Physical and social settings (poverty, violence, migration/mobility, HIV & AIDS etc)

Mother to child transmission is by far the largest source of HIV infection in children below the age of 15. Prevention of mother to child transmission (PMTCT) programmes have been implemented nationally in South Africa since 2000. This report presents the results of research conducted at a pilot site in the Eastern Cape into the use of resources associated with the implementation of a PMTCT programme. It is part of a larger research project that seeks to examine and compare the costs of providing nevirapine and AZT in both urban and rural contexts. It is hoped that this study will contribute to the national programme of monitoring and evaluating the costs and effectiveness of PMTCT interventions in South Africa

This report explores the connections between tackling AIDS and tackling poverty and draws attention to the fact that millions of children affected by HIV and AIDS are in need of care and protection. There is an equally important and parallel agenda of expanding support for the millions of people needing access to treatment for HIV/AIDS. ARV treatment represents a crucial gateway to supporting millions of children yet it is rarely attempted. The report aims to examine the implications of expanded access to HIV/AIDS treatment, as exemplified by the 3 x 5 initiative, for prevention of HIV in children and young people and expanding support and care for orphans and other children made vulnerable by HIV/AIDS. Achieving the 3 by 5 goal set by WHO would mean that millions fewer children would lose their parents. Community based, NGO and governmental work could be pre-emptive in supporting children who do become orphaned rather than responding to mitigate impact. There are examples of programme good practice which illustrate the feasibility of developing effective treatment and care programmes and key findings and recommendations are made in the concluding section

A set of eight booklets designed to support programme design and practice at the community level around children made vulnerable or orphaned by HIV or AIDS in Africa. The resources are all locally adaptable and are based on the experience of Alliance, its partners and other organisations. The booklets are called "Overview"; "Psychosocial support"; "Health and nutrition"; "Economic strengthening"; "Education"; "Social inclusion"; "Older Carers"; and "Young children and HIV"

This report provides a brief overview of the responses of the international community and governments in rising to these challenges, the roles of the private and civil society sectors, as well as the responses of families and communities

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

The overall goal for the survey was to gather baseline data to facilitate an evaluation of the effectiveness of the Strengthening Community Participation for the Empowerment of Orphans and Vulnerable Children (SCOPE - OVC) project in particular areas of Zambia. Specific study objectives were to: gather information that will describe the impact of HIV/AIDS on children as well as measure the impact that programmes are having on the quality of life of the children; provide information that will be useful in the ongoing development of programmes designed to strengthen the care and support to orphans and vulnerable children, specifically in relation to their psycho-social needs; provide a framework that will show the progression of the SCOPE - OVC project towards its program goals and objectives; and document lessons learned in conducting OVC work as well as in documenting the use of a participatory evaluation process

This report looks at projects and programmes that aim to respond to the needs of very young children in southern and eastern Africa whose lives have been affected by both poverty and HIV. What is highlighted in the interventions that are examined is the effort of human beings in caring and supporting people and sharing resources

An interesting article noting the challenges of supplying the medicines to HIV positive children who have received little attention. Early in 2004 the South African national programme to provide anti-retrovirals (ARVs) became operational. There is now hope that this will bring opportunities for under 14 year olds including very young children to gain more access to the drugs. The government is seeking to treat over 50,000 people per year under the ARV programme. In private clinics it costs almost US$93 to put a child on ARV for one month although this has halved since two years ago. Doctors and health officials are debating about what age is right for a child to start ARV treatment although theoretically it can start as soon as it is born. Doctors Without Borders advises that treatment should start as soon as a child is discovered to be HIV positive so that the immune system is bolstered

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 is a slide presentation which considers the role of food and nutrition in the context of HIV and AIDS. It notes the vicious cycle of malnutrition, HIV and poverty and the effects of HIV and AIDS on nutrition, household food security and food production. HIV and AIDS also have an impact on the agricultural sector and examples are shown from Kenya, Zambia and Malawi. Increased malnutrition can lead to adults needing more access to quality health care but not getting it, increased caring for sick adults means less time for childcare, and children drop out of school to help with household labour. Finally, UNICEF support to nutrition and HIV and AIDS is shown along with their current operational approach. The Food and Agriculture Organization (FAO) and World Food Program (WFP) approach is also considered

This publication explores child- and youth-led organisations from many different angles, amongst others, HIV and AIDS prevention, the critical role of adults within these organisations, and economic strengthening. What is also perhaps distinctive about the approach outlined in this booklet is the fact that organisation of children into their own child- and youth-led organisations is considered primarily from a psychosocial wellbeing perspective

The document suggests how services that address young children's needs might be fully integrated into a national multisectoral HIV/AIDS programme. It gives advice on developing national ECD policies, programmes and interventions, multisectoral ECD approaches, and ways to advocate, implement, monitor and evaluate these efforts. It makes suggestions of interventions for very young children and is a resource for other national HIV/AIDS programme topics

This document recognises that psychosocial support for children affected by HIV and AIDS is as important as responding to their material needs. It explores children's experience of loss and grief, and suggests ways to deal with aggressive behaviour and to overcome stigma and discrimination. Some of the topics discussed are accompanied by useful handouts. It is designed as a training tool for professionals working directly with children or in community building projects

This advocacy paper stresses the importance of involving children in HIV and AIDS interventions of which they are a part. Child participation creates a sense of selfhood and agency which helps them cope with loss and better equips them to manage any future problems

An analysis of the most cost effective way of providing care for orphaned children in South Africa. It examines six models of care ranging from formal children's homes to community-based structures. The paper is part of a combined study, the other part of which looks at the quality of different types of orphan care and their associated costs. There is initially a detailed look at the various categories of care followed by an outline of the method used to evaluate cost. Six case studies are examined and conclusions and recommendations are made as a result of evaluation

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

To date, responses to the needs of orphans and vulnerable children have not typically been guided by research, though a body of empirical evidence related to the impact of HIV and AIDS on children is growing. USAID/AFR/SD and the SARA project commissioned a review of 48 selected studies to summarize the findings that represent the most current understanding of children's vulnerability due to AIDS. The review captures what is known and not yet known about the impact of HIV and AIDS on the survival, health, education, social, and emotional needs of children; identifies the content gaps and methodological limitations of existing research; suggests priorities for future research; and informs programmatic and political responses

This document presents profiles of 114 projects (90 country-specific, 12 regional, and 12 global) funded by USAID. It includes a section on USAID projects that support access to education in Africa. The project profiles include the names of implementing organisations, funding periods and amounts, objectives, strategies, key accomplishments, priority activities for the year ahead, and materials and tools available to other projects that can help meet the needs of children and youth affected by HIV and AIDS. The diversity of these projects demonstrates the US government's efforts to meet the wide variety of needs of children and youth affected by HIV and AIDS. Approaches vary in both strategy and scale. The vast majority of projects work with communities to identify opportunities that strengthen existing resources without undermining local ownership. In many places, communities are already mobilised and have systems in place to identify, protect, and provide basic necessities to the most vulnerable children. USAID supports the strengthening and monitoring of these existing activities

This is a position paper on HIV and breastfeeding. It makes broad statements on the situation of breastfeeding mothers in the light of HIV. It states that it is concerned that recent changes in WHO, UNICEF and UNAIDS policy regarding breastfeeding and HIV as these changes appear to put major stress on the use of infant formula and less on alternative feeding methods. Recommendations are then made which indicate what some of these alternatives are

This paper aims ..."to assess whether the government of Andhra Pradesh is giving sufficient priority to investment in children at the state and the sub-state levels, through both rural and urban local bodies, to ensure improved outcomes for children"

This paper assesses how the needs of children are incorporated in Ethiopia’s Poverty Reduction Strategy Paper (PRSP) - the Ethiopian Sustainable Development and Poverty Reduction Program 2002-05 (SDRDP) - and seeks to develop policy recommendations for the second PRSP, based on a comparative content analysis with other countries’ PRSPs

This report looks at attempts to draw children in Ethiopia into the Poverty Reduction Strategy Paper process. It is divided into two sections. The first looks at the importance of mapping the policy context so as to carry out effective policy influencing for and with children; and the second reviews the experience of the Young Lives project in Ethiopia

This note provides an introduction to how social transfers - particularly cash transfers and vouchers - can improve human development, particularly for the extreme poor and socially excluded

This website focuses on a package of proven prevention and treatment measures for diarrhoea. It is divided into sections which include: the global burden of diarrhoea, the basics of diarrhoeal diseases; where we stand today in preventing and treating childhood diarrhoea; and a seven-point plan for comprehensive diarrhoeal control. The website is a version of the UNICEF/WHO report 'Diarrhoea: why children are still dying and what can be done'. It would be useful to the general public, health workers, government, NGOs, United Nations organisations, policy makers and private sector workers

The aim of this booklet is to provide concise, practical guidance on how to ensure appropriate infant and young child feeding in emergencies