As of 2013, an estimated 17.7 million children worldwide had lost one or both parents to AIDS. Most of these children (15.2 million) live in sub-Saharan Africa. Many millions more were orphaned for other reasons.
Schools can be an important source of protection and stability for vulnerable children, and many countries in sub-Saharan Africa have made impressive strides towards parity in school attendance among orphans and non-orphans. A growing number of countries, in Africa and elsewhere, are also drawing up national action plans in support of orphans and other children at risk, embracing a wide definition of ‘vulnerability’.
RISKS FACED BY ORPHANS AND OTHER VULNERABLE CHILDREN
Orphans and children considered vulnerable for other reasons, including HIV and AIDS, are at higher risk of missing out on schooling, living in households with less food security, and suffering from anxiety and depression. They are also in greater danger of exposure to HIV. Their experiences differ across families, communities and countries, and are influenced by a complex mix of variables, including children’s relationships to their caregivers, the wealth of their household and community, HIV prevalence in the area and many other factors. To care properly for orphans and vulnerable children, a minimum package of support is needed and includes access to services such as education, health care, social welfare and protection. However, without laws, policies and services that assist families and communities in caring for children at risk, such support tends to remain low.
Developing routine monitoring indicators and tools for collecting data on orphans and vulnerable children is difficult since a standard definition of ‘vulnerability’ has not been established and a minimum package of services has yet to be determined. In addition, poor coordination of services means there is the strong possibility that children will receive multiple services and be counted more than once. Greater attention needs to be given to defining optimum services and beneficiaries as well as strengthening coordination and reporting on the services provided to orphans and vulnerable children.
PROGRESS: ATTENDANCE IN SCHOOL
Schools continue to be a strong source of protection and support for all children, including children affected by HIV and AIDS. Schools often serve as entry points for children in need of health services and meals, for instance. Moreover, the routine of schooling can help children affected by HIV and AIDS cope with their situation and regain a sense of normalcy and stability. The protective nature of schooling is, however, dependent on safeguarding rights within education and providing safe and inclusive learning environments at a reasonable distance from children’s homes and with access to clean water and sanitation.
Children who have lost both parents are generally less likely to attend school than children whose parents are both still alive. Thus, a key indicator of the situation of AIDS-affected children is the school attendance ratio of orphans. This ratio compares school attendance of children aged 10 to 14 who have lost both parents with those children whose parents are both still alive and who live with one or both parents. Most countries in sub-Saharan Africa have made significant progress towards parity in school attendance for orphans and non-orphans aged 10 to 14. Globally, children who have lost both parents are now 84 per cent as likely to attend school as their non-orphaned peers. Within sub-Saharan Africa, they nearly have reached parity and children who have lost both parents are 96 per cent as likely to attend schools as their non-orphaned peers.
The nature of vulnerability in children can be complex and needs to be analysed within specific country and local contexts. For example, an analysis of household surveys in 36 countries found that, in many countries, children who are orphaned fare far worse than other children when measured by certain indicators of child development, such as nutritional status, school attendance and age at sexual debut. However, in other countries, orphans fare the same or are statistically better off than other children. Some of this inconsistency can be explained by the situational context. In countries with high levels of school attendance overall, nearly the same percentages of both orphans and non-orphans attend school. In contrast, in countries with lower levels of school attendance, many show large disparities between orphans and non-orphans, in favour of those who have not lost their parents.
PROGRESS: NATIONAL-LEVEL RESPONSES
In 24 countries where household surveys were conducted since 2005, the proportion of orphans and vulnerable children whose households received basic external support ranged between 1 per cent in Sierra Leone to 41 per cent in Swaziland, with a median value of 12 per cent. Such support included education assistance, medical care, clothing, financial support and psychosocial services.
The shift towards inclusive programming to help all vulnerable children, including those directly affected by AIDS, is making an impact. The growing call for a broader, more inclusive definition of vulnerability is reflected in many national action plans in Eastern and Southern Africa. In Zimbabwe, for instance, the National Plan of Action for Orphans and Other Vulnerable Children embraces a broad definition of vulnerability that extends beyond orphanhood and the impact of HIV and AIDS.
Over 30 countries have developed or finalized national plans of action with benefits for orphans and other vulnerable children. Countries in Eastern and Southern Africa have continued to make significant progress in this regard, followed by those in West and Central Africa. National-level responses to orphans and vulnerable children have increasingly become part of broader social welfare and assistance to vulnerable populations, including children, such as social protection programmes that are HIV-sensitive. In sub-Saharan Africa, social protection programmes have been scaled up – from operating in 9 countries in 2000 to 41 countries in 2012.*
That said, the process of developing national action plans for orphans and other vulnerable children has been generally slow, and implementation at scale is lacking. The often limited capacity of governments and implementing partners and lengthy periods for plan development – three to seven years or more – are major challenges. Insufficient resources for implementing national action plans are reflected in the levels of social assistance provided to vulnerable households. Efforts and investment should nonetheless be directed towards increasing access to basic services, ensuring appropriate alternative care, and providing social support and protection from abuse and neglect.
For more data and analysis on HIV and AIDS in children, see UNICEF’s Children and AIDS: Sixth stocktaking report by clicking here.
* Garcia, M., and C. M. T. Moore, The Cash Dividend: The rise of cash transfer programs in sub-Saharan Africa, The World Bank, Washington, D.C., 2012.
REFERENCES
UNICEF, Children and AIDS: Sixth stocktaking report, UNICEF, New York, 2013.
UNAIDS, Report on the Global AIDS Epidemic, UNAIDS, Geneva, 2013.
UNICEF, Progress for Children: A report card on adolescents, No. 10, UNICEF New York, 2012.
UNICEF, Progress for Children: Achieving the MDGs with equity, No. 9, UNICEF New York, 2010.
UNICEF, The State of the World’s Children 2014 in Numbers: Every child counts – Revealing disparities, advancing children’s rights, UNICEF, New York, 2014.
UNICEF, The State of the World’s Children 2013: Children with disabilities, UNICEF, New York, 2013.
UNICEF, UNAIDS, UNESCO, UNFPA, ILO, WHO and The World Bank, Opportunity in Crisis: Preventing HIV from early adolescence to young adulthood, UNICEF, New York, 2011.
WHO, Global Update on HIV Treatment 2013: Results, impact and opportunities, WHO, Geneva, 2013.
WHO, UNAIDS and UNICEF, Global HIV/AIDS Response: Epidemic update and health sector progress towards universal access – Progress report 2011, UNAIDS, Geneva, 2011.
