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OVC Programme Effort Index 2007:Progress since 2004

Douglas Webb, Richard MatikanyaUNICEF

Regional Inter-Agency Task Team on Children and AIDS Conference, September 2008

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OVC Support in southern Africa

OVC support in 7 of 10 Southern African countries

0

10

20

30

40

50

60

2003 2005 2007

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MALAWI

SWAZILAND

ZAMBIA

LESOTHO

ZIMBABWE

NAMIBIA

BOTSWANA

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The Programme Effort Index (PEI)

• Developed to measure the current response by countries in sub-Saharan Africa to the crisis facing OVC

• First conducted in 2004• Specifically designed to assess how countries are

progressing with the national infrastructure to underpin the Framework for the Protection, Care and Support of OVC living in a world of HIV and AIDS (2004)

• UN Declaration of Commitment on HIV/AIDS (2001) Reporting requirement

• Overall 35/40 countries in Sub-Saharan Africa completed the questionnaire

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The Index Questionnaire: 8 componentsComponent The questions related to this component explore

National Situation Analysis Whether country has investigated the situation of OVC made vulnerable by HIV & AIDS &, if so, the nature of that research.

Consultative process Extent to which key stakeholders are involved in planning interventions for OVC made vulnerable by HIV & AIDS.

Coordinating mechanism Whether action for OVC made vulnerable by HIV & AIDS is being coordinated and the nature of that coordination

National Action Plans Whether country has a national plan of action for OVC made vulnerable by HIV & AIDS, and the nature of that plan

Policy Whether country has a policy on OVC made vulnerable by HIV & AIDS and the nature of that policy

Legislative review Whether country has reviewed & updated the legal framework relating to OVC made vulnerable by HIV/AIDS

Monitoring & evaluation Whether M&E is being conducted nationally into the situation of OVC and into programmes addressing their needs

Resources Availability of resources to meet needs of OVC in the country

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Preliminary findings: Interpretation of scores

• OVC index scores are based on responses that are a mixture of fact and judgement: scores do not provide a truly objective measure of effort that can be used to rank countries precisely.

• The OVC Effort Index scores represent a self-assessment, useful for examining countries’ own level and profile of effort and deciding where increased efforts are needed.

• The index is intended to measure programme effort independent of programme outputs.

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Overall findings - 2007

• In 2007, the overall effort index score for Sub-Saharan Africa is 59%; an improvement of 10% on the score of 2004

• The countries in Southern Africa have on average the highest score with 69% closely followed by the countries in East Africa with 64%

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Overall score: trends 2004-2007

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Distribution of countries by total index score

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East Africa 2004-2007

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East Africa

• Marginal improvement in regional average from 63% in 2004 to 64% in 2007

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Southern Africa 2004-2007

121

Southern Africa

• Overall improvement in regional average from 54% in 2004 to 69% in 2007

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Index scores by component

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Ranking of components from overall highest average score to lowest

• National situation analysis• National Action planning• Consultative process• Coordination mechanism• Policy• Monitoring and evaluation• Resources • Legislative review

151

Progress in the implementation of national situation analysis

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National situation analysis• All countries excluding Guinea Bissau had completed

situation analysis by end of 2007• Strengths: • countries have a clearer and more robust picture of the

situation of OVC made vulnerable by HIV and AIDS and almost all report that the analysis produced specific recommendations for action.

• There is movement away from narrow assessments that focus on OVC affected by HIV to inclusive assessments that focus on all (vulnerable) children

• Challenges: Many of the national situation analyses that inform existing programming have not been recently updated, but intentions exist to update them. Rigour is essential.

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Progress in developing a national plan of action for OVC,

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National action planning• 16 countries in ESAR have national action plans specifically

focused on OVC• Strengths: Planning for children recognised as important. • Move to second generation national plans that are inclusive of all

children. • Almost all have integrated OVC in national AIDS strategic

frameworks and plans and social protection strategies where these are in place.

• Challenges: Limited integration into national development plans/PRSPs. NPAs not synchronised with government funding & planning cycles. In addition, a number of the plans developed have limitations (not strategic, not sufficiently detailed, not evidence based due to limited strategic information, not prioritised, not costed & do not provide clear guidance on roles and responsibilities of stakeholders)

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Progress in involving key stakeholders in national response for OVC,

201

Consultative process• A significant majority of countries report having

held national meeting to formally discuss situation of children recently

• Strengths: In general these meetings included senior representatives from a range of stakeholders and have led to the establishment of formal structures that meet regularly

• Challenges: These national consultative meetings do not happen as often as countries would require, plus stakeholder involvement is seen as between poor and fair

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Progress in establishing a mechanism to coordinate the national response

221

Coordination mechanisms

• Almost all countries report that bodies have been formally established to coordinate national action for OVC, led by government with multisectoral representation

• Strengths: Improved coordination of national action for OVC with coordinating mechanisms that have clear terms of reference and engagement.

• Some countries have established coordination mechanisms headed within powerful government departments or ministries enabling high level coordination e.g. Kenya and Namibia

• Challenges: Coordination mechanisms do not generally meet regularly, have limited institutional capacity of coordinating authorities to guide and coordinate national responses for children, including alignment of partners, as well as overall managerial capacity.

• Coordinating mechanisms tend to be underfunded

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Policy

• Generally countries have either adopted specific policies on OVC or have adopted inclusive policies on all children

• Strengths: policy frameworks exist that are supportive of implementation of programming for children

• Challenges: Majority of national policies are outdated and have not been updated. As a result, many do not reflect new developments and evidence based approaches.

• Several are still in draft form and have stalled at draft stage or are yet to be approved by government.

