ENHANCING SERVICES AND LINKAGES FOR CHILDREN AFFECTED BY HIV AND AIDS – ELIKIA
FY18 ANNUAL REPORT October 1, 2017 – September 30, 2018
Submission Date: October 30, 2018
Contract Number: AID-660-C-16-000001 Contract Period: April 28, 2016 – April 27, 2021 COR: Olivier Kabeya
Submitted by: EDUCATION DEVELOPMENT CENTER, INC. (EDC) 1025 Thomas Jefferson Street NW, Suite 700W Washington, DC 20007
This document was produced for review by the United States Agency for International Development Democratic Republic of Congo Mission (USAID/DRC).
LIST OF ACRONYMS
ALHIV / CLHIV Adolescents / Children Living with HIV ART Antiretroviral Therapy CRS Catholic Relief Services CSI Child Status Index CSO Civil Society Organization DIVAS Division of Social Affairs ECD Early Childhood Development EDC Education Development Center EID Early Infant Diagnosis EMMP Environmental Management & Mitigation Plan GDRC Government of the Democratic Republic of Congo HVAT Household Vulnerability Assessment Tool IEE Initial Environmental Examination MINAS Ministry of Social Affairs MIS Management Information System NACS Nutritional Assessment and Counseling Services NGO Non-Governmental Organization OCA-Plus Organizational Capacity Assessment Plus Tool OVC Orphans and Vulnerable Children PEPFAR President’s Emergency Plan For AIDS Relief PLHIV Person Living with HIV PMEP Performance Monitoring & Evaluation Plan PMTCT Prevention of Mother-to-Child Transmission of HIV PNMLS Programme National Multisectoriel de Lutte contre le SIDA PSP SILC Private Service Provider RAAP Rapid Assessment & Action Planning RECOPE Réseau Communautaire pour la Protection de l'Enfance RFA Request for Applications RSAM Referral System Assessment & Monitoring Tool SILC Savings and Internal Lending Communities
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 2
TABLE OF CONTENTS
1. Program Overview/Summary ...... 4
2. Activity Implementation Progress ...... 5 2.1 Progress Narrative...... 5 2.2 Implementation Status ...... 11 2.3 Implementation Challenges & Proposed Solutions ...... 21 2.4 Performance Monitoring Update ...... 22
3. Key Issue Narrative ...... 23
4. Integration of Cross-Cutting Issues and USAID Forward Priorities..... 25 4.1 Gender Equality and Female Empowerment ...... 25 4.2 Sustainability Mechanisms...... 25 4.3 Environmental Compliance ...... 25 4.4 Local Capacity Development...... 26
5. Stakeholder Participation and Involvement ...... 26
6. Lessons Learned ...... 27
7. Management and Administrative Summary ...... 28
8. Planned Activities for Next Quarter ...... 28
9. Actions Taken to Address A/COR Comments ...... 29
Annex A: Progress Summary—Annual ...... 31
USAID/DRC ELIKIA Project | Fiscal Year 2016 Annual Report | EDC | October 30, 2016 | Page 3 1. PROGRAM OVERVIEW/SUMMARY
Enhancing Services and Linkages for Children Affected by HIV and AIDS Program Name – ELIKIA Activity Start Date and April 28, 2016 – April 27, 2021 End Date Name of Prime Education Development Center (EDC) Implementing Partner Contract Number AID-660-C-16-00001 Name of Subcontractors Catholic Relief Services (CRS), Palladium Group, Caritas Katanga Major Counterpart Division of Social Affairs (DIVAS) Organizations Geographic Coverage Haut-Katanga Province (Kalamondo, Kampemba, Kenya, Lubumbashi, (Provinces and Sub- and Rwashi health zones) – all year. Lualaba Province (Dilala and Manika Provinces) health zones) – from August 2018. Reporting Period October 1, 2017 – September 30, 2018
Program Description/Introduction
ELIKIA is a five-year program awarded to Education Development Center, Inc. (EDC) by the United States Agency for International Development (USAID/DRC) designed to improve the health, wellbeing, and economic security of orphans and vulnerable children (OVC) in five target PEPFAR health zones in the Haut-Katanga province of the Democratic Republic of the Congo. Following a contract modification in FY18, ELIKIA will begin working in two new health zones in Lualaba province (Dilala and Manika) before the beginning of FY19.
EDC’s implementing partners for this activity include Catholic Relief Services (CRS), Palladium Group, and Caritas Katanga. The ELIKIA consortium will implement a variety of activities aimed at improving the wellbeing of OVC and their households, including economic strengthening; skill- building for parents and caregivers; strengthening referral systems and linking vulnerable households to health and social services. The program will build capacity of actors within the provincial, district, and community health and social service sectors to effectively provide for the needs of OVC with a coordinated continuum of care.
The project’s objectives include the following:
Objective 1: Reduce economic vulnerability of target households to provide for the essential needs of children in their care.
Objective 2: Increase utilization of essential services among orphans and vulnerable children and their households.
Objective 3: Strengthen GDRC provincial and district social welfare systems.
Over the life of the project, ELIKIA is expected to achieve the following results:
• Support 27,000OVC_SERV, comprising OVC and caregivers from 4,600 vulnerable households • Deliver cash transfers to 700 highly vulnerable households
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 4 • Establish 125 savings groups benefiting 1,800 vulnerable households, generating pooled savings to support 10,000 individual beneficiaries • Train 500 savings (SILC) group participants in entrepreneurship training • Develop a package of tailored parenting education sessions that include content on basic parenting skills, household communication, early childhood development, adolescent health and wellbeing, and caring for children living with HIV (CLHIV) • Develop a provincial social service referral toolkit and zonal-level social service guides • Train 22 community facilitators for delivering parenting education sessions • Train 64 case managers in vulnerability assessments, case management, and referrals • Provide education support to 2,000 beneficiaries through direct support and school block grants • Strengthen existing 30 Child Protection Committees in PEPFAR target health zones • Complete organizational development assessments and annual planning with Haut- Katanga DIVAS • Issue at least $1,000,000 in small grants to 4-6 civil society organizations to provide support and services to OVC households • Establish a provincial-level OVC Technical Working Group in Haut-Katanga province.
2. ACTIVITY IMPLEMENTATION PROGRESS
2.1 Progress Narrative
OVC_SERV During FY18, 11,611 beneficiaries received support from the ELIKIA project (OVC_SERV), against a target of 11,117 (104% of target). A total of 10,642 beneficiaries were active at the end of FY18, and 969 graduated during the year.
Of all beneficiaries, 8,896 (77%) Fig. 1: FY18 Active and Graduated were OVC <18 years of age are, Beneficiaries by Quarter and Age while the other 2,715 10000 beneficiaries (23%) are >18. This 8519 8484 8155 includes caregivers of OVC, 7590 8000 spouses who are actively 6000 engaged in project activities, as well as some household 4000 members >18 years old who are 2728 2663 2487 2409 still in school or also have 2000 562 children (OVC) living in these 0 0 142 21 37 16 191 0 households. 969 beneficiaries Q1 Q2 Q3 Q4 graduated during FY18. ELIKIA began graduating beneficiaries in Actifs <18 ans Actifs >18 ans Gradues <18 ans Gradues >18 ans Q2 of FY18, starting with those who had completed their case management plans and fulfilled all graduation criteria as developed by ELIKIA in line with PEPFAR guidelines. Q4 had the greatest number of graduated beneficiaries to date (753).
While the project fell slightly short of the FY18 target for OVC_SERV <18, this is explained in more detail in Figure 1 below. The overall shortfall was due to delayed start-up of activities in Lualaba as a result of contract negotiations with USAID, which brought down overall numbers for OVC <18. However, as shown, ELIKIA surpassed its target for OVC <18 in Haut-Katanga and overall, where activities were implemented throughout the year.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 5 Figure 2: OVC_SERV targets by province, disaggregated by age (<18 / >18) FY18 Total % of FY18 FY18 Target Achieved Target Achieved OVC_SERV 11,117 11,611 104% OVC-SERV <18 9,493 8,896 94% OVC_SERV > 18 1,624 2,715 167% OVC
Fig. 3: Household Enrollment 2000 1742 1724 1753 1571 1591 1500 1000 321 341 500 168 0 127 143 132 108 43 81 87 23 0 FY18_Q1 FY18_Q2 FY18_Q3 FY18_Q4
# menages enroles pendant FY17 et toujours actifs debut FY18 menages sortis sans graduation ou gradués menages enroles menages reenroles Menages
In Q2 the project began to graduate the first beneficiaries who had completed their case management plans and fulfilled the established graduation criteria. A total of 969 beneficiaries graduated during FY18, with a majority graduating in Q4 (77%). Figure 5 below shows graduation figures for each quarter, disaggregated by enrollment period.
Fig. 4: Graduated Beneficiaries by Enrollment Period 400 294 300
200 172 155 123 95 100 32 31 24 11 6 16 0 8 0 0 0 0 0 0 0 0 0 0 0 0 OND 2016 JFM 2017 AMJ 2017 JAS 2017 OND 2017 JFM 2018 AMJ 2018 JAS 2018
Bénéficiaires gradues en Q2 Bénéficiaires gradues en Q3 Bénéficiaires gradues en Q4
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 6 Of the 741 OVC <18 who graduated, 37 were HIV- OVC on ARVs and tracked by the ELIKIA project for at least one year and which did not have problems related to non-adherence to ARVs. 509 were tested and HIV-, and 195 completed an HIV risk assessment which indicated no need for a for testing referral.
