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Base de datos de evaluación

Evaluation report

2005 TNZ: Evaluation of Tahea Supported 'Mama Makubwa' Initiative in Makete and Iringa Regions

Author: Dr. Mwaipopo, R.

Executive summary

This report is based on an evaluation of the effectiveness of TAHEA (Tanzania Home Economics Association)-supported Mama Mkubwa initiative in Makete District, Iringa Region, that was conducted between May and June 2005. The Mama Mkubwa (MM) initiative is a community-based initiative for the care and support of Most Vulnerable Children and Other Vulnerable Children (MVC/OVC) that was introduced in the district in 1999. The objective was to complement the care and support to orphans by providing psychosocial needs to these orphans, who were increasingly becoming a significant aspect in the social life of communities in Makete.

Among the key drivers for this evaluation was the prevailing feeling that, despite the positive aspects of supporting most vulnerable children, Makete's MM - women who take on the task of fostering orphaned children in the community - have faced different challenges that have rendered their work to be very tasking and, in some cases, leading to withdrawal. The burden of providing care and support to an increasingly large number of children, the poor economic status on the part of MM themselves, inadequate skills to handle and provide some support such as psychosocial support to the most vulnerable children, just to mention a few, have limited the capacity of the MM to respond adequately to the needs of these children. Yet, despite its limitations, the system has managed to provide support to child-headed households and vulnerable children who needed close supervision and follow-up. Based on the strengths and challenges facing the strategy, it was felt there is a need to conduct an evaluation in order to understand the initiative within the framework of foster care and to establish the extent to which the initiative has achieved its primary goal of providing foster care and support to the MVC/OVC.

The overall objective was to undertake an evaluation on the viability and effectiveness of the current Mama Mkubwa strategy on the care and support of orphaned and vulnerable children in Makete District. Specific objectives included: To make an assessment of the Mama Mkubwa strategy, its conception, the rationale, the process involved and how it operates; To Identify the positive traits/strengths and challenges of the strategy; To map out the key needs of the strategy in order to ensure that when addressed, it works, and provide the care and support of MVC/OVC; To assess the current situation of Mama Mkubwa in Makete District and recommend strategies for future support for MVC, both in Makete and elsewhere; To assess its impact on attaining its primary goal for the care, support and protection of vulnerable children at family and community levels; and to suggest/recommend how the Mama Mkubwa strategy can be redefined to ensure it achieves its primary goal.

This evaluation was conducted basically as a qualitative study, using an interpretive approach. Quantitative data was collected to complement the qualitative data and as evidence of certain key indicators, and to support official explanations and people's accounts of their experiences. The primary sampling unit was the village, whose selection was conducted purposively in accordance with the TOR, and for purposes of achieving representativeness of the study population. MVC/OVC were also purposively selected to capture age differences, gender, and nature of vulnerability (such as loss of both or one parent; destitute parents, deserted children, child heads of households). A total of 47 children were therefore consulted in the study. Of these, 8 non-schooling children were also consulted. Other sources of information consulted included guardians of MVC/OVC, representatives of Village Governments, MVC Committees, Ward Level Officials, Heads or representatives of Institutions (Schools, Faith Organisations, NGOs) and District level Authorities.

The information was collected by focusing on specific themes relevant to the evaluation of psychosocial support. The techniques also had equal focus on mama Mkubwa as well as the children because of the understanding that children are the best communicators of their internal subjective feelings and, therefore, they were facilitated to express themselves freely. Local Assistants (a youngster and adult) who could communicate in the local language, ki-Kinga, participated in the study to facilitate the dialogue. The situation of children under 6 was explained by Mama Mkubwa and the Guardians.

Semi-structured interviews were the basic tool for primary data collection. The interviews were conducted mainly as one-to-one discussions, or in more participatory Focus Group fora.

