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Identifying Interventions that Benefit OVC
Once you have analyzed the factors that contribute to children falling through the cracks and the consequences of such failures, you will need to analyze your project to see if it could potentially contribute to the problem or could, alternatively, help diminish the factors creating these OVC groups and the negative outcomes they experience as a result. The result of this phase of analysis will be a long list of possible interventions or adjustments that you could make to your project to maximize its positive impact on OVC, while minimizing its negative impact.
This can be done using the worksheets below. In the first column, list all of the factors or roots of the tree that you identified during the previous exercise. Include a row for each factor identified. At this stage, you will be consolidating all of the factors that you identified for different OVC groups for which you developed a problem tree. If different trees identified the same factors, just include that factor once in your list. Don't be concerned that your list does not differentiate between the different levels of your tree, it will not affect the outcome of the exercise. If you are open to financing coping interventions for OVC (rather than just preventive), you should do the same with the branches or consequences of your problem tree.
In the second column, you will note ways in which your project might contribute to or exacerbate the factor mentioned in the first column. For example, a program that offers HIV testing services may exacerbate the problem of depression among children whose parents are newly diagnosed with HIV/AIDS. In this case, we would note this in the second column. In the third column, we will note ways in which the project could serve to diminish or eliminate a cause or factor. For example, the project could plan to offer psycho-social counseling services to children in HIV/AIDS affected households. Be creative here, keeping in mind that even small adjustments to the project may make a difference. You will worry later about eliminating those interventions that are not feasible
| Factors/Causes (all factors identified in bottom half of your problem tree) |
Project Exacerbates |
Project can help diminish or eliminate |
| Mother dies |
No |
Indirectly, through AIDS prevention |
| Father dies |
No |
Indirectly, through AIDS prevention |
| Maternal death in childbirth |
No |
Indirectly, MAP's effort to test all pregnant women could increase chance that these women receive prenatal care and trained assistance at birth, thus lowering risk of maternal death |
| Limited access to tertiary health care services |
No |
No |
| Limited healthcare budget |
No |
MAP will inject significant resources into the healthcare budget - increased supplies, capacity-building etc. at the national and local level |
| Not enough trained doctors in rural areas |
No |
MAP should consider including incentives to attract young doctors to work in underserved areas, as a prerequesite to getting a medical license - at a minimum, these should include housing; another option would be to require graduating doctors to spend 1 to 2 years in underserved areas immediately after completing their studies |
| Unsanitary conditions at delivery |
No |
MAP planned training of public health workers on AIDS prevention can include a module on basic sanitation |
| Poorly trained traditional birth attendants (TBAs) |
No |
MAP could work in partnership with TBAs to get pregnant women into the clinics for testing; as part of this partnership, MAP could offer training to TBAs in basic practices of safe delivery and minimizing transmission from patient to TBA and mother to child and in new skills that will extend the role of TBAs in maintaining community health |
| Contaminated transfusions and needles |
MAP could exacerbate this problem if it does not adequately train the primary healthcare workers responsible for testing pregnant mothers for HIV infection. |
Training of primary healthcare workers should include a module on minimizing transmission through transfusions and infected needles |
| Consequences/Effects in top half of your problem tree) |
Project exacerbates |
Project help diminish or eliminate |
| Loss of affection and nurturing |
No |
Project can develop psycho-social counseling for orphans and their caretakers |
| Depression |
Knowledge of HIV+ status of self or parents may cause some children to become depressed |
Project can develop psycho-social counseling for orphans and their caretakers |
| Inadequate hygiene |
No |
Community health workers trained with MAP funding can educate children and grandparents about the importance of hygiene; community support network can be organized to assist households with orphans in maintaining personal and household hygiene |
| Loss of guidance and discipline |
No |
Psycho-social counseliong services can make up for lack of parental guidance; community support network should address this issue |
| Risk of prostitution and other risky behaviors |
No |
HIV prevention education program should target orphans to make sure they use protection; provide alternative income generating activities to households with orphans |
| Loss of regular primary healthcare |
No |
Project will greatly expand the availability of primary healthcare services; the project should finance fee waivers or healthcare vouchers for orphans |
| Increased economic distress |
No |
MAP should finance income-generating activities for households with orphans |
| Child labor |
No |
Psycho-social counselors should educate children about the risks of child labor; households with orphans should receive transfers or food supplements to make it un-necessary for children to work |
| School drop out |
No |
MAP should finance conditional transfers for orphaned children to keep them in school |
If you are a policy-maker with no specific project in mind, this exercise will be useful to you as you seek to identify a package of interventions that could help address the OVC problem in the country. In your case, the heading for the second column should be “Existing policies or programs that exacerbate this factor/consequence” and the heading for the third column should be “New policies or programs needed to address this factor/consequence”, (See the section entitled Making National OVC Policies for more information.)
The table above illustrates what this exercise will look like when complete. Click her for another example developed in the context of a transport project.
You are likely to find that some of the ideas that come up during this process are not very good, based upon past experience elsewhere, research, or incompatibility with the Bank's mission. The section on common pitfalls may help you weed out some of these bad ideas.
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