Organisational Profile
Cotlands is a non-profit organisation with Head Office in Turffontein, Johannesburg. We currently operate in six provinces in South Africa: Gauteng, KwaZulu-Natal, Eastern Cape, Western Cape, Mpumalanga and North West.
Background
Poverty is a key underlying factor in most of the cases referred to us. The authors call on all sectors to assist in tackling these issues if our country is to accomplish the Millennium Development Goals for maternal, newborn and child survival — and towards the goal of combating HIV/AIDS by 2015.
Cotlands is committed to aligning our programmes as closely as possible with government and global objectives for the welfare and protection of children and our response has been to focus our intervention programmes on health, social and emotional well-being, poverty alleviation and nutrition. We have also added education as a critical component, because we believe education is a basic human right and provides the foundation for children’s lifelong learning and work opportunities. These factors in turn determine the earning potential of the child once he/she reaches adulthood.
Today Cotlands offers a variety of residential and community-based programmes to meet the needs of vulnerable children. These programmes include children’s hospices, places of safety, home based care projects, nutrition and early childhood development programmes. All these projects offer holistic care to children and comprise several components that are aimed at empowering the clients, including medical, physical, psychosocial, education and emotional care, as well as antiretroviral (ART) programmes.
Services
10,9% of South Africa’s population comprises children from birth to four years old. *
Cotlands’ mission is to care for young children in need by providing psychosocial, education and healthcare services through residential and community based programmes.
Although declining, it is estimated that 55% of South African children (about 10-million) live below the ultra-poverty line — households with an income of less than R800 per month.
Cotlands’ focus is changing as we move from hand-outs to hand-ups. We are working hard to empower the families we encounter by introducing them to income-generating skills and projects.
A recent unanticipated challenge has been a trend of families becoming increasingly dependent on Cotlands for material aid. This dependency is not only disempowering for the caregivers, but also threatens the long-term sustainability of the organisation, both financially and in terms of capacity.
Families who rely on Cotlands for material aid cannot be discharged from the programme, which reduces opportunities for new referrals to be accommodated.
Children aged 0 – 4 account for 10.4% of all deaths in South Africa. Forty percent of these deaths are caused by HIV-related illnesses.
One of the greatest achievements of Cotlands’ proud 75-year history has been the ongoing significant impact antiretroviral therapy (ART) has had on reducing the death rate among HIV-infected infants and children. In 2009, across the country, nine children in the care of Cotlands died. Although this is still nine children too many, it is a marked reduction from the hundreds of children who passed away every year before ART became available.
Cotlands’ Counselling Project operating at Chris Hani Baragwanath Hospital has counsellors who, among other vital services, follow up clinic defaulters telephonically and through house visits.
Sick children are also cared for at home by Cotlands’ community caregivers, under the supervision of professional nurses and supported by social workers. Here our services range across a broad range of needs, to ensure that families receive whatever support they require in order to care for their children adequately at home.
84% of young children do not have access to formal Early Childhood Development (ECD) programmes and rely on their primary caregivers for stimulation and development.
Children from disadvantaged backgrounds, children who experience early institutionalisation and chronically ill children are likely to experience developmental delays. Educational theorists believe that a strong foundation in the early stages of development drastically improves the performance of the children once they enter the senior phases.
Cotlands’ education programmes operate in Gauteng, Western Cape, KwaZulu-Natal, North West, Eastern Cape, and Mpumalanga. They are designed to address children’s developmental needs by providing a variety of innovative programmes. Our ECD centres provide learning opportunities for children between the ages of two and six years. Daily programmes ensure holistic development and aim to address development delays. Learning is achieved through a play-based approach using a variety of educational equipment, both indoors and outdoors.
The Cotlands team works with babies and toddlers individually, allowing opportunities for personal contact, while focusing on individual developmental needs. An array of activities, including “Baby Gym” boost children’s language, motor and sensory skills.
Cotlands also manages homework support sites to support school going children with their homework, as well as to provide them with opportunities to create artwork, play educational games, read and participate in outdoor activities. Intervention programmes to address delays in reading and mathematics have also been implemented.
One of our latest projects is to create Active Learning Libraries to serve the impoverished community of Hlabisa in KwaZulu-Natal, where Cotlands provides Home Based Care to orphans, vulnerable and sick children. This programme will be rolled out to the other provinces in 2010.
21.1% of children between one and six display stunted growth from chronic malnourishment. The highest prevalence of hunger (83%) is found in the Eastern Cape.
The Cotlands Nutrition Project aims to provide early identification and treatment of malnutrition in children between birth and five years of age, as it is vital that children are adequately nourished at this stage to ensure appropriate development through to adulthood. A professional nurse assesses the adequacy of the local children’s nutrition and prescribes a re-nourishment programme for each child. If the malnutrition is HIV-related and cannot be reversed through a feeding programme alone, these children are referred to an appropriate clinic or hospital.
