| Last update: April 2008 |
Protect and Support Children Affected by HIV and AIDS
UNICEF, Africa's Orphaned and Vulnerable Generations, New York, 2006
| UNGASS Target |
| By 2005, implement policies and strategies to strengthen capacities to provide a supportive environment for orphans and children affected by AIDS and ensure that they have access to education and to health services on an equal basis with other children (UNGASS, 2001). |
The Challenge
As of 2005, an estimated 133 million children around the world had lost one or both parents due to all causes, including AIDS, and the number of orphans continues to increase. In sub-Saharan Africa, the most-affected region, there are an estimated 12.1 million [11.7–14.0 million] orphans due to AIDS in 2007.
Orphans and vulnerable children are at higher risk of missing out on schooling, live in households with less food security, suffer anxiety and depression, and are at higher risk of exposure to HIV. Their experiences vary significantly 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 community, and many other factors. In order to properly care for orphans and vulnerable children, the minimum package for them includes access to services like education, health care, social welfare and protection. Without laws, policies and services that support families and communities in caring for all orphans and vulnerable children, children in this situation face grave risks to their education, health and well-being, and support for them remains low.
Because a definition of vulnerability has not been standardized and a minimum package of services has yet to be determined, developing routine monitoring indicators and tools for collecting data on orphans and vulnerable children is difficult. Poor coordination of services means there is a high chance that children will receive multiple services and be counted more than once. Defining optimum services and beneficiaries, as well as strengthening coordination and reporting on the services provided to orphans and vulnerable children should be given greater attention.
Estimated number of children under 18 orphaned by AIDS in sub-Saharan Africa, 1990–2007
Note: The bar ( I ) indicates the range around the estimates that define the boundaries within which the actual numbers lie, based on the best available information.
Source: UNAIDS/WHO unpublished estimates, 2007.
Progress
| MDG Indicator |
| Ratio of school attendance of orphans to school attendance of non-orphans aged 10–14 years |
Children who have lost both parents are generally less likely to be in school than children whose parents are both still alive. Thus, a key indicator of the situation of AIDS-affected children is the orphan school attendance ratio. This ratio compares school attendance of children aged 10–14 years old who have lost both parents with those children whose parents are both still alive and who live with one or both parents. Currently in Sub-Saharan Africa, for every 100 per cent of children with both parents alive and living with at least one parent who attend school, 80 per cent of orphaned children attend school.
The disparity between orphan and non-orphan school attendance appears to be shrinking in several countries. This improvement in access to education is an important benefit for children who may learn lifesaving skills in school, such as good hygiene and how to protect themselves from HIV, and may receive other services like vitamin supplementation and immunization.
Orphan school attendance ratio, 2000–2006
Note: Asterisk (*) indicates that data for the 2000–2002 bar are for earlier or different years than 2000–2002.
Source: UNICEF global databases, 2008
| UNGASS Indicator |
| Percentage of children whose households received external support |
Data on the proportion of orphaned and vulnerable children whose households received free basic external support in caring for the child are still lacking. There are 19 countries that have national survey data available on this indicator, collected between 2004 and 2006. In these countries, the coverage of external support to households with orphans and vulnerable children ranges from 1 per cent in Sierra Leone to 41 per cent in Swaziland, with a median of 9 per cent. Coverage remains low even in countries with high HIV prevalence and concerted efforts need to be intensified to reach as many children as possible. The care of orphans and vulnerable children should be a priority in national strategic planning to make communities and families the primary beneficiaries of an increased global response for orphans and vulnerable children.
Percentage of orphans and vulnerable children (0–17 years) whose households received external support in countries with HIV prevalence of 5 per cent or more, 2004–2006
Source: UNICEF global databases, 2008
Although governments and most large international agencies were initially slow to respond to the challenges children affected by AIDS face, this has been changing. An increasing number of countries have developed specific national plans of action for orphans and vulnerable children. In 2007, 24 countries in the world, including 21 in sub-Saharan Africa, had completed such plans, and 10 countries in the world, including 9 countries in sub-Saharan Africa, had plans in process. Many countries are integrating policies for children affected by AIDS into national development plans, overall national plans of action for children and the policy plans of ministries such as education and health.
The new South Asia Regional Strategic Framework for the Protection, Care and Support of Children Affected by HIV/AIDS provides guidance to the eight member countries of the South Asian Association for Regional Cooperation on protecting and supporting children affected by AIDS and calls for specific measures to address AIDS-related stigma. The framework positions children affected by AIDS within the broader group of children in difficult circumstances, and it promotes universal access to basic services without singling out the AIDS-affected children. As a follow-up, India has developed a national policy framework for children and AIDS that includes strategies, objectives and targets in the areas of prevention, PMTCT, paediatric treatment and protection for children affected by AIDS.
References
UNAIDS and WHO, Aids Epidemic Update, Geneva, 2007.UNICEF, Progress for Children: A World Fit for Children Statistical Review, No. 6, New York, 2007.
UNICEF, UNAIDS and PEPFAR, Africa’s Orphaned and Vulnerable Generations: Children affected by AIDS, New York, 2006.
UNICEF, UNAIDS and the World Health Organization. Children and AIDS: Second Stocktaking Report, New York, 2008.
UNICEF, UNAIDS and World Health Organization. Children and AIDS: A stocktaking report, New York, 2006.