Tanzania Experience on Adaptation of CSI Tool: Case of Africare COPE Presenter: Maalim K. Maalim, M&E Officer, COPE, Tanzania Presented at CSI Tool Regional Conference, Kigali, Rwanda 18 th , March 2009

Presentation outlines Background: Africare Tanzania COPE Project Why CSI Methodology Results and Discussion Lessons learned Challenges Way forward Conclusion

Background: Africare Tanzania COPE Project

Why CSI

Methodology

Results and Discussion

Lessons learned

Challenges

Way forward

Conclusion

Africare/ Tanzania COPE Project Africare - US based non profit organization established in 1971 Africare work in in twenty seven African countries whereas in Tanzania started development projects in 1994 Africare through PEPFAR funding implements a regional Community – based Orphan care, Protection and Empowerment project (Mozambique, Rwanda, Uganda and Tanzania) COPE’s goal is “ to reduce the socioeconomic impact of HIV/AIDS to orphans and vulnerable children (OVC) and their caregivers ”

Africare/ Tanzania COPE Project

Africare - US based non profit organization established in 1971

Africare work in in twenty seven African countries whereas in Tanzania started development projects in 1994

Africare through PEPFAR funding implements a regional Community – based Orphan care, Protection and Empowerment project (Mozambique, Rwanda, Uganda and Tanzania)

COPE’s goal is “ to reduce the socioeconomic impact of HIV/AIDS to orphans and vulnerable children (OVC) and their caregivers ”

Africare/ Tanzania COPE Project …. continues COPE project Strategic objectives Enhanced community capacity to coordinate care and support services for OVC and caregivers Provision of Life Skills training, peer education and psychosocial care and support to OVC and their families Increased access to educational support services to OVC Increased access to health care and nutritional support (including nutrition education and food) for OVC and caregivers Increased access to IGA for caregivers and OVC

COPE project Strategic objectives

Enhanced community capacity to coordinate care and support services for OVC and caregivers

Provision of Life Skills training, peer education and psychosocial care and support to OVC and their families

Increased access to educational support services to OVC

Increased access to health care and nutritional support (including nutrition education and food) for OVC and caregivers

Increased access to IGA for caregivers and OVC

Why CSI Home visits to vulnerable households are a core component to COPE – SCVs, MVCC, DFPs and Project staff MVC households are the primary point of entry for needs assessment, caregiver training, psychosocial support to MVC and other forms of service provision Since 2005, home visits were informal, with few written records to assess and monitor the MVC wellbeing In early 2008, project found the need of having formal records and CSI adapted to improve project implementation and documentation

Why CSI

Home visits to vulnerable households are a core component to COPE – SCVs, MVCC, DFPs and Project staff

MVC households are the primary point of entry for needs assessment, caregiver training, psychosocial support to MVC and other forms of service provision

Since 2005, home visits were informal, with few written records to assess and monitor the MVC wellbeing

In early 2008, project found the need of having formal records and CSI adapted to improve project implementation and documentation

Adaptation of CSI Consensus workshop for adaptation (CSI Tool versus Family Version) Translation of Tool Family Version (English to Swahili) Pre testing and adaptation (SCVs, DFPs and Staff) – household level Shared pre-tested tool with QI Sub Task Force - Endorsement Training of SCVs and District Focal Persons to strengthen capacity in monitoring OVC wellbeing – (role plays, plenary sessions, field work) Training of district MVC implementing partners on Tool – rolling strategy for Dodoma region

Adaptation of CSI

Consensus workshop for adaptation (CSI Tool versus Family Version)

Translation of Tool Family Version (English to Swahili)

Pre testing and adaptation (SCVs, DFPs and Staff) – household level

Shared pre-tested tool with QI Sub Task Force - Endorsement

Training of SCVs and District Focal Persons to strengthen capacity in monitoring OVC wellbeing – (role plays, plenary sessions, field work)

Training of district MVC implementing partners on Tool – rolling strategy for Dodoma region

Adaptation of CSI …….. Continues Data collection – Household visits by SCVs Participation for monthly National QI Sub Task Force meetings – sharing experience with other Implementing Partners Monthly SCVs and DFP meetings – sharing experience using the tool. Reporting, Analysis and storage Piloting CSI Database Advocacy for incorporation of CSI database to National Data management system (DMS)

Data collection – Household visits by SCVs

Participation for monthly National QI Sub Task Force meetings – sharing experience with other Implementing Partners

Monthly SCVs and DFP meetings – sharing experience using the tool.

