1. Furaha Graduation and Resilience Model
Sustainable, COmprehensive REsponses (SCORE) for vulnerable children and their families
Furaha Graduation and Resilience Model
15 March 2017, Speke Resort Munyonyo

2. SCORE Briefer: USAID/PEPFAR Funding
LEAD AGENCY AVSI Foundation – Care International FHI360 and TPO Uganda PARTNERS *12 Local Implementers (from 66) DURATION 7 Years (Apr 2011 – Apr 2018) TARGET 25,000 HHs, 125,000 people REACH *31,943 HHs *178,974 people COVERAGE 35 districts *21 districts (oct 16) BUDGET 38,322,700 USD (34,326,470 USAID and 3,996,230 Cost share)

3. Coverage 35 districts 23 districts COP 16: 21 districts Staff 177 Staff (14 TSC, 73 Regional level and 90 IP level)

4. Objective 1: Economic strengthening:
SCORE Goal and Menu of Interventions Goal: To decrease the vulnerability of moderately and critically vulnerable children (VC) and their households.
Objective 1: Economic strengthening:
Village Savings and Loans Associations, Community skills training, Financial Literacy, Apprenticeship training, Market intelligence and linkages, Value Chain Development
Objective 2: Food security and Nutrition:
Farmer field school, junior farmer field schools, urban horticulture and kitchen gardens, Behavior change and communication; cooking demonstrations, radio spot messages, nutrition learning sessions, identification and referral of children with malnutrition
Objective 3: Child protection and legal services
child friendly school model, home visits, interactive learning sessions, Legal clinics, identification and referral of protection cases, birth registration
Objective 4: Family strengthening & access to critical services
Referrals to access critical services, parenting skills training, Life skills training, community dialogues, psychosocial support interventions, Early childhood development, mental health
DREAMS: Reducing HIV incidence among AGYW 10-24
Combined SES (apprenticeship, VSLA, Financial literacy, Community skills), Reducing HIV risk and Social asset building (HCT, VMMC, life skills, parenting skills, stepping stones), mobilizing communities for change (GBV reduction, dialogues and health messaging)

5. SCORE Approach
Multi-sectoral. Wide menu targeting members of the beneficiary households.
Family-centered approach. Engaging individual household members in different activities within the family
Commitment to “fit the project to the people”. Family- specific household development plans, featuring a mix of activities deemed most appropriate.
Use of evidence and robust M&E System: Unique identifier for each HH member, CLA: Parenting skills Life skills, VSLA studies, Bank linkages, Measure Evaluation, Resilience
Premised on capacity building and “Graduation model”
Working with existing community resources, people, implementing partners

6. SCORE Approach – Tailored pathways

7. Beneficiary Flow Chart – Case management model
Total ever enrolled 31,943 households
28,736 SCORE & 3,027 DREAMS
Active: 8,161 with 5,134 SCORE and 3,027 DREAMS
Household Development tool
PEPFAR Funded initiatives
VAT
Health facilities
VAT
Police
Retrogressed
(26%)
Resilient
(74%)
10,164 (66%) out of 15,298 enrolled Vatted households “graduated”
2,196 out of 5,134 (43%) of active households in pre-graduation at VAT5
Multiple pathways tailored to individual HH needs and resources/capacities

8. SCORE Beneficiary Profile

9. SCORE Beneficiary Household Characteristics

10. HIV Status

11. 90/90 Contribution

12. Activity Results Outcomes across result areas

13. Objective 1- Socio-economic strengthening

14. Objective 1- Socio-economic strengthening – Income changes

15. Socio-economic strengthening
1,615 VSLAs with 37,200 members have saved USD 3,889,055 and loaned USD 4,842,994. Av savings USD ,264 youth enrolled into apprenticeship 1,348 (76%) gainfully employed or own businesses

16. 13,375 trained in financial literacy 8,461 in community skills 11,580 in enterprise selection, planning and management (SPM) of IGAs

17. Objective 2- Food Security and Nutrition

18. Food security and Nutrition
15,124 members trained in improved agronomic skills through 504 farmer filed school groups
357 (71%) legally registered production and marketing groups.
60% (12,451) of enrolled household members (43% female) engaged in horticulture
27,946 people engaged in BCC (Nutrition dialogues/demos)
27.5% (2,973) households in FFS adopted environmentally friendly nutritional practices (use of energy-saving stoves)
Established a network of certified resourceful community- based personnel (122 FFS Facilitators and 333 Nutrition Peer Educators)

19. 7 to 9.5 months increment in the # of months households have adequate food in a year
51.6% to 13.5% (13.1% UW and 0.4% wasting/edema) reduction in the incidence of malnutrition
931 children identified with SAM and MAM referred and managed

