SACBC AIDS Office Report 2013

SACBC AIDS Office Report 2013

This past year has been one of winding down activities at the ART sites in preparation for the termination of the grant in May 2014.  A huge emphasis has been placed on the transfer out of patients on treatment to Department of Health Facilities.

The annual report also outlines the other programmes of the SACBC AIDS Office, with a strong emphasis on the needs of children orphaned and made vulnerable by AIDS……


SACBC AIDS Office Report, December 2013

Sr Alison Munro, OP

Antiretroviral Treatment (ART) Programme

The ARV treatment programme which was started in late 2003 has entered its last phase under the SACBC AIDS Office.  It will end in May 2013 with the majority of patients having been transferred into Department of Health Clinics.  Over the history of the programme over 45 000 patients were initiated on treatment, and relationships were established with Department of Health clinics. Treatment services at three Catholic clinics are likely to continue under new funding arrangements.

Orphan and Vulnerable Children (OVC) Programme

  • The PEPFAR OVC programme which has been operational in most provinces will end in May 2013.  Many projects,  by no means all of them,  have been successful in establishing new partnerships and sourcing other funding which will allow them to continue serving the needs of vulnerable children.
  • The Global Fund OVC programme operates only in inland provinces and only in priority districts of the Departments of Health and Social Development. In some instances the AIDS Office has been able to transfer individual OVC projects between PEPFAR and Global Fund funding, allowing some of them to continue under the SACBC AIDS Office beyond May 2013.
  • A Catholic Relief Services (CRS) grant which ended in September allowed for the support of small OVC projects in all three countries.  In 2014, a small new grant will assist OVC mainly in Swaziland.

Home Based Care (HBC) and the Early Detection of TB Programme

  • Because of the greater availability of treatment the focus of what was home based care has shifted to the early detection of TB which is often an indicator of possible HIV infection.
  • CRS small grants-, Global Fund-, Department of Health– and DFID-funded projects in the programme have placed major emphasis on screening for and follow up services/treatment around TB.  Trained lay counsellors are now able to do rapid HIV testing and TB screening in households they visit.  The programme is offered in Swaziland and several dioceses in South Africa.

Orphan Housing Programme

  • The SACBC AIDS Office between mid 2010 and the end of 2013 has constructed 302 two-roomed houses for child-headed families and for grandparents caring for orphaned and vulnerable children in rural areas. The main donors have been Homeplan, an anonymous donor and Kindermissionswerk.
  • Lotto funding has covered extensions to an OVC office and the construction of two orphan drop-in centres in the Diocese of Kroonstad.

Retreats, Training, Publications

  • All SACBC AIDS Office sites have benefitted from the retreats offered to caregivers and project personnel.  Some of these were funded by Mensen met een Missie.
  • Many opportunities for training were offered to caregivers and project personnel (including lay counselling, HIV testing, TB screening, project administration and fund-raising.)
  • The SACBC AIDS Office co-hosted with St Joseph’s Theological Institute a theological conference in January.  The papers were published in two editions of Grace and Truth. Our book Catholic Responses to AIDS in Southern Africa is being launched in January 2014.

Finance

The audit of the SACBC AIDS Office by the Office of the Inspector General of the USA was completed in 2013.  Separately an 18 month audit to the end of December 2012 required by PEPFAR and the US government was submitted. The finance team is to be commended for the tight controls it exercises to ensure complete accountability of all donor finances. The annual audited statement for the period January to December 2012 forms part of this report.

Monitoring, evaluation and reporting

Regular reports have been submitted to all donors and to the Departments of Health and Social Development in respect of specific programmes. (Monthly treatment statistics and monthly data concerning PEPFAR services to orphan and vulnerable children).  The M and E team is to be commended for its work on the electronic SQL database at OVC sites. Once data from this has been exported into the new CBIMS system of the Department of Social Development the participating sites will be in a position to do monthly reports as required by the Department.

Staffing

The profile of the SACBC AIDS Office will change from mid 2014 with the ending of the PEPFAR grant, and staff numbers are to be halved.


APPENDIX A:  TREATMENT PROGRAMME

Theresa Bossert

The objective of SACBC AIDS Office was for the existing 11 treatment sites, which have over the last year been reduced to 6  sites, to ensure that 8,900 patients (now decreased to 6,300) receive optimum quality ART care, and to provide persons not qualifying for ARV treatment the necessary care and support. The final no-cost extension year started on 1 June 2013; the six remaining sites will either phase out by transferring their patients to DoH facilities or they will have to secure future funding to continue beyond the grant date.

