This TBD mechanism is for a follow-on non-competitive CDC cooperative agreement with the Ministry of Family, Women, and Social Affairs (MFFAS) of Côte d'Ivoire (Mechanism #9650), which is responsible for planning, coordinating, monitoring, and evaluating care and support services for orphans and vulnerable children due to HIV/AIDS (OVC) through its National OVC Program (PNOEV), with support from the national technical advisory group on OVC (CEROS-EV). Over the past five years, the PNOEV has developed a multi-sector strategy built around social centers aimed at supporting OVC within family units and communities. PEPFAR funds have contributed to this effort by strengthening the capacities of the PNOEV and social centers. With financial and technical support from PEPFAR and technical support from Measure/Evaluation and FHI, the PNOEV has improved its monitoring and evaluation system by updating harmonized data collection tools, including the Child Status Index (CSI) and the elaboration of an OVC database at peripheral and central levels. It has also emphasized capacity building for social workers and community caregivers as well as community mobilization and advocacy for holistic OVC care and protection. Through these interventions, the PNOEV has coordinated care for 63,000 OVC (50,000 supported by PEPFAR), training for 2,000 social workers and caregivers, and support for 148 community-based organizations and 28 platforms since its inception.

Based on an assessment of a pilot in San Pedro, a restructured social center model (IRIS) was scaled up to 15 other sites (Abobo, Yopougon, Koumassi, Abengourou, Bondoukou, Korhogo, Dabakala, Gagnoa, Dimbokro, Daloa, Man, Bouaké, Agboville, Bouna, and Yamoussoukro). This decentralized and integrated coordination model provides a good referral system in support of a continuum of care for OVC and their families. In addition, the PNOEV and its partners developed an integrated strategy for empowering women and addressing other gender issues, including the vulnerability of adolescent female OVC, and conducted a study to better understand factors contributing to vulnerability.

To better coordinate the national response, the PNOEV has developed a collaboration framework with technical ministries (Education, Vocational and Technical Training, Sports and Youth, Justice) and NGOs to address the educational needs of OVC ages 16-18. In collaboration with MFFAS technical units (including the Direction of Family Promotion and Socio-Economic Activities (DPFASE), Social Protection (DPS), Gender (DPEG), Documentation and Planning (DPD), and Disabled People (DPPH)), the PNOEV has developed a national guide for income-generating activities (IGA) for vulnerable people, including OVC and their families. The PNOEV is also establishing close working relationships with the Direction of Social Protection, which is responsible for OVC due to causes other than HIV, in order to maximize synergies between the two programs. To address gender issues, the PNOEV is developing strong links with the Direction of Gender Promotion and supporting ongoing reflections on gender issues in HIV/AIDS committees.

Advocacy to reduce discrimination and stigma toward OVC will be strengthened through promotion of individual behavior and social change communication and continuation of the media campaign advocating for human rights of vulnerable children, in accordance with the National OVC Strategic Plan. Johns Hopkins Center for Communication Programs and UNICEF are assisting this effort, and strategies include working through community support groups; rapid and cost-effective coverage in sites by deploying community animators using a coordinated team of local taxies with posters, sound systems and other materials; and targeting a variety of subgroups (chiefs, elders, parent substitutes, women's and youth associations, religious leaders, etc.) to strengthen community dialogue. In these sessions, a particular emphasis will be placed on the importance of registering children for official documents, the reduction of intergenerational and transactional sex, male norms, exploitation and abuse of vulnerable children, equitable access to girls' and boys' education, and the importance of women's and children's inheritance rights. The PNOEV will emphasize the promotion of children's rights and the effective participation and leadership of children in OVC activities. The PNOEV will advocate with the Ministry of Justice to facilitate access to legal support for women and children in the case of rights abuses.

