standard service delivery guidelines - usaid assist · the standard service delivery guidelines)....

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Standard Service Delivery Guidelines for OVC Care and Support Programs

Standard Service Delivery Guidelines FOR ORPHANS AND VULNERABLE CHILDREN’S

CARE AND SUPPORT PROGRAMS

FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA

February 2010Addis Ababa

Ministry of Women’s Affairs Federal HIV/AIDS PreventionAnd Control Office

List of Acronyms

ACRWC African Charter on the Rights and Welfare of the ChildAIDS Acquired Immune-deficiency SyndromeANC Antenatal CareART Anti-retroviral TherapyBCC Behavior Change CommunicationsCBO Community-Based OrganizationsCPU Child Protection Unit CRC Convention on the Rights of the ChildEDHS Ethiopia Demographic and Health SurveyFBO Faith-based OrganizationHAPCO HIV/AIDS Prevention and Control OfficeHBC Home-based CareHH Household HIV Human Immune deficiency Virus IEC Information, Education and CommunicationIGA Income Generating ActivitiesKETB Kebele Education and Training BoardMOH Ministry of HealthNGOs Non-Governmental OrganizationsOVC Orphans and other Vulnerable ChildrenPEPFAR United States of America’s President’s Emergency Plan for AIDS ReliefPLHIV People Living with HIV PRA Participatory Rapid AppraisalPSS Psychosocial Support ServicesPTA Parent-Teacher AssociationQAI Quality Assurance IndicatorQI Quality ImprovementSA Situational AnalysisUSA United States of America

Acknowledgements

The Ministry of Women’s Affairs (MOWA) and the Federal HIV/AIDS Prevention and Control Office (FHAPCO) would like to express sincere appreciation to the United States Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR) for funding and providing technical assistance for the development of the OVC Care and Support Standard Service Delivery Guidelines. We would also like to recognize Save the Children USA and OVC-PEPFAR partners for the development and piloting of the Standard Service Delivery Guidelines. Our special thanks is also extended to the community based organizations (CBOs), community members and the many orphans and other vulnerable children (OVC) who provided their thoughtful feedback and support during the piloting phase of this work. These important partnerships have allowed the important work being done for vulnerable Ethiopian children to be documented and it is our hope that the QI initiative serves as an impetus to continue this most valuable work for the most vulnerable of our society.

We would also like to extend our gratitude to the partners who directly or indirectly contributed to the development of this document as well as to the participants of the validation workshop held in Adama in April 2009. Last but not least, we would like to thank the National OVC Task Force, the Technical Working Group of the Task Force, and the Inter-Agency Technical Task Team for reviewing and finalizing this document.

The production of this document is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents do not necessarily reflect the views of USAID or the United States Government.

Technical Assistance provided by Save the Children USA , Ethiopia Country Office


TABLE OF CONTENTS

List of Acronyms ___________________________________________________________________ -

Acknowledgements ________________________________________________________________ -

SECTION I: OVERVIEW ___________________________________________________________ - 1

Background ______________________________________________________________________ - 1

Introduction ______________________________________________________________________ - 2

Goal ______________________________________________________________________________ - 2

Need for Standard Service Delivery Guidelines ____________________________________ - 2

Definition of Standard Service Delivery Guidelines ________________________________ - 3

How Do We Define OVC? _________________________________________________________ - 3

Who Should Use the Standard Service Delivery Guidelines ________________________ - 3

Guiding Principles ________________________________________________________________ - 4

Strategies ________________________________________________________________________ - 5

Roles and Responsibilities of Stakeholder _________________________________________ - 6

2.1 Standard Service Delivery Guidelines and Dimensions ________________________ - 8

Dimensions of Quality per Service Area ___________________________________________ - 8

2.2 Service Components ________________________________________________________ - 102.2.1 Shelter and Care ________________________________________________________ - 102.2.2 Economic Strengthening ________________________________________________ - 122.2.3 Legal Protection _________________________________________________________ - 142.2.4 Health Care ___________________________________________________________ - 162.2.5 Psychosocial Support ____________________________________________________ - 182.2.6 Education _______________________________________________________________ - 222.2.7 Food and Nutrition ______________________________________________________ - 25

2.3 Coordination of Care ________________________________________________________ - 27

Section III: Critical Minimum and Additional Activities ______________________ - 30

Section IV: Application of the Standard Service Delivery Guidelines _____ - 34

Section V: Monitoring and Evaluation of the Quality Standards ________ - 37

Annexes __________________________________________________________________________ - 39

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SECTION I: OVERVIEW

BackgroundWith a total population of over 73.9 million, Ethiopia is the second most populous country in Africa, More than half (55.5%) of the population is constituted by children below the age of 18 (CSA, 2007). Though the national prevalence of HIV in Ethiopia, estimated to be 2.3%, is considerable lower than rates in other sub-Saharan African countries, the number of people living with HIV and orphans continue to grow. As of 2009, Ethiopia is estimated to have 5,459,139 orphans of whom 855,720 are orphans due to HIV and AIDS (Single Point HIV Prevalence Estimate, MOH 2007), one of the largest populations of OVC in Africa. Given the context of Ethiopia, all OVC, directly or indirectly are vulnerable to HIV and AIDS and other health, socio-economic, psychological and legal problems. This vulnerability may be linked to extreme poverty, hunger, armed conflict and child labor practices, among other threats. All of these issues fuel and are fuelled by HIV and AIDS.

In response to the aforementioned situation, the government of Ethiopia has taken various measures to positively address the complex issues. The Federal Constitution has clearly articulated the rights of children in Article 36. Ethiopia has ratified both the UN Child Rights Convention (CRC) and the African Charter on Rights and Welfare of Child (ACRWC). The country has harmonized domestic laws and policies with the provisions of both conventions and which creates an enabling environment for improving the wellbeing of OVC. MOWA is the government ministry mandated to coordinate the issue of children including OVC. FHAPCO is charged with leading and coordinating the overall multi-sectoral response to HIV and AIDS, including the issue of care and support for OVC.

The legal and policy framework created by the government has enhanced the involvement of NGOs, UN agencies, INGOs, FBOs and CBOs in the provision of various care and support services to OVC. In spite of all the positive steps forward, there has still been a lack of standards and uniformity in the services and support offered to OVC and their caregivers. Despite all these efforts made so far, due to lack of standards and uniformity in the services the majority of the OVC are still facing the problems.

Therefore, to provide standardized service delivery to OVC and to enable key stakeholders to uniformly provide services to beneficiaries at varying levels the Ethiopian government has developed the Standard Service Delivery Guidelines with the hopes of maximizing quality and utilization of resource while simultaneously minimizing duplication.

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IntroductionTo date, the services offered to OVC by government, non-governmental and community-based organizations have not been standardized or made uniform in terms of quality and size. To address this issue, the Ministry of Women’s Affairs (MoWA) and Federal HIV/AIDS Prevention and Control Office (FHAPCO) have developed the Standard Service Delivery Guidelines for Orphans and Vulnerable Children (OVC) Care and Support Programs (henceforth referred to as the Standard Service Delivery Guidelines). The Standard Service Delivery Guidelines have been pre-tested and piloted with specific emphasis on the basic principles of quality assurance and universal access.

The OVC Standard Service Delivery Guidelines document has three parts. The first part deals with the background, guiding principles, and implementation at different levels. The second part of Service Standard Service Delivery Guidelines addresses the service components and standards with their respective dimensions of quality as well as identifying the critical minimum and additional activities which should be implemented. Part three of the Standard Service Delivery Guidelines covers monitoring and evaluation. The document provides the latest approaches for implementing Standard Service Delivery Guidelines for OVC. The recommendations in the document are based on a pilot exercise conducted in selected sites in Ethiopia, which was designed to test the feasibility of the standards. It also provides further information on the dimensions of quality for each service area.

GoalThe overall goal of the Standard Service Delivery Guidelines is to standardize the implementation of OVC services in an effort to improve the general wellbeing of OVC. The objectives of the OVC Standard Service Delivery Guidelines include:

To provide key OVC stakeholders with Standard Service Delivery Guidelines and an 1. implementation guide;To harmonize OVC service delivery thereby increasing access to and quality of care and 2. support; andTo contribute to an OVC data management system for OVC issues.3.

Need for Standard Service Delivery GuidelinesWith an increased number of OVC and involved stakeholders working in the area of care and support, it is more important than ever to assess how well the needs of children are being met by those services. While each governmental, non-governmental or community-based organization has individually addressed monitoring and evaluation issues related to their work for and with OVC, there has not been a unified approach. This gap has made it difficult for programs to measure progress in achieving overall outcomes for children. The development of the Standard Service Delivery Guidelines and implementation manual sets a framework within which stakeholders involved in the area of OVC can operate to ensure that the desired outcomes are achieved.

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Definition of Standard Service Delivery GuidelinesOVC services may be broadly defined as interventions that address the need to improve health, wellbeing and development of OVC. OVC service providers have a responsibility to assess, refer and potentially follow-up on cases that cannot be managed at community levels. As such, the Standard Service Delivery Guidelines deal with the community - level approaches to OVC services and support. The Standard Service Delivery Guidelines define the dimensions of care and outline the specific actions and steps that must be taken by OVC service providers to assure a systematic approach and effective delivery of services to children.

How Do We Define OVC?In Ethiopia, it is commonly understood and legally defined that an orphan is defined as a child who is less than 18 years old and who has lost one or both parents, regardless of the cause of the loss. A vulnerable child is a child who is less than 18 years of age and whose survival, care, protection or development might have been jeopardized due to a particular condition, and who is found in a situation that precludes the fulfillment of his or her rights1. However, for these standards a more inclusive definition is used which includes all of the following:

A child who lost one or both parents;A child whose parent(s) is/are terminally ill and can no longer support the child;Children living on or in the streets;A child exposed to different forms of abuse, violence and/or exploitation;A child in conflict with the law; 2

A child who is sexually exploited;A child with disabilities;Unaccompanied children due to displacement 3

Who Should Use the Standard Service Delivery GuidelinesThis document will be used by service providers, donors and community volunteers for program planning, service delivery, monitoring and evaluation to improve overall service delivery for OVC within their family. The Standard Service Guidelines serve as a tool for improvement of services and is recommended to be used by:

Policy makers and Program ManagersStakeholders working on OVC programs at all levelsCommunity membersBeneficiaries

1 Alternative Childcare Guidelines on Community-based Childcare, Reunification and Reintegration Program, Foster Care, Adoption and Institutional Care Services (2009). Ministry of Women’s Affairs, Ethiopia

2 A child in conflict with the law is a person who at the time of the commission of the offence is below age 18, but not less than nine years and one day old.

3 Comprehensive Community-Based Care and Support Guideline for PLHA, OVC and Affected Families, 2006 (FHAPCO).

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Guiding Principles Several key stakeholders have the responsibility for implementation of program level standards. It is not only the program itself that should monitor these standards but government, institutions and communities have a role to play as well. When implementing the Standard Service Delivery Guidelines, the following are key principles which should always be observed:

Target Focused: Program implementers should ensure that interventions are OVC-focused and age appropriate, with services tailored to the holistic needs of OVC.

Minimize Risk and Vulnerability: Provision of services to OVC should seek to prevent further vulnerability. Implementation of the Standards should minimize risks of harm and not exacerbate the already vulnerable status of program beneficiaries. Programs should strive for consistent application of the standards within agreed upon dimensions. In order to minimize risks, various strategies may be adopted such as, seeking community input when implementing programs and ensuring the consistent and continued participation of OVC, their caregivers and all other interested stakeholders.

Participation: Programs should seek to enhance the participation of all beneficiaries and their caregivers. In the implementation and monitoring of the Standard Service Delivery Guidelines it is crucial to have active beneficiary feedback. This participation will enhance the quality of services and help to ensure that services are being provided according to the true needs and wants of the beneficiaries.

Evidence based: Interventions aimed to address the needs of OVC should be evidence-based. Programs should apply available evidence to tailor activities and services accordingly and place a particular focus on monitoring and data collection to generate the evidence for improving service delivery mechanisms.

Gender Equity: Ensuring gender equity in service provision for OVC is an important principle that these Standard Service Delivery Guidelines promote. Programs should ensure that interventions and services meet the special individual needs of both girls and boys, despite the difference in gender.

Confidentiality: To obtain the desired results, confidentiality should be observed by all aspects of the program. The Program and staff or volunteers with knowledge of information should make all efforts to ensure that information shared by children such as their personal history or HIV status are not disclosed unnecessarily without the child’s and/or family’s consent.

Respect: Service providers should treat beneficiaries with due respect

Result oriented: Focus on the anticipated outcomes of services and support for OVC should be a key priority of program implementers. Standard Service Delivery Guidelines enable programs to enhance their monitoring and evaluation systems. For example, programs should use these standards to ensure that their processes are leading to the intended outcome/impact.

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Coordination: The needs of OVC may not be met by a single organization or an individual’s support. In order to fulfill the vast needs of OVC all service providers should identify service gaps and fill the gaps by coordinating their effort.

StrategiesThe following strategies should be used by program implementers to apply the OVC Standard Service Delivery Guidelines:

Capacity-building: All key stakeholders involved in providing service and support to OVC should ensure that users of the Standards, at all levels including federal, regional and local are trained in the application of the Guideline. The stakeholders should also ensure implementers have technical, financial and managerial capacities necessary to successfully utilize the Standard Service Delivery Guidelines.

Use Existing Coordinating Mechanisms at All Level: There are a number of existing structures that support OVC programs and services at the national, regional and community level. Programs shouldbuild upon these existing structures to promote the use of the standards rather than establish new ones.

Social Mobilization: Empowering communities to mobilize and utilize existing resources will help generate ownership and sustained action to support OVC. Programs should ensure that communities have the necessary support to take responsibility for addressing the needs of OVC. Such an approach will work towards ensuring ownership of the services by the community and hopefully enhancing the sustainability of services and support.

For appropriate use and application of the Standard Service Delivery Guidelines, programs need to invest in sensitizing key stakeholders and beneficiaries as to the importance of the document and advocate for its integration into the overall design and planning of programs for OVC. Advocacy efforts should focus on quality of services and support for all OVC programming efforts.

Partnerships: Partnering and collaborating with other actors involved should enhance the ability to apply the three-one principle, (one coordinating body; one agreed framework and one M & E system thus allowing the Standards to be utilized at greater scale and impact.,

Linkages and Integration: Programs should facilitate linkages and referrals with other services to fill gaps that may be identified. Service gaps can be overcome through referral linkages and integration.

