The scale, scope and impact of alternative care for OVC in developing countries

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Over 145 million children worldwide have lost one or both parents due to various causes, 15 million of these are due to AIDS; and many more have been made vulnerable due to other causes. The global community has responded by putting in place various care arrangements for these children. However, the scale, scope and impact of these alternative care approaches have not been well summarized. The aim of this literature review is to synthesize and analyze available data on alternative care placements and their impact on the lives of orphans and other vulnerable children (OVC). Both the short-term and long term wellbeing of a child depends a lot on where they live and the care they receive in those settings.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

Children of female sex workers and injection drug users: a review of vulnerability,resilience, and family-centered models of care in low and middle-income countries

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Female sex workers (FSWs) and injection drug users (IDUs) are often categorized as two of the four populations “most-at-risk” for becoming infected with HIV due to behaviors that heighten their vulnerability to the virus. According to UNAIDS, the term “most-at-risk populations” refers to men who have sex with men, injection drug users, sex workers and their clients. Injecting drugs with non-sterile needles and unsafe sex between male couples and sex workers and clients are believed to drive the HIV epidemics in Western countries, former Soviet republics, and Asia. Interventions for most-at-risk populations tend to focus on the needs of adults with the objective of reducing their risk for HIV through prevention and behavior-change education and risk-reduction strategies. But, to date, little attention has been paid in the published literature to the vulnerabilities faced by their children or to interventions focused on keeping these potentially vulnerable families together, improving the wellbeing of both parents and children, and reducing the risk of both generations for becoming infected with or transmitting HIV.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

The scale, scope and impact of alternative care for OVC in developing countries

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Over 145 million children worldwide have lost one or both parents due to various causes, 15 million of these are due to AIDS (1,2); and many more have been made vulnerable due to other causes. The global community has responded by putting in place various care arrangements for these children. However, the scale, scope and impact of these alternative care approaches have not been well summarized. The aim of this literature review is to synthesize and analyze available data on alternative care approaches and the impact of these placements on the lives of orphans and other vulnerable children. Both the short-term and long term wellbeing of a child depends a lot on where they live and the care they receive in those settings.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

Children of female sex workers and injection drug users: a review of vulnerability, resilience, and family-centered models of care in low and middle-income countries

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Background: Injection drug users and female sex workers are often categorized as two of the populations most at risk for becoming infected with HIV in countries with concentrated epidemics. Many of the adults who fall into these categories in low and middle income contexts are also parents, but little is known about the vulnerabilities faced by their children, their sources of resilience, or programs providing services to these often fragile families. Methods: We reviewed the peer-reviewed and gray literature to synthesize current knowledge on the situation of these children and families, and interventions currently in place in low and middle income countries. Organizational websites and references of all relevant sources were manually searched, and key informants from service organizations were contacted by phone and email. Results: A large amount of literature assessing the vulnerability and resilience of children of drug users and alcoholics in developed countries was found. Their children can face unique risks, stigma, and discrimination, but child vulnerability and resilience are associated in the substance abuse literature with the physical and mental health of parents and family context. Research on the situation of the children of sex workers is extremely limited. Interventions have been implemented in low and middle-income contexts but they tend to be small, piecemeal, struggling to meet demand; and undocumented, and most have not been evaluated. We present preliminary descriptive data from an organization working with pregnant and new mothers who are drug users in Ukraine and an organization providing services to sex workers and their families in Zambia. Discussion: Because parents’ drug use, sex work, or same sex relationships are often illegal and hidden, identifying their children can be difficult and may increase their vulnerability and marginalization. Therefore, researchers and service providers must proceed with caution when attempting to reach this population. Promising components of family-centered care include: strengthening family caring capacity through home visitation and peer support, providing early childhood development programs and crèches or drop-in centers for children; economic strengthening and job skills training for parents. Integration of legal assistance with health and other social services is also gaining increased international attention.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

Nigeria research situation analysis on orphans and other vulnerable children

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Addressing the needs of orphans and vulnerable children (OVC) and mitigating negative outcomes of the growing OVC population worldwide is a high priority for national governments and international stakeholders across the globe who recognize this as an issue with social, economic, and human rights dimensions. Assembling the relevant available data on OVC in one place, and acknowledging the gaps that still exist in our knowledge, will assist policy makers and program implementers to make evidence-based decisions about how best to direct funding and program activities and maximize positive outcomes for children and their caretakers.This Research Situation Analysis on OVC presents a program-focused summary of available information on: • Current policies, programs and interventions designed and implemented to assist them • Gaps in these policies, programs and interventions • OVC research conducted between 2004-2008 • Gaps in the Nigerian OVC evidence base. The Brief analyzes the available data for critical gaps in the national response and our understanding about whether current interventions are fulfilling the needs and improving the lives of vulnerable children. The report then recommends actions required to increase the knowledge base for improving the effectiveness and impact of OVC programs.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

Kenya research situation analysis on orphans and other vulnerable children

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Addressing the needs of orphans and vulnerable children (OVC) and mitigating negative outcomes of the growing OVC population worldwide is a high priority for national governments and international stakeholders that recognize this as an issue with social, economic, and human rights dimensions. Assembling the relevant available data on OVC in one place, and acknowledging the gaps that still exist in our knowledge, will assist policy makers and program implementers to make evidence-based decisions about how best to direct funding and program activities and maximize positive outcomes for children and their caretakers. This Research Situation Analysis, Kenya Country Brief, presents a program-focused summary of available information on: • The number of orphans and vulnerable children in Kenya. • Current policies, programs and interventions designed and implemented to assist them. • Gaps in these policies, programs and interventions. • OVC research conducted between 2004 and 2008. • Gaps in the Kenyan OVC evidence base.The Brief analyzes the available data for critical gaps in the national response and our understanding about whether current interventions are fulfilling the needs and improving the lives of vulnerable children. The report then recommends actions required to increase the knowledge base for improving the effectiveness and impact of OVC programs.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

Zambia research situation analysis on orphans and other vulnerable children

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Addressing the needs of orphans and vulnerable children (OVC) and mitigating negative outcomes of the growing OVC population worldwide is a high priority for national governments and international stakeholders across the globe who recognize this as an issue with social, economic, and human rights dimensions. Assembling the relevant available data on OVC in one place, and acknowledging the gaps that still exist in our knowledge, will assist policy makers and program implementers to make evidence-based decisions about how best to direct funding and program activities and maximize positive outcomes for children and their caretakers. This Research Situation Analysis, Zambia Country Brief presents a program-focused summary of available information on: • The number of orphans and vulnerable children in Zambia • Current policies, programs and interventions designed and implemented to assist them • Gaps in these policies, programs and interventions • OVC research conducted between 2004-2008 • Gaps in the Zambian OVC evidence base. The Brief analyzes the available data for critical gaps in the national response and our understanding about whether current interventions are fulfilling the needs and improving the lives of vulnerable children. The report then recommends actions required to increase the knowledge base for improving the effectiveness and impact of OVC programs

Vietnam research situation analysis on orphans and other vulnerable children

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Addressing the needs of orphans and vulnerable children (OVC) and mitigating negative outcomes of the growing OVC population worldwide is a high priority for national governments and international stakeholders across the globe who recognize this as an issue with social, economic, and human rights dimensions. Assembling the relevant available data on OVC in one place, and acknowledging the gaps that still exist in our knowledge, will assist policy makers and program implementers to make evidence-based decisions about how best to direct funding and program activities and maximize positive outcomes for children and their caretakers. This Research Situation Analysis, Vietnam Country Brief presents a program-focused summary of available information on: • The number of orphans and vulnerable children in Vietnam. • Current policies, programs and interventions designed and implemented to assist them. • Gaps in these policies, programs and interventions. • OVC research conducted between 2004 -2008. • Gaps in the OVC evidence base. The Brief analyzes the available data for critical gaps in the national response and our understanding about whether current interventions are fulfilling the needs and improving the lives of vulnerable children. The report then recommends actions required to increase the knowledge base for improving the effectiveness and impact of OVC programs.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

Namibia research situation analysis on orphans and other vulnerable children

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Addressing the needs of orphans and vulnerable children (OVC) and mitigating negative outcomes of the growing OVC population worldwide is a high priority for national governments and international stakeholders across the globe that recognizes this as an issue with social, economic, and human rights dimensions. Assembling the relevant available data on OVC in one place, and acknowledging the gaps that still exist in our knowledge will assist policy makers and program implementers to make evidence-based decisions about how best to direct funding and program activities and maximize positive outcomes for children and their caretakers. This Research Situation Analysis, Namibia Country Brief presents a program-focused summary of available information on: • The number of orphans and vulnerable children in Namibia. • Current policies, programs and interventions designed and implemented to assist them. • Gaps in these policies, programs and interventions. • OVC research conducted between 2004-2008. • Gaps in the Namibian OVC evidence base.The Brief analyzes the available data for critical gaps in the national response and our understanding about whether current interventions are fulfilling the needs and improving the lives of vulnerable children. The report then recommends actions required to increase the knowledge base for improving the effectiveness and impact of OVC programs.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

A Qualitative Exploration of Community Ownership of a Maternity Waiting Home Model in Rural Zambia

Context Ownership is an important construct of sustainability for community-based health programming, though it is often not clearly defined or measured. We implemented and evaluated a community-driven maternity waiting home (MWH) model in rural Zambia. We engaged stakeholders at all levels and provided intensive mentorship to an MWH governance committee comprised of community-selected members. We then examined how different stakeholders perceive community ownership of the MWH. Methods We conducted 42 focus group discussions with community stakeholders (pregnant women, fathers, elders, and community health volunteers) and 161 in-depth interviews with MWH stakeholders (health facility staff, district health officials, and MWH governance committee and management unit members) at multiple time-points over 24 months. We conducted a content analysis and triangulated findings to understand community ownership of the MWH and observe changes in perceptions of ownership over time. Results Community members’ perceptions of ownership were related to their ability to use the MWH and a responsibility toward its success. Community and MWH stakeholders described increasingly more specific responsibilities over time. Governance committee and management unit members perceived their ability to represent the community as a crucial component of their role. Multiple respondent types saw collaboration between the governance committee and the health facility staff as key to allowing the MWH to meet its goal of serving the community. Conclusion The perceptions of community ownership evolved as the intervention became more established. Use of the MWH, and clear understanding of roles and responsibilities in management of the MWH, seemed to foster feelings of community ownership. To improve the sustainability of community-based maternal and child health programs, interventions should be accessible to target communities and clear roles should be established among stakeholders