Working to support orphans and vulnerable children in southern Africa pdf

Working to support orphans and vulnerable children in southern Africa A reflection on values, principles and organisational issues Donald Skinner, Alicia Davids, Tsela Matlhaku, Reba Pha

Working to support orphans and vulnerable

children in southern Africa

A reflection on values, principles and organisational issues

Donald Skinner, Alicia Davids, Tsela Matlhaku, Reba Phakedi, Phomolo Mohapeloa, Sonja Romao, Tshepo Mdwaba, Nene Kazi & Jephias Mundondo

Published by HSRC PressPrivate Bag X9182, Cape Town, 8000, South Africawww.hsrcpress.ac.za

© 2006 Human Sciences Research Council, Family AIDS Caring Trust, Nelson Mandela Children’s Fund, Masiela Trust Fund, Foundation for Community Development, Child Protection Network, Non-Governmental Organisations Coalition on the Rights of the Child

First published 2006All rights reserved No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, including photocopying and recording, or in any information storage or retrieval system, without permission

in writing from the publishers

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Acknowledgements vExecutive Summary viChapter 1: Introduction 1Background to the project 2

Methodology 3

Agreed values and principles 5Decision-making processes and criteria 10Conclusion 12

Appendix 1:

Values and principles of each of the grant makers 13

Appendix 2:

Decision-making process and criteria used when deciding on a project

to support by grant makers 19

We would like to thank the WK Kellogg Foundation for providing the funding forthe project

We would like to acknowledge the contributions of:

• The Masiela Trust Fund (MTF), Botswana

• The Non-Governmental Organisations Coalition on the Rights of the Child (NGOC), Lesotho

• The Foundation for Community Development (FDC), Mozambique

• The Nelson Mandela Children’s Fund (NMCF), South Africa

• The Child Protection Network, Swaziland

• The Family AIDS Caring Trust (FACT), ZimbabweACKNOWLEDGEMENTS

EXECUTIVE SUMMARY

In 2002 the HSRC received funding from the Kellogg Foundation to develop and implement a 5-year intervention project on the care of orphans and vulnerable children (OVC) as well as households and communities coping with the care of affected children

in Botswana, South Africa and Zimbabwe The project comprises two components, firstly funding and technical assistance directed at interventions to assist OVC, and secondly research to develop a better understanding of the situation of OVC and towards the development of best practice approaches for interventions

The establishment of clear base values and principles of working with the target community is fundamental to the establishment of congruent intervention strategies These are often hidden assumptions in the work that we do, but appear as the intervention develops By adopting a shared set of values and principles the project should be able to offer a more congruent set of services and interventions

The organisations participating in the study are:

• Masiela Trust Fund (MTF) in Botswana;

• Non-Governmental Organisations Coalition on the Rights of the Child (NGOC) in Lesotho;

• Foundation for Community Development (FDC) in Mozambique;

• Nelson Mandela Children’s Fund (NMCF) in South Africa;

• Committee on OVC in the Ministry of Education in Swaziland;

• Family AIDS Caring Trust (FACT) in Zimbabwe

Two sets of documents were drawn from each of the participating organisations

Additional materials were drawn from the discussions at a previous workshop on best practice approaches in Mutare

Key themes that were raised as part of the agreed values and principles included:

• The needs and rights of children should be a core focus of work

• The need to look beyond orphans in all contexts that put children at risk was highlighted

• All the grant makers should take a child-centered approach for their OVC programme

• The grant makers should oppose discrimination in any form Social justice is implicit

as a value in every intervention

• Gender sensitivity is an area of social justice that requires particular attention

• Core to all work and interventions has to be a respect for the community

• Interventions should be based within communities, preferably using resources from within

• It is of central importance to get community members involved in both the development and ongoing functioning of the interventions

• Use and prioritisation of indigenous knowledge is required

• The realities of the lives of community members in the context of their communities need to be acknowledged and respected

• Respect for the dignity of individuals is crucial

• All services, interventions, interactions and decisions should reflect compassionand care

• Sustainability is a core ideal for all projects, for funders, intervention agents and those receiving services

• Interventions should be holistic and at multiple levels

• Accountability, transparency and integrity are key

• Best use must be made of resources and there must be professionalism in delivery

For the second portion of the document specific processes need to be considered when making decisions about which interventions they would support either with financial or technical assistance A similar structure would be used for the evaluation of interventions developed internally and those developed externally, with some obvious variations for those proposals developed internally A structured approach is required

Some crucial capacity indicators included:

• Project management capacity;

• Financial management capacity;

