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Africa Fund Concept Paper: Supporting the Income and Basic Needs of AIDS-Affected Households (SIMBA)



1.0 Purpose And Rational For The Proposed Activities

The spread of HIV/AIDS in Zimbabwe has reached epidemic proportions the significance of which can not be
overemphasized. Ramifications of the pandemic are manifested at the macroeconomic, social and household levels
of the economy. The spread of HIV is significantly reducing the country’s active and productive labor force due to
the fact that more than half the cases affect people in their prime. In fact, the latest estimates indicate that 1600
people die of HIV-related illnesses every week.1 Social consequences are revealed through family systems being
dissolved and restructured, and increases in prostitution and crime as alternative means of obtaining income.

The most extreme consequences, however, are revealed at the household level. Women in particular bear the brunt
of this pandemic because they are usually the main caregivers, often left to do so in isolation. Through illness or
loss of family members, the capacity of families to meet their basic needs and generate income is acutely impaired.
While income generation is a challenge for all Zimbabweans, unfavorable economic conditions and the turmoil
associated with HIV/AIDS profoundly destabilizes the living conditions and coping mechanisms of HIV/AIDS-
affected households, for whom social and financial expenses become increasingly burdensome. 2 Young children
often become heads of households by default. To date more than 500,000 children have lost one or both parents to
the disease.3 Families in which one or more members is HIV-positive or have AIDS are likely to experience a
reduction in income and productivity precisely as their spending patterns change to care for the sick. Furthermore,
school-age children often interrupt their education to become caretakers for ill parents or siblings, to contribute to
household income or food needs, or simply because the family can no longer afford school fees.4

There are currently over 140 AIDS Service Organizations (ASOs) whose current mitigation efforts are primarily
socially oriented such as HIV/AIDS education, prevention, and counseling services. While such services are
necessary to curb the spread of the disease, a more holistic approach is needed to address both the social and
economic dimensions of the problem. HIV/AIDS-affected households urgently need more reliable and self-
sustaining sources of income to withstand the threats associated with HIV/AIDS and to increase HLS. However,
virtually none of the existing ASOs have the capacity to address the income generation needs of HIV/AIDS-affected

In response, CARE is seeking support from the Africa Fund for the Supporting the Income and Basic Needs of
AIDS-Affected Households (SIMBA) project. SIMBA, the Shona word for strength, represents a new CARE
initiative aimed at determining how local Zimbabwean ASOs can best address the financial and non-financial
services needs of their clients, i.e. persons and households severely affected by HIV/AIDS. The project ultimately
aims to mitigate the adverse effects of the pandemic by strengthening the capacity of ASOs to increase their clients’
ability to sustain their livelihoods through micro-enterprise development and improved income generation. The
project will make a deliberate effort to work with ASOs that target various client groups, specifically, women,
youth, orphans, and commercial sex workers in urban (high density) and rural areas. Consequently, the project will
effectively link CARE’s strengths with the health and income-generating needs of the HIV/AIDS-affected
population in Zimbabwe.

1.1 Goals and Objectives of the Intervention

1.1.1 Project Goal

The overarching goal of the project is to strengthen and sustain the capacity of HIV/AIDS-affected households to
increase household income, economic security and employment opportunities. Towards the achievement of this
goal, the project’s purpose is to develop, test and refine a clearly articulated process for identifying representative
ASOs, assessing their strength’s, capacity and resources, and subsequently developing a partnership intervention

AIDS Pandemic Bites Deep into National Health Budget, The Herald – September 2, 1999
HIV/AIDS Socioeconomic Impact Assessments – Forsythe and Rau
AIDS Pandemic Bites Deep into National Health Budget, The Herald – September 2, 1999
HIV/AIDS Socioeconomic Impact Assessments – Forsythe and Rau

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Africa Fund Concept Paper: Supporting the Income and Basic Needs of AIDS-Affected Households (SIMBA)

that effectively integrates financial or non-financial services into existing programs. The development of a defined
process, drawing on the experiences and lessons learned from the SIMBA project will be instrumental for future
collaborative efforts between ASOs and MEDPs in Zimbabwe and in the region of Southern Africa.