The project operated in 8 dioceses (Rustenburg, Tzaneen, Bloemfontein, Johannesburg, Eshowe, Dundee, Mzimkhulu and Pretoria) now reduced to 6 (Rustenburg, Tzaneen, Bloemfontein, Johannesburg, Eshowe and Dundee).

Collaboration with others:

  • Across the board, collaboration at local level with the Department of Health has been very good;  sites are attending meetings. In some provinces sites have attended trainings offered by DoH, HBC training and Data capturing workshops.
  • A wonderful working relationship between DoH and Tapologo in Freedom Park (Rustenburg) is blooming, and the patients are benefiting tremendously. Deputy President Kgalema Motlante visited Tapologo, Phokeng, Diocese of Rustenburg, Tuesday 8 October 2013, accompanied by Health Minister Aaron Motsoaledi, North West Premier Thandi  Modise and North West MEC for Health, Masike. Other dignitaries of the National Department of Health, the North West Provincial Department of Health, and SANAC (the South African National AIDS Council) were joined by board members, staff and friends of Tapologo for a short programme which included a tour of the in-patient unit. Tapologo submitted their last order to Scriptwise, the PEPFAR-paid ARV supplier, on 18 November 2013 and have been  receiving DoH drugs since then.
  • Siyathokoza in Botshabelo has been dually funded by SACBC and Aurum, another PEPFAR partner from 1 March 2013. Aurum is the DoH District PEPFAR partner assisting with technical suppor; they pay Siyathokoza’s salaries on behalf of the District and they are in the process of negotiating that DoH absorbs the staff.
  • Kurisanani Holy Family site was handed to DoH Motupa on 29 November 2013. Kurisanani St Joseph site has secured funding from Lotto and will continue beyond PEPFAR with the support of the Department of Health re drugs. Monthly meetings are held between the stakeholders.

Training, retreats, campaigns, events

Admin, finance and management training was hosted by SACBC in five different provinces during August and September: four of the six treatment sites were able to attend, 8 staff members participated.  Concurrent with the Admin, finance and management training an HCT and Rapid testing training was presented by FPD: 7 caregivers from the treatment sites were trained. Nurses training in Bloemfontein: All six ART sites sent 2 nurses each to attend this training to strengthen our clinical governance and Standard Operating Procedure, and to close all the gaps identified in a recent clinical audit by CDC.

Major achievements and challenges: This is a time of final transition of direct services by church to Government. The transition looks different at different sites, but overall the transition steps are to transfer patients to Department of Health facilities, transfer assets and where possible program staff are to be absorbed by either Department of Health or Department of Health partners giving technical support going forward.

  • SACBC AIDS Office has successfully transitioned 5 sites since June 2012 (Hope for Life, Inkanyezi HIV/AIDS org, St Francis Care Centre, Holy Cross and Centocow Development Program). Two Parkhomes (at Inkanyezi and Hope for Life) and one vehicle (at Centocow), an X-ray machine (Hope for Life) and other clinical equipment were transferred for continued use by the Department of Health.
  • Of the 6 remaining SACBC ART projects (Tapologo, Kurisanani, Siyathokoza, Nazareth House Yeoville, Blessed Gerard Care Centre and Newcastle ARV project), 1 site and 1 sub-site operate from Department of Health property, these parkhomes to be transferred to DoH at the end of the program. Four of the remaining 6 sites are receiving ARV’s and Laboratory services from DoH. And 1 site’s staff salaries are covered by a District PEPFAR partner, Aurum Institute.
  • Tapologo received a final Cohsasa (Council for health service accreditation of Southern Africa) accreditation audit on 13 March 2013 and received an organisational average of 98%. SACBC AIDS Office assisted with computer server upgrades and with the transformation of Tapologo’s dispensary to meet the requirements of Department of Health.

Nazareth house has introduced a teen support group and this seemed to help with teenagers’ adherence.

  • In February and March we had visits from CDC staff to track and document the transition process as it takes place. Our partner SCMS (Supply chain management systems) who distributes our Anti-retroviral medication also visited the ART sites during February and March this year.

CDC did a SMS (Site Monitoring System) audit at five Tapologo sub- clinics in August 2013, we learned a lot regarding gaps we need to fill in the clinics and this led to a Nurses training  in October 2013 at which clinics worked through the DoH national guidelines and created Standard Operating Procedures.

How the programme is funded currently

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Programme in 2014 and beyond.

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Statistics: As at the end of October 2013 there were 8,913 patients in HIV care at the 6 supported sites; of these patients, 6,329 were on treatment of whom 5,492 (86.78%) receive DOH funded drugs.