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Progress in reviewing and updating the legal framework related to OVC

251

Legislative review• Generally, very few countries have enacted specific

legislation on OVC. Majority feel that existing legislation is sufficient.

• Strengths: Move to inclusive legislation and integration of children’s issues into existing legislation or upcoming legislation. Mechanisms to enforce laws e.g. Child protection units within police services and community based child protection mechanisms have been established

• Challenges: Much of the legislation is in form of bills that have yet to be enacted by parliament. Very few countries have established enforcement mechanisms and where they do exist, all countries report that they are not sufficiently resourced to effectively carry out their functions.

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Progress in conducting monitoring and evaluation of the national response to OVC

271

Monitoring and evaluation• Strengths: Almost all countries have nationally agreed definition of

orphans and are collecting either through DHS, MICS or AIDS Indicator Surveys. In addition, some M&E frameworks have been developed

• Challenges: – Many M&E programmes are insufficiently staffed, lack specific

technical expertise to identify and aggregate available data and adequately coordinate and manage new data collection among multiple partners.

– Most importantly, there is a lack of capacity to synthesize the information that is collected for strategic decision making and accountability.

– Systems for dissemination of such strategic information are not developed and in many cases non-existent.

– 100% of the countries note that the organization mandated to conduct national M&E for OVC does not have the resources required to enable it to do so effectively.

– 80% of countries do not have estimates of coverage data

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Progress in resource mobilization for the national response to OVC

291

Resources• Strengths: NAPs have been used to mobilize resources in several countries,

however far more is needed. In addition, as a result of the Global Fund, PEPFAR, MAP and large bilateral and multilateral funding, there are significantly more resources available to support responses for OVC

• Challenges: – Low levels of government funding as manifested in the fact that OVC are not

programmed in the national budget or MTEF. – No Resource tracking systems are in place. – Many of the national plans of action are not adequately costed or prioritised.– Absorption capacity (for both government and civil society) has also been

regularly cited as a challenge. – 65% of countries feel that while their governments are committed to responding

to OVC, given the numerous developmental challenges faced, prioritising resources for children is ‘difficult’

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Conclusions

1. Overall but uneven progress since 20042. Greatest improvements between 2004 and

2007 are national situation analyses, consultative processes, coordination mechanisms and national action planning

3. Need for more effective coordination mechanisms at national and sub-national levels

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Conclusions

4. National action plans must be prioritised, results focused, evidence based and accurately costed.

5. There has been limited progress in enforcing legislation that protects children.

6. Greater efforts are made to resource and strengthen national monitoring and evaluation systems.

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National Responses for Children Affected by AIDS:

Review of Progress and Lessons Learned

Inter Agency Task Team on Children HIV & AIDSWorking Group on National Plans of Action

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Progress in East & Southern Africa• Most NPAs (16) developed through the RAAAP process 2004-2005• Strong flow of donor resources but limited government funds for NPA

implementation• Not just targeting children affected by AIDS but orphans and vulnerable

children due to all causes:– Targeting on basis of orphanhood is not robust for identifying

vulnerability– Most children affected by AIDS, so targeting on vulnerability rather than

AIDS-specific criteria more effective– Targeting on AIDS-specific criteria risks increasing stigma against

children affected by AIDS• Increasingly governments and donors focusing on social protection and

cash transfers to households with vulnerable children

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Headline findings- High level government ownership and political will e.g. Namibia,

Malawi- Availability of resources e.g. PEPFAR and GFATM- Involvement of non-governmental organizations in

programming e.g. Zimbabwe & advocacy e.g. South Africa- Integration of vulnerable children into national policies,

particularly PRSPs, has made little difference in reality re: domestic budget contributions, sectoral coordination and weak operational capacity

- Integration into sectors, especially national AIDS instruments (NSFs), have brought clear short-term benefits for vulnerable children i.e. external funds. Education, health & social protection more varied in country & over time

- Off-budget resources can challenge long-term national ownership and need greater alignment and phased handing-over

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Headline findings- General agreement that MSWs are under-funded,

under-staffed and politically weak. - Multi-sectoral coordination and budget allocation may

be better when coordination rests above line ministries e.g. PM’s office

- Limited data on national scale-up of NPAs, but indications of large scale activity in many countries in Africa e.g. cash transfers (Malawi) neighbourhood care points (Swaziland), nutrition interventions, PSS (Namibia), community justice education (Tanzania)

- M&E hampered by variation between global, national & local definitions of target group - multiple data requirements for different sectors & donors

- Few NPAs deal with stigma and discrimination

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Recommendations1. The IATT and other global and regional

stakeholders should provide countries with more contextualized guidance on national responses for children affected by AIDS and other vulnerable children

2. Countries and their partners need to build the capacity of national social welfare and justice systems to protect all children

3. Global, regional and country level stakeholders must strengthen all aspects of monitoring and evaluation for national responses to children affected by AIDS and other vulnerable children

4. National, regional and global stakeholders should increase effort and resources to reduce HIV-related stigma and discrimination, which persist as significant barriers in most countries.

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East and Southern Africa Regional Status Report:

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Overall opportunities and challenges to scaling up universal access for prevention, treatment, care and

support for children affected by AIDS• Strengths:• Increasing child participation• Increasing awareness of the importance of monitoring and evaluation in

effectively and efficiently programming and planning for children;• Increasing awareness of the effectiveness of an integrated approach (government,

civil society and faith based organizations, the private sector and development partners)

• Challenges:• Food insecurity;• Political instability and / or conflict;• National and household poverty: government can’t provide services and people

can’t access services;• Magnitude of the HIV pandemic and the increasing number of orphans;• Lack of coordination between the national and district levels, primarily due to the

lack of resources;• Lack of awareness of the value of strong civil (death) registration systems in

planning and protecting children.