The challenges and hardships that vulnerable children and adolescents face in Tanzania are complex. Many of their families have difficulty affording school or enough food to eat. Many are at high risk of acquiring HIV or are already living with HIV. They may work in hazardous occupations to help take care of younger siblings. Or, with no adult caregivers at home, they may be heading their household with little or no help. They may be living or working on the streets.
When Pact launched the Kizazi Kipya project in 2016 to holistically improve the lives of orphans and vulnerable children (OVC) across the country, we knew that our interventions would need to be complex as well. Five years later, as Kizazi Kipya comes to a close, we are proud of what we’ve accomplished with our many partners, especially the resilient and determined families and children we served.
Funded through USAID by PEPFAR, Kizazi Kipya, or New Generation, used a case-management approach to connect OVC and their caregivers with vital services to improve their health and socioeconomic wellbeing. Pact implemented the project with Elizabeth Glaser Pediatric AIDS Foundation, Railway Children Africa, Ifakara Health Institute, Aga Khan Foundation and Restless Development. To achieve our goal of ensuring children and youth thrive and survive through sustainable improvements, we also partnered with civil society organizations, the government of Tanzania at the national, regional and district levels, and other stakeholders.
Throughout the life of the project, we served more than 1.7 million people, enabling 1.2 million OVC and 470,000 caregivers to access age-appropriate HIV-related and other services for improved care, health, nutrition, education, protection, livelihoods and psycho-social wellbeing. To do this, we scaled-up evidenced-based interventions across the 152 councils and 26 regions where we worked. For example, we supported more than 28,000 community case workers to provide tailored and HIV-sensitive case management services. The project established and supported more than 12,000 community savings and lending groups. Nearly 93,000 vulnerable households, covering over 360,000 household members, received medical insurance. Nearly 10,000 youth received vocational scholarships and income-generating start-up kits, and more than 100,000 children received education subsidies.
On a broader level, Kizazi Kipya scaled up high-impact interventions to save lives and prevent new HIV infections, made measurable improvements in OVC and families’ overall well-being, and contributed to Tanzania’s goals for HIV control and response, child and family resilience, violence prevention and response, and poverty reduction.
Given all of this, the Kizazi Kipya team believed it was critical to document what we did and what we learned so that future implementors could build off the project and apply our approaches and learnings. We felt that it was important to describe the specific uniqueness of the project, especially in terms of innovations in operations, services, delivery and coordination. Two key audiences we had in mind for this document were the government of Tanzania and the local organizations that will be receiving direct funding from USAID to continue carrying this OVC work forward in Tanzania.
This is why we recently published a Kizazi Kipya compendium of best practices for OVC programming. The compendium is organized into five sections. The first four sections cover PEPFAR’s OVC wellbeing domains: Healthy, Safe, Schooled and Stable, with the corresponding interventions that Kizazi Kipya implemented detailed out in each section. We wanted readers to have a snapshot of the specifics of each intervention—the purpose, participants and process, so those components are included. At the end of each section, we have captured the most salient lessons learned and reflections over the course of the project. The compendium’s final section covers differentiated services, as the project designed specific approaches and service packages for children and youth living and working on the streets, children in mining and children of female sex workers.
The Kizazi Kipya team believed it was critical to document what we did and what we learned so that future implementors could build off the project and apply our approaches and learnings.
Some of the key themes across the lessons learned include:
- Agility is critical. Kizazi Kipya changed and adapted, adjusting based on donor and country priorities, the HIV epidemic and Covid-19. We also adapted based on what was working and what wasn’t. Gathering feedback from OVC and caregivers, using data for decision-making and documenting lessons learned across the program, and then using that information to make changes, was essential to ensure high-quality service delivery.
- Implementation and monitoring must be intentional and systematic. Given the number of interventions delivered and scale reached, the project had to clearly define structures and processes, roll out thorough guidance and develop and cascade effective trainings and tools.
- Tailored solutions have greater impact than universal services. This approach was at the heart of Kizazi Kipya. Each one of the interventions delivered was adapted to the Tanzanian context and packages of services were designed to address OVC and caregivers’ most pressing needs.
- Partnerships enable impact that lasts. A key to success for Kizazi Kipya was engagement and collaboration with government (from village to national level) as well with clinical partners, health facilities, schools and indigenous civil society organizations.
We hope other implementers will find these reflections and the rest of the compendium useful. And we hope the pathways that Kizazi Kipya has built will continue to help children flourish into thriving adults and agents of even greater positive change.