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APPENDIX B:  PEPFAR ORPHAN AND VULNERABLE CHILDREN (OVC)  PROGRAMME

Priscilla Rakhetsi & Nandi Sithole

The aim of the SACBC AIDS Office OVC programme is to provide quality services to Orphans and Vulnerable Children. This could be done through encouraging projects to network with different stakeholders within their area of operation. This assists the projects to have access to different skills and expertise that is crucial to the needs of children.

SACBC AIDS Office OVC programme has been targeting the rural areas where government services are limited, and poverty and HIV/AIDS are prevalent. This programme is operating in seven provinces of South Africa namely KwaZulu Natal, Eastern Cape, Free State, North West, Gauteng, Mpumalanga and Limpopo.

The OVC programme at SACBC AIDS Office and its funded projects have a good relationship with the Department of Social Development and the  Department of Health, and NGOs such as Zoe Life, Realeboga Bakubung and NACCW. The SACBC AIDS Office OVC programme activities are aligned to the South African OVC National Strategic Plan.

NACCW Graduation Ceremony: On May 22nd 2013, the National Association of Child Care Workers (NACCW) hosted the graduation of two hundred and sixty one graduates from Gauteng, North West and Mpumalanga. Among them thirteen Child and Youth Care Workers were from SACBC AIDS Office funded projects. They performed exceptionally well to obtain the Child and Youth Care Worker qualification. The event was held at Sandton Convention Centre in Johannesburg and sponsored by USAID.

The National Action Plan M&E Workshop: The SACBC AIDS Office funded projects in Mpumalanga and KwaZulu Natal attended a National Action Plan M&E workshop. The workshop was organized by the Department of Social Development. The main purpose of the workshop was to empower NACCA partners with skills and knowledge on how to analyse, interpret and utilise data for programming decisions and also to understand the importance of data quality. There were three projects that took part in the Mpumalanga workshop and it was conducted from the 4th to 8th March 2013.  A total of six delegates benefited from the workshop. In KwaZulu Natal a total of six projects took part in the M&E workshop that was conducted from the 11th to 15th March 2013 and ten delegates benefited from the workshop.

National OVCY Conference: Two Project Managers of the OVC programme attended the South African National Conference on Orphans, Children and Youth made vulnerable by HIV and AIDS which was held in Durban at the  ICC from 27th to 30th May 2013. The main purpose of the conference was to evaluate the progress made regarding recommendations of the 2006 OVC conference;  highlight models of protection, care and support plans that are appropriate in addressing the challenges faced by orphans, vulnerable children and youth; share the gaps and challenges that still exist in our country and also to look at the contribution made by the National Action Plan for orphans and other children made vulnerable by HIV and AIDS in addressing those gaps. The conference was hosted by the Department of Social Development and USAID.

Nutrition Assessment, Counselling and Support: A total of six care givers from three SACBC AIDS funded projects attended a Nutrition Assessment Counselling and support workshop that took place in Durban from 11th to 13th June 2013. This workshop targeted PEPFAR partners in KZN and was organized by USAID in collaboration with Family Health International 360 and the Department of Health. The main objectives of the workshop were to update PEPFAR implementing partners on the current nutrition situation in South Africa, to provide guidance on how to align work plans to support Department of Health nutrition priorities, as well as USAID PEPFAR food and Nutrition guidance, and how to improve coordination and collaboration among Department of Health nutrition and other departments with PEPFAR partners.

World TB Day: During March 2013, all the SACBC AIDS Office funded projects had an opportunity to celebrate World TB Day by means of hosting TB campaigns at their sites. The projects collaborated with the Department of Health at the district level which assisted with TB screening and education. The focus of the world TB day was to educate people about TB infection, modes of transmission, signs and symptoms and how can it be treated.

Retreat: In March 2013 all the OVC projects had an opportunity to organise a retreat for all the Care givers. The main idea of the retreats was to give the care givers a chance to share with each other their experiences of working with children. This enabled the care givers to voice their challenges and also to reflect on their personal lives.

HIV /AIDS Counselling and Testing: During August and September 2013, the SACBC AIDS Office organized HIV Counselling and testing training. The training was facilitated by Foundation for Professional Development.  All SACBC AIDS Office OVC funded projects benefited from this accredited training and this training targeted care workers. One of the requirements of the training was that each care worker should  test 50 patients under the supervision of a professional nurse in order to obtain a certificate as a lay counsellor. This training took place in five different venues namely Aliwal Mount Carmel, Tzaneen Ave Maria, Lydenburg Maria Trost, Newcastle Pax Christi, Mariannhill Trefontane, and Germiston Mazenod Centre.

