SUMMARY: The Southern African Catholic Bishops' Conference AIDS Office (SACBC) provides comprehensive care for orphans and vulnerable children (OVC) to help them grow to be healthy, educated, and socially well-adjusted adults. SACBC supports community programs and projects, linking them to various sources of financial assistance, healthcare, legal aid and nutritional support. The major emphasis area of the SACBC program is community mobilization and participation, minor emphasis areas are local organization capacity development and food and nutrition support. Target populations are OVC, caregivers of OVC (including primary caregivers or guardians), HIV and AIDS affected families, community and religious leaders, volunteers and faith- and community-based organizations (FBO/CBOs) providing OVC services. OVC services will be provided in 21 sites in all nine provinces of rural South Africa within 17 dioceses of the SACBC Region. SACBC is a sub-partner through Catholic Relief Services for its HIV care (#7488) and treatment (#7487) programs.

BACKGROUND: Over the last five years, SACBC, in collaboration with Catholic Medical Mission Board (CMMB), has provided services to OVC through the 'Choose to Care' program. Under this program 5,390 community volunteers have been trained, 8,982 OVC have been served, and 40,403 people offered home-based care. This program first received PEPFAR funding in FY 2006. The SACBC will use FY 2007 PEPFAR funds to expand and scale up existing services to meet the increasing needs of OVC in South Africa.

The SACBC coordinates OVC services at 21 sites. Identification of the OVC sites was based on evaluations of previous programs. Six of the 21 OVC sites also provide antiretroviral (ARV) treatment to people living with HIV, including OVC. Many SACBC sites have a network of trained volunteers who still need specialized OVC training. Many volunteers are unemployed women, who volunteer in return for training and a monthly stipend. Many of these volunteers become auxiliary community home-based caregivers and continue to develop into specialized OVC caregivers. Some of the volunteer caregivers are so well-trained that they are able to move on to more sustainable jobs in other healthcare sectors. This creates a need for ongoing recruitment of new volunteers and training.

OVC at schools are highly stigmatized, and therefore the SACBC response includes stigma mitigation. OVC face many forms of differential treatment and human rights abuses, being denied access to schools and health care facilities. The OVC program will target gender sensitivity and awareness training at schools, and will focus on advocating for the rights of the girl-child, especially adolescent girls.

One of the key partners in this program is the Catholic Institute of Education, which focuses on the Education Access Project (EAP). The EAP aims to enable OVC in Catholic schools to continue their education and remain healthy. EAP's strategy is to provide resources to poor schools to assist selected learners orphaned by HIV and AIDS and made vulnerable by poverty with education expenses, including fees, uniforms, transport, sport, outings and a daily ration of food (depending on individual needs) and to motivate school communities to contribute to the care of those affected by HIV and AIDS.

SACBC is in partnership with the National Department of Social Development (DoSD) National Action Committee for Children Affected by HIV and AIDS (NACCA). The mandate for NACCA at national level is to coordinate action for children affected by HIV and AIDS. SACBC adheres to the DoSD's Policy Framework on Orphans and other Children made Vulnerable by HIV and AIDS. SACBC is also an active member of the various tasks teams that have been mandated by NACCA, including Food and Nutrition, Care and Support Task Teams. SACBC will encourage their sites to become active members of the provincial structures of NACCA as well as local districts structures.

Most of the selected OVC sites provide community care; only one (St. Philomena's Community Care Program) provides residential care. The family-centered developmental approach of the SACBC OVC program ensures that OVC are placed in families and communities of care. The community mobilization program ensures that members of the local community are in the best position to know which households need assistance and what assistance is required for OVC care.

ACTIVITIES AND EXPECTED RESULTS:

The main strategies used by SACBC with FY 2007 PEPFAR funds are: ACTIVITY 1: Support to parents SACBC will strengthen the capacity of families to protect and care for OVC by prolonging the lives of parents and providing economic, psychosocial and other support. This is currently carried out at some of centers and will be expanded to other sites with PEPFAR funds. Economic strengthening, such as income-generating activities play a key role in maintaining the livelihoods of OVC and their families. These income-generating activities include food gardens, sewing school uniforms, brick making training etc.

ACTIVITY 2: Community mobilization SACBC will mobilize and support FBO/CBO community-based responses to OVC care by building community responses through local networks and advocacy initiatives. This includes establishing Child Care Forums at local level to reinforce the capacity of communities to respond to the needs of OVC. SACBC will also increase the capacity of FBOs/CBOs with training programs for OVC care and support, utilizing lessons learned and best practices from 'Choose to Care' to enhance training skills. SACBC will provide technical assistance to FBO/CBO projects as they respond to the needs of OVC and their families. Technical assistance will be provided to individual OVC projects, local FBOs/CBOs, for skills training and development and assistance to access the funding necessary to provide needed services.

ACTIVITY 3: Access to services SACBC will ensure that OVC and their families access essential services including education, healthcare and other support. Existing services will be improved and expanded, including psychosocial counseling. Coping strategies will include life skills training to reduce vulnerability, as well as assistance for education costs (school uniforms and stationery) in line with South African government policies and programs. The SACBC project will also scale up educational, nutritional, social, medical assistance and psychosocial support for OVC at new sites within 17 dioceses. OVC caregivers, community leaders and volunteers will be trained. The components of the program will feature cross-cutting issues, child participation, gender issues and will address stigma and HIV prevention.

ACTIVITY 4: Gender, Stigma and HIV Prevention Plus Up funding will support an Education for Life Programme. This is a behavior change skills building program geared towards young people, targeting OVCs aged 10 -15. The program is divided into 3 stages, whereby the participants are led through a process of self-introspection on their present reality to name and own behaviors that are life threatening and harmful to their dignity. Through ongoing questioning and various participative activities youth are led to choose and commit themselves to possible new behaviors that promote a positive and healthy lifestyle. The process will provide positive engagement and open discussion around sexuality, sexual behavior, teenage pregnancies and the role of women. It also addresses gender mainstreaming, and the SACBC will continue to develop sites on the promotion of the needs of the girl child, especially from age 10-16.