strategic directions & the global evidence base
DESCRIPTION
Highlights from the Global Evidence Base PEPFAR Orphans and Vulnerable Children’ Program: Taking Programming to the Next Level for an AIDS Free Generation - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/1.jpg)
PEPFAR
Highlights from the Global Evidence Base
PEPFAR Orphans and Vulnerable Children’ Program:Taking Programming to the Next Level for an AIDS Free
Generation
Neil Boothby, EdDUnited States Special Advisor for Public Law 109-95 and Senior Coordinator
to the USAID Administrator on Children in Adversity
AIDS 2012 - Turning the Tide Together
![Page 2: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/2.jpg)
Strategic Directions & The Global Evidence Base
I. Start youngII. Rebuild Fragile FamiliesIII. Protect women and children from
violence and exploitation
![Page 3: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/3.jpg)
I. Start Young• Use Early Child Development platform to establish linkages
across clinic and community in order to achieve comprehensive outcomes for children –
a) Ensure survival of young children
b) Eliminate mother to child transmission
c) Promote secure attachment and bonding
d) Protect children from lifelong impacts of “toxic stress”
![Page 4: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/4.jpg)
Toxic Stress Derails Healthy Development
![Page 5: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/5.jpg)
ToxicProlonged activation of stress response systems
in the absence of protective relationships.
The Biology of Adversity:Three Levels of Stress
TolerableSerious, temporary stress responses, buffered by supportive relationships.
PositiveBrief increases in heart rate,
mild elevations in stress hormone levels.
![Page 6: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/6.jpg)
Protection from Toxic Stress Leads to Lifelong Health and Well-being
http://www.cdc.gov/aceIncreased adverse childhood experiences (ACE) correlate with greater HIV risk
![Page 7: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/7.jpg)
II. Rebuild Fragile Families • Economic stability • Emotional stability and social
connectedness• Parenting skills
![Page 8: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/8.jpg)
Evidence: HES & Social Protection• Cash transfers (well established evidence)
– Enhance child health, nutrition, growth– Improve school attendance, especially for girls– Increase family consumption, assets, income
Adato & Basset 2008. Hagen-Zanker, McCord, & Holmes 2011. DFID 2011.
• Savings and money management (emerging evidence)
– Reduce erratic/seasonal spending– Stimulate family investment in nutrition, health, education
and asset accumulation– Promote goal-setting, planning, future-oriented behavior
Rutherford 1999. Collins, Morduch, Rutherford, & Ruthven 2009. Duflo, Kremer, & Robinson 2010. Dupas & Robinson 2011a. Dupas & Robinson 2011b. Barber 2011.
![Page 9: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/9.jpg)
Savings + Parenting Discussion Groups
Savings had significant impact on economic wellbeing but did not translate (yet) into better child outcomes:• 4% reduction in poverty• Improved food security• Increased assets (equivalent to 1 cow/family)
Savings + parenting showed significant improvements for children:• Substantial reductions in harsh discipline• Improvements in child mental health• Reduced family problems (reported by children)• Improved child wellbeing (reported by children)
Bundervoet, Annan & Armstrong 2011.
Randomized Controlled Trial in Burundi | Midterm Findings
![Page 10: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/10.jpg)
III. Protect Women and Children from violence and exploitation
• Strengthen Child Welfare & Protection Systems• Promote child protection models that encompass both
informal and formal systems
![Page 11: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/11.jpg)
High rates of violence against women and children with particular concern for
adolescent girls
![Page 12: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/12.jpg)
Weak Formal Protection Systems High Vacancy/High Turnover Rates
• South Africa – 50% of social work posts vacant and 50% leave their jobs within 5 years
• Malawi – 66% vacancy rate in Department of Social Welfare; 47% vacancy rate in Ministry of Women and Child Development
• Lesotho – on average, social workers leave their jobs within 5 years compared to 7 years in the health sector
Davis, Rebecca; “Opportunities and Constraints in Human Capacity within Child Welfare Systems: The Social Work Workforce in Africa,” GH TECH, USAID 2010
![Page 13: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/13.jpg)
Poor linkages Between Formal and Informal (Community) Protection Systems
• Stark, et. al., “A qualitative study of community-based child protection mechanisms in Aceh, Indonesia”, forthcoming in Vulnerable Children and Youth Studies
• Wessells, et. al. “The disconnect between community-based child protection mechanisms and the formal child protection system in rural Sierra Leone: Challenges to building an effective national child protection system”, forthcoming in Vulnerable Children and Youth Studies
![Page 14: Strategic Directions & The Global Evidence Base](https://reader035.vdocuments.net/reader035/viewer/2022062501/56815ec4550346895dcd4cfd/html5/thumbnails/14.jpg)
Thank You