Secondary data was collected through the review of a range of literature related to HIV/AIDS in Tanzania, Makete District information, Children’s Rights, Vulnerability, and experiences on the Care and Support of Vulnerable children in Tanzania and elsewhere. Other relevant documents on the Mama Mkubwa strategy such as on its inception, associated statistics and self-assessments on the initiative were also reviewed. Conversation facilitated by drawings and illustrations to draw the attention of the younger MVC/OVC (6-10) and to give them freedom of expression were used. However, since the use of pencils at tender ages is not very common due to cultural circumstances, the children were not very comfortable in drawing by themselves but could use illustrations to express what they experience in their daily lives.

Four case studies based on life stories were conducted. Two of them with two of the Mama Mkubwa, and two with OVCs. Both respondents were purposively selected to respond to experiences of care and support. The children, in particular, were selected according to age and gender differences.

The data was analysed by using qualitative coding, and categorising information according to key themes.

Findings and Conclusions
Mama Mkubwa – the person – has indeed been a welcome complement for the care and support of orphans in the communities where the initiative has been introduced. Not only has the process been able to fill a felt gap in terms of psychosocial support for MVC/OVCs, MM has also been able, to some extent, to stimulate sentiments about community responsibility to a local problem otherwise eroded. The fact that caring for orphans – bapina – was handled by immediate kin or relatives, introducing a Mama Mkubwa in replacement of these kin has indeed cultural validity. It is not a new concept, albeit slightly reformed – and the meaning and intention remains the same. This service is clearly felt as a gap in those communities without MM, hence, their demand to also have their own MM. This was because, even with the presence of MVC Committees, the special type of service performed by MM could not be substituted. Many of the MVCs were able to relate MM with positive reinforcement and the sense of social attachment they were experiencing.

The biggest challenge, however, and an issue that demands further research is the effectiveness of MM's care and support to the very young MVC/OVC who were almost totally dependent on guardians for care because of the complexity in attending to them by MM. This is because of the different needs and demands for care that MVCs in different age groups require. While schooling MVC/OVC do receive some attention at school, reaching out to young MVCs may demand a more specific kind of care focusing more around the household and collaboration with immediate care providers, the guardians. This aspect cements the recognition of guardians as a crucial component in the whole aspect of care giving to young orphans. Nevertheless, if the institutional collaboration at Village level is streamlined, more sophisticated care could be directed to young MVCs. At the same time, community mapping of MVC needs has, at the moment, sidelined the reality of the continuum of care that in fact supports MM in their responsibilities. The multiple efforts from different players in the communities (MM inclusive), school environments, and District and National/International levels have, in different ways, managed to reach the children with some form of support, but with limited support to MMs who provide a crucial aspect in this care. The absence of coordination of activities has, therefore, limited the effectiveness of these activities and has failed to harness the expertise of crucial actors such as Health personnel, who could provide necessary information on the physical health of young MVC children who have only the home to depend on.

The inter-connectedness of material support to the mental well-being of the MVC demands that resource management programmes in the District be rethought. Currently, the lack of an integrated approach has allowed resources at District level – such as Donor funding - to continue to be channelled in 'straight-jacket' fashion to single issues, rather than pooling them and identifying ways in which the various efforts could be jointly supported. The impact is often minimal and its outreach limited to certain population categories. This has, however, been difficult in the absence of a clear, coordinating mechanism for MVC/OVC care and support.

Currently, being basically a TAHEA-supported initiative, the development of MM in Makete District has largely depended on decisions made by TAHEA regional Headquarters at Iringa, limiting local District people's ability to pursue and embrace the initiative as a local Makete process. These include decisions to make periodic assessments on MM, or developing a periodic sensitization programme to keep them up-to-date on psychosocial aspects of care and support to orphans. This is because of the inability to secure funds. TAHEA admits that shortage of resources has been a major factor affecting the monitoring of MM.

The shortage of resources faced by MM and the wider community has limited MMs' capacities to care and, therefore, most of what they do can be rightfully termed as support. Low agricultural productivity, petty income-generating activities, many of them managing households single-handedly, and the added burden of MVC/OVC are indeed constraining, not only to the MM but also for guardians. What seems more feasible is identifying ways in which local communities could be empowered to independently handle the process, both in terms of management and in terms of material support to the children.

A general conclusion is also drawn from the psychological status of MVC/OVC themselves and the degree to which they have been able to handle loss [their parents] by embracing substitutes, in this case the MM. Generally, there seems to be too much compassion placed on the plight of MVC/OVC by policy makers and donors, which is justifiable, given the circumstances confronting Makete District. But, on the other hand, less emphasis is placed on empowering them psychologically to enable them to recognise that they, too, have a responsibility in the MM - MVC/OVC relationship. In the opinion of the MM, there is a need for MVC/OVC to be sensitized in their relationship with MM and their responsibility in the process.

Altogether, therefore, the whole context within which MM operates needs to be clearly thought through and improved for the initiative to have continuity.

1. Integrate/Mainstream MM in District Development processes:
In view of the challenging circumstances for providing care and support to MVC/OVC in Makete, it is necessary for the District to introduce a holistic approach rather than sector-based thinking on MVC/OVC care, and identify activities that reinforce each other. This could be done through the following steps: 1. Integrate orphans' care and support into National/District Poverty reduction strategies/programmes; 2. Identify and support a District level inter-sectoral coordinating and monitoring mechanism – preferably under the District Social Welfare Department [incorporating relevant departments e.g. Health, Community Dev.] that reach the Village through a Ward level MM or foster care coordinating program. This mechanism can follow-up on these issues:
- Progress on MM could be tabled during annual reporting on service provision
- Integrate MM into existing Committees – especially the School Committees – to promote coordination between the two major care providers to
schooling orphans.
- Ensure that the objectives and management of MVC Accounts are made transparent to community members – especially MVC/OVC and MM. Responsible institution: District Planning Office, Social welfare, Community Development

2. Monitoring and Evaluation:
Developing locally-relevant and age-specific tools for systematic evaluating and monitoring of the situation of MVC/OVC in the country, is necessary in order to establish the achievements being realised from interventions directed to orphaned children. These tools can be generated from the three key areas singled out in this study, which are: the situation and disposition of the care provider; the social environment; and the range of psychosocial indicators on well-being relevant for children in that particular context. It is, therefore, recommended to: Identify or Develop monitoring criteria/indicators – from the expectations of policy, MVC/OVC and MMs - in order to be able to assess MMs contribution to the provision of care and support to MVC/OVC in future (ref appendix viii for example of Monitoring Indicators); The monitoring indicators should be age-group specific, in consideration of the different exposure to psychosocial risks that children of different age groups are usually confronted with. A useful procedure can be taken from the MLYDS (n.d.) document that delineates 4 such age groups – 0-2 years; 2-6 years; 6-12 years; 12-17 years (pp. 145-163); Train Mama Mkubwa with simple techniques of identifying, monitoring and reporting on an individual problem of MVC/OVC problem
Responsible institutions: Social Welfare; Community Development; Health

3. Empowering local communities to achieve household food security:
It is necessary to identify incentives for Mama Mkubwa in order to boost their performance towards MVC/OVC. However, since Mama Mkubwa are part of the general community, singling them out for concerted support or compensation may actually fuel their identification as 'project-based' foster parents – and hence limit community support to them. It may also kill the community or voluntary spirit necessary for the sustainability of the process because MMs may regard themselves as employees, rather than members of a community responding to a felt need. It is important, therefore, to approach them from the community level, and thus target to enhance household capacity in general, to achieve food security and raise local incomes for communities in which MVC/OVC has high prevalence.
In consideration of the lack of viability that other strategies have so far had in raising incomes or funds for MVC/OVC, one of the best options is therefore raising the capacity of communities/women to initiate and run such projects through training on skills/techniques for improved productivity. MM and other members of the community understand that significant investments need to be made for their economic empowerment and they give highest priority at improving the productive capacity of the land, their basic means of sustenance. It is, therefore, recommended as follows: Introduce ways for people to access low-cost technology and inputs for agricultural production – promote neighbourhood demonstration plots on good farming practices; Explore the existing potential for small industry development, or small projects that target women, youth.
Responsible institution: Agriculture/Livestock; Community Development