Administration workshop: In August and September 2013 the SACBC AIDS Office organized administration workshops for SACBC AIDS funded projects. The main purpose of the workshop was to equip Project Coordinators, Finance and M&E officers with basic skills on how to keep a proper documentation system, write a formal letter, how to do resource mobilisation, the importance of governance and how to maintain a good cash book and petty cash record.

Tiyimiseleni: Tiyimiseleni HBC managed to secure funding from Savana Lodge near Kruger National Park;  the lodge is currently building them a dining hall and kitchen where the children will have enough place to sit and have a meal.  The lodge is also assisting the project with food and clothing.  The project has a huge garden that the Department of Public Works and the Independent Development Trust (IDT) is funding. The project sells the vegetables and also feeds the children. The money gained from the garden assists the project with the daily running of the project.

Batho Ba Lerato Project: Batho ba Lerato project has a good relationship with the Department of Social Development and in September the social workers conducted a parenting skills workshop for foster parents. The aim of the workshop was to equip foster parents with skills and knowledge on how to deal with foster children and also encourage the parents to do food gardening. The project has secured R380 000 once off funding from Motsepe Foundation for the skills development programme. This amount will give 45 heading households an opportunity to be sent to Motheo FET College to acquire different skills to enable them to support their families. The project also managed to secure R120 000 from the American Embassy.

HIV/AIDS Disclosure Program at Kopano Lerato: In April 2012, SACBC AIDS Office organised an adherence workshop in Durban which was conducted by an organisation called Zoe Life. Kopano Lerato OVC project had an opportunity to take part in this training since they had experienced a lot of challenges with children defaulting from ARV treatment. The training was on how to improve services and assist children to adhere to ARV treatment since it is a challenge to our society. From July 2012 to June 2013, a total of twenty children between the ages of 9 and 18 years who are on ARV treatment have been made aware of their HIV status and also understand the importance of adhering to the treatment. It was not an easy process to make the children aware of their condition but through the skills and knowledge acquired during the training, determination and cooperation between the Care givers and parents, they managed to overcome this obstacle.

Career exhibition at Kroonstad Project: During March 2013 school holidays, Kroonstad OVC programme organized a career exhibition for grade 10 and 11. A total of 87 children across Lejweleputswa benefited from this exhibition. It was a one-day exhibition aiming at exposing learners to various opportunities post-matric and to prepare them to make informed decisions concerning their career choice. Different exhibitors such as Thabiso Centre Skills Development, Central University of Technology (Welkom campus), South African Police Service and UNISA had an opportunity to showcase different opportunities offered by their institution to the Children.

Vegetable Garden at Rorisang: Four years ago the ward councillor of Khuma Extension 6 ward 33 gave Rorisang project land for gardening.  Recently the management of Rorisang project took an initiative to contact different stakeholders to fund raise for the garden. As a result, in April 2013 ABSA bank provided and installed three tunnel shades and also provided the project with seeds and fertilizers. ABSA Bank approved three more tunnels that will be installed in January 2014. The total cost for three tunnel shades was R390 000. The garden provides vegetables for the after school care program and also feeds the families. The project is working closely with the community where the guardians have a responsibility to maintain the garden on a daily basis.

Winter Project: Ahead of the cold winter a total of 12 718 children within the OVC programme received blankets, tracksuits and towels, socks and shoes. These were bought from PEP Store. It was a huge collaboration between the sites, SACBC staff members and PEP Stores personnel, to ensure that this became a success.

Lotto Funding in Kroonstad: The SACBC AIDS Office received funding from Lotto to extend the OVC office in Kroonstad and to build OVC drop-in centres in Hennenman and Viljoenskroon.

Challenges

  • High staff turnover which impacts negatively on service delivery at site level
  • Inadequate involvement of social workers at site level which results in some issues not fully addressed and attended to.
  • Social problems such as teenage pregnancy, gangsterism and sexual abuse are high.
  • Shortage of funding since some projects are solely depended on PEPFAR.
  • Some projects still operate in isolation which results in less community involvement in them.

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APPENDIX  C : EARLY DETECTION OF TB,  AND HBC (Funded by DFID and DOH)

Johan Viljoen

Overall aims and objectives of the programme:

  • Conducting house to house screening of all community members in target communities for TB.
  • Enrolling those who are found to have TB on TB treatment at their local clinic.
  • Monitoring those on TB treatment for adherence, until they have finished their treatment course.
  • Counselling and testing for HIV all household members of houses visited.
  • Initiating those found to be HIV positive and who have CD4 counts below 250 on antiretroviral treatment at their local clinic.
  • Monitoring those who are on antiretroviral treatment for adherence.

