Expanding orphans and vulnerable children support in Haiti: Improving the definition of ‘support’ Elaine Baruwa, PhD, Rachelle Castagnol, MD, Asha Sharma, MA, Natasha Hsi, MPH, Abt Associates www.abtassociates.com June 2011 Background *http:/www.measuredhs.com/pub_details.cfm?ID=767 Objectives and Methods Educational Support Results All partners report providing educational support to thousands of OVC but Type of support varies widely Cost per child varies widely HIV can further debilitate Haitian children beyond their already challenged circumstances 2008 WHO estimates for Haiti: 50% primary school enrollment, DTP3 immunization rate of 53%, 29% of children <5 years old are moderately to severely malnourished PEPFAR and Global Fund have been funding OVC programs since 2003 June 12th earthquake exacerbated an already harsh situation for children in and around Haiti’s densely populated capital, Port-au-Prince EMMUS-IV* estimated 25% of children to be ‘vulnerable’ in 2006 – which equates to approximately 800,000 children in 2009 Precisely define and cost the OVC services delivered in Haiti To deepen understanding of OVC support provided beyond broad PEPFAR indicators reported To support program funding decision-making To support quality improvement activities The four largest PEPFAR implementing partners were selected for: Key informant interviews (program managers, financial officers) Financial report reviews Monitoring and evaluation data reviews Next Steps Increasing the specificity of M&E and financial reporting Health Systems20/20 is piloting output-based financial reporting of community-based care (including OVC care) in Mozambique and Tanzania in 2011 Further work on understanding impact of services delivered is highly recommended To differentiate between process measures and actual impact/achievements and streamline care to high-impact interventions To ensure appropriate use of costing information – the cheapest should not always be used and the most expensive should not always be dropped To reduce barriers to partnering with other funders by ensuring that each funder can identify their contribution and impact To increase our understanding of potential use of OVC support/partners in reaching OVCs with health interventions, referral 'systems' and monitoring of impact Recommendations include: Partners should be required to report precise descriptions of support and costs per child supported Impact evaluations are critical, funders fund children in school but school fees ≠ educated child $ 0 $ 5 0 $ 1 0 0 $ 1 5 0 $ 2 0 0 $ 2 5 0 $ 3 0 0 Primary Education Secondary Education Uniforms School Bags Vocational Training Partner 1 Partner 2 Partner 3 Partner 4 Nutritional Support Results All partners report providing educational support to thousands of OVC but Type and cost of support varies widely across partners (as low as $50 and as high as $450) Recommendations include: Partners should be required to report precise descriptions of support and costs per child supported Impact evaluations are critical, funders want to increase/improve OVC nutrition, but no partner monitored child weight $ 0 $ 5 0 $ 1 0 0 $ 1 5 0 $ 2 0 0 $ 2 5 0 $ 3 0 0 $ 3 5 0 $ 4 0 0 $ 4 5 0 $ 5 0 0 H o u s e h o l d F o o d P a c k a g e I n d i v i d u a l F o o d P a c k a g e R e a d y - t o - U s e T h e r a p e u t i c F o o d C o u r s e / C h i l d 3 M e a l s / D a y / C h i l d P a r t n e r 1 P a r t n e r 2 P a r t n e r 3 P a r t n e r 4 January 2010

Expanding Orphans and Vulnerable Children Support in Haiti: Improving the Definition of 'Support

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Page 1: Expanding Orphans and Vulnerable Children Support in Haiti: Improving the Definition of 'Support

Expanding orphans and vulnerable children support in Haiti: Improving the definition of ‘support’Elaine Baruwa, PhD, Rachelle Castagnol, MD, Asha Sharma, MA, Natasha Hsi, MPH, Abt Associates

www.abtassociates.com

June

Background

*http:/www.measuredhs.com/pub_details.cfm?ID=767

Objectives and Methods

Educational Support Results

All partners report providing educational support to thousands of OVC but

Type of support varies widely Cost per child varies widely

HIV can further debilitate Haitian children beyond their already challenged circumstances 2008 WHO estimates for Haiti: 50% primary

school enrollment, DTP3 immunization rate of 53%, 29% of children <5 years old are moderately to severely malnourished

PEPFAR and Global Fund have been funding OVC programs since 2003

June 12th earthquake exacerbated an already harsh situation for children in and around Haiti’s densely populated capital, Port-au-Prince

EMMUS-IV* estimated 25% of children to be ‘vulnerable’ in 2006 – which equates to approximately 800,000 children in 2009

Precisely define and cost the OVC services delivered in Haiti To deepen understanding of OVC support provided

beyond broad PEPFAR indicators reported To support program funding decision-making To support quality improvement activities

The four largest PEPFAR implementing partners were selected for: Key informant interviews (program managers,

financial o�cers) Financial report reviews Monitoring and evaluation data reviews

Next Steps Increasing the specificity of M&E and financial reporting Health Systems20/20 is piloting output-based financial reporting of community-based care (including

OVC care) in Mozambique and Tanzania in 2011 Further work on understanding impact of services delivered is highly recommended To di�erentiate between process measures and actual impact/achievements and streamline care to

high-impact interventions To ensure appropriate use of costing information – the cheapest should not always be used and the

most expensive should not always be dropped To reduce barriers to partnering with other funders by ensuring that each funder can identify their

contribution and impact To increase our understanding of potential use of OVC support/partners in reaching OVCs with health

interventions, referral 'systems' and monitoring of impact

Recommendations include: Partners should be required to report precise descriptions

of support and costs per child supported Impact evaluations are critical, funders fund children in

school but school fees ≠ educated child

$50

$100

$150

$200

$250