Purpose of the Programme
To  fund 45 projects aimed to reduce vulnerability caused by psychosocial aspects related to HIV and AIDS prevention, treatment, care and support as these affect groupings such as  orphans, vulnerable children, persons living with HIV and AIDS, older persons, youth and people living with disabilities

Policy mandates

  • The following strategic policies, priorities and objectives were identified:
  • The Constitution of the Republic of South Africa, 106 of 1996
  • The Provincial Strategic Plan on STI,TB and HIV and AIDS: 2007-2011
  • The HIV and AIDS Workplace Program.
  • Children’s Act 38 of 2005
  • National Action Plan for Children infected and affected by HIV and AIDS: 2009-2012
  • Orphans and Vulnerable Children Policy Framework,2006
  • Maternal Orphans Surveillance System
  • Guideline on the Services to Children Infected and Affected by HIV and AIDS
  • Minimum Norms and Standards for  Home Community – Based Care and Support Programs
  • Coordinated Action for Children Infected and Affected by HIV and AIDS
  • National Youth Policy: 2009-2012
  • Older persons Act
  • Expansion of Public Works Programme (EPWP)


Situation Analysis

The 2008 National HIV prevalence Survey Results indicates that South Africa is experiencing a maturing generalized HIV epidemic.  The HIV prevalence in the total population in 2008 has stabilized at a level of around 11%.  However HIV infection levels differ substantially by age and sex and also show a very uneven distribution among the nine provinces.  The Northern Cape Province has a population of about 1,125 million and in 2008 had the second lowest HIV prevalence of 5,9% compared nationally.  However infection levels remain high and still represent a severe epidemic which demands a sustained response.  The 2007 Antenatal Survey indicates inter-district variations in the Northern Cape province with Frances Baard District having the highest HIV prevalence and Namaqua the lowest. This suggests that risks and needs may vary for different communities. Variations occur for example in contributing factors. Contributing factors that give impetus to the epidemic include deep poverty, a high number of people living in informal settlements in Frances Baard District, a large mobile community and major transport routes in Pixley Ka Seme District, and large numbers of seasonal migrant farm and mine workers in Siyanda and John Taolo Gaetsewe Districts. These inter-district variations should be taken into account in the response targeting the Northern Cape population.

 

 

The social impact of HIV and AIDS in all 5 Districts of the Northern Cape is evidenced in the following:

 

  • Disintegration of basic family units due to illness demanding that primary care giving and support be provided by home community based caregivers.
  • The decrease in adult caregivers who die of AIDS with the consequent increase in the number of child and youth headed households.
  • The increase in the number of orphans and other children made vulnerable by HIV and AIDS and the impact this has for families and communities.  These place huge demands for programmes targeted at restoring the dignity and creating an enabling environment for the meeting of the basic needs and rights of orphans and vulnerable children.
  • Threatening and compromising of the economical capacity and security of communities as bread winners die of AIDS and this increase vulnerability to HIV and AIDS placing demands on food security needs and coping interventions such as support groups.
  • ARV treatment default and interruption due to lack of food security or psychosocial support to cope and adhere to treatment. This places further demands for the availability of support groups and food security to those on ARV treatment.
  • The Maternal Orphans Surveillance System indicates that by end 2009,  Northern Cape had 26 900 children up to the age of 16 years who are maternal orphans. 54% of these children receive some type of a grant.  There is thus a demand for urgent consolidated efforts to trace these maternal orphans and link them to psychosocial support services including ensuring  financial security by 2015.


Heterosexual sex has been identified as the predominant mode of HIV transmission in South Africa. The 2008 National HIV Prevalence Study identified an emerging trend of specific socio-cultural practices linked to sexual transmission of HIV. These are early sexual debut, multiple concurrent sexual partners and intergenerational sex between females aged 15-19 and older partners. Materialism and financial benefit is linked to these. Northern Cape has a high unemployment rate and these practices could attract the unemployed and poor thus all of these socio-cultural practices require prevention interventions aimed at behavior change targeting the most at risk populations.

 

 

The current response by the Department of Social Development to the socio-economic aspects of HIV include a Programme aimed at prevention, intervention and support to reduce vulnerability of most at risk groupings eg orphans, child headed households, youth , disabled etc. The programme is implemented in partnership by the Department of Social Development, community-based organizations and private sector entities.  The Department of Social Development has partnered with about 28 of these community-based organizations to render home-community based care (HCBC), services to orphans and vulnerable children as well as information, education and communication services to prevent HIV infection. The major challenge is that in the Northern Cape there are many other community-based organizations that render similar services with funding from private and external donors and are thus not accountable to government. This implies that there is no guarantee that the National Policy for HCBC and Policy Framework for services to OVCs are really implemented by these service providers resulting in a possible poor quality of services.  The Department does not really have the human resource capacity to render these services and based on the fact that community-based organizations realize this, there seem to be a demand for recognition and the next 5 years could see the formulation of legislation/policy obliging the Department to improve remuneration and the conditions of services for community caregivers serving in these organizations. This has a huge implication for the budget (stipends).  The vastness of the province imposes a challenge to our on-going concerted efforts to provide with care and support services as Government departments and Partners. In every square kilometer there are only three (3) persons you get in the population of  1, 125 million, according to the Statistics South Africa 2006 mid- year data. This has led to accessibility of services being better in urban than rural areas of John Taolo Gaetsewe, Siyanda and Namaqua. This geographic challenge thus requires the availability of transport for organizations serving these areas.

