Recently, I attended the Sub-Saharan Africa Regional Case Management Learning Forum hosted by the Government of Zimbabwe, UNICEF and World Education Initiative (WEI) 13-15 September 2017.
Case Management is an approach in child protection which includes measures to identify, assess, plan, provide services, follow-up, and monitor and evaluate a child protection case. Collaboration and multi-sectorality are key, bringing together communities, government and civil society in the form of social services, health, justice services on each case so not lose the child when transitioning between sectors. The government appointed case manager remains responsible and coordinates all support provided to the child.
The Forum agenda included a tour of Binga, in the north–eastern Zimbabwe for participants to engage with some on-the-ground implementers.
The approach has made distinct efforts to be HIV and Disability inclusive and incorporate an online data management system.
From the country presentations and discussions, it is clear that Zimbabwe had gone furthest in implementing the case management system. It follows then that the country would have the most to share in terms of challenges and bottle necks encountered.
Aside from technical issues, two fundamental implementation challenges which caught my attention were low-reporting of violation cases, and lack of follow-through to see the cases addressed to completion. While these challenges were articulated and some possible solutions flagged, the underlying causes were not explored.
Why, I asked myself would households not report when clearly much time, effort and money had been invested in identifying and training community care workers and establishing systems to process abuse cases as per government policy?
The answer apparently lies at the nexus of power and household economics. In many cases, perpetrators are known to the households and are often bread winners in the child’s household or in their own households. This fact is borne out by research in Malawi and South Africa. It follows that a number of people/households would be affected if the perpetrator were arrested. As a result, families are intimidated into silence and/or accept compensation by cash or livestock.
In addition, in such an environment of silence would likely breed corruption among some law enforcement and other officials who would take advantage and accept bribes to secure inaction on their part. This in the long run, would discourage even the few who would seek redress through the legal system.
The second major implementation challenge was the cost barrier to accessing services, prompting the development of a transport voucher system to aid survivors and their families to travel to hospitals and courts. This intervention did not have intended impact due to delayed payment of transport operators.
These two challenges reminded me that the basics have to be first in place for any system to function optimally. A functional social protection system would boost the operation of the child protection system by addressing the economic barriers to service uptake. If this were true the question then is could the distinction between child protection and social protection be arbitrary, at least in low income countries?
One presentation at the Forum, the Zimbabwe Harmonised Social Cash Transfer Programme, outlined a small pilot programme that seeks to establish the evidence for linking cash transfers to child protection outcomes. These learnings need to be brought more into the mainstream case management thinking.
At the very least, it is vital to note that simple referrals may not be enough, there is need for close collaboration in the targeting, delivery and scale up of child protection and social protection interventions.
Many African states have an established history of social protection, including cash transfers, and in-kind interventions such as school feeding programmes and emergency food aid. According to a RIATT-ESA report (Resourcing Resilience 2016) there has been an expansion in unconditional cash transfers since the 1990s as part of social development and poverty reduction efforts. The South African child assistance grant stands out as protecting children from the extreme effects of poverty. It is now time to for the region to build on this momentum and target the poorest households not just with cash but with a package of interventions that includes parenting and family support and community mobilisation.
Contact Naume Kupe - email@example.com
Z. Ganda and L. Muwoni, Making Cash work for Child Protection - Redefining the HSCT Theory of Change in Zimbabwe, Ministry of Public Service, Labour and Social Welfare and UNICEF, Zimbabwe
Meink, F Oxford University; UNICEF Malawi Violence against Children Study Report cited in RIATT-ESA Webinar 2015
Gittings L, Toska C, Hodes R, Cluver L, Zungu N, Govender K, Chademana KE, Gutiérrez VE. Resourcing resilience: The case for social protection for adherence and HIV-related outcomes in children and adolescents in Eastern and Southern Africa. RIATT-ESA Report, June 2016.
Integrating Case Management for Vulnerable Children, February 2017. UNICEF Eastern and Southern Africa Regional Office (ESARO) and Maestral International.