Fig. 5: HIV status of graduated OVC beneficiaries Graduated Q2 Graduated Q3 Graduated Q4 Total HIV+ 14 0 23 37 HIV- 98 26 385 509 Test Not 30 11 154 195 Inidicated Total 142 37 562 741
The table below shows detail for OVC exited without graduation:
Fig. 6 : HIV status of OVC beneficiaries exited without graduation HIV Status Moved out of Refused services Moved to Turned age 18 health zone or ICAP health not found zones HIV+ 12 4 3 2 HIV- 115 71 19 13 Test not indicated 35 23 11 3 Unknown; test indicated 23 1 9 1 Unknown 7 1 2 0 Not evaluated 19 6 3 10 Total 161 106 47 29
OVC_HIVSTAT By the end of FY18, 98% of ELIKIA OVC knew their status (HIV+ or HIV-, or who were evaluated and not considered at risk). 607 (7%) of OVC were HIV+ and on ARV, and monitored regularly in the household by case managers with regard to their treatment adherence and retention, as well as provided with regular psychosocial support and counseling for caregivers. 6,088 OVC obtained negative HIV test results, and testing was not indicated for an additional 2,017 OVC following HIV risk assessments. However, 184 OVC were not evaluated, or after evaluation were considered at risk but had not received test results; 143 of these were indicated for testing and provided with referral forms but did not complete the test, with the primary reason being refusal or hesitation of caregivers to refer their children to health facilities for testing. Fig. 7: OVC_HIVSTAT September 2018 98% Data/Organisation Unit DRC - Elikia OVC (0-17 yrs/beneficiairies) 8896 OVC HIV positive (beneficiairies) 607 OVC HIV positive on ART (beneficiairies) 607 OVC HIV positive not on ART (beneficiairies) 0 OVC HIV negative (beneficiaries) 6088 OVC HIV unknown- all (beneficiaries) 2201 OVC HIV UNK - test not indicated (beneficiaries) 2017 OVC HIV UNK - at risk and not evaluated (beneficiaries) 184
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 7 HIV risk evaluations commenced in July 2017. During the year, the ELIKIA team devoted significant effort to strengthening the referral system between case managers and health structures, particularly to ensure the completion of counter-referrals to enable case managers and the project to effectively track the OVC_HIVSTAT indicator and provide appropriate support for HIV-affected households. During FY18, 99% of OVC were screened for HIV risk. Of all OVC enrolled in the project, 581 were enrolled with known HIV+ status, and 4,861 with known HIV- status. Testing was not indicated for 2,017 OVC, while 1,412 OVC were evaluated and presented with HIV risk. 1,302 of those at risk (92%) were referred for testing; 1,253 (96%) completed the referral, allowing the project to obtain test results and contribute to the “first 90”. 1,227 OVC tested HIV-, and 26 OVC were identified as HIV+. All those who received positive test results were put on ART and followed up regularly for adherence and retention in care and treatment by the case management teams. 110 OVC (8%) presenting with HIV risk following evaluation were not referred due primarily to refusal or hesitation on the part of caregivers.
Fig. 8: Clinical Cascade (Jul 2017 - Sep 2018) 10000 9000 8000 Total: 7459 7000 6000 2017 5000 4000 8896 8875 3000 4861 2000 1000 1412 1302 1253 1227 0 581 26 26 Total OEV Nbre Evalués par Test Reférés Completé le Negatif Positif après Positif sous d'OEV statut VIH Indiqués pour Test référence apres test test ARV evalués
VIH positif VIH negatif Inconnu et test non-indiqué
Of all HIV+ OVC enrolled in the ELIKIA program, 64% are biological children of the primary caregiver; the remaining 36% are primarily in the care of other family members such as aunts/uncles and grandparents. 278 HIV+ OVC have at least one HIV+ biological parent; 169 have one HIV+ parent, and 109 have two HIV+ parents. HIV+ individuals who were the first to be identified as eligible for enrollment in ELIKIA become the index case to identify other HIV+ members in the family during risk assessments and subsequent testing referrals by case managers. HIV screenings of OVC have stimulated demand for HIV testing among adults in a number of households.
Fig. 9 : Family care situation and HIV status of OVC caregivers Category Caregiver HIV Status Number With biological parents (389) HIV+ Caregiver 278 HIV- Caregiver 38 Caregiver Status Unknown 73 With other family members (215) HIV+ Caregiver 70 HIV- Caregiver 92 Caregiver Status Unknown 53
51% of adult caregivers of OVC reported an HIV+ status to the project in FY18; 21% are known HIV+ and 26% do not know their status. Under the guidance of USAID, ELIKIA began coordinating with other PEPFAR clinical partners to increase index testing referrals via ELIKIA. This included collaboration on adult screening tools and establishing a referral process for adult caregivers and household members, including sex workers.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 8 Fig. 10: Adults in ELIKIA project by HIV status HIV+ HIV- Not Reported Total Head of Household 896 360 461 1717 Spouse 340 152 226 718 Total 1236 512 687 2435
ELIKIA contribution to 90-90-90 ELIKIA’s contribution to achieving 90-90-90 goals in FY18 was as follows :
1st 90: In FY18 1,253 OVC completed HIV testing, and 26 OVC were reported with HIV+ status by their caregivers after testing (2%), while 1,227 were reported as having HIV- status. The status of 98% of ELIKIA OVC have HIV status known by their caregivers or presented without HIV risk after evaluation.
2nd 90: The caregivers of all tested OVC know their child’s status, and all 607 HIV+ OVC in the project are on ART and monitored by case managers and in health structures implemented by IHAP- H/L to ensure adherence and retention in treatment.
3rd 90: ELIKIA commenced collection of VLM data in Q4 of FY18 and is still establishing processes to collect this data in collaboration with health facilities. The project plans to collect this information semi-annually starting in FY19. According to the ELIKIA household categorization system put in place in FY18, all households with at least one HIV+ OVC are automatically classified as Category A (most vulnerable), requiring monthly home visits by case managers and systematically offering adherence counseling, not only for HIV+ OVC but also for HIV+ caregivers. Shown in the table below, viral load monitoring is collected at the health facility level where beneficiaries complete their treatment.
Fig. 11: Viral load monitoring (VLM) for ELIKIA PLHIV beneficiaries enrolled in FY18 Viral load Viral Viral load Not eligible collected; Viral Load Age load not not Total for VLM awaiting Suppressed collected suppressed results < 18 50 247 14 99 198 608 ≥ 18 17 385 83 220 531 1236 Total 67 632 97 319 729 1844
Viral load monitoring data contained in the table was collected actively by case managers in collaboration with staff of health facilities supported by IHAP where HIV+ ELIKIA beneficiaries receive their ARV treatments. Of the 607 HIV+ OVC supported by the project, 212 had completed viral load monitoring and results were available from health facilities; 198 of them (93%) were followed up in the community by ELIKIA and were virally suppressed. The suppression of viral load in adults engaged by ELIKIA is 86% (531 of 614 HIV+ adults). With 97 people presenting non-suppressed viral count results, including 14 OVC and 83 adults, ELIKIA will work to strengthen treatment adherence counseling in these households. It should be noted that 34% (632/1777) of eligible PLHIV have not benefited from VLM and 17% (319/1777) who had completed it are awaiting results at the end of Q4.
Support for sex workers During the year, ELIKIA collaborated with the LINKAGES project to identify sex workers with children who may be eligible for ELIKIA support. 186 sex workers were enrolled in ELIKIA as OVC caregivers; among them, 21 were HIV+ and monitored through HIV care and treatment structures, 48 had HIV status unknown or unreported to the project, and 117 were HIV-. In addition, 16 HIV+ OVC were living in households: four with HIV+ sex workers, 10 in households with HIV- sex workers, and two in households where sex workers’ ‘HIV status was not reported.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 9 While ELIKIA has primarily enrolled sex workers through Fig. 12: Adult Sex Workers & OVC LINKAGES drop-in centers by HIV Status and have only noted this 1000 group in the database, case 591 managers acknowledged that 500 117 207 some beneficiaries enrolled at 21 109 48 health centers serving HIV+ 0 clients are also sex workers, PS positif PS négatifs PS VIH inconnu and are not included in the PS Total oev above data. The project is working to add a data point in the database in order to be able to acknowledge these sex workers in our analysis.
Fig. 13: HIV status of sex workers and OVC living in their households HIV+ Sex HIV- Sex Sex Workers with Workers Workers Unknown Status Sex Workers 21 117 48 Total OVC 109 591 207 HIV+ OVC 4 10 2 HIV- OVC 78 353 120 OVC with test not indicated 27 223 79 OVC with HIV test indicated 0 5 6
Case Management & Services Offered to Beneficiaries During FY18, ELIKIA partners offered a variety of direct services to beneficiaries, and additional services through referrals. The table below summarizes beneficiaries by service area in Q4 only, disaggregated by age and HIV status.
Fig. 14: ELIKIA beneficiaries disaggregated by age and services received (Q4 FY18) Service Offered During # # >18 <18 <18 years FY18 Q4 Households Beneficiaries years HIV+ SILC 990 6387 1369 5018 313 School Support through block grants 814 2444 0 2444 175 Psychosocial Support & Counseling 764 2229 1123 1106 100 School Support through financial 753 2014 0 1999 151 strengthening activities Positive Parenting 406 2445 494 1951 103 Cash Transfers 283 1962 366 1566 119 Completed HIV Testing Referral n/a 1253 0 1253 26 The Faithful House 12 103 22 81 3 Referral for Birth Registration 3 4 0 4 0 Nutrition 3 4 0 4 2 Family Planning 2 2 2 0 0 Referral for abuse 0 0 0 0 0 Referral for indigence certificate 1 1 0 1 0
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 10 SILC groups comprised the largest number of beneficiaries in a single service category, representing 61% of active beneficiaries in the last quarter. This includes not only ELIKIA SILCs but also the AVECs offered by LINKAGES to sex workers. 2229 beneficiaries received psychosocial support during home visits by case managers. For PLHIV (adults and children/adolescents) who know their HIV status, this includes support for adherence to treatment as well as disclosure support to caregivers in the case of HIV- OVC who do not yet know their status.
