Community Care Worker Management Policy Framework – Draft Version 6 – Developing a Children Sector Position & Advocacy Strategy Menaka Jayakody (NACOSA) & Anthony Ambrose (World Vision) Children’s Sector Summit November 2009 Durban

Background The formulation of this document commenced more than a year ago. There were attempts made to consult with civil society, which made several submissions on earlier versions, but concerns are still being raised that only a very small portion of NPOs and an even smaller group of CCWs have had the opportunity to be informed about this process, despite the effects this would have on them and the consequential risks with which they might be confronted.

Background Draft version 6 of the Community Care Worker Management Policy Framework (“the document”) became available for civil society input in October 2009 after the versions between version 4 and this draft were embargoed. Several of the concerns identified by civil society during the Boksburg workshop in June 2009 were addressed in this document (even if not sufficiently), but more concerns were raised by civil society as it became evident that implementing this document in its current format will have far reaching implications for community care workers (CCWs), non profit organisations (NPOs) and the entire primary health care (PHC) system.

Overview Official service package for HCBC and support-to expand beyond HIV Systemic processes and management philosophy- systemic issues-improving workforce- extension of health and social development systems-Community care workers Minimum requirements for public funded caregivers- management, support and skills development NPO based Funding the policy framework: stipends, training

Community/ Care Worker Department of Social Development Department of Health Department of Labour Department of Agriculture Extended Public Works Programme NGO’s Local and International Donors

DRAFT Community Care Worker Policy Frame Work SANAC Children’s Sector SANAC PIC / Care and Support TTT SANAC NGO Sector NACCA Government

DRAFT Community Care Worker Managemnt Policy Frame Work SANAC Children’s Sector SANAC PIC / Care and Support TTT SANAC NGO Sector NACCA Government AIDS Consortium, ALP, ECHO, CMT, RHRU, TAC, UWC Public School Health, Yezingane Network, CRC, MSF, COSATU Et al DSD – HIV & AIDS Directorate, DSD - OVC Directorate DOH – HIV & AIDS Directorate Department of Labour DSD, DoH, DoA, Child Welfare SA, World Vision, NMCF REPSSI, SCUK, Care SA et al Yezingane Network, CRC, ECHO, Child Welfare, World Vision, Childline, NACOSA, CINDI, ACESS, CIE, et al

What are the Issues: 2PF Community Care Worker Policy Framework version 6 SA National Policy Framework for Home and Community Based Care and Support Programme

Some issues specific to detail of current draft Section on volunteers problematic- contracts, conditions of service, and differentiates volunteers from CCWs- hours of work and not adhering to basic conditions of employment Silent on targets regarding coverage-services, frequency, coverage, what by when Single approach to community care workers- what about the range of services they offer Has a rand amount in the framework- surely this should change with inflation- rather have a commitment to a minimum wage Flow in the management structure between community level, sub districts and facility level and district level and CCW.

Community Care Workers Decades of Community Based Workers Impact of HIV/AIDS & burden of disease Formal health and social welfare systems not coping Inaccessibility of services to some communities CCW programmes create entry point to accessing services for communities

Partners? Gov funding stipends and some admin (%) Contracting – Service Level Agreements NPO provide services with CCWs Dry season funding periods Disruption of services CCWs continue to serve (passion) Loss of staff seeking job security Collapse of services

Costing Decent work and wages Conditions of service & benefits Operational costs and logistics Transport for delivering service

Unit cost Salary (specified draft 6) Training (not specified draft 6) Supervision (not in draft 6) Care for the carer (not in draft 6) Administration (not included) Management (not in draft 6)

Engagements Treatment care and support technical task team NGO sector working group 11 th -12 th November 2009 NACCA SC- 17 th Nov 2009 Children’s Sector 2009 National Summit networks- informal- ALP,AC, NACOSA-CBCC, CRC, et

Civil Society and Government – Proposed meeting A proposed meeting between civil society and the relevant government Departments of Health and Social Development (DOH/DSD) under the leadership of the South African National AIDS Council (SANAC) secretariat’s new head, Dr Nono Simelela, will be scheduled for late November The purpose of this meeting will be to allow civil society to raise their concerns over the document, as well as for meaningful engagement and involvement in the strengthening of this vital document that will have wide ranging implications and effects on not only and significantly, on the implementation of the the National Strategic Plan for STIs and HIV/AIDS , but also on the entire healthcare provision landscape.

Consultative Response Needed What is our response as Yezingane Network What are the children’s sector specific issues on the CCWMPF?