1. Improving Quality and Assessing Impact at the Child Level on an Orphans and Vulnerable Children (OVC) Program in Africa using an Adapted Child Status Index (CSI) Sandra Dalebout, Project HOPE

2. Presenter disclosures (1)The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Sandra Dalebout “No relationships to disclose”

3. Program background Sustainable Strengthening of Families of Orphans and Vulnerable Children in Mozambique and Namibia USAID Funded project April 4, 2005 to April 2, 2010 Aim: Improve economic status and quality of life of 45,000 OVC and strengthen the capacity of families to provide care and support to 75,000 OVC

4. Program area Gaza and Zambezia Provinces, Mozambique Omusati, Oshana, and Ohangwena Regions, Namibia

5. Integrated model Provide to OVC caregivers: health education parenting skills training across multiple domains economic strengthening volunteer home visits

6. Measuring impact at caregiver level Since program inception, collecting data at the caregiver level to measure economic impact of program (encompassing quality of housing, household assets, nutrition, vulnerability and reported income) Data is collected at baseline & follow up after 1 year

7. Caregiver economic impact - % exceeding specific economic standards

8. Measuring impact at child level Since program inception, collecting data at the child level to measure: economic impact of program some child level indicators across domains Data is collected at baseline & follow up after 1 year

9. Child impact: nutrition (Namibia)

10. Child Status Index (CSI) Tool developed by Duke University & MEASURE EVALUATION in collaboration with USAID Designed to help OVC programs better meet the needs of OVC across six domains (health, nutrition, shelter/care, education, protection, psychosocial support). Uses descriptive statements (has enough, looks like, is sometimes)

11. CSI picture

12. Field team meeting Discussed using the CSI Conducted a detailed review of CSI form Consensus across countries

13. Team review results Too complicated for low literacy volunteers to use in their household visits in our programs Team did not want to lose the greater detail and clearly defined indicators we were already collecting

14. CSI PH Indicators Food & Nutrition 1. Food security2. Nutrition & Growth Child has sufficient food to eat at all times of the year Child is growing well compared to others of his/her age. Nutrition & Development Growth monitoring (< 5) Appears same height & weight as others his/her age Received 4 meals in last 2 days Eats food from all groups in last 2 days

15. Tool re-design Team developed a tool that… Low literacy volunteers and caregivers could use easily at the household level, using a simple happy or sad face approach  Shows caregiver goals for the child (in line with our curriculum) and where they are in meeting them Can be used at multiple levels (household, community, region, project) to see progress and identify gaps

16. Field Testing Field staff reviewed, trained, and tested parenting map Local cartoonist hired to do artwork Field tested with staff, volunteers, two different groups of OVC caregivers

17. Final product: “Parenting map”

18. Results To date, we have collected 2,922 parenting maps from Namibia and Mozambique in a short period of time The next data collection period is scheduled for January 2009

19. Results across domains

20. Results: health indicators

21. Data collection results

22. Next steps Share analysis at the community level with volunteers, community leaders, & MOH to address community-wide issues Recollect data in 6 months to assess status Continue working to improve lives of OVC!

23. Conclusion Tool acceptability and buy-in from field staff and caregivers Sustainable tool that generates data results with clean data