Legal Units - Child Protection Support in Côte d'Ivoire

Protecting Orphans and Vulnerable Children in Côte d’Ivoire

Côte d’Ivoire, where HIV prevalence is 4.7 percent (Institut National de la Statistique 2006), is home to an estimated 540,000 OVC, of whom approximately 40,000 are infected with the virus. Since 2004, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), via the Centers for Disease Control and Prevention, has provided capacity building to the National Program for Orphans and Vulnerable Children (PNOEV [the French acronym]). This cooperative agreement, coordinated through the Ministry of Family, Women and Social Affairs (MFFAS), supports 30 social centers around the country. These centers collaborate with community “task forces” of local nongovernmental organizations (NGOs), public agencies, and other civil society partners that offer community-centered services for vulnerable children, including those with HIV.

In September 2008, 26 of the social centers established Legal Units through an MFFAS initiative, with technical assistance provided by PNOEV. A Legal Unit is a network of individuals and resources that can be tapped as needed to protect the rights of children and their families. Their mission is to help resolve legal problems for OVC and their families either by mediation or prosecution, and to raise awareness about children’s rights among OVC and their communities. The Legal Units thus reflect the priorities and mechanisms of the Protective Environment Framework in that they are integrated into existing structures and, because they serve all vulnerable children, act to counter stigma and marginalization. As described in the Framework, they also strengthen the capacity of families to protect and care for OVC by providing economic, social, psychological, and other support. The Legal Units place great emphasis on mobilizing and supporting community-based responses while also helping the government improve policy and legislation.

Legal Unit Activities

The Legal Units are staffed primarily by professionals—judges, nurses, social workers, municipal officials, police officers, and others— who volunteer their time and skills within the context of their employment. For example, the registrar at the town hall can be called on when necessary by the social centers to help individuals get birth certificates. Nurses or judges may refer cases they see in their daily work for support from the social centers. In fact, the social centers and individual Legal Unit team members operate a system of referrals and counter-referrals for OVC and their families for legal assistance and other support.

The composition of each Legal Unit team differs by site, reflecting local needs. In addition to nurses, teams of 10 to 15 individuals may include such public servants as prosecutors, children's court judges, lawyers, clerks of the court, social workers attached to local courts, local police commissioners, town hall registrars, and social center directors. Also participating on Legal Unit teams are representatives of civil society, including NGOs specializing in legal matters, children's organizations (such as the Children's Parliament), local collaborating organizations involved in the social center, and the courts of local kings and traditional chiefs. The diverse backgrounds of Legal Unit members address various aspects of the Protective Environment Framework. For example, the participation of the local chiefs may help address harmful customary or traditional practices (see Component 1, Table 1), while the involvement of local teachers and nurses may improve the provision of essential services (see Component 8).

The Legal Unit teams also carry out communication activities through formal and informal media, such as radio and traditional praise singers, to raise public awareness about children's rights and potentially prevent legal problems or, for example, to encourage families to get birth certificates for their children. Another function is advocacy among local legal and judicial structures (the Ministry of Justice, local mayors, the police, and local courts) to resolve the legal problems of OVC and their families.

Many Legal Unit members participated in a PEPFAR-funded three-day training course in child rights and legal recourse, including relevant laws and civil procedures (held in June/July 2009). The participants were then able to train others to promote child protection and to build community capacity to protect children using existing social and cultural systems, such as traditional leaders, as well as draw on services provided by governmental and nongovernmental sources.

In some cases, children's own resilience may be strengthened by giving them a means of voicing their concerns to social workers and other specially trained individuals. They can also be empowered in other ways, such as when Legal Units help children get birth certificates so that they can enroll in school. In this way, the Legal Unit becomes an integrated, low-resource, easily replicable model to help children with multiple vulnerabilities, not only those living with or affected by HIV. In fact, the HIV status of children or family members that the Legal Unit helps is often unknown by team members who do not need that information, such as a town hall registrar who helps a family procure a birth certificate.

Political will to recognize that OVC have a need for legal services to protect them is needed to establish such an intervention, and, as described, the Legal Units rely on the goodwill of their volunteer members. In Côte d'Ivoire, both of these elements have been forthcoming, and the Legal Unit program can serve as a flagship innovation for other countries in the region and more widely.