Reporting, Analysis and storage

Piloting CSI Database

Advocacy for incorporation of CSI database to National Data management system (DMS)

CSI Tool

CSI Tool

Mapendekezo kwa vyanzo vyenginevyo vya rasilimali au huduma zinazohitajika c. Uangalizi (mlezi amepata mafunzo au msaada) b. Makazi na huduma mbalimbali (kama ukarabati nyumba, malazi na mavazi) a. Huduma ya chakula na lishe (resheni ya chakula, chakula cha kulikiza) III. AINA YA HUDUMA ZILIZOTOLEWA (kwa sasa) Mtoto ametoka kwenye mpango Mwanafamilia amefariki Mtoto amepata ujauzito Mtoto ametoka kwenye mpango Mwanafamilia amefariki Mtoto amepata ujauzito Mtoto ametoka kwenye mpango Mwanafamilia amefariki Mtoto amepata ujauzito II. MATUKIO MUHIMU: (Chagua tukeo lolote lilitokea baada ya ukaguzi wa mwishouliofanyika wa hali ya mtoto.) Mtoto, Mzazi, Mlezi, Ndugu, Jirani, Mwalimu, Rafiki wa familia, Mfanyakazi wa jamii, Wengineo ____________ Mtoto, Mzazi, Mlezi, Ndugu, Jirani, Mwalimu, Rafiki wa familia, Mfanyakazi wa jamii, Wengineo ____________ Mtoto, Mzazi, Mlezi, Ndugu, Jirani, Mwalimu, Rafiki wa familia, Mfanyakazi wa jamii, Wengineo ____________ Chanzo cha taarifa: (zungushia inayohusika) 4 3 2 1 4 3 2 1 4 3 2 1 6b. Elimu//Kazi 6. ELIMU NA MAARIFA 5. SAIKOLOJIA 4 3 2 1 4 3 2 1 4 3 2 1 2a. Makazi 2. MAKAZI NA UANGALIZI 4 3 2 1 4 3 2 1 4 3 2 1 1a. Uhakika wa chakula 1. CHAKULA NA LISHE Hatua zilizochukuliwa leo/maoni Alama (Zungushia moja) Hatua zilizochukuliwa leo/maoni Alama (Zungushia moja) Hatua zilizochukuliwa leo/maoni Alama (Zungushia moja) AINA ZA HUDUMA Tarehe ya udadisi: Tarehe ya udadisi: Tarehe ya udadisi: Mahusiano na mlezi: Mahusiano na mlezi: Mahusiano na mlezi: Jinsia: Me/Ke Umri: Jinsia: Me/Ke Umri: Jinsia: Me/Ke Umri: Jina la mtoto: Jina la mtoto: Jina la mtoto: Jina la mtathimini: Mahali: Wilaya: _______________ Tarafa _______________ Kata _________________ Kijiji/Mtaa __________________ Jina la mlezi _________________________ Jinsia (Me/Ke) ________________ Idadi ya watoto katika kaya ________________ DODOSO LA FAMILIA LA KUPIMA KIWANGO CHA HALI YA MTOTO

Results and Discussion 139 out of 145 SCV trained: Bahi (18); Chamwino (28); Dodoma urban (27); Kongwa (14); Kondoa (34); Mpwapwa (18) – active in the field Each trained SCV received copy of binder of translated Swahili CSI tool & CSI Made Easy – reference and documenting Each SCV visits 14 households/ward/month – target is to reach 12,000 caregivers in 6 months SCVs share experience in adapting CSI Tool – monthly feedback meetings Project shares experience at Monthly IPG and QI Sub Task Force meetings Trained 37 (M19, F 18) Dodoma Urban District IPG Network members from 22 organizations – rolling out Project staff provides supportive supervision to SCVs and DFPs - monitored, methodological guidance

Results and Discussion

139 out of 145 SCV trained: Bahi (18); Chamwino (28); Dodoma urban (27); Kongwa (14); Kondoa (34); Mpwapwa (18) – active in the field

Each trained SCV received copy of binder of translated Swahili CSI tool & CSI Made Easy – reference and documenting

Each SCV visits 14 households/ward/month – target is to reach 12,000 caregivers in 6 months

