With funds reprogrammed in April 2009, Save will support OVC services delivered by subpartners in

additional geographic zones. The funding will permit Save to provide care and support for a total of 9,300

OVC by September 2010.

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

• The total number of OVC supported will increase to 7,500.

• Livelihoods activities for the most vulnerable OVC and their families will provide economic strengthening.

• Community gardens will mobilize community members' commitment to caring for and supporting OVC and

will also improve the nutritional status of OVC.

• The project will increasingly emphasize a focus on OVC in a family/household context rather than focusing

only on the child.

COMPLETE COP09 NARRATIVE:

This activity builds upon and extends FY07 and FY08 activities that aim to provide better health, social

protection, and education services for OVC in western and northwestern regions of Côte d'Ivoire that were

severely affected by the country's politico-military crisis and remain largely without functioning government

services or with severely limited government services.

With FY08 funding, Save the Children UK Cote d'Ivoire is working to build capacity of six local partner

organizations (four of which were also supported with FY07 funding) to link communities to available

services, train 120 community caregivers and 200 government service providers, and provide direct care for

5,000 OVC in and around Toulepleu, Bloléquin, Guiglo, Duékoué, Man, and Odienné by September 2009.

Specific intervention sites around these towns are selected in consultation with local NGOs, service

providers, and the National OVC Program (PNOEV) to ensure that the project reaches the most

underserved zones.

With FY09 funding, Save will reinforce FY08 activities and expand them to additional villages, especially

around Odienné (far Northwest), filling significant gaps in national OVC coverage. The project will provide

direct care for at least 7,500 OVC by September 2010. Save will also, in collaboration with the

PNOEV/MFFAS and UNICEF, work to strengthen the capacity of the social centers in Guiglo, Duékoué,

Man, and Odienné (if the social center in Odienné reopens) through material and technical support.

With the gradual return of government services to zones previously controlled by the Forces Nouvelles,

Save will ensure that project activities are well-coordinated with relevant social-service structures and the

PNOEV to ensure that activities contribute to national strategies and objectives. Save will participate in

relevant technical working groups and will work in coordination with other PEPFAR partners and other

donors to avoid duplication and maximize synergies. The PNOEV-led OVC platforms will be especially

important for this coordination, and Save will be an active, integral member of platforms. Project activities

will also complement Save's non-PEPFAR-funded work in education, child protection, and health in western

and northwestern Côte d'Ivoire, which includes the rehabilitation of school facilities, training for health

workers and teachers, community gardens for malnourished children, sexual and reproductive health

awareness-raising, the creation of referral pathways to services for victims of abuse, and support for

vulnerable youth, including child victims of sexual exploitation and abuse.

Save will implement a multi-tiered approach designed to assist OVC individually and at the systems level

by:

• providing core priority services to the children;

• supporting the families of extremely impoverished children through livelihoods activities;

• training and supporting community caregivers who will monitor children's progress and refer them to

appropriate services;

• enhancing community commitment to caring for and supporting OVC; and

• strengthening health, social protection, and education systems that provide services to OVC.

At the service-delivery level, Save will train community caregivers to identify OVC due to HIV/AIDS, assess

their needs using the Child Status Index, provide regular home visits, refer OVC to appropriate support

mechanisms, and monitor their well-being. Community caregivers will serve as essential links between

Save, local partner organizations, service providers, and the children. These caregivers will be selected by

the communities - with input from vulnerable children - and will receive a monthly stipend for their work. By

September 2009, there will be 150 caregivers directly supporting OVC, an increase from 70 who were

working at the end of September 2008.

Training will be conducted in collaboration with the PNOEV and will use nationally approved materials and

trainers. Follow-up visit forms and additional monitoring mechanisms will also follow national-level guidance.

Caregivers will link to and be supervised by six local partner NGOs that will ensure proper follow-up of

referrals. Through trainings and work sessions, the project will link these local partner organizations to state

services so that referrals occur smoothly and in the best interests of the children.

