Evaluation of the Community Faith-Based Regional Initiative for Vulnerable Children (FABRIC)

Project Description

In Sub-Saharan Africa alone, around 14 million children have lost one or both parents to HIV (UNAIDS, 2008).  The majority of these orphans and vulnerable children (OVC) are cared for by extended families.  However, growing disparities, economic difficulties within households providing care, and insufficient capacity among social services require attention from policy makers and program planners. In ten countries with adult HIV prevalence estimates of 5% or more, recent household surveys suggest that only 15% of orphans live in households receiving some form of assistance, such as medical care, school assistance, financial support, or psychosocial services (UNAIDS, 2008).

Family Health International (FHI) implemented a five-year regional PEPFAR-funded program beginning in August 2005. The project, entitled the Community Faith-Based Regional Initiative for Vulnerable Children (FABRIC), aimed to improve the quality of life for orphans and vulnerable children (OVC) in Namibia, South Africa, and Zambia by ensuring delivery of essential services in the PEPFAR OVC domains and by developing the capacity of implementing agencies to coordinate sub-recipients to deliver services effectively.

The CGHD collaborated with FHI to conduct the FABRIC end-of-project evaluation (EoPE).  Findings suggest the FABRIC recruitment and targeting strategies were successful as the FABRIC sample is generally worse off than the community comparison sample, but also reveal high rates of vulnerability and unmet need in the general communities.  At the end of the project, disparities between the two groups seem to be less widespread.  We can reasonably assume, though cannot prove, that the initial FABRIC beneficiaries were from households in greatest need, and the lack of differences in  many of the wellbeing indicators measured by this end-of-project evaluation could be interpreted as the FABRIC project interventions bringing its beneficiaries up to, or maintaining them at, the levels of need and vulnerability of the general population.  Though the needs are still profound, the lack of disparity between the two populations can be seen as a proxy measure of success for the FABRIC efforts.  Organizational capacity strengthening with respect to administration and, monitoring and evaluation, is undoubtedly beneficial, but further efforts are needed to strengthen the technical capacities of the organizations to implement effective, sustainable OVC services.

The evaluation represents an in-depth examination of child health and household status and is one of the only  studies to link OVC programming with specific OVC outcomes.  Additionally, the EoPE aimed to estimate the full cost of inputs (goods and services) used to implement the FABRIC program at the level of the FABRIC community-level Faith-Based Organizations in Zambia and South Africa 2009.

This evaluation established the baseline for a prospective cohort study and provides the opportunity for ongoing input into OVC policy development and programming.  Over the next year, we will continue to follow the population longitudinally to assess longer-term programmatic impact.   Findings will add to the global body of knowledge about OVC care and support, which is urgently needed to guide international policy and resource allocation.

This project is funded in part by the CGHD’s Orphans and Vulnerable Children—Comprehensive Action Research project (OVC-CARE).

Project Details

Principal Investigator Jonathon Simon
Boston University Co-Investigators Nancy Scott, Katherine Semrau, Melissa Pfaff
  • Thomas Mugala and Joseph Kamanga, Family Health International
Country(ies) Zambia
Dates of Research September 2010-August 2011