2444 OVC are benefiting from schooling through the block grant process for the 2017-2018 school year; of those OVC,175 are HIV + (7%), coming from 814 households. In addition, 1,676 OVC are supported to enroll and remain in school through other support provided at the household level, e.g. SILC activities and cash transfers; this includes151 HIV+ OVC whose caregivers have been supported to save and allocate funds to cover their children’s schooling.
Fig. 15: Provision of services to households by quarter 2500
2000 1970
1705 1718 1668 1500 1564 1300 1209 1000 1006 990
500 573 508562 423 364 406 298 283 149 221 0 2378 19 10 12 44 Q1 Q2 Q3 Q4 At least one time in the year
Number of household receiving at least one visit a quarter Number of HH participating in a SILC group Number of HH receiving Cash transfers Number of HH participatin in Parenting Positive group Number of HH participatin in Faithful House group
2.2 Implementation Status
Project management and start-up of activities in new health zones: FY18 commenced with the process of extending ELIKIA project activities to new health zones in Sakania in Haut Katanga and two health zones in the city of Kolwezi (Dilala and Manika). During Q2, the ELIKIA team conducted field visits to meet public health authorities in Lualaba and Sakania and understand the HIV and OVC environment in Kolwezi and Sakania. The team also released a call for proposals to recruit two local NGOs to implement field activities in the three health zones. This process resulted in the identification of two organizations for the health zones in Kolwezi, followed by evaluation of their organizational and technical capacities. Following the reduction in funds announced by USAID at the start of Q3, the process was put on hold until the end of Q4 for Kolwezi. Sakania was removed from ELIKIA’s implementation zones due to budget constraints. Sakania targets remained as part of the overall targes for Haut-Katanga.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 11 In Q4, activities in Lualaba resumed with exchanges with health and political authorities, and negotiations with Caritas/BDOM, which was selected to implement activities in Kolwezi as a result of the NGO grants RFA held in Q2. Project implementation in Lualaba was coordinated with the PEPFAR IHAP-H/L project as a clinical partner. In August ELIKIA organized a training of case managers and SILC field agents for the commencement of activities in the two Lualaba health zones one month before the end of the fiscal year.
As a result of budget constraints, in the new zones ELIKIA will offer a reduced package of support to beneficiaries, which will include: 1) psychosocial support to households and support for treatment adherence and retention; 2) enrollment of beneficiaries in SILC groups; 3) referrals for HIV testing, and care and support for HIV+-identified cases; 4) other health and social service referrals.
Contrary to what was planned, faced with budget reductions ELIKIA did not implement the following planned activities: 1) recruitment of new staff for Lualaba; 2) identification of office space for project management staff in Lualaba; 3) the annual ELIKIA project review with key stakeholders.
Beneficiary identification, enrollment, and case management: Given the large number of beneficiaries already active in the ELIKIA program, it was decided to put in place a continuous referral system with IHAP health sites as well as the LINKAGES project. As soon as agents working in clinics and drop-in centers from these projects identify HIV+ individuals meeting the criteria of having children under age 18 and with interest in the project, they communicate directly with case managers linked to each structure to enroll them in the ELIKIA project.
Before Q1 FY18, ELIKIA proceeded with classification of all households into categories according to their level of vulnerability. Three categories were stablished (Category A-C), with Category A for the most vulnerable beneficiaries based on pre-established criteria that allowed case managers and supervisors to proceed with the exercise easily (see current criteria in Annex B). Households in this category require more attention from the ELIKIA teams, and are visited a minimum of once/month, in order to make support to households with HIV+ children and/or malnourished children most effective. All households with HIV+ children are automatically included in this category. Category B includes moderately vulnerable households, while Category C is for households which are vulnerable but have reached a greater level of stability following ELIKIA support. The categorization established in Q1 was reviewed in Q4, allowing for readjustment based on the evolution of support needed by households. During the quarter, certain events observed in households influenced their categorization, notably the HIV status of OVC, academic failure of OVC supported by the project, and malnutrition cases among OVC. The categorization evolved as follows:
Figure 1: Evolution of household categorization from Q1 to Q4 FY18, by partner
Fig. 16: Evolution of household categorization from Q1-Q4 by implementing partner 250
200 207 195 190 190 178 178 166 168 168 150 145 151 155 155 127 134 115 116 118 116 100 102 98 83 81 50
0 Q1 Q4 Q1 Q4 Q1 Q4 Q1 Q4 CRISEM ADHG DIVAS CARITAS
A B C
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 12 Overall, household categorization has evolved. In Q1 households in Category A represented 32%, which did not change in Q4. Those in Category B represented 36%, falling to 33% in Q4. There was a slight increase in households in Category C, from 32% in Q1 to 35% in Q4. Though households supported by ELIKIA are all vulnerable from the outset, the project opted to put greater emphasis on households with increased vulnerability factors for more regular follow-up, reducing case managers’ workload over the course of the month, and putting emphasis on the most critical households. As such, during the course of a quarter, a case manager will spend more time being in direct contact with Category A households, while keeping contact with households in Category B and C, whom they will visit once every two months or once per quarter, respectively. During time where they do not conduct home visits, they will keep phone contact or meet with household members during SILC or support group meetings to assess household wellbeing.
Progress with household graduation: The graduation process started in Q2, when a tool was put in place to allow not only monitoring the accomplishment of household case plans, but also to ensure that all OVC eligible for HIV testing received a test and that all households with HIV+ OVC were followed for at least one year with the project. A final criterion for viral suppression was also added. Given the difficulty in obtaining this information at present, following a child for one year serves as a proxy for this criterion. Based on these elements, the project obtained the results shown in Section 2.1 for graduated beneficiaries.
Continued support to case managers: ELIKIA continued supporting case managers and supervisors via mentoring in the field during home visits, as well as active participation in weekly meetings held regularly in the offices of implementing partners, where case managers and their supervisors review the week’s activities. Case Management Coordinators, under the direction of ELIKIA, took active part in these meetings to offer support and hear directly about the evolution of activities in the field. In addition to these meetings, all supervisors took part in weekly technical meetings. Further, case managers put in place a framework for social media-based discussion and exchange (“WhatsApp Family ELIKIA”), where all case managers can share challenges and receive support from more experienced case managers, as well as supervisor guidance.
During Q3 of FY18, to better support the process of supervising field activities and provide support to supervisors, a workshop was organized to strengthen supervisor capacity in aspects related to case management supervision.
ELIKIA developed a tool for evaluating case manager performance and taking appropriate measures for improvements. All case managers were evaluated, and for any with weak performance based on quantitative data as well as qualitative data from their direct supervisor, their organization was strongly recommended to develop an improvement plan.
Activities in Lubumbashi health zones: Case management continues as the key element for guiding interventions with households. All households active in FY18 benefited from a minimum of one visit per quarter based on their level of vulnerability and individual need. More and more, the ELIKIA approach as well as all tools developed by the project became systematic, with good practices undertaken by all actors.
In Q2 ELIKIA held a basic training of 15 new case managers who were recruited to replace case managers promoted as supervisors and those who had quit the program. Just after the training, all 45 project case managers working in Lubumbashi (including the 15 newly recruited) and 17 other participants (including Case Management Supervisors and certain agents from the zonal health staff (BCZS), a total of 62 participants, participated in a refresher training for reviewing key concepts and upgrading competencies one year after the first training. This training allowed ELIKIA to introduce new project management tools, namely job aids containing key messages to impart to households during household visits by case managers; household graduation criteria; and a training for all on psychosocial support to households.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 13 Throughout FY18, the Psychosocial Support Form was reviewed regularly; during Q4, per PEPFAR guidance the project integrated additional information on viral load monitoring and outcomes for HIV+ adults on treatment.
In the area of strengthening case management linkages between households and social service and health partners, case conference sessions initiated by ELIKIA as a permanent consultation framework under the coordination of Chief Medical Officers (MCZ) at the zonal level were held in the five health zones in Lubumbashi once per quarter, with the involvement of all social service and health partners. This consultation framework allowed participants to address, discuss, and find solutions for a number of problems raised during household case management visits, and to review all ELIKIA project data shared with the health zone before each case conference in a quarterly bulletin. (Quarterly bulletins as well as the case conference reports are available on Google Drive).
In Q3, ELIKIA participated in a SIMS activity in the four organizations offering direct services to beneficiaries. This activity allowed for evaluation of the quality of services implemented during the year – the major results of this activity are summarized in the Q3 quarterly report, available on Google Drive.
Start-up activities in Lualaba: To implement activities in Lualaba, a basic training for case managers and supervisors was held in Kolwezi in August. The case managers had already been identified by the NGO BDOM/Caritas and IHAP, to initiate the case management process for enrollment in the ELIKIA project in the two health zones in Lualaba (Manika and Dilala). In total, 14 participants were trained, including nine case managers and two supervisors, and other participants coming from BCZS and PNMLS. Among the case managers trained, two were from Lualaba DIVAS. However, at the start of activity implementation, only seven case managers were available. The case managers in Lualaba are essentially volunteers receiving stipends rather than employees. At present, as the contract is not finalized with BDOM/Caritas, these agents are paid their stipends directly by ELIKIA.
After the training of case managers and supervisors, the project proceeded with active enrollment of beneficiaries in support groups at HPK and the Mwangeji General Referral Hospital, followed by vulnerability assessments and HIV risk evaluation for enrolled households. The case managers were newly trained and were coached by the team of Case Management Coordinators under the direction of ELIKIA. Many of these households were directly enrolled (if interested) into the SILCs that were being formed after the SILC Field Agent training and case management training. All these activities took place from the end of August to the end of September to launch activities and register a modest number of beneficiaries in the program as OVC_SERV.
