In 2011, the Conrad N. Hilton Foundation launched what has become a remarkably successful strategic initiative to protect, promote and support the development of youngchildren affected by HIV and AIDS. Highlights of the Initiative include the Foundation's leadership and leverage, opening up a new area and generating international and nationalinterest in the work; the partnerships it has established with many of the largest and most experienced implementers of programs for children and communities affected by HIV andAIDS in sub-Saharan Africa; the large numbers of children and families who have been supported through the activities of partners and collaborating community-based organizations and local government services; the unique learning networkcreated among researchers, implementers, policy makers and community groups; the growing awareness in the sub-Saharan African region of the importance of supportingfamilies during the earliest years of a child's life; improved implementation and accountability through joint work on logic models and measurement tools, and innovation in assessment, practice, and advocacy.
In the three years that we have monitored the Foundation's Children Affected by HIV and AIDS (CABA) Initiative, 320,549 children have been provided with one or more services (seeFigure 5), as have 177,754 parents or caregivers. A third of children (119,180) attended partner-supported community-based child care centers. Nearly three hundred thousand (277,054) home visits were made to approximately 54,000 households and more than 37,000 professionals, community and government workers received some form of training.
There is a lot to celebrate, but still a lot to do. The success of the Initiative has opened doors and there are new thresholds to cross. The Foundation has the opportunity to take the lead on several fronts. Our balanced scorecard analysis points the way to areas that need strengthening, particularly regarding the quality of programs on the ground and evidence for their effectiveness. We recommend that the Foundation identify the niche it wants to occupy, and the areas in which it will continue to lead. The Foundation should consider either directly supporting, or addressing the following via partnerships: ensuring that community workers are properly trained, accredited and remunerated; very young children receive the diverse foods they need to fuel their development; that sufficient small media learning aids are produced to make community work more effective and maintain changes in parent behavior, and that philanthropically funded programs get closer and more aligned to government provisions so that, at least with respect to some interventions, we can anticipate that they are provided for all children.