Resource Mobilization: Short-term and long-term plans of actions for resource mobilization should be a part of every organization or group providing services and support for OVC. Resource mobilization may be done both domestically and internationally.

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Sectoral Mainstreaming: Programs for OVC should advocate for mainstreaming of services in key sectors such as education, health and youth development to expand the scope for service delivery. Once mainstreaming is achieved, OVC stakeholders should ensure that Standard Service Delivery Guidelines are applied by actors in the aforementioned sectors to ensure quality of service delivery to vulnerable children.

Roles and Responsibilities of StakeholderThe application of the Standard Service Delivery Guidelines will require concerted efforts by all stakeholders at various including the federal, regional and local levels. Specific roles and responsibilities for each level will include the following:

Federal LevelProvide guidance and leadership; Create conducive environment for actors (including policies and strategies);Ensure necessary resource mobilization and allocation;Develop an overall program strategy for planning, resource mobilization and allocation, implementation, and monitoring and evaluation;Strengthen the legal framework and enforcement mechanisms for OVC support;Create partnership networks with and coordinate key partners and stakeholders;Protect the rights of beneficiaries through existing protection mechanisms;Ensure the provision of quality services to OVC through effective application of Standard Service Delivery Guidelines; andMonitor and evaluate overall service delivery.

Regional LevelProvide guidance and leadership; Adapt relevant policies and strategies in relation to the regional context;Ensure resource mobilization and allocation;Create enabling working atmosphere for all stakeholders; Utilize the Service Standard Guideline as a planning and monitoring tool;Mobilize resources to support OVC activities;Ensure that the Standard Service Delivery Guidelines are in place to promote quality services;Provide capacity building programs to implementing partners;Build partnerships with all actors and coordinate OVC programs at the regional level;Ensure OVC programs provide quality services and produce the expected outcomes;Actively monitor and evaluate program implementation and service delivery; andDocument and disseminate promising practices and lessons learned.

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Woreda LevelBuild partnerships, coordinate and follow-up implementation of OVC programs;Create enabling environment for implementing partners; Mobilize community and resources to support OVC activities;Ensure that Standard Service Delivery Guidelines are available to all implementing partners to assure quality service delivery;Provide capacity building programs to implementing partners;Build partnerships with all actors and coordinate OVC programs; Actively monitor and evaluate program implementation and service delivery; andDocument and disseminate promising practices and lessons learned.

Kebele LevelIdentify partners and support the application of Standard Service Delivery Guidelines; Lead the identification of OVC and organize a database which includes geographic coverage; Identify needy OVC in collaboration with key actors, mobilize community resources and

coordinate the responses of various players;Promote and protect the human and legal rights of OVC including reduction of stigma and discrimination;Facilitate access to health care (issue IDs and recommendation letter for free services) and birth registration services for OVC;Facilitate the integration of OVC services with Kebele level services; andParticipate in program planning, implementation, monitoring and evaluation and reporting on OVC activities.

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Section II: Standard Service Delivery Guidelines and Dimensions

2.1 Dimensions of Quality To provide quality services to OVC, all stakeholders and program implementers should adhere to and take into account the dimensions of quality described below.

Dimensions of QualityDimensions of Quality Definition of Quality Dimension

SafetyThe degree to which risks related to service provision are minimized, with specific focus on the do no harm principle.

AccessThe lack of geographic, economic, social, cultural, organizational or linguistic barriers to services.

Effectiveness The degree to which desired results or outcomes are achieved.

Technical performance

The degree to which tasks are carried out in accordance with program standards and current professional practice.

EfficiencyThe extent to which the cost of achieving the desired results is minimized so that the reach and impact of programs can be maximized.

ContinuityThe delivery and stability of care by the same person, as well as timely referral and effective communication between providers when multiple providers.

Compassionate Relations

The establishment of trust, respect, confidentiality and responsiveness achieved through ethical practice, effective communication and appropriate socio-emotional interactions.

AppropriatenessThe adaptation of services and overall care to needs or circumstances based on gender, age, disability, culture or socio-economic factors.

ParticipationThe participation of caregivers, communities, and children themselves in the design and delivery of services and in decision making regarding their own care.

SustainabilityThe service is designed in a way that it could be maintained at the community level, in terms of direction and management as well as procuring resources, in the foreseeable future.

2.2 Quality Dimensions and Core Service ComponentsThe lessons learned from previous experiences indicate that support targeting OVC were not often standardized, comprehensive or sustainable. The need to standardize and provide the services in a uniform manner was a crucial reason for the development of the Service Standard Service Delivery Guidelines. The Standard Service Delivery Guidelines document contains seven core service areas which are considered critical components of a set of services for programming targeting vulnerable children. The seven service areas include the following:

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Shelter and Care: These services strive to prevent children from going without shelter and work to ensure sufficient clothing and access to clean safe water or basic personal hygiene. An additional focus is ensuring that vulnerable children have at least one adult who provides them with love and support.

Economic Strengthening: These services seek to enable families to meet their own needs from an economic perspective regardless of changes in the family situation.

Legal Protection: These services aim to reduce stigma, discrimination and social neglect while ensuring access to basic rights and services protecting children from violence, abuse and exploitation.

Health care: These services include provision of primary care, immunization, treatment for ill children, ongoing treatment for HIV positive children and HIV prevention.

Psychosocial Support: These services aim to provide OVC with the human relationships necessary for normal development. It also seeks to promote and support the acquirement of life skills that allow adolescents in particular to participate in activities such as school, recreation and work and eventually live independently.

Education: These services seek to ensure that orphans and vulnerable children receive educational, vocational and occupational opportunities needed for them to be productive adults.

Food and Nutrition: These services aim to ensure that vulnerable children have access to similar nutritional resources as other children in their communities.

Each of the seven core service areas highlighted in the Standard Service Delivery Guidelines is discussed with specific focus on the quality dimensions and quality characteristics. In addition to the seven service areas, coordination of care is also discussed from the same perspective as it is a critical component of any comprehensive care package for OVC.

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Standard Service Delivery Guidelines for OVC Care and Support Programs 2

.2.1

Sh

elt

er

an

d C

are

DES

IRED

OU

TC

OM

E: A

ll O

VC

hav

e ad

equa

te sh

elte

r, cl

othi

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erso

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dult

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give

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acco

rdan

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ith c

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no

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DIM

ENSI

ON

S O

F Q

UA

LIT

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ATR

IX: S

HEL

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AN

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E

Dim

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Qua

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helte

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. h

as w

alls,

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trine

and

clo

se to

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and

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e sh

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nviro

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safe

dry

with

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tilat

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with

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thin

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c as

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the

shel

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inim

um st

anda

rds.

Ens

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have

app

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adu

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perv

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om ri

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f an

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right

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in a

safe

shel

ter w

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thei

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Ens

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shel

ter p

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faci

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s (i.e

. toi

let,

wat

er, e

tc.).

Sh

elte

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visio

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link

ing

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ren

with

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oste

rs, c

aret

aker

s. Li

nk c

hild

ren

to c

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coun

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ay c

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mpo

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se o

f hi

gh v

ulne

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on th

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ren

abus

ed).

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ctiv

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Shel

ters

are

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m a

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s to

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es.

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Perform

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Build

the

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etw

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and

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elte

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mun

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that

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e ca

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ith o

ther

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mun

ity-b

ased

shel

ter s

ervi

ces.

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Con

tinu

ity

Vul

nera

ble

child

ren

are

care

d fo

r by

mem

bers

of

thei

r com

mun

ity.

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unifi

catio

n or

rein

tegr

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n of

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C w

ith re

lativ

es is

prio

ritiz

ed.

C

omm

unity

mob

iliza

tion

of a

ltern

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es su

ch a

s ado

ptio

n, fo

ster

fam

ilies

, etc

..

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aren

ess b

uild

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and

com

mun

ity a

war

enes

s aro

und

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inat

ing

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ma

and

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rimin

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n oc

curs

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ice

prov

ision

is m

onito

red.

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gaps

exi

st b

etw

een

need

s ass

essm

ent a

nd a

ctua

l pro

visio

n of

serv

ice.

C

hild

ren

don’

t los

e th

eir r

ight

to in

herit

ance

, esp

ecia

lly th

e ho

me.

Com

passiona

te

Relat

ions

Serv

ice

does

not

incr

ease

stig

ma

and

disc

rimin

atio

n.

Sele

ctio

n cr

iteria

of

OV

C a

nd h

ouse

hold

s are

wel

l defi

ned.

Shel

ter i

s pro

vide

d ba

sed

on n

eed

and

in a

ccor

danc

e w

ith c

omm

unity

nor

ms.

C

omm

uniti

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re in

volv

ed in

setti

ng se

lect

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nd d

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ng n

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Est

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t of

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and

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latio

n w

ith c

aret

aker

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n of

an

envi

ronm

ent w

here

chi

ldre

n liv

e an

d ex

pres

s the

ir fe

elin

gs a

nd id

eas f

reel

y.

Ens

ure

posit

ive

care

take

r-chi

ld re

latio

nshi

ps a

re e

stab

lishe

d an

d su

ppor

ted.

App

ropr

iatene

ss

Ade

quat

e sp

ace

for t

he c

hild

(in

the

case

of

inst

itutio

nal c

are,

the

dorm

itory

shou

ld b

e di

vide

d by

age

; gen

der;

equa

l

cond

ition

s for

all

child

ren,

in a

ccor

danc

e w

ith th

e N

atio

nal G

uide

lines

for A

ltern

ativ

e C

are)

.G

ende

r sen

sitiz

atio

n an

d pr

iorit

y pl

aced

on

the

prot

ectio

n of

fem

ale

child

ren.

Resp

onsiv

e to

the

exist

ing

com

mun

ity n

orm

s and

stan

dard

s.

Shel

ter s

ervi

ces a

re p

rovi

ded

base

d on

nee

d as

sess

men

ts a

nd c

onse

nt o

f O

VC

and

/or c

aret

aker

.

Par

ticipa

tion

C

omm

unity

invo

lved

in se

rvic

e pr

ovisi

on.

A

ctiv

ities

impl

emen

ted

with

con

sent

and

par

ticip

atio

n of

OV

C a

nd th

eir g

uard

ians

and

com

mun

ity m

embe

rs.

C

hild

ren,

com

mun

ities

and

key

loca

l sta

keho

lder

s are

invo

lved

in th

e de

cisio

n-m

akin

g pr

oces

s and

serv

ice

prov

ision

.

Sustai

nability

Biol

ogic

al a

nd e

xten

ded

fam

ily re

latio

nshi

ps a

re st

reng

then

ed.

A

dvoc

acy

and

com

mun

ity m

obili

zatio

n is

prio

ritiz

ed a

nd su

ppor

ted.

C

omm

uniti

es a

nd o

ther

sta

keho

lder

s ar

e in

volv

ed in

the

prov

ision

and

sup

port

of

safe

and

env

ironm

enta

lly-s

ound

shel

ter t

o O

VC.

Fam

ily re

unifi

catio

n is

prio

ritiz

ed a

nd su

ppor

ted.

| 12


.2.2

Eco

no

mic

Str

en

gth

en

ing

DES

IRED

OU

TC

OM

E: H

ouse

hold

s car

ing

for v

ulne

rabl

e ch

ildre

n ha

ve su

ffici

ent i

ncom

e to

car

e fo

r chi

ldre

n

DIM

ENSI

ON

S O

F Q

UA

LIT

Y M

ATR

IX: E

CO

NO

MIC

ST

REN

GT

HEN

ING

Dim

ensi

ons

of

Qua

lity

Qua

lity

Cha

ract

eris

tic o

f E

cono

mic

Str

engt

heni

ng

Safety

Dev

elop

fina

ncia

l ser

vice

del

iver

y m

echa

nism

to

redu

ce fi

nanc

ial v

ulne

rabi

litie

s (s

avin

g le

d fin

anci

al s

ervi

ces)

of

ca

regi

vers

and

OV

C.C

hild

labo

r exp

loita

tion

is pr

otec

ted

in a

ccor

danc

e w

ith th

e C

RC.

E

mpl

oyer

s are

aw

are

of re

quire

men

ts fo

r a sa

fe w

orki

ng e

nviro

nmen

t.

Inco

me

Gen

erat

ing

Act

iviti

es (I

GA

) whi

ch a

re d

eem

ed il

lega

l or d

ange

rous

are

avo

ided

.

Access

Con

veni

ence

to ta

rget

gro

up is

con

sider

ed w

hen

deliv

erin

g se

rvic

es.

A

ll tra

inin

g m

ater

ials

are

in a

ccor

danc

e to

and

resp

ectfu

l of

the

loca

l con

text

.

Geo

grap

hica

l pro

xim

ity to

OV

C sh

ould

be

cons

ider

ed w

hen

arra

ngin

g se

rvic

e de

liver

y.

Sele

ctio

n cr

iteria

are

tran

spar

ent a

nd p

riorit

ize

the

mos

t vul

nera

ble.

Fa

mili

es sh

ould

hav

e ac

cess

to fi

nanc

ial r

esou

rces

.

Effe

ctiv

eness

Inco

me

gene

rate

d is

used

to c

are

for c

hild

ren.

Lo

w c

apita

l or r

esou

rce

requ

irem

ent o

f th

e sc

hem

e m

akin

g it

acce

ssib

le to

thos

e in

mos

t nee

d.

Hou

seho

ld a

sset

s (ec

onom

ic a

nd so

cial

) are

bui

lt to

with

stan

d sh

ocks

as r

esul

t of

HIV

and

AID

S.

A

fina

ncia

l ser

vice

del

iver

y m

echa

nism

is d

evel

oped

to re

duce

deb

t (sa

ving

s led

fina

ncia

l ser

vice

s).

H

ouse

hold

inco

me

sour

ce is

sust

aine

d an

d di

vers

ified

.

Techn

ical

Perform

ance

Tech

nica

l sup

port

con

sider

ed c

ritic

al in

all

circ

umst

ance

s.

All

activ

ities

and

serv

ices

are

man

aged

by

the

com

mun

ity.

IG

As a

re e

nviro

nmen

tally

sust

aina

ble.

Fa

mili

es a

nd c

areg

iver

s kno

w/a

re tr

aine

d in

how

to m

anag

e fin

anci

al re

sour

ces.

Se

rvic

es h

ave e

stab

lishe

d m

echa

nism

s to

min

imiz

e risk

(e.g.

pro

vidi

ng ch

ild fr

iend

ly IG

As,

follo

w-u

p to

avoi

d po

ssib

le

ris

ks, s

treng

then

ing

appr

opria

te d

ata

man

agem

ent,

confi

dent

ialit

y, et

c.).

