Module 2 OVC_SERV Orphans and Vulnerable Children

Module 2 OVC_SERV Orphans and Vulnerable Children
Monitoring, Evaluation and Reporting (MER) Indicators Implementing Partner Training December 2018

Overview 2.1. Introduction 2.2. Data definitions 2.3. Reporting
2.4. Eligible orphans and vulnerable children (OVC) services 2.5. Essential case management services 2.6. Timing and participation status 2.7. Transitions 2.8. Caregiver services 2.9. Special cases 2.10. PEPFAR’s DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) partnership 2.11. Avoiding double counting 2.12. Review

2.1. Introduction

Introduction The goal of OVC programs is to build stability and resilience in children and families who are exposed, living with, at risk of, or affected by HIV/AIDS. OVC programs accomplish these goals by providing case management focused on: Continuity of care Comprehensive care Family-centered care

Introduction Continuity of care: Children and their primary caregivers receive services every quarter according to their needs. Services start promptly after assessment and continue without unnecessary interruptions. Comprehensive care: The indicator specifies a minimum of one service per quarter. The majority of children will require multiple services. Family-centered care: Children and their primary caregivers should both receive services together. Programs should not plan to provide services only to one group or the other.

Introduction Learning objectives Define OVC_SERV disaggregates.
Calculate the total number of beneficiaries served as of semi- annual period of reporting (SAPR) and annual period of reporting (APR). Identify minimum services necessary to be considered active. Explain the concept of graduation benchmarks. Understand how the list of eligible OVC services is applied to children and caregivers. Differentiate between essential case management activities and eligible OVC services. Master how the timing of services delivered has an impact on program participation status.

2.2. Data definitions

Data definitions OVC_SERV definition
Number of beneficiaries served by PEPFAR OVC programs for children and families affected by HIV OVC_SERV is assessed at the individual level. OVC_SERV is reported in DATIM semi-annually.

Data elements Beneficiaries Active beneficiaries
Graduated beneficiaries Disaggregates Age Sex Exited or transferred beneficiaries Transferred out to a PEPFAR-supported partner Transferred out to a non-PEPFAR-supported partner Exited without graduation

Data elements Included in OVC_SERV total Beneficiaries
Active beneficiaries Graduated beneficiaries Disaggregates Age Sex Included in OVC_SERV total

Data elements Not included in OVC_SERV total
Exited or transferred beneficiaries Transferred out to a PEPFAR-supported partner Transferred out to a non-PEPFAR supported partner Exited without graduation Not included in OVC_SERV total Although not included in the OVC_SERV total, reported in DATIM under OVC_SERV indicator

+ Graduated beneficiaries
Data definitions Calculating the OVC_SERV total Active beneficiaries + Graduated beneficiaries = Total beneficiaries This definition means that some beneficiaries will be not be reported in DATIM as part of OVC_SERV total. We will discuss this issue in more depth later in this module. Each individual is counted only once under OVC_SERV per partner per reporting period.

Data definitions Active child beneficiaries Who Children (ages 0-17)
Youth ages who are still in secondary school What Received at least one age-appropriate service Have a case plan updated within the past four quarters Monitored at least quarterly When In each of the past two quarters Or in past quarter if beneficiary was newly enrolled Youth over the age of 20 are not eligible to be counted under OVC_SERV, unless they are serving as a primary caregiver to OVC in the household. Youth ages 18–20 in vocational school cannot be counted as child beneficiaries. Only secondary school enrollment qualifies youth in this age group to be counted. Report as of the last day of the reporting period.

Data definitions Active caregiver beneficiaries Who
Up to two primary caregivers of beneficiary children per child What Received at least one caregiver-appropriate service When In each of the past two quarters Or in past quarter if beneficiary was newly enrolled It is important that OVC programs only include as caregiver beneficiaries those adults who are actively fulfilling the role of parent or guardian. We will refer to these adults as “primary caregivers.” Report as of the last day of the reporting period.

Data definitions Graduated beneficiaries Who Children (0-17 years)
Youth (18-20 years) who are still in secondary school Caregivers of beneficiary children What Entire household (beneficiary children and up to two primary caregivers per child) has achieved all relevant graduation benchmarks When Graduated beneficiaries should be reported for previous 2 quarters at Q2 Graduated beneficiaries should be reported cumulatively for all 4 quarters at Q4

Disaggregation by sex is required for all age categories
Data definitions Disaggregates Disaggregation by sex is required for all age categories Note that disaggregation of younger children is a new requirement for all PEPFAR MER indicators. Disaggregates are required for active and graduated beneficiaries.

Data definitions Exited or transferred beneficiaries
Record and report these data in DATIM, but do not include in calculations for OVC_SERV total. These data capture critical information on resources invested in children who have exited or transferred. These data track the movement of children and their caregivers between PEPFAR and host-country programs that provide a sustainable response to OVC needs. An individual cannot be counted as exited or transferred and as active or graduated in the same reporting period by the same partner.

Data definitions Transferred to a PEPFAR partner
Who: beneficiaries (children and primary caregivers) What: transferred to another PEPFAR-supported partner When: Transferred beneficiaries should be reported for previous 2 quarters at Q2 Transferred beneficiaries should be reported cumulatively for all 4 quarters at Q4 Do not include when calculating OVC_SERV total.

Data definitions Transferred to a non-PEPFAR partner
Who: beneficiaries (children and primary caregivers) What: transferred to a non-PEPFAR-supported partner, including country-led services or other donor-funded programs When: Transferred beneficiaries should be reported for previous 2 quarters at Q2 Transferred beneficiaries should be reported cumulatively for all 4 quarters at Q4 Do not include when calculating OVC_SERV total.

Data definitions Exited without graduation
Who: Beneficiaries (children and primary caregivers) What: When: Exited beneficiaries should be reported for previous 2 quarters at Q2 Exited beneficiaries should be reported cumulatively for all 4 quarters at Q4, but any previously exited beneficiaries who become active again should not be reported in the total exited at APR Children Caregivers Have not received services in each of the past two quarters Have not received services in each of the past two quarters Have not received quarterly monitoring Do not have a case plan that has been updated within the past year [Note to facilitator: Do not engage in discussion of criteria for re-enrollment or re-entry into program. If participants raise this question, state that it is up to the country to decide how children will be re-enrolled into a program after exit.]

Data definitions Possible reasons for exiting without graduation
A child or caregiver may be exited without graduation if he or she: Has not received program services in each of the past two quarters Has not received quarterly monitoring (child) Does not have an updated case plan (child) Is lost to follow-up Has relocated Has died Has aged out of the program (child) without meeting graduation benchmarks Do not include when calculating OVC_SERV total.

Exited vs. not reported in DATIM
Applies to beneficiaries that have been active in past but do not meet criteria for being counted as active in past reporting period Applies to beneficiaries who are newly enrolled and have not yet met the criteria for becoming active Beneficiaries who have been active must continue to be reported in DATIM until they have exited without graduation, transferred, or graduated from the OVC program These beneficiaries have never been active and have never been reported in DATIM

2.3. Reporting

SAPR reporting OVC_SERV total Active beneficiaries
(any beneficiary active in Q2) plus Graduated beneficiaries (any graduated beneficiary in Q1 + Q2) Equals total beneficiaries at SAPR SAPR is Semi-Annual Program Results, including data from Q1 and Q2.

APR reporting OVC_SERV total Active beneficiaries
(any beneficiary active in Q4) plus Graduated beneficiaries (any graduated beneficiary in Q1 + Q2 + Q3 + Q4) Equals Annual total beneficiaries at APR APR is Annual Program Results, including data from Q1, Q2, Q3, and Q4.

APR reporting Exits Q1/Q2 exited beneficiaries plus
Q3/Q4 exited beneficiaries minus These new reporting guidelines may result in declines in the number of beneficiaries reported under OVC_SERV. As this is a global change, similar trends will likely be seen across all PEPFAR countries and programs. The narrative portion of the report provides a space to explain scenarios in which beneficiaries were served but could not be reported under OVC_SERV, such as a scenario in which many beneficiaries who had been receiving services were exited without graduation. Q1/Q2 exited beneficiaries who were active in Q3/Q4 Equals Annual exited beneficiaries at APR An individual who was counted as exited at Q2 and active at Q4 must be removed from the Q4 cumulative report of exits.

2.4. Eligible OVC services

Eligible OVC services Grouped into four domains Healthy Stable Safe
Interventions that support the achievement of health outcomes, build health and nutrition knowledge and skills in caregivers, facilitate access to key health services (especially HIV testing and care and treatment services), to enable vulnerable children (especially girls) to stay HIV-free Healthy Interventions that reduce economic vulnerabilities and increase resilience in adolescents and families affected by and vulnerable to HIV Stable Safe Interventions that support children and adolescents affected by and vulnerable to HIV to overcome barriers to accessing education (including enrollment, attendance, retention, progression, and/or transition), and provide vocational training for some adolescents Schooled Interventions that prevent and mitigate violence, abuse, exploitation, and neglect of children and adolescents, including sexual and gender-based violence. Source: Standard Operating Procedures for Case Management, Coordinating Comprehensive Care for Children (4Children) 2018

Eligible OVC services Overview (1)
The list of eligible OVC services defines minimum services that beneficiaries (children and caregivers) may receive to be considered active. These services will move beneficiaries toward graduation, which will be attained when the child and primary caregivers can be deemed healthy, safe, schooled, and stable. List of eligible OVC services

Eligible OVC services Overview (2)
PEPFAR provides a list of illustrative eligible interventions for the following groups of beneficiaries: Children (all) Children (infants and young children) Children (adolescents) Caregivers

Eligible OVC services Definition of a service
A beneficiary is counted as receiving a service if he or she: Received the service directly from project Was facilitated to obtain the service (e.g., given transport subsidy, accompanied) Has a completed referral (a referral for service is insufficient) PEPFAR does not allow purchase of commodities, but facilitating beneficiaries to obtain commodities is an eligible service. This might include public-private partnerships, such as an OVC program successfully advocating for services even if the program did not directly purchase or obtain the service. Note that “provided a referral for” is not on this list. A referral is not considered an eligible service unless the referral is completed.

Eligible OVC services Illustrative nature of the list
The list is comprehensive but not exhaustive. For services that are not captured in the list, implementing partners must submit a written request to a local United States Government (USG) funding agency point of contact (POC) describing those specific services. Written approval must be received in order to count proposed services toward active OVC status.

Eligible OVC services Children (<18 years)
Age-appropriate services for child beneficiaries are designated with a check mark in the columns “All children,” “Infants and young children,” or “Adolescents.” While one service is the minimum to be considered active, most children will require multiple services. Remember that the goal is continuous, comprehensive, and family-centered care. To be counted as active, children must also receive annual case plans and quarterly monitoring in addition to services.

Eligible OVC services Caregivers
Caregiver services are designated with a check mark in the columns “Caregiver” or “Caregiver and child.” A select number of services may count both primary caregivers and children “active,” because they provide direct benefit to the child. These services are designated with a check mark in the column “Caregiver and child.” Situations in which a child is only counted active because the primary caregiver receives a “caregiver and child” service should be rare and occur only when a child has received all eligible services, and the caregiver continues in a “caregiver and child” service. There should be no more than two primary caregivers for each child beneficiary.

Eligible OVC services Exercise
The list of services on the Eligible OVC Services Worksheet is comprehensive but not exhaustive. In small groups, please review each service and determine which ones: Your organization is currently providing Your organization would like to provide Are not applicable to the program

Eligible OVC services Discussion (1)
What are your general impressions of the list of OVC services? Are your organizations already providing services from each of the four domains? What proportion of the services are you already providing? Versus those you would like to provide? What immediate actions will you take to better align with the published list of eligible OVC services?

Eligible OVC services Discussion (2)
What services are you providing that are not captured in the list? Please note: For services that are not captured in the list, local USG funding agency approval must be received in order to count these services toward active OVC status.

2.5. Essential case management services

Other activities Not considered OVC services
Although critical to case management, these activities alone are considered administrative practices rather than OVC services: Initial assessment Enrollment Case plan development Case plan monitoring HIV assessment An updated case plan and quarterly monitoring are necessary but not sufficient for children to be counted as active.

Other activities Monitoring
Monitoring includes establishing contact in person to ensure that the case plan is progressing. Documentation of this contact is recorded in the case plan. Children should be monitored at least quarterly, but as often as necessary according to the child’s safety, schooling, stability, and health status. With prior approval of USG POC, contact may be made by telephone in circumstances that make in-person monitoring difficult, such as when a child is at boarding school.

Other activities Discussion
How will the introduction of the “Illustrative Eligible Services List” impact your organization? Perceived benefits? Anticipated obstacles?

2.6. Timing and participation status

SAPR reporting examples

SAPR reporting Active beneficiaries Q1 Q2 Q3 Q4
Beneficiaries are considered active if they have received one or more services in each of the preceding two quarters. today’s date Q1 Q2 Q3 Q4 Kabongo received a service in Q1 Kabongo received a service in Q2 Kabongo is active Report data as of the last day of the reporting period.

SAPR reporting Active beneficiaries recently enrolled Q1 Q2 Q3 Q4
Beneficiaries are considered active if they were enrolled for the first time during the reporting period and received at least one service during the previous quarter. today’s date Q1 Q2 Q3 Q4 Ibrahim was enrolled for the first time Ibrahim received a service in Q2 Ibrahim is active Although not shown, children also must have an updated case plan and receive quarterly monitoring to be considered active.

Prossy was enrolled but has not yet received a service
SAPR reporting Beneficiaries not reported in DATIM Beneficiaries are not reported in DATIM if if they have been registered (i.e., enrolled and assessed) but have not yet received any services. today’s date Q1 Q2 Q3 Q4 Prossy was enrolled but has not yet received a service Prossy is not reported in DATIM

SAPR reporting Exited beneficiaries Q1 Q2 Q3 Q4
Beneficiaries are considered “exited without graduation” when they have not received program services in each of the past two quarters. today’s date Q1 Q2 Q3 Q4 Linathi received services Linathi did not receive services Linathi is exited A lapse in services of only one quarter results in the beneficiary being exited.

APR reporting examples

APR reporting Active beneficiaries Q1 Q2 Q3 Q4
Beneficiaries are counted as active at APR if they received services every quarter. today’s date Q1 Q2 Q3 Q4 Godfrey received services Godfrey received services Godfrey received services Godfrey received services Godfrey is active Beneficiaries are expected to receive at least one service every quarter.

APR reporting Active beneficiaries Q1 Q2 Q3 Q4
Beneficiaries are counted as active at APR if they received services in Q3 and Q4 even if they did not receive services in Q1 and/or Q2. today’s date At APR, Beatus should be removed from APR exits. He would have been reported as exited at SAPR, as he did not receive services in Q2. Although exited beneficiaries should be reported cumulatively for all four quarters at Q4, any previously exited beneficiaries who become active again should not be reported in the total exited at APR (see guidance on slide 20). Q1 Q2 Q3 Q4 Beatus did not receive services Beatus received services Beatus received services Beatus received services Beatus is active Such a lapse in services should be rare, and IP should provide a narrative explanation of why services were not provided.

APR reporting Q1 Q2 Q3 Q4 Beneficiaries not reported in DATIM
Beneficiaries are not reported in DATIM if they were registered in a previous reporting period and have not yet received services in two consecutive quarters. today’s date Q1 Q2 Q3 Q4 Samuel was enrolled Samuel received monitoring and a case plan but no services Samuel received a service Samuel is not reported in DATIM Monitoring and a case plan alone do not make a beneficiary active. The goal is to initiate services quickly.

APR reporting Exited beneficiaries Q1 Q2 Q3 Q4
Beneficiaries are considered exited if they have not received services in Q3 and/or Q4. today’s date Q1 Q2 Q3 Q4 Charlotte received services Charlotte received services Charlotte did not receive services Charlotte received services Charlotte is exited

2.7. Transitions

Pamela is not reported in DATIM Pamela is still not reported in DATIM
Transitions Becoming active Beneficiaries become active when they receive a service in two consecutive quarters. Pamela is not reported in DATIM Pamela is still not reported in DATIM Pamela is active Pamela is active Q1 Q2 Q3 Q4 Q4 Pamela received monitoring and a case plan but no services yet Pamela began to receive services Pamela received services Pamela received services Pamela was enrolled

Transitions Exited  active (1) Q1 Q2 Q3 Q4
Beneficiaries are counted as active for the FY if they received services in the past two quarters of the FY, even if they had been reported as exited earlier in the year. Kanko is exited Kanko is active Q1 Q2 Q3 Q4 Kanko did not receive services Kanko received services Kanko received services Kanko received services Such a lapse in services should be rare, and IP should provide a narrative explanation of why services were not provided.

Transitions Exited  active (2) Q1 Q2 Q3 Q4 Q1 Q2
Exited beneficiaries are considered active again once they have received services in two consecutive quarters. Diop is exited Diop is still exited Diop is active Diop is active Q1 Q2 Q3 Q4 Q1 Q2 Diop did not receive services Diop did not receive services Diop received services Diop received services Diop received services Diop received services Such a lapse in services should be rare, and IP should provide a narrative explanation of why services were not provided.

2.8. Caregiver services

“Caregiver and child” services
Some caregiver services qualify both caregiver and child to be counted as active, because there is direct benefit to the child. Mother and child are active at APR Mother joins OVC savings group Mother continues in savings group Mother continues in savings group Mother continues in savings group Q1 Q2 Q3 Q4 Child is accompanied to clinic for HIV test but is negative Child receives a school uniform Child is assessed and does not require added services but continues to be monitored Child is assessed and does not require added services but continues to be monitored

Caregiver-only services
Other caregiver services do not directly benefit a child, and therefore do not qualify the child to be counted as active unless the child is also receiving an eligible service. Mother is accompanied to clinic for HIV test and is HIV-positive Mother is facilitated to obtain HIV treatment Mother is active at SAPR Q1 Q2 Q3 Q4 Child completes referral for vaccination, has updated case plan and is monitored Child has updated case plan and is monitored Child is exited at SAPR

2.9. Special cases

Active status while waiting
to meet benchmarks A beneficiary may have received all the services for which he or she is eligible. However. . . He or she may not have met graduation benchmarks (example: 12 months of viral suppression or ART adherence) In this case, a beneficiary may be considered active if he or she: Has an annually updated case plan (if a child) Continues to be assessed quarterly (if a child) Continues to receive services if needed

Active status while waiting
for family to meet benchmarks A beneficiary may have received all the services for which he or she is eligible. However. . . The remaining family members may not have met graduation benchmarks (example: 12 months of viral suppression or ART adherence) In this case, a beneficiary may be considered active if he or she: Has an annually updated case plan (if a child) Continues to be assessed quarterly (if a child) Continues to receive services if needed

Second quarter of reporting period
Active status summary In a small number of cases, beneficiaries may be considered active without actually having received an eligible service in each quarter. Situation First quarter of reporting period Second quarter of reporting period New enrollment Enrolled for the first time 1. Receive eligible service 2. Updated case plan* 3. Monitoring visit* Continuous services Pending graduation 1. Have received all eligible services but either the beneficiary (or family member) has not yet met all graduation benchmarks 2. Updated case plan* 3. Monitoring visit* * Updated case plans and monitoring visits applicable to child beneficiaries only

Special cases Psychosocial support
Evidence-based psychosocial support, including structured interventions that take place in the home, do count as a service. However, home visits that provide care plan development and monitoring without a specific, evidence-based psychosocial intervention do not count as a service.

Special cases Educational support Q1 Q2 Q3 Q4
A child or adolescent (up to age 20) is considered active for the period during which school fees have been paid and the child is attending school. Carlos is active Annual tuition is paid A child who is attending school cannot be counted as active just because he or she is attending school, unless the OVC program is also providing educational support. The program may provide support by paying school fees or through other means which facilitate the child’s attendance, such as a block grant. PEPFAR guidance does not consider support to attend vocational school an eligible service. Remember that local U.S. government funding agencies may give approval to services that are not included in the global list of eligible services. Q1 Q2 Q3 Q4 Carlos attends school School attendance alone does not count as an eligible OVC service.

Special cases Peace Corps program graduation
Peace Corps training programs are often time-limited and celebrate trainees’ “graduation” at the program’s conclusion. Despite having completed the training program, these beneficiaries do not graduate from the OVC program unless they have also met the required graduation benchmarks. To remain active, a beneficiary must continue to receive at least one service in each of the preceding two quarters.