SCVs share experience in adapting CSI Tool – monthly feedback meetings

Project shares experience at Monthly IPG and QI Sub Task Force meetings

Trained 37 (M19, F 18) Dodoma Urban District IPG Network members from 22 organizations – rolling out

Project staff provides supportive supervision to SCVs and DFPs - monitored, methodological guidance

Results and Discussion ………. Continues The chart shows HH visited by volunteer for January 2009 The filled CSI tool entered in simple excel file for analysis Volunteers are eager to document household visit information using tool There is clear picture on the service delivery and the needs of MVC identified

Results and Discussion ………. Continues

The chart shows HH visited by volunteer for January 2009

The filled CSI tool entered in simple excel file for analysis

Volunteers are eager to document household visit information using tool

There is clear picture on the service delivery and the needs of MVC identified

Lessons learnt Training to use CSI Tool is cost effective – practical, evidence based, participatory, duration for training CSI Tool is user- friendly – build trust (SCVs and MVC/ caregivers) e.g. interviews and focus group discussions Training personnel with experience in working with MVC is easier to adapt the tool Self introduction and background of HH visit using CSI minimizes expectations for material support (MVC and caregivers) CSI is a useful tool for monitoring the wellbeing of MVC and services provided – score sheet and comments Findings from CSI score sheet can be used to verify data obtained in the Identification Register Book for OVC/ MVC Data collection using CSI reflects the National Data Management System

Lessons learnt

Training to use CSI Tool is cost effective – practical, evidence based, participatory, duration for training

CSI Tool is user- friendly – build trust (SCVs and MVC/ caregivers) e.g. interviews and focus group discussions

Training personnel with experience in working with MVC is easier to adapt the tool

Self introduction and background of HH visit using CSI minimizes expectations for material support (MVC and caregivers)

CSI is a useful tool for monitoring the wellbeing of MVC and services provided – score sheet and comments

Findings from CSI score sheet can be used to verify data obtained in the Identification Register Book for OVC/ MVC

Data collection using CSI reflects the National Data Management System

Challenges Delayed pace of accommodating CSI information to the National DMS e.g. Conflict of interest among IPG members Increased number of MVC versus personnel to reach more HH Provision of comprehensive material support to all identified MVC Lack of commitment by some of MVCC members and community leaders

Challenges

Delayed pace of accommodating CSI information to the National DMS e.g. Conflict of interest among IPG members

Increased number of MVC versus personnel to reach more HH

Provision of comprehensive material support to all identified MVC

Lack of commitment by some of MVCC members and community leaders

Way forward On site training to 6 SCVs not attended SCI training Support SCVs to train MVCC members to use tools – each assigned households to visit To print carbonated household children assessment tool in triplets To record all identified MVC in CSI tool – Up dating DMS Provide methodological guidance to the districts to manage CSI Tool for monitoring, documenting/ inputting DMS and planning Sharing CSI analysis with all six districts – quarterly, biannual and annual To advocate CSI information to be accommodated into National DMS To hand over CSI to district authorities - management

Way forward

On site training to 6 SCVs not attended SCI training

Support SCVs to train MVCC members to use tools – each assigned households to visit

To print carbonated household children assessment tool in triplets

To record all identified MVC in CSI tool – Up dating DMS

Provide methodological guidance to the districts to manage CSI Tool for monitoring, documenting/ inputting DMS and planning

Sharing CSI analysis with all six districts – quarterly, biannual and annual

To advocate CSI information to be accommodated into National DMS

To hand over CSI to district authorities - management

Conclusion CSI is a useful and accessible resource for use by volunteers/ community. Minimal training required particularly for household visitors CSI demonstrates competence and self-efficacy to volunteers CSI data are being used to benefit individual children (or program) CSI is an assessment tool to improve service delivery by volunteers at the household level. CSI allow volunteers to measure change in knowledge, skills and assessing the needs of MVC CSI monitors and suggest for improvements and changes

Conclusion

CSI is a useful and accessible resource for use by volunteers/ community.

Minimal training required particularly for household visitors

CSI demonstrates competence and self-efficacy to volunteers

CSI data are being used to benefit individual children (or program)

CSI is an assessment tool to improve service delivery by volunteers at the household level.

CSI allow volunteers to measure change in knowledge, skills and assessing the needs of MVC

CSI monitors and suggest for improvements and changes

Ahsanteni sana Thanks for listening

Ahsanteni sana

Thanks for listening