IGA

s are

bas

ed o

n m

arke

t ass

essm

ents

(sup

ply/

dem

and

driv

en).

Pr

ogre

ss o

f be

nefic

iarie

s is m

onito

red

and

docu

men

ted.

| 13


Effi

cien

cy

Serv

ice

deliv

ery

stra

tegy

has

a lo

w o

pera

tion

cost

.

Leve

rage

pub

lic a

nd p

rivat

e se

ctor

reso

urce

s.

Serv

ice

deliv

ery

stra

tegi

es a

re c

onsis

tent

with

com

mun

ity n

orm

s and

val

ues.

IG

A o

ppor

tuni

ties a

re d

iver

se.

Con

tinu

ity

Refe

rral

serv

ice

is ap

prop

riate

ly li

nked

with

oth

er se

rvic

e pr

ovid

ers.

Se

rvic

e de

liver

y st

rate

gy is

man

aged

by

the

com

mun

ity.

Se

rvic

es a

re c

onsis

tent

with

loca

l law

s and

regu

latio

ns.

Se

rvic

es a

re b

uilt

on in

dige

nous

com

mun

ity k

now

ledg

e an

d tra

ditio

n.

Serv

ices

are

bas

ed o

n lo

cal r

esou

rces

and

out

lets.

Tr

aine

d pa

rtic

ipan

ts a

re li

nked

to p

oten

tial e

mpl

oyer

s.

Com

mun

ities

are

faci

litat

ed a

nd e

ncou

rage

d to

inte

ract

or b

uild

rela

tions

hips

with

the

priv

ate

sect

or.

Respe

ctfu

lRelat

ions

Serv

ice

deliv

ery

is pa

rtic

ipat

ory.

Se

rvic

e de

liver

y is

need

bas

ed n

ot su

pply

driv

en.

Se

rvic

es a

nd p

rodu

cts m

ade

shou

ld n

ot b

e la

bele

d to

avo

id st

igm

a.

App

ropr

iatene

ss

HIV

pos

itive

OV

C a

nd c

areg

iver

s are

not

eng

aged

in a

ctiv

ities

that

are

ove

rly st

renu

ous o

r put

thei

r hea

lth a

t risk

.

Serv

ice

deliv

ery

is de

man

d dr

iven

.

Serv

ices

are

bas

ed o

n lo

cal t

radi

tion

norm

s and

val

ues.

Se

rvic

es a

re fo

cuse

d on

prim

ary

need

s of

mos

t vul

nera

ble.

Par

ticipa

tion

Car

egiv

ers a

nd O

VC

par

ticip

ate

in se

lect

ion,

pla

nnin

g an

d m

anag

emen

t of

the

activ

ities

.

Flex

ibili

ty o

f se

rvic

e de

liver

y.

Com

mun

ity c

onve

nien

ce is

con

sider

ed in

con

duct

ing

activ

ities

.

Sele

ctio

n of

ben

efici

arie

s is t

rans

pare

nt.

C

omm

unity

is in

volv

ed in

dec

ision

mak

ing

lead

ing

to e

mpo

wer

men

t.

Sustai

nability

Loca

l law

s and

regu

latio

ns m

aint

aine

d an

d re

cogn

ition

giv

en to

inno

vativ

e se

rvic

e de

liver

y m

echa

nism

s.

The

serv

ices

pro

vide

d ar

e bu

ilt o

n st

reng

then

ing

tradi

tiona

l cop

ing

mec

hani

sms.

Re

ferr

al sy

stem

is p

rope

rly li

nked

and

mai

ntai

ned

with

safe

ty-n

et p

rogr

ams s

uch

as u

rban

gar

deni

ng, W

FP an

d ot

hers

in th

e ta

rget

ed a

reas

.Re

sour

ces a

re le

vera

ged

from

com

mun

ities

, priv

ate

and

publ

ic se

ctor

.

Bene

ficia

ries a

re tr

aine

d in

bus

ines

s man

agem

ent,

savi

ngs,

and

inve

stm

ent.

| 14


.2.3

Leg

al

Pro

tect

ion

DE

SIR

ED

OU

TC

OM

E: O

VC re

ceiv

e le

gal i

nfor

mat

ion

and

acce

ss to

lega

l ser

vice

s as n

eede

d in

clud

ing

birt

h re

gist

ratio

n an

d pr

oper

ty in

herit

ance

pla

ns.

OVC

are

pro

tect

ed fr

om a

ll fo

rms

of a

buse

s, v

iole

nce

and

negl

ect.

DIM

EN

SIO

NS

OF

QU

ALI

TY

MA

TR

IX:

LEG

AL

PRO

TE

CT

ION

Dim

ensi

ons

of

Qua

lity

Qua

lity

Cha

ract

eris

tics

for L

egal

Pro

tect

ion

Safety

Repo

rtin

g m

echa

nism

pro

tect

s the

iden

tity

of th

e pe

rson

repo

rtin

g (to

redu

ce th

e ch

ance

s of

retri

butio

n).

T

he re

cord

s, in

form

atio

n an

d fil

es in

the p

olic

e sta

tion,

pub

lic p

rose

cuto

r offi

ce an

d th

e Cou

rt ar

e con

fiden

tial a

nd

th

e pr

ivac

y of

the

child

is p

rote

cted

by

the

med

ia.

Safe

inte

rrog

atio

n of

chi

ldre

n is

enfo

rced

.

Access

Lega

l ser

vice

s are

free

for O

VC.

Stro

ng re

ferr

al n

etw

orks

are

est

ablis

hed

betw

een

stak

ehol

ders

.

Serv

ices

are

chi

ld-f

riend

ly a

nd in

form

atio

n is

easil

y un

ders

tand

able

and

acc

essib

le.

Se

rvic

es a

re p

rovi

ded

proa

ctiv

ely

to c

hild

ren

inst

ead

of th

e ch

ild h

avin

g to

sear

ch fo

r ser

vice

s.

Cur

rent

serv

ice

map

ping

is a

vaila

ble

and

iden

tifies

lega

l ser

vice

pro

vide

rs.

In

form

atio

n ab

out s

ervi

ces i

s ava

ilabl

e in

a v

arie

ty o

f m

edia

incl

udin

g e

lect

roni

c, pr

int a

nd p

ublic

foru

ms s

uch

as

sc

hool

s, Ke

bele

offic

es, m

edia

etc

.

Effe

ctiv

eness

Info

rmat

ion

and

advi

ce is

rele

vant

and

acc

urat

e.

OV

C h

ave

timel

y ac

cess

to le

gal a

ssist

ance

(i.e.

bef

ore

the

issue

bec

omes

too

serio

us).

O

VC

lega

l iss

ues a

re fo

llow

ed-u

p to

det

erm

ine

if m

ore

advi

ce/a

ssist

ance

is n

eede

d.

O

VC

- frie

ndly

cou

rts a

re e

stab

lishe

d.

Le

gal i

ssue

s are

reso

lved

acc

ordi

ng to

the

law a

nd w

here

the

law d

oes n

ot p

rote

ct O

VC,

cha

nge

is ad

voca

ted.

OV

C a

nd c

areg

iver

s lea

rn o

r are

trai

ned

to id

entif

y w

hen

they

hav

e a

lega

l pro

blem

and

how

to a

cces

s ass

istan

ce.

Techn

ical

Perform

ance

Serv

ice

prov

ider

s are

sens

itive

to O

VC

lega

l rig

hts a

nd n

eeds

.

Lega

l ser

vice

is a

ppro

pria

te fo

r the

chi

ld o

r car

egiv

ers.

Su

ppor

t on

lega

l iss

ues o

f O

VC

con

tinue

s unt

il su

cces

sful

reso

lutio

n.

Form

al re

ferr

al sy

stem

s are

est

ablis

hed

amon

g th

e re

leva

nt le

gal i

nstit

utio

ns.

Tr

aini

ng is

pro

vide

d fo

r leg

al b

odie

s an

d se

rvic

e pr

ovid

ers

on d

iffer

ent d

imen

sion

(em

otio

nal,

soci

al im

pact

and

child

dev

elop

men

t nee

ds a

nd st

ages

).

| 15


Effi

cien

cy

Info

rmat

ion

is ac

cess

ible

and

ava

ilabl

e to

OV

C.

O

VC

and

car

egiv

ers k

now

whe

n to

acc

ess i

nfor

mat

ion

or a

sk fo

r leg

al h

elp.

OV

C’s

lega

l pro

blem

s are

reso

lved

qui

ckly

with

app

ropr

iate

follo

w-u

p.

A c

ompr

ehen

sive

appr

oach

is ta

ken

so th

at le

gal n

eeds

are

not

add

ress

ed in

isol

atio

n of

oth

er is

sues

, and

whe

n

othe

r nee

ds a

re d

iscov

ered

, chi

ldre

n ar

e ap

prop

riate

ly re

ferr

ed to

the

serv

ices

that

they

nee

d.

Refe

rral

, rep

ortin

g sy

stem

s and

net

wor

ks a

re e

stab

lishe

d fo

r eas

y ac

quisi

tion

of e

vide

nce

for s

peed

y tri

al.

C

ontin

uity

and

stab

ility

in th

e pr

ovisi

on o

f le

gal a

ssist

ance

and

follo

w-u

p so

that

chi

ld is

not

pas

sed

from

per

son

to

per

son

and

follo

w-u

p is

docu

men

ted

and

timel

y so

that

lega

l pro

blem

s are

reso

lved

qui

ckly.

Con

tinu

ity

Edu

catio

n ab

out l

aw, s

tand

ards

, and

repo

rtin

g m

echa

nism

s are

pro

vide

d to

OV

C a

nd c

areg

iver

s.

Com

passiona

te

Relat

ions

OV

C a

re d

ealt

with

sens

itive

ly a

nd a

re a

ctiv

ely

liste

ned

to b

y co

ncer

ned

stak

ehol

ders

.

OV

C a

re re

pres

ente

d in

cou

rt o

r in

nego

tiatio

ns.

C

hild

-frie

ndly

cou

rts a

re e

stab

lishe

d an

d/ o

r adv

ocat

ed fo

r (es

peci

ally

for t

akin

g ev

iden

ce in

abu

se c

ases

).

App

ropr

iatene

ssIn

form

atio

n an

d se

rvic

es a

re c

hild

-frie

ndly,

app

ropr

iate

and

acc

essib

le b

y ag

e, cu

lture

, ed

ucat

iona

l le

vel

and

es

peci

ally

for c

hild

ren

with

disa

bilit

y.

Par

ticipa

tion

Chi

ldre

n an

d th

eir c

areg

iver

s are

list

ened

to a

nd in

volv

ed in

solv

ing

thei

r leg

al p

robl

ems.

Thr

ough

edu

catio

n ab

out t

he la

w a

nd le

gal s

yste

m, c

hild

ren

and

thei

r car

egiv

ers a

re e

mpo

wer

ed to

iden

tify

whe

n

they

hav

e a

lega

l iss

ue a

nd h

ow it

shou

ld b

e re

solv

ed a

nd w

ho to

look

to fo

r ass

istan

ce.

Step

s are

take

n to

incr

ease

com

mun

ity p

artic

ipat

ion

in p

rote

ctin

g ch

ildre

n fr

om a

buse

, rep

ortin

g ab

uses

, res

olvi

ng

iss

ues o

ut o

f co

urt w

here

app

ropr

iate

and

hel

ping

chi

ldre

n to

acc

ess l

egal

hel

p;

Gov

ernm

ent

is em

pow

ered

to

mor

e ac

tivel

y pa

rtic

ipat

e in

pro

tect

ing

child

ren

thro

ugh

Chi

ld P

rote

ctio

n U

nits

(CPU

) and

Chi

ld R

ight

s Com

mitt

ees.

Ens

ure

polit

ical

par

ticip

atio

n of

chi

ldre

n th

roug

h pr

ogra

ms s

uch

as th

e ch

ild p

arlia

men

t.

Sustai

nability

Com

mun

ity o

wne

rshi

p an

d aw

aren

ess a

bout

chi

ldre

n’s ri

ghts

pro

mot

ed.

St

reng

then

Chi

ld R

ight

s Clu

bs a

nd C

omm

ittee

s and

CPU

s.

Est

ablis

h an

d st

reng

then

refe

rral

net

wor

ks.

| 16


2.2

.4 H

ealt

h C

are

DES

IRED

OU

TC

OM

E: C

hild

has

acc

ess t

o he

alth

serv

ices

, inc

ludi

ng H

IV a

nd A

IDS

prev

entio

n, c

are

and

treat

men

t

DIM

ENSI

ON

S O

F Q

UA

LIT

Y M

ATR

IX:

HEA

LTH

CA

RE

Dim

ensio

ns o

f Q

ualit

yQ

ualit

y C

hara

cter

istic

s for

Hea

lth C

are

Safety

Serv

ices

are

pro

vide

d in

a c

onfid

entia

l m

anne

r (in

acc

orda

nce

with

the

do

no h

arm

prin

cipl

e) b

y sk

illed

prof

essio

nals.

Refe

rral

s are

mad

e to

skill

ed p

rofe

ssio

nals

and

on th

e ba

sis o

f ne

ed.

H

ealth

serv

ices

are

pro

vide

d sa

fely

(acc

ordi

ng to

reco

gniz

ed st

anda

rds)

and

in a

ppro

pria

te se

tting

s with

app

ropr

iate

equi

pmen

t and

supp

lies.

Access/Rea

ch

Exi

sten

ce o

f a

refe

rral

net

wor

k of

loca

l ser

vice

s.

Com

mun

ity-b

ased

serv

ices

are

stre

ngth

ened

.

Serv

ices

are

pro

vide

d lo

cally

(eith

er in

the

com

mun

ity b

y co

mm

unity

bas

ed w

orke

rs o

r at

loca

l hea

lth f

acili

ties

or

se

rvic

e pr

ovid

ers)

.Ba

rrie

rs to

hea

lth c

are

serv

ices

are

ass

esse

d an

d ad

dres

sed

(i.e.

trans

port

atio

n, fe

e w

aiver

s).

O

n-go

ing

acce

ss to

trea

tmen

t (in

clud

ing

ART

) is e

nsur

ed.

Se

rvic

es a

re c

hild

-frie

ndly.

Effe

ctiv

eness

Prev

entio

n m

easu

res a

nd p

reve

ntiv

e he

alth

car

e is

prom

oted

.