1.1.2 Project Objectives

The following objectives will be achieved in pursuit of the project’s goal and purpose:
• Development of a defined methodology for identifying, assessing and developing effective partnership
interventions with ASOs such that their capacity is strengthened to increase their clients’ HLS.
• Development and refinement of an appropriate methodology for delivering financial and non-financial services
to HIV/AIDS -affected households. In particular, women, youth, orphans, and commercial sex workers.
• Improved HLS and income generation of HIV/AIDS-affected households
• Generate conclusions and lessons learned that can be applied throughout the Southern African sub-region.
• Identify and assess potential strategic partners (e.g. Africare, PACT) for future complimentary ventures.

2.0 Description of Proposed Activities

The sequence of the project’s activities focuses on the development of a process of identification, assessment,
intervention design, and linkages. CARE has acquired significant experience developing appropriate methodologies
for implementing MEDPs in partnership and can adapt existing methodologies to meet the needs of the ASO and
client group. Interventions will not be prescriptive, rather the project will adopt a research/action strategy that will
pilot various methodologies that are appropriate to the assessed needs of the ASOs and clients. Annex 1 provides a
flow chart of the project’s activities. A schematic timeline outlining various project activities over the two-year
project time span is attached as Annex 2. Project activities can generally be grouped into the following components.

2.1 Identification of Representative ASOs

Given the numerous organizations that are actively working with HIV/AIDS-affected populations, the prospect of
forming collaborative efforts with ASOs is promising. The infrastructure and outreach already in place will enable
the project to cost effectively implement interventions that achieve large-scale outreach and impact.

It is not feasible to work with each and every organization active in this field, therefore, the initial stages of the
project will be devoted to identifying potential partners that work with clients of various economic and social
backgrounds, such as women, youth, orphans and commercial sex workers. An organizational mapping survey will
be conducted to develop a list of organizations active in the field, client groups and geographic areas covered. The
SEAD principles of partner selection will be utilized as an identification tool. CARE will also draw on its
partnership experience, dating to 1994, with such organizations as Commercial Bank of Zimbabwe (CBZ),
Zimbabwe Women’s Finance Trust (ZWFT) and the Self-Help Development Foundation (SHDF). Engaging in
dialogues with potential partners will reveal information regarding mutual interests, shared visions and prospects for
complimentary interventions.

From the initial mapping survey and assessment CARE will select a “representative sample” of 6-8 ASOs that
together comprise a cross section of the universe of ASOs operating in Zimbabwe. This is in order to generate the
maximum experience and lessons learned that will inform subsequent efforts to expand or scale up in future phases
of SIMBA. Selection of the partner organization will be based on the feasibility of the integration, the level of
outreach, and the potential for piloting methodologies with different client groups. Accordingly, efforts will be made
to work with organizations that support women-and child-headed households, commercial sex workers, and orphans
in both urban (high-density) and rural areas. The varied economic needs and resources of these client groups will
enable the project to develop and test appropriate methodologies, which can then be modified for future up scaling
and replication. While resource efficiency can be harnessed by working in districts where CARE already has a
presence, the project will adopt a flexible approach and not limit itself to operating exclusively in these regions.

An effort will be made to work through ‘umbrella’ ASOs that represent and support a consortium of LNGOs in
order to create synergies for the project and promote gains in efficiency and outreach, while obviating direct
implementation with CBOs. In Zimbabwe, there are several organizations that work with local organizations. For

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Africa Fund Concept Paper: Supporting the Income and Basic Needs of AIDS-Affected Households (SIMBA)

example, the Zimbabwe AIDS Network (ZAN) works with 120 LNGOs in providing such services as information
sharing amongst members, training assistance, advocacy, and resource mobilisation. Pact is also working with 15
LNGOs by providing organizational capacity building. Catholic Relief Services (CRS) has an HIV/AIDS support
program which works entirely through local partner organizations. The recent start of Africare’s Adolecent
Reproductive Health Project is aimed at implementation through local organizations as well. Such organizations
provide a ready venue for the project to integrate MEDPs.

2.2 Assessment of ASO and Clients

2.2.1 Institutional Needs Assessment of the ASO

The method of integrating a MEDP into an ASO depends on its institutional capacity. As such, the institutional
assessment will provide the necessary information regarding the appropriate strategy for integrating a MEDP. The
assessment will consist of conducting an institutional needs assessment of the ASO. This will provide useful
information regarding the organizations capacity and resources to undertake the implementation of a MEDP.
Ultimately, the needs assessment will guide the project’s intervention strategy because it provides the framework for
the project’s methodology and design.

2.2.2 Socioeconomic Assessment of the Client Group – Impact on HLS

In order to successfully address the income generation needs of the client group it is imperative to first examine the
particular characteristics and constraints to HLS of clients to determine the impact HIV/AIDS has had on intra
household resources and coping mechanisms. As such, once organizations have been selected, socioeconomic
assessments will be conducted of client households. This exercise is an important tool for program planning and
will assist in designing an approach that is cost effective and sustainable for mitigating the impact of HIV/AIDS at
the household level. The assessment will involve collecting baseline information through focus group discussions
and individual household interviews. This will serve as an indicator as to the type of services, financial or non-
financial, that are the most appropriate for the clients.

2.3 Institutional Capacity Building of the ASO

There are several project strategies that can be implemented to incorporate MEDPs into an ASO’s mission, however,
the SIMBA project will implement a process by which the most appropriate strategy is executed based on the ASO
and client assessment. The socioeconomic assessment of HIV/AIDS-affected households will provide a strong
foundation for designing the most appropriate intervention strategy. The choice and adaptation of the intervention is
dependent on the particular needs and characteristics of the ASO’s client group. In designing the appropriate
intervention the project will bear in mind the risks associated with certain types of micro-enterprise development
activities so as not to place additional threats on HLS.

The project will provide institutional capacity building to the ASO such that it is able to effectively respond to the
economic needs of its client group through the delivery of micro-enterprise development services, be they financial
or non-financial. Capacity building will focus on the provision of organizational capacity building, training of
trainers (TOT), and cultivating linkages with MEDP providers.

2.3.1 Organizational Capacity Building

Integrating an MEDP into an ASO’s mission will require strengthening its human resources, administrative and
accounting systems to effectively monitor and manage the MEDP activities. As such, the project will examine
existing systems and make recommendations for improvement and development of appropriate policies and systems
to accommodate the integrated activities.

In addition, organizational capacity building will feature training the ASO on the methodology and design of savings
and credit programs that stimulate sustained micro-enterprise growth and development. Policies, procedures and
record-keeping regarding internal and external lending, and accessing a revolving loan fund (RLF) will be
developed in collaboration with the ASO. Furthermore, guidance can be provided in the development of associated
MIS forms and records to ensure tracking of RLFs, as well as transparency of the organization’s loan operations.

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Africa Fund Concept Paper: Supporting the Income and Basic Needs of AIDS-Affected Households (SIMBA)

2.3.2 Training of Trainers (TOT)

ASO staff will be trained so that they are able to independently deliver training directly to their clients. In the case
of financial services, staff will be trained on group mobilization, fund development, and internal and external
lending cycles in the context of the solidarity group lending methodology.

Not all financial services interventions are appropriate for HIV/AIDS-affected households. For example, programs
aimed at providing credit may not be suitable for a youth population. As a result, ASO staff can also be trained in
the delivery of non-financial service interventions that address the business development services (BDS) needs of
the client group. This will include access to training in: entrepreneurship, business management (such as record-
keeping, pricing, and marketing), IGA production improvement, IGA diversification, or market research and access.
Such training will enable clients to upgrade product quality and productive capacity, diversify their IGA activities
and access new markets.

To ensure effective training, CARE or a sourced training provider will initially train client groups in the presence of
ASO staff so that the are able to directly observe the methodology and participatory techniques required to
successfully train and monitor groups. After a specified period of time, the ASO staff person will assume the
training as CARE monitors and observes.

ASO staff will also be trained on designing, administering and analyzing baseline surveys so that they are able to
monitor the impact their training has had on their clients and determine areas of improvement.

2.3.3 Linkages

Linkages with existing institutions will feature prominently in the project. For example, an ASO that has received
organizational capacity building and TOT in the context of financial services can eventually be linked to an existing
micro-finance institution (MFI).

ASO staff that have been trained in BDS interventions will be linked with existing BDS providers so that they can
receive refresher courses or training in new BDS skills. In facilitating these types of linkages, the ASO will be able
continuously provide appropriate training in IGA activity for their clients that is consistent with client demands as
well as market changes.

2.3 Monitoring and Evaluation

Continuous monitoring and evaluation at the organizational and client level is essential to assuring that objectives
are being met. At the organizational level monthly reviews of progress towards mutually agreed benchmarks will be
utilized. In addition, at the end of each project year a new institutional needs assessment will be conducted and
compared with the initial analysis as another measure of progress made.

