Highly Vulnerable Children Research Center

Monitoring and evaluation

Standardized case management monitoring system for OVC programmes

To improve the availability of high-quality routine data from South Africa for PEPFAR-supported OVC program planning and assessment, Tulane developed standardized indicators, procedures and forms for case management monitoring. Beginning in 2018, USAID Southern Africa OVC partners utilize this set of forms and related procedures for monitoring the family-centred, HIV-inclusive activities they conduct.

Monitoring covers a range of programme processes including enrolment, service delivery and HIV and antiretroviral treatment (ART) status tracking. The new forms are intended to supplement, not replace, other forms that partners may be using to meet the full range of their information needs. CBIMS, the Community-Based Intervention Monitoring System database used by South African OVC partners, has also been updated to reflect these improvements. As in previous years, push-button reports in CBIMS are available to generate the Monitoring, Evaluation and Reporting (MER) indicator results that partners enter routinely in DATIM (Data for Accountability Transparency and Impact), PEPFAR’s centralized reporting system. Additional reports produce results on custom indicators and populate case management reports to support performance management.

Adolescents living with HIV cohort study

A critical component of the global HIV response is scaling up interventions that promote viral suppression among individuals on antiretroviral treatment. However, there is limited evidence related to the effectiveness of service cascade support programming for youth living with HIV. The aim of this cohort study is to follow a group of adolescents living with HIV and enrolled in PEPFAR OVC programming over time to examine if and how participation in a structured support group (Vhutshilo 3) and supportive case management services contribute to desired outcomes including greater treatment adherence, reduced sexual risk behaviour, and better mental health. The study will include pre- and post- intervention surveys implemented as part of Vhutshilo 3 programming. Results will be used to improve future programs and intervention targeting by identifying the services and service packages associated with better outcomes.

Strengthening relationships and resilience among HIV-affected adolescents and their caregivers: a pilot study of the Let’s Talk program in South Africa.

This pilot study evaluated a structured, theory-based intervention for HIV-affected families drawing on evidence-informed curricula from the U.S. and South Africa. The intervention engages both adolescents and their primary caregivers with the primary aims of improving the adolescents’ mental health and behavioral outcomes. This one group pre- and post-test study enrolled adolescent Let’s Talk participants  age 13-17 and their caregivers. All study participants were beneficiaries of a partner community-based organization (CBO) of HIVSA or CINDI, two South African non-profit organizations focused on building the capacity of CBOs that serve orphans and vulnerable children and youth (OVCY) and their families. Results provide important insight about potential program effects, as well as the feasibility and acceptability of the program. Findings have been used to further refine program content. Support for this research was provided by USAID under Cooperative Agreement No. AID-674-A-12-0002

Results available: Click on the title below to read a summary or download a pdf of key research findings.

Peer Reviewed Publications:

Can family-centered programming mitigate HIV risk factors among orphaned and vulnerable adolescents? Results from a pilot study in South Africa

Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa

Program Brief:

The Let’s Talk Program:  Origins, development and future directions

Coping with loss: Abangane grief groups for adolescent girls

This is randomized controlled trial assessed the effectiveness of an 8-session school-based peer support group (Abangane, meaning “friends) targeting female adolescents who have experienced the death of someone important in their lives. The intervention was developed by Khululeka Grief Support Program in South Africa (http://www.khululeka.org/) and applied and adapted for implementation by social workers from community-based organization Child Welfare Bloemfontein and Childline Free State (CWBFN & CLFS) (http://childwelfarebfn.org.za/). The study population was identified through the CWBFN & CLFS school-based intake process and included bereaved female adolescents aged 13- 17 years from 11 participating schools. Nearly 450 eligible adolescents were randomly assigned to receive the intervention in 2015 or wait-listed for enrollment in 2016 following the study period. Survey data was collected from adolescents and their caregivers before and approximately three months following the completion of the interventions. Findings address key psychosocial outcomes, including grief, resilience, mental health, social support, and academic competence among program participants relative to the waitlisted group.

Protocol available: Click here for a PDF version of the IRB approved study protocol.
Results available: Click on the title below to read a summary or download a pdf of key research findings.

Linkages to care: home visiting for OVC families in urban townships

This one-year randomized controlled trial evaluated the effectiveness of a biweekly home visiting program for families caring for orphans and vulnerable children (OVC) in Tshwane (aka Pretoria) townships, South Africa. (http://futurefamilies.co.za/wp/). Future Families takes a family-based approach to addressing the needs of OVC by providing caregivers with information, psychosocial support, and access to external services through a cadre of Trained care workers. Nearly 500 newly enrolled caregivers were randomly assigned to either program participation beginning in August 2014 or to delayed participation following the study. The survey included questions about caregivers’ personal wellbeing as well as key indicators of children’s welfare. Analyses were focused on indicators pertaining to HIV prevention and care, access to social services, education, early childhood development and psychosocial wellbeing. In addition to the trial, survey data were collected from 282 beneficiary caregivers enrolled in the program for approximately 18 months to facilitate a post-test quasi-experimental analysis. This study aims to strengthen the evidence base for effective family-centered programming to address the needs of AIDS-affected children and their caregivers. Support for this research was provided by USAID under Cooperative Agreement No. AID-674-A-12-0002

Results available: Click on the title below to read a summary or download a pdf of key research findings.

Adolescent risk reduction: psychological and behavioral interventions for orphaned and vulnerable adolescents

This two-year randomized control trial evaluated the impact of two interventions on depression and HIV risk behavior among highly vulnerable adolescents in the Eastern Cape of South Africa. The study examines the efficacy of a psychological and behavioral intervention, alone and in combination, among vulnerable youth ages 14-17. The interventions were implemented by World Vision South Africa (http://www.worldvision.co.za/) and included Interpersonal Therapy for Groups as well as Vhutshilo, a structured HIV prevention program developed by the Centre for Support for Peer Education (http://cspe.org.za/). A mixed methods approach was applied, including a community-randomized controlled trial with a factorial design, a cost-effectiveness analysis, and a qualitative component. At baseline data in January 2012 more than 1000 adolescents and their caregivers were interviewed; participants were invited to take part in two additional survey rounds over a two-year period to facilitate identification of the interventions’ immediate and long term effects. Results provide evidence for how best to address HIV prevention and psychological health among AIDS-affected adolescents.

Results available: Click on the title below to read a summary or download a pdf of key research findings.

A case study describing the psychological intervention is available at the link below: Click on the title below to read a summary or download a pdf of this report.

Assessing the impact of home visiting to meet the needs of orphans and vulnerable children

This two-year quasi-experimental study evaluated the effectiveness of various home visiting approaches implemented by organizations serving orphans and other vulnerable children in KwaZulu-Natal (KZN) province, South Africa. In 2010, baseline data collection was completed with over 1800 orphaned and vulnerable children age 10-17 and their caregivers; a follow-up survey was administered two years later. Analyses examined how exposure to home visiting may have affected beneficiaries’ psychological health, economic and physical wellbeing. This research aims to document the quality, scope and comprehensiveness of home visiting and to describe program components that are key to improving the wellbeing of vulnerable children in South Africa.  Support for this research was provided by USAID under Cooperative Agreement No. AID-674-A-12-0002 and through contract No. GHS-I-00-07-00002-00 under Task Order No. GHS-I-03-07-00002-00.

Results available!  Click on the title below to read a summary or download a pdf of key research findings.

Peer Reviewed Publications:

Study Reports:

The Highly Vulnerable Children Research Center is funded by the United States Agency for International Development and implemented by Tulane University. The information provided on this website is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government. The contents are the responsibility of Tulane University and do not necessarily reflect the views of USAID or the United States Government.