. This lack of engagement with the community, he added, undermines their contribution or effectiveness in addressing the problems they set out to address. He noted, “I think they may have a fear for high demand from the community. Even I have a doubt on how well they know the community and their ability to find out who the real poor are.”

Participants also reiterated the importance of holding agencies providing community- and family-based alternative care accountable, which is contrary to the traditional passive recipients as articulated in a traditional folklore Yesitota feres tirsu aytayem (It is not appropriate to see the teeth of a horse given as gift). They called for further examination of the contribution of institutions working with OVC. They emphasized the need to undertake strict supervision and monitoring of service-providing institutions, because of malpractice and failure to meet the standard guidelines.

The government has introduced certain rules to improve quality. But there still is a problem. Except few organizations I do not feel that the services do address the needs of the beneficiaries. Let me tell you what they are doing. They rent a house and they hire their relatives or family members. They are working for their benefit, not for the betterment of the community. The government should closely monitor them.

-64-year-old male local elder, Discussant in Sodo



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Another challenge was ensuring sustainability of community- and family-based alternative care. One problem emphasized in this regard is the discontinuation of services by the agencies, in most cases reportedly without the institutions communicating when or the reasons for stopping the service. This was attributed to a lack of formal linkages between the community and service provider and relevant government agency.

The problem of sustainability is always there due to lack of linkage and formal agreement between the organization and the local community or government organization. So the community members should identify for how long the organization will provide its service in that particular area.

-27-year-old male cluster supervisor, Addis Ababa

The KIs stated that they do not expect sustainability because some agencies come without the resources and capacity to implement projects long-term. Problems resurface and children are returned to the same situation when the project terminates.

From what I have seen in our school, I would say the support that this agency is providing is not sufficient and sustainable to address the problem. Especially there are problems related to the continuity of the service. One organization started supplying milk to our school and after some period the delivery stopped for unknown reasons. So the children started to suffer. This is a common problem; they start something but they couldn’t bring it to an end.

32-year-old male cluster supervisor, Addis Ababa

Respondents underscored the lack of services that bring about lasting impact and socioeconomic development in the area. They suggested that sustainability could be ensured through strengthening small-scale local associations, income-generating activities and savings.

The type of help that organizations offer has to include strategies that bring sustainable poverty reduction. It doesn’t bring permanent change when they focus only on sharing what they got. Rather they should work on building the capacity of children, families, and schools in sustainable way.

-29-year-old female unit leader, Addis Ababa



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The challenge of dealing with high demand from target community for services was the most prominent challenge cited by agencies offering community-based child-care services compared to agencies providing family-based alternative child-care services. Evidence from the qualitative assessment corroborated this. Participants noted that some of the existing assistance is not really enough to meet the needs of children adequately. Respondents cited how insufficient were the financial support families receive to cover food, educational materials and other expenses of children, reportedly 460 birr per annum in Amhara region.

The number of OVC is increasing, though some children are getting support, it is not adequate in terms of quantity and quality. One NGO gives educational materials, another one food support and still another school uniform. However, all different kinds of services are inadequate and incomplete. There are many children not supported and even for those who received support, their needs are not fulfilled.

-24-year-old female youth representative, Ambo, Oromia

There were reports of instances where only one of the siblings in the same family is supported, creating resentment and frustration for the rest of the family.

Aid has led so many people to develop hostile attitude to each other. In one family where there are so many children, one child is picked and given support. What about the others? They are also brothers and sisters.

-53-year-old man, Hawassa

Lack of access to standard guidelines was cited by at least one in every 10 service-providing agencies. The qualitative assessment highlighted a lack of capacity as a major stumbling block. Participants reported a tendency among many agencies not to accept the existing guidelines even though they are familiar with them because they feel that the standards do not fit the objective realities of their locality2

The guideline was given to us. However, we found it so ambitious. It applies to the services in Europe or America. Do we have a capacity to meet all the standards? I don’t think so, because we are not capacitated by concerned bodies to do so. Funds should be generated locally if we need to meet all the standards. We can’t achieve standards while depending on external donations which is not sustainable. I want such things to be improved.

-IDI informant, Hawasa


2 It should be noted that lack of funding/investment was reported by a large proportion of agencies ranging from one in every four adoption agency (23.2 percent) and one in two community-based service providers (54.9 percent).