Where it has operated:

  • Diocese of Dundee: Noyi Bazi Clinic (Pomeroy), Duduza Care Centre (Maria Ratschitz Mission), Zanethemba (Madadeni, Newcastle)
  • Archdiocese of Durban: Ithembalethu (Estcourt), Sipithemba (Elandskop)
  • Diocese of Port Elizabeth:  Care Ministry
  • Diocese of Kroonstad: Mangaung (Kroonstad), Viljoenskroon, Virginia
  • Diocese of Keimoes/Upington: Bisdom Vigsministerie (Keimoes)
  • Diocese of Port Elizabeth: Care Ministry
  • Diocese of Queenstown: Ntaba Maria Clinic
  • Diocese of Aliwal North: Joe Qwabi HBC (Aliwal North), Masabelane (Sterkspruit)
  • Diocese of Manzini: Regina Mundi (Piggs Peak), Good Shepherd (Siteki)

At the above mentioned sites the program is being fully implemented. Four new sites began implementing the program with effect from 1 November 2013. These are:

  • Diocese of Rustenburg: Tapologo
  • Diocese of Tzaneen: St Joseph’s Clinic (Thohoyandou), Mothupa Clinic (Mothupa), Mokgolobotha Home Based Care (Mokgolobotha)

Collaboration with others:  Early detection of TB by means of house-to-house screening is one of the top priorities of the Department of Health’s National Strategic Plan (NSP) for 2011 – 2016, although it is referred to either as “accelerated case finding of TB” or as “intensified case finding of TB”. The SACBC program is therefore fully in support of the NSP’s priorities. The other top priority is HIV testing, and initiation on antiretroviral treatment of everybody who qualifies. The program also supports this NSP priority.

Training, retreats, campaigns, events:  Community health workers at all sites who are involved in this program have been trained by the Foundation for Professional Development (FPD) as lay counsellors and to conduct the HIV rapid tests. All training is government accredited. All implementation sites hosted World TB Day events, where large numbers of people were screened for TB.

Major achievements and challenges: The first success is the fact that, on average, initiation of TB positive community members on TB treatment has increased three fold since the program started. The second major success has been the fact that targets for TB screening determined in conjunction with the donors have been far exceeded. The third success is the fact that many community health workers in this program have been trained in government accredited courses to be HIV lay counsellors and to conduct HIV rapid tests.

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APPENDIX D:  HBC and OVC SMALL GRANTS (funded by CRS)

Nondumiso Jwara

The SACBC AIDS Office supports small projects in South Africa, Swaziland and Botswana which provide care and support to people infected and affected by HIV and AIDS through Home Based Care as well as Child Care activities, which include nutritional, social, psycho-social, material and educational support.

The AIDS Office has collaborated with CIE and CRS-Botswana to reach learners in rural schools in need of school uniforms. CATHCA and Education for Life of the SACBC Youth Department also collaborated with the AIDS Office in providing retreats to caregivers as well as raising TB awareness and conducting TB screening. Local clinics and district health offices at some sites were very involved in the TB screening and awareness campaigns.

Retreats: Small grants of up to  R7 500 were made available to sites to afford their staff an opportunity to attend retreats. This was also extended to CATHCA as well as Education for Life projects. Durban: Siyabathanda CBO, Ikhaya Community Development,  Asiphile eSt James,  Ithembalethu Outreach Project;  Keimoes:  Diocesan AIDS Ministry;  Francis Shannon Hospice(Kimberley), Nazareth Haven Hospice(through CATHCA),  Inkanyezi HIV AIDS Organization(through CATHCA), SACBC Education for Life,  Youth Alive Kokstad, Education for Life Cape Town, Education for Life Durban, Education for Life Witbank,  Education for Life St Nivard’s, and CATHCA participated in the programme.

TB Day Events: Once-off funding of up to R5 000 was made available to sites to conduct awareness programs as well as conduct TB screening and HIV counselling and testing to mark World TB day. 582 Adults and 259 children were reached. 72 people were screened for TB and 158 were counselled and tested for HIV in Durban and Mariannhill projects.

During this year 2013, The AIDS Office took a “Once-off funding” approach to assist small projects which over the years have unmistakably struggled to comply and to cope with annual “lump sum” grant funding. The only two sites who were getting monthly tranches were Ithembalethu Outreach Project and Siphithemba. Ithembalethu later advanced to the DFID program and Siphithemba is now also partly supported through the DFID program. The rest of the sites report for specific projects for which funding has been given; i.e. gardens; shelter improvement and school uniforms.

