The Impact of Community Caregivers on OVC in Côte D'ivoire: Improving Service Delivery to Vulnerable Children

Background: Côte d’Ivoire has one of the highest adult HIV prevalence rates in West Africa, estimated at 3.7%. HIV-related orphans and vulnerable children (OVC) are estimated to number 410,000; 61,000 are children living with HIV. In Côte d'Ivoire, community caregivers (CC) are often recruited and supported by local NGOs to provide care and support to children left vulnerable by the epidemic.

Objective: The study examined the impact of CCs on health and social outcomes for OVC and their households 

Methods: This study used a mixed methods approach to evaluate the impact of 453 CCs’ care on 23,000 OVC in Côte d’Ivoire. The study used a quasi-experimental design to compare an intervention group of 512 OVC under the program to a control group of 212 OVC not under the program. Participants were selected from 5 regions in the country. Additional qualitative data analysis was used to investigate factors that enhance or impede CCs’ work in the field.     

Results: The average age of children in the study was 10.8 years (SD=4.3) for the intervention group and 10.2 years (SD=4.2) for the control group.  On average, CC- supported OVC had received 2 years of support. Eighty-six percent of the households interviewed indicated a high level of satisfaction with the support they received from their assigned CC.  About half of the OVC and households received 2 clinical services and about 68% received 5 to 8 services out of the 10 available. On average the CC- supported OVC were 7 times more likely to receive better care and service compared to non-CC supported OVC. They were also more likely to be connected to the community through social support groups than those OVC without CC support.

Conclusions & Implications: CC-supported households had better access to clinical and social services.  The results consistently showed that OVC got better access to care and at a higher rate than those not being supported by a CC.  Programs should consider using CCs to support adherence to HIV treatment, improve psychosocial wellbeing of caregivers and children and increase overall access to needed services.