• Technical knowledge in the intervention areas;

CHAPTER 1

Introduction

The current situation of children in sub-Saharan Africa requires the development of powerful and effective solutions The HIV/AIDS epidemic and the number of orphans and vulnerable children is increasing the problems faced by children The prevalence of HIV/AIDS in sub-Saharan Africa is estimated at 25.4 million infected persons at the end of

2004 (UNAIDS, 2005) According to a national population-based survey for South Africa

in 2002, 3% of 2–14 year olds had lost a mother, and 8.4% had lost a father (Shisana and Simbayi, 2002) This would not be exclusively due to HIV/AIDS, but the disease is the major contributor to the high percentage of parental loss Internationally the figures are also extremely high: it is projected that by the year 2010, 25 million children under the age of 15 years are likely to be orphaned world wide (UNICEF, 2005)

Vulnerability is not limited to orphanhood While HIV/AIDS is not responsible for all of the problems listed below, the epidemic has certainly contributed to their severity (Andrews, Skinner and Zuma, 2005) The situations that make children vulnerable go beyond the loss

of their parents to include children who are affected in the following ways:

• Material problems include access to money, food, clothing, shelter, health care and education

• Emotional problems include the lack of experiencing care, love, support, time to grieve and having to contain emotions

• Social problems include the lack of supportive peer groups, of role models to follow,

of guidance in difficult situations, stigma, and risks in the immediate environment

(Skinner et al., 2004)

It is clear from the magnitude of the problems faced that particular efforts and attention are required With the complexity of the problems and the need to mobilise large-scale resources, there is a danger that these resources may be abused or the groups identified could be stigmatised Already the identification of the children as vulnerable has lead to stigmatisation, both in communities and among policy makers and academic researchers

The money made available also opens the space for people to establish organisations

to take advantage of these resources, and there is the risk of poorly constructed interventions being established and financed Part of the checks on this is a clearly established set of values, principles and criteria for supporting interventions It was out of the need for standardising and understanding this process that this report originated

The establishment of clear base values and principles for working with the target group

of OVC is fundamental to the establishment of congruent intervention strategies These are often hidden assumptions in the work that we do, but appear as the intervention develops By adopting a shared set of values and principles, the project should be able to offer a more congruent set of services and interventions All the organisations participating in this project looking at providing care for OVC have a set of values that guide their work Outlines of these are provided in the appendices

The values and principles of an organisation are the set of beliefs to guide the work and behaviour of the organisation and its members While these are fundamental and all people live by a set of such beliefs, for a project such as this OVC one, there are benefits

in coming to a common agreement on these principles and elucidating them further

Inevitably there is considerable overlap as these values and principles are listed and they

do tend to feed into one another

Supporting OVC in southern Africa: values, principles & organisational issues

2

To develop a better understanding of the process of decision making when allocating resources and assistance for the implementation of projects and interventions, this paper compares these practices of all the grant-maker organisations from the countries participating in the WK Kellogg Foundation (WKKF) OVC project The two criteria looked at were the values and principles of the six grant makers in the project, and their decision-making processes and criteria used when deciding on a project to support There is very little material on the guidance of values and principles in the published scientific literature This is a separate discussion to that of ethics, which has received more coverage Many of principles will overlap, such as attention to patient autonomy, informed consent and beneficence (O’Hare, 2003) Core to both sets of principles

is respect for the patient or the recipients of services (O’Hare, 2003; Cimino, 2003) Another basic principle that has emerged is the importance of the cost effectiveness

of standardised interventions, which has in turn raised concerns about the interaction between cost and quality of care (American Academy of Pediatrics, 2001) Another response to the standardised interventions is a growing recognition of the need for adaptive interventions that allow for treatment or intervention components to be adapted

to the patient/recipient or context (Collins, Murphy and Bierman, 2004)

Background to the project

In 2002 the HSRC received funding from the Kellogg Foundation to develop and implement a 5-year intervention project on the care of OVC, as well as households and communities coping with the care of affected children in Botswana, South Africa and Zimbabwe The project comprises two components, firstly funding and technical assistance directed at interventions to assist OVC, and secondly research to develop

a better understanding of the situation of OVC and towards the development of best practice approaches for interventions The HSRC is collaborating with research institutions

in Zimbabwe and Botswana, and with non-governmental organisations (NGOs) that would act as implementing partners for the interventions In South Africa the Nelson Mandela Children’s Fund (NMCF) was chosen to work with the HSRC as an

implementing partner

As an implementing partner, the NMCF will work with and direct project funding to various community-based organisations (CBOs) and faith-based organisations (FBOs) in the intervention areas to deliver necessary services to those who need them The project will also work in partnership with all levels of government in each country as well as with the local communities at the various sites to ensure that the intervention programmes continue after the project officially ends in December 2006