4. Social safety nets:
In view of the socio-economic challenges facing MVC/OVC and the limited outreach that individual actors face when they need to extend support, it becomes necessary for the Government to identify locally-relevant social safety nets with the potential of sustainability. It is thus recommended that: Eliminate targeting of specific homes of MVC/OVC by establishing a basket fund for MVC that is subscribed to by local, international and multi-lateral partners that would be accessible in relative proportions to village communities in order to cater for MVC's needs; Identify a range of care and support systems depending on the situation. Therefore, review policy on the care and support to MVC/OVC to incorporate loosely-bound structures such as boarding facilities for schooling MVC since their home environments are not conducive. This may allow concentration in education and may also ensure that the children are monitored, given support, yet raised within the same environment; Vocational skills training – continue prioritising or making special provisions to include ALL MVC/OVC – as the ultimate livelihood security; Introduce a cash-transfer scheme that starts by prioritizing MM with credit for mini-projects, and whose payment goes to a revolving fund.
Responsible institution: District Planning Office/DAC; Community Development

5. Wider sensitization and training on MVC/OVC to communities:
A comprehensive programme for training and continuous sensitization of the community on the care and support of MVC/OVC is also important to generate commitment to guardianship or the Mama Mkubwa initiative. The lack of it may be one of the reasons why there is minimal community ownership, while Mama Mkubwa are, in some places, regarded as UNICEF's or TAHEA's employees. Such training also needs to be localised. Meaningful training on community-based approaches makes sense and enables trainees to touch base with reality when they are trained and practice within the same or similar environments.
Another advantage of sensitizing and training communities on care and support is the necessity of developing a stronger link with MM. This relationship can be developed by each performing and liaising with the other on different aspects of care. Currently, since the workloads of most MMs limit their ability to spend enough time with children, it has been difficult to notice signs of distress, or expressions of discomfort in some of them, especially for the very young, and non-schooling children, unless told by guardians or neighbours. Elderly guardians are themselves in need of such support and cannot effectively handle the children's emotional needs. If guardians of all kinds are empowered to take up this responsibility, the possibilities that the psychosocial well-being of MVC/OVC is checked will be high. It is thus recommended that:
- Introduce periodic and locally-conducted sensitization programmes on care and support of orphans in the same environment where the MVC/OVC live in to enable MM and the community to identify with the process.
- Training of Community Leaders – e.g. Ward and VG Government leaders on the range of ways the care and support of MVC/OVC – including the role of foster care that MM provides.
- Sensitize guardians and neighbours to act as primary units of care, and therefore supporting MM – e.g. noticing signs of, and addressing, psychological stress among children.
Responsible institution: Social Welfare/Community Development/WEO

6. Empowering MVC/OVC:
A committed participation of MVC/OVC themselves in the care and support system is also crucial. Balancing their demand for rights with responsibilities, especially for older MVC/OVC, is important to allow them to become responsible citizens in future. It is, therefore, important to sensitize MVC/OVC on how to build relationships with MM and what they should be expecting from each other. It is, therefore, recommended to: Sensitize MVC/OVC, through counselling, on building responsible relationships with MMs and other people; Introduce ways in which the 'naming' or singling out of orphans can be reduced – e.g. through promoting and encouraging recreation activities across communities that help to smoothen differences, youth clubs etc.
Responsible Institution: Village Government/WEO/Community Development/Social Welfare

7. Expanding the definition of Care givers to include Baba Mkubwa and voluntary surrogate mothers:
The challenges that Makete's MM face in managing the range of psychosocial needs necessary for MVC/OVC care and support demands a broader and more integrative classification of care giving to incorporate other members of the community, in addition to the structures that have been proposed in Recommendation 2 above. Therefore: Expand the identification or selection of foster parents through the Mama Mkubwa initiative by encouraging communities to identify people with complementary qualities, including Baba Mkubwa – to address better developments caused by physiological changes, gender issues; Extend and encourage foster care to couples – in order to generate family commitment and to minimise differences on care between couples, where there is an MM; Establish more participatory mechanisms for the succession of MM, such as encouraging individuals to voluntarily identify MVC/OVC they would be willing to support. This is particularly necessary for the care of very young MVC; Spread number of MM and foster parenting to spread out responsibilities and, therefore, the burden to care.

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