Caregivers participated in the various training events organised by the SACBC AIDS Office to cover all its programmes, and mentioned elsewhere in this report.


APPENDIX E:  GLOBAL FUND HBC and OVC IN INLAND PROVINCES

Sibonakaliso Mkhize and Nondumiso Jwara

Overall aims and objectives of the programme: To reach 828 patients with Home Based Care services and 1080 OVC with child and youth care services in priority districts identified by the Global Fund within the 5 inland provinces of South Africa.

Where it has operated: Limpopo: Dwars River; Makhado; Modjadjiskloof; Phalaborwa; Glen Cowie & Polokwane. Mpumalanga:  Hazyview; Leandra. Gauteng: Winterveldt; Bronkhorstspruit and Sebokeng. Free State: Welkom

Training, retreats, campaigns, events : 14 Home Based caregivers were trained by FPD in HCT and rapid testing. Modjadjiskloof(3), Phalaborwa(3), Polokwane(3) Mercy Clinic, Winterveld(2) and Vezokuhle, Hazyview(3). Another 14 caregivers, who work with OVC were trained by FPD in HCT and rapid testing. These OVC sites benefited: Bakhita, Dwars River(2), Nzhelele(3), Ekuthuleni, Leandra, 3) Vezokuhle(3) and Ahanang, Sebokeng (3) . Caregivers have to do practicals at clinics to finish their accreditation requirements.

Major achievements and challenges: 72 HBC caregivers were deployed. These Care Givers were deployed at Ahanang, Sebokeng(10); Lesedi,Makhado (8); BBRC, Kroonstad(10); Phalaborwa(8); Mercy Clinic, Winterveld (8); Modjadjiskloof(9); Polokwane Diocese(10); Vezokuhle, Hazyview(9).

39 OVC Care Givers were deployed. Nzhelele and Ahanang at 10 caregivers each and 7 caregivers at Bakhita. Vezokuhle and Ekuthuleni had 6 caregivers each. OVCs received food plates; food parcels; school uniforms; household goods as well as services such as counselling; homework assistance; referrals.

The need for ongoing training, mentoring and coaching with reporting, especially financial and statistical reporting is still there. HBC kits shortage was a big challenge for HBC sites.

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APPENDIX F:  OVC HOUSING

Sibonakaliso Mkhize

Overall aims and objectives of the programme: Since October 2010 when the Housing project was launched, the overall aims and objectives of the programme have been to build two-roomed houses for orphans and vulnerable children (OVC). The programme works with OVC projects together with caregivers to identify the orphan headed households, or orphans who are looked after by impoverished grandparents who live in bad conditions.  To avoid eviction of the beneficiaries by some relatives or neighbours, the beneficiaries are required to have a right to occupy a piece of land, granted in writing by a local chief. Once a letter from a chief has been granted and proper quotations have been sent to the Office, SACBC AIDS Office then releases money to build a 24 square meter two-roomed house with a 2500L  rain water tank and a pit latrine where needed. The programme also provides employment by using local builders.

The aims and objectives have been met in all the places that were selected. There is a huge improvement in OVCs school performance, security and in life as a whole.

Where it has operated: The SACBC AIDS Office OVC & Human Settlement Programme operated in five different provinces in South Africa, and in Swaziland.

  • Mpumalanga: Inkomazi, Tiyimiseleni (Schoonoord), Ngwana Swara (Sekukhune).
  • Free State: Batho ba Lerato (Thaba Nchu), St. Kizito (Phutatijhaba), Siyathokoza (Botsabelo)
  • KwaZuluNatal: Bergville, Elandskop, Wembezi, St. Anthony’s (Dundee), Dundee, Hlabisa, Ndumo, Kosi Bay, Mtubatuba, Pomeroy, Maria Ratchitz (Wasbank), Sicelimpilo (Port Shepstone), Sizanani (Nkandla).
  • Eastern Cape: King Williams Town, Mthatha, Aliwal North, Queens Town.
  • Limpopo: Tzaneen, Modjadjiskloof.
  • Swaziland

Major achievements and challenges: Although we experienced a few challenges what we have achieved surpasses all the challenges that we encountered. We have  302 houses that will be completed before the end of this year (2013). We have had a weeklong visit in March 2012 by Dutch Homeplan Donors who spent  quality time in KZN (Hlabisa) and again in March 2013 in Inkomazi/Malelane. We have established a good relationship with many OVC Sites, churches, chiefs, indunas (traditional leaders), ward councillors, priests and bishops. The programme has brought joy to many people in South Africa and Swaziland, not forgetting the smiles it brings to the orphans. The program targets the poorest of the poor and provides them with an immediate, dramatic and tangible improvement in their conditions.

