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Vulnerable Children and Families


Applying Improvement Methods to Care and Support Services for Vulnerable Children and Families

URC leads the Care that Counts Initiative, a partnership of the US Agency for International Development (USAID) Health Care Improvement Project (HCI) and programs seeking to strengthen the capacity, effectiveness, and reach of the global response to vulnerable children and families. URC provides technical assistance to governments, local and international organizations, and communities to improve the quality of care for children and families affected by HIV/AIDS and other diseases, orphanhood, poverty, gender and social inequities, disasters, and other risk factors that contribute to vulnerability in children.

Quality care for at-risk children is characterized as easily accessible, effective and efficient, consistent and comprehensive, and adapted to the needs of a child based on gender, age, disability, community and cultural context, and socioeconomic factors. Importantly, quality care is also based on local and expert knowledge and requires the participation of children and caregivers in designing and carrying out programs.

URC is working with national, provincial, and district governments in Cote d’Ivoire, Ethiopia, Haiti, Kenya, Malawi, Mozambique, Nigeria, Tanzania, and Zambia to develop and pilot care standards for vulnerable children in the community, the point of service delivery. The standards cover services in seven sectors: education, health, food security and nutrition, household economic strengthening, legal protection, shelter, and psychosocial support. Through the piloting and implementation of standards, URC contributes to country efforts to improve the coordination of services provided to vulnerable children and caregivers, strengthen existing formal and informal community systems of care, increase technical capacity of service providers in the community, empower communities to mobilize existing resources to care for their vulnerable members, and drive toward the sustainability of solutions.

Together with the School of Social Work of Addis Ababa University in Ethiopia, URC is conducting operations research through the Communities of Excellence project to determine and measure essential community competencies in providing coordinated and adequate care for vulnerable children.

Additionally, in partnership with local African organizations, URC is establishing a regional community of learning and practice around standards-based and evidence-based child and family protection systems. The project focus is on mechanisms and interventions operating at the district level in the protection of children and the preservation and strengthening of families.

Care that Counts Initiative: Community-led Improvements in Quality of Services to Vulnerable Children in Bagamoyo District, Tanzania

Tanzania’s Ministry of Health and Social Welfare has led the development of the National Guidelines for Improving Quality of Care, Support, and Protection for Most Vulnerable Children in Tanzania since 2009. URC conducted a rapid assessment to define gaps in quality of services for vulnerable children in three wards in Bagamoyo District. We then trained 25 Most Vulnerable Children Committees to serve as quality improvement (QI) teams to test and apply changes to service delivery processes.

Findings:

  • After training, the QI Teams identified priority needs; prepared QI implementation plans; met monthly at learning sessions to share experiences on mobilizing resources for the children; and used data to determine whether tested changes yielded improvement.
  • After nine months of implementation of the national guidelines, children’s well-being notably improved: access to adequate shelter improved from 43% to 84% (see figure).
  • Access and use of insecticide-treated nets improved from 15% to 100%.
  • The percentage of children getting two or more meals a day increased from 62% to 100%.
  • Children with birth certificates increased from 6% to 45%
  • The Most Vulnerable Children Committees demonstrated the ability to implement the national guidelines and to gather and use data effectively to generate support for quality services from resources available at the community level.
  • Building on nationally recognized community structures, the committees strengthened the capacity of local members and created exceptional opportunities for integrated and sustainable local ownership of problems and their solutions.

Current Projects

USAID Health Care Improvement Project (HCI) | Global
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Zambia
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2011 to present

USAID Health Care Improvement Project (HCI) | Haiti
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2012 to present

Nutri-Salud: Community Nutrition and Health Project
Funded By: US Agency for International Development
Project Duration: 2012 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Global
Funded By: US Agency for International Development (USAID) through the USAID Bureau for Global Health, Office of Health Systems
Project Duration: 2012 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Kenya
Funded By: Agency for International Development (USAID) through USAID/Kenya
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Malawi
Funded By: US Agency for International Development (USAID) through USAID/Malawi
Project Duration: January 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Nigeria
Funded By: US Agency for International Development (USAID) through USAID/Nigeria
Project Duration: October 2012 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Tanzania
Funded By: US Agency for International Development (USAID) through USAID/Tanzania and USAID Bureau for Global Health, Office of HIV and AIDS
Project Duration: October 2012 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Uganda
Funded By: US Agency for International Development (USAID) through USAID/Uganda and the Bureau for Global Health, Office of HIV and AIDS and the Office of Health Systems
Project Duration: 2012 to present

Quality Health Services for Haiti (Services de Santé de Qualité pour Haïti – SSQH) North Project
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Mozambique
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

Resilience and Economic Growth in Sahel – Enhanced Resilience (REGIS-ER)
Funded By: US Agency for International Development (USAID)
Project Duration: 2013 to present

USAID Quality Health Services
Funded By: USAID
Project Duration: 2014-2019

The Quality Health Services project, funded by USAID, will draw on and scale up successful initiatives started under USAID Cambodia’s recently ended Better Health Services (BHS) project, which was also managed by URC. In addition, the team will apply the knowledge and systems built during BHS to create new capacity-building activities in areas where critical gaps remain.

Past Projects

USAID Health Care Improvement Project (HCI) | Ethiopia
Funded By: US Agency for International Development
Project Duration: 2007–2012

USAID Health Care Improvement Project (HCI) | Cote d’Ivoire
Funded By: United States Agency for International Development
Project Duration: 2008-2013

USAID Health Care Improvement Project (HCI) | Kenya
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2009-2013

USAID Health Care Improvement Project (HCI) | Mozambique
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2009-2013

USAID Health Care Improvement Project (HCI) | Tanzania
Funded By: US Agency for International Development
Project Duration: 2007-2012

USAID Health Care Improvement Project (HCI) | Malawi
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2011-2013

USAID Health Care Improvement Project (HCI) | Nigeria
Funded By: US Agency for International Development (USAID)
Project Duration: 2011-2012



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