Special Initiative for Orphans and Vulnerable Children Assessing the Scalability of an Early Childhood Development-Integrated Intervention in Eswatini

Author(s): MEASURE Evaluation

Year: 2019

Abstract:

The HIV epidemic has a profound effect on children in sub-Saharan Africa, where more than 15.1 million children have lost one or both parents. In June 2014, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) announced, as part of its orphans and vulnerable children (OVC) programming, a special initiative for children under age five affected by the epidemic. The initiative funds interventions and research in southern Africa—Lesotho, Eswatini (formerly Swaziland), and Zimbabwe—to generate data on approaches that improve health. Its goals are to establish evidence to improve and inform programming and determine the potential for program scale-up.

The programs integrate OVC programming with pediatric treatment and prevention of mother-to-child transmission (PMTCT) of HIV. Outcome evaluations of each intervention in the three countries seek to examine both early childhood development (ECD) and clinical aspects of interventions for a more holistic understanding of children’s needs. Evaluations of each intervention generate data on successful approaches that improve health and establish evidence to improve programs. However, evidence of effectiveness is not enough to ensure that interventions become part of routine program implementation elsewhere. Achieving that end requires early planning and strong advocacy from multiple stakeholders. To prepare for potential scale-up once the results of the evaluation become available, the United States Agency for International Development (USAID) asked its funded project—MEASURE Evaluation—to assess the scalability of the ECD-integrated intervention in each country. Scale up pertains to deliberate efforts to use a proven practice to reach more people more quickly and more effectively, to bring about lasting change.

This document concerns itself solely with Eswatini. The Eswatini program, implemented by mothers2mothers (m2m), trains “mentor mothers” to provide good quality early childhood development (ECD) services for vulnerable children ages 0–2 years and their parents and caregivers.