The ultimate goals of the project are to develop, implement and evaluate some existing and/or new OVC intervention programmes, in order to:

• Improve the social conditions, health, development, and quality of life of vulnerable children and orphans;

• Support families and households coping with an increased burden of care for affected and vulnerable children;

• Strengthen community-based support systems as an indirect means of assisting vulnerable children;

• Build capacity in community-based systems for sustaining care and support to vulnerable children and households, over the long term

The original structure of the OVC project included the countries of Botswana, South Africa and Zimbabwe In each country there are two partners, focusing on research and intervention This has subsequently been extended to Lesotho, Mozambique and Swaziland, although the focus in the latter three countries is more directly on intervention

The list of grant makers and intervention leaders are provided in Table 1 below

Table 1: List of grant makers involved in the WK Kellogg Foundation Project for Orphaned and Vulnerable Children

Botswana Masiela Trust Fund (MTF)

Lesotho Non-Governmental Organisations Coalition on the rights of the Child (NGOC)

Mozambique Foundation for Community Development (FDC)

South Africa Nelson Mandela Children’s Fund (NMCF)

Swaziland Committee on OVC in the Ministry of Education

Zimbabwe Family AIDS Caring Trust (FACT)

Methodology

The information used in this report was drawn from two particular sources The first was discussions held at a workshop directed towards the development of best practice approaches held in Mutare, Zimbabwe in August 2004 There was no formal process at the workshop for drawing out the common values, but during the discussions on best practice approaches for caring for OVC these values and principles emerged from the discussion After the workshop they were captured into a single document that formed part of the basis for this report

The second component of the methodology was an analysis of the values and principles, and selection processes and selection criteria for deciding on which intervention projects

to support, of all of the grant-maker structures in the project The principal author requested this information from all the grant makers, and details were forwarded The team working in Swaziland did not feel able to advance a specific set of documents outlining their values and principles and selection critieria at the time of writing this report, as the intervention partners were still being drawn together However, those working on the project agreed with the principles outlined The values and principles submitted are all outlined in Appendix 1, and the decision-making processes and criteria used when deciding on a project to support can be found in Appendix 2 The information on values and principles and on selection processes used was integrated using a content analysis method References are made to documents from the grant makers where useful and illustrative of the points needing to be made

The analysis is divided into two phases: firstly, an account of the values and principles held in common within the project; and secondly, an account of the decision-making processes of the different grant makers, including additional factors that are considered

at this point over and above the values and principles This document was distributed for review among all the partners in the project for comment A process of editing and review was used to generate the final version Particular effort was made to obtain critical comments and agreement from all the grant-maker structures, by following up with all the grant makers until agreement was reached on the content

Free download from www.hsrcpress.ac.za

Agreed values and principles

The values and principles of the organisation were agreed to explicitly or implicitly by all the grant-maker organisations Any points specific to one organisation are listed as such

The points have been organised both regarding priority, and development of a narrative picture of the overall decision criteria

a secondary effect that may impact on the child’s rights It further implies that the needs

of the child must be the fundamental consideration in all interventions, even if the initial target is not the child itself, but its carers or a community structure

There needs to be preparedness for and a history of taking up issues and advocating children’s rights, especially around stigma and discrimination Education needs to be done in the community around current legislation that protects children, and advocacy needs to be done in the community to ensure that these rights are upheld Targeting key stakeholders such as educators, health workers, traditional leaders and religious leaders should be part of this direct intervention

The Nelson Mandela Children’s Fund illustrates this perspective:

…facilitate change through the work of societal norms and practices that force children to focus only on their basic needs The absence of hunger, abuse, exploitation and homelessness are basic conditions that all children should enjoy The programmes of the Nelson Mandela Children’s Fund’s partners should enhance the rights of children to reach their full potential; and promote best practice, encourage professionalism and be oriented towards achieving measurable results (See page 16 of this report.)