Prev

enta

tive

heal

th -s

eeki

ng b

ehav

iors

incr

ease

d.

Chi

ld re

ceiv

es a

ppro

pria

te c

are

for t

he id

entifi

ed n

eeds

.

Act

iviti

es to

pro

mot

e he

alth

seek

ing

(wel

l bei

ng) b

ehav

iors

are

impl

emen

ted.

Refe

rral

s are

act

ed u

pon

and

follo

wed

-up.

Techn

ical

Perform

ance

Serv

ice

prov

ider

s are

sens

itize

d to

chi

ldre

n’s n

eeds

and

hol

istic

app

roac

h is

prom

oted

.

Chi

ldre

n re

ceiv

e ag

e ap

prop

riate

serv

ices

.

Chi

ldre

n re

cove

r fro

m il

lnes

s.

Eff

ectiv

e re

ferr

al sy

stem

s in

plac

e in

clud

ing

coun

ter-r

efer

rals.

Hom

e-ba

sed

care

pro

vide

rs a

re tr

aine

d to

reco

gniz

e ne

eds o

f ch

ildre

n.

| 17


Effi

cien

cy

Com

preh

ensiv

e se

rvic

es a

re p

rovi

ded

in o

ne lo

catio

n.

Car

egiv

ers

iden

tify

prob

lem

s in

a ti

mel

y m

anne

r an

d th

roug

h re

gula

r in

tera

ctio

n at

hou

seho

ld le

vel.

Basic

rou

tine

he

alth

scre

enin

g is

prov

ided

to id

entif

y pr

oble

ms (

i.e. c

omm

unity

cas

e fin

ding

for O

VC

).C

ontin

uous

acc

ess t

o ne

cess

ary

drug

s, ca

re (i

.e. h

ome

base

d ca

re) a

nd c

are

prov

ider

.

Con

tinu

ity

Reci

pien

ts a

re e

ncou

rage

d to

com

plet

e th

e fu

ll co

urse

of

med

icat

ion.

HIV

pre

vent

ion

mes

sage

s are

con

tinuo

us.

E

nsur

e on

goin

g ac

cess

to tr

eatm

ent (

incl

udin

g A

RT) a

nd a

dher

ence

for H

IV p

ositi

ve O

VC

and

car

egiv

ers.

Re

ferr

als a

re fo

llow

ed-u

p in

a ti

mel

y m

anne

r.

Com

passiona

te

Relat

ions

Serv

ice

prov

ision

is d

one

in a

chi

ld-f

riend

ly m

anne

r.

Ens

ure

abili

ty o

f ca

regi

vers

and

pro

vide

rs to

list

en a

nd re

cogn

ize

need

s.

Hea

lth c

are

is pr

ovid

ed w

ith d

igni

ty a

nd re

spec

t.

App

ropr

iatene

ss(R

elev

ance)

Hea

lth c

are

and

med

icat

ion

are

age-

appr

opria

te (i

nclu

ding

ARS

H f

or a

dole

scen

ts a

nd im

mun

izat

ions

for

chi

ldre

n

unde

r five

).Se

rvic

es a

re re

leva

nt a

nd b

ased

upo

n ne

ed (o

n th

e ba

sis o

f di

agno

sis).

Par

ticipa

tion

H

ealth

car

e w

orke

rs li

sten

to a

nd o

bser

ve th

e ch

ild in

the

prov

ision

of

care

.

Car

egiv

ers,

CBO

s, an

d ch

ildre

n ar

e ac

tivel

y in

volv

ed in

the

ir tre

atm

ent,

heal

th e

duca

tion

and

othe

r he

alth

car

es

ac

tiviti

es.

Sustai

nability

Com

mun

ity o

wne

rshi

p an

d he

alth

edu

catio

n is

prom

oted

. Car

egiv

ers

are

enco

urag

ed a

nd s

uppo

rted

to s

eek

heal

th

se

rvic

es.

Civ

il so

ciet

y an

d pr

ivat

e he

alth

faci

litie

s are

invo

lved

in a

n ef

fort

to im

prov

e th

e qu

ality

of

heal

th c

are.

T

he c

omm

unity

has

kno

wle

dge

of h

ealth

issu

es a

nd th

e ab

ility

to re

lay th

is in

form

atio

n.

Prev

entio

n ac

tiviti

es a

nd re

ferr

al li

nkag

es a

re in

pla

ce, s

treng

then

ed a

nd w

ell f

unct

ioni

ng.

In

crea

sed

gove

rnm

ent r

esou

rces

for s

yste

m st

reng

then

ing

and

cove

rage

to im

prov

e ac

cess

and

qua

lity

of se

rvic

es.

| 18


2.2

.5 P

sych

oso

cial

Su

pp

ort

DES

IRED

OU

TC

OM

E: O

VC

cop

e w

ith lo

ses a

nd o

ther

trau

ma

and

has i

mpr

oved

self-

este

em a

nd se

lf-ef

ficie

ncy.

DIM

EN

SIO

NS

OF

QU

ALI

TY

MA

TR

IX: P

SYC

HO

SOC

IAL

SUPP

OR

T

Dim

ensi

ons

of

Qua

lity

Qua

lity

Cha

ract

eris

tics

for P

sych

osoc

ial S

uppo

rt

Safety

Prog

ram

s are

con

duct

ed in

phy

sical

ly sa

fe e

nviro

nmen

ts.

OV

C a

re p

rote

cted

from

har

sh p

unish

men

ts, st

igm

a an

d la

belin

g.

OV

C ar

e pro

tect

ed fr

om al

l typ

es o

f abu

ses (

child

labo

r exp

loita

tion,

emot

iona

l abu

se su

ch as

insu

lting

, war

ning

,

belit

tling

, bul

lyin

g, te

asin

g et

c.), e

spec

ially

whe

n th

ey re

port

cas

es o

f ab

use.

OV

C h

ave

the

abili

ty (k

now

ledg

e, sk

ill, e

mot

iona

l stre

ngth

) to

say

NO

to d

ange

rous

situ

atio

ns.

A

stab

le a

nd p

redi

ctab

le e

nviro

nmen

t exi

sts f

or th

e O

VC

to fi

nd su

ppor

t with

in.

C

hild

ren

cogn

izan

t tha

t the

ir rig

ht to

inhe

ritan

ce a

nd o

ther

righ

ts w

ill b

e pr

otec

ted.

C

areg

iver

s and

thos

e w

orki

ng w

ith c

hild

ren

are

not k

now

n or

susp

ecte

d ch

ild a

buse

rs.

C

onfid

entia

lity

of in

form

atio

n re

late

d to

cou

nsel

ing,

test

ing

and

treat

men

t is p

rote

cted

.

Chi

ldre

n eq

ually

par

ticip

ate

in d

iffer

ent a

ctiv

ities

.

Ens

ure

that

BC

C a

nd IE

C m

ater

ials

are

tailo

r mad

e.

Faci

litie

s and

env

ironm

ents

are

chi

ld fr

iend

ly. G

roup

dyn

amic

s are

mai

ntai

ned

by a

ge, r

elig

ion,

etc

.

Access

Chi

ldre

n ha

ve a

cces

s to

play

mat

eria

ls an

d en

viro

nmen

t.

Trai

ning

and

oth

er se

rvic

e ar

eas a

re c

onve

nien

t.

Mat

eria

ls an

d se

rvic

es a

re in

acc

orda

nce

with

ben

efici

arie

s’ cu

ltura

l and

ling

uist

ic se

tting

s.

Eve

ry c

hild

has

acc

ess t

o co

unse

ling

– w

ith p

ara-

prof

essio

nal o

r lay

pers

ons,

and

with

pro

fess

iona

ls if

nee

ded

or

requ

este

d.A

ll se

rvic

es in

com

mun

ity a

re a

cces

sible

rega

rdle

ss o

f ge

nder

, disa

bilit

y, et

c.

Eve

ry c

hild

/car

egiv

er h

as in

form

atio

n ab

out w

here

and

how

to a

cces

s res

ourc

es/s

ervi

ces.

E

nviro

nmen

t and

par

ticip

atio

n ar

e fr

ee fr

om st

igm

a an

d di

scrim

inat

ion.

A

ll co

mm

unity

serv

ices

are

chi

ld- f

riend

ly.

H

IV-r

elat

ed c

ouns

elin

g, te

stin

g, a

nd tr

eatm

ent i

s con

fiden

tial a

nd o

f hi

gh q

ualit

y.

Chi

ldre

n ha

ve a

cces

s to

guid

ance

and

ther

apy

as n

eede

d.

| 19


Effe

ctiv

eness

Chi

ldre

n ar

e ha

ppy

part

icip

atin

g in

act

iviti

es a

nd n

ot is

olat

ed.

C

hild

ren

are

inte

ract

ive,

confi

dent

and

em

pow

ered

to b

e de

cisio

n- m

aker

s.

Chi

ldre

n ar

e pr

otec

ted

from

HIV

and

AID

S an

d ot

her r

epro

duct

ive

heal

th a

ssoc

iate

d pr

oble

ms.

Pr

ogra

ms a

nd se

rvic

es a

ctiv

ely

prom

ote

self-

confi

denc

e, nu

rtur

e ho

pe, a

nd fa

cilit

ate

happ

ines

s in

child

ren.

O

VC

has

opp

ortu

nitie

s to

ful

fill

his/

her

pote

ntia

ls –

e.g.

tale

nts,

skill

s, an

d in

tere

sts

(to p

ursu

e hi

s /h

er

dr

eam

s).

OV

C h

ave

oppo

rtun

ity fo

r fun

and

laug

hter

.

The

env

ironm

ent i

s ope

n, su

ppor

tive,

nurt

urin

g, a

ccep

ting

of c

hild

ren

and

prom

otes

opp

ortu

nitie

s for

a c

hild

to m

eet n

eeds

and

fulfi

ll dr

eam

s. C

hild

ren

lear

n le

ader

ship

and

life

-ski

lls.

C

areg

iver

s ha

ve k

now

ledg

e ab

out

pare

ntin

g, p

ositi

ve d

iscip

line

tech

niqu

es,

com

mun

icat

ion

and

child

ren’s

need

s.A

dults

in

com

mun

ity a

re c

ompe

tent

to

deal

with

tra

uma,

grie

f, be

reav

emen

t, in

herit

ance

and

cap

able

of

pr

ovid

ing

emot

iona

l and

spiri

tual

supp

orts.

Techn

ical

Perform

ance

Eve

ry c

hild

has

one

com

pete

nt a

dult

with

who

m th

ere

is re

gula

r and

gen

uine

con

tact

, to

who

m h

e/sh

e ca

n go

for g

uida

nce,

enco

urag

emen

t, an

d pr

oble

m-s

olvi

ng su

ppor

t.

Pare

nts

disc

lose

the

ir he

alth

sta

tus

and

mak

e th

e ne

cess

ary

succ

essio

n pl

anni

ng f

or c

hild

ren

toge

ther

with

them

.E

mot

iona

l wel

lbei

ng o

f ch

ild is

mon

itore

d.

Peer

-gro

ups

and

yout

h cl

ubs

are

form

ed a

nd c

hild

ren

are

enco

urag

ed a

nd s

uppo

rted

to c

onsis

tent

ly a

ttend

regu

lar a

ctiv

ities

.Se

rvic

e pr

ovid

ers a

re ro

le m

odel

s: et

hica

l, pa

ssio

nate

, car

ing,

ope

n-m

inde

d, a

nd tr

ustw

orth

y.

Con

fiden

tialit

y is

resp

ecte

d by

com

mun

ity m

embe

rs.

Pa

rtic

ipat

ing

com

mun

ity m

embe

rs h

ave

asse

ssm

ent a

nd re

ferr

al sk

ills (

and

cond

uct f

ollo

w-u

p).

Li

fe-s

kills

trai

ners

hav

e ca

paci

ty a

nd a

bilit

y to

ens

ure

activ

ities

.

IEC

and

BC

C m

ater

ials

shou

ld c

onta

in a

ppro

pria

te in

form

atio

n.

| 20


Effi

cien

cy

Volu

ntee

rs p

rovi

de se

rvic

es su

ffici

ently

.

Refe

rral

link

ages

are

util

ized

for p

rofe

ssio

nal c

ouns

elin

g, p

lay m

ater

ials

and

train

ings

.

Chi

ldre

n ar

e fu

lly in

tegr

ated

into

fam

ily a

nd c

omm

unity

life

– th

ere

is no

rmal

cy in

thei

r liv

es a

nd th

ey d

o no

t

feel

isol

ated

.A

ll O

VC

pro

gram

s and

serv

ices

incl

ude

psyc

ho-s

ocia

l sup

port

(PSS

).

Con

tinu

ity

Clu

bs fo

r chi

ldre

n an

d ca

regi

vers

are

est

ablis

hed.

Se

rvic

e pr

ovid

ers a

re m

otiv

ated

.

Refe

rral

sys

tem

s fo

r pr

ofes

siona

l co

unse

ling,

spi

ritua

l su

ppor

t, lif

e sk

ills

train

ing

and

othe

r ac

tiviti

es a

re

pr

omot

ed a

nd su

ppor

ted.

PSS

com

pete

nce

is ac

hiev

ed b

y ac

tors

at c

omm

unity

leve

l, so

that

it is

ong

oing

and

sus

tain

able.

Thi

s m

eans

that

the

re s

houl

d be

bas

ic t

rain

ing/

know

ledg

e in

act

ive

liste

ning

and

res

pond

ing

skill

s, ch

ild d

evel

opm

ent,

refe

rral

(coo

rdin

atio

n of

car

e).

Com

mun

ity sh

ould

pro

vide

supp

ort f

or th

e ca

regi

vers

.

Chi

ldre

n ar

e en

cour

aged

and

/or

supp

orte

d to

hav

e an

ong

oing

spi

ritua

l lif

e (re

ligio

us a

ffilia

tion

and

re

latio

nshi

p).

Com

passiona

te

Relat

ions

Chi

ldre

n ar

e tre

ated

equ

ally,

but

not

the

sam

e, by

car

egiv

ers,

serv

ice

prov

ider

s, tra

iner

s and

com

mun

ity.

Bo

th O

VC

and

non

-OV

C p

artic

ipat

e in

serv

ices

in a

n ef

fort

to a

void

stig

ma

and

disc

rimin

atio

n.

Chi

ldre

n ar

e no

t neg

lect

ed.

E

very

chi

ld is

abl

e to

exp

ress

feel

ings

and

con

cern

s with

out f

ear o

f pu

nish

men

t.