2.10. DREAMS Determined, Resilient, Empowered,
AIDS-free, Mentored and Safe

DREAMS Relationship of OVC_SERV to AGYW_PREV
AGYW_PREV is a semi-annual indicator (new in FY19) to measure how many AGYW have completed the DREAMS primary package of evidence-based services/interventions. AGYW_PREV is complementary to other MER indicators that track the receipt of individual services under DREAMS programs. The DREAMS program is offered to adolescent girls and young women (AGYW) in 14 countries in Africa, plus Haiti. DREAMS programs offer layered interventions which may include OVC services. AGYW_PREV is a semi-annual indicator (new in fiscal year 19) that measures how many AGYW have completed the DREAMS primary package of evidence-based services and interventions. DREAMS programs are layered, which means that they provide multiple interventions and services from the DREAMS core package to each DREAMS beneficiary. The AGYW_PREV indicator measures this layering by measuring what proportion of DREAMS beneficiaries have completed at least the primary package of interventions. AGYW_PREV is complementary to other MER indicators that track the receipt of individual services under DREAMS programs. Because of the comprehensive nature of DREAMS programs, they can also be reported using 12 other MER indicators besides AGYW_PREV. Some of these 12 indicators are listed in the middle column in the figure, and one of those indicators is OVC_SERV. These additional indicators track individual services such as HIV prevention, OVC care, and clinical interventions such as HIV treatment. These other MER indicators are complementary to AGYW_PREV. A DREAMS program should report under OVC_SERV those beneficiaries who are receiving eligible OVC services. For example, a DREAMS beneficiary who is receiving educational support would be counted by the DREAMS program under OVC_SERV, since she is receiving an eligible OVC service. DREAMS is an acronym for Determined, Resilient, Empowered, AIDS-free, Mentored and Safe Botswana, Cote d’Ivoire, Haiti, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe GEND_GBV, HTS_TST, KP_PREV, OVC_SERV, PMTCT_STAT, PP_PREV, PrEP_NEW, PrEP_CURR, TX_NEW, TX_CURR, TX_PVLS, and VMMC_CIRC Country Operational Plan (COP) funding HKID HVAB HVOP HTS etc. Individual services received by AGYW OVC_SERV PP_PREV PREP_NEW PREP_CURR HTS_TST GEND_GBV PMTCT_STAT KP_PREV DREAMS layering AGYW_PREV

DREAMS DREAMS participants who are also enrolled in an OVC program
Adolescent girls (ages 10─17) enrolled in an OVC program and in DREAMS: Must meet OVC program requirements Must meet DREAMS program requirements May be counted under both AGYW_PREV and OVC_SERV OVC program DREAMS This slide shows a case in which a beneficiary aged 10 to 17 is enrolled in both an OVC program and in DREAMS. If she meets the requirements to be counted as active by the OVC program, the OVC program would report her under OVC_SERV. If she meets DREAMS program requirements, the DREAMS program would report her under the main DREAMS indicator AGYW_PREV. The DREAMS program could also report her under OVC_SERV if she had received one or more services that are eligible under OVC_SERV. In this scenario, both programs would report her under OVC_SERV. Because each beneficiary may be counted only once per reporting period under OVC_SERV, OVC_SERV data would have to be de-duplicated at the country level so that beneficiaries who had been counted by two different programs (i.e., counted twice) are only counted once. If the same IP is providing an OVC program and a DREAMS program under different implementing mechanisms to the same beneficiary, that IP would count the beneficiary under each program and then would have to de-duplicate the data so that the beneficiary was not counted twice under OVC_SERV. Each beneficiary may be counted only once under OVC_SERV.

DREAMS DREAMS participants who are not enrolled in an OVC program
Adolescent girls and young women (AGYW) ages 10─17 enrolled in DREAMS but not in an OVC program may be counted under OVC_SERV if: What: They have received one or more services under DREAMS that are also eligible services under OVC_SERV When: In each of the past two quarters or in the past quarter, if beneficiary was enrolled in this reporting period The other possible scenario is that a beneficiary age 10–17 is enrolled in a DREAMS program but not in an OVC program. The DREAMS program could report her under OVC_SERV if she had received one or more eligible OVC services. In order for a DREAMS program to report a beneficiary under OVC_SERV, the girl must receive eligible OVC services which meet OVC_SERV’s requirements for continuous services. Just as for other beneficiaries counted under OVC_SERV, the beneficiary must have received services in the past two quarters or in the previous quarter only if the beneficiary was newly enrolled during the reporting period. However, DREAMS beneficiaries are not required to have an annual case plan or quarterly monitoring to be counted under OVC_SERV. In other words, the requirement that OVC_SERV beneficiaries have an updated case plan and quarterly monitoring to be considered active does not apply to DREAMS beneficiaries who are counted under OVC_SERV, because the DREAMS program has separate requirements for case plan management. DREAMS OVC program DREAMS participants counted under OVC_SERV do not need an annual case plan or quarterly monitoring, because DREAMS has separate requirements.

