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Acknowledgments FHI greatly appreciates the opportunity to present in this publication experiences and lessons learned from individuals ranging from data collectors to policy makers. FHI would also like to give credit to the courageous adults and children who participated in the information gathering that made this publication possible. In addition, FHI would like to acknowledge the many dedicated stakeholders who will turn this information into action. FHI recognizes that many reviewers found “extra” hours in their day to provide detailed input that substantially transformed the text. While it is impossible to recognize everyone who directly or indirectly contributed to the guide, the following individuals, many of whom served in multiple capacities, deserve special acknowledgement for their contributions. Author Renee DeMarco HIV/AIDS Prevention and Mitigation Consultant Technical Lead Sara Bowsky FHI/Arlington Contributing Writers Ken Carswell Research Consultant HIV/AIDS CARE Cambodia Katie Hornowski FHI/Arlington Leslie Snider Tulane University School of Public Health and Tropical Medicine, Department of International Health and Development and Regional Psychosocial Support Initiative of Southern and Eastern Africa (REPSSI), Associate Consultant Document Coordinator Susan Mathew FHI/Arlington Reviewers Gretchen Bachman FHI/Arlington Janet Chime FHI/Zambia Carol J. Culler HIV/AIDS Specialist USAID/Mozambique Gina Dallabetta FHI/Arlington Moses Dombo FHI/Arlington Leanne Dougherty Futures Group Donna Flanagan FHI/Thailand Bitra George FHI/India Stefan E. Germann REPSSI, Seconded by Salvation Army Advisor for Strategic Partnerships Inoussa Kabore FHI/Arlington Jean-Claude Legrand Regional Advisor Child Protection West and Central Africa Regional Office, UNICEF Mark Loudon Development Consultant Robert Magnani FHI/Arlington Karen Doll-Manda FHI/Zambia Mike Merigan FHI/Cambodia Ntjantja T. Ned Director, Programmes Nelson Mandela Children’s Fund (NMCF) Walter Obiero FHI/Arlington Rosemary Nnamdi-Okagbue FHI/Nigeria Suzi Peel FHI/Arlington Paul Pope FHI/Namibia Sujata Rana HIV/AIDS Specialist Community REACH Project, Pact Inc. Rose Smart HIV/AIDS Consultant Sharifah Tahir FHI/Arlington Julie Victor-Ahuchogu FHI/Arlington Angela M. Wakhweya Senior Technical Advisor for OVC Programs Save the Children USA John Williamson Senior Technical Advisor Displaced Children and Orphans Fund Sonal Zaveri Consultant ii A Framework and Resource Guide
Preface For over a decade, stakeholders at all levels have been mobilizing to mitigate the devastating effects of HIV/AIDS on children and their families. How do we know if we are making progress? An analysis of the situation of orphans and vulnerable children serves as a neutral measure of action for children and families living in a world with HIV and AIDS. Collecting data that is not directly linked to specific programs allows stakeholders to identify strengths and weaknesses in national and sub-national responses. This guide offers a step-wise approach to conducting a situation analysis in conjunction with social science expertise in quantitative and qualitative research methods. It does not replace the need for technical guidance in data collection and analysis. The text and tools have emerged from Family Health International’s countryspecific work, as well as from harvesting experiences and lessons learned from those who have undertaken situation analyses of orphans and vulnerable children. The great variance in the way different countries have conducted such assessments dictates the need to promote a standard framework. A complementary document, Conducting a Situation Analysis of Orphans and Vulnerable Children Affected by HIV/AIDS: A Framework and Resource Guide, 1 offers a broad orientation to the process. Both documents reinforce the need for a participatory and systematic approach to assessing child vulnerability and its context. The standards advocated in these documents can be followed regardless of the scale of an initial or repeat situation analysis. The breadth of an analysis will be influenced by the available resources, the extent of the epidemic, and existing information and actions. As described in these pages, a participatory situation analysis relies on gathering information from children. It is important to ensuring that the process promotes their human rights. Ethical Guidelines for Gathering Information from Children and Adolescents 2 provides concrete guidance on protecting children’s rights and is an essential companion to this guide. Choosing to conduct a participatory situation analysis demonstrates a serious commitment to improving the well-being of orphans and vulnerable children living in a world with HIV and AIDS. When used to mobilize stakeholders, the process will fuel informed decisionmaking and decisive action and enable us to measure the progress of our collective actions. In this way, we will know that we are making a difference. Peter McDermott Chief, HIV/AIDS Section, Programme Division United Nations Children’s Fund (UNICEF) New York 1 Produced by the Population, Health and Nutrition Information Project for the United States Agency for International Development, Bureau for Africa, Office of Sustainable Development in February 2004 (www.phnip.com) 2 Being produced with USAID, Horizons, Family Health International, and UNICEF, Ethical Guidelines for Gathering Information from Children and Adolescents will be available soon at www.popcouncil.org/horizons Conducting a Situation Analysis of Orphans and Vulnerable Children Affected by HIV/AIDS iii
Page 1 and 2: A Framework and Resource Guide Cond
Page 3: A Framework and Resource Guide Cond
Page 7 and 8: Table of Contents Acronyms . . . .
Page 9 and 10: Abbreviations and Acronyms AIDS . .
Page 11 and 12: Introduction Worldwide, the number
Page 13 and 14: to them, but conditions will evolve
Page 15 and 16: Chapter One: Overview One of the mo
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Page 19 and 20: III. Overview of Situation Analysis
Page 21 and 22: and updated throughout the situatio
Page 23 and 24: are able to formulate and take resp
Page 25 and 26: Chapter Two: Situation Analysis Man
Page 27 and 28: Responsibilities of Technical Lead
Page 29 and 30: cially launch the primary data coll
Page 31 and 32: The role of a PSSP is to provide im
Page 33 and 34: Illustrative Organization Chart Sit
Page 35 and 36: Training In-Depth Interviewers and
Page 37 and 38: Situation Analysis Phase Planning 1
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Page 41 and 42: can then be designed to focus on th
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Page 45 and 46: may produce an endless list of topi
Page 47 and 48: themes or domains for the situation
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Existing Survey Data Collection Too
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Experience from the Field: Determin
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Chapter Four: Management of Data Co
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Gain access to field sites Gaining
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Example from the Field: Consent Pro
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An interviewer fatigue factor must
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Special note on selecting household
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Experience from the Field: Question
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Chapter Five: Data Analysis This ch
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Computer Software for Quantitative
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to be significant may not be releva
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If only one person will conduct the
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eading each set of notes or transcr
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Chapter Six: Reporting and Dissemin
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sis, but also ensure that no harm c
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Analytical approach The analytical
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Education District 1 District 1 Dis
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Creating a Terminology List One key
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“This is what I’m hearing; Does
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Working with the Media The media pl
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Chapter Seven: Translating Data int
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more appealing to other stakeholder
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AIDS, children living in extreme po
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Glossary of Terms Advocacy: Act or
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nuclear family, including grandpare
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Orphans: Children 18 years or young
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Social desirability bias: Bias that
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References Demographics Loudon M. 2
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Orphans and Vulnerable Children in
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Appendix A: Resources Orphans and V
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Kalton, G. 1989. Introduction to Su
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Appendix B: Criteria Used To Select
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Appendix C: Example Protocol Exampl
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Appendix D: Ethical Considerations
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Appendix E: Example Organizational
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22. What are the organization’s s
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Specific care for children with HIV
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Appendix F: Example In-Depth Interv
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Appendix G: Example Focus Group Dis
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Topic Guide for Focus Group Discuss
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Topic Guide for Focus Group Discuss
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Example Focus Group Discussion Guid
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Support and Training Needs of Careg
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Example Focus Group Discussion Guid
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Probe: • Volunteer care provider?
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Appendix H: Example Baseline Survey
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The 6- to 12-year-old children’s
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Section 2: Food Intake This section
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Section 3: Psychosocial Issues (con
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Section 4: Emotional Well-Being Che
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The 13- to 18-year-old children’s
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Section 2: Food Intake This section
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3.1: Background Information on Fath
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No. Q322 3.2: Background Informatio
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3.3: HIV/AIDS Issues and Relationsh
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No. Q351 Q352 Q353 Q354 3.3: HIV/AI
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3.4: Child/Guardian Relationship (c
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No. Q376 Questions and Filters How
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Section 4: Risk-Taking (continued)
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SECTION 0: IDENTIFICATION DATA 001
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Section 1: Background Characteristi
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Section 3: Perceptions of Guardians
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Section 3: Perceptions of Guardians
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Section 5: Household Economic Statu
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No. Q515 Q516 Q517 Q518 Questions a
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C1 C2 C3 C4 C5 C6 C7 C8 C9 C10 C11
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Section 10: Household Access to Sup
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Section 1: Background Information N
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No. Q119 Q120 Q121 Questions and Fi
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Section 3: Household Head/Caregiver
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No. Q401 Q402 Q403 Q404 Q405 Q406 Q
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No. Q501 Q502 Q503 Q504 Q505 Q506 Q
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Appendix I: Example Consent Forms E
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Family Health International Institu
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