All

serv

ices

are

pro

vide

d w

ith d

igni

ty, re

spec

t, an

d ca

re.

A

ll ad

ults

in c

omm

unity

pos

itive

ly a

ckno

wle

dge

and

enga

ge c

hild

ren.

App

ropr

iatene

ss

Serv

ices

are

cul

tura

lly a

nd a

ge a

ppro

pria

te.

M

ater

ials

deve

lope

d ar

e se

nsiti

ve to

resp

ectiv

e cu

ltura

l and

relig

ious

con

text

s.

Serv

ices

and

prog

ram

s are

indi

vidu

aliz

ed m

eani

ng th

at th

ey sh

ould

reco

gniz

e th

e un

ique

ness

of

each

child

and

be

tailo

red

to th

e re

leva

nt a

spec

ts o

f th

e ch

ild’s

own

need

s and

situ

atio

n.Se

rvic

es a

re g

ende

r and

age

spec

ific

(sen

sitiv

e).

| 21


Par

ticipa

tion

Chi

ldre

n pa

rtic

ipat

e eq

ually

and

vol

unta

rily

in d

iffer

ent g

ames

and

act

iviti

es.

C

hild

ren

and

care

give

rs a

ctiv

ely

part

icip

ate

in th

e de

cisio

n-m

akin

g pr

oces

s re

gard

ing

type

s of

ser

vice

s, w

here

and

whe

n to

get

serv

ices

, sel

ectin

g th

eir l

eade

rs in

clu

bs a

nd p

eer-g

roup

s.C

hild

ren

part

icip

ate

in p

rovi

ding

, mon

itorin

g, a

nd e

valu

atin

g se

rvic

es.

O

VC

hav

e fe

ed-b

ack

loop

s (to

eva

luat

e th

eir s

ervi

ces,

situa

tion)

.

Chi

ldre

n pa

rtic

ipat

e in

set

ting

rule

s an

d re

gula

tions

in t

heir

club

s an

d pe

er-

grou

ps a

nd in

sel

ectin

g th

eir

ca

regi

vers

.O

VC

are

giv

en th

e op

port

unity

and

supp

ort t

o su

ccee

d in

som

ethi

ng th

at is

mea

ning

ful t

o th

em (

e.g

. eng

age

in

self-

expr

essio

n, e

xplo

re ta

lent

s, an

d fu

lfill

drea

ms)

.O

VC

enc

oura

ged/

trai

ned

in g

ood

com

mun

icat

ion

skill

s.

Com

mun

ity a

nd s

yste

ms-

leve

l sho

uld

enco

urag

e ac

tive

child

par

ticip

atio

n al

thou

gh th

is re

quire

s an

atti

tude

shift

/cha

nge.

O

VC

hav

e th

e rig

ht to

des

ign

and

choo

se se

rvic

es, a

ctiv

ities

, affi

liatio

ns, a

nd a

dult

linka

ges.

Sustai

nability

Adv

ocac

y ef

fort

s fo

cus

on P

SS a

nd L

S in

prim

ary

scho

ol a

nd c

omm

unity

set

-up.

(

e.g. C

urric

ulum

and

play

gr

ound

.)Pe

rson

al h

istor

y of

par

ents

kep

t/do

cum

ente

d fo

r chi

ldre

n (i

.e. m

emor

y w

ork)

C

omm

unity

invo

lvem

ent i

n pr

ovid

ing

supp

ort i

s pro

mot

ed.

Fo

rmal

refe

rral

link

ages

bet

wee

n co

mm

unity

and

serv

ice

prov

ider

s are

est

ablis

hed.

Lo

cally

ava

ilabl

e, ch

ild-f

riend

ly a

nd c

ultu

rally

soun

d m

ater

ials

are

utili

zed.

PS

S is

inte

grat

ed in

to

Id

irs (t

radi

tiona

l bur

ial s

ocie

ties -

loca

l CBO

) act

iviti

es.

Com

mun

ity le

ader

s are

trai

ned

and

enco

urag

ed to

pro

mot

e PS

S ac

tiviti

es.

Yo

uth

are

empo

wer

ed to

bec

ome

lead

ers (

peer

supp

orts

and

you

th-m

odel

s).

C

hild

righ

ts a

ppro

ach

is ap

plie

d fo

r sys

tem

s and

atti

tudi

nal c

hang

e.

| 22


2.2.6 Education

DESIRED OUTCOME: OVC is enrolled, regularly attend school and completes aminimum of TVET and preparatory education.

DIMENSIONS OF QUALITY MATRIX: EDUCATION

Dimensions of Quality Quality Characteristics for Education Services

Safety

Children are secure from abduction, rape and harassment when they walk to or from school.Services provided to OVC are the same or similar to those provided to other students (i.e. no special uniforms for OVC or made from more expensive or different materials) so reducing the possibility of stigma and discrimination.HIV status of OVC remains confidential to reduce stigma which may lead to isolation, bullying, and other forms of harassment and psychological abuse.Protect children from abuse (physical and emotional) from teachers other students, caregivers or community members. Promote permanency for OVC and ensure they have a secure home-base rather than living on the street or in a temporary structure.Promote a safe environment for the child at school, at home and in the community.

Access/Reach

Eliminate school charges or fees (. e.g. primary school attendance is free but there are other school costs that may hinder enrollment and attendance). Encourage government and community to build additional schools as distance and lack of security may keep OVC out of school.Encourage government and community to increase the availability of early childhood education (i.e. pre-schools) especially in rural areas.Ensure enrollment of all children seven years of age in grade one. Promote gender equity by encouraging parents to send their daughters to school rather than having girls remain home to perform household chores of perform other work.Provide sufficient school materials, supplies and uniforms to encourage OVC school retention. Organize a school, community or home-based feeding program to ensure that hunger does not prevent OVC from attending school.Address child labor exploitation issues so that OVC are not denied educational opportunities because of the need to sustain them.

| 23


Effectiveness

Advocate and bring OVC issues to the forefront of community concerns.Empower community bodies such as Parent-Teacher Associations (PTA) or Iddirs to support OVC needs.Increase promotion rates among OVC through tutorial classes, summer programs and other supplementary educational support.Enhance OVC performance at school through improvements in the quality of learning through facilitating tutorial services, improving class attendance, student/book ratio…etc. Increase community and OVC understanding the rights-based protection policy.Promote more effective school supervision through increased parental involvement in school affairs and more intense supervision by Woreda educational officials.

Technical Performance

Increase capacity building for PTA and teachers through better planning, provision of tutorials and other methods to support OVC in school.Use school-based data to assist schools and communities make more informed decisions.Mobilize local resources and government and NGO support.Develop more effective communication channels between school and home (i.e .caregivers) for OVC.

Efficiency

Improve enrollment rates, class promotion rates, and retention, and reduce drop-outs.Prioritize school and individual needs. Target the neediest. Leverage local resources.

Continuity

Assist OVC with making the transition from primary to vocational school or promote other economic opportunities.Strengthen livelihood activities for families to ensure they have resources to pay for educational materials after end of project. Encourage and mobilize community to continue support for OVC after external projects end.

| 24



Train para-professional counselors from the community to mentor and encourage OVC on a regular basis.Promote nurturing relationships and communication between teachers and students. Ensure confidentiality of OVC.Respect, trust, value, and recognize OVC as individuals rather than as a group.Provide services with dignity and in a respectable manner without stigmatizing OVC.

Appropriateness(Relevance)

Provide needs-based support.Match services with need, gender and age.Provide tutorial and supplementary assistance to all academically challenged children in school to reduce stigma and discrimination. However, the majority of participants should be OVC. Programs should be scheduled when OVC are available and able to participate. Develop health care referral system for OVC in-school.

Participation

Encourage age-appropriate OVC involvement in planning, implementation and monitoring of programs.Facilitate active participation of beneficiaries and caregivers in decision-making processes.

Sustainability

Promote sense of community ownership for OVC support by involving all stakeholders in programs (e.g. PTA, KETB, caregivers, Woreda Education Officers, community members, OVC).Generate long-term commitment from community.Develop a broad community vision beyond a short-term focus on OVC needs.Develop a resource generation focus that is multi-sectoral and not only targeting community or government (synergy of resources).

| 25


2.2.7 Food and Nutrition

DESIRED OUTCOME FOR FOOD AND NUTRITION: Balanced food is available for OVC and in accordance with their age and need DIMENSIONS OF QUALITY MATRIX: FOOD AND NUTRITIONDimensions of Quality Quality Characteristics for Food and Nutrition Services

Safety

Ensure child has food on a regular and consistent basis. Ensure child has fresh and nutritious food to meet the requirements for his/her healthy development. Potable water is free from chemicals (no pesticides used).Avoid child labor exploitation during food collection ( e.g. expecting children to travel long distance to get food aid and carry the food to home). Promote better food handling practices such as using good sanitation ( e.g. hand wash exercise before and after meal) and safe food preparation and handling by OVC and caretakers. Promote healthy food preservation. PMTCT and PCR are available for pregnant women and newborns.Therapeutic feeding for malnourished children is available and accessible ( e.g. community-based initiatives).

Access/Reach

Local availability of food for OVC is ensured throughout the year.Exclusive breast feeding (up to six month) is encouraged and safe complementary feeding practices are also promoted.Devise coping mechanisms during “shocks” such as eating unusual food such as rice during disaster time rather than expecting standard food products and distribution of available food. Improve transportation and infrastructure facilities to improve availability of potable water within a short distance.Encourage caretakers to practice good food sharing practices.

Effectiveness

Increase awareness and practice of a balanced and nutritious diet for OVC and caregivers. Develop skills in food production, preparation and handling.Ensure that OVC have access to food ( i.e. change traditional customs of children eating after adults).

Technical Performance

Promote awareness of community members regarding supplementary feeding programs and identification of cases for referral to feeding programs.Develop criteria for how and where the community refers children.Innovate and learn from best practices.Build capacity of service providers related to nutrition provision.Mobilize local resources. Create opportunities for capacity building throughout the year.

Efficiency

Enhance local agricultural production knowledge; maximize local markets and mainstream food and nutrition aspect in all service areas.Proper food management and storage is promoted.Caregivers sensitive to the food need of children/OVC.Food distributed fairly (OVC have to come first).Prioritization of neediest OVC.

| 26

Continuity

Families encouraged to produce twice in a year using alternative agricultural technology (like irrigation) to ensure availability of food throughout the year.Promote diversification of food sources. Integrate food production with other income generating activities so that OVC/ caregivers have enough income to purchase food.Ensure steady food supply throughout the year by promoting storage by households. Train OVC on food production and preparation, so they can take care of themselves in the absence of the caregivers. Build resilience of the caregivers against hunger and disaster.


Promote informed community decision making in meeting the nutritional needs of OVC so as to minimize disturbances to the normal life of the community.Design programs to prevent stigma while providing food and nutrition services for OVC,Provide food with respect, dignity and care. Design programs that are responsive to culture ( i.e. should be accepted in the community).Encourage community members to care for OVC with love and respect.

Appropriateness(Relevance)

Services are provided at the household level.Services and education are age and need specific.Services discourage dependency.Services are culturally sensitive and responsive.Training is given in the primary language of the household.

Participation OVC and caregivers participate in decisions that affect their lives.Stakeholders participate at all levels of program planning and implementation.Distribution of food is based on the actual need of OVC in the home.

Sustainability

Planning and implementation is linked with other stakeholders, economic sectors and government systems.Programs are integrated into school system ( e.g. vegetable production at school compound and nutrition education).Promote school attendance through food supply.IGA and community initiatives to create access to food for the OVC.Mobilize sustainable food/nutrition supply (long term not only immediate support).Best practices of agricultural production in the community are identified and shared. Promote healthy cultural nutritional practices while encouraging a change in attitude against those that affect health in local communities (e.g. some groups will not eat seafood during fasting times, which is essential for child health development).Promote community ownership and participation in operating and financing the program including contribution of cash or commodities.

| 27

2.3 Coordination of Care Coordination of care can be defined as a child-focused process that augments and coordinates existing services and manages child-wellness through advocacy, communication, education, identification of needs and referral to services. This involves planning care for a child or family, monitoring that care, and making adjustment to the combination of services when needed. Coordinated care requires linkages with all sectors to ensure the appropriate mix of services for program beneficiaries.4

Coordinated Care is selected to be the overall guiding principle through which services would be delivered in an integrated manner so as to reduce duplication, fill service gaps and increase service coverage and increase program efficiency and effectiveness. In order to deliver quality services to OVC, coordination should occur at all levels, not just at service delivery point. Coordination of care is the critical integrative activity that assures that services have the desired impact.

Coordinated care does not mean that programs should provide all the services. However, in order to ensure quality service provision, partners should be able to monitor children’s/households’ receipt of necessary services through linkages and referrals. Moreover, it has to be noted that coordination of care is overarching to the other service areas & also needs strong information sharing mechanism, good level of cooperation, collective vision & long-term commitment.

4 Toolkit for Positive Change: Providing Family-focused, Results –driven and Cost-effective Programming for Orphans and Vulnerable Children. Radeny, S. and Bunkers K.; Save the Children Federation, Inc. 2009.

| 28

The

fol

low

ing

tabl

e ill

ustra

tes

& s

umm

ariz

es t

he m

ajor

issu

es r

elat

ed t

o co

ordi

natio

n of

car

e in

ligh

t of

the

qua

lity

dim

ensio

ns &

ch

arac

teris

tics:

DES

IRED

OU

TC

OM

E fo

r Coo

rdin

atio

n of

Car

e pr

ovid

ed in

Eth

iopi

a: C

hild

’s ne

eds a

re a

sses

sed

and

met

in a

coo

rdin

ated

way

.

DIM

EN

SIO

NS

OF

QU

ALI

TY

MA

TR

IX: C

OO

RD

INA

TIO

N O

F C

AR

E

Dim

ensi

ons

of

Qua

lity

Qua

lity

Cha

ract

eris

tics

for C

oord

inat

ed C

are

Safety

Ens

ure

confi

dent

ialit

y; c

hild

-sen

sitiv

e as

sess

men

ts;

prev

entio

n of

stig

ma,

and

trans

pare

ncy

in n

etw

ork

pr

actic

es.

Prov

ide

a w

atch

-dog

func

tion

to v

erify

safe

ty a

nd q

ualit

y ac

ross

gro

ups i

n th

e co

ordi

nate

d ca

re m

echa

nism

.

Access

Eng

age

gove

rnm

ent r

esou

rces

(mon

ey, p

hysic

al, h

uman

).

