More than half of the 17.1 million children under the age of 18 in Uganda live in situations that present significant risks to their physical, emotional, and/or mental wellbeing. The Government of Uganda estimates that up to 8.6 million children (50% of all Ugandan children) are moderately or critically vulnerable due to factors including high rates of poverty, disability, high HIV prevalence, low school persistence, and harmful cultural norms and practices that not only put girls and women at disproportionately high risk for HIV but also increase the vulnerability of boys to neglect, abuse, and exploitation.
To address these issues, World Education's Bantwana Initiative led a consortium of development partners to implement the Better Outcomes for Children and Youth in Eastern and Northern Uganda program, an integrated community approach designed to scale up proven models of health, education, child protection, and youth and livelihoods services while strengthening referrals, networking, and case management systems between community (informal) and district (formal) systems.
The USAID Better Outcomes for Children and Youth Program (BOCY) mitigated the risks and impacts of violence and HIV for 137,000 vulnerable children and families, including 19,036 children, adolescents and caregivers living with HIV across 22 districts in eastern and northern Uganda. BOCY's HIV and social protection services built resilience in children and families, and improved community to district social welfare structures to coordinate and deliver HIV and social protection services within a case management approach and clinic- community referral network in partnership with clinics, schools and communities.
An estimated 95,000 children and adolescents live with HIV in Uganda and another 8 million children are highly vulnerable to HIV and violence, especially adolescent girls and young women. WEI/Bantwana, with local partners and the government of Uganda, aimed to strengthen coordination and quality service delivery to build child and family resilience while contributing to Uganda's HIV epidemic control goals.
The Better Outcomes team utilized Bantwana’s proven case management and integrated health and social welfare referrals model in all 20 districts through targeted training of community resource persons in parasocial work, case management, and referrals to build the capacity of local government and CSOs to better coordinate, plan, advocate for and expand resources for critical service delivery. A sound Monitoring and Evaluation (M&E) approach ensured that age and gender-disaggregated data was captured and used for decision-making to improve services, advocate for increased financing and refine program design.
By the close of the program, BOCY has delivered services to 137,000 vulnerable children and caregivers across 22 districts. At program close, 95% of children and youth knew their HIV status, 90% were on ART and 82% of children and adolescents living with HIV were virally suppressed. BOCY improved economic stability of 22,669 families, 83% of whom covered basic necessities by the close of the program. BOCY savings group member raised more than 260,000 USD through the OVC Fund embedded in savings groups at scale who supported 95,000 children with critical health, education, and nutrition services. BOCY delivered evidence-based parenting services to 53,000 families and GBV prevention to 74,253 adolescents including 20,765 adolescent girls and young women, 99% of whom remained HIV negative after four years. BOCY left behind 137,000 empowered children and caregivers, a robust cadre of 2910 trained parasocial workers, 258 functional clinic community referral networks, 22 strengthened local governments and 5 strengthened local partners able to continue to deliver integrated HIV and social protection services within a case management approach and clinic-community referral network into the future.
Bantwana’s evidence-based gender and age specific interventions are designed to meet the evolving needs of HIV-infected and -affected OVC, youth, and their caregivers across the developmental and HIV continuum with a focus on very young children (under 5) and adolescent youth, particularly girls. Based on evidence from Bantwana’s programming in Uganda and in the region, the team uses clinics, schools, village savings and loan associations (VSLAs), and other community-based groups as entry points to reach children, youth and caregivers with a comprehensive services. Aligned with the new OVC and programming guidance under PEPFAR 3.0, Bantwana’s inclusive targeting approach prioritized HIV+ children, youth and their caregivers for services as well as children and youth most at risk of HIV transmission.
Better Outcomes was a seven year program that operated in 20 districts in eastern and northern Uganda, which reached more than 24,000 households and 144,532 caregivers and children with comprehensive services across the HIV continuum of care. World Education/Bantwana collaborated with international partners Mercy Corps, AVSI, and mothers2mothers as well as national partners Youth Alive, UWESO, THETA, and FOC-REV.
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