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The family-based alternative child-care services are being provided based on the existing capacity of the community and the country. The need of the children might be many but just because certain needs were not met does not necessarily mean that the rights of the child are not being protected. Hence, you need to look at the economic capacity of the country and also of the society. So considering these factors, I believe these services are up to the standard. But if you look at it from the angle of existing international or national guidelines, it may not be up to standard.

-KII respondent from MOWCYA

Misuse of support by families and care-providing agencies, dependency among beneficiaries, and inappropriate screening of beneficiaries were mentioned solely by community-based child-care service providers. Participants representing various categories in the qualitative assessment reiterated this phenomenon. The following excerpts explain this assertion:

As I have seen in our school, organizations provide support to the children as well as financial support to families of the children. Many of those parents who received support in the form of money consume it for other purposes rather than fulfilling the needs of the child. They are not concerned whether the student’s educational materials are in place or the child attended education regularly. This is mainly due to lack of effective monitoring on the part of oversight bodies and service-providing organizations.

-26-year-old male teacher

In line with this, former beneficiaries shared their experiences of the difficulty of finding foster families that have their best interests in mind. Many kin, they reported, are clattering to have custody of the child as a source of income or labour.

I lost my father when I was two and my mother when I was six years old. Since then I started living with my grandparents together with my older sister. Our grandparents were not giving the kind of support we needed although they were receiving support in order to care for us. Sometimes they didn’t give us food to eat and they didn’t have the capacity to care for us. Gradually my sister took the responsibility to take care of me and I started receiving the support through my sister. Initially, my grandparents did not agree on my sister receiving the support.

-A former beneficiary, Addis Ababa



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Community representatives in the FGD reiterated the existence of institutions led by self-serving individuals who seemed to engage in all sorts of malpractice. This was noted as another challenge in the provision of formal community- and family-based child care.

We have to see this in relative terms. As there are organizations which strive to bring change there also certain organizations preoccupied with how to make business. They realize that running an NGO is profitable business. By the way this is not a mere accusation. We have tangible evidences.… The problem is not lack of capacity. It is lack of transparency and commitment. Many are for profit organizations.

-54-year-old Idir leader and other respondents, Sodo

Another challenge that featured only in the qualitative assessment was the stigma associated with being recipients of FPS in the community. Case studies on former beneficiaries revealed the prevalence of such stigma.

There was bad perception in the community about the service. I didn’t forget the days I was insulted by our neighbours when I went to the organization and took some materials. They used to call me ‘Beggar’. They yelled at me saying ‘Are you going to the place where you beg?’ None of these people have tried to help me when I was in trouble. But since I know my family background, I felt nothing.

-A former beneficiary, Addis Ababa

Different groups of informants involved in the study made suggestions to help address the challenges facing the organizations and improve the quality and coverage of community-based alternative child-care services. Some of these suggestions included: improve working relationships with communities, other agencies and government; address the protracted bureaucratic procedures; improve the capacity of organizations; empower families to be self-sufficient; empower communities to play more active roles; supervise and follow up with children after placement; and supervise agencies providing alternative child-care services.

FINDINGS/RESULTS CONTINUED 4


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4.1 SCOPE AND LIMITATIONS OF THE ASSESSMENT

Securing an up-to-date and complete list of agencies providing formal community- and family-based alternative child-care services was a huge challenge as a result of poor official recording practices of relevant government authorities on the number and category of agencies engaged in providing these services. This resonates with findings of an earlier assessment that identified a problematic information-management practice by agencies providing services to children living in vulnerable circumstances, and underscored the importance of building MOWCYA’s capacity as a solution.

There are differing information-management practices among organizations implementing different programs to benefit children in vulnerable circumstances. It is not common among such organizations to record detail profile of their beneficiaries. There is a tendency to treat beneficiaries grossly, and to focus on keeping track of how many received certain services. This is often done as part of a monitoring exercise whereby the data is required for internal consumption such as preparing periodic reports for donors or for evaluation and monitoring purposes. [13]

Another major gap in the data collected was that it includes only nongovernmental child-care agencies. Hence, government agencies are clearly absent. Due to this lack of information, it is not possible to comment on the magnitude and quality of care of government agencies.

Misunderstanding or mistrusting the purpose of the research by some representatives of child-care agencies was the other prominent challenge encountered. Some agencies considered the research as a fault-finding mission that would entail harsh administrative measures against their programs. Thus, there were instances when they refused to allow members of the research team from entering their compound, let alone provide information to them.

