Development of Minimum Care Standards for Orphans and Vulnerable Children in Haiti
Due to increasing numbers of children affected by HIV and AIDS and other difficulties that increase their vulnerability, efforts to provide services for orphans and vulnerable children (OVC) experienced rapid growth around the globe in recent years. Early in the response, for children left vulnerable by HIV and AIDS, programs focused more on providing services to the highest number of children and delivering products (such as backpacks and school supplies), without paying attention to whether the services were actually making a difference in children's lives (outcomes). It was not always clear that the services provided were effective, efficient, and/or equitable. Recently, stakeholders have realized that more attention should be given to outcomes and the need to provide quality services.
Through the technical assistance of the USAID Health Care Improvement Project (HCI) and its follow-on, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project, several countries have developed minimum service guidelines or standards in OVC programming through a national consensus process. The guidelines cover the sectors important in providing for overall child wellness, including health, nutrition, education, shelter and adult care, psychosocial care and support, child protection, and household economic strengthening. The development of service standards represents an important step for a country to improve OVC programming and reflects best practices developed locally through consensus among stakeholders, including government and implementing partners. Service standards clearly indicate the results desired by service area, and based on minimum dimensions of quality, essential actions to achieve the desired results.
HCI was invited by USAID Haiti in 2010 to provide technical assistance to the Ministry of Social Affairs/Institut du Bien Etre Social et de la Recherche (Institute of Social Well Being and Research) (IBESR), implementing partners, and the US Government in Haiti, to improve the quality of services offered to vulnerable children (VC) and families affected by HIV. As one of the world's poorest countries, Haiti’s children and families are faced with poverty, corruption, poor infrastructure, lack of health care and education, and repeated national disasters (e.g., hurricanes, the 2010 earthquake, and cholera outbreaks). In December 2013, the USAID ASSIST Project continued the work of HCI. Both the ASSIST and HCI work were funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
The project focused on building consensus among stakeholders on a set of minimum services for vulnerable children at the point of service delivery. The guiding principle of the work was to engage stakeholders to reflect on the essential question: What measurable differences do our programs make in the lives of vulnerable children and how would we know that our programs are making a difference?
This report outlines the key steps taken by HCI and ASSIST in helping create the OVC service standards in Haiti and the capacity-building that was conducted to implement the standards locally.