Summary: The African Medical and Research Foundation (AMREF) will strengthen capacity of South African district government departments, Child Care Forums (CCFs), NGOs and CBOs, and service providers to provide quality and accessible care and support for OVC and caregivers through training, mentoring, awareness-raising and advocacy for OVC. Background: Under FY06, AMREF developed strong partnerships with key government and civil society stakeholders in both Limpopo (Sekhukhune district) and KwaZulu Natal (Umkhanyakude district). In these two particular districts, AMREF will expand its sub-grants with local CBOs (sub-grantees) and second-line partners (those who work are involved in the programme but have no grant agreement with AMREF for now) to provide a wellness program for caregivers.

Activity 1: Comprehensive Care for OVC In addition to providing school fee exemption, psycho-social counseling, birth registration and social security grants, nutrition programmes, and lifeskills (HIV prevention messages, gender based violence (GBV) awareness), AMREF-trained community care workers and service providers will also provide comprehensive home based care. Care workers and providers will be trained to conduct basic health care needs assessments, provide first-aid and refer for clinical services that include screening, diagnosis, doctor consultations and treatment. Carers will linked with partner clinics and hospitals to ensure the provision of quality follow-up support for sick OVC. Carers will also engage and be linked to primary healthcare initiatives such as immunisation drives and preventive screening. AMREF will work with each of its partner Children's Drop in Centres, ChildCare forums, CBOS and NGOs including Home-Based Care Organisations to define and implement an appropriate home based care service package for vulnerabale families.

Activity 2: Wellness Programmes for Care Givers The wellness model that AMREF will implement for for caregivers will empower caregivers and help them develop healthier lifestyles and enhance wellness in both the individual caregivers as well as their families. AMREF will also use the Plus-Up funding to conduct wellness programs, in collaboration with subpartners, for volunteer caregivers through facilitating linkage with the health care centres and Counselling and Testing centres (clinics/hospitals) to ensure that carers receive the non-clinical (psychosocial support, spiritual counselling, nutritional counselling) and clinical care (screening, diagnosis, doctor consultations, treatment, and follow-up care) required. AMREF will also work with the CBO partners and the health care centres to develop support groups to share coping skills and provide a support sytem for care givers.

SUMMARY: The African Medical and Research Foundation (AMREF) will strengthen capacity of South African district government departments, Child Care Forums (CCFs), NGOs and CBOs, and service providers to provide quality and accessible care and support for OVC, through training, mentoring, awareness-raising and advocacy for children's rights. AMREF has seven local partners providing services to OVC located in sites in two districts in KwaZulu-Natal and Limpopo provinces where intervention will continue with FY 2007 PEPFAR funding. Emphasis areas for this program are training, development of networks, linkages and referral systems and local organization capacity development. Target groups include OVC, caregivers of OVC, community and public sector health and social service workers, civil society groups and government departments. BACKGROUND: AMREF, an international NGO, worked in Mpumalanga province from 2001 to 2004 strengthening community care-giving infrastructures for OVC. Building on this initiative, AMREF has formed partnerships with key government and civil society stakeholders in Sekhukhune District in Limpopo province, and Umkhanyakude District in KwaZulu-Natal (KZN). In these two districts, AMREF has identified need for a comprehensive program to address OVC by strengthening collaboration between, and capacity of, local service providers, government and civil society groups. The districts are priority areas for the South African Government (SAG). AMREF activities are aligned with the Department of Social Development's (DoSD) National Plan of Action for OVC.

ACTIVITIES AND EXPECTED RESULTS: ACTIVITY 1: Human Capacity Development With FY 2007 PEPFAR funding AMREF will provide training, mentoring and on-site support to strengthen care and support systems for OVC in the two districts. AMREF train on identification, referral, support and monitoring of OVC, tailored for the needs of specific groups including Traditional Health Practitioners, Home-Based Carers, Community Health Workers and Community Child-Care workers. AMREF will provide training on life skills facilitation for school officials and drop in centre staff using materials including HIV and gender-based violence (GBV) prevention messages. Local partners are trained as mentors to provide support life skills sessions.

AMREF will engage CCFs members to provide ongoing assistance and mentor trainees. CCFs are community-based structures focusing on OVC in the community and ensuring that their needs (physical, emotional, social, economic and spiritual) are met. AMREF will work with community and government structures to establish, strengthen and support CCFs. AMREF will train CCFs in identification, referral, support and monitoring of OVC, and facilitation skills for meetings; and strengthen program planning and engage CCFs in advocacy for increased support for OVC. CCFs will be linked to AMREF's local partners for support and referral of OVC to essential services. CCFs will assist in the development and implementation of referral systems linking OVC to necessary services. AMREF will work with CCFs to strengthen data collection and monitoring systems while ensuring sustainability.

ACTIVITY 2: Care and Support Services AMREF-trained community care workers and service providers will provide a service package which includes: access to primary healthcare (e.g. immunization), school fee exemption, psychosocial counseling, birth registration and social security grants, nutrition programs, life skills, HIV prevention messages and interventions to reduce gender-based violence (GBV). This service package is provided directly to OVC by the Children's Drop in Centers, CCFs, CBOs and NGOs including home-based care organizations. AMREF strengthens service provision through sub-granting, training and providing on-going support to these organizations and committees and public sector service providers including (teachers, health workers, and social workers). Trained service providers will identify OVC and conduct needs assessments, home-visits, psychosocial support, life skills support and homework supervision and provide assistance with SAG social security grant applications, succession planning and birth registration as well as on-going monitoring and follow-up of other services to OVC. This includes timely and effective referral to appropriate services (e.g. child protection services and referral for pediatric AIDS treatment as well as participation in advocacy for school fee exemption).

ACTIVITY 3: Strengthening district and civil society capacity and coordination

To ensure sustainability of support for OVC, AMREF will provide training in program design, planning and implementation, monitoring and evaluation as well as technical support for government at district and municipality levels (including Local/District AIDS Council and SAG). AMREF will facilitate improved collaboration between departments and integration of services by organizing and facilitating regular inter-agency/ departmental meetings and forums. AMREF will provide organizational strengthening training and systems development, support and follow-up for CBOs/NGOs engaged in OVC service delivery, including financial and program management skills, leadership and resource mobilization training. AMREF will train selected NGO workers and community care workers in psychosocial support and counseling for OVC.

ACTIVITY 4: Community-level Advocacy With FY 2007 funding AMREF will conduct consultations with civil society and government stakeholders to determine community level advocacy issues. In response, AMREF will train youth, caregivers, service providers on advocacy skills and planning and assist to develop strategies to advocate for changes to SAG policy and practice concerning OVC, identify and work to eliminate bottlenecks in service provision and mobilize resources. AMREF will facilitate and support advocacy meetings with traditional leaders, local and district government. AMREF will also continue to support CCFs in their advocacy role at community level on behalf of OVC. Specifically, AMREF will provide CCF members with training to support advocacy against GBV, especially against female OVC.

ACTIVITY 5: Strengthening linkages and referrals AMREF will continue to strengthen collaboration between government departments, civil society groups and service providers. AMREF will establish and support local Project Steering Committees in the two districts consisting of key stakeholders to promote linkages between public sectors and community.

Activity 6: Gender Mainstreaming AMREF will use Plus funds to train community care workers, sub partners and other stakeholders (e.g. traditional leaders, teachers, health workers, social workers) on mainstreaming gender into the delivery of a comprehensive service package for OVC. AMREF will work with OVC service providers and statekolders to develop and implement gender-based violence awareness campaigns with specific focus on vulnerable populations such as female OVC. In addtion, AMREF will work to sensitise parents and teachers to mainstream gender issues in lifeskills training. Gender mainstreaming will include training on gender roles, gender based violence recognition and prevention, male/female norms and behaviours in OVC identification, referral, care and support. and will be linked with previous OVC rights workshops and HIV. AMREF will also mobilise and educate community leaders around the gender and gender based violence issues affecting OVC (children and adolescents).

AMREF, by providing care for OVC through the expansion of local communities' capacity to deliver quality care for OVC, will contribute towards the PEPFAR goal of providing 10 million people with care by improving the quality of life of OVC and HIV-infected and affected families.