Company Address: Address 2821 Emerywood Parkway, Richmond, VA 23294

  • Grant Finance Officer

    Grant Finance Officer

    General Description of the Role:
     Reporting to the  ChildFund Kenya Child protection Advisor, and working closely with Child Rise Development programme coordinator,  Tharaka Nithi County Children Children’s Coordinator, Tharaka South and Igamba Ngombe Sub counties Children officers, respective volunteer children officers, the community child protection focal persons and other relevant government departments, the successful candidate will coordinate implementation of project activities aimed at Increasing and improving the capacity of Community based teams to prevent and respond to Child Protection threats with a specific focus on combating Child marriage and FGM, Promoting children agency (fora) and Enhancing the effectiveness and efficiency of the formal Child protection systems service delivery through improved linkages to the community based child protection mechanisms (CBCPM).
     Specific Description of the Role:

    Coordinate planned capacity building activities for community resource persons.
    Oversee community mobilization working closely with the department of Children services in consultation with other government departments, likeminded stakeholders and community based resource persons.
    Oversee implementation of planned community outreach activities.
    Undertake documentation of field activities in line with donor guidelines and timely submission of Quarterly and Annual reports.
    Represent ChildFund at County level and below.

  • Child Protection Officer

    Child Protection Officer

    Job description
    General Description Of The Role
    Reporting to the ChildFund Kenya Child protection Advisor, and working closely with Child Rise Development programme coordinator, Tharaka Nithi County Children Children’s Coordinator, Tharaka South and Igamba Ngombe Sub counties Children officers, respective volunteer children officers, the community child protection focal persons and other relevant government departments, the successful candidate will coordinate implementation of project activities aimed at Increasing and improving the capacity of Community based teams to prevent and respond to Child Protection threats with a specific focus on combating Child marriage and FGM, Promoting children agency (fora) and Enhancing the effectiveness and efficiency of the formal Child protection systems service delivery through improved linkages to the community based child protection mechanisms (CBCPM).
    Specific Description Of The Role

    Coordinate planned capacity building activities for community resource persons.
    Oversee community mobilization working closely with the department of Children services in consultation with other government departments, likeminded stakeholders and community based resource persons.
    Oversee implementation of planned community outreach activities.
    Undertake documentation of field activities in line with donor guidelines and timely submission of Quarterly and Annual reports.
    Represent ChildFund at County level and below.

  • Project Officer – Wash

    Project Officer – Wash

    Overall Objectives of the position:
    Facilitate successful implementation of a grant funded WASH project in Mukuru, Kasarani and Njiru informal settlements within Nairobi County and contribute to the wellbeing of children through promotion of Safe and healthy Environment for Children to grow in.
    General Description of the Role:

    The Project Officer will be responsible for the grant activities; mobilize communities and leaders in the implementation and coordination of stakeholders to deliver Nairobi WASH Project. The project officer will assist to develop and maintain good relationships with the project participants, LP teams, relevant Government Departments at the National and County level to deliver on his /her mandate.
    Reporting to the Program Manager Nairobi and Metropolitan, the WASH Project Officer will be based at MCO office in Mukuru and will be responsible for:
    Ensuring that the project activities are implemented according to the Project Design as provided in the proposal
    Mobilizing community support, including participation in the planned WASH activities and ensure buy in of the project for successful implementation of the project.
    Participate in the WASH coordination mechanisms including, steering committees and working groups that coordinate and guide the WATSAN sector response plans, operations and related activities within Nairobi.
    Managing the assigned WASH project to meet the project objectives within budget and allotted time frame.
    Providing strong leadership of the assigned WASH project and ensure both short and long-term positive impacts and outcomes for the beneficiaries and Metropolitan ChildCare Organization (MCO).
    Supporting the application/implementation and adherence to existing policies, WASH strategies and set standards by donor and Government.
    Assisting in documenting lessons learnt/good practices and other relevant reports for better WASH programming.
    Regularly review project status, comparing budgeted to actual expenditure
    Ensuring accurate and timely progress reports according to ChildFund Kenya and Korea timeframes and formats.
    Monitoring and troubleshooting on issues/factors that can affect the smooth implementation of the project and share in a timely manner with the supervisor and stakeholders.
    Preparing requests for activity implementation and payments.
    Facilitating routine data collection to track beneficiaries of the WASH project.
    Any other duties as may be assigned from time to time by the supervisor

    Person Specifications

    A minimum of a Bachelor’s Degree in the Social Sciences or public health
    At least three (3) years’ experience in the management of community projects and preferably working with local partners.
    Proven ability to conceptualize, develop, plan and manage projects/mass events as well as transfer information and skills.
    Proven organizational, analytical, negotiating, communication (oral and written) and training skills
    Excellent written, verbal, interpersonal and cross-cultural communications skills.
    Ability to prioritize, focus and deliver quality results within deadlines while meeting conflicting work demands and targets; working with or without teams with minimum supervision.
    Experience in developing systems to capture and measure the impact of WASH activities.
    Excellent interpersonal skills and ability to interact professionally with donor, project stakeholders, County collaborators and staff at all levels of the organization.
    Ability to work independently and with minimum supervision to meet strict deadlines

  • Country Director

    Country Director

    SUMMARY
    Responsible for strategic leadership and oversight of ChildFund operations in the assigned Country office (NO), including program direction, country strategy development, program quality, innovation and impact, emergency preparedness and response, human resource management and talent development, financial and organization’s assets stewardship, resource acquisition, and administrative operations.
    The Country Director is expected to play an important role in the evolution of NO operations to become more effective and efficient in reducing costs while maximizing social impact and appropriate role of an INGO in the country of assignment working with strong local partners, and fostering alternative creative/ innovative approaches to deliver program social impact.  S/he will also guide the Country office team in ensuring operational effectiveness and efficiency (with the Shared Support Unit where applicable), an organizational culture where ChildFund core values and operational principles are practiced, appropriate systems are in place and properly implemented, maintenance of good working relationships with local partners, government officials, and donors, and to ensure all staff and representatives are fully aware of and adhere to ChildFund policy and commitments about Child Safeguarding.
    DUTIES/RESPONSIBILITIES

    Take all appropriate corrective actions, including disciplinary, legal or other actions in response to any violation of the Child Safeguarding Policy and follow up on any findings of a violation and review the applicable policies, procedures and protocols to identify and address any gaps or weaknesses.
    Supervise guide and mentor staff to achieve performance metrics and core outcomes and oversee the establishment and functioning of a strong, effective senior management/leadership team.
    Oversee the recruitment and orientation of senior and middle management staff, provide on-going talent management supervision, leadership, and guidance, and provide oversight in the management and development of NO human resources.
    Provide strategic oversight and ensure excellence for a healthy growing operational portfolio with program quality, satisfied and engaged staff, program strategies with monitoring and learning systems, and grant acquisition with appropriate pre- and post-award management.
    Drive, develop, and ensure the adaption, integration, and learning around key areas including child safeguard standards, monitoring and evaluation, disaster risks reduction, gender equity and diversity, and that an appropriate/timely/ effective disaster emergency response and preparedness plan is in place and updated regularly.
    Develop ChildFund reputation and brand among government and peer INGOs to pre-position, advocate, network and raise profile and reputation among key influencers important to children’s right.
    Ensure the organization is recognized by stakeholders (relevant government authorities, donors, other NGOs, media etc) as a strong child development organization and credible reference point on issues related to development, and specifically to be seen as a leader in children’s issues.
    Ensure optimal financial, human and physical resource allocation and management and quality standards (with the Shared Support Unit where applicable) for successful implementation of the country’s and organization’s strategic plan and mission and to monitor and report on their progress.
    Provide leadership in the development or management of assigned functions associated with the new program Delivery Models(s) initiative.
    Ensure proper use of ChildFund resources in pursuit of quality programs for child development, and ensure that adequate internal control are in place to protect NO financial and non-monetary assets and that they are used in accordance with donor terms and conditions.