In Côte d'Ivoire, at each social center, there are four main modes of intervention: social protection, family welfare, social mobilization, and monitoring and evaluation. Social protection includes such maternal and child health services as baby weighing and immunization. The family welfare department offers counseling, mediation, and conflict resolution services, including home visits to vulnerable individuals. The social mobilization department carries out awarenessraising and community sensitization about health and welfare issues, while the monitoring and evaluation service collects and reports the social center data. Together, the four complementary departments form an integrated service network, referring cases both among each other and outside the social centers. The head of family welfare is the first point of contact for the Legal Unit and refers and follows up legal cases with other members of the network.

For example, some of the workers in the social protection department in Attecoubé noticed that mothers coming in to have their babies weighed often had only the child's preliminary birth certificate, which they receive after delivery in the maternity unit. If this certificate is not presented at the registrar's office in the local town hall within three months of the child's birth, it becomes very complicated and expensive to get a birth certificate. (In Côte d'Ivoire, a child without a birth certificate cannot go to school, so it is extremely important to acquire a birth certificate as early as possible.) Those who exceed the three-month deadline are referred by the health care workers in social protection to the family welfare department, which begins the complex administrative procedure to get the birth registered. The social workers in family welfare then ask members of the Legal Unit, such as the town hall registrar, to get the children the certificates. (These functions fulfill Framework Components 4 and 8.) They also involve "providing access to specialist services that cater to the specific needs of children who have experienced child-protection violations" (Long 2010, 18).

Examples of Legal Unit Interventions

Mariam, a survivor of gender-based violence, and her children wish to return to Mali.

Facilitating access to educational assistance: Sylvie recounted how, when she was eight months pregnant, she went to her boyfriend’s house to find that he had moved away without leaving a forwarding address. She desperately searched for him once Anna, now seven years, was born, and moved in with his parents briefly. Meanwhile, he had married another woman, and eventually his entire family attempted to disown her. Try as she might, Sylvie could not persuade her former boyfriend to acknowledge Anna—he even refused to allow her to use his family name. (There is no legal obligation for a man to give his family name to his offspring.) Sylvie moved back to Abidjan, found work as a domestic servant, and became involved with a new partner, a pastor at a local church.

After they had been together a year or so, he became ill and tested positive for HIV—shortly afterwards, so did Sylvie. Since then, she has encountered hostility from members of her own family, including the aunt who brought her up in Abidjan and on whom, now penniless and unemployed, she relied. “It is as if I have the HIV virus in my blood which will not go away, but worse than that, they are infected with a virus of intolerance,” she sobbed.

Even though Anna did not have a full birth certificate, Sylvie managed to get her into school by negotiating with a sympathetic school director. However, her teacher noticed that the child often arrived hungry and tired from the five-kilometer walk from her house and referred her to the social center. Associazione Volontari per il Servizio Internazionale (AVSI), a partner NGO that participates in the Koumassi social center’s Legal Unit, now pays for Anna’s bus fare and provides subsidies for medication when she is sick. AVSI discussed Sylvie’s situation with her to determine what kind of support she required. They decided Anna was eligible for help because she is possibly living with HIV and definitely affected by HIV and because there is no working adult (and therefore regular income) in her household. AVSI staff also made sure she got a proper birth certificate from the town hall. They closely monitor the family, have developed a case management plan, and are working hard to get Sylvie employment as a domestic servant.

The response to Sylvie’s case corresponds to the element of the Protective Environment Framework dealing with capacity building of families and communities (Component 5) because of the efforts by the Legal Unit and AVSI to support protective childrearing practices and also provide Sylvie and her daughter with recovery and reintegration services, including schooling. Sylvie’s case was well documented, drawing together information from her daughter’s school, the social center, and the hospital where she received antiretrovirals, underscoring the importance of monitoring and reporting (Component 7).

Addressing child abuse: Six-year-old Ibrahim does not live with his parents anymore. His father is dead, and his mother, sick with HIV-related illness, cannot care for him. He periodically sees a social worker who works with the Legal Unit. During a recent visit, she gently asked him to lift up his faded t-shirt. On his tiny torso is a web of scars, the result of an attack with a razor blade by his caregiver, his own grandmother, because one day, according to her, “He did not want to go to school.”