Und

erta

ke se

rvic

e m

appi

ng.

E

nhan

ce a

vaila

bilit

y of

cap

acity

for c

oord

inat

ed c

are

to m

eet d

eman

d.

Ens

ure

info

rmat

ion

is av

aila

ble

on w

here

and

how

to a

cces

s ser

vice

s (ch

ild fr

iend

ly).

Se

rvic

e ac

cess

mec

hani

sms a

re e

stab

lishe

d an

d fu

nctio

ning

.

Effe

ctiv

eness

Ens

ure

serv

ices

resp

onsiv

e to

nee

ds o

f th

e w

hole

chi

ld.

St

akeh

olde

rs a

re in

volv

ed in

pla

nnin

g fo

r OV

C.

Est

ablis

hed

obje

ctiv

es th

at a

re b

eing

met

.

Techn

ical

Perform

ance

Prob

lem

s of

doub

le c

ount

ing

reso

lved

.

Prom

ising

pra

ctic

es a

re id

entifi

ed, d

issem

inat

ed a

nd a

pplie

d.

Mon

itorin

g an

d ev

alua

tion

proc

edur

es in

pla

ce a

cros

s all

part

icip

atin

g pa

rtne

rs.

Pr

oced

ures

est

ablis

hed

to m

onito

r cap

acity

to a

void

ove

r ext

ensio

n.

Ens

ure

that

join

t pla

nnin

g is

dyna

mic

not

stat

ic.

Trai

n st

aff

rega

rdin

g ch

ild-c

ente

red

asse

ssm

ent

so t

hat

serv

ices

are

bas

ed o

n ne

ed a

nd n

ot o

rgan

izat

iona

l

offe

rings

.

| 29

Effi

cien

cy

No

dupl

icat

ion

of e

ffor

t.

Reso

urce

util

izat

ion

is tra

nspa

rent

and

mob

ilize

d.

Lead

resp

onsib

ility

hon

ored

with

out c

ompe

titio

n.

Nat

iona

l or r

egio

nal l

evel

coo

rdin

atio

n is

in d

ialo

gue

with

loca

l lev

el to

incr

ease

serv

ice

asse

ss.

Con

tinu

ity

Coo

rdin

atio

n is

a lo

ng-te

rm c

omm

itmen

t.

Net

wor

king

is e

stab

lishe

d, n

urtu

red,

and

func

tiona

l.

Uni

fied

push

for a

long

-term

per

spec

tive

from

don

ors.

Sy

stem

s are

form

ed a

nd fu

nctio

ning

acr

oss s

take

hold

ers.

C

are

plan

s for

indi

vidu

al c

hild

ren

are

com

plet

ed a

nd fo

llow

ed.

Com

passiona

te

Relat

ions

Col

labo

rativ

e at

mos

pher

e is

fost

ered

.

Chi

ld-f

riend

ly c

oord

inat

ion

mec

hani

sms a

re p

ract

iced

.

App

ropr

iatene

ssC

hild

-frie

ndly

serv

ices

ens

ured

.

Serv

ices

are

resp

onsiv

e to

gen

der,

age,

and

spec

ial n

eeds

of

child

ren.

Par

ticipa

tion

Chi

ld in

put i

nfor

ms n

eeds

ass

essm

ent a

s age

app

ropr

iate

.

Pro

cedu

res a

re in

pla

ce fo

r the

chi

ldre

n to

pro

vide

feed

back

on

serv

ice

prov

ision

.

Sustai

nability

Exi

stin

g co

mm

unity

stru

ctur

es a

re u

sed.

Sh

ared

ow

ners

hip

of c

are

prov

ision

is fo

ster

ed.

Pl

an d

evel

oped

for r

educ

tion

in e

xter

nal r

esou

rces

.

A ra

nge

of m

ulti-

sect

or st

akeh

olde

rs a

re e

ngag

ed in

pla

nnin

g, im

plem

enta

tion

and

mon

itorin

g.

Cap

acity

bui

ldin

g fo

r coo

rdin

atio

n of

car

e is

a pr

iorit

y.

Inno

vation

Cre

ativ

e us

e of

reso

urce

s is f

oste

red.

A

ppro

ach

to c

oord

inat

ion

is fle

xibl

e an

d re

spon

sive

to c

omm

unity

cha

nges

.

Foru

ms a

re c

ondu

cted

per

iodi

cally

to st

imul

ate

and

enco

urag

e ne

w w

ays t

o co

ordi

nate

d is

in p

lace

.

Sect

ion

III

- C

riti

cal M

inim

um

an

d A

dd

itio

nal A

ctiv

itie

s

Crit

ical

min

imum

act

iviti

es a

re a

ctiv

ities

that

mus

t be

done

by

all p

artn

ers i

mpl

emen

ting

serv

ices

for O

VC.

The

se a

ctiv

ities

form

the

basis

of

a qu

ality

serv

ice

and

repr

esen

t wha

t is

doab

le b

y al

l ser

vice

par

tner

s irr

espe

ctiv

e of

fina

ncia

l and

hum

an re

sour

ces.

Add

ition

al a

ctiv

ities

are

act

iviti

es th

at w

ill e

nhan

ce th

e or

gani

zatio

n’s a

bilit

y to

ach

ieve

mea

sura

ble

impr

ovem

ents

in th

e liv

es o

f ch

ildre

n be

ing

serv

ed b

y th

eir p

rogr

am b

ut th

ey a

re n

ot m

anda

tory

act

ions

. T

hese

of

ten

rely

on

addi

tiona

l fina

ncia

l and

hum

an re

sour

ces.

Serv

ice

Are

aC

ritic

al M

inim

um A

ctiv

ities

Add

ition

al A

ctiv

ities

Shelter an

d Car

e

Desired

Out

come:

All

OV

C h

ave

shel

ter c

loth

ing,

pe

rson

al h

ygie

ne

and

adul

t car

egiv

er

whi

ch is

the

sam

e as

or s

imila

r to

the

non-

OV

C in

co

mm

unity

.

Regu

larly

ass

ess t

he n

eeds

of

OV

C fo

r she

lter.

Id

entif

y an

d m

obili

ze c

omm

unity

res

ourc

es t

o co

nstr

uct,

im

prov

e an

d re

nova

te sh

elte

r for

OV

C.A

dvoc

ate f

or th

e pro

visio

n of

alte

rnat

ive o

ptio

ns to

hou

sing

ch

ildre

n su

ch a

s day

care

, tem

pora

ry sh

elte

r, et

c.Li

nk a

nd a

dvoc

ate

with

sta

keho

lder

s (le

gal s

ervi

ces,

Ke

beles

, ot

hers

)Re

gula

rly a

sses

s the

shel

ter a

nd c

are

need

s of

OV

C.

Ens

ure

that

an

adul

t/fo

ster

car

egiv

er v

isits

the

chi

ld a

t

hom

e an

d pr

ovid

es a

ppro

pria

te su

ppor

t.Re

fer

child

ren

with

out a

dequ

ate

supp

ort t

o ot

her

serv

ices

incl

udin

g te

mpo

rary

shel

ter.

Sens

itize

com

mun

ity,

line

gove

rnm

ent

offic

es a

nd o

ther

stak

ehol

ders

to m

onito

r pro

gres

s of

the

child

ren

(sta

tus o

f sh

elte

r and

car

e)Re

crui

tmen

t, tra

inin

g an

d as

signm

ent

of a

n ad

ult/

fost

er

ca

re g

iver

or

adop

tive

pare

nts

for

OV

C b

ased

on

cons

ent

from

OV

C an

d ca

regi

ver.

Incl

udes

trai

ning

and

prov

ision

of

cont

inuo

us su

ppor

t to

care

give

rs to

pro

vide

PSS

to O

VC

Prov

ide

shor

t-ter

m s

helte

r fo

r ab

ando

ned

and

othe

r ne

edy

ch

ildre

n (e.

g. le

gal p

rote

ctio

n).

Mak

e sa

nita

ry fa

cilit

ies (

wat

er a

nd to

ilets

) and

mat

eria

ls

acce

ssib

le to

OV

C.Li

nk w

ith

Ke

bele

adm

inist

ratio

n to

secu

re h

ome w

hich

is w

arm

, saf

e and

mee

ts th

e lo

cal s

tand

ards

for

OV

C a

nd th

eir c

aret

aker

s.Li

nk w

ith le

gal i

nstit

utio

n to

ens

ure

inhe

ritan

ce ri

ghts

esp

ecia

lly

to

the

hom

e fo

r OV

C.

Edu

cate

OV

C o

n hy

gien

ic

Prac

tices

(per

sona

l, ho

me

and

envi

ronm

enta

l).

Prov

ide

clot

hing

to O

VC.

Pr

ovid

e ch

ild re

unifi

catio

n an

d fa

mily

rein

tegr

atio

n as

nee

ded.

Ens

ure

day-

care

serv

ices

are

ava

ilabl

e an

d ac

cess

ible

to O

VC.

Eco

nomic

Streng

then

ing

Desired

Out

come:

Hou

seho

lds c

arin

g fo

r OV

C h

ave

addi

tiona

l and

di

vers

ified

sour

ce o

f in

com

e to

car

e fo

r fa

mily

.

Ass

ess h

ouse

hold

situ

atio

n in

whi

ch O

VC

live

and

dete

rmin

e if

ther

e is

inco

me

to su

ppor

t nee

ds o

f ch

ildre

n.Re

fer c

areg

iver

s to

IGA

opp

ortu

nitie

s (sa

ving

s gro

ups,

et

c).

Map

serv

ice

prov

ider

s and

leve

rage

reso

urce

s fro

m th

e

priv

ate

sect

or fo

r tra

inin

g an

d fu

ture

em

ploy

men

t of

thos

e tra

ined

.C

ondu

ct m

arke

t ana

lysis

for b

usin

ess v

iabi

lity

befo

re

tra

inin

g.H

elp

hous

ehol

ds c

arin

g fo

r OV

C to

get

fina

ncia

l

reso

urce

s.Pr

ovid

e tra

inin

g on

how

to g

ener

ate

and

man

age

inco

me.

Pr

ovid

e m

ater

ials,

fina

ncia

l, an

d jo

b op

port

uniti

es.

M

onito

r/do

cum

ent p

rogr

ess o

f be

nefic

iarie

s thr

ough

an

as

sess

men

t che

cklis

t.

Leg

al P

rotection

Desired

Out

come:

Chi

ld re

ceiv

es

lega

l inf

orm

atio

n an

d ac

cess

to le

gal

serv

ices

as n

eede

d,

incl

udin

g bi

rth

regi

stra

tion,

will

w

ritin

g, p

rope

rty

inhe

ritan

ce a

nd is

pr

otec

ted

from

all

form

s of

abus

e an

d vi

olen

ce

Ass

ess l

egal

nee

ds o

f ch

ildre

n (

i.e

. birt

h ce

rtifi

cate

s, w

ills a

nd

othe

r iss

ues s

uch

as ra

pe, a

buse

, etc

.).Re

fer O

VC

to le

gal p

rote

ctio

n se

rvic

es.

C

ondu

ct m

appi

ng o

f leg

al se

rvic

es av

aila

ble i

n th

e com

mun

ity,

in

clud

ing C

hild

Rig

hts C

omm

ittee

s, N

GO

s, C

hild

Pro

tect

ion

Uni

ts, e

tc.

Con

duct

com

mun

ity e

duca

tion

and

awar

enes

s-ra

ising

on

ch

ild-r

elat

ed la

ws a

nd ri

ghts.

Iden

tify

vuln

erab

le c

hild

ren

and

thei

r ca

regi

vers

and

mak

e

regu

lar v

isits.

Mon

itor

prot

ectio

n ne

eds

of

vuln

erab

le

child

ren

and

ca

regi

vers

.Se

nsiti

ze th

e m

edia

to in

form

the

publ

ic a

bout

the

right

s and

need

s of

OV

C.Pr

omot

e bi

rth

regi

stra

tion.

E

stab

lish

and

stre

ngth

en n

etw

orki

ng s

yste

ms

with

oth

er

se

rvic

e pr

ovid

ers

such

as

sh

elte

r, m

edic

al

care

an

d ps

ycho

soci

al su

ppor

t.

If a

CPU

doe

s not

exi

st, a

dvoc

ate

for t

he e

stab

lishm

ent a

nd

st

reng

then

ing

of o

ne.

Raise

com

mun

ity a

war

enes

s w

ithin

the

com

mun

ity, i

n th

e sc

hool

s,

abou

t ch

ild-r

elat

ed la

ws,

self

pro

tect

ion

skill

s, tim

ely

repo

rtin

g of

ca

ses,

and

child

par

ticip

atio

n an

d ch

ild ri

ghts

thro

ugh

child

frie

ndly

an

d cu

ltura

lly a

ppro

pria

te m

ater

ial.

Info

rmat

ion

(for

exam

ple

in b

roch

ures

and

new

slette

rs)

rega

rdin

g

com

mon

lega

l iss

ues a

re w

idel

y di

strib

uted

.A

dvoc

ate a

nd n

etw

ork

with

Gov

ernm

ent a

nd o

ther

key

stak

ehol

ders

for c

hang

e in

laws t

hat a

re n

ot fa

ir to

child

ren

or fo

r the

enfo

rcem

ent

of la

ws t

hat p

rote

ct c

hild

ren.

Cap

acity

bui

ldin

g of

sta

keho

lder

s, pa

rtic

ular

ly s

ensit

izin

g po

lice,

ju

dges

Chi

ld R

ight

s Clu

bs an

d C

hild

Rig

hts C

omm

ittee

s to

the n

eeds

of

chi

ldre

n an

d ho

w to

com

pass

iona

tely

ass

ist th

em.

Hea

lth

Serv

ices

Desired

Out

come:

Chi

ld h

as a

cces

s to

hea

lth se

rvic

es,

incl

udin

g H

IV a

nd

AID

S pr

even

tion,

ca

re a

nd tr

eatm

ent.

Ass

ess

and

mon

itor

the

heal

th s

tatu

s of

OV

C t

hrou

gh

ho

useh

old

visit

s.Re

fer O

VC

to h

ealth

serv

ices

bas

ed o

n ne

ed.

Fo

llow

up

to e

nsur

e re

ceip

t of

hea

lth s

ervi

ces

and

iden

tify

w

heth

er c

hild

is b

ette

rC

ondu

ct m

appi

ng o

f he

alth

ser

vice

s in

the

com

mun

ity w

ith

pa

rtic

ipat

ion

of k

ey st

akeh

olde

rs.