    QUALIFICATIONS/EXPERIENCE

    7 – 8 years’ experience in senior management position in development field
    Experience in emergency programs, and/or community development
    Experience in the management of large institutional grants preferred
    Proven track record of strong management skills with complex programs and a large number of staff.
    Experienced in child focused programming and sponsorship.
    Outstanding written and oral communication skills in English.
    Ability to grow/develop a development agency by attracting local and intercountry resources and building alliances.
    Demonstrated high-level interpersonal and cross-cultural skills including the ability to build collaborative relationships internally and externally with sensitivity to cultural, ethnic, social and political issues.
    Ability to pragmatically solve problems, plan a course of action using analytical, conceptual, strategic and forward-thinking abilities to achieve an effective resolution.
    Demonstrated technical expertise in such areas as: project, budget and resource management.
    Strong leadership skills in such areas as: fostering teamwork; developing and motivating others; managing change; conflict resolution; initiative and flexibility.
    Strong visioning, strategic planning, implementation ability and effective under pressure, results oriented and proactive with the ability to multi-task.
    Ability to demonstrate support for innovation and organizational changes needed to improve the organization’s effectiveness; helping others to successfully manage organizational change.
    Ability to recognize, react and adjust to rapidly changing conditions and to lead the resources in appropriate direction with cohesiveness and a sense of urgency
    Coalition building capabilities, external networking and experience in developing strategic partnerships
    Fluency in English and or Spanish (in Americas) – some countries would require fluency in Portuguese or French; and thus ability to communicate in another major language is highly desired.

    EDUCATION/CERTIFICATIONS

    Master degree in related field of community development/social science or relevant discipline.

  • Sponsorship Relations Supervisor

    Sponsorship Relations Supervisor

    Job description
    Summary
    Responsible for providing technical leadership for sponsorship programs in assigned areas through developing staff capacities, supporting quality growth and accountability and ensuring sponsorship service and programming standards and guidelines
    Duties/Responsibilities

    Strategic Development: Support the assigned areas with implementing strategies and proposals for acquisition and retention of sponsors. Support development and application of Sponsorship Monitoring and Reporting standards and tools for Areas/projects
    Capacity Building; Support improved capacities for staff as appropriate. Support, facilitate capacity building among staff. Support development and review of sponsorship Project Description Designs, child protection and monitoring and reporting systems. In liaison with assigned areas, identify training needs, supports training plans
    Sponsorship management. Support quality improvements in the area offices to ensure adherence to policies, and standards related to sponsorship. Responsible for overseeing performance in areas and communities as assigned to make sure that all sponsorship standards and guidelines of alignment of sponsorship and programs are being met. Conduct analysis of sponsorship information available through existing systems and databases and interpret trends and observations for management action. Generates proactive reports from the sponsorship systems, manages sponsor inquiries, and coordinates sponsor visits
    Correspondence management: Manage the quality, timeliness and inflow/outflow of correspondence between Child and Sponsor. Interpret the need/perceived need of the sponsors to the area/communities to ensure the sponsor needs are met. Provide support to the sponsorship team at AO to ensure that all child correspondence is satisfactorily processed and responded to within the set standards and ensure that IO/ IAs receive fast, efficient and comprehensive action on their requests for information
    Provide administrative support as indicated by management in analysis and use of the Sponsorship performance information and data from the area offices for program and management purposes. Maintain and update a calendar of key sponsorship activities and events. Participate in sponsorship related processes and events (e.g. the Sponsorship Forum, child counts etc.) to review the quality of sponsorship monitoring and reporting systems and tools; practices and processes; and thus contribute to continual improvements
    Monitoring and Evaluation; Together with the Programs, Finance and Quality Assurance work with various area offices in the development and utilization of agreed monitoring, evaluation, quality assurance tools and reporting procedures and to effectively improve the quality of sponsorship and programming. Monitor the implementation of Safety Net PDDs, Quality Assurance, child and benefit tracking, agreed sponsorship standards/ guidelines sponsor retention strategies, DFC management, integration of sponsorship with programs and others as arise in the financial year
    Contribute to organizational learning by supporting the documentation of critical lessons learned in sponsorship quality improvement through operational research and critical reflection activities as appropriate (for example CVS for decision making). Bring forth the expertise and the experiences of the national office in the development of common sponsorship guidelines and tools

    Required Skills

    Must be a clear, fast thinker who can define action plans and implement them
    Proven skills in data analysis using computer programs
    Ability to work in a team environment
    Outstanding written and oral communication skills in English; fluency in Swahili required
    Computer proficiency in general office software applications (i.e. Word, Excel, Outlook)
    Bachelor’s or higher-level degree preferred

    Required Experience

    6 years’ experience.
    Must have a good understanding of Sponsorship Operations and Workflows, sponsorship programming, sponsorship policies and standards
    Experience in design and facilitation of training programs
    Experience and understanding of community and family care issues

  • Grant Finance Officer

    Grant Finance Officer

    General Description of the Role:
     Reporting to the  ChildFund Kenya Child protection Advisor, and working closely with Child Rise Development programme coordinator,  Tharaka Nithi County Children Children’s Coordinator, Tharaka South and Igamba Ngombe Sub counties Children officers, respective volunteer children officers, the community child protection focal persons and other relevant government departments, the successful candidate will coordinate implementation of project activities aimed at Increasing and improving the capacity of Community based teams to prevent and respond to Child Protection threats with a specific focus on combating Child marriage and FGM, Promoting children agency (fora) and Enhancing the effectiveness and efficiency of the formal Child protection systems service delivery through improved linkages to the community based child protection mechanisms (CBCPM).
     Specific Description of the Role:

    Coordinate planned capacity building activities for community resource persons.
    Oversee community mobilization working closely with the department of Children services in consultation with other government departments, likeminded stakeholders and community based resource persons.
    Oversee implementation of planned community outreach activities.
    Undertake documentation of field activities in line with donor guidelines and timely submission of Quarterly and Annual reports.
    Represent ChildFund at County level and below.

  • Child Protection Officer

    Child Protection Officer

    Job description
    General Description Of The Role
    Reporting to the ChildFund Kenya Child protection Advisor, and working closely with Child Rise Development programme coordinator, Tharaka Nithi County Children Children’s Coordinator, Tharaka South and Igamba Ngombe Sub counties Children officers, respective volunteer children officers, the community child protection focal persons and other relevant government departments, the successful candidate will coordinate implementation of project activities aimed at Increasing and improving the capacity of Community based teams to prevent and respond to Child Protection threats with a specific focus on combating Child marriage and FGM, Promoting children agency (fora) and Enhancing the effectiveness and efficiency of the formal Child protection systems service delivery through improved linkages to the community based child protection mechanisms (CBCPM).
    Specific Description Of The Role

    Coordinate planned capacity building activities for community resource persons.
    Oversee community mobilization working closely with the department of Children services in consultation with other government departments, likeminded stakeholders and community based resource persons.
    Oversee implementation of planned community outreach activities.
    Undertake documentation of field activities in line with donor guidelines and timely submission of Quarterly and Annual reports.
    Represent ChildFund at County level and below.

  • Project Officer – Wash

    Project Officer – Wash

    Overall Objectives of the position:
    Facilitate successful implementation of a grant funded WASH project in Mukuru, Kasarani and Njiru informal settlements within Nairobi County and contribute to the wellbeing of children through promotion of Safe and healthy Environment for Children to grow in.
    General Description of the Role:

    The Project Officer will be responsible for the grant activities; mobilize communities and leaders in the implementation and coordination of stakeholders to deliver Nairobi WASH Project. The project officer will assist to develop and maintain good relationships with the project participants, LP teams, relevant Government Departments at the National and County level to deliver on his /her mandate.
    Reporting to the Program Manager Nairobi and Metropolitan, the WASH Project Officer will be based at MCO office in Mukuru and will be responsible for:
    Ensuring that the project activities are implemented according to the Project Design as provided in the proposal
    Mobilizing community support, including participation in the planned WASH activities and ensure buy in of the project for successful implementation of the project.
    Participate in the WASH coordination mechanisms including, steering committees and working groups that coordinate and guide the WATSAN sector response plans, operations and related activities within Nairobi.
    Managing the assigned WASH project to meet the project objectives within budget and allotted time frame.
    Providing strong leadership of the assigned WASH project and ensure both short and long-term positive impacts and outcomes for the beneficiaries and Metropolitan ChildCare Organization (MCO).
    Supporting the application/implementation and adherence to existing policies, WASH strategies and set standards by donor and Government.
    Assisting in documenting lessons learnt/good practices and other relevant reports for better WASH programming.
    Regularly review project status, comparing budgeted to actual expenditure
    Ensuring accurate and timely progress reports according to ChildFund Kenya and Korea timeframes and formats.
    Monitoring and troubleshooting on issues/factors that can affect the smooth implementation of the project and share in a timely manner with the supervisor and stakeholders.
    Preparing requests for activity implementation and payments.
    Facilitating routine data collection to track beneficiaries of the WASH project.
    Any other duties as may be assigned from time to time by the supervisor

