Positive Change: Children, Communities and Care (PC3)

This is an ongoing activity from FY05. This activity is linked to Food Support for PLWHA (#5774), OVC Food Support (#5744), Scale Up Hope (#5578), IOCC HIV/AIDS Response Mechanisms Project (#5593), Care and Support for PLWHA (#5734), To date, SCUSA has received 100% of FY06 funding and the activity is on schedule per the workplan. FY06 Accomplishments: The umbrella Cooperative Agreement, called Positive Change: Children, Communities and Care (PC3), was awarded in September 2004 to Save the Children USG (SCUSA) as prime recipient, with CARE, Family Health International (FHI), Hope for African Children Initiative (HACI), World Learning and World Vision as key partners. During the first half of FY 2006, PC3 partners have reached 40% of the annual target (39,940 OVC), and expect accelerated implementation in the second half of the year to reach the FY06 targets. PC3 has nearly national coverage, working in eight of the nine regions. Fully 75% of PC3 funds are utilized for CBO and FBO capacity building and sub-grants. This has facilitated increased capacity of Ethiopian CBO and FBO to provide care and support services to OVC and their families. A partnership with Coca Cola has initiated engagement with the private sector to enhance youth livelihood options for older OVC. Several operations manuals have been developed to achieve increased consistency of effort among PC3 partners. These materials will be broadly shared with other PEPFAR Ethiopia OVC programs to reduce duplication of effort.

FY07 Plan: As the largest PEPFAR Ethiopia supported OVC activity in Ethiopia, this activity sets the tone and the pace for all USG OVC programming. During FY07, this activity will increase collaboration and coordination with the full range of PEPFAR HIV/AIDS services to demonstrate effective referrals and follow-up to ensure continuum care in HIV/AIDS prevention, care, and treatment. PC3 and its five prime partners will collaborate with the following 30 seasoned Ethiopian NGOs that will in turn mentor an estimated 600 CBO and FBO (500 current and 100 additional). SCUSA: Pro Pride, Mekdem Ethiopia - works in four different operational areas, Yeteem Children and Destitute Mothers Fund, Nazareth Children Integrated Development Ethiopia, Evangelical Church Mekane Yesus, and PTA. CARE Ethiopia: Ethiopian Women Lawyers Association (EWLA), Organization for Social Support for AIDS (OSSA) - works in two different operational areas, Hope for Children (HFC), Ethiopian Evangelical church Mekaneyesus Central Synod, Mekdem Ethiopia National Association - works in four different operational areas, Tesfa social and Development Association, Love for Children, Dawn of Hope Association, Family Health International: Hiwot HIV/AIDS Prevention Care and Support Organization (HAPCSO), Beza Lehiwot Ethiopia, Ethiopian Kalehiwot Church, Wogen Aden Ethiopia, Organization for Social Services - Amhara - works in two different operational areas World Vision International: Abebech Gobena, Ethiopian Evangelical Church Mekaneyesus Central Synod, Ethiopian Muluwongel Church, Mary Joy HACI: Action for Self-Reliance, Children Aid Ethiopia, Education for Development Maedot, Meserete Kirstos Church RDA, Progynist, Society for Women and AIDS. The goal is to reach a minimum of 150,000 OVC in 300 communities. The partner agency, HACI, through a small grants fund, will continue funding to CBO and FBO to enhance OVC service provision at the community level. Whenever possible, OVC programs will be located within ART health networks and link to other PEPFAR Ethiopia programs.

This activity has a commitment to strengthen the community capacity to undertake long-term, child-friendly interventions. OVC-focused interventions will support: (1) Provision of "school kits," including uniforms, book packs, and school supplies to enable OVC to attend school; (2) Provision of livelihood-enhancing skills training to out-of-school OVC; (3) Formation of community-managed savings and credit groups and linkages to micro-credit; (4) Provision of group and individual psychosocial counseling; (5) Provision of legal aid to protect property rights and protect individuals from abuse; (6) Provision of life skills to youth for making healthy life choices; (7) Development of oversight mechanisms to ensure that OVC are served by health facilities and assisted in referrals to VCT and PMTCT services; (8) Promotion of household-centered preventive practices and treatment seeking behavior

for common childhood illnesses; and (9) Protection of young girls from sexual exploitation.

Building upon the experiences of USAID's Basic Education Strategic Objective (BESO) project, activity partner World Learning will continue to support 200 Parent-Teacher Associations (PTA) in 200 schools. The PTA are supported primarily through grants awarded to develop school-based OVC activities including provision of school supplies, tutoring, and development of sustainable income generation activities.

Save the Children, USA and its international partners will provide organizational and technical assistance to local NGOs, CBO and FBO to ensure provision of high quality, standardized care services, to enhance organizational capacity, to expand program coverage, to diversify local organizations' resource base, and to carry out participatory capacity assessments and develop organizational development plans of action.

This activity will continue to partner with Coca Cola to reach additional OVC and their families through the livelihood initiative. Since the number of OVC in Addis Ababa is very high, this program will expand in Addis Ababa, including 60-80 children who are vending soft drinks, and promoting some high-performing young adults to a kiosk level business. Activity partners will use experiences gained through the Coca Cola partnership to extend activities with the private sector that engage the core capacities of this sector to increase the reach, efficiency and effectiveness of OVC programs. The PEPFAR Technical Working Group on public private partners will be consulted on these activities.

The PC3 consortium representatives will actively participate in the National OVC Task Force as in past years and will promote the adoption and dissemination of the national OVC care and support guidelines and standardized training manuals for different OVC services.

This activity will strengthen collaboration with other PEPFAR Ethiopia partners by networking to link OVC with other services through referrals including educational services, clinical support, and IGA services.

In partnership with other PEPFAR Ethiopia OVC partners, this activity will work with the new PEPFAR APS recipient to coordinate activities to achieve most efficient use of resources for OVC in the highest HIV/AIDS prevalence areas. This includes harmonization on indicators, reporting, and OVC standards of care in line with Government of Ethiopia national guidelines and policies and OGAC OVC Program Guidance, as well as achieving quality assurance in OVC programming. Data from the EDHS 2005 and the results of USG Ethiopia mapping will be used to further inform geographic priority areas to increase reach in areas ranked highest for children affected by HIV/AIDS and with service availability to meet OVC comprehensive needs. This is especially relevant to PC3 which has the broadest geographic coverage among all the PEPFAR OVC programs.

This activity incorporates an exit strategy promoting sustainability by strengthening the capacities of local NGO, FBO and traditional community organizations that are already stratified in a tiered system (Tier I is the prime partner, Tier II is the local NGO and the Tier III is the Community Organizations). Through this approach, the community takes the responsibility to continue support of the OVC services once the program ends.

OVC Food Support

This is a continuing activity from FY05.

This activity is linked to: Positive Change: Children, Communities and Care (PC3) (5578), Food Procurement for Food-By Prescription (New) and Scale Up Hope (Track 1 - #936-3090.28) To date, Save the Children US has received 100% of its FY06 funding. The activity is on schedule per workplan. Funding has been increased based on the achievements of partial FY06 performance. In FY07, the aim is to scale up the program to a national level.

Household food insecurity is one of the major problems encountered by OVC in Ethiopia. Lack of food and other resources are among the "push" factors that cause children to leave home and seek income opportunities on the street. Those in food insecure rural areas encounter food shortages more so than those in the city. However, when the adult breadwinner is ill or has died, the situation is the same in both food secure and insecure areas and children become increasingly vulnerable. Save the Children's OVC Food Support program will provide critically needed nutritional resources to the most vulnerable OVC households in eight regions: Addis Ababa, Amhara, SNNPR, Dire Dawa, Afar, Oromia, Tigray and Benshangul. The program will also support the Government of Ethiopia "Strategic Plan for the Multi-sectoral Response for HIV/AIDS" by strengthening care and support for HIV/AIDS-affected households through the provision of nutritional assistance.

In COP07, PEPFAR Ethiopia will strengthen support for OVC and strategically link with food aid programming in Ethiopia through the Office of Food for Peace (FFP). Currently, through a World Food Program (WFP)-supported grant, SCUSA provides food support to OVC and other HIV/AIDS affected groups in Nazareth and Dire Dawa, along the "High Risk Corridor". This activity will expand food programming to an additional six sites where OVC work is currently ongoing, and link it to community-based OVC work throughout the country.

The program will leverage and scale up food support to an additional 15 sites to ensure coverage of programs implemented by partners and continue efforts in areas supported by Scale Up Hope as it phases out. The 15 expansion sites are in Scale Up Hope and PC3 intervention areas in order to achieve rapid impact. Site selection is based on high prevalence areas with critical food needs for OVC and affected households. Selection of OVC for food distribution will be based on household needs since general school feeding is not possible with PEPFAR funds. The program will ensure that OVC are included in the food distribution system. Existing PTA, as well as community committees will be involved in managing and ensuring that all designated food is directed and used by the OVC.

Although the OVC food support program will initially scale up food programming for OVC, PEPFAR Ethiopia expects food resources to be provided to OVC at additional sites throughout the life of the PC3 program.

In FY07 Save the Children will follow OGAC's OVC Guidance and the USG Policy on the Use of Emergency Plan Funds to address nutrition and food needs of PLWHA. This program will not buy food through PEPFAR funds but will leverage and link to WFP food support. Additionally, the program will complement Food-By-Prescription (FBP) for PLWHA.

SCUSA will ensure that: (1) Nutrition and food support directly contributes to meeting prevention, treatment and care goals stated in the US Five Year Global HIV/AIDS Strategy (2) Nutritional interventions are based on the scientifically established World Health Organization (WHO) assessment criteria and guidelines for nutritional care (3) Emergency Plan programs first attempt to access food resources for therapeutic and supplementary feeding from other sources (4) Emergency Plan food support to clinically malnourished patients is provided within the context of clear eligibility and exit anthropometric criteria and plans to transition to more sustainable food security for recipients. (5) Resources are leveraged to provide support to PLWHA and their families to address their broader health, food security and livelihood needs.

In partnership with other PEPFAR Ethiopia OVC partners, Save the Children will work with the new PEPFAR APS recipient to coordinate activities to achieve most efficient use of resources for OVC in the highest HIV/AIDS prevalence areas. This includes harmonization on indicators, reporting, and OVC standards of care in line with Government of Ethiopia national guidelines and policies and OGAC OVC Program Guidance, as well as achieving quality assurance in OVC programming. Data from the EDHS 2005 and the results of USG Ethiopia mapping will used to further inform geographic priority areas to increase reach in areas ranked highest for children affected by HIV/AIDS and with service availability to meet OVC comprehensive needs.

The exit strategy will also be determined and adhered to per the policies. The program ensures that OVC are provided with food on as needed basis and exit from dependency on food provision. This will be designed carefully by SCUSA, will be properly implemented and adhered to effectively.