Going beyond just providing food for the community’s children, the Cotlands team refers primary caregivers to programmes that teach them income generating skills and how to plant and maintain food gardens. Other training offered to the families includes educational talks on nutrition, basic child care and stimulating the pre-school child.
Cotlands also runs feeding schemes for orphans in KwaZulu-Natal and for children at risk in Eastern Cape.
93% of children from 0 – 4 have both parents alive, but only 42,8% live in the same household as their parents.
Many of the children Cotlands supports live in granny-headed households or in foster care with extended families, as a result of being orphaned or having been abandoned by their parents. In response, all our services have a strong psychosocial focus to provide support both to the children and their families.
Services include counselling, support groups, memory books, formalising placements, and assisting families to access government services such as applying for birth and death certificates and social grants.
Monitoring and Evaluation
All Cotlands programmes are monitored through the use of statistical data, as well as via monthly progress reports submitted to the Child Development Committee. These reports evaluate progress in relation to project objectives.
Our personnel also undergo quarterly performance reviews, while supervision reports are submitted by project managers to measure the impact and efficacy of each project. Finances are monitored by measuring performance to budget and this information is submitted monthly to the Finance Committee for review. Quarterly or half-yearly progress reports are submitted to donors on request.
Future Plans
Under the guidance of our national managers, Cotlands is poised to move from a residential organisation with some community outreach, to a community outreach organisation with a residential component that is only brought into play as a last resort.
If we are to continue serving more and more children in needs, we must focus our efforts on the most cost-effective programmes. We will therefore continue to operate in the five provinces of South Africa we already serve — Gauteng, Western Province, KwaZulu-Natal, Eastern Cape and Mpumalanga. However, in the current economic climate, expansion plans will be minimal. As far as possible, we will try to form partnerships and increase our networks when doing so, in order to continue to meet the needs of vulnerable children and their families, without these needs necessarily being supplied by Cotlands.
A joint report published by the Department of Health, the United Nations Children’s Fund (UNICEF), the University of Pretoria, Save the Children, and the Medical Research Council identifies “the Big Five” causes of child deaths in the current social climate: pregnancy and childbirth complications, newborn illnesses, childhood illnesses, HIV and AIDS and malnutrition.
In order to be sustainable, these interventions include training and supporting the children’s primary caregivers. Our ultimate goal is to equip families to care for their children at home by imparting the appropriate skills and providing sufficient resources.
For the past 75 years, our core focus has been on babies and pre-school children and we have been particularly successful at restoring their health and wellbeing through a holistic spectrum of interventions. In recent years, we’ve also been able to introduce the children who are HIV positive onto antiretroviral therapy (ART), with marvellous results.
In response, we have set ambitious goals for increased numbers of food gardens and income-generation projects in the 2011 fiscal year. We have been very successful in establishing food gardens in the Eastern Cape and have started to replicate this success in Gauteng and KwaZulu-Natal. To encourage self-sufficiency, our goal is to expand our income-generating projects to accommodate an increasing number of the women in our home-based care programme within the next two years.
Although the introduction of ART has dramatically reduced the death rate of children in Cotlands’ care, for a variety of reasons, some children still succumb to AIDS-related illnesses or need palliative care for other life limiting or life threatening illnesses. As part of Cotlands’ residential care, we operate two paediatric hospices — in Gauteng and the Western Cape — which care for chronically, acutely and terminally ill children who cannot be cared for within the community. Care is offered by a transdisciplinary team and extends across the full spectrum to address the health, psychosocial and educational needs of the child.
All these efforts are bearing much fruit. For the first time in about 10 years, since the admission of HIV positive children at Cotlands, our Grade R class have been assessed and found to be school-ready at the milestone age. This is a result of a combination of the ART and the exceptional work done by the Cotlands Education and Childcare departments.
For a limited period of time Cotlands undertakes to provide material aid (food parcels, milk formula and e-pap) to families in need, until a more permanent solution — such as accessing government grants — can be organised, or home food gardens are established.
For the children who cannot remain in the community, Cotlands has two children’s homes and two community houses. Our aim in these residential care facilities is to minimise the duration of the children’s stay, and every effort is made to reunify the families or seek alternative placements through adoption or foster care.
* Statistics provided by UNICEF
Cotlands’ Scope
- Cotlands cares for on average of 4000 primary beneficiaries (children)
- We provide nutritional support to more than 1600 children every month
- The death rate in Cotlands Children’s Hospice in Johannesburg reduced from 84 in 2002 to just one in 2009.
- Cotlands currently operates in six provinces
- Cotlands will celebrate its 75th birthday in 2011.
Annual expenditure over the past four years:
| 2008 | 2009 | 2010 | 2011* |
| R 21 353 588 | R 26 911 161 | R 28 066 208 | R 29 507 281 |
* Budget
Staff complement over the past four years:
| 2008 | 2009 | 2010 | 2011* |
| 241 | 268 | 296 | 372 |
* This total includes 110 contract workers that Cotlands coordinates on behalf of the Department of Health in KwaZulu-Natal