Preparation of activities in Kinshasa: For the handover of OVC activities implemented to date by 4Children in Kinshasa, ELIKIA worked jointly with 4Children, with the support of USAID, for the organization and implementation of the transition process. The transition process, as outlined in the transition plan, was completed by the end of September. Overall, the process has been successfully closed, however there are still some small activities focused on the handover of files and records planned in Q1 of FY19. Given that ELIKIA takes over 4Children activities in Kinshasa on October 1, in order to avoid interruption of activities and to have a smooth transition from 4Children it was it was decided that CRS will continue with the same organization (RNOAC) implementing activities in Kinshasa.
Preparation for FY19 reduction of activities: Following budget reductions announced for ELIKIA for FY19, measures were taken to eliminate some activities, namely: 1) block grants for OVC; 2) cash transfer activities; 3) the positive parenting and Faithful House program. This includes activities in Lualaba where there is only case management with psychosocial support and SILC remaining the only direct services offered by ELIKIA for project households. However, all referrals to health, HIV and protection services by referral will be ensured.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 14 This reduction also led to the decision to terminate the sub-contract with Caritas Katanga and to absorb five of their 11 case managers and two of their six SILC supervisors in the project through ADHG, CRISEM, and CRS.
Objective 1: Reduced economic vulnerability
Activity 1.1: Cash transfers. During the course of the fiscal year, the project continued distribution of cash transfers to 122 new households selected by ELIKIA in Lubumbashi. As a result of budget reductions, there will not bbbebe e new houeholds next year in Lubumbashi, nor Kinshasa or Lualaba.
The project was able to refer 250 beneficiaries to SILC groups during the year. Cash transfer recipients were typically encouraged to join SILC groups after six months of transfers.
Activity 1.2: SILC. SILCs continued to facilitate savings by members, access to loans or credits for microenterprises, and simple social insurance for members who strengthened their social cohesion. Beneficiaries continued to be referred by case managers during their household visits in Lubumbashi; new beneficiaries in Kolwezi were sensitized in self-help groups supported by IHAP in Lualaba.
Of the 65 SILC groups organized in FY17, 45 SILC groups arrived at the end of their first cycle and shared dividends during the year. In FY18, 32 new SILC groups were establisshed in the five health zones in Lubumbashi. As seen in section 2.1, 1,564 beneficiaries have partipated in SILC (or AVEC) groups over the year. Of those, 304 benefiiaries were referred to new groups, and 206 are active.
A summary of the evolution of ELIKIA SILC groups is as follows:
Groups FY17 groups FY17 FY17 FY17 FY17 non- SILC Groups formed in sharing groups in groups in groups in functional groups formed by FY18 dividends in third second first SILC groups created in ELIKIA FY18 SILC SILC cycle cycle FY18 cycle 65 45 1 44 20 1 32 97
The funds accumulated (and shared by groups at the end of their cycle) were as follows: • 45 SILCs formed in FY17 shared dividends of $82,683 in FY18 • 20 additional SILCs formed in FY17 will share dividends of $23,450 at the start of FY19 • 32 SILCs formed in FY18 have $20,094 accumulated to date
During the quarter, the project strengthened collaboration between SILC field agents and case managers to improve the frequency of household referrals to services offered. On a weekly basis, follow-up contacts were made with supervisors and field agents to ensure that referral slips were received to enable harmonization of data across project activities.
Activity 1.3: Promotion of income-generating activities. After saving and receiving dividends in the SILC groups, with support from entrepreneurship-trained Field Agents, beneficiaries developed income-generating activities in different sectors (sale of agricultural products, sale of food products, clothing, crafts, spices, animal breeding, transport by bicycle, communication, etc.) with average start-up capital of $110. Follow-up coaching is provided by the SILC agents on a monthly basis. The impact of income-generating activities on households was noticeable in terms of increased caregiver ability to support primary needs (diet, schooling, etc.) as well as increased adherence to ARV treatment.
Activity 1.4: Strengthening parenting skills. The goal of the positive parenting (Sinovuyo) approach is to strengthen communication and relationships between parents and children. In addition, The Faithful House program, which focuses on strengthening relationships and communication between couples, has also contributed to this effort. All beneficiaries of the program
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 15 are eligible for these activities, but in households with problems identified by the case manager and caregivers, these programs were strongly encouraged. CRS offered these services to 406 beneficiaries referred by case managers during FY18. FY17 was focused on teen-centered classes, so this year more effort was focused on children's classes.
During FY18, all 23 children's positive parenting groups, four teenagers' positive parenting groups for adolescents 10-14 years, one teen group of 15-17 years old teens and their parents, as well as eight Faithful House (TFH) groups completed their sessions. Celebrations were organized in the five health zones and certificates given to all participants for encouragement. These ceremonies allowed participants to share their testimonies, and a follow-up program in the community called " Sinovuyu Companions" was established to ensure permanent contact between people trained in this approach.
An experience-sharing meeting was held in March 2018 for teen beneficiaries (parents and their teenagers) to discuss the impact of parenting and TFH sessions in their households for beneficiaries who have finished the sessions. Participant Simeon Numbi testified: "I was very hard on my children, I gave them harsh punishments, even for minor mistakes, I did not take the time to listen to them, but since I took these positive parenting trainings, I'm sharing my time with my children, and I listen to them attentively. "
Objective 2: Increasing the utilization of essential services
Activity 2.1: Strengthening referral systems. MOUs with IHAP were updated in Q4 given the evolving context of the project; in addition, another MOU was initiated by ELIKIA and is in the process of finalization with the IHAP-Kinshasa project for the new intervention zones after the transition from 4Children to ELIKIA. See MOUs on Google Drive.
As mentioned above, from September 12-17 the project held the last case conferences of FY19 in Lubumbashi. The challenges encountered in the field regarding case management during the quarter included support for malnutrition cases, and cases of adolescent sex workers who have become pregnant and/or dropped out of school. Case conference reports as well as zonal bulletins are available on Google Drive.
Given the magnitude of these problems, they have become three key priorities for referrals and coordination with partners. Discussions related to malnutrition focused on cases of severe malnutrition, referred to structures where clients have difficulty with access to care. Proposed solutions included involvement of nutritionists in health zones for management of moderate malnutrition through nutritional and dietary counseling; the involvement of BCZS in supporting a referral process to UNTI; advocacy to be done by BCZS with nutrition partners; referring all information on malnutrition cases in households to the BCZS level.
Some project households, including sex worker households, knew of cases of adolescents who had dropped out of school because they had become pregnant. To address this issue, it was decided to work in collaboration with LINKAGES to offer education sessions that will include adolescent sexual-reproductive health for sex workers.
Among the 608 HIV+ OVC (<18 years) followed by ELIKIA, 101 (16%) are young HIV+ adolescent girls (12-17 years), among which there are concerns related to sexual behavior. The following steps were proposed: 1) capitalize on appointments of HIV+ adolescents when they are receiving mediation to talk about safe sexual behavior; 2) educate parents/HIV+ caregivers on youth supervision and support during appointments; 3) refer HIV+ adolescents to support groups.
Activity 2.2: Reduce barriers to health and social services. As discussed above, there has been an increase in referrals to nutrition services in particular, as well as other medical services, family planning, vaccination, etc. through the trainings and fact sheets introduced during this fiscal year. HIV risk assessment is a flagship activity of the project – all households enrolled in the project are beneficiaries of both the household vulnerability assessment and the HIV risk assessment, and all
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 16 OVC identified as HIV+ continue to be referred for screening. The return rate of those who completed the referral process was 96.2%. From the experience accumulated over the last two years, ELIKIA has realized that households that are hesitant to go for testing often face real risks. An accompaniment by case managers proves to be essential in this case.
In addition, to ensure greater contribution to the 90-90-90 first 90, discussions concerning index testing and, more specifically, home-based testing started with IHAP in Q2. However, home-based testing is not yet effective in all health zones. As the majority of ELIKIA beneficiaries have already been referred for screening, we will focus on new enrollments in FY19 in Lubumbashi and Lualaba, which will enable ELIKIA, in collaboration with IHAP, to improve index testing.
Activity 2.3: Reduce barriers to education for children and adolescents. During the 2017-2018 school year, the ELIKIA project supported 1,981 OVC through block grants awarded to 77 schools and catch-up centers. Preparatory consultation meetings were held between the ELIKIA project team and the two Divisions of Social Affairs and Primary and Secondary Education to develop a joint strategy for OVC school support. Officials conducted joint mapping of education institutions in the project health zones.
The team held information sessions for Heads of School on the ELIKIA project and the block grants approach. 75 schools and two academic catch-up centers signed partnership agreements with ELIKIA to guarantee the reception of OVCs referred by the project. Case managers were briefed on the selection criteria for OVC eligible for school support and the reference and counter-referral process to schools and catch-up centers;
After signing partnership agreements, the schools received support for needs identification and preparation of their needs statements, which were submitted for review and approval by the ELIKIA project. ELIKIA granted in-kind subsidies of goods, materials, or equipment and services. ELIKIA held a handover ceremony with authorities of the Divisions of Social Affairs and Primary and Secondary Education, pictured below.
Official handover ceremony for 207-2018 block grants. Delivery of desks to Matoleo School (Rwashi).
The graphic below shows the number of OVC beneficiaries of school support at the beginning and end of the 2017-2018 school year. A total of 1,981 OVC were referred and enrolled at the start of the year:1,110 girls (56%; 933 primary / 177 secondary) and 871 boys (44%; 795 primary / 76 secondary).
1,854 OVC completed the school year: 1,026 girls (92% completion rate; 94.6% primary / 80.8% secondary) and 828 boys (95% completion rate; 96.9% primary / 76.3% secondary). A total of 127 OVC (84 girls / 43 boys) dropped out for reasons including decision of parents/caregivers, relocation of households outside ELIKIA areas, recurrent illnesses, cases of early pregnancy, and maladjustment to school due to delayed enrollment.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 17 Given the disparity between girls and boys in the Fig. 17: Evolution of OVC at Start and transition from primary to End of School Year 2017-2018 secondary school due to 2500 socio-cultural and economic factors, the ELIKIA project 2000 pays particular attention to girls in the primary phase 871 1500 828 (primary 6) and those in the 795 initial phase of secondary 770 (secondary 1). Thus, among 1000 the girls supported, 56 girls 1110 or 5% were considered in 500 933 1026 7 883 58 the transition phase between the two cycles 0 177 143 (primary 6 and secondary total primaire secondaire total primaire secondaire 1). 44 are included among Debut de l'annee Fin de l'annee the OVC eligible for school Filles Garcons support in the 2018-2019 school year (FY19), while among the 12 not referred, one became pregnant, six moved, and five chose to drop out to pursue work activities.