Need to look beyond orphans to look at all contexts that put children at risk

The focus should not only be on orphans, but on all vulnerable children This requires advance recognition of who and where these children are and planning to reach them

The report on the definition of vulnerability refined in the introduction to this report provides a starting point for identifying children

Poverty has a significant impact on children, particularly in concert with HIV\AIDS, and

is highly prevalent Eradication of poverty was a core issue for some organisations For example the FDC stated as their mission to ‘Strengthen the capacity of underprivileged communities to eradicate poverty and promote social justice in Mozambique.’ Key within this is the strengthening of the role and position of women and youth Further community

Supporting OVC in southern Africa: values, principles & organisational issues

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threats include child abuse, crime, violence, availability of drugs, gangs, poor housing and resources, lack of facilities etc All of these can increase children’s vulnerability, alone and

in conjunction with HIV\AIDS

HIV/AIDS prevention still requires specific attention Agreement existed about the need

to raise awareness about the causes, effects and prevention of HIV/AIDS infection; offer

a counselling and testing service to people infected with HIV and their families; and

to address the emotional, physical and spiritual needs of HIV-infected persons andtheir families

Child centred

All the grant makers recommended a child-centred approach for their OVC programmes, meaning that children need to be the core focus of the intervention work Partnerships with communities should empower and improve the well-being of children and youth This implies that the needs of the children should be considered before the other potential beneficiaries, and should be the focus of interventions Basic to this was the respect of the dignity of the child

Social justice

The grant makers should oppose discrimination in any form Social justice is implicit

as a value in every intervention This should include opposition to discrimination on the basis of gender, culture, ethnicity, age, physical capacity, religion, economic class, political party or social status People need to be accepted as individuals and as part of communities Where this discrimination exists, it should not be supported and advocacy against discrimination needs to be practised

Gender sensitivity

Gender sensitivity is a particular area of social justice that requires individual attention Sexism needs to be opposed and the rights of women and girl children enhanced Girl children are often particularly vulnerable in the contexts outlined in the introduction

to this report, particularly to sexual abuse and neglect So special emphasis needs

to be placed on protecting and providing the girl child with the opportunity for her development as a full member of society Having stated this, boy children are also victims

of sexual abuse, and this must not be ignored

Core values of respect, empowerment and consultation

Core to all work and interventions has to be a respect for the community This is fundamental to many of the other principles below and so will be represented in different forms under subsequent headings The community representatives and target group drawn into the intervention must be seen as whole people who need to be accorded full respect as thinking persons with emotions Respect as a person includes requesting permission to enter their community and work with them, consulting with the community representatives as to what they want within the constraints of the study, and involving them in the implementation of the work Respect also has to be shown to what is found

in their community context, culture and language The community representatives, OVC and their carers are not simply disadvantaged people who need us to be able to survive, and do not have to just accept with gratitude anything we want to implement in their communities

Regarding interventions, this principle means that consultation about any activities that take place and the use of interventions to empower community members are fundamental considerations that must be maintained at all stages of the work This does not mean that the fundamentals of the project should be changed on request, but that these constraints should be made known early and fully, and that open negotiation is held within these structures Control over interventions has to go eventually to the community members, who need to participate in making core decisions about what services get delivered, how often and how to provide them

Work should be done in solidarity and should aim at the reducing of dependency The knowledge required for the intervention, the resources used and the capacity generated should be shared with the communities, with the aim of strengthening communities, families and individuals Where possible, all resources that come into the community through the project should remain there

The power and capacity of the local NGOs and CBOs should be increased via the interventions By extension, the power and capacity of the entire community should

be enhanced by these processes Part of this extension of power and capacity is the provision of knowledge and technical skill These interventions should leverage the core competencies of stakeholders and mobilise resources to provide financial support to interventions enhancing community development and project sustainability

Community based

Interventions should be based within communities, preferably using resources from within This means working with the CBOs and FBOs that already exist in each community, or working with local representatives to develop these structures

Partnerships need to be used and developed between those in need and those with resources to ensure transfer of resources and the development of communities Working from a community basis is fundamental to the project being owned by the community, having a better understanding of what is needed and how best to deliver it, and to the intervention reaching as many people as possible

All community members should have access to the services Nobody should be precluded from services on the basis of distance from services, religion, ideology or political

affiliation

Community involvement

It is of core importance to get community members involved in both the development and ongoing functioning of the interventions This is important for incorporating local knowledge, generating community ownership, and extending the access of the intervention into the community

It is particularly important to incorporate the involvement of children Effective methods for involving children need to be attached to all interventions This involvement should

go beyond their participation as recipients of the service These involvements have to

be appropriate and should incorporate the children and youth taking responsibility for aspects of the intervention This includes giving specific platforms for children to express their own needs Children need to be empowered to protect and look after themselves