There is little that can blunt the horror of this heartbreaking story, but Ibrahim now has allies with the power to defend him from abuse. Although he has no alternative but to continue to live with his grandmother, the Legal Unit provides Ibrahim (and other vulnerable and abused children) with protective care and a voice. His social worker—a member of the Legal Unit—knows how to spot signs of abuse during periodic check-ins, thanks to training on OVC and their psychosocial problems that she received at Côte d’Ivoire’s National Social Work School. She has gained Ibrahim’s trust, and he confides in her. The community nurse, also an active member of the Legal Unit, tended to Ibrahim during his treatment and recovery. The Legal Unit billed the grandmother for medicines and bandages and has explained that child abuse is unacceptable and that she will go to prison if she ever lays a finger on him again. Yet despite these efforts, it is acknowledged that this is an inadequate and perhaps even dangerous response to the situation (i.e., if the grandmother were to seek retribution and further harm Ibrahim). The Legal Unit program acknowledges that the program must work to ensure a better response to ensure Ibrahim—and others like him—are better protected.

Addressing gender-based violence: Legal Units are capable of helping children and families with multiple vulnerabilities, not just those directly related to HIV. Mariam lives in Attecoubé but is of Malian origin, and both her parents live near the Malian town of Sikasso. Mariam reports that from day one of her marriage, she has been regularly beaten and raped by her husband. She has no income and says, “When I ask my husband for money to buy food, he hits me!” Her husband smokes excessive amounts of cannabis, even in their bedroom, which affects the health of her eldest child. Mariam is reduced to begging for food from neighbors. Recently her husband threatened to kill her, and her father-in-law commented, “He should just go ahead and do so—I don’t care!”

A representative from a local NGO involved with the Attecoubé social center noticed Mariam’s plight. She brought her to the social center to ask for help from the Legal Unit. Mariam wants to divorce her husband and return to the safety of her parents in Mali. The local police superintendent, a member of the Legal Unit, ordered the husband to stop hitting her or he would lock him up, and to give Mariam CFA100,000 (about US$200) to pay for her transport back to Sikasso. Mariam was sure that, thanks to the superintendent’s intervention, her husband would pay up, and she could be free to leave the suffering of her marriage behind her. Sure enough, in early July, although the husband did not come up with the full amount requested, he gave Mariam CFA50,000 (US$100) to enable her to return to Mali.

Mobilizing access to birth certificates: Seven-year-old Amadou is from Abengourou. His father had two wives (including Amadou’s mother, the second wife). The first wife got sick and died, closely followed by Amadou’s father. The family accused Amadou’s mother of using witchcraft to kill her co-wife and husband. She herself started to become sick and tested positive for HIV, as did Amadou. When she died, the family threw Amadou out, saying that he too was involved in the sorcery that caused the deaths. His mother’s cousin (whom he calls his “auntie”) took him in and contacted the social center for help. The family welfare department mobilized the Legal Unit, which began the application process to get Amadou’s birth certificate. Amadou could not hide his excitement at the thought of starting school in the fall. He says he wants to learn to write and will eventually become a doctor, adding generously, “If my auntie becomes sick, I will treat her for free!”

Challenges

The judge who hears children’s cases in Abengourou.

Fear of reprisals: In many cases, women who had pursued legal complaints against spouses or husbands for neglect or violence dropped their grievances at the last minute, afraid of the consequences if they succeeded in getting the perpetrator jailed (although there are also consequences as a result of filing the grievance, and if the perpetrator is not jailed). For example, a woman may be married to a cousin, and the family closes ranks to force her to drop the case, even for the most violent of crimes. In one case reviewed by the police superintendent of Koumassi, a woman was beaten by her husband whenever she asked him for money to buy food. However, her own parents persuaded her to go back to him because the couple was related by blood as well as by marriage. This illustrates that some aspects of the Protective Environment Framework may be more difficult to implement than others. In this cultural context, traditional practices may make it challenging to fully prioritize child protection. Thus it is necessary to work to change local perceptions and practices with sensitivity, to modify culture and customs (Component 1), in order to give priority to the welfare of women and children.

