In 2008, I joined USAID as an Orphans and other Vulnerable Children (OVC) Specialist, and I am still in the same position. As the HIV epidemic has evolved, so has the OVC portfolio. Previously, the portfolio was focusing more on addressing the welfare issues of children left behind by parents who would have died from HIV/AIDS. But with the advent of medication, there are fewer deaths.
My greatest achievement has been ensuring that the OVC portfolio remains relevant to the HIV response.
The focus is now more on ensuring that parents and children know their HIV status and–for those who are positive–ensuring that they are on and stay on medication with a suppressed viral load. The portfolio now links the communities (households) and the health facilities, and addresses the social determinants (household income, gender-based violence) that affect the health outcomes of children and adults. It now has strategic linkages with the Pediatric and Maternal Clinical Branch, and we now have a Job Aid for OVC Case Managers on Pediatric Dolutegravir 10 mg (pDTG)–something we never dreamed of in 2008.
My greatest achievement has been ensuring that the OVC portfolio remains relevant to the HIV response through advocating at various fora for continued focus on how children are infected and affected by HIV/AIDS. Also, I have been championing the rights of people with disabilities and helped the Mission to successfully apply for disability program funds on three occasions. Under the OVC program, there now is a subpopulation of children on antiretroviral therapy (ART) who have a disability.
I enjoyed managing the 2014-2017 Integrated Management of Paediatric AIDS/HIV Care and Treatment (IMPACT) activity co-funded by USAID and ELMA Philanthropies, whose objectives were to create demand for pediatric ART while building the capacity of local health facilities to integrate and provide quality pediatric ART services. We helped many children get tested and for those that tested positive, linked them to care and treatment. The project also introduced case management, a concept from social welfare as an implementation model offering adherence support to children on ART.
I have been championing the rights of people with disabilities and helped the Mission to successfully apply for disability program funds on three occasions.
With PEPFAR, I’ve seen big changes in the development of the current strategy. The process was very participatory, and the outcome as shown by the strategic pillars and enablers are easy to understand and implement.
I like the “transformative partnership” pillar, as it reminds program staff of the need to work in partnerships if they are to achieve results. The “sustaining the response pillar” is equally important, as we need to ensure that activities continue beyond the implementation period.
Collen Marawanyika is an Orphans and Other Vulnerable Children (OVC) Specialist at USAID Zimbabwe.