We have also experienced some challenges with quotations, delays with building, family issues etc. but most of them were dealt with in due course.

How it is funded currently and from 2014:  Homeplan has committed further funding for 2014.

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APPENDIX G: FINANCE

Finance Team

Overall aims and objectives of the programme

  • To provide accurate financial information in a timely manner which includes preparation of the AIDS Office Monthly Management accounts and Donor financial reports;
  • To manage the cash flow and ensure that sufficient funds are on hand or will be in place to meet the SACBC AIDS Office commitments; in the short, medium and long term this includes preparations of budgets, monitoring of performance against budget and requesting where necessary budget reallocations;
  • To initiate and implement procedures  to ensure that SACBC AIDS Office can meet and fully address the financial obligations under the terms of the awards that it receives from  Donors;
  • To provide support and financial advice and guidance to the SACBC AIDS Office Director, staff and the recipients of SACBC AIDS Office Donor funding.

Major achievements and challenges

  • Ensuring that adequate policies, procedures and documentation is in place to meet the requirements of SACBC AIDS Office Donors.

† SACBC AIDS Office this year has undergone two major external audits (this excludes the internal audits that the Donors have carried out) both of which have resulted in clean audit reports.  This has in part been due to the significant improvement in the reporting from the recipients of the SACBC funding as a result of the additional controls and checks implemented by the finance team.

† In addition to this the audit by the Office of the Inspector General of the US government of the SACBC AIDS Office was finally completed.  Whilst it was disappointing that the SACBC AIDS Office had to repay funds of circa $15k the amount represented less than 0.15 per cent of the total award of circa $10.5million

  • Managing cash flow and funding in the short, medium and long term.

† Cash flow as in any organisation is often a challenge.  For SACBC AIDS Office this is usually due to the late receipt of funding from Donors; normally this is not an issue and the Finance team will be aware of any potential delays and take the appropriate action.  However this year in October we were caught unawares as a result of the US Government shut down. SACBC AIDS Office was not able to access its PEPFAR funds.  Fortunately the US Government shut down was resolved before the critical time. However it meant that payments were made in October to the sites at the latest possible time.   SACBC AIDS Office is aware of a potential shut down occurring again early next year and we will ensure that funds are drawdown well in advance.

† One of the major achievements this year for the SACBC Finance Team was securing a no cost extension from CDC under its PEPFAR Program, albeit not to the same levels as previously awarded.   Numerous submissions were made to CDC to secure the extension and its award meant that a lifeline was provided to the OVC and ART sites funded by the program for a further 12 months to May 2014.

† Whilst the PEPFAR no cost extension provided a lifeline for a further twelve months which is the upside, the down side is that beyond May 2014 there will be no further PEPFAR funding for this grant.   The key challenge therefore in the latter part of this year has been to ensure that the finance team and the sites are prepared for the cessation of the program.

† From a financial point of view measures have been put in place to ensure that the Program can be closed in an efficient and effective manner; however, for a number of the recipients of this funding the sustainability of their program without these funds is doubtful.

† Beyond May 2014 and with the cessation of the PEPFAR funding, the funding profile of the SACBC AIDS Office will alter significantly.  This is not a surprise; the SACBC AIDS Office has been working on this  over the last three years. However, the greatest achievement is that the SACBC AIDS Office even in this challenging environment has secured funds from other Donors and albeit on a smaller scale the SACBC AIDS Office, given its reserves and the other Donors, should be able to sustain itself well beyond May 2014.

Compliance at Diocesan Sites

  • Overall aims and objectives of the programme

† Safe guarding of Assets purchased by PEPFAR funding

† Ensuring all costs reported are allowable, allocable and reasonable according to the approved budget and that all transactions are adequately documented

† Reconciling of site financial reports with the approved budgets

† Ensuring accurate and complete financial reports

† Ensuring that expenses in excess of USD500 are supported by three quotations

  • Major   challenges

† Missing signatures on documents received; high staff turnover; lack of timeous reporting by the sites; purchases not supported by a full tax invoice  and payment vouchers; timesheets not adequately authorised;  buying from non- reputable dealers and being vulnerable  to fraud

† Some sites do not follow the general accepted accounting principles because they have high staff turnover. Staff leave the sites once they have been trained and gained some experience.