Similarly, Mariam, described previously, who suffered beatings at the hands of her drug-addicted husband, said, “He should be imprisoned, but not because of something I say—if this happens, I will have a lot of problems.” Her husband’s relatives, aware of her suffering, told her to, “Just put up with it, it is part of married life—that’s what marriage is like!” Other women express fear of supernatural reprisals if they testify against their husbands, again underscoring the difficulty Legal Units have in enforcing the Protective Environment Framework actions that relate to modifying culture and customs (Component 1). Fear of sorcery and accusations of witchcraft can have devastating consequences, often splitting families and turning individuals against each other. In addition, the police superintendent in Koumassi remarked that, right before he passes judgment, many women plea for clemency for the husbands. The man is often the only breadwinner, and sentencing him to prison would only weaken the family further by depriving it of income to cover basic needs. This reflects the need for greater capacity building among families and communities (Component 5) so that women can successfully prosecute men who harm them without compromising their economic status.

This dynamic points to a degree of dissonance between the mission of the Legal Units as seen by outsiders (including donors) and the priorities of the beneficiaries. The former seek to enable women and children to assert their legal rights to the fullest by allowing them access to the justice system. However, due to sociocultural and economic factors, most cases involving the prosecution of a man by a woman do not come to fruition (i.e., end with prosecution or imprisonment). Nevertheless, the Legal Units do effectively improve women’s and children’s circumstances and enhance protection by simply using the threat of legal prosecution rather than prosecution itself. These examples show that synergy among Protective Environment Framework elements is important, because even if the legislation is in place, the modification of culture and customs (Component 1) has not yet occurred to enable enforcement. This will require building the capacity of families and communities (Component 5) to overcome fears of supernatural reprisals and to support victims of crime or abuse economically as well as psychosocially.

The traditional chief in the Koumassi neighborhood of Abidjan, an active member of the Legal Unit.

Conflicts between traditional and state laws: For cases of inheritance, the Legal Units apply Ivorian law, which decrees that a deceased man’s spouse and children should share his wealth, with the spouse getting half and the children splitting the other half equally. However, many societies in central and eastern Côte d’Ivoire are matrilineal: when a man dies, his oldest sister’s son inherits his estate.

The importance of traditional kings and chiefs who uphold traditional law cannot be underestimated, even in urban Abidjan. In most cases, traditional law takes precedence over state law (that is, the nephew rather than the widow and sons inherit). This can cause conflict and may undermine the authority of conventional Ivorian jurisprudence on which the Legal Units are based. In terms of the Protective Environment Framework, this points to a conflict between legislation and its enforcement and the culture and customs that the Legal Units frequently confront.

A highly mobile population: In many cases, particularly in Abidjan, clients using the social centers were born outside of Côte d’Ivoire, in such places as the neighboring countries of Mali, Burkina Faso, or Guinea. Members of these immigrant or second-generation communities tend to be very vulnerable, especially if they lack identity papers or birth certificates. If a child is born in Côte d’Ivoire to immigrant parents who do not have identity cards issued in their own country or by their consulate in Abidjan, the newborn child cannot get a birth certificate and thus cannot enroll in school. This creates a vicious cycle of marginalization, discrimination, and poverty inextricably linked to issues of child rights and protection that, to date, have not been addressed by existing legislation.

Many migrant as well as Ivorian-born couples married under traditional law lack formal marriage certificates, again illustrating a gap in the application of legislation and a lack of knowledge about the law. This is particularly a problem when one partner dies and the other wishes to claim inheritance. Aissata from Guinea was living in Korogho when she was widowed and left with four children, one of whom is living with HIV. She knew that her late husband (who died of HIV-related causes in 2006) had CFA500,000 (about US$1,000) in a bank account in Mali. However, when she traveled to Bamako to claim this sum, she was told that she was not entitled to the funds because she had no legal marriage certificate. Aissata is now living in great poverty in Abidjan, where she fled after experiencing stigmatization in Korogho.

Confusion about the mission of Legal Units: Because the Legal Units are run on a voluntary basis and their members are called on as and when needed, there is some confusion about their exact nature and mission. Although PNOEV suggests that the Legal Units meet regularly, few do. This may be because the members are reluctant to formalize their existence and create expectations about payment or reimbursement for transport that could not be met. In Koumassi, even getting the members to participate in the Legal Unit (which they are obliged to do, as their role in the Legal Unit is included in their daily job guidelines) has been a challenge. A judge who was called to advise social center staff on a child protection case said he would not come unless they could cover his transport costs. Similarly, a doctor who is part of a Legal Unit requested CFA10,000 (US$20) for estimating the biological age of a child needing a birth certificate. It may be that, because there is no direct funding for them, the Legal Units might function better if they were called “networks.” Changing the name from Legal Unit (which implies having an office, paid staff, and a budget) to Legal Network could avoid confusion and help manage expectations about payment.

