TUKUNDANE CARE MODEL

Key populations
 Female caregivers living with HIV/AIDS
 Sex workers
 Fishing communities
 Trucker stops
 Children and Adolescents

These key populations will help us to reach out to under-served populations or at increased risk of
having HIV where they cannot easily access Health Treatment Services. Very useful for reaching out
to people in higher risk and specific localized epidemics (so-called “hotspots”), fishing
encampments, truck stops and areas of poverty or overcrowding and schools where there is the
greatest need for HIV and /or TB treatment and prevention.

Selection Criteria
 Female caregiver is HIV positive
 Child headed homes orphaned as a result of HIV/AIDs
 Sexually abused children
 Falls in one of our key population above
 Locally identified through community outreaches or by community leaders within our areas of
operation.

An Illustration of Tukundane Care Model

Exit

Sustatinability

Engagement

Identification

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1. Identification stage
At the identification stage, the caregiver/mother and her family are in a sorry state; the mother
is living positive could be a widow or not, either her husband or children are sick, children not in
school, with acute lack of food or malnourished, the shelter is in a very dangerous state, they
lack adequate clothing, beddings and other household’s utensils, the family has no viable income
generating activity. In most cases, the children and sometimes the caregivers are highly
traumatized and are in critical need of care and support. Caregiver belongs to our key population
and lives within our areas of operation.

Identification usually takes a period of two months, this involves conducting a needs assessment,
necessary documentation and profiling.

2. Engagement stage
At the engagement stage, the family moves from the very dangerous situation to a more stable
one. Families in this stage have healthy children, the children and the caregivers are regaining
hope in life and in themselves, begin to be joyful, children enter school and start attending youth
clubs. Tukundane provides technical support to the family for example counselling, trainings that
address various key topics, including psychosocial support, Nutrition Care and Support for people
living with HIV/AIDS, maternal and newborn health, prevention and care of common childhood
illnesses and environmental, Business skills. At this stage, we prove an income generation activity
after the family has undergone vigorous business skills empowerment and we keep monitoring
it.

The purpose of the IGA support is to empower the caregiver financially so that she is able to save
at least 10,000 per week to enable them provide household basic needs for their families. The
family is helped to attain food security through the provision of urban farming implements,
trainings, and linking them to agricultural extension workers for more technical support. We
organize for them exchange visits to successful urban farmers for mentorship and hands on
training.

Tukundane also ensures that the home maintains good sanitation and hygiene, which includes a
clean latrine, a clean bathing shelter, a drying rack, safe rubbish disposal areas, a food store, and
an animal pen if there are any animals at home and a clean compound. We mobilize our
beneficiaries into Care support groups (CSG) and train them in group dynamics for peer support
and participation in community activities such as counselling, training other community
members. However the major purpose for these groups is to be able to save on a weekly basis
and for easy linkages in case of available government support to community groups.

This stage takes 22 months

3. Sustainability stage

Sustainability is a self-reliant, stable, caring, loving, protective (safe), happy and healthy family.
Our goal is to make a family stable and self-reliant and not dependent or expectant for assistance
from outsiders

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 At this stage, the family is now a model home and the caregiver becomes a leader mother (LM),
having attained all the indicators within the 9 building blocks (Good Health and Well-being, Food
security, Education, Housing and sanitation, Income generating Activities (IGA), psychosocial
support, participation, spiritual mentorship and Affordable and Clean Energy) Families in this
stage are expected to join a community savings group where they start receiving loans to scale
up their IGA’s. This is when the family graduates to the Exit stage.

How can you identify a family that has reached permanency level?
 One that is able to provide medical care for the sick children and other people at home
 One that has food security through urban farming
 One that is able to provide education for all school going age children
 One that has a responsible head or guardian
 One that is able to use clean energy sources for lighting and cooking
 One that has clean source of water and all water handling utensils
 One that can afford the basic needs of soap, sugar, salt, fuel
 One that participates fully in community activities
 One that shows love, happiness for the children
This stage takes 8 months and mainly involves assessment and mentorship.

4. Exit stage;
At the exit stage, families which have reached permanency should not deteriorate but should
steadily grow in a dynamic, progressive and improved state. They should be role models in the
community and be able influence other families as Leader Mothers.
At this stage, the family is self-supporting and can mentor other families. At this stage, the
caregiver and her family ceases to receive support from Tukundane.
Takes 4 months and mainly involves reporting, documentation and providing an exit package.

5. Referral
This happens at all stages of project implementation based on the urgent need of services that
Tukundane doesn’t offer. We work with various partners that offer different services in Health
together with other care services (e.g. primary care, antenatal care, and immunization)
education, Affordable and Clean Energy and other sectors.

This will enable our beneficiaries receive integrated out-of-facility HTS: HTS will be offered
together with the primary health service the outreach is intended to extend to the under-served
community/population. HTS can be integrated in outreaches for TB screening, primary health
services (immunization, child days plus and others), VMMC and STD screening and management,
mobile health/MCH clinics and family health days. This is likely to increase access and uptake of
HIV testing services to people with difficulty in accessing HTS at health facilities at a marginal
cost

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Family responsibilities

1. Housing, environment, hygiene and sanitation

The family should have a home, a house with roof not leaking, windows, fairly strong door, strong
wall and ventilation. Latrine, bath shelter, kitchen, animal pen, rubbish pit, basic household items
such as utensils rack, cups, plates, saucepans, salt, sugar, soap, drying line, children’s hut, visitors
shade/hut, plant fruits, shade in the compound, clean compound and environment and clean /
open path to home.

2. Food security
The family should work hard and have food sufficiency, with at least 2 meals a day, proper
balanced nutrition, feeding plan.

3. Education
The family should ensure that all school going children go to school. Out of school OVC should
be trained in vocational skills and adults should attend seminars.

4. Good Health and Well-being

This involves a clean environment, clean source of water, hygiene, no malnutrition and reduced
illnesses. Prompt treatment on common illnesses related to HIV/AIDS.

5. Participation
The family should be able to participate in community activities, social activities and economic
activities and the OVC should join children’s clubs.

6. Income generating Activities (IGA),

The family should have an income generating activity (IGA), be able to cater for common
domestic needs e.g. medical expenses, soap, sugar, salt, children’s clothing and have work
opportunities.

7. Psychosocial support
Meet the spiritual and emotional needs of the family members. Show love, care and support to
children and other members in the community

8. Mentorship and Affordable Clean Energy

The family has the desire and accepts to care for vulnerable members from other families in the
community. They are able to cook using improved stoves, biogas and are able to make cooking
brick lets.