Community caregivers will identify OVC in a variety of ways, including:

• Direct identification in the community, in consultation with community leaders and village-level

associations;

• Links with HIV counseling and testing centers, ART sites, TB sites, and hospitals (some of the local

partners already run CT centers and ART sites);Identification in schools; andIdentification through social

centers.

After assessing children's needs, caregivers will focus on ensuring that OVC receive four of the seven core

OVC services, as needed: health care, protection, psychosocial support, and education. Save will also

Activity Narrative: pursue wraparound nutritional support from the World Food Program for cases in which families are

extremely impoverished. An activity piloted in FY08 will provide economic strengthening for 150 extremely

vulnerable households, who will receive income-generating training and start-up kits. Save will follow

PNOEV guidance on implementing IGAs and draw upon its own experience of having provided such

activities to more than 1,000 children. The monitoring and evaluation officer will support local partners to put

in place monitoring systems to ensure that the activities become sustainable livelihoods activities for the

families. Save intends to pilot the activity with 100 families by the end of FY08 and expand to another 150

families, for a total of 250 families by the end of FY09.

Another new activity will seek to enhance community commitment to care and support for OVC while

improving their nutritional status. In consultation with the PNOEV, Save will support community gardens that

will provide nutritious fruits and vegetables to OVC while creating an activity around which community

members can coalesce to support those most vulnerable among them. Collaborating with FAO, Save has

piloted these gardens as part of its health program and has found them to be a low-cost, locally sustainable

solution for improving the nutritional status of vulnerable children and pregnant women. Communities are

able to make a profit through the sale of a portion of the fruits and vegetables they grow while dedicating the

remainder to children exhibiting malnutrition. Save intends to approach both FAO and IYCN/PATH to

identify best practices in community gardening and to implement this activity in several project sites. Save

will also explore collaboration possibilities with the rural development agency ANADER to take forward both

the IGAs and the community gardens.

1. Health care - Save's local partners and community caregivers will link OVC with appropriate health

services. Save will oversee coordination between these partners and health centers to ensure smooth

referrals. Save will train health-care personnel on working with vulnerable children and will provide essential

drugs free to OVC. The project will also advocate (in collaboration with the PNOEV and PNPEC) with the

Ministry of Health to abolish user fees for OVC, building upon Save's ongoing work to abolish user fees for

pregnant women and children under age 5. The project will support vaccination campaigns, in collaboration

with the national vaccination program, for OVC who are at least 1 year old. Save will encourage HIV testing

for children of HIV-positive parents (as well as for all family members of HIV-positive children) and will

ensure appropriate referrals, including for ART, and follow-up.

2. Protection - Working in zones with large immigrant populations and highly mobile populations, Save will

collaborate with the PNOEV, mayors or other local structures, social centers, the Norwegian Refugee

Council, and the International Organization for Migration to establish identity papers for children up to 13

years old. Save will train local partners and community caregivers to identify and report cases of child

abuse, especially sexual abuse. Save will also encourage local partners and community caregivers to

sensitize their communities about acceptance and support of OVC. Community caregivers' regular home

visits will also serve as a protective factor for OVC. During home visits, caregivers will assess not only the

status of the OVC themselves but also the general status of the family; families identified as extremely

vulnerable (including child-headed households) will be referred for economic strengthening. All people

involved with the project - government actors, local partners, community caregivers, OVC - will engage

with Save the Children UK's Child Protection Policy, which seeks to minimize protection risks for children.

3. Psychosocial support - Social workers, local partners, and community caregivers will receive training in

listening skills and other basic psychosocial support mechanisms. They will provide support through needs

assessments, referrals and follow-up, and regular home visits. Psychosocial support will be targeted to the

entire family and may include such activities as inheritance planning and memory books. Caregivers will

also organize recreational activities to promote the social integration of OVC.

