Africare implements Pamoja Tuwalee, a five-year cooperative agreement that aims to improve the well-being of OVC households using sustainable approaches. The project targets vulnerable children and their families in Central Zone. The main objectives are the project are to strengthen the ability of local government authorities (LGAs) to plan, coordinate, manage, and monitor the OVC response at local levels; increase access to quality, community-level health and social services; support child protection systems and increase child participation in problems affecting OVC; and strengthen capacity of Tanzanian institutions to provide leadership in addressing OVC issues.

The program contributes to goal one of the Partnership Framework, which aims to maintain and scale-up services to improve the lives of Tanzanians affected by HIV/AIDS. It also contributes to the Tanzania Global Health Initiative strategy that is focused on increased access to quality maternal, child, and reproductive health services.

Africares program approach builds sustainability and efficiency by partnering with LGAs to establish ownership of program interventions. Africare then builds the capacity of the LGAs to meet their commitments. The project also trains and provides grants to 18 local organizations. Training of community volunteers is a key component of the project as it is anticipated that volunteers will remain within the communities long after the project ends.

Africare will continue to collect program data as identified in their M&E plan, which includes mandatory PEPFAR indicators. In addition, baseline data will be utilited to strategically target communities for service packages.

Africare is an international organization that has implemented OVC programs in Tanzania with support from PEPFAR since 2006. Africares approach of supporting community-level most vulnerable childrens committee (MVCC) members, para-social workers, peer educators, and others supports the PEPFAR OVC priority to strengthen community safety nets for vulnerable children. The project targets households that are considered most vulnerable, such as those that comprise of children or caregivers infected and affected by HIV, children with disabilities, children or elderly heads of households, and households in high HIV prevalence areas that live below the poverty line.

Africare will continue to support delivery of health and social services using a household approach through grants and technical assistance to local organizations. Adoption of a household approach to service delivery reflects evidence that vulnerable children are best cared for through support to the whole household. One strategy that Africare will continue to use involves provision of birth certificates and health access cards, as needed, at the point of identification. In addition, Africare will focus its resources on strengthening households, primarily through economic strengthening and service linkages. To increase local ownership of interventions, Africare will continue to work with districts to appropriately allocate resources for the OVC response and engage community leaders and LGAs in program planning and implementation. Africare will also concentrate on mobilizing communities to support care activities for vulnerable households and address stigma and discrimination of vulnerable children and their families. By implementing an evidence-based approach to HIV prevention in adolescents, Africare will target vulnerable youth with life skills, reproductive health education, and psychosocial support.

In Iringa, the region with the highest prevalence of HIV, scale up HIV prevention strategies will be implemented using funds from the global gender-based violence (GBV) initiative and funds targeted for HIV prevention amongst youth. GBV activities will focus on women and girls, offering protection services against physical and sexual violence, which will also include community-level outreach to change social norms that contribute to GBV and HIV transmission. Meanwhile, youth prevention activities will be centered on economic strengthening and life skills to reduce vulnerability and transactional sex.

Through the use of baseline data, plans to tailor interventions primarily at the community-level with specialized support to individual households will be conducted. Although this approach is in contrast to a general service delivery strategy, the outcome will be increased efficiencies. Africare will document this experience to contribute to the evidence-based research in this area.

Africare has been challenged with slow program start-up, which may have resulted in gaps in services to children who previously received services under former mechanisms in Africares catchment regions. However, in FY 2011 adjustments have been made to improve and meet required targets, mainly by combining its baseline activity with the government MVC identification process.