Other challenges include the following, and are addressed in more detail in the Recommendations section:

• Inadequate follow-up systems
• Minimal psychosocial/specialized support for victims of violence and abuse
• Limited involvement of clinical professionals on Legal Unit teams
• Lack of standardization of the price of a birth certificate
• Minimal sharing of best practices and experiences.

Recommendations

Establish better follow-up systems: To date, it is difficult to say how many cases have been brought to closure by the Legal Units, primarily because documentation and follow-up of cases are inconsistent. However, in Abengourou, the Legal Unit has a follow-up committee that includes four members, over which a social worker from family welfare presides. The committee meets regularly to share information and report back on the cases that have been referred for legal assistance. Their most important task is to follow up in the field, visiting families who may reside some distance away. Their transport costs are covered by Save the Children-Sweden, which supports other rights-based activities at the social center. Thanks to follow-up, the committee knows the outcome of each case and can take extra steps if the problem has not been satisfactorily resolved. For Legal Units without follow-up committees, it is often difficult to determine whether a particular case had been concluded, especially if a child has been referred to another institution, such as an orphanage. PNOEV should seek additional funding to create follow-up committees at all social centers where there is a Legal Unit to provide long-term, consistent support; improve the documentation of cases; and ensure that children and their families receive high-quality services.

Provide long-term psychological support for victims of violence and abuse: Many if not most of the cases that the social centers routinely deal with, including child rape and domestic violence, require long-term psychological support and the services of a psychologist trained in matters of protection. Social center staff work for the legal or social resolution of client cases and refer to other members of the OVC Coordination Platform, who provide longer-term psychosocial and health services. In many cases, such as the case of Ibrahim who was abused by his grandmother, case management requires more than interventions from social workers and medical professionals, but also necessitates long-term psychological support and counseling and often referrals to specialized services that cannot be offered by the Legal Unit teams. It is highly recommended that this long-term psychological sequelae of abuse and violence be addressed by a trained professional with more formalized referral processes. Without such help, the physical scars of abuse may heal, but the long-lasting psychological damage is likely to be so severe that the child will be compromised throughout childhood and indeed later in life.

Include a nurse in the Legal Unit team: The composition of the Legal Units is left up to each social center to best reflect local needs. However, Legal Units with a nurse actively participating in the system of referrals and counter-referrals function especially well. The nurse can see OVC and treat their physical problems but also refer them to the social center as needed for extra support and care as well as help them access the Legal Unit if necessary. For example, the nurse in the Abengourou Legal Unit treated a 14-year-old girl for gastric ulcers. When she asked the girl why someone so young would suffer from this stress-related problem, she said that, after her father divorced her mother, he treated her badly and did not cover her basic needs. The situation was affecting her studies and she was extremely anxious. The nurse contacted the social center, which contacted the judge in the Legal Unit. She ordered the father to take better care of his daughter. He subsequently complied.

Standardize the price of a birth certificate: One problem that the program encounters is that the price of procuring a birth certificate varies enormously. The process is long, requiring the negotiation of complex bureaucracies, something that many poorly educated individuals may find difficult. Under normal circumstances, a birth certificate issued after the three-month post-birth deadline costs CFA30,000 (US$60), not including the extra costs of requesting paperwork from the local justice office or town hall. However, many Legal Units, especially those that include the local registrar, have been able to negotiate the costs down to around CFA3,000 (US$6). (Even this was too much for some families, who were then given the option to pay in installments.) Birth certificate applications were often submitted by the social centers in batches, and the price per certificate in each batch often ranged considerably. PNOEV could lobby the Ministry of Justice to standardize the price of birth certificates across the country and, as an even better solution, ensure that they are given out free to OVC.

Encourage Legal Units to share practices and experiences with each other: When a Legal Unit has especially effective programming and good results, other Legal Units should send members to see first-hand how this successful model operates with a view to replicating it. For example, the Legal Unit at Abengourou seems to work well, with a president who is a very committed judge, an active nurse who both receives referrals for medical problems and counterrefers cases to the social center, and a follow-up committee, which receives a small budget from Save the Children-Sweden, that brings all cases to resolution. In terms of the Protective Environment Framework, such visits to a well-functioning center and Legal Unit would contribute to facilitating open discussion around protection (Component 3) and to enhancing life skills, knowledge, and participation (Component 6) among service users elsewhere.

Involve foreign consulates: Future work in Abidjan should target the embassies and consulates of migrant families so that their children can get birth certificates. As described previously, children of migrant workers from surrounding countries often come to Côte d’Ivoire with no identity papers or are second-generation immigrants who are themselves unregistered. Even if their children are born in Côte d’Ivoire, their births cannot be registered if the parents have no papers. This was a particularly common and frustrating issue in social centers such as Attoucoubé, which serve a large number of people of Burkinabé and Malian origin. At the social center in Koumassi, the elected representative of young Burkinabés was a member of the Legal Unit, which facilitated the registration of children born in his community. Future work should involve country representatives in the Legal Units’ work and seek to create effective ties with country consulates to expedite the processing of parental papers so that children born in Côte d’Ivoire can be registered. Within the Protective Environment Framework, this will contribute to building the capacity of families and communities (Component 5) as well as enhancing government commitment and capacity (Component 2)—in this case, governments from outside Côte d’Ivoire.

Future Programming

Radio spots: PNOEV is commissioning a number of television and radio spots to be broadcast throughout the country on the importance of getting children birth certificates. Some registrars have already successfully collaborated with local radio stations on this matter. The spots will underscore the importance of registering a birth in the first three months of life so that the child can first and foremost have an identity, as well as the chance to go to school. This is an extremely important initiative and one that is likely to substantially increase the numbers of children registered. Within the Protective Environment Framework, this contributes to developing legislation and enforcement (Component 4).

Lobbying the Ministry of Justice: PNOEV will continue to lobby the Ministry of Justice to reduce the lengthy paperwork needed for birth certificates after the three-month deadline. It will also continue to lobby for the free distribution of birth certificates to OVC. Now that the Legal Units are, for the most part, functioning well, there is hard evidence of the impact of their work, particularly with regard to getting birth certificates for OVC so that they can enroll in school. This success can be used for advocacy at the national and local levels. With regard to the Protective Environment Framework, this activity will enhance government commitment and capacity (Component 2), as well as contribute to the provision of essential services (Component 8), which in this case is schooling.

References

Institut National de la Statistique et Ministère de la Lutte contre le SIDA (Côte d’Ivoire) and ORC Macro. 2006. Enquête sur les indicateurs du SIDA, Côte d’Ivoire 2005. Calverton, MD: INS and ORC Macro.

Long, S. 2010. Child Protection within OVC Programming (DRAFT). Arlington, VA: USAID’s AIDSTAR-One Project, Task Order 1.

UN Children’s Fund (UNICEF). 2007. Enhanced Protection for Children Affected by AIDS: A Companion Paper to The Framework for the Protection, Care and Support of Orphans and Vulnerable Children Living in a World of HIV/AIDS. New York: UNICEF.

Acknowledgements

The author is grateful to Côte d’Ivoire’s Ministry of Women, Families and Social Affairs for providing access to staff and facilities for this study. The support of the PNOEV Director, Dr. Clementine Koua-Anderson, is greatly appreciated, along with the kind cooperation of the PEPFAR team in Abidjan. In particular, Cynthia Coulibaly-Curtis and Marthe Bohi of PNOEV were instrumental in facilitating the fieldwork. The authors are also grateful to the staff and clients of the social centers of Koumassi, Attecoubé, and Abengourou who agreed to be interviewed, as well as to members of the Legal Units who participated in the study. Additional thanks to Gretchen Bachman (Senior Technical Advisor, PEPFAR OVC Technical Working Group Co-chair, Office of HIV/AIDS, USAID), and to Maury Mendenhall (Technical Advisor, OVC, Office of HIV/AIDS, USAID) who worked closely with the AIDSTAR-One team to develop this case study and provided invaluable technical input.

Recommended Citation

Castle, Sarah. 2011. Legal Units: Child Protection Support for Orphans and Vulnerable Children and Their Families in Côte d’Ivoire. Case Study Series. Arlington, VA: USAID’s AIDS Support and Technical Assistance Resources, AIDSTAR-One, Task Order 1.