effective economic strengthening (es) for the ultra poor affected by hiv meaghan murphy, fhi 360...
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Effective Economic Strengthening (ES) for the Ultra Poor Affected by HIV
Meaghan Murphy, FHI 360Mandy Swann, FHI 360
Gareth Evans, Save the ChildrenKirsten Weeks, DAI
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
LEARNING OBJECTIVES• Learn about three proven tools & approaches for
improved understanding of the vulnerabilities of HIV affected ultra poor households (HH) for economic strengthening (ES)
• Put concepts, tools and approaches into action
• Practitioner-focused discussion around key issues, opportunities and challenges
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
WORKSHOP OVERVIEW
• Discuss vulnerabilities of HIV-affected populations, especially the ultra poor
• Brief presentation of practitioner-developed ES tools and approaches
• Small group activity
• Debrief and discussion
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
UNIQUE VULNERABILITIES OF HIV- AFFECTED POPULATIONS
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
Household Livelihoods and Food Security: Conceptual Framework
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
LOW
HO
USE
HO
LD L
IVEL
IHO
OD
& F
OO
D S
ECU
RITY
HIG
H
ProtectionAsset protection
Income and consumption stabilization
PromotionAsset, income and
consumption growth
HIG
HH
OU
SEH
OLD
VU
LNER
ABIL
ITY
LOW
ProvisionAsset recovery
Consumption support
HIG
HH
OU
SEH
OLD
VU
LN
ER
AB
ILIT
YLO
W
LO
WH
OU
SEH
OLD
LIV
ELIH
OO
D &
FO
OD
SEC
UR
ITY
HIG
H
Provision
Protection
Promotion
Higher risk threshold potential: Engaging in higher-risk, higher-return income generating activities
Minimal risk taking threshold: Engaging in low-risk, low-return income generating activities; diversifying income generating activities; building productive assets
Reversible: Selling/liquidating protective assets; seeking wage labor or migrating for work; borrowing; reducing spending and food consumption; drawing on social assetsLess reversible: Selling productive assets; borrowing at exorbitant rates; further reducing spending and food consumption
Income Growth
Income Stabilization
Risk Reduction
Loss Management
Destitute / Distress
Asset depletion: Depending on charity; breaking up household; migrating; going without food
Expand household income & consumption
Smooth household income & promote asset growth
Smooth household consumption & manage household cash flow
Build self-insurance methods & protect key assets
Recover, build assets & stabilize household consumption
Workforce development; credit and savings; business development services; micro, small and medium enterprise development; business enabling environment reform
Credit and savings; business development services; facilitate business/social networks; microenterprise development
Strengthen social networks; financial and market literacy; credit and savings
Income-based safety-nets; access to savings; credit; micro insurance; strengthen social safety nets; extend legal protection & reform laws
Transfers; social services
LIVELIHOOD
PHASE
COPING MECHANISMS / LIVELIHOODS STRATEGIES
LIVELIHOOD OBJECTIVES
POTENTIAL LIVELIHOOD INTERVENTIONS
PURPOSE OF ES/L/FS FRAMEWORK
• Assess HH characteristics in terms of vulnerability, livelihoods and food security
• Connect HH characteristics to coping mechanisms, strategies and livelihood phases
• Identify appropriate potential livelihood, ES and food security interventions to meet HH needs and interests
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
LIFT LIVELIHOODS AND FOOD SECURITY TECHNICAL ASSISTANCE PROJECT
Develop and strengthen referral mechanisms for linking PLHIV with ES/L/FS services through a facilitation model
Strengthen service provider capacity to deliver quality and appropriate ES/L/FS support to vulnerable, HIV-affected households
Expand the evidence base for ES/L/FS programming related to food security, nutrition and health
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
FRAMEWORK IN ACTION
• Provide a platform for common dialogue across donors, decision makers and stakeholders from different backgrounds (i.e., Health and Economic Development)
• Assist service providers and implementers to identify household vulnerability and assets, and understand household risk profiles
• Inform development of a diagnostic to match HIV client household needs with appropriate ES/L/FS activities
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
MATCH FAMILY TYPOLOGIES TO INTERVENTION STRATEGIES
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
Families prepared to grow PROMOTION Strategies to grow
income/expenses
Families struggling to make ends meet PROTECTION Strategies to match
income to expenses
Families in destitution PROVISION Strategies to meet basic needs
Household Livelihood Phase
Economic Strengthening Strategy
VULNERABILITY AND RESILIENCE INDICES USING HOUSEHOLD LEVEL DATA - WHY?