With regard to school monitoring of OVC, ELIKIA raised awareness and awareness of households on their role and responsibilities in relation to the education of their children during home visits by managers cases, and collects school results as presented in the graph below.
Of the 1,854 OVCs who completed the school year, 1,611 passed (87%; 1,480 primary / 131 secondary) and 243 failed (13%; 173 primary school / 70 secondary). Pass rates were 95.7% for girls and 87.5% for boys. The project Fig. 17: OVC School Success / Failure team conducted an analysis of Rates for 2017-2018 School Year reasons for school failure, to take appropriate corrective measures to 1800 increase school success. These 1600 173 included: 1) establishing a list of children who have failed and sharing 1400 the list with case managers, and 1200 discussing barriers observed and 1000 developing accompaniment plans. 800 88 These efforts will focus on 1480 85 70 identification of OVC with 2+ years 600 out of school and following up their 131 52 400 795 schooling; prioritizing relevant 685 91 18 40 200 households during planning of home visits and taking advantage of 0 Total Filles Garcons Total Filles Garcons opportunities to offer advice and discuss with parents/caregivers and, Primaire Secondaire where possible, children; and sharing Reussite Echec information with schools to ensure joint monitoring of concerned OVC.
For the 2018-2019 school year, which will be the final year of block grants to schools and catch-up centers due to limited resources, the ELIKIA project, in consultation with DIVAS and the DEPSP, convened meetings to develop sustainability strategies for continued provision of school support to OVC. This culminated in partnership agreements with DIVAS and DESPS to safeguard ELIKIA’s
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 18 achievements on education and promote the continuation of OVC schooling in the coming years. Per the agreement, for FY19 15% of OVC referred for school support will be enrolled in school free of charge based on the certificate of indigence issued by DIVAS, while the block grant awarded to the school will be calculated on the basis of remaining number (85%). For the following school years, the schools or catch-up centers will promote the schooling of OVC; 15% of OVC will be issued with the indigence certificate by DIVAS for a complete waiver of school fees, 50% will benefit from a 50% reduction in school fees under the care of their parents/caregivers, and 35% will have to pay 100% of school fees.
Activity 2.4: Reduce barriers to protection and social services. ELIKIA continued building capacities of its coordination staff (10) and partners in charge of implementation (15) through a training on the institutional child protection policy, led by a consultant from the Keeping Children Safe Coalition in Q2. At the end of this workshop, EDC's child protection policy was reviewed for updates, and the draft is in the process of being validated before printing and dissemination. See the workshop report and the updated draft policy on Google Drive.
In addition, new case managers and supervisors as well as SILC field agents, attended an orientation session on EDC's child protection policy, followed by receipt of a copy of the policy, which was signed by an additional 41 staff and project partners.
As regards the involvement of community networks for the protection of children (RECOPEs), the action plan developed after their functional assessment in FY17 was followed by a workshop with eight RECOPE representatives and subsequent network meetings in each health zone together with DIVAS. However, the technical support to facilitate the implementation of this revitalization and extension plan was interrupted due to budget cuts. However, the ELIKIA project continued to work with DIVAS, which coordinates the RECOPEs to promote and facilitate the granting of the certificate of indigence to OVC so that they benefit from the various services, in particular health care and education as well as referrals for obtaining a birth certificate.
Objective 3: Strengthening the provincial social welfare system
Activity 3.1: Development and implementation of a plan for working collaboratively with DIVAS. As part of the implementation of interventions during the year, the ELIKIA project has continued to strengthen its collaboration with DIVAS. Thus, the involvement of DIVAS resulted in the participation of its staff (10 existing and three new case managers, and three supervisors) in initial training and/or retraining sessions on case management and data collection in the DHIS2 database. During the same period, this staff, whose skills are constantly improving, has contributed to case management of beneficiary households (~30 households per case manager) by performing all the tasks expected of a case manager.
On a technical level, the DIVAS staff involved in the ELIKIA project and the DIVAS coordination team benefited from sustained technical assistance throughout the via guidance during weekly meetings of case managers and supervisors, observations during supervisory visits in their offices and in the field, and exchanges with the management team on certain initiatives or issues relating to the use and valuation of the certificate of indigence, and the role of DIVAS and its agents in obtaining birth certificates and reducing barriers to access to social and health services. The in-kind equipment to support the operation of the DIVAS in FY17 was delivered Q4 of FY17 (office furniture, computer hardware and internet service). This support is expected to continue under the capacity building plan based on periodic assessments of needs and progress being recorded, however this year DIVAS only benefited from in-kind support for internet connectivity due to limited resources.
The ELIKIA project works closely with the two Divisions of Social Affairs and the EPSP in implementing school block grants. These two bodies, that have in their respective mandates the protection of vulnerable children and the education of all Congolese children, including the disadvantaged, again designated their staff to support the project in the identification and selection of
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 19 schools, the sensitization of the teaching staff, school enrollment of children, and supervision and monitoring.
Teams from both divisions participated and contributed to all stages of the implementation of the school block grants. At the same time, led by the ELIKIA team, these two entities are drawing lessons from this approach with a view to ownership and sustainability.
Activity 3.2: Development and implementation of a plan for working with local partners. The positive results recorded by the ELIKIA project during FY18 with the commitment and effort of the two NGO partner ADHG and CRISEM motivated the renewal of their awards for FY19. These organizations will continue to implement project activities in the health zones of Kamalondo and Kenya for the NGO ADHG, and Ruashi, Kampemba and Lubumbashi for the NGO CRISEM.
On a technical level, the two NGOs benefited from the support and accompaniment of the ELIKIA staff through orientations or guidelines, training and/or retraining sessions, formative supervision, and accompanied visits to households. Case managers who are pillars in the care of beneficiaries have been supported in: • Use of data sheets and documentation of psychosocial support; • The review of case management plans that enabled the graduation of households; • The planning of home visits, taking into account the categorization of households; • Tablet-based data entry into the DHIS2 database, with regular updates • Monitoring and updating data on services provided to households as well as the analysis and exploitation of data; • Evaluation of case managers and development of capacity building plans; • The handover of households from Caritas case managers to the case managers of the other two NGOs; • Referral and counter-referrals to HIV services and education.
Financially, the two NGOs benefited not only from ELIKIA project grants, but also from supervision activities and orientations to identify financial and administrative weaknesses. Some reporting weaknesses were noted during the Q3 and Q4 period of FY17, but during FY18 there were major improvements in reporting (e.g. budgets and related expenditures, the reconciliation of financial statements, and the budget tracking table are clear).
Due to budget constraints, it was decided to terminate the subcontract with Caritas Katanga in Q1 of FY19. A transition plan was developed and discussed with the Caritas organization (see Google Drive), which included three essential parts, namely the transition of staff (case mannagers and SILC supervisors); the transfer of households, and; transfer of materials. Regarding staff transfers, five Carritas case managers were transferred (three to CRISEM and two tot ADHG); the others were part of the Caritas staff to be reduced, including their supervisors. A total of 641 household records were transferred from Caritas to both organizations (CRISEM and ADHG); among them were 392 active household files (126 to ADHG and 266 to CRISEM). In addition, 249 more households in the program were transferred to project files with these new partners: 109 graduated households (24 ADHG and 85 CRISEM) and 140 households exited without graduation (44 ADGH and 96 CRISEM).
Concerning materials, ELIKIA recovered 16 cabinets for storage of files, seven tables/desks, 10 chairs, four Flyboxes, and 14 tablets. Two computers will be recovered in October 2018 after submission of the final report. This equipment will be used by NGOs covering Caritas beneficiaries. This process was sanctioned by the surrender and handover minutes (see Google Drive).
