HIV/AIDS and early childhood development (ECD)

This report identifies barriers that children and families face in accessing anti-retroviral therapy (ART) centres in rural India. The report also seeks to find solutions to these barriers based on an operations research conducted in Maharashtra Pradesh and Manipur. Operations research objectives: * To build an understanding among policy makers of the barriers faced by children and caregivers accessing ART services in rural communities. * To assess and highlight a basic minimum level of standards for ART centres in terms of adequacy, quality and timeliness of support needed. * To explore opportunities for linkages with state and district level departments and/or local self-governing institutions

This policy brief is based on operations research conducted by India HIV/AIDS Alliance in Andhra Pradesh which explored the challenges that faced facilitating HIV testing and disclosure for children in 0-6, 7-14 and 15-18 age groups. The aim of the research was to understand current challenges and to provide possible short to medium term solutions, thereby strengthening child-centric care and support to children living with and affected by HIV. The briefing also outlines recommendations and key actions for improving HIV testing and disclosure with children and adolescents

This tool was designed to help communities assess the situations and needs of their children and the available resources, and to identify what action they can take, using the "participatory learning in action" process. The tool corresponds to the topics in the Building Blocks briefing notes

This report assesses some of the most important actions and changes for children affected by AIDS that occurred in the first year of the global campaign Unite for Children

This case study documents a successful model for facilitating a strong community response to HIV and AIDS. The Salvation Army Change Programme in Ndola and Choma Districts in Zambia illustrates the facilitation process stimulating an appropriate local response to HIV and AIDS and essential component of human capacity development. The model builds on local strengths and resources, stimulating ordinary people to address the barriers that prevent them from using HIV and AIDS information and services to prevent new infections, compassionately care for those who are infected and mitigate the effects of the epidemic on families and the community. Only by addressing personal risk, stigma and the potential for personal and societal change will the demand for and use of voluntary counselling and testing, prevention of mother to child transmission and antiretroviral therapy services increase

This document moves towards a standard framework to help people involved in programmes conduct a situation analysis concerning orphans and vulnerable children (OVCs) in the context of HIV/AIDS. It includes the process of planning the situation analysis, defining its purpose, goals and objectives. It provides advice on methods to gather data and frameworks for assessing health, education and economic impacts of HIV/AIDS on OVCs. Analysis, reporting and communication of the information found is discussed

This paper articulates the vulnerabilities and protection risks of children affected by AIDS and proposes practical actions to address them. It is a companion paper to "The Framework for the Protection, Care and Support of Orphans and Vulnerable Children Living in a World with HIV and AIDS". It aims to help translate government commitment into practice, building on the strategies laid out in the Framework

This report looks at the challenges in facilitating testing and disclosure for children in 0-6, 7-14 and 15-18 age groups. The report is based on operations research conducted by India HIV/AIDS Alliance in Andhra Pradesh and Manipur. This operations research was aimed at understanding current challenges with facilitating testing and disclosure for children, and to provide possible short to medium term solutions. Three broad objectives of the study were: * Identifying challenges and factors that prevent the community from seeking HIV testing of their children * Understanding issues related to disclosure of HIV status to children, and the social impact related to disclosure faced by parents and children * Using the study findings in formulating practical solutions to address these issues, and to come up with practical recommendations on building links between policy and practice

The publication examines the economic, social and emotional problems experienced by older carers, orphans and vulnerable children through case studies of community responses in Africa and Asia. It concludes with recommendations for action by national governments, international development institutions, NGOs and CBOs

This handbook intends to provide users in resource-poor countries with a tool that can be adapted to their needs. It follows the four principles of the United Nations Convention on the Rights of the Child and aims to provide a simple, accessible and practical handbook for health workers involved in preventing infection and caring for children infected and affected by HIV. It includes substantial chapters on caring for HIV-exposed and HIV-infected children, infants and orphans; diagnosis and the clinical stages of HIV infection; clinical conditions associated with HIV (diarrhoea, malnutrition, neurological manifestations, skin manifestations and more); pulmonary conditions; anti-retroviral therapy for children; youth issues, long-term and terminal care planning; psychosocial support. The primary targets are medical students and their lecturers, nurses, clinicians, community health workers and other service providers in resource poor settings where there is a significant HIV and AIDS burden