At the client level, social and economic impact indicators will be developed and monitored in conjunction with the
ASO throughout the course of the project. Baseline surveys will be administered for the purposes of the assessment
and will be used as a point of comparison for the monitoring and evaluation component of the project. The project’s
progress towards empowering women will be monitored through the collection of gender disaggregated data.

As means of sharing lessons amongst all the partner organizations, quarterly partner workshops will be held to
review progress against partnership objectives. This will serve as a forum to assess progress, share lessons learned,
and strategize for program delivery improvement. Furthermore, an annual ‘lessons learned’ workshop will be
organized for regional CARE country offices so that the experiences of SIMBA can be shared on a larger scale and
lessons learned from similar regional initiatives can be integrated into the program’s current activities. Facilitating
this type of information sharing will reinforce the research/action methodology of the project and ultimately
strengthen the effectiveness of the project.

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Africa Fund Concept Paper: Supporting the Income and Basic Needs of AIDS-Affected Households (SIMBA)

3.0 Africa Fund Criteria

3.1 Leverage

CARE believes that there are potential opportunities for leverage of impact and complimentary resources. For
example, USAID Zimbabwe, following a recent decision not to phase out its development program in Zimbabwe, is
currently developing its country strategy, which will feature support to SMEs and HIV/AIDS affected persons. In
addition, Africare has expressed its interest to collaborate with CARE Zimbabwe in the context of a reproductive
health project. The 3-year project is aimed at improving the reproductive health of adolescents and young adults
through the provision of proper family planning for at risk and infected communities. The project will work through
existing CBOs that are experiencing constraints of limited expertise and capacity. CARE has met on two occasions
with representatives from Africare, who have expressed a keen interest in working with CARE to integrate a micro-
finance component into their program to improve the income-generating ability of youth.

Another potential organizational leveraging point is Pact Zimbabwe, which is currently working with 15 LNGOs
that provide HIV/AIDS support services. Pact provides institutional and capacity building services to these
organizations. In cases where the organizations require services outside the scope of Pact’s abilities, Pact sub-
contracts other organizations to provide the services. This framework has led to the partnership between CARE and
Pact in which CARE is providing micro-finance and capacity building services to the Gweru Women’s Association
for the Prevention of Aids (GWAPA). GWAPA works with commercial sex workers and provides them with
information and training on the causes and spread of HIV/AIDS, as well as the requisite skills to engage in
alternative income generating activities. CARE’s role is to strengthen GWAPA’s institutional capacity to efficiently
manage a revolving loan fund. In addition, CARE is directly training GWAPA’s existing groups on such topics as
fund development, internal and external lending, budgeting and group constitutions. This methodology can be
refined and replicated for integration into other existing HIV/AIDs support projects. Pact has indicated that several
other LNGOs have requested similar services. As such, there is potential for providing the same services to other
LNGOs under Pact’s purview.

Other sources of leverage include ZAN, which actively supports 120 LNGOs. There is scope for complimenting
ZAN’s resource mobilization efforts with MEDPs. In addition, Catholic Relief Services (CRS) is also supporting
HIV/AIDS-affected households through a home-based care project, material support and most recently, financial
support in the form of support for IGAs. This component is a pilot program that provides loans to primary care-
givers through self-selected community based committees. The project works through two local partner
organizations. The community-based committees have expressed a need to gain more support for their IGAs, in the
form of training and credit, therefore CRS is anxious to expand the scale of their micro-finance component. Further
research will be undertaken in the initial stage of the project to identify other opportunities for complementary
collaboration and funding leverage.

3.2 Program Growth

The SIMBA project represents a new program that will accelerate CARE Zimbabwe’s efforts at working specifically
with HIV/AIDS-affected households and broaden the characteristics of its existing client group. In addition, the
project’s partnership with ASOs will be a new strategy for CARE.

3.3 New Initiatives

The proposed project presents several opportunities for CARE Zimbabwe. It enables CARE to adapt and pilot its
existing MEDP methodologies for a new, and more at risk client group. Broadening the methodology to encompass
a new client group provides the means to expand program outreach to a population segment that it is not adequately
being serviced. As such, the project positions CARE to meaningfully participate in mitigating the effects of the
HIV/AIDS pandemic at the household level.