In Q3 of FY18, ELIKIA conducted a SIMS activity in the four organizations that offer direct services to beneficiaries. This activity was used to evaluate the quality of services implemented during the year, the major results of this activity are all included in the quarterly report submitted to USAID in Q3. The report is in Google Drive.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 20 2.3 Implementation Challenges & Proposed Solutions
Challenges Solutions
Monitoring and improving the In collaboration with the LINKAGES project, situation of households of sex ELIKIA has planned a Q1 FY19 start-up of workers and their OVC is difficult due education sessions on child protection issues to their lifestyle and their conception (adolescent sexual-reproductive health, the of it. Work with sex worker households has impact of drugs on children, necessary proved particularly difficult, because the supervision of children, nutrition, etc.). These children of sex workers face multiple challenges sessions are not only to educate sex workers, such as lack of supervision, especially around but also to find solutions to problems related schooling; high mobility of the mother; and lack to these topics. In addition, regular of information, especially for girls, about sexual- coordination meetings between field staff from reproductive health. In addition, strong both organizations were also initiated to pressure is felt by the sex workers (for the facilitate solutions to specific problems faced by good reason) to practice safe sex, even though some sex worker households. it is often very difficult to negotiate with clients. When a sex worker experiences a failure of this practice, for example if a female sex worker becomes pregnant, she feels guilty and hides, thereby making it impossible to visit her home and her children. The level of vulnerability for some ELIKIA instructed case managers to pay close households is so high that even with attention to each household, especially in the project support for the most most vulnerable category, to distinguish people vulnerable, the household can still fall really too poor to buy notebooks, meals, or into serious situations due to poverty. save even small amounts. They must The most common example are households understand that these are exceptions and must receiving school support through block grants. be brought to their supervisor and project With this support, families do not need to pay hierarchy to rectify the problem. An OVC monthly fees, but there are always other so- cannot miss school because of the money called “additional fees” (buying notebooks, required for a notebook. ELIKIA has a small badges, class journals). In some cases, children pool of funds available through fines collected in these families are at risk of being kicked out from staff who arrive late at the weekly of school for lack of small items. Often, case technical meetings. These small funds can help managers are not aware or know they do not purchase supplies for households in know what to do as the project cannot cover emergencies. Also, ELIKIA is working to these costs. Now, with the project funding cuts identify for a small pool of additional funds to there will be no further cash transfers or block reinstate a form of cash transfers to a small grant. These problems may become more number of extremely vulnerable households. important and common. It takes significant time and effort to ELIKIA organizes weekly technical meetings for have correct and consistent data in all partners involved in the project. At these the database, especially for specific meetings, there is always discussion of the data services offered. There are often to show partners and technical services exactly discrepancies between the data entered by case where the discrepancies are. This review of managers and the data compiled within services data is not only to rectify the data but also to (block grants, SILC, PP). Comparing these data show that we are all responsible for reviewing is essential for regularly correcting errors the data to ensure the reliability that is either in the database or in service-level paramount in the project. We found that monitoring. Coordination between case outside of these meetings, it is very effective to managers, field agents, and other staff have meetings between case managers, field
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 21 responsible for services is time consuming and agents, and supervisors to ensure the adequacy needs to become more automatic and efficient. of all data. It is difficult for case managers to ELIKIA has already discussed with all identify and report extreme supervisors that any emergency should be emergency issues in households that communicated immediately to their supervisor. need immediate intervention beyond Even if the problem is outside the ELIKIA their own capacity to provide program scope, supervisors and management support. The delay in the perception of will discuss if there are opportunities to certain emergencies at the household level respond. In addition, a training session at the households requiring quick intervention shows weekly case management meetings in each that the case managers do not always react in partner organization will provide case managers an adequate manner. That said, the program a better understanding of emergencies and how does not provide the full range of support to deal with them. these households need. However, since these households are in our program, we must do our utmost as soon as possible to try to provide assistance when they face a severe situation.
2.4 Performance Monitoring Update
Strengthening the database and its use: In FY18, the team continued the design and revision of data collection tools and design of the project database. This year included significant achievements in the electronic storage of data, which was first conducted in an online database designed in Excel, which was been replaced by a new database using the DHIS2 platform. This one, operational since January 2018, allowed the project to collect and store data through two programs; a household program and a beneficiaries program. This database contains all project data collection forms exactly as they are designed, and stores the same data from the Excel database with some enhancements and more details for some items.
This database is directly used by case managers using a tablet, which allows them to access the DHIS2 tracker capture application and the database via a unique login. The data entered on the tablet is uploaded into the database server each time the tablet connects to a wifi network, thus providing the opportunity for case managers to synchronize all data in the server after working offline.
The use of the data contained in this database has been reinforced by the creation of dashboards, allowing the display of information from automatically calculated indicators. This is particularly the case for tracking active households during the quarter. The project M&E and technical team made progress in preparing for linking household records with beneficiary records (planned for FY19 Q1) to better visualize the beneficiaries served (OVC_SERV) and the selection of active beneficiaries for an exact calculation of OVC_HIVSTAT.
The establishment of elements in the monitoring and evaluation system, such as data collection tools, the database, the tablet as a data collection medium, has required capacity building for individuals involved in data collection. Two large trainings were organized, the first for 40 case managers and eight supervisors on the use of data collection tools, and the second facilitated by database development firm BAO Systems in use of the DHIS2 tracker capture application via tablets. In addition to training, the project's local M&E team mentored teams of partner organizations for weeks in the use of data collection tools, organizing the household categorization, using the DHIS2 database, and the resolution of some technical problems occurring while using the tracker capture application.
In June 2018, the project supervisors were trained on the analyses to be carried out in DHIS2 so that, at their level, the organizations are able to follow the work they are doing with the data contained in the database.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 22 Monitoring of activities, analysis of results, and development of periodic reports: In order to strengthen partners' coordination, regular technical meetings were organized with partners to monitor project performance. In these weekly technical meetings or those for monitoring and evaluation, project M&E systems and staff contributed the provision of data and information through presentations made in order to allow the project to achieve targets and monitor results.
Data Quality Assurance: Data quality is a constant challenge for the project. To ensure this, the project designed consensual data collection tools to standardize data collection and ensure the reliability of the data collected. This reliability has been enhanced by the development of the Data Management Guide, which has been made available to partner organizations and case managers. In addition, a manual of quality assurance procedures is being developed, which should allow case managers, as producers of data, to control the various elements that can compromise the quality of data. As a recommendation of USAID's DQA visit in February 2018, the project developed a checklist for supervisors to ensure data quality control. This control will increase the quality of the data in terms of reliability and validity. The recommendations of this USAID visit are being implemented, and the project has planned to organize its own DQA visits by the end of December 2018, not having been made as expected in the last quarter as priority was given to the implementation of the recommendations of the MECC audit, which were received in Q4.
3. KEY ISSUE NARRATIVE
Children in Adversity ELIKIA contributes to all three principal objectives of the Action Plan on Children in Adversity, and undertook activities in FY18 that advanced their achievement in Lubumbashi/Haut-Katanga.
Objective 1: Build Strong Beginnings. Orphans and vulnerable children in the DRC face acute risks of failure to thrive due to issues including the impact of HIV on care and family wellbeing, persistent insecurity and conflict, and a lack of functional health and social welfare systems and governance structures. For AIDS-affected households in particular, parents and caregivers require additional support to ensure that children’s health, intellectual development, and social-emotional wellbeing is positively and productively fostered from their earliest days. ELIKIA has continued to deliver comprehensive support to vulnerable households through case management, including identifying household and child vulnerability based on children’s age and stage; providing psychosocial support to parents and caregivers of young children; and offering parenting education as well as individual coaching during home visits to improve parenting skills.
ELIKIA’s training for case managers has included content on early childhood development, accompanied by key messages to transmit to parents and caregivers of infants and young children to promote optimal child development. In addition, in FY18 ELIKIA increased attention to malnutrition among infants and young children, strengthening its process for screening/identifying malnourished children, further reinforcing referrals for specific treatment for moderate and acute malnutrition, and working with local government structures to strengthen advocacy and coordination around malnutrition response.
Objective 2: Put Family Care First. Strengthening parent/caregiver capacity to provide for children’s needs is at the heart of the ELIKIA approach. In FY18 the project continued to undertake a variety of activities to strengthen family care and ensure that children are retained in family settings. ELIKIA case managers continue to assess families’ vulnerability as a cornerstone to their household support strategy, and routinely monitor issues related to child neglect and abandonment, continuous provision of parental care by a trusted caregiver, and family movements and changes for each household they support. Case managers serve as the project’s front line in supporting parents to keep children in family care, and helping them to address challenges that might lead to breakups of family care.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 23 Objective 3: Protect Children. ELIKIA staff has ensured that case managers are linked to structures for reporting and addressing child protection concerns, and provided training to case managers in identifying protection issues (e.g. abuse, neglect, exploitation, and violence), reporting protection concerns, and linking affected households to child protection services where necessary. Case managers, project partners, and staff receive training in the ELIKIA child protection policy, and are required to sign in affirmation of their commitment to upholding it. In addition, this year the project staff and partners participated in a training on child protection policies, resulting in an update of the ELIKIA policy.
Objective 4: Strengthen Child Welfare & Protection Systems. Throughout FY18, ELIKIA continued to build the capacity of the provincial Division of Social Affairs (DIVAS), which includes the mandate to oversee child protection issues and systems across the province. While ELIKIA’s funding for direct work with child protection committees was cut, resulting in a discontinuation of these activities, the project team has continued to support DIVAS in overseeing the function of these groups. In addition, the ELIKIA case management system constitutes its own child welfare and protection system; the project has taken steps to institutionalize this system by building capacity of the DIVAS and three civil society partners to deliver high-quality, coordinated case management for vulnerable children beyond the life of the project.
Youth Development Throughout FY18, ELIKIA continued to foster youth development through education support for primary and secondary school-aged OVC. The project provided assistance for enrollment in formal schools and academic catch-up centers for 1,988 students, ensuring their continued academic and life skills development. In addition, during FY18 ELIKIA offered education sessions for adolescents aged 10-14 and 15-18 and their parents, addressing adolescent development and behavior and related parenting needs and practices. Finally, ELIKIA continued to make referrals of adolescent OVC for sexual-reproductive health and family planning services where possible, and began establishing plans for increased delivery of adolescent health and HIV prevention education to OVC in FY19 in coordination with the USAID LINKAGES project.
Gender Equality/Women’s Empowerment ELIKIA continued to support mothers and female caregivers as its primary adult beneficiaries of case management support, financial strengthening, and parenting education. In particular, financial strengthening activities have been instrumental in empowering women to generate savings and income, and have greater access to and control of household resources. In FY18, as financial strengthening activities have matured over the life of the project, more and more female beneficiaries have developed successful income-generating activities with project support; in many cases, this has enabled them to transition away from sex work, street begging, or other risky and exploitative means of earning money. Men and women also continued to participate in The Faithful House sessions, which address issues of decision-making and communication between married couples or domestic partners; these sessions often resulted in greater autonomy and authority on the part of women, improved treatment by male partners, and greater harmony and equality between couples.