The initial plan was to conduct a national survey, involving all regions and special administrations, but time and resource constraints necessitated limiting the study to five diverse regions. These purposively selected regions represent the differences in population size, livelihood, geographic location and culture in the country. This reduction in scope means that the study can now be generalized only to the five regions, and not to a national level.

DISCUSSION4


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The standard guidelines contain a whole list of indicators of quality. This study focused on certain overarching themes that offer an overview of the state of the situation. Hence, not all indicators are covered, but a significant proportion of them are. Similar data reduction was done during data analysis — the findings are presented under a selected set of overarching themes covering issues of access, safety, participation, continuum of care and quality assurance. The indicators included are hoped to provide insight into the ones that are not covered.

The confusion and diversity of definitions associated with OVC, family-based alternative child care and community-based care was another challenge. For the sake of consistency, this study adopted the definitions in the standard guidelines, as those documents serve as benchmarks for measuring quality. But differentiating these different categories in practice is also difficult, as agencies may provide not just one type of care, but a continuum of care, offering a range of services all on their own or through linkages and referral systems with other institutions, based on the needs of children.

Finally, collected quantitative information was largely of a self-reported nature, which may be prone to some inaccuracies as a result of recall problems, lack of information or social desirability. Furthermore, some of the quantitative information that was gathered provides insight only into size and magnitude, and does not fully address issues of quality, information that is lacking in some cases. For instance, information about the number and qualifications of staff is gathered, but it is not easy to ascertain whether the staff have the appropriate qualifications and skills for the roles they have.

4.2 ACCESS TO COMMUNITY- AND FAMILY-BASED ALTERNATIVE CHILD-CARE SERVICES

Considering the vast proportion of OVC and the small number of agencies operating in the different parts of the country, clearly a large proportion of OVC are left without access to alternative care options, subject to deprivation, discrimination, neglect, abuse and exploitation. The state of child domestic workers in Addis Ababa who live under dismal conditions shed light on the life situation of children without proper parental care. [7][8]

One challenge reiterated in the qualitative assessment was access to services and the lack of equity in accessing services. Most if not all formal family-based alternative care and community-based alternative child-care services are concentrated in Addis Ababa and other urban centres, leaving the majority of needy children in rural areas with little access to these services. The imbalance in the concentration of the institutions could be attributed to the

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sheer demand for services in Addis Ababa and other urban centres, but also to the motive of the organizations to be located in the city, where there is more ease of operation, access to different social and economic services and available qualified personnel.

Only about half of the agencies providing community-based child-care services claimed to include services for children with special needs (disabilities). This was corroborated in the findings from the qualitative assessment whereby some respondents indicated the underwhelming level of integration of services for children with special needs. They emphasized how these children are under the radar of care-giving institutions. The situation is further complicated by traditional notions that associate disability with a curse or as something that reflects badly on parents. As a result, many families resort to hiding children at home and restricting their contact with the outside world. These and other related factors have contributed to a growing recognition of disability as one of the reasons for the separation of children from their families. [1]

Other barriers included the lack of adherence to eligibility criteria or formal procedures during the recruitment of target children, the lack of adequate formal procedures to assess eligibility, the failure to make provisions for pre- and post-placement support, and the lack of follow-up. Respondents emphasized that despite the positive intentions and benefits accrued to OVC, these shortcomings could undermine the best interests of the child and expose children to further vulnerability in forms of abuse and exploitation.

The issue of high demand featured a great deal in the qualitative assessment, from beneficiaries/communities, and there was a consensus among participants that there is a mismatch between demand for these services and what is available in their respective com-munities. Accordingly, a large proportion of OVC in the community have not been reached through such services. Participants also noted that some of the existing assistance is not really enough to meet the needs of children adequately. There were reports of instances where only one of the siblings in the same family is supported, resulting in possible resent-ment and frustration for the rest of the family. All respondents concurred that the support they are receiving is minimal and enough to change the life of a child in a meaningful way.

Lack of linkages and referral systems, and collaboration among agencies providing community- and family-based services was another challenge underscored in the study. Most agencies tend to work in isolation and little coordinated efforts are in place. Many respondents across the regions stressed the importance of networking and experience sharing programs to deal with such problems. Some informants in Addis Ababa and Amhara Region, however, mentioned the emerging signs of collaboration and networking among child-care agencies, but undertaken in a fragmented manner.


