Learning to Work with Orphans and Vulnerable Children

1. Learning to Work with Orphans and Vulnerable Children A Project of the Social Work HIV/AIDS Partnership for Orphans and Vulnerable Children in Tanzania Day 8 Monitoring and Evaluation, Addressing Stigma and Discrimination

2. Objectives At the end of this day, Para Social Workers will be able to: • Explain the basic concept and process of Monitoring and Evaluating Most Vulnerable Children activities at the village and ward level • Demonstrate the ability to use reporting forms for Most Vulnerable Children • Identify factors that contribute to stigma related to HIV and/or being a vulnerable child • Identify the effects of stigma and discrimination • Identify actions that can be taken at the community and societal levels to reduce stigma

3. Monitoring and Evaluation

4. Monitoring and Evaluation • What is Monitoring? • What is Evaluation • What are examples of evaluation and monitoring you have worked on? Brainstorm in small groups and Discuss

5. Monitoring and Evaluation What is monitoring? Monitoringinvolves collecting and analyzing information in order to determine how our activities are progressing in relation to the goals we set.

6. Who does monitoring? • Monitoring is done by different stakeholders of a program or project • For instance, monitoring in the Para Social Work program is done by: • Para Social Worker • Supervisors • District Social Welfare Officers • Intrahealth • Institute of Social Work and other development partners

7. What is evaluation? • An Evaluation is an objective assessment of the design, implementation, improvement or outcomes of a program. Source: Rossi, P.H,& Freeman, H.E (1993). Evaluation: A systematic approach (5th ed.). Newbury Park, CA:Sage Publications, Inc

8. Who does evaluation? • Just as in monitoring, evaluation is done by different stakeholders in a project or program: -For instance, monitoring in the Para Social Work program is done by: • Para Social Workers • Supervisors • District Social Welfare Officers • Intrahealth • ISW and other partners

9. The Link Between Program Objectives and Evaluation

10. What is a goal? • Goals are what a Para Social Worker hopes to achieve by providing services to children and families within a certain period of time. • Can you think of some general goals of what you hope to achieve with the children and families you are helping?

11. Why set Goals? • Goals guide the activities we have planned to do in order to achieve the outcomes we expect • Promotes accountability– helps to prove we are actually doing what we intend to • Goals enable us to clarify the role of each worker in solving a problem • Determine program outcomes: • Goals enable us to learn whether we have solved the problem

12. What is an objective? An objective is a specific target of a goal that may be a number or another specific outcome. Can you think of an example of an objective to achieve the goal you set earlier?

13. Objectives Examples of an objective to achieve the goal you set earlier • A general objective is usually long term such as reducing the number of vulnerable children in Chamwino District by 20% by 2012 • A specific objective may be to update your record about how much services you provided for most vulnerable children by December 2012

14. Who should set goals and objectives? Program stakeholders at all levels Para Social Workers Supervisors District Social welfare officers Intrahealth, ISW

15. What to consider when setting goals? Time or duration of the program/project Goals should be achievable and measurable Select important indicators that provide evidence (a number that counts resources or outcomes) Inputs or materials that assist us in doing the job (bicycles, stationery) Conditions and general environment that can affect results (floods, hot season, rainy season, lack of resources, illness, etc) What has gone well (past achievements) and what are the barriers or challenges to our goals

16. In setting goals for the Para Social Work project : Remember… The Ministry of Health and Social Welfare recommends that each volunteer should serve NOT MORE THAN 20 CHILDREN EACH MONTH

17. Evaluating services to Vulnerable Children and their Families

18. Evaluating services to Vulnerable Children and their Families We will go through the Child Status Index (CSI) items. Let’s try to think of some goals and objectives that we can evaluate for each You work with 2-3 other participants for 5 minutes for each of them and then we’ll do brief report backs

19. Description of services to Most Vulnerable Children • Food and Nutrition-A service to children or others in the household to enable them have a steady and sufficient supply of food to meet their nutrition needs.

20. Description of services to Most Vulnerable Children Shelter-A service that enables a child to have a safe, adequate and dry place to live according to the norms of the community. The child is also able to access clean drinking water, lives in a clean environment and has clothing

21. Description of services to Most Vulnerable Children Protection- A service that ensures a child is free from abuse, neglect and all forms of exploitation and has adequate legal protection

22. Description of services to Most Vulnerable Children Health-A service that ensures that a child and other household members have access to primary preventive and treatment heath services including health education, vaccination, HIV AIDS counseling and testing, and sanitation services

23. Description of services to Most Vulnerable Children Psychosocial support services- A service that ensures the child enjoys good relationships with adults and other children, feels satisfied, confident.