In FY18, ELIKIA provided support to female students in primary and secondary school to ensure continued enrollment and academic success. ELIKIA conducted significant monitoring of students receiving academic support through block grants, including tracking school drop-outs and end-of- year outcomes for all 1,988 students receiving education support. This was accompanied by case manager coaching for parents and individual students to address factors associated with drop-out or failure to succeed in school. Given prevalent cultural norms and disparities that prohibit girls’ success in school, ELIKIA placed a special focus on monitoring and supporting girls in their transition from primary to secondary school, a point at which many girls drop out of school. Among the female students supported through ELIKIA block grants, 92.7% completed the 2017-2018 school year thanks to project support, and of those, 95.8% successfully passed their exams and proceeded to the
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 24 next grade. This included 80.8% of secondary school girls receiving block grants who completed the current school year.
4. INTEGRATION OF CROSS-CUTTING ISSUES AND USAID FORWARD PRIORITIES
4.1 Gender Equality and Female Empowerment
As described above, ELIKIA has utilized financial strengthening and parenting education activities to strengthen gender equality for female caregivers and between heads of household. Reports from participants in SILC groups and The Faithful House sessions are overwhelmingly positive in terms of empowering women and increasing their financial and overall autonomy, changing gender norms that disadvantage women vis-à-vis their male partners, shifting balances of power between male and female caregivers, and increasing women’s decision-making authority within the household. In addition, male caregivers participating in parenting education sessions have reported improved childcare practices and more regular and robust engagement in parenting activities.
Meanwhile, the project has closely tracked educational outcomes for girls in primary, secondary, and alternative education programs receiving support by the project. ELIKIA’s efforts to enroll and retain girls in school has a direct impact on their empowerment, wellbeing, and future prospects. This fiscal year, ELIKIA deepened its surveillance mechanisms for school-age female OVC, with particular attention to specific risk points where girls fail to matriculate.
4.2 Sustainability Mechanisms
ELIKIA continued to work closely with government and civil society implementing partners in FY18. This included a robust series of technical trainings in OVC case management and support; combined with substantial ongoing accompaniment, monitoring, and coaching, both the Haut-Katanga Division of Social Affairs and three NGO partners have demonstrated significant gains in technical capacity and the ability to independently plan, implement, and monitor OVC support activities. Simultaneously, for the project’s NGO partners, capacity building around financial and administrative management has been ongoing, with notable improvements by two of the project’s civil society partners that will enable them to operate more successfully and independently after the end of the project.
ELIKIA also strengthened systems for coordination between the health and OVC/social welfare sectors during the year. This centered around quarterly case conferences at the health zone level. ELIKIA staff worked with Chief Medical Officers from the BCZS to chair the conferences, thereby building capacity of health system staff to address multisectoral OVC needs and increase coordination within the HIV continuum of care.
A major achievement for sustainability in FY18 was the facilitation of ongoing coordination and a partnership agreement between the Haut-Katanga DIVAS and Department of Primary and Secondary Education (DSPE). As ELIKIA block grants will end after FY19, the ELIKIA team worked closely with local authorities to broker an arrangement to provide continued school support for OVC beyond the next fiscal year.
4.3 Environmental Compliance
ELIKIA continued to ensure environmental compliance in accordance with the IEE established for the project. The project opted not to undertake activities via block grants or otherwise that had potential environmental impacts.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 25 4.4 Local Capacity Development
ELIKIA’s strategy for local capacity development in FY18 was closely linked to its sustainability strategy. As described above, the project focused the majority of its capacity development efforts on the staff and structures of the Haut-Katanga Division of Social Affairs, and three local NGO partners. These intensive efforts took place through multiple trainings, weekly meetings, and ongoing technical assistance. As noted, the project team saw meaningful improvements in both technical function and administrative and financial capacity among all project partners. Most notable has been the increase in capacity among case management staff, both at the case manager and supervisor levels. Between these increases in human resource capacity and the efforts to strengthen referral and coordination systems for the benefit of vulnerable households, ELIKIA has made significant gains in building capacity of the local social work and child protection system in Haut-Katanga province.
5. STAKEHOLDER PARTICIPATION AND INVOLVEMENT
BCZS and health structures: During FY18 ELIKIA collaborated with the BCZS, as all case conference meetings were coordinated and directed by the Chief Medical Officer of each of the five health zones in Lubumbashi. Close coordination with nurses from the zonal health structures was facilitated by mapping case managers to all health structures. It was also reinforced during these various meetings that the health structures and, in particular, registered nurses, have a role in the passive referral of new people identified as HIV+ to the ELIKIA project via the case manager assigned to each health structure, and to use simple criteria to identify beneficiaries known to be HIV+ and have children <18 years in their care.
PEPFAR implementing partners – IHAP and LINKAGES: ELIKIA held several meetings during FY18 as part of coordination of field activities with the IHAP-H/L and LINKAGES projects. These meetings were part of start-up of OVC activities in Lualaba province, which facilitated the initiation of revisions and signatures of MOUs with these organizations. The MOUs facilitated on-site collaboration between the three projects, and included recommendations to better achieve targets. Recommendations included: • ELIKIA will work in close collaboration with community agents from IHAP and LINKAGES to establish a process for index testing; • Facilitate case-finding for loss-to-follow-up among clients of health structures and ELIKIA beneficiaries; • IHAP will aid in the collection of viral count monitoring for ELIKIA to follow up; • Support for the identification of HIV+ cases in households, both adult and child; • Working collaboratively between ELIKIA and LINKAGES to provide support to OVC of sex workers, given the complexity of the challenges that they present.
DIVAS & EPSP: The government leadership, embodied by DIVAS, is essential to ensure strengthening of the child protection system, in particular through the ownership of partner implementation of initiatives and approaches, the scaling up of interventions, as well as the sustainability of interventions and achievements. It is within this framework that the ELIKIA project has been working to involve and strengthen the technical and operational capacities of DIVAS through multiple approaches: • The participation of its staff social workers in case management, thus ensuring the strengthening of their skills and improvement of the social benefits which fall within the mandate of the DIVAS. These personnel have gradually acquired a mastery of tools and and the jointly developed protocols that may be taken over by DIVAS;
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 26 • Strengthening the collaboration between DIVAS and the DEPSP (education) aimed at reducing barriers related to school access and retention among OVC, as well as the certificate of indigence. New modalities in the partnership agreements proposed for the 2018-2019 school year, and the awareness of the schools, were the result of the leadership and involvement of these two entities. • The revitalization of the indigence certificate through popularization and more efficient use for the benefit of the needy, especially orphans and vulnerable children, to meet their vital needs (health care, education, supplementary judgment for the obtaining of the birth certificate, justice, etc.). Recommendations on the monitoring and reporting of data related to its use were also made. • Facilitation in obtaining birth certificates at civil registry offices by DIVAS social staff when case managers refer beneficiaries.
Education and protection partners: Contacts and exchanges were made between the ELIKIA project and certain partners (UNICEF, EAGLE, ACCELERE, World Vision) working in the fields of education and protection to promote synergies and capitalize on previous experiences; this made it possible to draw from lessons learned and use them to better orient the block grant approach to schools in the context of Haut-Katanga province (targeting schools and catch-up centers, consultation and negotiation with stakeholders, calculation of costs or amounts for block grants, establishment of lists of eligible items, tutoring activities, mentoring and children’s clubs in schools). However, the different zones of interventions and schools of certain partners (UNICEF/World Vision/ACCELERE) and the closure of the EAGLE project in March 2018 have not facilitated the synergy and capitalization of certain interventions.
6. LESSONS LEARNED
With psychosocial support and counseling from case managers, cash transfers to the poorest households prepare them to begin saving in SILCs and transition out of extreme poverty. Cash transfers, being a limited form of assistance, have enabled many households to not only meet their immediate needs, raise their acceptable standards of living, and better support OVC on several levels (nutrition, clothing, medical care in the short term), but many of them have started to become involved in savings and credit activities and have even started modest income-generating activities. These caregivers never thought they would be able to save with the little they had. With the advice of case managers and the help of cash transfers, a permanent change is now possible for these most vulnerable households.
The systematic assessment of nutritional status for OVC <5 during each home visit, and the referral to nutrition services, can save children’s lives. Through the assessment of nutritional status done by case managers using MUAC measurements, the identification of OVC with moderate and/or severe malnutrition can prevent negative health outcomes. Especially with moderately malnourished children, case managers have a key role to play in providing the nutritional advice that is essential to avoid falling into severe malnutrition, which becomes much more complicated to treat and which requires a referral, and often therapeutic inputs are not available.
The main criterion of OVC eligibility for school support, out-of-school attendance or drop-out during the previous school year, led the project to also select children with several years of non-school. This requires good evaluation and follow-up to ensure that they are enrolled in the right class to ensure their success. Children who have had a school break of several years in school may have maladjustment problems not initially identified, leading to school failure or dropping out of school due to being enrolled at the wrong grade level. Problems can be related to their ages or levels of understanding, including their integration with classes of younger children. After analyzing this situation, case
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 27 managers were coached on this problem so that they identify and evaluate each child in this situation and plan follow-up visits in the first quarter based on the level of study or class proposed, to take appropriate measures for support.
7. MANAGEMENT AND ADMINISTRATIVE SUMMARY
During this fiscal year there were a number of staffing changes of note:
• The resignation of the DCOP-Finance & Administration. As a result, ELIKIA chose to promote two internal staff, namely the Accountant in the role of Senior Finance Manager and the HR & Office Manager to Senior Admin & HR Manager This decision was made considering their capacities and the proposed cost savings. The project IT Specialist also resigned and was not replaced.
• The contract of the Adminstrative Assistant ended its term and was not renewed, in favor of adding a Finance Assistant.
• Change of title of Clinical Director to DCOP-OVC & HIV.
Anticipating the reduction of substantial funds for AF19, ELIKIA decided to terminate the subcontracts of two partners in the project consortium. Following the end of Palladium's contract, their local Director of Monitoring & Evaluation became an employee of EDC for the same position.
The second organization, Caritas, will complete its contract on October 15 in order to complete all reports. Five Caritas case managers were transferred to other NGOs, as well as two SILC agents to CRS Supervisors.