  • Major Achievements

† Financial Compliance training conducted for OVC sites

† Reclaiming VAT from SARS on a monthly basis

† We have managed to visit all our sites and reconcile our books and align them to ours going forward and reduce the two months tranche to one month tranche which will be easy to monitor.

† Those sites which had problems with indicators on which line item to report on were also helped


APPENDIX H: IMPLEMENTATION OF THE CHILD DATABASE AT OVC PROJECTS

Marisa Wilke and Tony Linden

Staying up to date with technological advances is crucial to manage projects effectively and adhere to funder reporting requirements. Technology in the workplace is an evolving issue and projects in resource poor settings need intensive on-site and remote support.

At the beginning of the grant the fast majority of the OVC projects based their project management on cumbersome paper based processes. Data quality was compromised by the vast number of children supported and tedious reporting systems. United States Government funded projects have complex reporting requirements that need reliable data collation systems to provide on-time reporting to manage projects and report to stakeholders. The paper based systems at the various independent NGOs  varied in complexity and accuracy.

The M&E team started the data management system by standardizing the paper based system that enabled the projects to streamline data collection. After extensive on-site training and continuous support the paper based system was well established. The second step was to replace the basic excel collation tool with a SQL database (Child Data system – CDS).  The CDS (Child Data System) is a comprehensive database system able to record and manage the complete details of the OVC children. The implementation of the CDS was completed in 2013 at all the SACBC PEPFAR managed OVC projects.  “Projects were taken from a world of paper control to the world of electronic data storage”. The CDS was installed and is now fully operational at 32 PEPFAR funded OVC projects (within a 12 month period). Projects are now able to manage their own data and meet reporting requirements for funders, South African Government and other stakeholders.

The CDS was adapted to Global Fund reporting requirements and now data is captured for 14  Global Fund – funded projects. The CDS enhances data quality and reduces dramatically time spent on the collation of data into a pre-set report. With less time spent manually doing reports, projects now have time to focus on ensuring the quality of services provided to their  beneficiaries. Reports are available at project level for management. Report generation is now an automated process.

The SACBC M&E team now does data quality checks monthly (based on encrypted backups) and can send reports to various stakeholders as needed.  Changes in the reporting indicators have become easier to manage and adapt to the program.

In the last year the number of beneficiaries registered on the CDS has risen to 22, 710 (18, 661 currently active). For the first ten months of 2013, 493, 546 services were recorded (number of services provided to beneficiaries).

During the past year the skill base at project level has increased dramatically and projects are now focussing on their core principles of giving quality care to the children entrusted to them, rather than getting bogged down with heaps of paper work.

In the next six months the focus will be on getting Global Fund – funded OVC projects to manage their own data on the CDS at site level.


APPENDIX I:  MONITORING AND EVALUATION,

Tansel Vosloo and Sibongile Tsepane

Data Quality

The objective of the program was to monitor and evaluate the quality of electronic data in order to ensure accurate reporting to the various funders.

PDS – Patient data system is the electronic database used for capturing and reporting at all the treatment sites under CDC. This system was implemented at the sites in 2009 / 2010. CDS – Child data system is the electronic database used for capturing and reporting at all the orphaned and vulnerable children projects under CDC. This system was implemented at CDC projects in 2012 / 2013. All OVC projects have data capturers on site and they capture all the information and weekly backups are sent for checking and safe storage off site.

This system was implemented for reporting purposes for Global Fund in 2013 – Within Global Fund, currently the data is captured centrally: Sites submit their data to the AIDS Office and then the M&E team checks, captures and validates the data.

TonyLinden has worked with many of the treatment sites in order to get their data transferred to the tier.net system which is the NDOH electronic data system. In 2014 there will be work on getting OVC data transferred into the CBIMS system of the Department of Social Development

Major achievements and challenges

  • All of the PDS databases underwent a data quality audit this year to ensure accurate reporting. Feedback was sent to the data capturers on site to correct. At the beginning of 2013 14 databases were operational throughout the treatment sites. With the closing out of programmes, currently there are 7 databases in operation.
  • All of the CDC databases underwent numerous data quality audits to ensure accurate reporting. Feedback was sent to data capturers on site to correct.
  • Some challenges were experienced with the PIMS system which is used to report quarterly data for PEPFAR partners. PEPFAR also made many changes to the indicators within the SASI manual. Thankfully with having electronic data and not a paper based system, we were able to merely adapt our reporting module and not have to interrupt operations within the projects.
  • Extensive fieldwork  was conducted at OVC sites, PEPFAR and Global Fund, to ensure quality of data captured in the electronic systems.