Unite for Children

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Unite for Children Unite Against AIDS Rights
based approach to protection care and support of
children affected by HIV/AIDS
Africas Orphaned and Vulnerable
Generations CHILDREN AFFECTED BY AIDS
Doug WebbChildren and AIDS Section, UNICEF ESARO
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The number of orphans is decreasing in all
regions except sub-Saharan Africa, where AIDS has
hit the hardest
Estimated number of orphans ages 0-17 by region
Asia
Sub-Saharan Africa
Latin America and the Caribbean
Source UNAIDS and UNICEF estimates, 2006
3
Rates of orphaning in sub-Saharan Africa are
highest in central and southern Africa
Percent of children ages 0-17 orphaned by any
cause, 1995 and 2005
1995
2005
Source UNAIDS and UNICEF estimates, 2006
These maps do not reflect a position by UNICEF,
UNAIDS or USAID on the legal status of any
country or territory or the delineation of any
frontiers.
4
Estimates of per cent of children 0-14 years
orphaned in 2001 and in 2010 by district Kenya.
2001
2010
Source Takona and Stover based on modeling
using sentinel ANC and DHS data
5
In sub-Saharan Africa 5.5 million children
experienced the death of a parent in 2005 alone
Estimated number of children ages 0-17 who will
experience the death of a parent during the
year, Sub-Saharan Africa
Source UNAIDS and UNICEF estimates, 2006
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The number of double orphans in sub-Saharan
Africa is increasing due to AIDS
Estimated number of double orphans ages 0-17 due
to AIDS and due to all other causes, Sub-Saharan
Africa
Source UNAIDS and UNICEF estimates, 2006
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Vulnerable children what are the numbers and how
do we identify or locate them?

• Zambia 11 of children have chronically ill
  parents or live in a household with chronically
  ill adult or where adult died in past year
  (Zambia Sexual Behaviour Survey 2005)
• Zimbabwe 24 (Survey on Orphans and Other
  Vulnerable Children in Rural Urban High Density
  Zimbabwe 2004/2005)

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Despite orphaning being more common at older
ages, the numbers of young children who have lost
one or both parents is cause for concern
Percentage of children ages 0-17 who are orphaned
by age group, 2005, Sub-Saharan Africa
Orphans due to all causes
Source UNAIDS and UNICEF estimates, 2006
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Households with orphans have higher dependency
ratios
Dependency ratio among households with orphans
and without orphans
The dependency ratio is calculated as the
proportion of household members who are either
less than 18 or over 59 versus the proportion of
household members ages 18-59. Source Monasch
and Boerma, AIDS, 2004
10
Vulnerable children in Malawi are less likely to
have basic material goods than non-orphaned or
orphaned children
Percentage of children with basic material goods
(blanket, shoes, two sets of clothing), Blantyre,
Malawi 2004
Vulnerable child whose parent is chronically
ill, or who lives in a household where an adult
has recently died or an adult is chronically
ill. Street a child who slept on the street
the night before the survey. Source
UNICEF/USAID, 2004, OVC Pilot Survey, Blantyre
Malawi.
11
Orphaned and vulnerable children in Zimbabwe are
at higher risk of becoming infected themselves
HIV infection and reproductive health outcomes by
OVC status, Manicaland, Zimbabwe 2004
Source Gregson and others. 2005. HIV infection
and reproductive health in teenage women orphaned
and made vulnerable by AIDS in Zimbabwe. AIDS
Care 17(7)796-794.
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Rwanda

• More than 1.25m children orphaned
• Around 30 of all children are orphans (census
  2002). This figure needs updating
• An unknown amount are vulnerable
• More than 100,000 orphans live in households
  with no parental supervision

13
Orphans have more signs of psychosocial distress
than non-orphans in Uganda
Percent of children responding positively to
questions related to distress
Source Atwine, B. E. Cantor-Graae, F. Bajunirwe.
2005. "Psychological distress among AIDS orphans
in rural Uganda". Social Science and Medicine
61555-564.
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Stabilising infections but deepening impact
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Nature of the response

• How far from universality?
• Are the rights of affected a cause of political
  concern?

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National Commitments Africa
UNAIDS Regional Support Team East and Southern
Africa
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Many children are not registered
Percent of births registered in the five years
preceding the survey, 1999 - 2003
Source UNICEF-MICS and Measure DHS, 1999 2003.
18
Disadvantage is reduced under a universal primary
education policy
Percent of 10-14 year olds attending school,
non-orphaned children living with at least one
parent versus double orphans, Kenya
Source Kenya Demographic and Health Surveys,
1998 and 2003
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External support to households with orphans and
vulnerable children in Tanzania
Percent of children whose households are
receiving free external support
Source Tanzania AIDS Indicator Survey 2004.
20
Orphans - of orphaned and vulnerable children
whose households receiving child care support in
east and southern Africa, end 2005
14 Countries did not report on the support that
they provide for orphans and vulnerable children
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UNAIDS Regional Support Team East and Southern
Africa
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UNAIDS Regional Support Team East and Southern
Africa
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Challenges for East and Southern Africa

• Resource mobilisation and use 20 billion needed
  2007
• Integration/mainstreaming of children affected by
  HIV/AIDS/OVC into all sector plans PRSP, MTEF,
  SWAPs
• Longer term donor commitments predictable
  funding flows.
• Strengthen resource coordination operationalise
  OECD/DAC and 3 ones commitments on aid
  effectiveness alignment, harmonisation,
  simplification.
• Improved resource and expenditure tracking.

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National plans of action on OVC and their
integration

• Aim to utilise the national development planning
  process in order to realise the NPAs
• Integration success in Mozambique, Zambia
• Need to monitor OVC interests in development
  planning?
• How can we capture the civil society response in
  national tracking and monitoring mechanisms?
• How can civil society contribute to these
  integration aims?
• Work with wider stakeholder groups
  parliamentarians

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Observations

• Situation of orphans and other vulnerable
  children deteriorating across the region
• Vulnerability of children affected by illness and
  recent death of adults is recognised (targeted?)
• Need for responses that are AIDS impact sensitive
  but not AIDS impact specific (exception may be
  psychological and emotional support)
• Coverage is low, difficult to measure, and not
  being prioritised in planning/target setting
• Social protection and universal child
  benefit..the new paradigm?

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Challenges for civil society

• Engagement with national agenda universal
  access target setting
• Provision of coverage data for national response
• Alignment of project/programme work with national
  priorities
• Identify, reach and bring the most vulnerable to
  the services available. If the services are not
  there demand them.

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Thank you!