Ens

ure

form

al re

ferr

al sy

stem

s exi

st.

Prov

ide b

asic

age-

appr

opria

te h

ealth

educ

atio

n an

d en

sure

that

child

ren

rece

ive H

IV an

d A

IDS

educ

atio

n ei

ther

dire

ctly

from

th

e C

BO o

r thr

ough

ano

ther

par

tner

, chu

rch,

or c

omm

unity

.Tr

ain

care

giv

ers/

volu

ntee

rs o

n a

com

preh

ensiv

e ra

nge

of

he

alth

issu

es: h

ygie

ne, A

RT is

sues

, IM

AI,

nutri

tion.

M

ake

refe

rral

s fo

r ra

pe/c

hild

abu

se/e

mot

iona

l pr

oble

ms,

ho

listic

car

e an

d fo

llow

up.

Cov

er fe

es, d

rugs

, tra

nspo

rtat

ion,

faci

litat

ing

free

med

icat

ion

pape

rs.

Tr

ain

care

give

rs a

nd v

olun

teer

s on

bas

ic h

ealth

car

e, hy

gien

e, V

CT,

ART

adh

eren

ce. H

IV a

nd A

IDS

prev

entio

n ed

ucat

ion

and

refe

rral

as

need

ed to

chi

ldre

n an

d co

mm

unity

mem

bers

. Pr

ovid

e w

ater

and

sani

tatio

n se

rvic

es to

OV

C.

Prov

ide

heal

th e

duca

tion

to v

olun

teer

s re

gard

ing

HIV

and

AID

S,

pe

rson

al h

ygie

ne, w

ater

and

san

itatio

n, a

nd o

ther

hea

lth c

are

issue

s in

clud

ing

Sexu

al a

nd R

epro

duct

ive

Hea

lth (

SRH

) fo

r yo

uth

aged

14

and

up.

Con

duct

act

iviti

es to

sen

sitiz

e th

e co

mm

unity

on

heal

th is

sue-

MC

H,

ST

I, O

VC,

HIV

and

AID

S.M

obili

ze c

omm

unity

reso

urce

s.

Psy

chos

ocia

l Car

e an

d Su

ppor

t

Desired

Out

come:

OV

C d

evel

op

pers

onal

stre

ngth

s an

d sk

ills t

o be

com

e se

lf-co

nfide

nt,

happ

y, ho

pefu

l, an

d ab

le to

cop

e w

ith

life’s

cha

lleng

es.

Ass

ess p

sych

osoc

ial n

eeds

of

child

ren.

Id

entif

y an

d ad

dres

s bar

riers

to P

SS fo

r chi

ldre

n.

Follo

w u

p re

gula

rly to

mon

itor c

hild

’s st

atus

.

Map

ping

of

PSS

serv

ices

inc

ludi

ng (

child

frie

ndly

cen

ters

,

relig

ious

lead

ers)

.Tr

ain

volu

ntee

rs in

reco

gniti

on o

f PS

S ne

eds a

nd c

ouns

elin

g.

Prov

ide

re-in

tegr

atio

n se

rvic

es a

re p

rovi

ded

for c

hild

ren

who

have

live

d ou

tsid

e of

fam

ily c

are.

Est

ablis

h su

ppor

t gr

oups

(ch

ildre

n an

d gu

ardi

an s

uppo

rt

gr

oups

and

clu

bs) t

o co

unse

l/su

ppor

t car

egiv

ers/

child

ren.

D

evel

op sa

fe sp

aces

for c

hild

ren

to e

ngag

e in

play

.

Incr

ease

aw

aren

ess

amon

gst

care

give

rs a

nd c

omm

unity

on

pa

rent

ing,

pos

itive

disc

iplin

ing,

com

mun

icat

ion,

ope

n di

alog

ue

with

chi

ldre

n on

RH

and

HIV

and

AID

S iss

ues e

tc.

Prov

ide

life

skill

s tra

inin

g th

roug

h pe

er g

roup

s.

Ass

ist /

supp

ort c

areg

iver

with

disc

losu

re o

f H

IV st

atus

.

Ass

ist in

succ

essio

n pl

anni

ng (w

ills)

.

Ass

ist fa

mili

es in

cre

atin

g m

emor

y bo

oks.

Pr

ovid

e co

unse

ling

serv

ices

with

resp

ect t

o gr

ief

and

HIV

disc

losu

re.

E

duca

te y

outh

abo

ut th

e da

nger

s of

dru

gs a

nd a

lcoh

ol. A

sk if

dru

gs

an

d al

coho

l are

abu

sed

by a

dults

in th

e ho

useh

old.

Scr

een

for s

igns

of

drug

or a

lcoh

ol u

se a

nd re

fer a

ny h

ouse

hold

mem

ber f

or tr

eatm

ent a

s ne

eded

.E

nsur

e tha

t the

child

is liv

ing a

nor

mal

life i

n te

rms o

f sch

ool, r

ecre

atio

n

and

links

to c

omm

unity

.E

nsur

e th

at c

hild

ren

are

enro

lled

in sc

hool

, atte

ndin

g sc

hool

, and

that

the

child

doe

s not

feel

isol

ated

or s

tigm

atiz

ed a

t sch

ool.

Mon

itor h

ouse

hold

dyn

amic

s vis-

à-vi

s car

egiv

er a

nd si

blin

gs.

E

stab

lish

mec

hani

sm to

addr

ess b

urno

ut o

f ca

regi

vers

such

as su

ppor

t

grou

ps t

o co

unse

l/su

ppor

t ca

regi

vers

to

prot

ect

care

give

rs f

rom

bu

rnou

ts a

nd e

nabl

e th

em to

cop

e.A

ssist

and

cou

nsel

chi

ldre

n w

ho h

ave

lived

out

side

of fa

mily

car

e.

Impl

emen

t a R

ole

Mod

elin

g pr

ogra

m w

here

reno

wne

d pe

ople

can

be

in

vite

d to

shar

e th

eir e

xper

ienc

e an

d su

cces

s.

Edu

cation

Desired

Out

come:

Chi

ld is

enr

olle

d,

regu

larly

atte

nds,

and

com

plet

es

a m

inim

um o

f pr

imar

y sc

hool

(g

rade

8).

Regu

larly

ass

ess

educ

atio

nal

need

s of

OV

C (

enro

llmen

t,

rete

ntio

n, p

rom

otio

n).

Iden

tify

and

addr

ess

barr

iers

to

ed

ucat

ion

on

an

in

divi

dual

ized

bas

is fo

r eac

h O

VC

in c

olla

bora

tion

with

key

st

akeh

olde

rs.

Con

duct

reso

urce

map

ping

for e

duca

tiona

l ser

vice

s.

Refe

r O

VC

to

educ

atio

nal

reso

urce

s fo

r tu

torin

g, s

choo

l

mat

eria

ls (u

nifo

rms,

etc)

.Re

gula

rly fo

llow

up

on c

hild

ren’s

stat

us.

Id

entif

y an

d en

gage

al

l st

akeh

olde

rs,

incl

udin

g

Kebe

le E

duca

tion

and

Trai

ning

Boa

rd, P

TAs a

nd C

BOs,

etc.

Bu

ild c

apac

ity t

o su

ppor

t O

VC

am

ong

PTA

, te

ache

rs,

co

mm

unity

repr

esen

tativ

es a

nd lo

cal g

over

nmen

t offi

cial

s.Su

ppor

t life

skill

s and

live

lihoo

d op

port

uniti

es as

an in

tegr

al

pa

rt o

f th

e ed

ucat

ion

prog

ram

.

Stre

ngth

en a

nd e

mpo

wer

PTA

and

tea

cher

s th

roug

h tra

inin

g,

es

peci

ally

on

PSS.

Mob

ilize

com

mun

ity s

uch

as P

TAs

and

othe

rs t

o co

nduc

t re

gula

r

com

mun

ity se

nsiti

zatio

n an

d m

eetin

gs.

Plan

for

loc

al r

esou

rces

mob

iliza

tion

on r

egul

ar b

asis

incl

udin

g

inco

me

gene

ratio

n ac

tiviti

es (I

GA

). D

evel

op sc

hool

and

com

mun

ity a

ctio

n pl

ans f

or O

VC

supp

ort.

In

itiat

e/im

plem

ent O

VC

pol

icy a

nd p

rogr

ams a

t diff

eren

t edu

catio

nal

sy

stem

leve

ls.

Dev

elop

trac

king

, mon

itorin

g an

d fe

edba

ck m

echa

nism

s with

educ

atio

nal p

rogr

am re

ferr

al se

rvic

es a

nd c

omm

unity

.

Food

and

N

utrit

ion

Desired

Out

come:

Ade

quat

e fo

od is

av

aila

ble

for t

he

child

to e

at re

gula

rly

thro

ugho

ut th

e ye

ar fo

r hea

lthy

and

activ

e lif

e.

Ass

ess f

ood

and

nutri

tiona

l nee

ds o

f ch

ildre

n.

Refe

r mal

nour

ished

or f

ood

inse

cure

chi

ldre

n an

d fa

mili

es to

food

sour

ces.

Follo

w u

p to

ens

ure

that

chi

ldre

n ha

ve re

ceiv

ed fo

od o

r oth

er

re

habi

litat

ive/

ther

apeu

tic se

rvic

e an

d m

onito

r the

ir st

atus

. Id

entif

y (th

roug

h m

appi

ng) a

nd e

ngag

e ot

her s

take

hold

ers t

o

stre

ngth

en li

nkag

es a

nd re

ferr

al sy

stem

s for

food

.E

ncou

ragi

ng ex

clus

ive b

reas

t fee

ding

and

safe

com

plem

enta

ry

fe

edin

g pr

actic

es.

Prov

ide

food

to h

ouse

hold

on

tem

pora

ry b

asis.

Tr

ain

hous

ehol

ds o

n nu

tritio

n (b

alan

ced

diet

, fo

od p

repa

ratio

n,

pr

eser

vatio

n, h

andl

ing

and

excl

usiv

e br

east

feed

ing)

.Tr

ain

com

mun

ity h

ealth

age

nts/

volu

ntee

rs o

n ba

sics

of m

alnu

tritio

n

diag

nosis

and

refe

rral

syst

em.

Con

duct

tra

inin

g fo

r th

ese

OV

C a

nd t

heir

care

give

rs o

n sa

nita

tion,

food

pro

duct

ion,

pre

para

tion

and

pres

erva

tion.

Tr

aini

ng o

n fo

od p

rodu

ctio

n (li

vest

ock

and

crop

pro

duct

ion)

and

inpu

t

prov

ision

.Id

entif

y pot

entia

l fee

ding

cent

ers a

nd cr

eate

refe

rral

syst

ems w

ith th

ese

em

erge

ncy

feed

ing

cent

ers.

| 34


Section IV: Application of the Standard Service Delivery Guidelines

The application of the standard needs the involvement and support different actors or stakeholders at all levels who are responding to the needs of OVC. In order to pave the ways for appropriate and necessary involvement, clear identification of the roles and responsibilities needs to be developed. The following is a description of the responsibilities of each key stakeholder at different levels for each key service area.

1. Food and nutrition: Depending upon the context, the range of services to be provided include the following:

Child level : nutritional assessment and counseling, supplementary feeding, and links to other health and nutrition interventions;Caregiver/family level : training on nutrition, diet, and food preparation.;Community level : community-based strategies to support vulnerable children, including gardens and feeding programs; andSystems level : policy development, regional and national coordination, technical assistance to the service providers, and advocacy.

2. Shelter: Depending upon the context, services might include:Child level: identifying potential caregivers prior to parent death, alternative care placement of child in institutional care, transitional care, or supported child-headed household.

Caregiver/family level : assisting with reunification for children without parental care and referral to programs that provide incentives for adoption, and foster care;Community level: support of family-based care with home visits and other strategies, development of innovative community alternatives when family-based care is not an option; and System level : policy development, regional and national coordination, education, mobilization of local resource, and monitoring of institutional care when needed.

3. Legal Protection: Depending upon the context, the range of services might include:Child level : assisting with birth registration and inheritance claims, preventing sibling separations, removing children from abusive situations; Caregiver/family level : support with parenting and care-giving responsibilities, assistance with access to available services;Community level : support for Child Protection Committees, training members of the community to identify and assist children needing assistance; andSystems level: legal and policy development, social mobilization, strengthening of social capital.

4. Health Care: Depending upon the context, the range of services might include: Child level: assist children in receiving health services through referral and orientation towards preventive health seeking behavior;

| 35


Caregiver/family level : train caregivers on a comprehensive range of health issues to effectively monitor health and seek care appropriately, refer OVC to health services;Community : conduct mapping of health services, mobilize and coordinate community volunteers; andSystems level: policy development to ensure access and a service delivery model that meets the needs of vulnerable children.

5. Psychosocial support: Depending upon the context, services might include:C hild level: assess psycho-social needs of children, activities that support life skills including peer teaching, individual and group counseling (including spiritual) for children, rehabilitation for children who might be abused or neglected; Caregiver/family level : follow-up to monitor children’s status, parenting and communication skills for caregivers, support during illness (assist with disclosure of information, grief management, succession planning, preserving memories, etc.);Community level : establish support groups, identify and address barriers for psychosocial support, increasing community understanding of psychosocial needs of vulnerable children; andS ystem level: provide trained counselors within school systems and develop safe spaces for children to engage in play.

6. Education: Services with regard to this component might include:Child level : school registration initiatives, direct assistance to subsidize school costs;Caregiver level: assessment of educational needs of OVC and identify and address barriers to education, train health providers and caregivers to identify and refer children who are not in the education system; Community level: conduct resource mapping for education, community mobilization and advocacy related to increasing access and developing appropriate curricula and tutorial support; andSystems level: build capacity to support OVC among Parent-Teacher Association (PTA)_, teachers and community representatives and support services like Lifeskills and livelihood opportunities as an integral part of the education program.

7. Economic strengthening: Depending upon the context, services could include:C hild/caregiver/family level: assess household situation in which OVC live and determine whether there is income to support needs of children, vocational training for caregivers, income-generating activities involving small business, urban/rural agriculture, and access to credit; Community level : mapping of related service providers in the community, community-based asset building; and S ystems level: policy development, advocacy and creation of an enabling environment to have access to financial institutions.

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Coordination of care is a critical integrative activity and approach which helps in ensuring that services have the desired impact on OVC. While it is critical that care is coordinated for each child, there are many activities that must be implemented at the community, regional, and systemic level. The following addresses what has to be considered at what level when coordinating care at the point of service delivery.

Coordination of Care at the Point of Service DeliveryAt the child/household level, coordination of care involves assessing needs, planning care for a child or family, monitoring care, and making adjustments to the combination of services when needed. Coordinators of care will usually provide both direct care and referral for services. Ideally, coordination of care involves a home visit so that all the relevant aspects of the child’s situation may be reviewed, but tools and approaches can be modified so that this individual assessment can take place in a group setting, such as a school, feeding program, or youth group. Regardless of whether the needed service is directly provided or arranged through referral, the home visitor/coordinator should monitor all the services that the child is receiving on an ongoing basis.

Coordination of Care at the Community and System Level: Effective coordination of care at the point of service delivery requires a great deal of coordination and information sharing at other levels. The following activities must be carried out to enable coordinated care and referral at the household level:

Community mobilization is required to organize the resources (human and other) to design, lead, and implement activities related to OVC care at the local level. This usually involves forming committees at the village levels or empowering existing groups to address OVC issues. The process involves dialogue within the community to foster recognition and ownership of the problem, identification of community resources, setting priorities, and developing and implementing action plans. Community leadership from the outset facilitates success and sustainability of coordinated care.

Service mapping is needed to identify gaps and mobilize resources in the continuum of care at the local level. Information about what services are available, who is eligible, and how services are accessed (registration procedures, criteria, etc.) must be gathered and relayed to the service providers who will coordinate care at the household level. Care coordinators, in turn, can then educate caretakers about available services.

Network building is also critical for coordinated care. Network building refers to the development of a web of relationships among implementing partners, civil society organizations, government agencies, donors, local resources and experts and also private sector. Network building involves meetings, sharing of information, and joint efforts to make policy and to plan, implement, monitor, and evaluate programs.

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Section V: Monitoring and Evaluation of the Quality Standards

The existing national monitoring and evaluation system captures data on routine OVC services delivered at different levels. This data informs program managers and donors about the number of children served and allows them to estimate how well the needs of the community is met or where the gaps are. However, the existing OVC service indicators utilized to date have not sufficiently captured the quality of those services or whether or not it made a difference for the children served. Integrating concepts from QI into routine monitoring will complement information about the number of services delivered or children served to better demonstrate that the care provided was up to the standard depending on the local context.

Routinely monitoring quality is a powerful way to assure that stakeholders are meeting objectives in providing quality service to children. It will be necessary to collect information on a routine basis to ensure that guidelines are implemented correctly and to provide a knowledge base for periodic program evaluation. Use of standard checklists by all stakeholders to monitor quality of service ensures that all indicators are covered and will assist in documenting comprehensive and comparable data on provision of services over time. These checklists will aid in conducting organized monitoring of implementation of the standard and developing corrective actions in order to achieve desired outcomes. A generic checklist to be used to collect data on service quality is attached in the annex of this document; which users might modify this depending on their local context while maintaining the minimum activities.

Some of the critical considerations in monitoring standards are:Effective monitoring system and clear procedures must exist or be established to ensure that programmes protect the confidentiality of any information regarding the identification by name, place of residence, and or HIV or AIDS status of any orphan or vulnerable child or household being assisted through programmes

Careful advance planning is crucial for data collection from children. Data collectors need to think through the consequences, both intentional and unintentional, of the information gathering activity on children and their households. If appropriate safeguards cannot be put in place, the activity should not proceed.

Monitoring the Implementation of the Standards Monitoring of quality should be done at various levels. Communities have a role to play as they are closest to the beneficiaries; program implementers and coordinators as facilitators of many of the services also must have a role to play in monitoring quality. Internal monitoring of day to day activities comparing with the quality standard has to be done routinely by all level implementers to ensure provision of quality service. Joint schedule for monitoring should also be established by program coordinators and managers at various levels to minimize the burden on providers. However, as quality improvement is an interactive process, joint monitoring supervision should be

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conducted regularly at least on bi-annual basis so as to modify the process of implementation. The details of care would be monitored by the provider, who also collects the indicator data and part of that data will be transferred to the next level structure; data flow for this reports needs to follow the mechanism established by OVC service coordinating bodies at each level. Recording and reporting tools will be annexed in this document to address standardization of the reporting system it self.

How to Measure the impact of the Standard Service Delivery GuidelinesThe OVC programs will be monitored and evaluated based on the national indicators; in addition, assessing the performance in line with the standards will help to look achievement of the intended outcomes in children. Monitoring systems have to be designed so that data are collected and compiled at various levels in a pyramid structure. Possible modalities for monitoring and evaluation of OVC programs include:

Service coverage specifically data on output level indicators will be captured through the routine M&E system; Outcome level indicators are monitored from large scale surveys like the welfare survey, EDHS and others;Evaluation studies (process and outcome evaluation) will also be conducted to gain detailed information on the extent of implementation of quality service in line with all quality dimensions and to explore the why and how part of program implementation; andConducting regular supervision to ensure and monitor implementation of the standard and identify challenges faced in the implementation process is also needed.

NB: In conducting such Monitoring and Evaluation activities we have to remember Quality of Care must be seen within the framework of the local context.

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Annexes

Supervision Checklists for Standard Service Delivery Guidelines for Orphans and Vulnerable Children’s Care and Support Programs

Preparatory Activities before the Field VisitReview the QAI Standards for OVC Programs before visit Read program reports and documents Carry the checklists, pencils and boardInform partner of visit

Name and title of supervisory officer(s)

Kebele:

Woreda:

Period under review

Date of visit

Purpose of visitGeneral comments/additions from reading reports before visit (attach documents if needed)

What are the standard service components offered by the Program?

Yes No Comments

Food and nutrition 1.

Shelter and Care 2.

Legal Protection 3.

Health Care 4.

Psychosocial support 5.

Educational6.

Economic Strengthening7.

Coordinated care8.

What are the activities implemented under each Standard Service Components offered by the program

Note: Please assess only for the services offered by the partner or program

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Verify the response for each of the service areas from records, minutes and by communicating with beneficiaries and community stakeholders.

N0 Questions: Shelter and Care Yes No Evidence/Comments

Is the program collaborating with the community to regularly assess and identify the shelter and care needs of OVC? 1 0

Is the program collaborating with the community to improve shelter and care according to the standards, including access to sanitary facilities (safe water and latrines)?

1 0

Is the program mobilizing community resources (including labor, materials) to improve shelter and care for OVC in the community? 1 0

Does program link OVC to resources for temporary alternatives for shelter and care? 1 0

Is the program linking with the community legal institutions such as the Kebele Administration, Child Protection Unit, and Women’s Groups etc… to ensure Shelter and Care services for OVC?

1 0

Does the legal protection component include protecting children’s rights to assets (shelter and others).? 1 0

Does the program have mechanisms in place to promote child reunification with family members if needed (is the program reintegrating children in transitional care)?

1 0

Is the program engaging communities in identifying potential caregivers (adults) who can visit the home of the child regularly prior to and after parent’s death?

1 0

Does the program support families with home visits? 1 0

Total Score for Shelter and Care

N0 Questions: Economic Strengthening Y N Evidence/Comments

Is the program identifying older OVC and guardians who are in need of economic strengthening activities? 1 0

Is the program engaging communities in defining criteria to identify OVC in need of economic strengthening services? 1 0

Does the program map community resources to promote economic strengthening activities for OVC and guardians? 1 0

Does the program conduct a market analysis to identify opportunities for economic strengthening activities? 1 0

Does the program inform the first point of contact (caregiver/volunteer) of children about the results of community mapping? 1 0

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Does the program train caregivers in assessing economic needs of OVC and their caregivers? 1 0

Does program link caregivers to appropriate IGA based on market demand, interest and skill level of caregiver? 1 0

Does the program provide training to OVC and guardians in economic strengthening activities to help them increase their economic assets?

1 0

Does program include volunteer caregivers in economic strengthening activities (access training for their own livelihood)? 1 2

Does program link OVC to vocational training opportunities? 1 0

Does program link caregivers to small loans/credit? 1 0Is the program linking with private sector to promote employment opportunities for OVC and guardians? 1 0

Total Score for Economic Strengthening

N0 Questions: Legal Protection Service Yes No Evidence/Comments

Does the program conduct a community mapping to identify existing legal structures to protect children? 1 0

Does the program share findings of community mapping with caregivers and community leaders? To help strengthen linkages with appropriate legal services when required?

1 0

Does program link OVC and guardians to legal services (identified in mapping exercise) and follow up on identified cases?

Does the program have a monitoring system to keep track of children identified with legal needs and their referrals? 1 0

Is the program linking with Kebele administration for birth registration? 1 0

Does the program sensitize/inform communities about the legal rights of children? 1 0

Is the program providing technical assistance and support to guardians to prepare for succession planning? 1 0

Is the program assisting with inheritance claims, activities to safeguard assets of children after parent’s death? 1 0

Is the program linking with appropriate child protection bodies for legal protection of children (e.g. Child Protection Unit)? 1 0

Total Score for Legal Protection:

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N0 Questions: Health Care Service Yes No Evidence/Comments

Does the program conduct a mapping exercise to identify health services available in the community (including treatment)?

1 0

Does the program share the findings with the community? 1 0Has program negotiated access to health services with different levels of service providersIs the program assisting with access to poverty certificates (card that allows children to have access to health services at the health post and health center) linked to the Kebele?

1 0

Does the program facilitate free access to health services for OVC and guardians? 1 0

Does the program conduct regular (once a month) home visits to assess health status of the child? 1 0

Is the program training caregivers to monitor health status and refer children for health services when needed? 1 0

Does the program provide training to caregivers on the importance of immunization, malaria prevention, ORT, hygiene and sanitation, optimal nutrition (e.g.: exclusive breast feeding, introduction of complementary feeding after 6 months, recuperative feeding after illness, food preparation and storage, recognition of danger signs, and need to adhere to ART treatment)?

Total score for health care service:

N0 Questions: PSS Yes NoEvidence and Comments

Is the organization implementing programs to raise community members’ awareness including caregivers of PSS needs for OVC and their families?

1 0

Is the organization implementing programs to develop psychosocial support groups to provide support to OVC and caregivers, youth clubs, mentoring groups, grieving groups)?

1 0

Is the organization implementing programs that strengthen connections between children and traditional social networks (religious leaders)?

1 0

Is the organization providing regular training, including on counseling skills on psychosocial support for OVC to its “care givers,” people who have direct contact with child?

1 0

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Is the organization implementing programs to mobilize community resources, including schools, clinics, Kebele to meet OVC PSS needs?

1 0

Is the organization implementing programs that promote life skills and inform about reproductive health in schools and clinics and other community structures such as youth clubs?

1 0

Is the organization implementing programs that provide counseling to children and caregivers regarding their HIV status?

1 0

Is the organization providing rehabilitation services for children who abuse alcohol and drugs? 1 0

Is the organization implementing programs that promote reunification of OVC with extended families? 1 0

Total score for PSS service:

N0 Questions: Education Yes No Evidence/Comments

Is the program identifying and promoting educational opportunities for OVC? 1 0

Is the program providing training to PTA, teachers, and other community members regarding OVC needs and supporting referrals to other services (nutrition, health, PSS, shelter and care, legal protection)?

1 0

Is the program engaging communities in identifying OVC in need of educational support? 1 0

Is the program sharing community based mapping of educational services with people who are in contact with children (volunteers, clinicians, religious leaders?)

1 0

Is the program conducting situation analysis to identify barriers to education for OVC? 1 0

Is the program designing interventions to promote OVC education services based on findings of situation analysis?

1 0

Is the program monitoring attendance of OVC already enrolled in school? 1 0

Is the program monitoring OVC school performance? 1 0Is the program training caregivers (volunteers) to identify and refer OVC who are not enrolled in school? 1 0

Is the program introducing life skills activities in schools, community groups (youth clubs)? 1 0

Does program have school based strategies to increase ability of school to support OVC (e.g. IGA)? 1 0

Total score for education service:

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N0 Questions: Food and Nutrition Yes No Evidence/Comments

Does the program train caregivers on nutrition including optimal infant young child feeding practices (exclusive breast feeding, appropriate introduction of complementary foods after 6 months, recuperative feeding after illness)

1 0

Does the program train caregivers on appropriate food handling practices (food preparation and safe storage)? 1 0

Does the program conduct a situation/community mapping analysis to identify other nutrition services (food distribution sites, agricultural programs, safety net programs)?

1 0

Does the program share the findings of situational analysis with the community and volunteer caregivers so that they are informed of other nutrition services in the community?

1 0

Does the program have links to other services (e.g. health: immunization, de-worming; access to clean and safe water)?

1 0

Does the program train caregivers to conduct individualized assessment to identify OVC in needs of nutrition services?

1 0

Does the program train caregivers on recognition of signs of malnutrition? 1 0

Does the program have linkages with health services and other nutrition intervention such as Community Management of Acute Malnutrition for severely malnourished children to receive therapeutic feeding services?

1 0

Does the program include a tracking mechanisms to ensure that children identified as needing food aid receive and consume food supplements appropriately?

1 0

Does the program use community based strategies to increase OVC and their guardians’ access to food (e.g. school feeding programs, community gardens, seeds, community kitchens)?

Total score for Food and Nutrition Service

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N0 Questions: Coordinated Care Yes No Evidence/Comments

Have you identified someone to supervise Volunteer Caregivers 1 0

Do you have a strategy in place to organize Volunteer Caregivers according to number of children to be reached 1 0

Have you identified capacity building needs of Volunteer Caregivers and links them to appropriate resources 1 0

Do you have mechanism to track activities of Caregivers 1 0

Do you use information gathered from monitoring activities to improve interventions for OVC 1 0

Do you orient Volunteer Caregivers on available services and has provided copies of referral forms to them 1 0

Have you established network for coordinated service delivery 1 0

Do you assess holistic needs of children served in program 1 0

Do you negotiate with network of service providers for OVC care and support services 1 0

Total Score for CBO coordinated Care

Comment (insert below each question)

Could you please describe some of the major challenges you face when providing this service?

What kind of help do you need to help provide this service to OVC in your community?

What best practices have you observed?

Other comments you would like to share:

Comments from supervisor:

Do you think the minimum activities are implemented?

If no, what are the gaps?

Recommendations:

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For More Information Contact:

The Ministry of Women’s Affairs (MOWA)

P.O Box 1293

Addis Ababa, Ethiopia

Telephone: +251-114- 166393/114-664049

Fax: +251-114-663995/114-166362

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