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Expanding orphans and vulnerable children
    support in Haiti: Improving the definition
    of ‘support’
    Elaine Baruwa, PhD, Rachelle Castagnol, MD, Asha Sharma, MA, Natasha Hsi, MPH, Abt Associates




Background                                                                                                               Educational Support Results                                                                      Nutritional Support Results
   HIV can further debilitate Haitian children beyond
                                                                                                    $300                                                                                                   $500
    their already challenged circumstances
                                                                                                                                                                                                           $450
     2008 WHO estimates for Haiti: 50% primary
                                                                                                    $250
       school enrollment, DTP3 immunization rate of                                                                                                                                                        $400

       53%, 29% of children <5 years old are moderately                                                                                                                                                    $350
                                                                                                    $200
       to severely malnourished                                                                                                                                                                            $300
   PEPFAR and Global Fund have been funding OVC                                                                                                                                                           $250
                                                                                                    $150
    programs since 2003                                                                                                                                                                                    $200
   June 12th earthquake exacerbated an already harsh
                                                                                                    $100                                                                                                   $150
    situation for children in and around Haiti’s densely
    populated capital, Port-au-Prince                                                                                                                                                                      $100

   EMMUS-IV* estimated 25% of children to be                                                        $50                                                                                                    $50

    ‘vulnerable’ in 2006 – which equates to                                                                                                                                                                  $0
                                                                                                                                                                                                                  Household Food     Individual Food Package     Ready-to-Use          3 Meals/Day/Child
    approximately 800,000 children in 2009                                                           $0
                                                                                                           Primary Education     Secondary             Uniforms        School Bags   Vocational Training
                                                                                                                                                                                                                     Package                                   Therapeutic Food
                                                                                                                                                                                                                                                                 Course/Child
                                                                                                                                 Education

    *http:/www.measuredhs.com/pub_details.cfm?ID=767                                                                           Partner 1   Partner 2     Partner 3   Partner 4                                                Partner 1        Partner 2       Partner 3          Partner 4




                                                                                                           All partners report providing educational support to thousands                                             All partners report providing educational support to thousands
Objectives and Methods                                                                                         of OVC but                                                                                                 of OVC but
                                                                                                            Type of support varies widely                                                                             Type and cost of support varies widely across partners (as
   Precisely define and cost the OVC services delivered                                                     Cost per child varies widely                                                                                 low as $50 and as high as $450)
    in Haiti
                                                                                                           Recommendations include:                                                                                   Recommendations include:
     To deepen understanding of OVC support provided
                                                                                                            Partners should be required to report precise descriptions                                                Partners should be required to report precise descriptions
       beyond broad PEPFAR indicators reported                                                                of support and costs per child supported                                                                   of support and costs per child supported
     To support program funding decision-making
                                                                                                            Impact evaluations are critical, funders fund children in                                                 Impact evaluations are critical, funders want to
                                                                                                              school but school fees ≠ educated child                                                                    increase/improve OVC nutrition, but no partner monitored
     To support quality improvement activities                                                                                                                                                                          child weight
   The four largest PEPFAR implementing partners were
    selected for:
     Key informant interviews (program managers,                                                      Next Steps
       financial o cers)                                                                                   Increasing the specificity of M&E and financial reporting
     Financial report reviews                                                                              Health Systems20/20 is piloting output-based financial reporting of community-based care (including
     Monitoring and evaluation data reviews                                                                  OVC care) in Mozambique and Tanzania in 2011
                                                                                                          Further work on understanding impact of services delivered is highly recommended
                                                                                                            To di erentiate between process measures and actual impact/achievements and streamline care to
                                                                                                              high-impact interventions
                                                                                                            To ensure appropriate use of costing information – the cheapest should not always be used and the
                                                                                                              most expensive should not always be dropped
                                                                                                            To reduce barriers to partnering with other funders by ensuring that each funder can identify their
                                                                                                              contribution and impact
                                                                                                            To increase our understanding of potential use of OVC support/partners in reaching OVCs with health




                                                                                                                                                                                                                                                                                                           June 2011
                          January 2010
                                                                                                              interventions, referral 'systems' and monitoring of impact

                                                                                                                                                                                                                                                                 www.abtassociates.com

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Expanding Orphans and Vulnerable Children Support in Haiti: Improving the Definition of 'Support'

  • 1. Expanding orphans and vulnerable children support in Haiti: Improving the definition of ‘support’ Elaine Baruwa, PhD, Rachelle Castagnol, MD, Asha Sharma, MA, Natasha Hsi, MPH, Abt Associates Background Educational Support Results Nutritional Support Results  HIV can further debilitate Haitian children beyond $300 $500 their already challenged circumstances $450  2008 WHO estimates for Haiti: 50% primary $250 school enrollment, DTP3 immunization rate of $400 53%, 29% of children <5 years old are moderately $350 $200 to severely malnourished $300  PEPFAR and Global Fund have been funding OVC $250 $150 programs since 2003 $200  June 12th earthquake exacerbated an already harsh $100 $150 situation for children in and around Haiti’s densely populated capital, Port-au-Prince $100  EMMUS-IV* estimated 25% of children to be $50 $50 ‘vulnerable’ in 2006 – which equates to $0 Household Food Individual Food Package Ready-to-Use 3 Meals/Day/Child approximately 800,000 children in 2009 $0 Primary Education Secondary Uniforms School Bags Vocational Training Package Therapeutic Food Course/Child Education *http:/www.measuredhs.com/pub_details.cfm?ID=767 Partner 1 Partner 2 Partner 3 Partner 4 Partner 1 Partner 2 Partner 3 Partner 4 All partners report providing educational support to thousands All partners report providing educational support to thousands Objectives and Methods of OVC but of OVC but  Type of support varies widely  Type and cost of support varies widely across partners (as  Precisely define and cost the OVC services delivered  Cost per child varies widely low as $50 and as high as $450) in Haiti Recommendations include: Recommendations include:  To deepen understanding of OVC support provided  Partners should be required to report precise descriptions  Partners should be required to report precise descriptions beyond broad PEPFAR indicators reported of support and costs per child supported of support and costs per child supported  To support program funding decision-making  Impact evaluations are critical, funders fund children in  Impact evaluations are critical, funders want to school but school fees ≠ educated child increase/improve OVC nutrition, but no partner monitored  To support quality improvement activities child weight  The four largest PEPFAR implementing partners were selected for:  Key informant interviews (program managers, Next Steps financial o cers)  Increasing the specificity of M&E and financial reporting  Financial report reviews  Health Systems20/20 is piloting output-based financial reporting of community-based care (including  Monitoring and evaluation data reviews OVC care) in Mozambique and Tanzania in 2011  Further work on understanding impact of services delivered is highly recommended  To di erentiate between process measures and actual impact/achievements and streamline care to high-impact interventions  To ensure appropriate use of costing information – the cheapest should not always be used and the most expensive should not always be dropped  To reduce barriers to partnering with other funders by ensuring that each funder can identify their contribution and impact  To increase our understanding of potential use of OVC support/partners in reaching OVCs with health June 2011 January 2010 interventions, referral 'systems' and monitoring of impact www.abtassociates.com