20. Food security and Nutrition: Ex. Innovations

21. Value Chain Development

22. Objective 3- Protection and legal services

23. Operational school management committees Increased enrollments Re-enrollment of pregnant girls Suggestion boxes Positive discipline
651 Child friendly schools – over 6,532 pupils engaged and 300 teachers trained and active

24. Protection and legal services
34,912 children supported to access birth certificates - children with birth cards increased from 29% to 81%
29,708 people engaged in interactive learning sessions on protection
Home visits: 29,000 (99%) of all households visited at home
Legal referrals: 21,700 legal referrals through formal and informal structures.
Created a network of community resources; 272 Community legal volunteers

25. Objective 4: Family Strengthening and Access to essential Services

26. Community dialogues: 33,535 people attended Life skills: 7,608 adolescents and youth trained in life skills Parenting skills: 6,500 caregivers trained in parenting skills Psychosocial Support: 10,840 people supported with individualized psychosocial activities

27. Referral: 11,924 people referred for critical services
Family Strengthening and Access to essential Services
Referral: 11,924 people referred for critical services  

28. Early Childhood Development
61 Community Play groups 1,800 children participating weekly

29. DREAMS
Combined SES
VSLA: 50 groups, 998 AGYW members, savings 19,463,900 UGX, loans 9,506,000 UGX
Apprenticeship skills: 514
Community skills: 1223
Social Asset building
Life skills 3,427
Parenting 713
Stepping stones – 110
HIV risk reduction messaging (2,593 AGYW)  

30. Changes in select variables over four years: Measure Evaluation
Change in outcomes over time, N=17,953

31. Multi-sectoral Interventions Benefits Correlate Across Result Areas
Improvements in one aspect of the life of the families (say, food security) are shown to be linked to improvement in another aspect, possibly in an entirely different technical area, say schooling. A strong argument in favor of multisectoral interventions, such as the SCORE Project.

32. Schooling and Food Security

33. Absenteeism and Food Security

34. Documentation and Learning
Evaluations
Documentaries
Pictures
Manuals

35. Furaha Graduation and Resilience Model Beginning, process and results and Lessons
“Happiness model”

36. Beginning, process and results and Lessons

37. Furaha Graduation and Resilience model: step wise – case management approach
Vulnerability
Pre-graduation
Graduation
Resilience

38. Key concepts
Vulnerability: State of being unable to withstand shock, risk and stress. When a household is assessed using the model’s vulnerability assessment tool [VAT] and it scores above 40, then it is vulnerable
Pre-graduation: When a household’s vulnerability score drops below enrollment threshold (40) for the first time after at least one cycle of external assistance [1 year]. The HH receives only a thin layer of external assistance and will be monitored for 1 more year before graduation
Graduation refers to that moment when project beneficiaries who return a vulnerability score below enrollment threshold for two consecutive measurements (annual measurements) are exited from direct project support.
Resilience is when a graduated household remains below enrollment threshold (maintains a graduation status) a year after the time of graduation/exit from direct support
Retrogression: When a pre-graduation or graduated HH returns a vulnerability score above enrolment threshold [40] after a year of monitoring.

39. Principles of Furaha Graduation model
Designed and implemented within the USAID funded SCORE project in 2011
Targeting vulnerable households (characteristics like HIV affected, orphan hood, disability, chronic illness, poverty)
Capacity building (no handouts), multi-sectoral and unique family tailored pathways
Determined vulnerability and graduation thresholds (VAT – with “RED Flags”)
Responsible graduation – allowing for pre-graduation stage for 1 year and follow up after graduation (3 year cycle)
Resilience: when a graduated household remains below enrollment threshold a year after the time of graduation % resilience levels recorded
SCORE program cost is $281/HH/year

40. Findings on Graduation and Resilience

41. Transition in vulnerability

43. Results of the AVSI Foundation graduation and resilience model
Enrolled 28,736 households
10,164 households graduated (66% of all active enrolled 15,289)
5,134 (17%) households still in care with 2,195 (43%) in pre-graduation
74% (3 of 4 households) of graduated households are resilient two years post exit

44. Resilience findings on sample of graduated households followed up
Resilience findings on sample of graduated households followed up *2 years post graduation {August 2016)

45. Deeper Analysis on Graduation: Regression analysis table
Analysis of overall improvement in vulnerability; where N = 17,482, LR Chi2 = , p < 0.01
Analysis of improvement in vulnerability from critical; where N = 17,482, LR Chi2 = , p < 0.01

46. Effect of interventions on graduation
Participation in all SCORE Project objectives will lead to a reduction in vulnerability with child protection (OR 1.09), economic strengthening (OR 1.O7) and family strengthening (1.06) responsible for the greatest association
Even if child protection (OR 1.09) is associated with improvement in vulnerability, it was not significantly associated with stability after graduation (P>0.05)
Family strengthening (OR 1.O6, P<0.05) can enable a family transition from critical to moderate, slight vulnerability and eventual graduation
Participation in family strengthening activities were found to enable maintenance of post graduation/ resilience status (OR 1.06, P<0.05)

47. Graduation- Regression analysis – Disability and HIV status
Disability: odds of improved vulnerability and subsequent resilience were about 30% lower among households with a disability when compared to those without (OR = 0.71). Disability compounds households’ vulnerability.

