ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

There is a need to formally evaluate the 'Caring for Carers' program. In addition, the new design of the

bereavement counseling/grief work for young people heading households, grannies heading households

and Isibindi child and youth care workers cannot be initiated in FY 2008 due to funding limitations. In view of

the of the importance for the expansion of the Caring for Carers program, as well as the importance of

developing more effective models for advanced grief work, the NACCW will consider making efforts to raise

cost share funding for these programs in both FY 2008 and FY 2009.

-----------------------

SUMMARY:

The National Association of Childcare Workers (NACCW) provides accredited child and youth care training

to community members in order to provide holistic services to family members of OVC. Funding will be used

in the emphasis areas of training and community mobilization, developing referrals and linkages, and

conducting needs assessments. Primary target populations are HIV-infected families and their caregivers,

and community organizations.

BACKGROUND:

NACCW is the only South African NGO focusing on provision of specialized, professional training in child

and youth care. NACCW has developed a unique community-based child and youth care response to the

HIV and AIDS crisis called the Isibindi Model. This program trains unemployed community members in an

accredited child and youth care course and provides an integrated child and youth care service to child

headed households and vulnerable families through partnerships between NACCW and community-based

organizations. This project is part of a larger initiative of the NACCW to replicate the Isibindi Model

nationally in partnership with the Department of Social Development (DOSD). Since 2004, PEPFAR has

supported 24 of NACCW's 40 Isibindi projects, providing direct services to 10 891 OVC and training for 430

child and youth care workers in 7 provinces in South Africa. The NACCW also offers this accredited training

to other PEPFAR funded projects. From FY 2007 PEPFAR funding has supported palliative care activities.

To promote the sustainability of the NACCW Isibindi childcare model, public-private partnerships will

support the program in selected provinces. Partners include De Beers Fund, Anglo America Chairman's

Fund, AngloGold, Royal Netherlands Embassy, UNICEF, ABSA Bank and the Impumelelo Innovations

Award Trust.

ACTIVITY 1: Clinical Services for Family Members of HIV-infected and OVC

Child and Youth Care Workers (CYCW) will provide information on clinical services and refer OVC and their

families for screening of pain and symptoms, diagnosis, treatment services such as TB or ARVs. CYCW will

regularly follow up to ensure that services are accessed and to provide adherence support for adults and

children on treatment. CYCW will be capacitated to identify children requiring clinical services or

hospitalization and to provide referrals to children and family members. NACCW will ensure each Isibindi

site is linked to a network of clinical care services and providers. The NACCW has a non-PEPFAR program

called Masihlangane: Make a Difference which focuses on securing funding for food parcels for the Isibindi

projects. Essential nutritional requirements through the food parcels will be provided to children and families

who are on antiretroviral treatment. This will complement the treatment process.

ACTIVITY 2: Psychological/Social Services for OVC and their Families

CYCW will assist family members of HIV-infected and OVC with a range of social and psychological

services. This will include providing information on and assisting caregivers to access disability grants and

other forms of economic support. CYCW will also provide family counseling and assist with succession

planning. This will include ensuring caregivers have wills, making arrangements for the care of children,

ensuring children have birth certificates and identity documents and providing support for disclosure. CYCW

will provide bereavement support and counseling and refer family members to social workers and other

support services. CYCW also ensure that families live in hygienic and safe home environments and assist

family members to maintain their households.

ACTIVITY 3: Training of CYCW

CYCW in Isibindi project sites will be trained by Bigshoes on a 5-day program focusing on providing

palliative care services to OVC and their families or caregivers with the aim of delaying orphanhood. This

will include providing referrals to clinical services, follow ups and providing social and psychological services

designed to support family caregivers and sick OVC. Monthly Regular mentorship will ensure that CYCW

are able to implement the services and provide quality care and support to family members of HIV-infected

individuals and OVC.

ACTIVITY 4: Care for Caregivers

NACCW will contract the services of registered therapists to provide support to CYCW in all Isibindi sites,

thereby facilitating deeper and more sustainable relationships with their clients. The less they are burdened

by their personal feelings and stories, the more emotionally available they will be for their clients. They

should also begin to develop a healthy discrimination for appropriate levels of involvement with their clients.

The support will include debriefing sessions, workshops and individual counseling in a structured six-month

program. It is anticipated that this intervention will reduce burn out, psychosomatic symptoms among

CYCW, increase the quality of services provided and improve the long-term sustainability of the program.

In all of the above activities, OVC will be counted only in the OVC program area. Palliative care to family

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

Activity Narrative: PLHIV will receive at least one clinical and one other category of palliative care service.

These activities will contribute to meeting PEPFAR's goals of providing 10 million people with care and

support, including family members of PLHIV and OVC.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14031

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14031 12366.08 U.S. Agency for National 6689 2312.08 $200,000

International Association of

Development Childcare Workers

12366 12366.07 U.S. Agency for National 4467 2312.07 USAID GHAI $250,000

International Association of

Development Childcare Workers

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's access to income and productive resources

* Reducing violence and coercion

Health-related Wraparound Programs

* TB

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $200,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.08:

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

With the increasing number of Isibindi Projects particularly in KwaZulu-Natal with children in granny-headed

households direct support to these aged and burdened caregivers is required to be strengthened in various

ways. Beginning in FY 2008 COP, the National Association of Childcare Workers (NACCW) the program

will be expanded to reach more grannies in FY 2009. There is a need for talking circles (a form of skills

building through facilitated dialogue) to promote positive parenting skills especially related to work with

teenagers and support for the active transfer of family and cultural tradition and rituals. A bereavement

counseling and support program will support grandmothers in overcoming personal grief and coping with

the grief of grandchildren.

This program will also provide OVC with bereavement support and counseling. A creative training/social

program will be developed to respond to this need and include access to a micro-finance/economic

empowerment programs designed especially for grannies. In addition the successful Isibindi Safe Park will

design specific activities and programs to involve grannies in the safe park - to relax, engage in story telling

activities and support the recreational activities of their grandchildren and other children (such as supporting

sports tournaments). The NACCW will also partner with schools - linking child and youth care workers to

support educators in work with OVC.

The program will include the establishment of the NACCW Safe Parks in schools where psychosocial

services will be offered at the 'Safe School Parks' with child and youth care workers deployed after school

hours in integrated multidisciplinary teams along with educators. In addition, in FY 2009 COP a partnership

with the Early Childhood Development (ECD) sector will ensure the Safe Park is used creatively to provide

easy access to ECD services - for all Isibindi and community children, but particularly for those from child-

headed households. Safe parks will also be made available to disabled children who will be transported to

the parks on a regular basis, increasing the social contact of disabled children, and destigmatizing disability

in communities. Disabled children included in Safe Park activities will be those provided with services in the

disability program as well as others in HIV/AIDS-affected communities where Isibindi projects are situated.

Participation of this group of children will increase the spread of preventative work. The disabled children at

the Safe Parks will have access to all the activities that occur at the Safe Park e.g. when there are

talks/sessions of sex and sexuality, ARVs, HIV/AIDS, etc. They will be a part of these activities and thus a

wider number of OVC will be reached with prevention messages.

The Women's Empowerment Program and Young Women's Empowerment Program will be enhanced to

focus on more economic empowerment activities and relevant microfinance programs for the young women.

This program will be documented in COP 08. It will also be reviewed and enhanced on recommendations

made by the researcher in COP 09. Young women will be awarded scholarships to study further after

completing school. Microfinance and income generation programs that were piloted in COP 08 will also be

implemented in COP 09. In addition, a Life Center Model will be initiated and remain an ongoing program

for young people (male and female) heading households where they will meet to discuss their challenges

and coping strategies, as well have space and fun away from the daily parental responsibilities of

associated with their roles as children heading households. This enhancement responds to the critical need

for localized, regular social networking was expressed by the young women in the pilot Young Women's

Empowerment Program. According to the Children's Act the development of cluster foster care programs is

one way of responding to the needs of OVC. The NACCW will design and pilot three different cluster foster

care models specifically responding to the needs of OVC in response to the expectations of the Children's

Act. One model will target children 16 years and over who are heading households and can, according to

the Act, live on their own without an adult. The second is a model for children under 16 years who are

currently living on their own in child-headed households but should, according to the Children's Act, not be

living in these circumstances - where a method of structuring adult supervision of such households will be

piloted. The third model will focus on children living in child-headed families who have added difficulties,

such as living with disability, and substance addiction. Other areas of services within the Isibindi Model that

will be strengthened (some with the inclusion of other expert consultants) include grief work, succession

planning, food security, Developmental Quality Assurance, planned Safe Park activities, and the Isibindi

Partners Network.

-------------------------

SUMMARY:

The National Association of Childcare Workers (NACCW) provides accredited child and youth care training

to community members in order to provide holistic services to OVC. Funding will be used in the emphasis

area of training and community mobilization, developing referrals and linkages, and conducting needs

assessments. Primary target populations are OVC, HIV-infected families and their caregivers, and

community organizations.

BACKGROUND:

NACCW is the only South African NGO focusing on provision of specialized, professional training in child

and youth care. NACCW has developed a unique community-based child and youth care response to the

HIV and AIDS crisis called the Isibindi Model. This program trains unemployed community members in an

accredited child and youth care course and provides an integrated child and youth care service to child-

headed households and vulnerable families through partnerships between NACCW and community-based

organizations. This project is part of a larger initiative of the NACCW to replicate the Isibindi Model

nationally in partnership with the Department of Social Development (DOSD). Since 2004, PEPFAR has

supported 24 of NACCW's 40 Isibindi projects, providing direct services to 10 891 OVC and training for 430

child and youth care workers in 7 provinces in South Africa. The NACCW also offers this accredited training

to other PEPFAR funded projects.

To promote the sustainability of the NACCW Isibindi childcare model, public-private partnerships will

support the program in selected provinces. Partners include De Beers Fund, Anglo America Chairman's

Fund, AngloGold, Royal Netherlands Embassy, UNICEF, ABSA Bank and the Impumelelo Innovations

Activity Narrative: Award Trust. The NACCW has a program called Masihlangane Ngezingane Zetu: Make a Difference which

focuses on securing funding for food parcels for the Isibindi projects from various other donors and private

enterprises like Old Mutual, Independent Newspapers and Private Sponsorships.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Training and Mentorship

Accredited child and youth care training at South Africa's National Qualification Framework (NQF) level will

be provided to child and youth care workers and selected volunteers in all sites. This training is the only

accredited basic child and youth care course in the country in the profession of Child Care Work. This

accredited training will allow workers to be registered as Auxiliary Child and Youth Care Workers with the

South African Professional Board for Child and Youth Care Work. This registration promotes professional

practice and ensures that workers function within a professional code of ethics. In FY 2008 expert

consultants and mentors will be provided to all 50 Isibindi Projects to ensure development of the project

staff and thus ensure provision of quality services.

ACTIVITY 2: OVC Outreach Services

NACCW will ensure that all OVC are visited regularly and provided with services within a child rights

framework. These services will include education on children's rights and assistance with access to

education, facilitating access to legal documents, food parcels, social security grants, ARV treatment for

children and health care, child protection, services for recreation and play, educational support and

bereavement and grief work. Health Care services will include general health care, health care for HIV-

infected OVC and preventive health care services. NACCW will ensure that OVC also receive child care

services including counseling, grief-work, age-appropriate developmental programs and assessment in the

context of ordinary daily events like bath-times, mealtimes, study times and playtimes. Lifespace work

(using daily events and routines like meal preparation, meal times, study times, play times etc

developmentally and therapeutically) will be offered in the community in homes, schools and drop-in centers

to build resilience and empower OVC to take charge of their lives. To respond to large numbers of children

requiring after school care services and less intensive support, the NACCW Isibindi projects will create safe

parks - safe places where children can play with access to child and youth care workers. The safe park will

provide homework supervision, health care assessments and HIV prevention and psychosocial discussions,

organized sports fixtures, free play, group discussions by age group and gender as appropriate, cultural

activities and the opportunity for children to connect with adults in a safe environment. This intervention will

be replicated in the communities and in the established Isibindi Projects; the additional components

serviced will be added.

ACTIVITY 3: Child Protection and Gender Equity

The NACCW program will focus on the identification, care, management and referral of children who are

abused and neglected. This will be a focus area of the NACCW project in FY 2008. Expert training and

support from other specialist organizations will ensure effective service from the child and youth care

workers according to minimum standards and practice procedure. Caregivers will be sensitized and trained

to actively identify and address gender-based violence in vulnerable households, particularly households-

headed by young females. Children with disabilities will benefit from focused developmental and support

programs by trained child care workers including referrals and physical therapy. In addition, a gender

program for the protection and promotion of the girl child will be developed in the 50 PEPFAR supported

NACCW sites. This gender program will include women's development/leadership skills workshops for the

child and youth workers so that gender sensitivity, women's rights and protection will be integrated into the

ethos of daily activities and programs of the Isibindi project. A specific girl child program will be in place in

all Isibindi sites including career camps and bursaries for girl children who have passed their final exams

(grade 12) and are heading households; this will increase the economic security for the girl child and

siblings in the home.

In addition to NACCW's child protection and gender equity activities, NACCW will also implement

interventions designed to meet the needs of adolescent OVC girls and boys. CYCW will be trained on the

needs of adolescent girls and boys and activities will be mainstreamed into all household visits and at Safe

Parks. Activities will include information and education on reproductive health and teenage pregnancy,

prevention of gender-based violence and gender roles and role models. This gender program initiated in FY

2007 will be ongoing in the sites that it was piloted in and new additional projects will be provided with the

program needs assessment. Ongoing follow up and support will be provided to sites that have already

started this program.

ACTIVITY 4: Advocacy

The Isibindi Model translates SAG policy for OVC into practice. By sharing better practices from the Isibindi

model with national and provincial government departments, NACCW will help inform national policy on

OVC. NACCW promotes the UN Children's Rights Charter, the South African National OVC policy and the

South African Draft Children's Bill as well as other national policy and legislation for the protection and

promotion of children rights and interests in the context of HIV and AIDS. The focused advocacy from the

NACCW in the consultations on the Draft Children's Bill has resulted in amendments for the inclusion of

child and youth care workers in the Bill in communities as a cadre of caregivers providing social services.

This will have significant impact on future of the Isibindi Model and the future security of the child and youth

care workers being developed. In FY 2008 NACCW will continue to target key stakeholders such as

magistrates, social workers, and officials in SAG departments such as Home Affairs (responsible for birth

certificates) and Education, at provincial local level through meetings and other forums to ensure that

government policy and legislation are implemented in the best interests of the child. In all Isibindi projects,

children who have been refused admission to school (for lack of school uniforms or nonpayment of school

fees) have all been successfully readmitted.

Activity Narrative: ACTIVITY 5: Care and Support for Disabled Orphans and Vulnerable Children

NACCW will conduct a needs assessment of each Isibindi site to identify OVC requiring care and support.

CYCW will network with health care facilities and service providers in each site to foster access to

specialized and disability services. A report for each site will document the number of children with special

needs, describe the identified needs (both in individual children and as a group), outline existing local

health/social service facilities, and articulate an action plan. NACCW mentors will meet with appropriate

rehabilitation departments at local hospitals or clinics. CYCW will refer OVC for services and follow up to

ensure services are received.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14032

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14032 3128.08 U.S. Agency for National 6689 2312.08 $4,197,500

International Association of

Development Childcare Workers

7564 3128.07 U.S. Agency for National 4467 2312.07 USAID GHAI $3,300,000

International Association of

Development Childcare Workers

3128 3128.06 U.S. Agency for National 2725 2312.06 USAID GHAI $1,200,000

International Association of

Development Childcare Workers

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's access to income and productive resources

* Increasing women's legal rights

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* TB

Workplace Programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $2,974,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Estimated amount of funding that is planned for Economic Strengthening $1,444,530

Education

Water

Estimated amount of funding that is planned for Water $3,970

Table 3.3.13: