Orphans and Other Vulnerable Children: Reflections on Targeting, Programming Gaps, and ScalingUp

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Orphans and Other Vulnerable Children
Reflections on Targeting, Programming Gaps, and
Scaling-Up

• GH Mini-University
• George Washington University
• October 24, 2007
• Dr. J. Kirk Felsman
• Senior OVC Technical Advisor
• U.S. Agency for International Development

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Rates of orphaning in sub-Saharan Africa are
highest in central and southern Africa (2005)
Source UNAIDS and UNICEF estimates, 2006
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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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A. Freud D. Burlingham War and Children 1943

• The war acquires comparatively little
  significance for children so long as it only
  threatens their lives, disturbs their material
  comfort or cuts their food rations. It becomes
  enormously significant the moment it breaks up
  family life and uproots the first emotional
  attachments of the child within the family group.
  London children, therefore, were on the whole
  much less upset by bombing than by evacuation to
  the country as a protection against it -

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Defining OVC and targeting

• Acronyms simplification stigma
• Sympathy vs Empathy
• s Other vulnerable Children
• Coverage
• Targeting resources or children?
• Capacity of households, communities,
• systems

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The childs experience

• Healthy child development hinges on social
  relationships Ubuntu
• Erikson Actuality (facts) and Reality (what it
  means feels like)
• Loss and separation at-risk for isolation and
  withdrawal
• Ego constriction childs self-perception
• Child vs Adult perspectives on vulnerability
• affective responses vs material needs
• Identification more absorbed than learned

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Perceived Problems related to children, by type
of household Kisesa, Tanzania
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Programming Gaps

• Developmental range ECD through livelihoods
  social protection with adolescence and youth
• HBC roles and needs of children
• competence/psychosocial support
• Pre-adolescent/adolescent girls Zim data girl
  guides
• Child Protection birth registration, abuse,
  separation displacement inheritance rights
• Support for national staff and volunteers

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Fine grained analysis Kisesa Cohort study,
Tanzania

• The major finding is the vulnerable situation of
  the girl who has lost her mother or if the mother
  is absent
• If the girl is 6 to 12 year old, she is by far
  the most likely to move to another households
  when a losing a parent
• If the girl is 6 to 12 years old, the chances are
  doubled that she will be sent away to help
  guardians/grandparents if her mother is away than
  if the father is away
• If the girl is 13 to 17 years old and loses her
  mother, the chances that she will be engaged in
  paid work are three times as big as if she lost
  her father
• If the girl is 7 to 9 years old and has lost her
  mother, the likelihood that she will be going to
  school is 0.80 compared to if she had lost her
  father
• If the girl has lost both her parents, she will
  start school one year later compared to the
  situation where her parents are alive
• If the girl is 13 to 17 years old and has lost
  her mother, she is the one getting on most poorly
  with her caretaker
• If the girl is 13 to 17 years of age, has lost
  her mother or both parents, and has lived in at
  least one other home, she is more likely to have
  experienced mistreatment than any other category
  of child

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In Zimbabwe girls who lost their mother are most
vulnerable to HIV
Percent ()
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Scaling-Up - Shared Challenges

• 64,000 question
• Scale vs Quality comprehensive care Good
  enough mothering
• Social protection Social/cash transfers
• Communities Role local ownership leadership
  including mechanisms to channel funds into local
  communities and yield the control of it
  vulnerability locally defined, including the
  childs perspective

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The Assistance to Orphans and Other Vulnerable
Children in Developing Countries Act

• What is Public Law 109-95?
• Landmark legislation requiring the U.S.
  Government (USG) to devise a single
• comprehensive strategy for addressing critical
  needs among the developing worlds
• collective of highly vulnerable children.

THE VISION Local responses for
global impact OJECTIVES
Efficiency and effectiveness of U.S. assistance,
communication and coordination
Primary point of information, telling the U.S.
story
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USG Resources and Commitment

• Value of continuity of OVC Care equated with the
  continuity of ART services
• Global Fund contribution
• 10 of PEPFAR OVC Care with pediatric ART within
  TX
• Reauthorization of PEPFAR Phase II Continuation
  of OVC Earmark
• Capacity building community national level

All told, FY 2006 commitments for USG-funded
programs that include services for HVC was in
excess of 5 billion, reaching more than 135
million children.