4. Education - Save will advocate with the Ministry of Education (MEN) to ensure that all school-age OVC

have access to school. The project will support the MEN's initiative to incorporate HIV/AIDS awareness and

prevention into the national curriculum by training teachers and education authorities on the use of the

MEN's life-skills materials. Save will also include teachers in trainings about non-discrimination and

psychosocial support for OVC. Save will support teachers' associations for HIV-related awareness-raising

activities. Save will work with school management committees to create innovative, locally sustainable

solutions to ensure that OVC are able to access school.

Community caregivers will also conduct age-appropriate, village-level HIV-prevention activities for project

beneficiaries and other at-risk community members. The caregivers will receive training in behavior change

communication and awareness-raising methodologies, and they will work with OVC to develop key

messages. Save will also create linkages between project beneficiaries and local media so that OVC are

able to speak to local populations about the special needs of OVC, non-discrimination, and HIV prevention.

To build sustainability, a crucial element of the project will be to strengthen the capacity of the ministries of

Health, Education, and Family, Women, and Social Affairs (MFFAS, which houses the PNOEV) to provide

needed services. By September 2009, the project will have trained 240 service providers representing these

ministries in identifying OVC, working with vulnerable children, providing psychosocial support, and

improving social inclusion of OVC. Of these providers, 80 will be "focal points" tasked with case

management of referrals. Save will collaborate with Care International and the PNOEV to coordinate

trainings.

Project staff will train staff at social centers in Guiglo, Duékoué, Man, Bangolo, and Odienné in care and

support to OVC following PNOEV guidance. Save will also contribute (with FHI and the PNOEV) to an OVC

situational analysis and will support the social centers' efforts to put in place OVC collaboration platforms to

streamline case management and ensure maximum coverage of the coordinated efforts of government and

civil society actors. Save will work with health centers near project sites, creating referral networks so that

OVC are able to access health care in a confidential, child-friendly way.

More specific support to ministries will include:

• Material and technical support to the five social centers to ensure proper follow-up of cases referred to

Activity Narrative: them and to support the creation and running of collaborative coordination platforms; the material support

will not take the form of salaries or incentives but will be decided in collaboration with the social centers

based upon their most pressing needs;

• Assistance to the national vaccination program;

• Provision of essential drugs, in collaboration with PNOEV, PNPEC, and UNICEF, for OVC to the Ministry

of Health; and

• Training assistance to the MEN.

The six local partner NGOs will form a crucial link between community caregivers and state service

providers. The partner NGOs will, for example, serve as the reference to health care providers for OVC

needing medical support. These partners will also advocate with regional MEN officials for all OVC to be in

school and will follow up the legal processes for OVC lacking birth certificates. They will be required to

participate actively, along with Save, in supporting PNOEV-led platforms. They will be selected using a

process that Save has developed for assessing local partners' capacity in eight domains of organizational

management. Although Save does not currently use a sub-granting system, the project will work with local

partners to identify in-kind and technical support that will help them to develop their capacities. Areas for

support are likely to include capacity building on issues related to OVC (identification, psychosocial support,

casework, and others); in-kind support for managing their offices; training support on financial management,

procurement, and logistics; training support for fund raising; and material and technical support for

monitoring and evaluation. Save will also assist the NGOs to build their capacity to supervise the community

caregivers.

New/Continuing Activity: Continuing Activity

Continuing Activity: 15157

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

15157 12217.08 U.S. Agency for Save the Children 7063 6123.08 Save the $900,000

International UK Children UK

Development

12217 12217.07 U.S. Agency for Save the Children 6123 6123.07 Save the $600,000

International UK Children UK

Development

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's access to income and productive resources

* Increasing women's legal rights

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

Refugees/Internally Displaced Persons

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $78,800

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Estimated amount of funding that is planned for Economic Strengthening $30,000

Education

Water

Estimated amount of funding that is planned for Water $25,000

Table 3.3.13: