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 CHILD PROTECTION NETWORK NON-GOVERNMENTAL ORGANISATIONS COALITION ON THE RIGHTS OF THE CHILD Free download from www.hsrcpress.ac.za Published by HSRC Press Private Bag X9182, Cape Town, 8000, South Africa www.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 2006 All 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. ISBN 0-7969-2142-3 Production management by comPress Distributed in Africa by Blue Weaver PO Box 30370, Tokai, Cape Town, 7966, South Africa Tel: +27 (0) 21 701 4477 Fax: +27 (0) 21 701 7302 email: orders@blueweaver.co.za www.oneworldbooks.com Distributed in Europe and the United Kingdom by Eurospan Distribution Services (EDS) 3 Henrietta Street, Covent Garden, London, WC2E 8LU, United Kingdom Tel: +44 (0) 20 7240 0856 Fax: +44 (0) 20 7379 0609 email: orders@edspubs.co.uk www.eurospanonline.com Distributed in North America by Independent Publishers Group (IPG) Order Department, 814 North Franklin Street, Chicago, IL 60610, USA Call toll-free: (800) 888 4741 All other enquiries: +1 (312) 337 0747 Fax: +1 (312) 337 5985 email: frontdesk@ipgbook.com www.ipgbook.com Free download from www.hsrcpress.ac.za CONTENTS Acknowledgements v Executive Summary vi Chapter 1: Introduction 1 Background to the project 2 Methodology 3 Chapter 2: Results 5 Agreed values and principles 5 Decision-making processes and criteria 10 Conclusion 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 References 25 Free download from www.hsrcpress.ac.za iv We would like to thank the WK Kellogg Foundation for providing the funding for the 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), Zimbabwe ACKNOWLEDGEMENTS Free download from www.hsrcpress.ac.za v 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 compassion and 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. Free download from www.hsrcpress.ac.za vi 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; • Community participation. Supporting OVC in southern Africa: values, principles & organisational issues Free download from www.hsrcpress.ac.za 1 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. Free download from www.hsrcpress.ac.za Supporting OVC in southern Africa: values, principles & organisational issues 2 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. Free download from www.hsrcpress.ac.za 3 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. Chapter 1 Free download from www.hsrcpress.ac.za Free download from www.hsrcpress.ac.za [...]... Fund and its implementing agencies provide interventions geared towards meeting the needs of orphans and vulnerable children which translates into: • Material support in the form of food and clothing; • Social support (counselling and psychosocial support) ; • Technical expertise and financial resources to strengthen family, community and national capacities in the care of orphans and vulnerable children, ... approaches; To have FACT advocating for and with communities responding to HIV/AIDS at local and international level; 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; To have autonomous, dynamic, sustainable CBOs and NGOs working with communities to provide integrated,... development and quality of life of orphans and vulnerable children and youth; • Strengthen families and households to cope; • Strengthen Community Support Systems to sustain care and support to vulnerable children, youth, households over the long term; • Build HIV/AIDS awareness, advocacy and policy to benefit orphans and vulnerable children; • Strengthen local government and traditional leadership to sustain... currently working in that area; • established systems and tools for programme planning, implementation and monitoring; • an ability to document and report on work adequately and timeously Financial Management Capacity The organisation driving the intervention must have an established financial accounting system and must have dedicated staff for financial monitoring and reporting Technical Knowledge In terms... 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 7 Supporting OVC in southern Africa: values, principles & organisational issues Use and prioritisation of indigenous... issues and the impact of HIV/AIDS on children; • Have experience in implementing programmes of HIV/AIDS; 21 Supporting OVC in southern Africa: values, principles & organisational issues • • • Be currently engaged in development work that falls within HIV/AIDS area and currently working in that area; Established systems and tools for programme planning, implementation and monitoring; Ability to document and. .. • To promote meaningful participation of children in decisions affecting them and responsibilities thereof; • To advocate for the production and service provision of children in all areas of their need; • To enable the improvement of NGOC members’ development practice and capacity through learning, information exchange, support, training and monitoring; • To provide a forum and mechanisms for networking... teachers and help other school children to become aware of how children affected by HIV might feel Target support to vulnerable households and children • In areas where the majority of families are living in poverty, targeting assistance to children affected by HIV/AIDS can cause resentment and increase stigmatisation of these children Help children and caregivers to cope with stigma and discrimination... report adequately and timeously Financial management capacity • Established financial accounting systems; • Dedicated staff for financial monitoring and reporting Technical knowledge • Capacity to provide basic services to OVC, families and households; • Ability to adopt and apply new approaches to OVC programmes; • Demonstrate knowledge and understanding in OVC programming and care; • Have minimum research... have target groupings beyond OVC In the same vein there should be a good understanding of the HIV/AIDS epidemic and its impact on communities and particularly children Experience both in working with children and with HIV/AIDS is an important consideration 11 Supporting OVC in southern Africa: values, principles & organisational issues Some of the grant makers demand that the intervening organisation, . Working to support orphans and vulnerable children in southern Africa A reflection on values, principles and organisational issues Donald Skinner,. learning, information exchange, support, training and monitoring; • To provide a forum and mechanisms for networking amongst NGOC members and other likeminded