Supporting OVC in southern Africa: values, principles & organisational issues

8

Use and prioritisation of indigenous knowledge

Since the programmes target vulnerable communities, it is important to highlight the use and understandings of indigenous methods and their application in African families and communities A wealth of knowledge exists in Africa about care of children, families and communities, and the survival of disasters Indigenous knowledge should be applied by communities and accepted as part of good practice and be included in the comprehensive

or holistic approach These may interact with programmes guided by the knowledge from other parts of the world as part of developing a comprehensive system

Role of volunteers and/or community workers

A particular discussion was held at the Mutare workshop, but did not achieve full resolution, on the use of volunteers and/or community workers The major differences

of opinion centered on whether these workers should be paid Those in favour of payment felt that it was abusive not to pay people for work and that this was an effective method of moving resources into communities The need for payment was emphasised

in situations where the volunteer work actually cost the volunteer, for example, paying for transport or for food for a person they are assisting A counter perspective was that this would break the volunteer spirit, and that people would take on the roles for money rather than out of a commitment to the issue and this would create employment issues Organisations using volunteers also have to be careful not to exploit their volunteers and expect them to work beyond the hours that they can reasonably afford, given their other responsibilities and work

Respect of context

The community members live their lives in the context of their communities The realities

of their lives need to be acknowledged and respected Aspects of context include lifestyle, culture and cultural tradition, language, social systems, values, religion, and the physical structure of the community and surroundings This does not mean that situations that induce risk or vulnerability cannot be challenged

Cultural processes of care are important, particularly in the context of OVC There is general recognition of the power of the extended family in Africa and the capacity of this structure to absorb a large number of additional children This should constitute a focus for intervention Culture can however be confronted on crucial issues, for example, inheritance rights that rob children of their property, unequal position of women, rights of children etc

Respect for the dignity of individuals

The context in which people live and things that have happened to them, including illness and death of family members, should not rob them of the dignity and respect

of others Emotions, life prospects and a person’s vision for the future should not be compromised by the interventions implemented FACT takes a particular perspective in relation to people living with HIV They see their role as ‘To have empowered people living with HIV/AIDS (PWAs) and autonomous support groups involved in decision-making, advocacy and service provision at all levels of HIV/AIDS interventions.’

Compassion and care

All services, interventions, interactions and decisions should reflect compassion and care

on the part of the grant makers for difficulties faced by the communities that they serve This should not be translated into paternalism, which can in its own right be destructive

Sustainability

Sustainability is a core ideal for all projects, for funders, intervention agents and those receiving services, so this must be part of the aims of the interventions developed Core

to sustainability is the development of a sound financial and knowledge base It needs

to be recognised that many of the projects are unsustainable in the long term without outside support This applies particularly to service providers, structures that distribute resources or food, or those that have regular paid employees, including feeding schemes, crèches and home-based care support Some of these can and need to be supported by local government structures such as primary health care clinics Clear systems of support are needed to maintain interventions in the long term

Need to intervene holistically and at multiple levels

In most communities multiple problems exist so interventions are needed at multiple levels Multi-faceted problems need multi-faceted solutions with as many sectors as possible being involved A holistic response is required to create an environment conducive to the development of children This can create a synergy that will allow for greater changes to happen than just the resources put in

Accountability, transparency and integrity

Lines of accountability within the intervention and the organisation implementing the intervention need to be clear, both to the community and to the project leadership This will contribute to a project reaching its goal and ensuring that resources are not wasted or abused The grant makers are the custodians of people’s resources so have an obligation

to ensure that it is the wishes of the community that are delivered Community members should have open access to the functioning and decisions of the grant makers so that decisions and actions can be effectively examined and if necessary queried Integrity is also fundamental and implies that grant makers are trusted by the communities that they serve, and that this relationship of trust is crucial to the operations of the organisation

Best use must be made of resources and there must be professionalism in delivery

Decisions on programmes and how to implement them should be based on evidence of effectiveness rather than personality or ideology Established best practice approaches should be used where these are available and are applicable to the context There must also be an openness to new and creative ideas, especially those that can open and unleash individual and community potential

The interventions should make efficient use of resources and be as cost effective as possible Focus of services should be on those in greatest need and those who can best use the services

Where interventions work there needs to be the capacity and the will to contribute these

to policy frameworks at a broader level Thus community development and assistance to impoverished communities can happen beyond the site of immediate intervention

Religious focus

FACT draws on a religious framework, which is core to its operations In addition some

of the intervention structures within communities operate from a religious base Religious belief can be a solid basis for intervention, as long as it does not lead to exclusion

Included in FACT’s approach is a specific focus on ‘sexual abstinence outside marriage