Presented by Moses Dombo CCIH Conference May 25 2009 World Vision USA Mdombo@worldvision

1. Groans of Joy are the Joy of Pain(A case study of one orphan, Musolima)Encouraging outcomesin OVC Programming Presented by Moses Dombo CCIH Conference May 25 2009 World Vision USA Mdombo@worldvision.org

3. Some initial discussion provoking thoughts • Due to High prevalence of HIV/AIDS in Sub-Saharan Africa, the number of orphans and vulnerable children has continued to increase • It is important to recognize that before AIDS, there were OVC and there will be OVC beyond HIV/AIDS. • Responding to the growing need and needs of OVC is becoming more complex: • Number, scale, rate, longevity, new occurrences, distribution, gender variations, location • The food and economic crisis, urbanization and low land productivity • Armed conflict and Domestic violence/ Child abuse issues • There is need for more comprehensive, less disjointed, more inclusive, longer lasting, family specific response models. How do you ensure better targeting? • How do you ensure equitable service delivery?

4. Percent of children under age 15 that are orphans by year, region and cause, 1990-2010 Percent (%) Sub-Saharan Africa Asia Latin America & Caribbean Source: Children on the Brink, 2002

5. Number of double orphans in sub-Saharan Africa is increasing due to HIV/AIDS Number in millions Source: Children on the Brink, 2002

6. Who takes care of orphans? Relationship of double orphans with head of household they live in Ethiopia Zimbabwe Source: DHS, 1999-2001

7. Munimuthu The story of Munimuthu – a helpless child Sold to meet the funeral expenses of his mother Picked up on the local media

8. Some initial discussion provoking thoughts • CBOs and FBOs are striving in their own way to support Orphaned and Vulnerable Children but with limited resources and transparency challenges, there is need to identify more effective service delivery models. • Cash transfers, Service coupons, Chief’s granaries, UPE, • There is need to identify the survival networks preferred by the children (or established by their parents) and strengthen those networks. families have access to comprehensive services. • Families, Households, the ‘Extended family’ and the immediate Communities in which these children live are the primary providers of support to the children. • If OVC programs will succeed, we need to learn how to build on the efforts of these households, families (narrower and wider)

9. Family Based OVC model • Makes children the centre of focus, but works with the Caregivers/ Guardians to determine most appropriate responses • Measures impact at the family level • Works through existing survival, development and safety networks • Coordinated by a central body for enhanced accountability • Is comprehensive and multi-sectoral

10. Bringing Hope Changing Lives:Munimuthu and family after WV Intervention

11. Lessons from Groans of Joy are the Joy of Pain • The pain of losing parents takes a very long time to heal. Every time something hurtful happens, it reminds the children of the loss of their parents. • Parental loss is very disruptive to a child’s growth, development, dreams and hopes for the future: • But most development programs focus more on their survival needs • Even Psychosocial support projects tend to ignore the socialization component.

12. Lessons fromGroans of Joy Are the Joy of Pain • Extended Family jealousies/ conflicts can undermine service delivery, therefore children should be given an opportunity to choose their caregivers. Programmers need to take time understanding the sociology of households, communities before intervening. (Unfortunately, this basic social development principle is undermined by current programming models that rush for numbers and quick development gains • Children never lose hope for a better future. They recognize when they have been taken advantage of; but are constantly looking for a helping hand that will help them to get to their destination.

13. Lessons fromGroans of Joy Are the Joy of Pain • Every little helps: It is not necessarily the big programs that make the difference. For the individual child, it is that which meets them at their point of need that counts. • Education is the best investment in the lives of OVC • Some outcomes are difficult to measure; but the impact of good programming goes beyond individual children to cover entire households.

14. Empowerment Continuum Community Ownership, Resources and Sustainability Natural Disaster, Political Instability, etc. Less Empowered More Empowered Service provision ~ Empowerment Community has little to no resources to provide for the most immediate needs but relies completely on WV. Community has ability to match the delivery and provision of services to meet immediate needs but still relies on WV resources while building their own capacity,. Community is able and willing to provide resources to respond to critical needs. Supplemental assistance by WV is not needed. Active and On-going Planning World Vision Involvement

15. ` Case Study of Joseph Kabogoza In 1990, World Vision received a grant from World Bank through the government of Uganda to implement a poverty alleviation and vulnerable population support program in Rakai district in Uganda. With that support, WV worked with the communities to get thousands of children who had fallen out of school, back to the classroom by engaging a multi-pronged strategy: First World Vision paid School fees for thousands of children, some of whom had fallen out of school after their parents fell sick and died, mostly to AIDS. Rakai at the time was the community worst hit by the HIV and AIDS pandemic globally. Despondence and lack of Hope were rife. The registration of children in some schools had fallen by more than 50%! In some cases children had fallen out of school for paltry sums of money (300 shillings or 20 cents!) By getting children back in school, World Vision was able to utilize that effort to advocate for retention of children in school and for greater accountability in schools, while working with communities to improve or create infrastructure (building schools and teachers’ houses). World Vision also worked with the parents and guardians of the children to improve household incomes and food security. When World Vision went to Rakai in 1990, the district used to be among the last in the annual Primary leaving examinations. Since then, with additional support from other donors like DANIDA and the government, the academic performance of Rakai is consistently among the top 20 districts in the country. The civil society is vibrant and evidently, WV has left a mark on the community and thousands of children’s livelihoods have been transformed for the better. In an evaluation conducted by World Bank, one grandparent told the evaluation team “World Vision can now go and help other people; because I have been empowered enough”. Joseph Kabogoza had first approached WV when his grandchildren failed to pay Shillings 1,200 as examination fees after World Vision had made a contribution of about Sh.4,000 in Tuition. World Vision helped him with his immediate need, but went ahead to support him start a bee keeping project and passion fruit production. World Vision also provided support for him to improve his house, as the one in which they lived risked killing them all. By the end of two years of working with Joseph, his household income rose from near zero, to approximately Shillings. 120,000 per year from fruit and honey production. World Vision US believes that this is how empowerment works. Rather than create a false dichotomy between Service delivery and Empowerment; ADP staff should be supported to learn how to prioritize development needs with communities and how to package development responses for maximum benefit.