SUMMARY:

The Southern African Catholic Bishops Conference (SACBC) AIDS Office has adopted a family-centered

developmental approach and a child-focused intervention for its OVC program. For the 2008 fiscal year the

SACBC AIDS Office will extend its program and services to the surviving parents, guardians and the foster

parents of HIV-infected individuals and orphans and other vulnerable children supported through this

program. The SACBC AIDS Office will support its sub-recipients in palliative care program design,

implementation and direct services for the surviving parents, guardians and foster parents living with HIV

and AIDS. The SACBC AIDS Office will guide its sub-recipients to implement a comprehensive, holistic and

interdisciplinary approach to HIV care. This program will strive to achieve optimal quality of life for people

living with HIV (PLHIV) and their families and minimize suffering through clinical, psychological, spiritual,

social and preventive care support. Through this program PLHIV will be referred to existing ART sites.

Some of the sub-recipient sites receive funding through a Track 1 partner, Catholic Relief Services, for HIV

care and treatment, and this co-location allows for ease of referrals.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Support to parents (primary caregivers)

The SACBC AIDS Office will strengthen the capacity of families to protect and care for OVC by prolonging

the lives of the primary caregivers through clinical care which include HIV counseling and testing, routine

follow-up to determine the optimal time to initiate ART if HIV-infected; prevention and treatment of

opportunistic infections including cotrimoxazole prophylaxis such as tuberculosis (TB); HIV prevention and

behavior change counseling including prevention with positives. Sub-recipients will be encouraged to run

counseling and testing (CT) campaigns. Through these campaigns primary caregivers will be encouraged to

know their status. In addition the SACBC AIDS Office will support its sub-recipients to provide clinical,

psychological, spiritual, social care and integrated prevention services. The SACBC AIDS Office will support

its sub-recipients to establish community-based support groups and appropriate training will be provided.

Advocacy initiatives will also be conducted at the congregational level to ensure that the local priests are

supportive and promotes spiritual care through retreats. In addition the SACBC AIDS Office will support its

sub-recipients to develop programs geared towards stigma reduction. Sub-recipients will be supported to

run awareness and acceptance HIV campaigns within their respective communities.

ACTIVITY 2: Building Networks through Linkages and Integration

The SACBC AIDS Office will provide technical support to its sub-recipients to strengthen and integrate

home-based care, community-based care and facility-based care for family members of HIV-infected into

the OVC programmatic interventions. The SACBC AIDS Office will ensure that its sub-recipients build and

sustain comprehensive HIV and AIDS care systems. The SACBC AIDS Office will ensure that strong

referral systems are in place at local level for the provision of prevention, treatment and care across

facilities, clinics, communities and homes. The SACBC AIDS Office has eight sites that already provide on-

site health care, and this ensures that access to health care for HIV-infected and OVC is improved.

ACTIVITY 3: Mainstreaming Gender

Gender equity will form an integral part of the SACBC AIDS Office program's activities. The SACBC AIDS

Office will ensure that women and men are receiving equitable support and access to essential palliative

care services, especially treatment. Sub-recipients will be encouraged to work with male groups in their

dioceses to mobilize the involvement of men as caregivers and members of various support groups.

Communities will be mobilized to enforce female protection from exploitation and abuse and to mitigate

against gender-based violence. The SACBC AIDS Office will support its sub-recipients to work with the

existing gender-based violence programs within the Department of Social Development at district level. .

The SACBC AIDS Office promotes the teaching of the Catholic Church concerning abstinence and fidelity,

as well as the appropriate use of condoms for discordant couples.

ACTIVITY 4: Capacity Building

The SACBC AIDS Office will provide technical support to strengthen the capacity of its sub-recipients by

providing training on various aspects of palliative care. In addition the sub-recipients will be provided with

ongoing supervision and mentoring. The SACBC AIDS Office will develop wraparounds with other partners

(such as the Department of Social Development) for food supplements and nutrition assistance to ensure

effective implementation of palliative care.

a) Training for secondary caregivers: In FY 2008, training of secondary caregivers will focus on treatment

literacy, psychosocial support and caring for PLHIV. The SACBC AIDS Office will identify a credible service

provider to provide the treatment literacy training. The course is conducted over five days. The Regional

Psychosocial Support Initiative (REPSSI) will provide the psychosocial support (PSS) course for caregivers

who are new to the program and are not well-versed in PSS. The psychosocial support course included

themes such as a sense of self-worth, of value, self-esteem, bereavement care, building resilience, listening

and talking to distressed children, child development; hero books and the holistic needs of human beings.

b) Training of primary caregivers: Families of HIV-infected individuals and OVC will be trained by secondary

caregivers in identifying and establishing viable income-generating activities for economic strengthening of

households. Primary caregivers will also be trained in basic nutrition, HIV and AIDS awareness and

prevention including prevention with positives, basic hygiene and treatment literacy particularly for families

of people living with HIV.

c) Training of trainers: In FY 2008, this program will target a few secondary caregivers from each sub-

recipient to be trained as trainers in treatment literacy, psychosocial support and home-based care. These

caregivers would then be responsible for training other caregivers using the same curriculum and materials

to maximize the impact of training and to improve chances that information gained from the various training

sessions is implemented at site level.

In all of the above activities, OVC will be counted only in the OVC program area. PLHIV will receive at least

Activity Narrative: one clinical and one other category of palliative care service. Palliative care to family members of PLHIV or

OVC will be provided in at least two or the five categories of palliative care services

These activities will contribute to the PEPFAR goal of reaching 10 million HIV-infected and affected

individuals with care.

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. OVC services will be provided in 23 sites

in all eight provinces of rural South Africa within 18 dioceses of the SACBC Region. SACBC is a sub-

partner through Catholic Relief Services for its HIV care and treatment programs.

BACKGROUND:

The SACBC launched this PEPFAR-funded OVC program in September 2007. Over the last eleven months

the SACBC AIDS Office supported 21 sites in eight provinces with funding provided directly to sub-

recipients. Through this program about 6,700 OVC were reached with psychosocial, educational, nutritional,

economic support, health care, pediatric treatment referrals and child protection. In FY 2008, the sub-

recipients will continue to use 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 23 sites. Identification

of the OVC sites was based on evaluations of previous programs. Six of the 23 OVC sites also provide

antiretroviral (ARV) treatment to people living with HIV (PLHIV), including OVC. Many SACBC sites have a

network of trained volunteers. Mostly these are unemployed women, who volunteer in return for training and

a monthly stipend. 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's (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 Policy

Framework on Orphans and other Children made Vulnerable by HIV and AIDS. SACBC is also an active

member of the various NACCA tasks teams, including Food and Nutrition, and Care and Support. 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 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:

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, and brick making training.

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,

including 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 18 dioceses. 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

The Education for Life Program, is a behavior change skills building program geared towards young people,

targeting OVC aged 10 -15. It 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

Activity Narrative: 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.

NEW ACTIVITIES

ACTIVITY 5: Bicycle Project

In FY 2008, the bicycle project through collaboration with the Institute for Transport and Development Policy

(ITDP) will be introduced and piloted in 10 sites. A feasibility assessment will be done in advance to identify

opportunities and challenges of introducing this project in the selected sites. The pilot will include the

bicycles for OVC who have to travel long distances to attend school and the secondary caregivers to reach

OVC.

ACTIVITY 6: Exit strategies for OVC

23 sites will be assisted in developing exit plans for children above 15. This is to ensure that when children

leave the program there are plans in place to further their education, access vocational training, establish

income generating activities or gain employment. The SACBC will develop wrap-around programs with

other partners (e.g.DOSD) for food supplements and nutrition assistance to ensure effective implementation

of OVC interventions.

ACTIVITY 7: Training

Secondary caregivers: Training to be provided will focus on child and youth care, psychosocial support and

caring for children with disabilities, equipping participants with an understanding of the fundamentals of child

and youth care work and developing basic caring skills for children and youth. Another important activity

inclusion. Training of primary caregivers: Families of OVC will be trained by secondary caregivers in

identifying and establishing viable income-generating activities for household economic strengthening.

Training will also focus on basic nutrition, HIV awareness and prevention, basic hygiene and treatment

literacy, particularly for families of PLHIV. Training of trainers: This program will target a few secondary

caregivers from each sub-recipient to be trained as trainers in child and youth care work, psychosocial

support and M&E. Training of OVC: A series of formal and informal training sessions will be conducted with

OVC across the program, including child-headed households, focusing on life skills training (provided by

two PEPFAR partners - Soul City and FHI), reproductive health and HIV and AIDS. Informal training

sessions will be held during career camps and the after school programs, covering various topics, including

child rights, basic saving and budgeting as well as career guidance for older youth. Training of sub-

recipients: In FY 2008, training will focus on proposal writing and financial management.

Family Health International (FHI) is also funding SACBC as a sub-partner but these are different sites. Once

the agreement with FHI ends, these sites will all be transitioned to the SACBC (as a prime partner)

program.

SACBC is currently a sub-partner under the Track 1 Catholic Relief Services (CRS) program. However, in

FY 2009 the Track 1 CRS program will transition, and SACBC will become one of three local implementing

partners that will have CRS funds and responsibilities transferred to it, and thus current funding levels will

increase in FY 2009. These will be adjusted through reprogramming in FY 2009.