The Godfrey’s Children Center

Idweli, Tanzania

Evaluation of a communitybased response to the needs of orphaned and vulnerable children
Idweli Evaluation — Lundy Foundation © April 2007 1

The OVC Challenge

Worldwide:

15 million children orphaned by AIDS  Number expected to double by 2020

Sub-Saharan Africa: Tanzania:

Home to over 80% of the world’s children orphaned by AIDS Approximately 12% of all children are orphans, half of those due to AIDS

Idweli Evaluation — Lundy Foundation © April 2007

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Traditional Support for OVC

OVC traditionally taken in by extended family Rate of OVC population growth overwhelming traditional support system

Most caregivers over-extended emotionally, physically and financially Source: Foster, Levine, Williamson (2005). A Generation
at Risk.
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Idweli Evaluation — Lundy Foundation © April 2007

Placement Alternatives for OVC
HIGH
Institutional Placement Out-of-Village Foster Placement Cost per Child
Range of Communitybased Supports

In-Village Foster Placement Extended Family Placement Familiarity of Child with Setting

LOW

HIGH
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Idweli Evaluation — Lundy Foundation © April 2007

COSTS

Institutional Placement  Stigmatization  Depression  High cost  Child removed from family & friends  Potential economic exploitation  Effectiveness unknown

BENEFITS
 Professional management  Accountability to donors  Family setting  Low to moderate cost  Contact maintained with family & friends  Low to moderate cost  Contact maintained with family & friends  Relatively low cost  Familiar & generally supportive setting  Low cost
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Out-of-Village Foster Placement Communitybased support In-Village Foster Placement Extended Family Placement

  

 Potential economic exploitation  Potential economic exploitation or homelessness

Idweli Evaluation — Lundy Foundation © April 2007

Context: Idweli

Location: 28 Km from the
city of Mbeya

Economy: primarily
subsistence farming

Population: 2,500
- approx. 460 school age children

Orphans: approx. 40% of
Idweli’s children are orphans (double or single)
Idweli
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Idweli Evaluation — Lundy Foundation © April 2007

Godfrey’s Children Center: Idweli

Vision: A participatory decision-making
process involved men, women and children

Planning: U.S. and Tanzanian NGO’s
collaborated in the planning process

Implementation:
NGOs and villagers worked together to finance and build the Center

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Godfrey’s Children Center (continued)

Operation: A village-based committee
 The Board…  Selects children, hires staff, supervises Center manager

including men, women and youth governs the Center

 Oversees budget and all other resources  Recruits volunteers  Maintains relations with current and future donors  Makes decisions regarding building maintenance and improvements Idweli Evaluation — Lundy Foundation © April 2007

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Godfrey’s Children Center (continued)

The name honors the late Godfrey Msemwa of Idweli The Center was officially opened by Acting U.S. Ambassador Michael Owen on June 8, 2005

Idweli Evaluation — Lundy Foundation © April 2007

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Godfrey’s Children Center (continued)

The Center complex includes:
 Two dormitories accommodating

58 children and four elders

 Small hall for meals, after-school  Kitchen, toilet, shower  Space for health care

classes, and community gatherings

and recreation

 Land for raising crops

and farm animals

Idweli Evaluation — Lundy Foundation © April 2007

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Godfrey’s Children Center (continued)

The Center provides an environment where the children have…  3 meals per day  Basic health care  Preschool and after-school classes  Compassionate adult nurturing

Idweli Evaluation — Lundy Foundation © April 2007

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Godfrey’s Children Center (continued)

As compared to traditional forms of institutionalized care that typically isolate children, Godfrey’s Children Center allows orphans to remain integrated within village life

Idweli Evaluation — Lundy Foundation © April 2007

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Godfrey’s Children Center is a Community-based Alternative
HIGH
Institutional Placement Out-of-Village Foster Placement Cost per Child Range of Community-Based Idweli Hybrid: Godfrey’s Children Supports Center In-Village Foster Placement Extended Family Placement

LOW

Familiarity of Child with Setting

HIGH
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Idweli Evaluation — Lundy Foundation © April 2007

Evaluation of the Children’s Center
Idweli Evaluation — Lundy Foundation © April 2007 14

Factors of Well-Being
Psychosocial OVC Well-Being Socioeconomic Physical

Evaluation of well-being through 3 lenses
Idweli Evaluation — Lundy Foundation © April 2007 15

Evaluation Questions

Does living at the Center positively impact the psychosocial well-being of resident orphans? Does living at the Center positively impact the orphans’ physical health? Is the support provided by the Center socially and economically sustainable?

What culturally appropriate measures and methods are effective in scientifically evaluating the well-being of Idweli Evaluation — Lundy Foundation © April 2007 OVC in Tanzania?

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Evaluation Design Team
Evaluation and statistical analysis Community development Leadership and collaboration Cultural competency Social anthropology Familial relationships Child psychology and development Psychiatry

AREAS OF EXPERTISE

Idweli Evaluation — Lundy Foundation © April 2007

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Tanzanian Field Team
 Fieldwork coordinator  10 trained field work assistants  Ethnographer  Typists and translators

Idweli Evaluation — Lundy Foundation © April 2007

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Survey Instruments
Quantitative and Qualitative

Psychosocial Well-Being
 Children’s Depression Inventory  Social Support Questionnaire  Strengths and Difficulties Questionnaire  School Performance Survey  Children’s Sense of Well-Being  Caring for Children

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Survey Instruments (continued)

Physical Well-Being
 Physical Health Survey

Socioeconomic Sustainability
 Children’s Center Development Process  Support and Sustainability Survey  Loan Recipient Interviews  Household Budget Survey

Idweli Evaluation — Lundy Foundation © April 2007

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Sampling Design

Four sample groups of children:
 Center orphans (n=51)  Village orphans — living with

extended family (n=40) both parents (n=99)

 Village non-orphans — living with  Children in households receiving

microfinance loans (n=19)

Idweli Evaluation — Lundy Foundation © April 2007

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Sampling Design (continued)

Interviews and focus groups conducted with:
 Children and their parents or

caregivers (n=209)

 Children and adults who

participated in the Center development process (n=19)
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 Key informants (n=70)
Idweli Evaluation — Lundy Foundation © April 2007

Findings Children’s Psychosoci al Well-Being

Idweli Evaluation — Lundy Foundation © April 2007

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Findings: Psychosocial Well-Being

Depression:
 Center orphans were significantly

less depressed than either orphans living in the village with extended family or children living with both parents (F=5.41; p<.05)

Idweli Evaluation — Lundy Foundation © April 2007

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Psychosocial Well-Being (continued)

Emotional & Behavioral Functioning:
 No significant differences among

sample groups of children with respect to emotional and behavioral functioning
…despite indications in previous research that OVC are more likely to demonstrate emotional and behavioral Idweli Evaluation — Lundy Foundation © April 2007 problems

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Psychosocial Well-Being (continued)

School Performance:
 Center children had better school

attendance than village orphans and expressed greater optimism and hopefulness about being able to shape a positive future for themselves, specifically through knowledge and study
Idweli Evaluation — Lundy Foundation © April 2007 26

Findings Children’s Physical Health

Idweli Evaluation — Lundy Foundation © April 2007

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Findings: Physical Health

After 8 months at the Center, the children did not differ significantly in terms of weigh, height, and other measures of physical well-being from other village children even though Center children were chosen from among the neediest in the village

Idweli Evaluation — Lundy Foundation © April 2007

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Findings Social Integratio n

Idweli Evaluation — Lundy Foundation © April 2007

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Findings: Social Integration

Center orphans reported having the same
number of people they can turn to for social support as village orphans and non-orphans

Center orphans expressed no feelings of
stigmatization or isolation

Many Center orphans visit with family
members on weekends

Many Village children attend preschool
and after-school programs at the Center

Idweli Evaluation — Lundy Foundation © April 2007

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Findings Socioecono mic Sustainabilit y

Idweli Evaluation — Lundy Foundation © April 2007

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Findings: Socioeconomic Sustainability

Source: Stover, Bollinger, Walker and Monasch (2007). Resource Needs to Support Orphans and Vulnerable Children in Sub-Saharan Africa.
Idweli Evaluation — Lundy Foundation © April 2007 32

Godfrey’s Children Center costs $1 USD per child per day Extended family placement costs range from $1.32 cents USD to $2.27 USD per child per day * Center operating costs consistent with other community-based alternatives Center costs per child significantly less than typical cost of institutionalized care

Socioeconomic Sustainability (continued)

The Center is becoming increasingly integrated into the social life of the village The Center will require ongoing external financial support to maintain the children’s current level of wellbeing

Idweli Evaluation — Lundy Foundation © April 2007

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In summary…
The Idweli evaluation empirically demonstrated that the Godfrey’s Children Center has been successful in providing its orphans with a significantly improved quality of life As compared to the other sample groups, Center children are demonstrating greater psychosocial well-being. They are…  Less depressed  Equally well-supported from a social perspective  Express a more positive attitude toward their future
Idweli Evaluation — Lundy Foundation © April 2007 34

Lessons Learned from Conducting the Evaluation
Idweli Evaluation — Lundy Foundation © April 2007 35

Lessons Learned from Conducting the Evaluation

Scientifically valid and reliable tools developed in the U.S. and other western countries can effectively be adapted for use in assessing the psychosocial well-being of OVC in a rural setting such as Idweli Triangulation of quantitative with qualitative data allowed for a robust interpretation of findings

Idweli Evaluation — Lundy Foundation © April 2007

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Lessons Learned from Conducting Evaluation (continued)

Providing adequate training and supervision of field researchers is essential to obtaining reliable data Working as a multicultural research team provided a broad perspective for understanding behaviors and cultural norms
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Idweli Evaluation — Lundy Foundation © April 2007

Policy Implications

Idweli Evaluation — Lundy Foundation © April 2007

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Policy Implications: Community-Based Approaches

Research indicates that community ownership, long-term social integration and sustainability are more likely to result when community members perceive that they…  Are collaborating in an open and credible process  Are directly influencing decisions made

Idweli Evaluation — Lundy Foundation © April 2007

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Community-Based Approaches (continued)

Community-based alternatives offer a promising response to the challenge of a growing population of OVC in sub-Saharan Africa

Idweli Evaluation — Lundy Foundation © April 2007

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Policy Implications: Evaluation

Systematic evaluation — including an objective and reliable process of measurement — is essential to determining the effectiveness of community-based placement alternatives for OVC

Idweli Evaluation — Lundy Foundation © April 2007

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Evaluation (continued)

Ongoing longitudinal evaluation, assessing psychosocial, physical and economic outcomes, is critical to determining if specific placement alternatives are positively affecting the long-term well-being of OVC

Idweli Evaluation — Lundy Foundation © April 2007

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Evaluation (continued)

A cost-benefit analysis should be conducted to determine what level of expenditure is needed to support OVC in becoming physically and psychologically healthy, productive members of society

Idweli Evaluation — Lundy Foundation © April 2007

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Evaluation (continued)

Systematic evaluation is expensive and timeconsuming…but essential to building a solid foundation on which to develop policies and implement programs that positively impact the overall well-being of OVC
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Idweli Evaluation — Lundy Foundation © April 2007

Epilogue
U.S. NGO and Godfrey’s governing board agreed to funding plan through 2008  U.S. NGO concerned about funding accountability

 Fired Center’s Accountant and Manager  Angered Villagers

U.S. NGO withdrew funding
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Idweli Evaluation — Lundy Foundation © April 2007

Epilogue: April 2007 Funding Response

Tanzanian AIDS coordinating agency: We want to think that the funders will always be there, but we need to clarify how the Idwelians have contributed to the Center Chief: We kept thinking that the funders would provide … . But they left. We still want this center for our children, but we need to look for ways to provide funds. We can contribute wood and vegetables, and the land can be cultivated
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Idweli Evaluation — Lundy Foundation © April 2007

Epilogue: April 2007 Funding Reponse
Villagers: What will the District [government] contribute? We can give food, but we need support for education and medicines  District Social Worker: Is it really necessary to take children away from their families? Isn’t that where children belong?

Idweli Evaluation — Lundy Foundation © April 2007 47

Epilogue
Village voted to keep center open  Tried to raise internal funds

 Only able to raise 100 USD

U.S. NGO continued to push for Center closure

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Epilogue
Local politicians were influenced by a variety of factors that led to the District Commissioner’s issuing of a formal closure order.  A group of volunteer Tanzanian attorneys responded to the closure notice but never received a reply from the District Commissioner’s office.

Idweli Evaluation — Lundy Foundation © April 2007 49

Epilogue
December 2007 the police showed up at the Center to carry out the District Commissioner’s closure order.  When they began tearing down the Center’s sign by the road, the villagers massed at the Center and the police retreated.  A few weeks later, the police returned unexpectedly, armed with rifles, entered the Center, and began throwing beds and other furnishings out of the buildings.  The children, at gunpoint, were ordered to leave.  When the villagers heard about this action, they ran to the Center and began stoning the officers. Idweli Evaluation — Lundy Foundation © April 2007 50

Epilogue
In the end, several community members were arrested for disorderly conduct  Buildings were padlocked with their contents strewn on the grounds outside  Where all of its children are currently living is unknown

Idweli Evaluation — Lundy Foundation © April 2007 51

Senior Research Team
Victor Dukay, Ph.D. — President, Lundy Foundation/U.S. Harryl Hollingsworth, M..A. — Project Manager, Lundy Foundation/U.S. Dr. Sylvia Kaaya — Head of Department of Psychiatry and Mental Health, Muhimbili University College of Health Sciences - Dar es Salaam, Tanzania Carl Larson, Ph.D. — Professor (Ret.), Department of Human Communication Studies, University of Denver/U.S. Laurie Larson, M.S.S. — Qualitative Data Analyst, OMNI Institute/U.S. Dr. Rehabiamu Mahenge — Psychiatrist, Head of Department, Mbeya Consultant Hospital/Tanzania
Idweli Evaluation — Lundy Ph.D. — Associate Claude Mellins, Foundation © April 2007

Rose Mwaipopo, Ph.D. — Social anthropologist and lecturer, University of Dar es Salaam/Tanzania Furaha Nsemwa — In-country (Tanzania) Project Coordinator Dr. Fausta Philip — Clinical Psychiatry, Department of Pediatrics and Child Health, Muhimbili Medical Centre/Tanzania Jennifer Thompson, Ph.D. — Consultant in the areas of conflict, culture and communication /U.S. Dorian Traube, Ph.D. — Quantitative Data Analyst, Assistant Professor, University of Southern California, 52 School of Social Work/U.S.

Children of Godfrey’s Children Center

Idweli Evaluation — Lundy Foundation © April 2007

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For further information regarding this study, contact : TANZANIA: Dr. Sylvia Kaaya Muhimbili University College of Health Sciences Dept. of Psychiatry and Mental Health telephone: +255 713 262 756 skaaya@gmail.com USA: Vic Dukay, PhD Lundy Foundation telephone: 303 825 0888 x3 This project was funded in part by a grant v.dukay@att.net from the Rockefeller Foundation www.lundy-africa.org
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Idweli Evaluation — Lundy Foundation © April 2007

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