24. Description of services to Most Vulnerable Children Education and training- A service that ensures the child is enrolled, attends, and is performing well in school/vocational training or work that is age appropriate. Children who are below school age are motivated by games, story telling, singing and participating in social activities

25. Description of services to Most Vulnerable Children Household economic strengthening-A service that enables parents or heads of households meet basic needs of most vulnerable children without depending on external support.

26. Debrief: Evaluation of our Services Discuss

27. Why We Need Data in Monitoring and Evaluation

28. Large Group DiscussionImportance of data  Discuss: Why do we collect data? Who needs the data we collect? What kind of decisions are made as a result of our data?

29. Why do we collect data? We collect data to help us: • Measure our achievements and challenges • Make plans for development work at our villages, wards and districts

30. Who needs our data? • Our data is needed by different people- : • Government (village, ward, region and national) • Non governmental organizations (NGOs)/civil society • Private individuals • Donors such as the World Bank, USAID, etc. • Ourselves!

31. What kind of decisions are made as a result of our data? • Make decisions on resource allocation. i.e what resources go where? Example: How many most vulnerable children need what kind of service? • Develop strategies to address various development challenges Example: How to help families of most vulnerable children receive economic strengthening services

32. Review of Monitoring and Evaluation Forms

33. Reporting Form

34. Para Social Worker Reporting System Takes quarterly report to Head of Department and Intrahealth by 30th of March, June, September and December SWO Takes to DSWO by 25th of March, June, September and December Supervisor Takes report to Supervisor by 10th of every month. Information collected every time PSW meets with most vulnerable children and their families PSW

35. Stigma and Discrimination

36. Introduction • Orphans and vulnerable children experience stigma due to: • HIV/AIDS • Family circumstances

37. What is Stigma? Discuss and Brainstorm

38. Stigma Defined • Stigma is “severe social disapproval of personal characteristics, circumstances or beliefs that are against cultural norms.” • A powerful tool of social control • Used to marginalize, exclude, exercise power over individuals with certain characteristics

39. Why are People Stigmatized? What can we do about Stigma?Brainstorm

40. Why are People Stigmatized? • Traditional beliefs • Fear • Belief system outside rational knowledge • Lack of education

41. Factors that Contribute to HIV/AIDS Related Stigma • HIV/AIDS is a life threatening disease • People are scared of contacting HIV • HIV is associated with behaviors that are already stigmatized • People with HIV/AIDS are thought of as being responsible for becoming infected • HIV/AIDS is often seen as result of moral fault that deserves punishment

42. Images that Reinforce Stigma • HIV/AIDS as punishment • HIV/AIDS as crime • HIV/AIDS as war • HIV/AIDS as horror • HIV/AIDS as otherness

43. Forms of HIV/AIDS Related Stigma • Laws, rules and policies • Community-level responses • Women • Family • Employment • Health Care • Denial

44. How is Stigma a Barrier to Getting Help for HIV? • Stigma – self imposed • You go so far accepting treatment but do not want to disclose to the people in your family and community who might help you to adhere to treatment regimens • Stigma – imposed by the Family and Community • People in your family and/or community prevent you from adhering to HIV therapy through intimidation, violence or isolation

45. What are the Consequences of HIV Related Stigma • For Adults • For Children Brainstorm and Discuss

46. What are the Consequences of HIV Stigma for Adults? People do not test for HIV If untested, people do not prevent HIV transmission and thus transmit disease unknowingly People do not get treated, putting themselves, putting their sexual partners and families at risk of death unnecessarily People who know their status do not disclose their status to their families and/or sexual partners, creating ideal vectors for the transmission of disease Women who are unwilling to test have a much greater probability of transmitting HIV to their babies Families are left with widows, orphans and greater social, economic and emotional burdens Poverty increases

47. What are the Consequences of Stigma for Children? • Child are excluded from families and from support • Children who are stigmatized may be injured, killed or abandoned • Children may be denied services in terms of school, health care or meeting basic needs • Children who survive may have feelings of worthlessness

48. What are the Consequences of Stigma for Children? These situations may create additional problems including: • Children may be harmed and/or killed • Children may be made fun or bullied • Beliefs about a child or parent’s HIV status may be used to control children inappropriately • All of these issues may get in the way of normal child development • Society is deprived of the productivity of children and youth • Families are left with widows, orphans and greater social, economic and emotional burdens • Poverty increases • Social instability increases

49. How can we Change these Messages to Reduce HIV Stigma? HIV/AIDS is a death sentence People are afraid of contracting HIV from ordinary contact HIV is associated with behaviours that are already stigmatized People with HIV/AIDS are considered to be responsible for becoming infected HIV/AIDS is often seen as punishment for sins that are deserved Required

50. How To Help • Societal Level • Legislation • Education • Monitoring • Enabling Environments • Public Messages