    Person Specifications

    A minimum of a Bachelor’s Degree in the Social Sciences or public health
    At least three (3) years’ experience in the management of community projects and preferably working with local partners.
    Proven ability to conceptualize, develop, plan and manage projects/mass events as well as transfer information and skills.
    Proven organizational, analytical, negotiating, communication (oral and written) and training skills
    Excellent written, verbal, interpersonal and cross-cultural communications skills.
    Ability to prioritize, focus and deliver quality results within deadlines while meeting conflicting work demands and targets; working with or without teams with minimum supervision.
    Experience in developing systems to capture and measure the impact of WASH activities.
    Excellent interpersonal skills and ability to interact professionally with donor, project stakeholders, County collaborators and staff at all levels of the organization.
    Ability to work independently and with minimum supervision to meet strict deadlines

  • Country Director

    Country Director

    SUMMARY
    Responsible for strategic leadership and oversight of ChildFund operations in the assigned Country office (NO), including program direction, country strategy development, program quality, innovation and impact, emergency preparedness and response, human resource management and talent development, financial and organization’s assets stewardship, resource acquisition, and administrative operations.
    The Country Director is expected to play an important role in the evolution of NO operations to become more effective and efficient in reducing costs while maximizing social impact and appropriate role of an INGO in the country of assignment working with strong local partners, and fostering alternative creative/ innovative approaches to deliver program social impact.  S/he will also guide the Country office team in ensuring operational effectiveness and efficiency (with the Shared Support Unit where applicable), an organizational culture where ChildFund core values and operational principles are practiced, appropriate systems are in place and properly implemented, maintenance of good working relationships with local partners, government officials, and donors, and to ensure all staff and representatives are fully aware of and adhere to ChildFund policy and commitments about Child Safeguarding.
    DUTIES/RESPONSIBILITIES

    Take all appropriate corrective actions, including disciplinary, legal or other actions in response to any violation of the Child Safeguarding Policy and follow up on any findings of a violation and review the applicable policies, procedures and protocols to identify and address any gaps or weaknesses.
    Supervise guide and mentor staff to achieve performance metrics and core outcomes and oversee the establishment and functioning of a strong, effective senior management/leadership team.
    Oversee the recruitment and orientation of senior and middle management staff, provide on-going talent management supervision, leadership, and guidance, and provide oversight in the management and development of NO human resources.
    Provide strategic oversight and ensure excellence for a healthy growing operational portfolio with program quality, satisfied and engaged staff, program strategies with monitoring and learning systems, and grant acquisition with appropriate pre- and post-award management.
    Drive, develop, and ensure the adaption, integration, and learning around key areas including child safeguard standards, monitoring and evaluation, disaster risks reduction, gender equity and diversity, and that an appropriate/timely/ effective disaster emergency response and preparedness plan is in place and updated regularly.
    Develop ChildFund reputation and brand among government and peer INGOs to pre-position, advocate, network and raise profile and reputation among key influencers important to children’s right.
    Ensure the organization is recognized by stakeholders (relevant government authorities, donors, other NGOs, media etc) as a strong child development organization and credible reference point on issues related to development, and specifically to be seen as a leader in children’s issues.
    Ensure optimal financial, human and physical resource allocation and management and quality standards (with the Shared Support Unit where applicable) for successful implementation of the country’s and organization’s strategic plan and mission and to monitor and report on their progress.
    Provide leadership in the development or management of assigned functions associated with the new program Delivery Models(s) initiative.
    Ensure proper use of ChildFund resources in pursuit of quality programs for child development, and ensure that adequate internal control are in place to protect NO financial and non-monetary assets and that they are used in accordance with donor terms and conditions.

    QUALIFICATIONS/EXPERIENCE

    7 – 8 years’ experience in senior management position in development field
    Experience in emergency programs, and/or community development
    Experience in the management of large institutional grants preferred
    Proven track record of strong management skills with complex programs and a large number of staff.
    Experienced in child focused programming and sponsorship.
    Outstanding written and oral communication skills in English.
    Ability to grow/develop a development agency by attracting local and intercountry resources and building alliances.
    Demonstrated high-level interpersonal and cross-cultural skills including the ability to build collaborative relationships internally and externally with sensitivity to cultural, ethnic, social and political issues.
    Ability to pragmatically solve problems, plan a course of action using analytical, conceptual, strategic and forward-thinking abilities to achieve an effective resolution.
    Demonstrated technical expertise in such areas as: project, budget and resource management.
    Strong leadership skills in such areas as: fostering teamwork; developing and motivating others; managing change; conflict resolution; initiative and flexibility.
    Strong visioning, strategic planning, implementation ability and effective under pressure, results oriented and proactive with the ability to multi-task.
    Ability to demonstrate support for innovation and organizational changes needed to improve the organization’s effectiveness; helping others to successfully manage organizational change.
    Ability to recognize, react and adjust to rapidly changing conditions and to lead the resources in appropriate direction with cohesiveness and a sense of urgency
    Coalition building capabilities, external networking and experience in developing strategic partnerships
    Fluency in English and or Spanish (in Americas) – some countries would require fluency in Portuguese or French; and thus ability to communicate in another major language is highly desired.

    EDUCATION/CERTIFICATIONS

    Master degree in related field of community development/social science or relevant discipline.

  • Sponsorship Relations Supervisor

    Sponsorship Relations Supervisor

    Job description
    Summary
    Responsible for providing technical leadership for sponsorship programs in assigned areas through developing staff capacities, supporting quality growth and accountability and ensuring sponsorship service and programming standards and guidelines
    Duties/Responsibilities

    Strategic Development: Support the assigned areas with implementing strategies and proposals for acquisition and retention of sponsors. Support development and application of Sponsorship Monitoring and Reporting standards and tools for Areas/projects
    Capacity Building; Support improved capacities for staff as appropriate. Support, facilitate capacity building among staff. Support development and review of sponsorship Project Description Designs, child protection and monitoring and reporting systems. In liaison with assigned areas, identify training needs, supports training plans
    Sponsorship management. Support quality improvements in the area offices to ensure adherence to policies, and standards related to sponsorship. Responsible for overseeing performance in areas and communities as assigned to make sure that all sponsorship standards and guidelines of alignment of sponsorship and programs are being met. Conduct analysis of sponsorship information available through existing systems and databases and interpret trends and observations for management action. Generates proactive reports from the sponsorship systems, manages sponsor inquiries, and coordinates sponsor visits
    Correspondence management: Manage the quality, timeliness and inflow/outflow of correspondence between Child and Sponsor. Interpret the need/perceived need of the sponsors to the area/communities to ensure the sponsor needs are met. Provide support to the sponsorship team at AO to ensure that all child correspondence is satisfactorily processed and responded to within the set standards and ensure that IO/ IAs receive fast, efficient and comprehensive action on their requests for information
    Provide administrative support as indicated by management in analysis and use of the Sponsorship performance information and data from the area offices for program and management purposes. Maintain and update a calendar of key sponsorship activities and events. Participate in sponsorship related processes and events (e.g. the Sponsorship Forum, child counts etc.) to review the quality of sponsorship monitoring and reporting systems and tools; practices and processes; and thus contribute to continual improvements
    Monitoring and Evaluation; Together with the Programs, Finance and Quality Assurance work with various area offices in the development and utilization of agreed monitoring, evaluation, quality assurance tools and reporting procedures and to effectively improve the quality of sponsorship and programming. Monitor the implementation of Safety Net PDDs, Quality Assurance, child and benefit tracking, agreed sponsorship standards/ guidelines sponsor retention strategies, DFC management, integration of sponsorship with programs and others as arise in the financial year
    Contribute to organizational learning by supporting the documentation of critical lessons learned in sponsorship quality improvement through operational research and critical reflection activities as appropriate (for example CVS for decision making). Bring forth the expertise and the experiences of the national office in the development of common sponsorship guidelines and tools

    Required Skills

    Must be a clear, fast thinker who can define action plans and implement them
    Proven skills in data analysis using computer programs
    Ability to work in a team environment
    Outstanding written and oral communication skills in English; fluency in Swahili required
    Computer proficiency in general office software applications (i.e. Word, Excel, Outlook)
    Bachelor’s or higher-level degree preferred

    Required Experience

    6 years’ experience.
    Must have a good understanding of Sponsorship Operations and Workflows, sponsorship programming, sponsorship policies and standards
    Experience in design and facilitation of training programs
    Experience and understanding of community and family care issues