The strategy of addressing the economic aspect of the pandemic is relatively new for Zimbabwe as well as other
countries in the southern African region. However, the mounting income generation needs of HIV/AIDS-affected

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Africa Fund Concept Paper: Supporting the Income and Basic Needs of AIDS-Affected Households (SIMBA)

households will surely prompt the design of similar programs in the near future. As a result, the project will provide
valuable lessons learned for other program design and implementations in the region.
3.4 Strengthening African Capacity

The project will strengthen the capacity of all staff involved with or exposed to it. In particular, the cultivation of a
defined and tested process for integrating MEDPs with ASOs will actively involve all staff. The lessons gleaned
from this process development will benefit the staff’s ability to broaden programming further and adapt
methodologies for various environments. Further, the institutional capacity building of the ASOs will strengthen
their staff compliment as well as broaden their skill set.

3.5 Sustainability

CARE has acquired significant experience developing appropriate methodologies for implementing MEDPs in
partnership. First of all, the group-based savings and lending methodology will be sustainable at the group level.
Furthermore, as the ASOs complete their institutional capacity building and as clients successfully complete their
training or lending cycles, there is scope to link the ASOs and clients with CARE’s existing MEDPs. For example,
linkages can be made with the Self-Help Development Foundation (SHDF), CBZ, and the Rural Micro-finance
Project (RMFP), thereby promoting sustainability. There is also scope for linking the clients to other CARE projects
that provide services that would benefit their HLS. For example, linking with CARE’s Small Dams Project can
facilitate clients’ establishment of vegetable gardens to provide cheap food. CARE’s Nutritional Initiatives for
Communal Areas (NICA) and Women’s Health and Development Project (WHDP) are other potential sources of
nutritional and economic development for the clients. Outside of CARE programs, there are other institutions that
the project can link clients to such as Zambuko Trust or Zimbabwe Women’s Finance Trust (ZWFT). Facilitating
linkages between clients, BDS providers, and markets is another mechanism that promotes sustainability because
such linkages can continue even after the project has ended.

4.0 Management & Reporting/Project Outputs

4.1 Management

The CARE SEAD Coordinator will work closely with the project manager in monitoring the project and ensuring
that progress is being made towards the achievement of the project goal and objectives. The project manager will be
responsible for overseeing the field officers as well as sourcing and liasing with BDS providers and organizing
partner workshops. S/he will also be responsible for meeting with ASOs on a monthly basis to review progress
against benchmarks. In addition to training ASOs and clients, the project’s field officers will conduct household
assessments and administer the baseline surveys. Field visit reports qualitatively commenting on clients progress
will be compiled after each visit for continuous monitoring.

4.2 Reporting

A institutional needs assessment and baseline report will be compiled using the data obtained during the ASO and
client assessment. This report will provide a picture of ASO capacity and the client’s socioeconomic status before
project implementation. Quarterly, semi-annual and annual reports will be compiled for the project commenting on
the project’s progress towards its objectives. At the end of each year of the project another baseline survey will be
administered and a report compiled for comparison with the initial baseline survey. For those organizations that
are receiving institutional capacity building, an end of year needs analysis will be conducted and reported against the
original analysis. At the end of the project a final report will be issued clearly detailing the achievements of the
project against its stated objectives, as well as highlighting lessons learned.

4.3 Expected Outputs of the Project

The project is expected to have significant results within the 2-year time span of the project, as well as long-term
benefits that are expected to continue after the project has ended. Most significantly, at the end of the project a
tested and refined process will have been developed to effectively identify and assess representative ASOs, and
design intervention strategies aimed at improving the socioeconomic environment of HIV/AIDs-affected
populations. Each partnership process will be recorded in the form of case studies that report on successes and

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Africa Fund Concept Paper: Supporting the Income and Basic Needs of AIDS-Affected Households (SIMBA)

challenges. By the end of the project, CARE will have developed a documented ideology that establishes best
practices for working with ASOs of varying capacity and clients with varying characteristics and needs. This will
signal the way forward for similar initiatives in the future. With an established and tested process already in place,
CARE can look to the experience of the SIMBA project as an intervention planning tool as it positions itself
throughout Southern Africa to work with other ASOs.

Specific project outputs include:

• Documented case studies that demonstrate a clearly articulated process of identifying, assessing and designing
intervention strategies for ASOs.
• Clearly defined process for assessing HIV/AIDS-affected household’s income generating needs and designing
the appropriate intervention strategy.
• Increased household income and HLS of HIV/AIDS-affected households: evidence of more frequent meal
consumption, increased ability to pay school fees, and medical expenses.

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