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4.3 COMPLIANCE WITH THE NATIONAL SERVICE STANDARDS OR GUIDELINES

Compliance to standard guidelines as gauged in this assessment is far from satisfactory. The reasons for agencies’ failure to comply include lack of access to these standards or guidelines, the capacity to enforce them, lack of familiarity with them, the perception that the standards do not fit the objective realities of their locality, and financial constraints. Government support and supervision is critical for ensuring compliance to quality standards.

One in every 10 service-providing agencies indicated they do not to have access to these guidelines, which reflects on the capacity and performance of the relevant government authority to oversee the distribution and availability of these guidelines. Capacity shortages, both financial and personnel, seem to compromise quality of service and capability of agencies to deal with the ever changing and complex problems of OVC and provide continuum of care.

Looking at the availability of specialized caregivers, only half of the agencies have social workers and health workers, three in every 10 have psychologists, one in every five has lawyers.

In the qualitative assessment, participants indicated that personnel quality and number in the child-care agencies and the various government agencies tasked with the responsibility of creating an enabling environment and enforcing the standards is wanting. Informants indicated that quality of care is undermined by issues related to personnel including lack of capacity, lack of motivation, high workload and high turnover.

In line with this, the new Charities and Societies Law was cited as constraining the ability of the agencies to bolster their human resource capacity, as it limits agencies to spending only 30 percent of their income for operational/administration purposes. Article 90 (1) of the Charities and Societies Proclamation states the following in relation to the Administrative and operational Costs, “Any charity or society shall allocate not less than 70 percent of the expenses in the budget year for the implementation of its purposes and an amount not exceeding 30 percent for its administrative activities.” [14] Notwithstanding the resource-poor setting, a large proportion of agencies reported they tried to fulfil the minimum conditions. With 95 percent of the agencies depending on financial support mainly from international donors, it would be relevant to examine in the future how well they are complying with the latest Charities and Societies Law, especially in the case of local agencies whereby the prescriptive 10:90 (foreign: local) funding scheme is supposed to apply, and how the advent of the law influences existing arrangement.



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The lack of capacity of agencies severely constrains their capacity for supervision and post-placement follow-up, which seems to be very much needed. As a case in point, respondents in the qualitative study expressed their dissatisfaction with the way guardians or foster parents spend the financial assistance they receive. Participants indicted that most of them were spending the money to serve their personal needs and not the needs of the children. This underscored the need for supporting organizations to ensure that financial support is dedicated to its intended purpose.

Informants in the IDIs also reported instances of foster parents who are mainly motivated to secure financial gains or labour of children under the pretext of helping the children. Most of the organizations argued that giving children to parents who do not have the best interests of the child results in a superficial relationship between the child and the foster parents. Some respondents argued that the more intrinsic the drive is that forces the parents to foster a child, the better the chance for social and emotional care the child would get.

A closer look reveals that many of the agencies fail to meet the range of minimum conditions prescribed in the standards. Lack of quality of services was also highlighted in the qualitative assessment. According to IDI informants, none of the agencies providing child-care services implements programs exactly in line with the standards provided in the guidelines. Some organizations were not certain about meeting the standards because they were not familiar with the existing standard guidelines.

The tendency among some agencies not to accept the existing guidelines was evident, even when the agencies were familiar with them. This is attributed to their perception that the standards do not fit the objective realities of their locality. The government, particularly the different substructures of Women, Children and Youth Affairs Office, is responsible to supervise the works of such organizations and provide technical support with the view of improving the quality of the services; however, the agencies complained about government officials often being busy with meetings and seldom visiting their programs or providing technical support. Organizations in Oromia, SNNPR, Amhara and Afar claimed that there were no regular follow-ups or supervisions by the government organizations. Monitoring by the higher-level structures (federal and regional) was described as inconsistent. Visits by both level structures did not follow up with any feedback for improvement. The following quote best illustrates lack of supervision and follow-up from oversight bodies:

There are no periodic follow-up or supervision done by relevant Woreda, Zonal and regional government authorities especially office of Women, Children and Youth Affairs either quarterly, bi-annually or annually. The regional authorities used to visit us in the past but no more now a days.

-IDI informant, Adama, Oromia Region



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This story from Oromia is not atypical; rather similar complaints were evident across the regions studied. Staff turnover in the government offices that oversee the activities of child-care organizations is also described as posing a challenge and hindering smooth provision of the services.