48. Graduation- Regression analysis table – Disability and HIV status
No significant variations in improved vulnerability (OR 0.88) (p>0.05) and subsequent resilience was noted if the household was HIV affected or not. (OR 0.93) (p>0.05). This finding suggests that transition out of vulnerability or resilience after graduation is not affected by HIV positive status.

49. Who Benefits? Change in Vulnerability scores by HIV status

50. Characteristics of households who graduate – 10,164 (66%) VS those who do NOT graduate- 462 (3%)
Prevalence of some demographic characteristics may affect transitions in vulnerability:
Orphan hood, child headed, elderly headed households, disability, chronic illness

51. MEASURE Evaluation Results: Graduated HH had better outcomes, % Yes
Food failure – orange (less among the grad HHs compared to grey)
School for graduated yellow compared to blue for continuing HHs
Findings from logistic regression with a random sample of 1000 children:
-Better outcomes for graduated HHs vs continued HHs for:
- food failure (p<0.0001)
- school enrollment (p=0.0048)

52. Qualitative findings on a sample of graduated households followed up
Qualitative findings on a sample of graduated households followed up *2 years post graduation {August 2016)
Do graduated households experience shocks? Which type of shocks?
How do they deal with the shocks?
Do shocks result into retrogression?
What interventions can better the management of shocks?
Do graduated HHs still participate in SCORE interventions post graduation?
Others include: Banana Bacteria wilt, Falling of the house, Imprisonment, Miscarriage, Mudslide, Robbery

53. Did graduated households experience shocks?
Others include: Banana Bacteria wilt, Falling of the house, Imprisonment, Miscarriage, Mudslide, Robbery

54. Type of shocks experienced
Others include: Banana Bacteria wilt, Falling of the house, Imprisonment, Miscarriage, Mudslide, Robbery

55. How do households deal with these shocks?
OTHERS? Got health care, got out of prison,
Evt: Organic pesticides, mulching, terraces, better agronomic practices, seed bulking,

56. Does experiencing a shock relate with retrogression? YES

57. Post graduation: Are SCORE interventions sustainable
Post graduation: Are SCORE interventions sustainable? Who is participating in what?
ATLEAST 16 activities with VSLA, FFS, Parenting,

58. Does continued participation provide immunity from retrogression
Does continued participation provide immunity from retrogression? NOT REALLY. Work well with HHs when you have them… NO

59. Conclusions
Even the most vulnerable households can graduate out of vulnerability once their capacities and confidence is built to enable them on their own meet their needs.
SCORE project without consumption smoothing has demonstrated that capacity building and confidence building within a robust case management approach can motivate and enable households transition out of vulnerability and remain resilient
Activity participants MUST be provided with a set of climate and other shock management approaches to enable them adapt and transform in front of these shocks post graduation
The time to implement is NOW – during the project period. Even if interventions are sustainable – what matters most is the activity time (how you worked with beneficiaries to prepare them for the period after the activity ends)
Multi-sectoral programs targeted to an entire household are critical as they respond to multiple needs and include several members thereby multiplying the effects and achieving ownership

60. Case Story: Akwero Santa A-KIR-0297-02
Before USAID/SCORE: Monthly household income of 60,000 UGX (17.6 USD), poor health, poor rented shelter, one meal a day, children missing school due to lack of scholastic materials, seasonal and dangerous source of income; stone quarrying/ bead making
After USAID/SCORE: Monthly household income 500,000 UGX (I47 USD), on ART care and treatment and living positively, family eats three meals a day, children attend school regularly, (Santa’s son Ochaya completed a certificate course in mechanics and is now employed). Diverse sources of income; bakery, tailoring, beads with value addition, and the family now lives in their completed permanent house
Vulnerability Assessment (VAT) SCORES
VAT 1: 65, VAT 2:54, VAT 3:44, VAT 4:34 (Pre-graduation), VAT 5:36 (Graduated!)
VAT 1: 65, VAT 2:54, VAT 3:44, VAT 4:34 (Pre-graduation), VAT 5:36 (Graduated!)

61. “SCORE has encouraged me to work hard. I can now generate income by engaging in different IGAs. I am no longer someone who sits and waits for organizations or programs to come and give me handouts. I try to work hard for myself.” (Namayingo, current beneficiary)

62. Rita Larok
Chief of Party
AVSI Foundation Uganda
Tel:
website: