Improving Access to Services for Children and Families Through Collaboration Among Health Workers and Social Service WorkersSubmitted by Nicole Brown on Tue, 10/06/2015 - 1:29pm
When health workers and social service workers collaborate to enhance community capacity to care for children and adolescents, vulnerable children and families reap the benefits. Last month, I witnessed first-hand some of those benefits.
Global evidence shows that children orphaned by AIDS or living with HIV-positive caregivers face an increased risk of physical and emotional abuse as compared to other children in sub-Saharan Africa, including other orphans. They also face stigma, neglect and many other issues that negatively impact their psychosocial wellbeing.
To strengthen linkages and referral systems between community and government service providers, the Bantwana Initiative was developed by World Education Initiative (WEI) and is an initiative of WEI and John Snow, Inc. The program prides itself on “innovative models of care that are based on existing community structures and address children’s comprehensive needs.” The program is supporting vulnerable children and families in Swaziland, Tanzania, Uganda, and in Zimbabwe, which I recently visited.
In Zimbabwe, nearly one in four children has lost one or both parents, most due to HIV/AIDS, and 1 in 11 children die before age five due to HIV-related illnesses. Additionally, there were an estimated 1.2 million Zimbabweans living with HIV/AIDS in 2011, 200,615 were children under age 15. Many of these children acquired HIV from their HIV-infected mothers during pregnancy, birth, or breastfeeding, with mother-to-child transmission accounting for virtually all new HIV infections among infants in Zimbabwe. There are also a total of 1.2 million children of school going age, between 3-16 years, who were out of school in 2012 and 843,266 people (ages 5-24 years) had never been to school. Overall, more than one quarter of children between 3 to 16 years were out of school. To combat these staggering statistics, Bantwana developed an integrated pediatric HIV/AIDS care and treatment program and is working closely with the government to strengthen the social service system.
I had the opportunity to meet Shelton Tshuna, one of the 9,765 community-level child care workers trained across 65 districts throughout Zimbabwe. The neighborhood where he works is familiar and convenient to him because it’s in his backyard. We drove less than 10 minutes from the tourist town of Victoria Falls to his community in the Chinotimba area. Only an SUV would be able to travel the paths of this village, for when we stepped out of the car, golden dust half covered our shoes.
I attended a meeting of 21 child care workers (CCWs) as they discussed some of the issues facing their community and how they can best address them. They’re easily recognizable, as each wears a t-shirt and hat that announce them as a child care worker within the community. They’ve received training to be sensitive to the needs of children living with HIV, case management procedures, and some psychosocial support. They’ve also attended a course on basic counselling and communication, receiving a certificate upon completion. The CCWs have come to gain the trust of their neighbors and are viewed as a formal role within the community, leading to community participation in identifying children in need of the CCW’s help. The CCWs work with the Child Protection Committee and Village Health Worker to implement an integrated approach to addressing the children's overall well-being.
“Working with the community is important,” Shelton told me. As a CCW for the last 1.5 years, he’s spent months getting to know 13-year-old Khethiwe* and gaining the trust of his grandfather. The boy moved from another area of Zimbabwe last year after his mother, father and younger brother all died from HIV. His grandfather and a maternal aunt are now his caregivers. Out-of-school for a period, Shelton helped Khethiwe re-enroll in school. He told me that social studies is his favorite class. He’s also begun making new friends. In fact, he was playing soccer with them when we arrived. The transition hasn’t been easy, though. Shelton visits Khethiwe and his caregivers frequently, which is apparent from their casual, friendly interaction.
Prior to Shelton’s help, the grandfather told me their “situation was pathetic, and we couldn’t afford much.” Shelton is helping enroll the family in World Vision’s food program, to ensure Khethiwe receives adequate, nutritious meals to help with his own HIV status. He’s also now receiving ARV treatments and paperwork is underway to obtain his birth certificate, which will help the family to access additional benefits and services from the government and volunteer organizations.
Bantwana is also collaborating with UNICEF and Zimbabwe’s Department of Social Services (DSS) on a three-year case management project. As part of the scale-up, CCWs receive training to work with vulnerable children until they no longer need their services. Through the program, DSS social work staff will be deployed to 30,000 vulnerable households by 2017, Yvonne Mandikutse, a child welfare officer with the government told me.
To-date, the program is having great results, some of these I witnessed first-hand. In Shelton’s ward, in the last year, community members have increased their sensitization to neglect and sexual abuse, leading to increased reporting of these issues; two children were reunited with their families; 34 students were re-enrolled in school; and CCWs helped 34 children/families to obtain birth certificates, necessary to help the families qualify for additional aid and support.
“How to handle children in distress is critical to training of para professionals. We’ve trained close to 1,500 para social workers. Strengthening of formal and informal systems to increase the wellbeing of children begins at the community level,” said Edton Babu Ndyabahika, Deputy Country Director, Bantwana Initiative, Uganda.
The need for more and better integrated services is beginning to receive more attention. I joined more than 400 attendees from 27 countries, largely within sub-Saharan Africa, at the Regional Psychosocial Support Initiative Forum (REPSSI Forum) in Zimbabwe for three days in September to discuss the importance and challenges of integrating child protection, HIV programming and psychosocial support by strengthening community level linkages. There, I met Edton and several others from Bantwana’s other country programs, who all shared examples of why this is important and how it’s making a difference in their countries.
“Strengthening the framework of psychosocial support must remain embedded in social services. Exposure to best practices and the exchange of knowledge adds quality to psychosocial support,” said Priscah Mupfumira, Minister of Public Service, Labour and Social Welfare, Zimbabwe, in her address to Forum attendees.
Initiatives like Bantwana in Zimbabwe are making this case on the ground, effectively integrating a case management model into existing government social services and extending the government’s reach to the children and families who need support most.
As a co-sponsor of the REPSSI Forum, the Global Social Service Workforce Alliance, the organization where I work, held three sessions on the importance of supporting community-level workers (or para professional workers), including increased training and recognition, so that they can be best utilized toward strengthening these community linkages. Community-level workers play critical roles in linking programs to health facilities, reinforcing promising practices, uniting organizations and government, and promoting a referral system. Largely community volunteers, these workers oftentimes lack the training and recognition to work hand-in-hand with health workers and others providing and advocating for children’s well-being. To help address these gaps, the Alliance’s Interest Group on Para Professionals, comprised of dedicated members of the Alliance, developed a competency framework. This new resource outlines functions and competencies of para professional social service workers. It is our hope it will be used to provide program guidance, accountability and ultimately inform training and supervision of para professionals.
It takes a strong social service workforce to provide the best care for vulnerable populations. The Alliance celebrates people like Shelton who are committed to making this dream a reality and supports these linkages through conferences, tools and resources.
*Child's name has been changed to protect his identity.
 The National Strategic Plan for Eliminating New HIV Infections in Children and Keeping Mothers and Families Alive (2011-2015)
 MOHCW AIDS & TB Unit Annual Report 2011
 UNICEF Commissioned a 'National Assessment of Out of School Children,' Dr Jeanette Manjengwa, June 2015
Protection and resilience: A simple checklist for why, where and how to coordinate HIV and child protection policy and programming, introduced at the REPSSI Forum during a session presented by OVCSupport.net.
by Jim McCaffery, Chair, Global Social Service Workforce Alliance Steering Committee
Welcome to Day Five of Social Service Workforce Week! This week, as you probably know, we have been celebrating the work of community level social ervice workers. Given the critical role these community workers play every day in providing care and support to children and families, it has been our premise that they form the backbone of a strong social service system.
We hope that through the various methods and communication channels this week – blogs, worker profiles, web visits, tweets, and so on – we have all gained a better understanding of what they do and how they do it. And that we would appreciate both the individual stories as well as the overall perspectives and tools that have been highlighted.
As we look at the bigger picture of community level social service workers, one cannot help but be impressed by the great diversity of roles and services that they provide. While this is a real strength in that community level work must fit different contexts, it also poses a challenge -- the functions and activities of these workers are not well described or delineated within or across countries. Training, credentialing, supervision and evaluation of para professional community social services vary as well based on local context, the existence or lack of formal social services or social welfare structures as well as the professional and local cultural stance on how vulnerable people are to be supported and helped.
Recognizing this, the Alliance formed the Interest Group on Para Professionals in the SSW (IGPP) in September 2013, which has been open to all members of the Alliance. Zeni Thumbadoo, National Association of Child and Youth Care Workers in South Africa, and Nathan Linsk, PhD, University of Illinois at Chicago, co-facilitate the group. Currently there are more than 30 member participants who represent seven countries from North America, Europe and Africa.
The Competency Framework for Para Professional Social Service Workers
The group developed a competency framework for para professionals that outlines the functions and competencies and can be used to provide program guidance, accountability and ultimately inform both training and supervision.
Today, we are releasing the full document, including the guiding principles and competency framework. We hope that all of you will take a look, try it out and provide feedback to make the next edition even more robust.
You can find the competency framework here.
Let me say a few words about the three key sections of the document:
1) Guiding Principles
The purpose of this section is to provide a set of principles that will be a useful base from which to develop programs and activities related to how programs can work to better plan, develop and support para professional social service workers. (For additional information on the Guiding Principles, please see the day one blog.)
2) Core Functions and Competencies
The purpose of describing core functions and competencies is to more clearly define the range of work of para professional social service workers. The competency framework can be used toward the development of service and training programs for para professionals working as direct care workers in the social service sector. These functions and competencies should serve as a useful base to develop such programs; however, based on the type of services provided as well as the professional and regional context, they often will need to be supplemented by functional areas and competencies specific to the context or discipline related to those served by the para professional workers.
The overall functions and competencies are generic in that they may apply to most para professional cadres, but at the same time not all para professionals are expected to need all of these competencies. Specific groups may have more specialized functions and competencies that can be combined with these generic functions and competencies in training and service programs
These functions may be viewed as a "menu" of competencies that may be helpful in developing service programs as well as training and supervising workers who do this work. They may be useful as well in developing credentialing or qualifying descriptions of these workers, including job descriptions, scopes of work or schemes of service. Potentially they may also be used to ensure ethical practice and enforce related laws and professional standards that relate to para professionals practicing in these fields.
The document presents eight overall functional areas as follows:
a) Communication skills
b) Direct work with children, youth and families
c) Application of knowledge related to client needs
d) Community work
e) Collaboration skills
f) Organization and leadership
g) Monitoring and evaluation
h) Developing self and others
Each functional area is divided into a series of competencies that provide more detail. Practice competencies are specific expected abilities that a worker may use in their work; these competencies can be used to develop or evaluate their skills and may be a part of a work description. Training competencies can be used to develop training objectives and activities as well as evaluate training success.
3) Specialized Functions and Competencies – Child and Youth Care Workers
Toward more specialized competencies, the current document also outlines functions and competencies associated with one specialized area of para professional social service work – Child and Youth Care Workers (CYCW). Child and youth care practice focuses on the infant, child, and adolescent, within the context of the family, the community and the life span. The developmental-ecological perspective emphasizes the interaction between persons and the physical and social environments, including cultural and political settings. This is an internationally recognized field with standardized competencies and training at the professional level that enables a career ladder for para professional child and youth care workers. The internationally accepted child and youth care competencies for professional CYCW can be found online. The IGPP document is a first effort to define specialized competencies for para professional CYCW.
It is hoped that future versions of the document will incorporate specialized functions and competencies for other types of cadres, including para social work and community development.
A major contribution…let us know what you think
Developing and publishing the guiding principles and competencies for community level social service workers is a major contribution to the field. The IGPP is congratulated for the hard work that went into the initiative and the document. I should add that validation exercises have been carried out in Kenya and Uganda with the specific aim of assessing the relevance of the framework’s functions and competencies to a specific group of para professional workers.
So, please read through the document – we hope you learn from it and, most important, if you have reactions and ideas and suggestions, please contribute them, as we want this to be a living document that grows and becomes more finely tuned based on broad input and experience. We request that as you use these tools you let us know how you do so, what groups you target and what are the results including needed modifications. Please email us with any and all comments and feedback. We look forward to hearing from you.
And thank you for joining us during this year’s social service workforce week. Take a look back through the week’s information here. If you haven’t become a member of the Global Social Service Workforce Alliance yet, we invite you to do so.
By Stela Grigoras, PhD, Director, Partnership for Every Child, Moldova, and Florence Martin, Director, Better Care Network
"The work of the community social worker is very important. The better the community social worker works, in collaboration with the community multidisciplinary team, the fewer children there are in the child care system. They are working to address the family situations early in the life of the problem. So if they identify problems and start working with this family early, fewer children will need alternative care. Once children are placed in family-based alternative care, community social workers will monitor their wellbeing and work for future family reintegration." (foster care social worker, Ungheni)
Children living outside of family care around the world
There are children without adequate family care in every country in the world — low, middle and high income, stable and fragile. Data on children in alternative care are notoriously unreliable, but estimates range between 2 and 8 million children living in institutional care. Research has also consistently found that the vast majority of children in these facilities have families, including at least one parent alive, while an even larger proportion have relatives. Instead, a combination of poverty, discrimination, lack of access to basic services and the relative ease of placement in care, are the main underlying factors behind their placement. There is growing recognition of the central role of family in child development and well-being and of the detrimental impact that loss of family care has on children. Increasing numbers of countries are working to make changes to their child care systems and mechanisms to promote and strengthen the capacity of families, prevent separation and ensure appropriate family-based alternative care options are available. Countries also increasingly understand that a strong social service workforce is integral to these care reforms.
The situation in Moldova
The population of the Republic of Moldova is 3,557,634, of which 20% are children under the age of 18. In January 2015, there were 3,644 children in large-scale residential care and 11,573 children in family-based alternative care, while in 2007 (at the beginning of the child care reform) there were 11,544 children in large-scale residential care and 6,562 children in family-based alternative care. Although the child care reform has resulted in significant positive steps forward in decreasing the reliance on large-scale residential care and establishing family-based alterative care options, issues such as family violence, alcohol abuse, parental economic migration, and limited access to effective primary social services and family support type services are common risk factors resulting in child and family vulnerability.
Community level workers are well-positioned to help
In Moldova the community social service workforce consists of Community Social Workers (CSWs). They are general social workers providing assistance at the community level to a range of clients, including children and families at risk of separation or out-of-home children. They provide individual case work, support households in applying for cash benefits and undertake community mobilization activities. There are around 1,200 CSWs deployed in the system of social assistance in Moldova, one per community of more than 3,000 population.
CSWs are working on a regular basis with children experiencing neglect, abuse and violence in the home and with their parents, extended family members and alternative care-givers. CSWs are important actors in the government’s policy of deinstitutionalization as they are the frontline in prevention of child separation and reintegration of children from institutional care to their birth or extended families. CSWs are engaged in referring children to alternative care and monitoring the well-being and quality of care of children in family-based alternative care, such as foster care, formal and informal guardianship, and family-type children’s homes.
Ways that community level workers are engaged in helping
CSWs have the following functions and responsibilities related to case management and working with children and families.
- Identification, referral and assessment - CSWs decide in the first instance whether a case should be opened and if so, whether it is a family support case which they can manage themselves using community resources or if it is a child protection case requiring a multi-disciplinary team meeting and subsequent referral to the District Child Protection Specialists and Gate-Keeping Commission.
- Planning, coordinating and implementing programs of support including referrals to other services - CSWs coordinate the community multi-disciplinary team, provide direct support to children and families at risk in the form of advice and practical support, are involved in removing children into care or support reintegration of children with their birth or extended families and into the community from institutional and family-based care. CSWs also have responsibilities for mobilizing support from other community actors to support individual children and families. In some districts of Moldova CSWs are involved in assessing potential adopters, guardians or foster carers of children at the request of District Child Protection Specialists who are responsible for these types of assessments. CSWs also have the responsibility to monitor children in placements with legal guardians, foster carers and in informal guardianship arrangements.
The type of support they need
In order to carry out this work effectively, CSWs need to be equipped with professional social work skills and knowledge so they can assess the needs of children and families; the socio-economic and cultural systems in the wider community; and to assess risk, identify the best interests of children based on a solid foundation of age-appropriate child development knowledge and plan and provide appropriate levels of intervention. Currently the training opportunities are provided mainly by NGOs and the Ministry of Labour, Social Protection and Family; very few districts are able to plan and provide initial and ongoing training opportunities to CSWs.
The CSW works in a matrix management structure with multiple reporting lines. The management arrangements vary slightly from district to district, but main structures and lines of reporting are largely similar as they are dictated by the Ministry of Labour and Social Protection and Family MLSPF guidance, including the CSWs’ job description, the mechanism for professional supervision of social workers, case management guide and by legislation – Law on Special Protection of Children, Law on Social Assistance, The National Strategy for Decentralization 2012-2015 and other legal and policy documents.
A performance management system is designed at the moment for the community social service workforce. The future appraisal system is meant to ensure a robust link with the current supervision process, which is the foundation upon which good appraisals are built. It is a two-way process that monitors, supports and develops good practice for CSWs.
Join us during Social Service Workforce Week in celebrating this work
Today we are featuring worker profiles of community level workers engaged in care reform in two countries. Please take some time to read these worker profiles on our website:
More information on this topic can be found in this working paper on The Role of the Social Service Workforce Development in Care Reform, recently released by the Alliance and the Better Care Network. Additional resources on care reform and community level workers can be found in the Alliance resource database here.
Also take a few minutes to review this webinar: Deinstitutionalizing the Alternative Care System for Children: Implications for the social service workforce with learning from Rwanda and Moldova
This video provides an overview of the way in which child and youth care workers from the Isibindi program in South Africa are supporting children and families. It is produced by the National Association of Child Care Workers and UNICEF.
Do you have more examples or resources? Join the conversation and tweet them using #SSWWeek or email us with updates and the Alliance will share your work with the broader network.
by Carol Bales, communications officer, IntraHealth International
“That was 2002 and stigma of HIV and AIDS was very, very high,” he says. “The prevalence rate was over 5% and a lot of people were in denial, not going for testing. And the children that had lost their mothers and fathers were neglected and treated terribly.”
At the time there wasn’t a lot of funding support for child protection at the local level in Nigeria. But Adangba signed up immediately as a community volunteer and received specialized training. He worked with community members to identify children in need, report cases of abuse and neglect, help children access care, and initiate a local response.
A shortage of social service workers to provide services for children in need
In 2014, there were 17.5 million orphans and vulnerable children in Nigeria. There’s also a shortage of trained social service workers like Adangba, who help these children receive the services they need. In Nigeria, 95% of orphans and vulnerable children do not receive any type of medical, emotional, social, material, or school-related assistance.
According to the most recent Nigeria Demographic and Health Survey, HIV/AIDS is still a major reason for the high number of orphans and vulnerable children. These children often lack basic support, like access to education and health care. Many are abused and neglected, affected by violence or trafficking, and struggle with mental, emotional, and physical health challenges.
And while the roles of doctors, for instance, are understood across countries, the roles of social service workers are often misunderstood and under-recognized. Social service workers often do not receive the support they need to carry out their jobs well and grow professionally, including appropriate and ongoing training.
Adangba has experienced this firsthand. “It’s overwhelming when you go to communities and the resources are not there to help as many people as you want,” he says. “The government ministries responsible for taking care of orphans and vulnerable children are grossly short of social workers, and those that are there lack capacity and need additional training.”
The Nigerian government has committed to helping these children and established the Orphans and Vulnerable Children Division in the Federal Ministry of Women Affairs and Social Development to provide integrated services for vulnerable children, focusing on the community level.
An important part of health teams
At IntraHealth International, where I work, we see social service workers like Adangba as an important part of health teams and vital to improving the population’s health.
To quote my colleagues, “Social service workers form a vital safety net for children and families made vulnerable by the HIV epidemic and other circumstances, providing access to an array of services to promote well-being and protection from harm, including referrals for primary health services such as family planning and maternal and child health care.”
Although IntraHealth’s work focuses on health workers, we’ve applied our health workforce expertise and approaches to strengthen the social service workforce. Together, frontline health workers and social service workers can identify and provide holistic care to more families in need.
We’ve even worked with Adangba.
Adangba worked with us on our global USAID-fundedproject, CapacityPlus—as well as the Ministry of Women Affairs and Social Development, UNICEF, and other partners—to coordinate the mapping of the state child protection system in Federal Capital Territory State. The goal was to strengthen the overall child protection system at the state level, improving the case management and referral processes so that children affected by HIV/AIDS and other vulnerabilities are identified and cared for in a timely way.
Part of a larger mapping activity in six states, the process involved identifying the laws, policies, and structures for child protection that currently exist in each state, assessing the system to see what needed to be improved, and identifying and costing priority changes. Nigeria now has a clearer picture of its social service workforce, and state governments are using the findings to improve services for vulnerable children.
IntraHealth has worked in other countries and at the global level to strengthen the social service workforce. For example, we’ve helped Malawi and Tanzania implement our iHRIS open source HR software to better manage and deploy their social service workforces; documented the composition of the social service workforce to move toward a common understanding of the functions, education, and training typically associated with different types of workers; and refined a framework for professionalizing the social service workforce. IntraHealth is also the fiscal sponsor and host of the Global Social Service Workforce Alliance.
Strengthen the system, so more children receive care
While some social service workers provide direct support to vulnerable children (like social workers) or focus on national-level policy and government coordination, Adangba continues to mobilize efforts at the community level. He’s now a protection manager with the International Rescue Committee in Nigeria.
Over the years he’s worked with traditional leaders, religious leaders, teachers, and health workers to organize efforts that recognize and respond to children’s needs.
Through his work, and community structures he helped set up, Adangba learned about four children who were living with their grandmother. Amos, Christiana, Elijah, and Wei (ages 2–17) lost their mother to HIV/AIDS. They have two different fathers, one is absent and the other died of HIV/AIDS.
“When I first met them, none of the children were going to school,” Adangba says.
He’s since enrolled all four children, and 300 more in similar situations, in school. He arranged for waivers for their school fees and worked with the community to provide books and uniforms.
For children with HIV and other health issues, he works with local health workers to get the medical care they need.
This week IntraHealth is joining the Global Social Service Workforce Alliance to participate in Social Service Workforce Week to celebrate the social service workforce and highlight promising ways to strengthen this vital workforce.
Learn about other social service workers like Mohammed Adamu Adangba. We’d like to introduce you to:
- Lintle Letsika, founder and director, Footprints of Hope, Lesotho
- Shelton Tshuna, child care worker, Zimbabwe
- Ssentamu Abdul, case care worker, Uganda
The Alliance has a wealth of information available on this topic, including this Webinar: Strengthening Social Service Systems through Cross-Sectoral Collaboration: Multidisciplinary teams in communities and local health facilities.
Preventing and Addressing Violence Against Children: The important role of the community level workerSubmitted by Grace Mayanja on Tue, 09/22/2015 - 8:00am
by Grace Mayanja, Chief of Party, USAID SUNRISE-OVC Project, Uganda
Orphaned as a child in a community heavily affected by HIV/AIDS, Doreen was defiled and became pregnant at 15, but she was determined to stay in school. She dropped out when students and school authorities shunned and stigmatized her, but with support from a community social worker, Doreen returned to school. The social worker advocated on Doreen’s behalf, lobbying and sensitizing parents, teachers and students. Doreen is one of the few girls who have returned to school after having a child.
Internationally there is growing attention to the prevalence of violence against children and huge momentum around preventing and addressing violence against children. Many studies, such as the Violence Against Children Studies (VAC), have added to the growing body of evidence that demonstrates how violence against children and the exploitation of children are global social, economic, human rights and public health issues, with significant negative health and social impacts.
Strategies to address violence, such as those outlined by THRIVES, reflect available evidence to help countries sharpen their focus on violence prevention priorities. UNICEF’s #Endviolence campaign has helped to foster global consensus that violence against children is unacceptable, and has also promoted strategies to prevent and respond to violence.
In Uganda, an estimated 25% of teenage girls are sexually abused, resulting in child motherhood and a high risk of HIV/AIDS and other sexually-transmitted infections (Uganda National Household Survey 2012/13). In addition, 38% of children experience violence at home and 32% at school. The evidence shows that children and adolescents in Uganda continue to face sexual exploitation, early marriages, human trafficking, drug and substance abuse, involvement in social unrest, and engaging in criminal activities.
We ask is enough being done to respond to the child protection needs of children affected by violence?
Protecting children from violence: the need to work together
Through our experience of supporting children in Uganda, we take a look at the role of community action in this area.
Grace Mukakimenyi is a government community development worker in the sub-county of Katikamu in Luwero district, Uganda. Through a process of community mapping, the most critically vulnerable families were identified in Grace’s area. This data was collected as part of the International HIV/AIDS Alliance-led, USAID funded, SUNRISE-OVC project which worked with local government and communities to improve services for children. Grace says, “Before SUNRISE, we didn’t know whether we were providing the right services to the right people.”
The role of community level workers
When it comes to integrating services, community workers play an essential role in creating demand for other services.
In the context of task-shifting, the concept of using community members to deliver certain basic health and social welfare services to their communities has gained currency. In 2013, the International HIV/AIDS Alliance conducted a systematic literature review of the role of volunteer community health workers in HIV care in sub-Saharan Africa. The study found that these workers clearly contributed to HIV service delivery and to strengthening the human resource capacity in their communities.
Evidence of the crucial role community level workers can play in preventing and addressing violence against children has been demonstrated by a five-year, USAID-PEPFAR funded project working with orphans and other vulnerable children (OVC) in Uganda.
The USAID Strengthening Local Government Responses for Orphans and Other Vulnerable Children (SUNRISE-OVC) project adopted a systems’ approach to protecting and caring for orphans and other vulnerable children. The project focused on strengthening district and community level systems by working with the central line ministry to increase capabilities and better respond to the needs of orphans and other vulnerable children in communities identified with high levels of child abuse and neglect to help improve each link in the child protection and care system. The ultimate goal was to support every orphan and other vulnerable children to attain their full potential.
The training of an army of 11,700 para professional social workers has been instrumental in supporting local government staff to identify vulnerable families, making first contact and referring them to services.
All the para social workers are community volunteers. They were already part of informal community groups such as village health teams and community development committees; others were local religious leaders or members of people living with HIV or adult literacy groups and therefore already active in the community. They received training in child protection, community mobilization, child abuse identification and reporting procedures, advocacy and data collection, using government and UNICEF developed curriculum.
Community para social workers conduct home visits to OVC families to ensure that children are in school and link families to more formal social service providers to support their well-being. Doreen, a 17-year-old mother and student, is an example of how the project has made a difference among Uganda’s youth.
Over 1 million children have benefited indirectly but all vulnerable children and families gain from a strengthened government and community systems. As USAID’s Mission Director Leslie Reed said, “When the child social welfare and protection system is functioning effectively, families and children have access to an array of quality services that promote wellness and protect them from harm.”
Para professionals are consistently identifying vulnerable families, providing first level response and referring them to services and to sub-county Community Development Officers. The system of identifying, responding and referring means an increase in preventing, responding and protecting OVC against abuse, neglect, violence and exploitation. These volunteers provide critical links between families and government services. Evidence from 43 of the districts in which SUNRISE-OVC operated indicate the majority (79%) saw a decrease in the number of orphans and other vulnerable children experiencing abuse between 2011 and 2014.
Through the work of community para social workers, the community has increased its understanding of child protection through community dialogue, and local government staff have increased their capacity at community level.
The impact of SUNRISE-OVC provides further evidence that a commitment to community systems strengthening including community level workers – which lies at the heart of growing movements such as the 1mCHW Campaign – must be adopted by those programming for vulnerable, hard to reach groups.
On this second day of Social Service Workforce Week, we are featuring worker profiles that display the skills and dedication that community level workers bring to addressing child protection issues. Please take some time to read these worker profiles on our website:
- Sowedi Kitanywa, Senior Probation and Welfare Officer, Kasese District, Uganda
- Kiko Joyce, Child Case Care Worker, Bantwana Initiative, Uganda
Please take a look at this SUNRISE-OVC project memoir.
For additional success stories, click on these links to see two of Uganda SUNRISE-OVC project case studies:
- A Case Study Highlighting the Results of Integrated Child Protection and Care Treatment Programming in Namutumba, Uganda
- Creative Community-Led Approaches to Preventing & Responding to Child Abuse: A case study in Uganda
Read this blog posted on the Global Social Service Workforce Alliance website by Kate Iorpenda, Senior Advisor on Children and Impact Mitigation, following her trip to Uganda to see the work of the SUNRISE-OVC project.
Take a few minutes to watch this video produced by CRS on addressing violence against children in Malawi.
Do you have more examples? Join the conversation and tweet them using #SSWWeek or send them to us via email and the Alliance will help to promote your work.
Welcome to Day One of Social Service Workforce Week! This week, we are celebrating the work of community level social service workers.
Building support for community level workers
When the Alliance was first launched, the most common area of interest expressed among our first few hundred members was to better understand and support community level workers. Many recognized that community level workers are the backbone of a strong social service system. Indeed, when we asked for voices of support during the launch in June 2013, a social welfare officer from Lesotho said,
“When we have an efficient, skilled and motivated social service workforce in our communities and its functioning well, children and their families have access to an array of quality services that promote their well-being and protection from harm, abuse and exploitation.”
Children’s well-being is dependent on the care provided to them by those around them. Immediate care providers such as families can find themselves facing challenges that can overwhelm their resources. When families are not fully able to cope on their own, the community can be a key source of support. Neighbors, friends, elders, teachers and community leaders working together and linking with government can form an all-encompassing care and support network that can promote the healthy development of children, strong families and safe communities.
However, the importance of this type of work often goes unrecognized. The role of those such as child protection workers, child welfare committee members, volunteer children’s officers, para social workers and child and youth care workers is often unclear, misunderstood, taken for granted and/or underfunded. Training programs can be brief and disconnected to a broader strategy of career development within a given country. Supervision and support is often lacking.
Recognizing the important roles of para professionals in the community
The Alliance members recognized these challenges and came together to form an interest group to advance knowledge and discuss solutions. Initially, the group focused on community level workers, and over time, due to both the Technical Brief on the Composition of the Social Service Workforce supported by the Alliance and ongoing conversations within the interest group, terminology has shifted to “para professionals.”
The Interest Group on Para Professionals in the SSW (IGPP) was announced in September 2013 and has been open to all members of the Alliance. Zeni Thumbadoo, National Association of Child and Youth Care Workers in South Africa, and Nathan Linsk, PhD, University of Illinois at Chicago, co-facilitate the group. Currently there are more than 30 member participants who represent seven countries from North America, Europe and Africa.
The group developed a set of guiding principles for working with para professionals to form a base from which to develop programs and activities related to how social service para professionals can be trained, developed, deployed and supported. The group also decided that an important contribution to this area of work would be the development of a competency framework for para professionals that would outline the functions and competencies of para professionals and could be used to provide program guidance, accountability and ultimately inform both training and supervision.
These two tools have benefited from input from many more people over the past year, including through presentations and discussions at conferences in the Philippines and South Africa and through two validation exercises in Kenya and Uganda with four groups of para professional social service workers and their supervisors.
The work of the IGPP and the Alliance aims to bring about more recognition of the important roles community level workers play in providing care and support to children and families. They raise awareness about child protection issues and mobilize communities to prevent and respond to child protection risks within the community. They assess the needs of vulnerable children and households and link them to appropriate services. They work together with health teams to promote healthy development and well-being of children. They support care reform efforts by supporting family tracing and reintegration for children outside of protective family care.
Social Service Workforce Week 2015: Celebrating community level workers
Therefore, for this year’s Social Service Workforce Week, we decided to focus each day on a particular area of work that would not be achieved without the dedication of community level workers. On Day Two, we will highlight the role of community workers in preventing and addressing violence against children. On Day Three, we will feature ways in which community level social service workers promote better health outcomes. Day Four will focus on ways in which these workers help to promote family based care and care reform.
On Friday, the full document including the competency framework will be made public and we hope that all of you will take a look, try it out and provide feedback to make the next edition even more robust.
In line with today’s general introduction, we are publicizing the Guiding Principles. Please take a look and let us know what you think.
Meet a colleague working in social services
Each day, we will also be featuring profiles of different workers. Today, we’d like to introduce you to Intan and Simon:
- Simon Peter Otieno, Project Manager and Founding Member, Make Me Smile Kenya
- Lutendo Maedza, Teamp supervisor and Mentor, National Association of Child Care Workers (NACCW), South Africa
- Intan Puspitasari, Case Worker, Pdak Cianjur, Indonesia
Advance global learning and share your expertise with others
Since our launch, the Alliance has attracted nearly 800 members from more than 70 countries. Each of you who has joined us has valuable knowledge and expertise to share with colleagues from around the world. We encourage you to do so through the following methods:
- Take a look around our website and the many resources it contains
- Check out our recent webinar on the guiding principles and competency framework that was live webcast from the Philippines
- Review the range of documents on the Alliance resource database that highlight the role of community workers.
- Our hope is that you will share your documents or insights about your own initiatives in this area so that others might profit as result of your work. You can send documents via email with a short description to disseminate them to this network.
- Join the conversation this week on Twitter! Do you think community level workers are the backbone of a strong social service workforce? Use #SSWWeek or tweet us @SSWAlliance to explain why or tell us about your programs or post a message on our Facebook page.
Thank you for joining us this week as we celebrate the work of those who have dedicated their lives to improving the lives of others. We look forward to continuing to exchange promising practices and innovative ideas in the shared spirit of strengthening the social service workforce.
On the final day of the National Association of Child Care Workers (NACCW) biennial conference in Cape Town, South Africa, the youth delegation took the stage chanting, “We are the answer!” The message was to the child and youth care workers there, as well as the South African government, what issues were important to them. They asked CYC workers to help them address the issues that are most challenging to South African youth, including gang violence to teenage pregnancy to illicit drug use.
On August 12, the United Nations will celebrate International Youth Day through the theme “Youth Civic Engagement.” Frequently, there are few opportunities for youth to engage with their government, but the NACCW offers the youth they serve with a platform to speak about the issues that are most critical in their lives and in society at large.
The Alliance values youth civic engagement as a key component of protecting vulnerable children, youth, and families. The youth at the NACCW conference demonstrated their deep knowledge of what they need to live healthy, safe, and productive lives. The social service workforce must take heed of these messages, joining with youth to achieve sustainable human development.
Learn more about youth civic engagement:
Alliance resources on youth and community advocacy:
Meet Grace Kozak, Alliance Summer MSW Intern
Grace Kozak is a Master of Social Work student at the University of Michigan, in Ann Arbor, Michigan, USA, studying community organizing and community social services with a certificate in global social work. She has spent the last three months working with the Global Social Service Workforce Alliance in fulfillment of her internationally-focused internship.
International Internship Placement
During her time with the Alliance, Kozak has participated in a wide spectrum of activities. She was able to attend and participate in the Alliance’s in-person Steering Committee meeting, the second annual Global Social Service Workforce Annual Symposium, and the National Association of Child Care Workers biennial conference in Cape Town, South Africa. While in South Africa, Kozak also visited the Isibindi project, learning first-hand about South Africa’s response to the AIDs crisis in the context of child care.
She has also focused much of her time on developing an evidence matrix for the Alliance’s Building Evidence Interest Group. The interest group was created to build a body of evidence to support workforce strengthening and monitor the impact of workforce strengthening efforts. The matrix is designed to be a systematic literature review to highlight gaps in research of the social service workforce, with these gaps revealing where more analysis is needed to better plan, develop, and support the workforce. This was Kozak’s first experience with a literature review and she found it to be a good challenge, “I was able to learn new skills while working on the matrix,” she said. “I worked with the University of Michigan social work librarian to make a research plan. I learned more about how to conduct comprehensive searches and how to filter through a lot of information to find what is needed.”
Kozak has also found ways to incorporate her other interests into this field placement. “I’m interested in human trafficking and social work, and so I was able to write a short post about these topics for World Day Against Trafficking in Persons.” Kozak is also passionate about social policy and advocacy, and she met with Dina Kastner, senior field organizer for the National Association of Social Workers (NASW) to discuss NASW’s current advocacy efforts.
Interest in Global Social Work
Kozak, who will graduate in December 2015, also has her Bachelor of Social Work degree from Ball State University in Indiana. There, she had the opportunity to undertake three social work internships. The first was with Enslavement Prevention Alliance- West Africa (EPAWA), an anti-trafficking organization where she spent a semester while studying abroad in Accra, Ghana. She cites this experience as the catalyst that got her thinking about her role within global social work.
“When I was at EPAWA, I realized that I wasn’t interested in direct service provision for my career. Global social work was still appealing to me, but I was becoming more interested in community-level work and cross cultural collaboration to help solve social problems.”
Kozak’s interest in global social work brought her to the University of Michigan School of Social Work’s Global Activities Scholar Program, which is an opportunity for students who want to work with communities and organizations in a global context. In addition to globally-focused courses, students complete one international field placement. “I wanted a placement that would give me exposure to global social work in a way that emphasized cross-national and cultural collaboration. The Alliance was a perfect fit for me.”
While Kozak is still interested in global social work, her interest in policy advocacy and political organizing has grown. She hopes one day to merge these two passions.
“I’ll be graduating in December, and having this internship has made me more confident in the direction I want to go with my career. I’m still passionate about the potential social work has to make a global impact, and seeing the way the Alliance helps to facilitate this impact has made me hopeful about the future of global social work.”
Ms. Kozak will be leaving the Alliance on August 10 to return to Michigan for her final semester. After graduation, she hopes to work in community-level organizing in East Lansing, Michigan.
by Yanica Faustin
When people find out that I experienced the 7.0 magnitude earthquake that struck Haiti in 2010, they are understandably curious.
But when I tell the story, even five years later, my heart rate rises. I get goosebumps. My palms sweat. I feel short of breath, and often tears well up in my eyes.
I was half asleep in the backseat of a car in sweltering Port-au-Prince when we felt the vehicle rock back and forth as if riding a huge wave. Buildings and houses began to fall, creating clouds of dust, and from those clouds people were running, barely escaping as the buildings collapsed.
We grabbed each other and ran, and every way we turned we saw destruction, despair, and death.
We made our way to my family’s home down the middle of a wide street with thousands of other people, quickening our pace as the aftershocks followed, some feeling as powerful as the initial quake. We slept outside on the ground that night as the earth continued to tremble. As each aftershock came and went, people erupted in song and prayer.
As I write this now, the memories—rubble piled high, screams and cries, having to step carefully to avoid the dead bodies lining the street, putting rubbing alcohol under my nose to avoid the smells—flood my mind.
When I first got back I had trouble in social interactions. I felt guilty, alone, and on edge. I woke up in cold sweats, and could feel the ground shaking even when it wasn’t.
These were all symptoms of the post-traumatic stress disorder (PTSD) I was suffering. With the help of therapy and treatment, many of my symptoms have faded. But I was lucky to have access to mental health care after the earthquake. Most Haitians did not.
What happens to a population’s health and well-being under that type of widespread, long-lasting stress? Especially when there are no trained health or social service workers there to help address the effects?
The earthquake in Haiti killed approximately 200,000 people. More than 300,000 were injured, more than 1 million displaced. Research in 2013 found that 90.5% of survey respondents had at least one relative or close friend who was injured or killed. And 93% saw dead bodies.
The psychological toll has been extraordinary for the people of Haiti, a country that already faced the many stressors of disease and chronic poverty: almost a quarter of the population experienced PTSD in the aftermath, and even more experienced a major depressive disorder.
Haiti’s health workforce was woefully underprepared to provide the physical care the population needed then, much less the psychosocial and mental health services. Since the quake, there have been some mental health capacity-building projects there. But mental health care is still a neglected need in Haiti—and around the world.
On July 14, the World Health Organization released the 2014 Mental Health Atlas, which provides a comprehensive overview of global mental health. This fourth edition includes data from 171 countries and shows dramatic differences in resources for mental health and access to care among high-, low-, and middle-income countries.
Mental illness affects about 1 in 10 people around the globe, yet only 1% of the global health workforce is dedicated to mental health.
Training for mental health workers is essential if we are to improve the capacity of the health workforce around the globe. And it could have far-reaching effects, as poor mental health is often the root cause of other health conditions, and it can inhibit people from participating in social and economic development.
The World Health Organization outlines three ways to make the mental health workforce a priority:
- The disparity in financial expenditures per person in global mental health in high-, low-, and middle-income countries must be bridged. Expenditures should be around $50 a day per person (as they are in high-income countries) instead of $2 a day.
- A greater percentage of the health workforce must be allocated to global mental health. But because there is a global shortage of health workers, the workforce must also increase overall so more health professionals can be trained to enter the field of mental health.
- Policies, plans, and procedures must be put in place to create resilient health systems that can provide mental health resources before and after emergencies, such as the quake in Haiti.
Despite the fact that noncommunicable diseases (NCDs) have become the leading cause of death across the globe, we have yet to make them a clear global health priority. And our discussions of NCDs often ignore mental health.
We must begin to consider the impact the quake had on mental health in Haiti, and make mental health care a priority there and around the world.
This post originally appeared on VITAL, the blog of IntraHealth International. More information on supporting children and families in emergencies, including mental health services, is available on the Alliance's website.
When people find out that I experienced the 7.0 magnitude earthquake that struck Haiti in 2010, they are understandably curious.
But when I tell the story, even five years later, my heart rate rises. I get goosebumps. My palms sweat. I feel short of breath, and often tears well up in my eyes.
“My dream has always been to work with children,” said Siphiwe Sikhasa, between playing at the soccer field at the Safe Park in Grabouw, South Africa. Just 45 minutes outside of cosmopolitan Cape Town, the small town with dirt roads looks like a world away.
Sikhasa is a coordinator of the Safe Park, a space where children of all ages can safely play, receive homework help, discuss issues burdening young minds, learn valuable skills and oftentimes receive a hot meal. His passion for helping children is apparent as he runs the field and freely gives hugs and high fives. On this particular overcast, drizzling June winter day, there are approximately 20 children playing soccer and 110 children at the Safe Park. Most days there are nearly 200 children.
The Safe Parks are a component of the 309 Isibindi programs established in 161 communities throughout South Africa by the National Association of Child Care Workers (NACCW). Meaning “courage” in IsiZulu, Isibindi is serving more than 200,000 vulnerable children nationwide, including those who are living in grandparent-headed households; child-headed households; have a disability, HIV/AIDS or other disease; are caring for ailing family members; are victims of abuse; face struggles at school or home; or are affected by a number of other factors that could lead to unsafe situations.
In addition to working at the Safe Park, Sikhasa and other trained and supervised Child and Youth Care Workers (CYCWs) continue to help families in their immediate communities by going door-to-door to assess needs and offer support to those who need it. Each worker aids up to 48 children, monitoring a child’s progress, acting as their confidant and providing support in various areas as needed in a child’s life. CYCWs build relationships with children through interaction in typical daily routines- cooking together, reading, household chores and life skills.
The Nghonyama* family is one of the thousands visited an average of 3-5 times a week by a CYCW. Since 2011, Edwina is the CYCW who has been working with the family’s five children, currently ages 5-17, and the grandmother caring for the children. Three of the children lost both parents to AIDS, one child was abused by his step-father and one was abandoned by her parents. In all cases, Granny Nghonyama stepped in. Some are her biological grandchildren, some she calls her grandchildren. “It doesn’t matter whose child it is, I just have a deep love for children.” Budgeting, homework and overcoming the stigma associated with HIV/AIDS haven’t been easy for this blended family, but have been made easier with the help of Edwina. She has helped to link the family with additional services, including a social worker and government subsidies.
Isibindi is in the second year of a five-year scale up and is being funded by PEPFAR through USAID. With a goal of training 10,000 CYCWs, to date 4,402 CYCWs have been trained.
The Isibindi model has helped formalize child and youth care work as a profession. The program trains unemployed people selected by their communities in a child and youth care accredited training program. Two universities in South Africa now offer a CYCW degree and more than 6,000 workers have been formally registered with the South African Council for Social Service Professions under a new statutory regulation championed by the NACCW.
The Para Professional Interest Group of the Global Social Service Workforce Alliance has drawn from the expertise of NACCW and many others to develop a competency framework for para professionals that includes a section on functions and competencies specific to auxiliary child and youth care workers. The framework is being tested and a first edition will be released later this year. The competencies build upon the Alliance’s global efforts to help plan, develop and support all levels of workers who make up the social service workforce.
In South Africa, the program has been embraced by the government as a best-practice model. Several other countries have recently expressed interest in developing new cadres of CYCWs and are receiving support from NACCW to do so. Ministers from the county government of Kisumu, one of 47 county governments in Kenya, recently visited the Grabouw Safe Park and met families benefiting from the support of CYCWs. “We have engaged the South African network to advise us and help us launch the Safe Park model. I want to…learn how to implement this program,” said Jennipher Atieno Kere, Executive Member for Education, Youth, Culture, Gender and Sports. The Safe Park model is also being replicated within South Africa by more than 20 other organizations and in Zambia.
“While the NACCW developed this program, we’re happy to share it with the world. These child and youth care workers are impacting one life, one family and one community at time, leading to real change here in South Africa, and eventually around the world,” said Zenuella Thumbadoo, Deputy Director, NACCW.
As Sikhasa continues to develop his skills as a CYCW, he prides himself on being a positive male role model to the young lives he influences. “I have younger siblings who have always looked up to me, and I want to continue to be a model for them, and all kids.”
(*names changed to protect the identity of the family)