At the management level, EDC HQ 's financial analyst's visit to support the project was a major support given changes in the level of financial and administrative operations.
During the year, EDC obtained all legal documents, namely the framework agreement, the ministerial decree and the certificate of registration, F96 of the Ministry of Justice.
On the security front, EDC has been registered with INSO (International NGO Safety Organization).
8. PLANNED ACTIVITIES FOR NEXT QUARTER
Start of activities in Kinshasa: Working with CRS, the ELIKIA technical team will focus on bringing RNOAC case managers up to speed on ELIKIA tools and the use of the database in DHIS2 on tablets. At the same time, the team will migrate and integrate data for households and beneficiaries inherited from 4Children into the ELIKIA database. All case management activities in Kinshasa will be harmonized with the approaches already established by ELIKIA in Lubumbashi.
Progress of activities in Lualaba: Even though activities (training of case managers and SILC agents, and the start of enrollment and services) have already begun in Lualaba, it will not be until FY19 that ELIKIA will have a contract signed with the Caritas/BDOM local partner. In addition, there will be several other active enrollment sessions in PLHIV support groups and hospitals, as well as with sex workers. SILCs, which were in training at the end of FY18, will be active in the first quarter of FY19.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 28 Implementation of USAID / MECC DQA recommendations as well as the implementation of an internal DQA: While some of these recommendations were already implemented in Q4, the rest will be completed in Q1 FY19. In terms of internal DQA, ELIKIA will focus on Q4 FY18 data with our partners ADHG, CRISEM, and DIVAS.
Follow-up of the block grant process: The signature of partnership agreements between EDC and the schools for block grants will be completed in Q1. Once complete, the priority items identified by each school will be distributed. During the quarter, case managers will ensure that OVC regularly attend partner schools and catch-up centers through home visits. At the same time, education supervisors will collect and analyze school results in order to address problems observed and improve academic performance if necessary.
9. ACTIONS TAKEN TO ADDRESS A/COR COMMENTS
No issues were raised in the prior report to USAID.
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 29
ANNEX A: PROGRESS SUMMARY—ANNUAL
Indicator title Disaggregated by Baseline Value FY 2018 Quarterly Results - FY2018 Deviati FY FY on ( %) 19 20
* Denotes PMP indicator Region Other (Sex, Year Value Annual Annual Q1 Q2 Q3 Q4 Sector, Planned Actual Institution, Target Age, etc.) Number of beneficiaries served by 18572 PEPFAR OVC Haut (incl. programs for children Katanga et 2017 9913 11117 11611 11136 11470 11409 11611 4% Kin- Lualaba and families affected by shasa) HIV/AIDS (OVC_SERV)* Number of enrolled 150 households receiving Haut (New 75 122 Katanga et 2017 444 Haut- (Haut 0 68 50 4 -19% conditional cash Lualaba Katanga, 75 Katanga) transfer* Lualaba) 54 (new 27 Haut Number of SILC Haut- 32 (Haut Katanga et 2017 82 5 10 4 13 -41% Katanga, 27 Katanga) groups established Lualaba Lualaba) 32 (22 32 Number of PSPs Haut Haut- (22- HK identified and trained Katanga et 2017 32 22 0 0 10 0% Katanga et 10- Lualaba on SILC process 10 Lualaba Lualaba)
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 31 Indicator title Disaggregated by Baseline Value FY 2018 Quarterly Results - FY2018 Deviati FY FY on ( %) 19 20
* Denotes PMP indicator Region Other (Sex, Year Value Annual Annual Q1 Q2 Q3 Q4 Sector, Planned Actual Institution, Target Age, etc.) Number of OVC 850 (450 households served by Haut Haut- ELIKIA assisted through Katanga et 2017 420 1564 (HK) 573 1209 1006 990 84% Katanga et Lualaba savings groups (SILC, 400 Lualaba AVEC, PSP)* Number of people Haut trained in 2017 0 1000 670 (HK) 50 261 242 117 -33% Katanga entrepreneurship Number of households enrolled in positive Haut 2017 252 540 562 78 149 221 406 4% parenting and faithful Katanga house courses Percentage child beneficiaries (< 18 years) with HIV status Haut known to the OVC Katanga et 2017 58% 50% 98% 91.9% 90.7% 98% 96% implementing partner Lualaba (IP) (including test not indicated)* Percent of child beneficiaries (<18 years) served by ELIKIA Haut Katanga et 2017 35 50% 97.5% 69%? 91% 88% 96.2% 95% who successfully Lualaba complete a referral for HIV testing services* Percentage of Haut households currently 12% Katanga et 2017 3% 0% 2.4% 3% 12 % 300% (HK) served by ELIKIA Lualaba achieving case plan
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 32 Indicator title Disaggregated by Baseline Value FY 2018 Quarterly Results - FY2018 Deviati FY FY on ( %) 19 20
* Denotes PMP indicator Region Other (Sex, Year Value Annual Annual Q1 Q2 Q3 Q4 Sector, Planned Actual Institution, Target Age, etc.) completion (graduation)* Number of case managers, supervisors Haut 73 (62-HK or facility-based focal Katanga et 2017 55 45 0 62 31 11 62% 11-L) points trained in case Lualaba management process Number of the children having received financial Haut support for the school Katanga et 2017 238 2000 2444 1981 1981 1854 2444 22% 0 0 admission and Lualaba retention* Number of girls having received support school transition from Haut Katanga et 2017 37 350 250 56 56 56 138 -29% primary to secondary Lualaba (6th grade, 1s and 2nd year secondary) Number of protection focal points (case managers, RECOPE members, DIVAS staff) trained in identifying Haut Katanga et 2017 0 NA 73 0 62 0 11 NA and responding in Lualaba SGBV, identifying at risk households, and delivering prevention messaging.*
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 33 Indicator title Disaggregated by Baseline Value FY 2018 Quarterly Results - FY2018 Deviati FY FY on ( %) 19 20
* Denotes PMP indicator Region Other (Sex, Year Value Annual Annual Q1 Q2 Q3 Q4 Sector, Planned Actual Institution, Target Age, etc.)
Number of individuals Haut receiving support for Katanga et 2017 NA 3 0 1 3 0 NA incidents of SGBV Lualaba MOU with DIVAS Haut Katanga et 2017 1 0 0 0 0 0 0 NA established* Lualaba Number of local organizations that received USAID assistance (assistance Haut may be in the form of Katanga et 2017 2 4 3 2 2 2 3 -25% grants, sub-grants, Lualaba training, technical assistance, commodity distribution) * Amount in USD provided to local Haut Katanga et 2017 $45,216 $215,000 $215,045 53,586 53,587 42,869 65,003 0% organizations (with Lualaba USAID funds). Number of grantee Haut Katanga et 2017 2 2 2 2 0 0 0 0% AWP produced Lualaba Learning agenda Haut Katanga et 2017 0 1 0 0 0 0 0 -100% developed Lualaba Permanent Database Haut Katanga et 2017 0 1 1 0 1 1 0 0% finalized Lualaba SIMS visits (internal and Haut Katanga et 2017 2 4 1 0 0 1 0 -75% external) Lualaba
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 34 CATEGORISATION DES MENAGES PROJET ELIKIA MISE A JOUR
CATEGORIE CRITERES CATEGORIE A • Chef de ménage mineur ou vieillard (70ans et plus) • Ménage de PS, cas de divorce de moins d’une année, cas de décès du chef de ménage et/ou MENAGES TRES autre absence prolongé de 6mois minimum du chef de ménage VULNERABLES A • Ménage où les OEV sont drogués (médicamenteux ou non médicamenteux) VISITER AU MOINS 3 • Ménage sans abris ou sans domicile fixe FOIS LE TRIMESTRE • Chef de ménage avec handicap sévère physique (Aveugle, Sourd-muet, moteur se déplaçant dans une chaise roulante), mental (trouble de comportement) et/ou alité • Ménage dont les enfants de moins de 5ans présentent une malnutrition sévère • Ménage avec notion des viols ou maltraitance des OEV de tout genre, actif ou antérieur • Ménage avec PVVih qui n’est pas sous traitement • Ménage où il y a une nouvelle naissance chez une PVVih • Ménages avec un nouveau-né non enregistrer à l’état civile • Ménages avec OEV scolarisés et fréquentant irrégulièrement (max 2 absence par semaine) l’école • Ménage avec référence récente vers les services : dépistage du VIH, enregistrement a l’état civil, PF, PTME ou vers Dépistage précoce de l’enfant exposée au VIH, ou pour le cas de viols. • Ménage avec OEV VIH+ • Ménage avec OEV/femme enceinte • Ménage avec OEV ayant échouer à l’issue de l’annee scolaire et ceux le rendement baisse en cour de l’annee scolaire. • Ménage avec malnutrition modérée des OEV de < 5 ans • Ménage avec PVVih non adhérant au traitement • CATEGORIE B • Ménage sans source de revenue
ELIKIA Annual Report | Fiscal Year 2018 | October 30, 2018 | Page 35 MENAGES • Ménage sous-logés (dans des conditions difficiles ex : chantier, maison sans tôles, maison en MOYENNEMENT tôles, maison qui suinte, avec grandes fissures, etc.) VULNERABLES A • Ménage pléthorique (Taille > 10) VISITER 2 FOIS LE • Ménages avec OEV esseulés, triste TRIMESTRE • Ménage où il n’y a pas partage de sérologie • Ménages avec enfants de < 1 année avec calendrier vaccinal non complété, • Ménage avec Jeune fille < 18 ans non scolarisée
CATEGORIE C • Ménage PVVih observant • Ménage avec partage du statut sérologique MENAGES MOINS • Ménage dont le plan d’actions est suivi normalement VULNERABLES A • Ménage impliquer dans les activités SILCs VISITER 1 FOIS LE • Ménages impliques dans les activités PP, TRIMESTRE • Ménages avec les OEV scolarisés et qui fréquentent régulièrement l’école
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