This paper tries to deepen understandings of the biological and programmatic implications of the transmission of HIV through breastfeeding which have previously been hampered by insufficient study and difficulties of interpretation. It is a careful look at the findings of programmatic approaches. The project attempted to find, summarise and analyse reports on a wide variety of relevant programmes conducted since 1998 UNICEF guidelines were issued. The programmes range from small community research projects to national programmes. The compilation addresses numerous controversial topics and constraints, including human resources, confused mothers, stigma and discrimination, spillover of replacement feeding, free or subsidised infant formula, family economics and the difficulty in providing integrated HIV testing, informed choice counselling, community support, logistics and follow-up care for mothers and infants

This report aims to clarify and refine existing UN guidance on HIV and infant feeding. It follows a previous technical consultation in 2000 and presents a summary of findings, conclusions and recommendations regarding HIV and Infant Feeding between 2000 and 2006

South Africa has, until now, focused its HIV prevention efforts on youth and adults, and now needs to expand its focus to include children. Much is already known about mother to child transmission, which is the dominant mode of HIV transmission among children. However, little investigation has been done into the potential for horizontal transmission of HIV on the population below reproductive age. This report focuses on children aged 2-9 years and, using a combination of qualitative and quantitative methods, presents evidence on the potential for HIV transmission in dental, maternity and paediatric service in public health facilities. A new finding concerns the practice of shared breastfeeding

This short paper reflects findings from research carried out to identify current responses to meet the needs of children age 0-8 living in HIV/AIDS affected communities. The overall results show that at local, national and international levels there are gaps in programming and policy to engage ideas and mobilise resources to address the needs and experiences of very young children both infected and affected by HIV/AIDS. The question is then raised: What can we actually do to include very young children in programming and policy responses in HIV/AIDS affected communities? Supporting existing family and community networks and current efforts that are being made by people confronting HIV/AIDS on a daily basis are important strategies. Conclusions are drawn indicating that services are required urgently to support very young children both directly and through the families and communities in which they live. Ways of listening to and including very young children in these processes need to be developed and used. Partnerships need to be developed between parents, families, NGOs, CBOs and government to ensure the holistic development of the child. At policy levels, very young children need to be included in programmes that address children, HIV/AIDS and community development. All government ministries can participate in meeting the needs of very young children in HIV/AIDS affected communities

This policy briefing sets out the background of the HIV pandemic and notes thats its impact has transformed childhood. Findings from a study in Botswana assessing the impact show results in areas of childcare, caring for sick children and parental time with children. Policy recommendations are made concerning the implications for the quality, quantity and nature of early childhood care and education services needed, and also for the supports that are necessary to enable parents and extended family members to care for children who are affected and infected by HIV

This manual is a tool for trainers to train concerned community members to assist distressed children, and to facilitate their interventions on the level of awareness, knowledge, skills and behaviour in relation to orphans. Its stated objective is to enhance the capacity of adults to listen and talk to orphans and children of terminally ill parents, and to understand their situation and their needs. In this way the community improves its capacity to cope with some of the consequences of AIDS. In the manual there are 16 modules that rely on participatory methods, each with detailed instructions for the facilitator and a handout for participants. The manual was produced by the Humuliza (Community Based Mental Health for Orphans) project team

"There are three reasons for wanting young children to be included in the National Plans of Action. First, as the numbers indicate, there are a substantial number of young children who are orphans and/or vulnerable, but they tend to escape notice. Second, they have specific rights and requirements for care that differ from those of older children...Third, because of the growth potential of young children, the possibilities for effective interventions to prevent long-term negative consequences are greater than at older ages"

The Horizons Program of the Population Council and the University of Cape Town are conducting a study to identify successful programme strategies in paediatric HIV treatment in South Africa and to determine priority knowledge gaps to be addressed by operations research. This report summarises key findings from the initial consultative workshop of expert practitioners and stake-holders, focusing on the status of providing antiretroviral therapy to children in South Africa and strategies to expand and improve services. It includes providing services to under six year olds

Guidelines on mainstreaming psycho-social support for children affected by HIV and AIDS

This report arose from recognition of the need to provide better care and follow up of mothers and infants in the postnatal period in order to improve maternal and neonatal outcomes in Swaziland. The objectives of the study were to determine if changes to the guidelines on postnatal care would result in improvements to provision of of maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum (PP) women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirmed that the introduction of an improved postnatal package with revised timing and content provided key components of maternal, newborn, and HIV care, and increased the utilization of services among postpartum women and their infants. An assessment of the quality of care during client-provider interactions for all postpartum women demonstrated a fourfold increase in the proportion that included all aspects of care: maternal and newborn health, counseling for HIV, family planning, and improved provider-client relationships

This project set out to help young people affected by HIV to find their voices and to provide them with a platform from which to speak not only in their home countries, but also internationally. At the heart of the project, was the participation of a team of six young people, aged 7 to 17, from the United Kingdom, Uganda and Mexico. These young people were the first ever to participate in an International AIDS Conference. They interviewed key participants and asked direct questions about how they will support HIV-affected children

This is a rare case study of a pilot project to address the specific needs of children under 5 affected by HIV/AIDS who are typically ignored at the programming level and often miss the benefits of general HIV/AIDS interventions. The project operated in Western Kenya and the study contains evidence of the work carried out, a lessons learned catalogue of the processes and tools developed, and a set of suggestions of how the tools and processes might be adapted to other groups in other contexts. It is an excellent example of a community based response to the needs of very young children and addresses the key challenges faced in attempting to do so

Taking Better Care looks at the situation facing orphaned and vulnerable children in the Rakai District in Uganda and at the legacy of Save the Children's Child Social Care Project (CSCP) there. The report examines the impact of the CSCP, implemented between 1991 and 1996, and at trends in Rakai since the CSCP ended, as well as outlining the lessons learned and providing recommendations for future action. It concludes that in order to support orphans and vulnerable children in a long-term, sustainable way, child-care models now need to incorporate a maximum of state support and civil society mobilisation, combined with more traditional family support

This is a study using a collection of 41 demographic and health surveys from 26 African countries. The households that provide care for orphans are characterised, and the impact of taking in orphans on outcomes for other household residents, including children's health and education, is estimated. A key finding is that orphan care is concentrated in households with fewer other childcare responsibilities, especially elderly households. The researcher found no evidence that having an orphan join the household significantly affected the household, contrary to popular views that orphans generate negative spillovers

This is a key report that documents community responses and coping mechanisms towards the HIV/AIDS pandemic in relation to children affected by AIDS (CABA) and orphans and vulnerable children (OVC). Fostering families are under enormous strain and local initiatives at the community level have been little studied or documented, and few organisations have sought to encourage their development. The paper analyses some of these initiatives and encourages external agencies to support them through building the capacity of local responses rather than imposing external solutions

This call for support aims to strengthen plans to help women who may be HIV positive to choose the right feeding option for their child. A framework has been created by the UN which recognises that special attention and practical support is needed in exceptionally difficult circumstances, including the presence of HIV. The framework outlines five priority areas

Voices from the Communities is a follow-up qualitative study by Family Health International (FHI) and Strengthening Community Partnerships for the Empowerment of Orphans and Vulnerable Children (SCOPE-OVC) to a 2001 quantitative survey. The quantitative study sought to determine the psychosocial and emotional needs of orphans and vulnerable children in sixteen communities in four districts of Zambia: Livingstone, Lusaka, Mongu and Kitwe. Voices extends the original research by ascertaining the psychosocial and emotional needs of OVC in greater detail. In Voices, 10 focus group discussions were held during 2002 in two townships; Itimpi in Kitwe and Chawama in Lusaka. The study sample of one hundred and eighty one discussants consisted of orphaned children, child heads of household and adult heads of household

This article describes the availability of data about men and families, in particular fathers, in sub-Saharan African surveys and longitudinal population cohorts. To date, there has been limited research to examine men's role in providing emotional and material support and protection for children and families affected by HIV and AIDS, however increasing interest in family-oriented interventions around HIV and AIDS mean that such information needs to be collected

This article argues that there is a need to improve HIV testing for fathers, increase understanding of the fathers and fathering and approach childbirth from a family perspective

This website is a useful resource for publications, conferences, documents and websites to do with childcare and is targeted at educators and caregivers. Although it is US-based, it does cover global issues. The key publication, Childcare Information Exchange is available through the website which also contains a list of early childhood organisations