The organizational governance capacity of these community-based organizations is fairly inadequate due to high levels of illiteracy among project managers, administrators and caregivers rendering these services. This places a huge demand for capacity building inclusive of mentoring and continuous support to organizations. Awareness and prevention campaigns and interventions provided  by these organizations have a physical health bias instead of a social focus and  are not evidence based and also do not really seem to be taking cognizance of behavior change dynamics. There seem to be an emerging trend of mushrooming of new organizations requiring funds from government claiming an interest to provide HIV & AIDS related services to vulnerable groupings.  Christianity is the major religion in the Northern Cape. The Christian church’s role is very fragmented and unstructured and evidenced mainly in the provision of food and hospital visit to the sick. This role could be structured to have the church inculcate and encourage values to form the basis for behavior change. Food could be directed to ensure those really in need access it. There is a need to educate church leaders on aspects of HIV & AIDS to equip them to counsel and support congregants more effectively. The next five years could see a more structured and visible role played by the church in the Northern Cape. The church is thus a crucial stakeholder to engage in the next 5 years.  South Africa is planning to host the World Cup Soccer event over the period of June-July 2010. Current Planning by Coordinators of this event in the Province is that Districts will set up Public viewing Sites where events will take place. There is a need to engage children in programmes to reduce their vulnerability at these sites.  The intention is for the HIV and AIDS Unit to facilitate the presentation of Lifeskills Programmes targeting children. Cooked meals or snacks will thus be needed to give to the children that are engaged in these programmes.

 

 

In light of the latter challenges a 5-Pronged Strategy that promises an effective Northern Cape specific HIV & AIDS prevention, intervention and support programme for the socio-economic/ psychosocial coping of vulnerable groupings is as follows:

  • Expansion of services to under serviced areas through partnership of Department Social Development with all existing Community-based Organizations rendering related services in John Taolo Gaetsewe, Siyanda, Namaqua and Pixley ka Seme Districts. Organizations currently rendering services in Frances Baard must be sustained.
  • Fund, capacitate and support organizations that render services as well as monitor and evaluate services to ensure alignment with Minimum Norms and Standards as stipulated in Policy.
  • Streamlining of prevention campaigns to be evidence-based and address social dynamics of behavior change.
  • Implement district specific responses that address the identified contributing factors in each district.
  • Facilitate the coordination of service delivery by various organizations to ensure resource mobilization and implementation of Policy Framework for HCBC and OVCs

Analysis of constraints and measures planned to overcome them

 

  • Poor institutional capacity of organizations:  Support, linking organizations with mentoring organizations as well as monitor and evaluate services
  • Non accessibility of services in the rural areas:  Strengthening and expansion of   services to rural areas and even considering funding a vehicle for organizations working in these areas to ensure coverage over large area by one organization.
  • Budget constraints deterring the implementation of minimum norms and standards: Identification and strengthening Organizations already rendering services, Establishing partnerships with existing funders of  programmes.
  • Poor  coordination and integration of targeted services: Facilitate coordination and collaboration with  stakeholders
  • Unavailability of the Accredited HCBC Training Service Provider in the Province. The Unit will facilitate fast-tracking of the accreditation process for Service Providers and advocate for the transfer of skills, and encourage consortiums, collaborations and cooperation amongst the service providers, also with external Service Providers.

 

 

Description of planned quality improvement measures

 

  • Implement the National HCBC Norms and standards as well as the HCBC M & E framework
  • Implement data verification and evaluate client satisfaction for HCBC/OVC /IEC services
  • Standardise OVC programmes to ensure a minimum basket of service by each organization.
  • Implement programme and not only stipend funding.
  • Use research and survey results as well as reports
  • to ensure targeted and evidence based programmes and campaigns.
  • Structure services to ensure focus on social aspects of HIV
  • District coordinators to have structured support, monitoring and evaluation visits to organizations
  • Accredited training and encouragement for ABET


Resource consideration

  • Funding of additional HCBC organizations in John Taolo Gaetsewe , Siyanda and Pixley ka Seme Districts.
  • 3 Vehicles (1 each in John Taolo Gaetsewe , Siyanda and Namaqua Districts).
  • Organizational capacity building including mentoring.
  • Care for caregiver (debriefing and support service for caregivers)
  • Standard minimum package of service for OVC by all organizations (Cooked meals, uniforms, play and recreation equipment etc)
  • Children and teenage camps for behavior change programmes
  • Auditing of financial statements


Risk Management

  • Partner with already funded organizations.
  • Partner with Other Funders eg EU, PEPFAR, Corporate sector etc to advocate for the funding of most necessary programme aspects.
  • Strengthen existing partnership with mentoring organizations so as to access free services for organizations.
  • Partner with Christian churches that provide cooked meals and food parcels to ensure referral and access.
  • Take full advantage of USAID funded Care for Caregivers Project planned for rollout in next 5 years.

Goal

To reduce the incidence and minimize the pshyco-social impact of HIV/AIDS

Outcome

A Long and Healthy Life for All South Africans

Strategic Objective

Prevention, intervention and support services to affected and vulnerable groupings.

Objective statement

To expand access to HIV prevention, intervention and support programmes by increasing funded projects  to 45 by 2014.

Baseline

42

Justification

Organizations implementing prevention, intervention and support programmes are mainly serving Frances Baard (Kimberley area). Orphans, child headed households, seasonal workers and their families experiencing increased vulnerability to HIV & AIDS are concentrated in John Taolo Gaetsewe, Siyanda and Namaqua districts. These districts do not have enough funded NPOs to provide prevention, intervention and support programmes.

Links

Organizations implementing prevention, intervention and support programmes are mainly serving Frances Baard (Kimberley area). Orphans, child headed households, seasonal workers and their families experiencing increased vulnerability to HIV & AIDS are concentrated in John Taolo Gaetsewe, Siyanda and Namaqua districts. These districts do not have enough funded NPOs to provide prevention, intervention and support programmes.