• Better understand the risks and challenges facing HIV-affected households in particular to foster better programming.
• Our indices usage has evolved from looking at measuring vulnerability (VI), that which puts households at risk, to complementing that with measuring resilience (RI), that what makes households stronger.
• We’ve developed localized indices three times (Cambodia [VI] and twice in Tanzania (ROADS [VI] and IMARISHA [VI, RI]).
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
HOW WAS THE INDEX DESIGNED?
• Data source: Household survey – Abbreviated Save the Children/UK’s Household Economic Assessment Tool (combined with other standard survey tools – DHS and household hunger scale)
• First two applications: Vulnerability index in Cambodia and East Africa based on predetermined set of indicators, weighted equally and chosen based on a literature review and in consultation with local partners
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
VULNERABILITY AND RESILIENCE INDICES (IMARISHA, TANZANIA)
• Partner consultation and qualitative research prioritized key factors that characterized vulnerable households (household hunger and inability to seek medical care due to finances as the two greatest challenges).
• VI variables identified based on bi- and multivariate risk-ratio analysis of variables with highest correlation of severe hunger and inability to seek care due to cost.
• Resiliency index introduced as those indicators most commonly found in households without hunger, access to care and access to education.
• Data analyzed in uni-, bi- and multivariate analysis with particular emphasis on odds and risk ratios. SEEP 2012 Annual Conference
Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
HOW WAS THE INDEX PART OF A SOLUTION?
• Indices have been used as practical tools to understand and guide programming, and not as a static indicator, but as a programming tool.
• Prioritize programming and intervention areas.
• Focus partner programming (e.g., greater investment in savings as a source of household stability rather than unfocused IGA activities)
• Iterative work in progress – we continue to gather data and are using the VI and RI as an evaluation tool for the final evaluation of IMARISHA to measure changes over time.
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
CHARACTERISTICS OF INDICESVulnerability Indicators• Household size• Number of earners within the
household • Household hunger scale• OVC within the household • Not receiving medical treatment
due to inability to pay• Lack of transport• Lack of savings
Resilience Indicators • Use of productive behaviors for
agriculture and business• Participation in savings• Engagement with the formal
financial sector • Perception of control About
economic future of the household (sense of greater control characterizes greater resiliency)
• Perception on household food situation (optimism characterizes greater resiliency)
• Perception on community economic situation (optimism characterizes greater resiliency) SEEP 2012 Annual Conference
Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
WHY LINK CLIENTS WITH COMPLEMENTARY SUPPORT?
Linking ES activities to clinical and community support for ultra poor HIV-affected households aims to:
• Build a continuum of support for people living with HIV
• Increase physical and social well-being
• Improve economic potential
• Reduce exposure to additional risk SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
NACS: A platform for integrating nutrition into the continuum of care
Nutrition care & support
Economic strengthening,
livelihoods & food security
Health system strengthening
HIV-free survival
OBJECTIVES:• Improve nutritional status• Improve infant survival• Reduce food insecurity• Strengthen health systems
GOAL: Improved health and quality of life
Nutrition Assessment Counseling and Support (NACS)
LIFT WORKING MODEL FOR LINKING ES SERVICES TO A CONTINUUM OF SUPPORT
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
INTEGRATION MODEL• Understand Household Vulnerability• Develop diagnostic tool to match client needs with appropriate
services
• Facilitate Referrals• Conduct organizational network analysis• Identify community intermediaries• Support improved clinic-community referral processes and follow
up• Build capacity
• Strengthen Quality of ES Services• Provide TA on ES standards of practice and application for
vulnerable populations• Support analysis and response with HIV lens SEEP 2012 Annual Conference
Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
RECENT EXPERIENCES INFORMING APPROACH
• Ethiopia Research: Promising Practices for Linking Economic Strengthening & Clinical Services
• National assessments and stakeholder consultations in Namibia and South Africa
• Coordination and planning to operationalize model in DRC, Malawi, Namibia, Lesotho and Zambia
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
GROUP ACTIVITY
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
LEARN MORE
DAI http://dai.com
FHI 360 http://fhi360.org
Save the Children http://www.savethechildren.org
LIFT Project http://kdid.org/projects/field-support/lift
Practitioner groups of interest STEP UP & HAMED
SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions
QUESTIONS? CONTACT US!
Meaghan Murphy, [email protected]
Mandy Swann, [email protected]
Gareth Evans, [email protected]
Kirsten Weeks, [email protected]
THANK YOU! SEEP 2012 Annual Conference Building Inclusive Markets: Impact Through Financial and Enterprise Solutions