DREAMS Reporting overlap by program enrollment (for girls ages 10─17 years) Program enrollment Services received Count under OVC_SERV Count under AGYW_PREV OVC only OVC services only1  OVC and DREAMS OVC1 and DREAMS2 services DREAMS only DREAMS2 services that are also eligible OVC services (e.g. education subsidy) DREAMS2 services that are not eligible OVC services This slide compares how beneficiaries enrolled in OVC and/or DREAMS programs would be reported under OVC_SERV and AGYW_PREV, according to different scenarios. In the first row, a beneficiary is enrolled in an OVC program only and so is counted only under OVC_SERV. In the second row, a beneficiary is enrolled in an OVC program and DREAMS. She is therefore receiving OVC services and DREAMS services, and is counted under OVC_SERV and AGYW_PREV. In last two rows, a beneficiary is enrolled in a DREAMS program only. If she is receiving DREAMS services that are also eligible OVC services, such as an education subsidy, she would be counted under both OVC_SERV and AGYW_PREV. Remember that to be counted under OVC_SERV, she must receive services continuously (i.e., she must have received eligible OVC services in the last two quarters or in the past quarter if newly enrolled), but she does not need quarterly monitoring and an annual case plan. If she is receiving DREAMS services that are not eligible OVC services, she would not be counted under OVC_SERV but would be counted under AGYW_PREV. 1 Must meet OVC program requirements; services must be on list of eligible OVC services 2 Must meet DREAMS program requirements; layered interventions

DREAMS Example: DREAMS reporting scenario
Brenda is enrolled in DREAMS. Brenda receives HIV testing, Stepping Stones, pre-exposure prophylaxis (PrEP), and an education subsidy through DREAMS partner(s). How is Brenda accounted for in various MER indicators? HIV testing Stepping Stones PrEP Education subsidy HTS_TST PP_PREV* PREP_NEW PREP_CURR OVC_SERV* AGYW_PREV This slide shows an example reporting scenario. In this scenario, Brenda has received a variety of interventions through DREAMS, shown in dark green boxes: HIV testing, Stepping Stones (an HIV prevention intervention), pre-exposure prophylaxis, and an education subsidy. Each of these interventions can be reported under a distinct MER indicator, as can be seen in the light green boxes. In the case of PP_PREV and OVC_SERV, there are also additional requirements she must meet to be reported under those indicators. In the case of OVC_SERV, she must meet the requirement for receiving services continuously but does not have to meet the requirements for receiving an annual case plan or quarterly monitoring. Brenda is also reported under AGYW_PREV, which measures whether she has received the primary package of layered interventions. *Brenda must qualify for PP_PREV and OVC_SERV under the definition of these indicators, with the exception that she does not have to receive a case plan or quarterly monitoring to qualify for OVC_SERV.

2.11. Avoiding double counting

Avoiding double counting
OVC caregivers under age 18 Some OVC caregivers are younger than 18 years of age. A child caregiver is considered active when he/she: Received at least one service in each of the preceding two quarters; Had a case plan updated within the past four quarters Is monitored at least quarterly The child caregiver may receive services either from the child or caregiver list of eligible OVC services. While OVC caregivers under the age of 18 may receive services from either category, they may not be counted twice.

those active and graduated Some beneficiaries receive short-term services (e.g. post-gender-based violence [GBV] care) that may both start and conclude in a reporting period. Although the beneficiary may have met one graduation benchmark (e.g., known HIV status), the following criteria must be met for graduation: She/he must meet all applicable graduation benchmarks. All members of the household must meet all applicable benchmarks. If these criteria are met, and the OVC beneficiary is ready to graduate in the same reporting period in which he/she was enrolled, the beneficiary should be reported as graduated rather than active. Beneficiaries may not be reported as active and graduated in the same reporting period.

transfers to another PEPFAR partner An OVC program may report OVC beneficiaries under the disaggregate “Transferred out to a PEPFAR-supported partner.” The receiving PEPFAR implementing partner would report the OVC beneficiaries as active if they were able to provide at least one service in each of the two quarters. Because the transfer disaggregate is not included in the OVC_SERV total, there is no need to account for duplication. Beneficiaries may not be reported as active and transferred by the same implementing partner, in the same reporting period.

Avoid double counting transfers to another PEPFAR partner
OVC_SERV= 530 total for both partners PEPFAR Partner 1 Report 300 beneficiaries as active Report 30 beneficiaries as graduated Report 200 beneficiaries as transferred to a PEPFAR partner PEPFAR Partner 2 Report 200 beneficiaries as active Report 0 beneficiaries as graduated Report 0 beneficiaries as transferred to a PEPFAR partner Beneficiaries may not be reported as active and transferred by the same implementing partner in the same reporting period.

Module 2 OVC_SERV Orphans and Vulnerable Children

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