To improve the quality of OVC care, in 2008 and 2009 standards for the quality of services regarding nutrition, health, education, psychosocial support, shelter, protection and economic strengthening support were developed with the assistance of URC, and technical and financial support from PEPFAR. In 2010, an intensive pilot in four sites (San Pedro, Bouake, Yamoussoukro, and Yopougon) will continue and be evaluated to inform the scale-up strategy, adaptation of national monitoring tools and refine practices related to implementing the standards. In order to involve all social workers and community caregivers in OVC care, the PNOEV will collaborate with SSDS and JHPIEGO to evaluate and support use of OVC modules that were integrated in the training curricula of health and social workers schools (INFS, INJS, INIPA, and INFAS) in 2008 and 2009. In addition, with support from PATH and AED/FANTA 2, existing training modules will be updated based on a new OVC nutritional care manual, and national OVC trainers will be trained in nutritional care and support.

With technical support from PEPFAR and Measure Evaluation, the PNOEV will work to improve the national M&E system, including working with UNICEF and other partners intervening in OVC care to compile quality data for the national OVC database. The PNOEV will develop a data quality-assurance strategy that will seek to provide OVC partners with the information they need for decision-making and will include partner capacity building for quality assurance regarding both services and data, with post-training coaching and monitoring to ensure expected results. Adapted national monitoring and assessment tools integrating the Child Status Index are being tested to determine their feasibility in providing data to analyze quality of services delivered and outcomes for individual children. PNOEV and other ministry staff, along with M&E focal points of social centers, community organizations, and partner organizations, will continue to benefit from capacity building and technical assistance in M&E, with support from PEPFAR, the Ministry of Health division of information, planning and evaluation, and Measure Evaluation (including for the elaboration of the OVC database and GIS mapping at central and decentralized levels).

Activities contribute to the key issues of child survival, through health, nutritional, social, and educational monitoring and support of infants and children by government social centers; family planning, through FP counseling during individual and group sessions at the social centers; increasing women's legal rights and protection, through promotion of the rights of OVC and their families, with an emphasis on girls and women; increasing gender equity, by working to improve access to basic social services for girls and the disabled, in collaboration with the Direction of Promotion of Gender Equity (DEPG); and increasing women's access to income and productive resources, through advocacy for income generating activities for OVC families and their communities, particularly women's associations.

None

The National Program for Orphans and Vulnerable Children (PNOEV), under the Ministry of Family, Women, and Social Affairs (MFFAS), is responsible for planning, coordinating, monitoring, and evaluating care and support services for orphans and vulnerable children due to HIV/AIDS (OVC) in Côte d'Ivoire. HIV prevention activities are included as part of the package of health and psycho-social support services available for OVC. In FY 2010, the USG team is adding prevention of sexual transmission funding to help the PNOEV to 1) engage parents to reinforce HIV prevention outcomes and 2) respond to the needs of victims of violence who access services through MFFAS social centers. The PNOEV will continue to participate with other ministries and partners in promoting abstinence and life skills for children ages 10-14, as well as integrating HIV prevention with sexual reproductive health and life skills among older adolescents.

In FY 2010, AB prevention strategies will be implemented through the following key activities:

Coordinate capacity building interventions for 300 parents and guardians of OVC through the Families Matter program, which will serve to improve communication between parents and children.

Integrate HIV prevention information and counseling with existing ministry needs assessment tools and include referral for post-exposure prophylaxis for victims of sexual violence through social centers and through centers of specialized social services and education that provide more advanced services.

Coordinate to ensure complementary geographic coverage and a national approach to training service providers in social centers and socio-educative centers to implement new integrated HIV prevention, counseling, and referral services.

In implementing these strategies, the PNOEV will work in collaboration with other divisions within MFFAS, the Ministry of AIDS (MLS), the Ministry of National Education (MEN), the Ministry of Health and Public Hygiene (MSHP) through the National HIV/AIDS Care and Treatment Program (PNPEC), the Ministry of Youth and Sports (MJS), UNFPA, UNICEF, and other PEPFAR technical partners strengthening or implementing HIV prevention with vulnerable male and female youth and parents.