Most services do not fulfil all the needs of the children in accordance with the quality standard guidelines. The categories of selected OVC, such as orphaned children, children with disabilities, children from terminally ill families and from extremely poor families, have diverse needs. These needs are not addressed by the agencies because of the financial constraint and focus of their programs. According to service providers, the quality of services is compromised because the number of beneficiaries is beyond the limited available resources. Against the expectations of the researchers, the agencies in the regions were found to have a relative superiority in meeting quality standards compared to those in Addis Ababa. This should be further examined.

It is worth noting that only a small proportion of the agencies providing community-based care claim to involve children in decision making, and it would be relevant to investigate in the future whether the reasons have to do with the popular notion of considering children and communities solely as recipients of services, and thus disregard their views and opinions.

4.4 EXISTENCE OF CONTINUUM OF CARE FOR CHILDREN WITHOUT PARENTAL CARE

The distribution of agencies by type of service they provide suggests alignment with the principle of continuum of care prescribed in the national and international standard guidelines for alternative child-care services The continuum of care emphasizes preventing unnecessary separation of children and placing them in familial environments as much as possible. Accordingly, nine in every ten agencies included in this assessment are engaged in community-based care services that implement preventive interventions against child separation, and ensure children’s access to basic services. The services include economic strengthening, parenting skills, conflict-management skills, food and nutrition, shelter, health care, education and psychosocial support. The concentration of agencies in the provision of community-based services could be understandable as they serve as the interface between the informal care and the formal alternative- family-based care. Being preventive in its nature, it encompasses a broad array of OVC.



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Agencies providing family-based alternative child-care services also claimed to recruit children from streets, orphanages, orphan households or relevant government authorities that are in line with the continuum of care principle. It also appears that the community-based child-care services interface with the informal care [15], which is supporting a staggering proportion of children without parental care [6], as the eligibility criteria of these agencies seems to encompass such families.

Domestic adoption was the least common category of family-based alternative child-care service, followed by foster care. The low uptake of local adoption was attributed to various barriers including lack of awareness about formal procedures on domestic adoption and misconceptions, reluctance to face legal procedures, cultural reasons, fear of stigma and labelling, and economic problems. The qualitative assessment also highlighted how the issue of going through legal procedures, particularly its implication on inheritance, puts off many potential adopting parents, who are used to the conventional and informal practices of kinship or non-kinship care of OVC. The informal practice entailed little accountability and supervision, and thus exposes children to labour exploitation, discrimination and neglect. It is widely known that there are individuals who are motivated to take in a child under their care, on temporary or permanent basis, seeking only to exploit the child’s labour. This was also established in the rapid assessment on domestic child workers in Addis Ababa. [7][8]

The responses from the qualitative assessment were more revealing in terms of improper application of the continuum of care: some children are separated from their living parents to join child-care institutions; living parents sometimes give away their children for adoption, claiming the child has lost its parents; and inter-country adoption placement has been cited as being used by guardians and parents who are keen to send their children abroad. The absence of a strong screening procedure and personal records allows this to happen. (These findings are corroborated in the 2010 FHI 360 assessment that identified positive perception towards residential care and inter-country adoption in the community. [9])



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This assessment attempted to generate evidence about formal community- and family-based alternative child-care services and service-providing agencies in Ethiopia, with a particular focus on magnitude, quality and quality-assurance mechanisms. Against the backdrop of a massive magnitude of OVC and a host of unmet basic and developmental needs, it is safe to conclude that existing agencies providing formal community- and family-based alternative child-care services could only scratch the surface of the problem. It is thus imperative to expand access of OVC to alternative care options to guarantee their well-being and development, and ensure application of the principle of continuum of care primarily emphasizing prevention of separation of children from their families. This is all the more important in the face of a large and possibly increasing magnitude of OVC, which is unmatched by existing services. The case for prevention outweighs all others.

Scaling up efforts to reduce the vulnerability of children and prevent their separation from their families requires a multipronged approach to address the underlying causes of vulnerability, including poverty and HIV/AIDS. The measures that need to be taken include providing integrated family-preservation services targeting all OVC, including those with special needs or disabilities; building livelihoods of vulnerable and marginalized families; promoting child rights; improving communication skills and management of conflict; and family planning. Similarly, reunification of children with their biological or extended families should be actively explored to find long-term solutions that are in the best interest of the child.

Community-based child-care services and reunification are the most popular services being provided by almost all and about half of the agencies, respectively. But the services are characteristically fragmented and fail to meet even the basic needs of OVC. The focus on educational support is to be expected, but this should be supplemented with other basic services focusing on food, shelter, psychosocial support and economic empowerment of families to avoid separation of children due to these factors. Collaboration and networking among agencies is acutely lacking and there is a need to address this gap. Reunification of children with their biological or extended families should be actively explored to find long-term solutions that are in the best interest of the child.

When it is necessary to separate children from their families, appropriate alternative forms of care such as (domestic) adoption and foster care should be explored and made more child friendly. Currently formal domestic adoption and foster care are the least popular forms of care, but there is untapped capacity in this regard, and innovative ways to promote these care options should be introduced. The concept and process of legalizing the arrangement seems alien and complicated to many potential foster parents, which often discourages them from reaching out to OVC. The negative perceptions about formal or legal

CONCLUSION AND RECOMMENDATIONS5


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arrangements need to be addressed. Efforts are also needed to sensitize the community about child rights in adoptions and foster placements. Existing efforts to expand both of these forms of alternative child care are insufficient.

It is worth exploring the significance of formalizing traditional ways, keeping in mind that such support is expected to strengthen families, but could undermine them if people take custody of children in anticipation of financial or material incentives. Many parents in the community who take OVC under their custody fail to treat them as one of their own, either by subjecting them to abuse or exploitation, or barring them from having the same inheritance rights as their children. Formalizing child-care arrangements needs to be preceded by extensive efforts of sensitization about child rights and dispelling underlying negative perceptions about formal/legal arrangement.

The need for making the national guidelines available and further sensitizing agencies adhering to them is evident in the study. A significant proportion of agencies do not meet the guidelines’ conditions, such as having written eligibility criteria, a process of selection, participation of children in decision making, conducting follow-ups after placement or provisions of support in the case of FPS. The study also highlighted that many agencies lack access to the guidelines or fail to follow them because of negative attitudes towards them. These issues call for MOWCYA and its substructures to step up their effort to ensure the guidelines are accessible and publicised, in the respective official language of the region; to ensure adequate understanding exists through periodic training; and to follow up that the guidelines are being followed.

Capacity shortages, in terms of technical, financial and human resources, have hampered the operation of the agencies. These shortages have prevented them from (1) offering integrated services, specialized care, emergency-placement services and special-needs services; (2) improving the quality of care; or (3) increasing the number of OVC served. Many agencies resorted to using a large number of low-skilled professionals, which underscores the need for providing regular on-the-job training for such professionals.

The situation seems to be further complicated by the dwindling funding environment and the new Charities and Societies Law applicable to CSOs, which has redefined the criteria for defining agencies as local or foreign according to the proportion of contribution from external sources and not on whether the founders are local or foreign based. The new proclamation dictates that state agencies can spend up to 30 percent only of their budget on administrative cost, which reduces their capacity to retain or attract qualified personnel.


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In addition to better integration and consolidation of alternative care services, viable mechanisms are needed to ensure the sustainability of support to OVC in the community. Despite the requirement of having a proper phase-out strategy, a significant proportion of the licensed agencies claim to have no such plan. MOWCYA needs to ensure that appropriate phase-out strategies are implemented well in advance, and should focus on enabling families and communities to look after their children, and promote local ways of family- or community-based child-care options such as Gudifecha and other customary practices.

The following recommendations are based on the findings of the assessment:

• Ensure the application of the principle of continuum of care and prevent the unnecessary separation of children from poverty stricken or conflict-prone families by expanding the availability of community-based prevention services.

• Improve the capacity of MOWCYA and its substructures to provide adequate support and supervision of agencies that provide formal alternative child-care services.

• Strengthen MOWCYA’s information management system and its substructures and that of agencies providing community- and family-based alternative care services in order to provide the platform for evidence-informed planning and program implementation.

• Improve compliance to quality-standard guidelines by making them widely accessible in the respective official language of the region, improving awareness and understanding through training and regular supervision and support of the service-providing agencies.

• Improve collaboration, referral systems and linkages among agencies and other relevant institutions to provide a continuum of care and emergency placement for at-risk children and ensure access to services for OVC with special needs or disabilities.

• Promote uptake and support for foster care and local adoption by addressing barriers such as stigma, lack of awareness about local adoption procedures, reluctance to face the legal process, fear related to inheritance of property, and limited economic capacity of households to care for additional children.

• Better sensitize communities regarding domestic adoption, foster care and fund raising.

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• Assess the implications of the new Charities and Societies law, which has reconfigured the criteria for defining agencies as local or foreign, and limited the fund local agencies have at their disposal for personnel and administrative costs.

• Promote existing informal and generally positive child-care options, mainly kinship care, by providing guidance, support and supervision to families that care for OVC.

• Protect the safety and well-being of children that are under the informal custody of families (relatives or non-relatives) and may be subject to exploitation, violence, abuse and neglect; and explore supporting and engaging community-based organizations like Idir in this regard.

• Provide support and supervision to community-based care initiatives being led by schools, community-based organizations (such as Idirs) and other associations to support OVC.

• Research the state of children under informal care, and the implications of formalizing informal/traditional family-based child-care options on the well-being of children, and readiness of families to provide support and care to OVC.

• Sustain existing community mobilization and empowerment efforts.

• Scale up access to alternative child-care services by mobilizing communities, improving government engagement, and increasing donor support.

[1] UNICEF, “Children without Parental Care: Child Protection Information Sheet,” 2006.

[2] G. Biemba, J. Beard, M. I. Brooks, M. Bresnahan, and D. Flynn, “The Scale , Scope and Impact of Alternative Care for OVC in Developing Countries : A Review of Literature,” 2010.

[3] UNICEF, “Monitoring the Situation of Children and Women: Orphan Estimates.” Geneva, 2013.

[4] UN General Assembly, “Guidelines for the Alternative Care of Children: Resolution adopted by the General Assembly,” vol. 53, no. 53. pp. 1–23, 2010.

[5] V. Mishra and S. B. Assche, “Orphans and Vulnerable Children in high HIV-prevalence countries in sub-Saharan Africa DHS Analytical studies 15,” 2008.

[6] Central Statistical Agency, “Ethiopia Demographic and Health Survey 2011,” Addis Ababa, 2011.

[7] UNICEF, “Afica’s Orphaned Generations,” New York, 2003.

[8] UNICEF, “The Framework for the Protection, Care and Support Orphans and Vulnerable Children living in a World with HIV and AIDS,” New York, 2004.


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[1] UNICEF, “Children without Parental Care: Child Protection Information Sheet,” 2006.

[2] G. Biemba, J. Beard, M. I. Brooks, M. Bresnahan, and D. Flynn, “The Scale , Scope and Impact of Alternative Care for OVC in Developing Countries : A Review of Literature,” 2010.

[3] UNICEF, “Monitoring the Situation of Children and Women: Orphan Estimates,” Geneva, 2013.

[4] UN General Assembly, “Guidelines for the Alternative Care of Children: Resolution adopted by the General Assembly,” vol. 53, no. 53. pp. 1–23, 2010.

[5] V. Mishra and S. B. Assche, “Orphans and Vulnerable Children in high HIV-prevalence countries in sub-Saharan Africa DHS Analytical studies 15,” 2008.

[6] Central Statistical Agency, “Ethiopia Demographic and Health Survey 2011,” Addis Ababa, 2011.

[7] UNICEF, “Africa’s Orphaned Generations,” New York, 2003.

[8] UNICEF, “The Framework for the Protection, Care and Support of Orphans and Vulnerable Children living in a World with HIV and AIDS,” New York, 2004.

[9] Family Health International, “Improving Care Options for Children in Ethiopia through Understanding Institutional Child Care and Factors Driving Institutionalization,” 2010.

[10] UN, “The Convention: on the rights of the child,” 1990.

[11] OAU, “African Charter on the Rights and Welfare of the Child,” 1999.

[12] Ministry of Women’s Affairs, “Alternative Childcare Guidelines on Community-Based Childcare, Reunification and Reintegration Program, Foster Care, Adoption and Institutional Care Service,” Addis Ababa, 2009.

[13] T. Getnet and K. Woldekidan, “Existing situation and best practices in the area of information management related to children living in vulnerable circumstances in Ethiopia,” Addis Ababa, 2006.

[14] Federal Democratic Republic of Ethiopia, “Charities and Societies Proclamation,” 2008.

[15] J. L. Roby, “Children in informal alternative care: Discussion Paper,” Geneva, 2011.

REFERENCES


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