Institutional support
Belated response to the orphan crisis
The international community has only recently begun to recognise and analyse the problem of caring for AIDS orphans Foster, 2002. Not until 2001 did the United Nations General Assembly adopt a “Declaration of Commitment” on HIV/AIDS regarding orphans and other children made vulnerable by HIV under a framework for action Grassly and Timaeus, 2003.
This Framework for Action was endorsed in 2004 by United Nations organisms making up UNAIDS and welcomed by international partners. It constitutes a basis to achieve a collective action and respond to the increasingly urgent needs of the growing number of orphans and vulnerable children; it also aims to protect children’s rights Gulaid, 2004, UNICEF, UNAIDS et al., 2004.
On a national level, African governments have also had a belated response to the orphan crisis. At the end of 2003, of the 40 sub-Saharan African countries where the epidemic is widespread, only six of them (15%) have a national policy to help orphans and other children made vulnerable by HIV/AIDS; eight countries (20%) are currently developing such policies, and twenty-six countries (65%) have no national policy of this kind UNICEF, UNAIDS et al., 2004.
This delay in terms of implementing national policies and strategies may rest on the fact that millions of children are placed within family networks, making the crisis “less visible.” Families have assumed a large part of the responsibility for care mechanisms to the point of overload. Government response has undoubtedly been delayed by a lack of financial resources and foreign support.
Current institutional response to improve orphan care
According to the international community, the family remains the best place to care for orphans. Therefore, strengthening families’ and communities’ capacity to care for and protect these children is a priority, as well as strengthening the institutional capacity of African governments so that they can develop national plans to help orphans and vulnerable children.
- Strengthening capacity for families to protect and care for orphans and other children made vulnerable by HIV/AIDS
The strategies to help orphans and other vulnerable children affected by HIV/AIDS envisaged today by the international community, African governments, and civil society are directed toward placing children within the family system Williamson, 2004.
“Keeping children within their extended family, community, and cultural setting—in the spirit of continuity—is now unanimously supported at an international level regarding children’s protection; all the more since this option is now a recognised right for children. According to Article 20 of the Convention on the Rights of the Child ‘when considering [placement] solutions, due regard shall be paid to the desirability of continuity in a child’s upbringing’” Service Social International and UNICEF, 2004.
This new international conception of orphan care was greatly influenced by numerous studies carried out in sub-Saharan Africa that revealed how ill suited the implemented institutional structures such as orphanages are to foster orphans. For several decades, building orphanages was considered an appropriate response to the growing number of orphans. However, researchers expressed criticisms concerning the care for children in such institutions while stating that on the one hand this form of care was not adapted to the African context because it represents a break with family and community structures, impeding the child’s well-being and socialisation and failing to respond to his or her needs Caldwell, Caldwell et al., 1993. On the other hand, in the end, orphanages only absorb a negligible number of orphans Mashumba, 1994, Ntozi and Nakayima, 1999.
When placement in the orphanage is inevitable, it should be considered temporary, and all efforts should be made to reintegrate the child into the community as soon as possible Landis, 2002.
In addition, costs for institutional care in an orphanage are high. According to the World Bank, in Tanzania, the cost for institutional care was approximately six times higher than that of placement in the family. UNICEF, UNAIDS et al., 2004.
Thus, recommendations seek to target support mechanisms for intergenerational solidarity in the context of HIV/AIDS Chevallier, 1994, Ntozi and Mukiza-Gapere, 1995, Foster, Makufa et al., 1996.
Consequently, actions tend toward strengthening these families’ capacity to raise and protect these children. Therefore, strategies and intervention programmes primarily aim to:
- Strengthen extended families’ economic capacity to provide for orphaned children’s needs through access to micro credit, professional training for the orphaned children, and the creation of income generating activities such as: “an innovative community initiative was set up in rural areas of eastern Zambia where traditional inheritance customs protect women and children allowing them to reside on their land after the death of their husbands or fathers. The Kanyanga Orphan Project (KOP) decided to improve agricultural output and nutrition for families and vulnerable children by providing seeds, fertilizer, and tools. After realising that the families did not have the necessary knowledge to improve food production, the project recruited an agronomist to improve skills and agricultural yield. The KOP project has since obtained funding that covers school fees for the project’s orphans and therefore has lightened the community’s financial burden “ Fleshman, 2001.
- Improve the health and prolong the lives of parents through access to antiretroviral treatment. “The MTCT-Plus Programme (Mother to Child transmission plus antiretroviral treatment) [implemented in South Africa, Cote d’Ivoire, Kenya, Mozambique, Rwanda, and Zambia] provides antiretroviral treatment for HIV-positive mothers, their infected partners, and children” UNAIDS, 2004.
- Provide psychosocial support to children and those who care for them especially by creating centres for Solidarity and Social Action (Solidarité Action Sociale; SAS), a programme implemented by the International Centre for Children and the French Ministry of Foreign Affairs and introduced in Cote d’Ivoire, the Central African Republic, and Burkina Faso. The programme’s main mission is to offer a welcoming place where children and families affected by HIV/AIDS can meet others and find direction and support Delcroix and Floury, 2000.
- Facilitate planning of the succession and avoid the loss of inheritance. According to UNAIDS, Rwanda recently enacted a law allowing women to inherit land. In addition, community health programs in Zambia have partnered with the Zambian police in charge of victim support. They inform women of their rights regarding inheritance. In Malawi, the CORE Group on the Wills and Inheritance Act organised on-going consultations across the country with widows, widowers, orphaned children and non-orphans, judges, traditional leaders, and other stakeholders. The CORE group discusses land and property take-over when unscrupulous adults threatened to seize the property of orphans who have no relative to protect their rights UNAIDS, 2002.
- Subsidise education by paying (primary) school fees, distributing uniforms, textbooks, and other supplies or ensuring professional education or informal training for adolescent orphans. Free education for orphans has been adopted by some African countries such as Malawi, Uganda, Kenya, Cameroon, Tanzania, and Zambia.
- Mobilising and strengthening community initiatives
Local actors and from civil society are developing awareness-raising programmes to address the impact of HIV and the situation of orphans and vulnerable children. These programmes aim to strengthen community mobilisation and promote dialogue within communities about HIV/AIDS in order to dispel prejudices surrounding the disease.
Collective activities to support families have been implemented, including: community support programmes, home visits for psychosocial support, community gardens, community childcare programmes, work assistance, and limited care for children Ntozi and Mukiza-Gapere, 1995 Ntozi and Nakayima, 1999.
In Tanzania, villagers created committees to help the most vulnerable children. These committees collect and redistribute donated food and money from villagers and set up income generating activities and other types of support.
In Swaziland, a programme pooled community resources to create a shop within the school whose revenues fund school fees for several children and also set up childcare centres managed by volunteers who take care of the children during the day White, 2003.
Finally, the community can care for children who are deprived of any family support through the development of possibilities for placement in foster families, adoption at a local level, and family-like households that are integrated into the community.
In addition, orphans are placed within religious institutions that also play a growing role. For example, in Muslim culture, boys are frequently sent to a Koronic school to learn the Koran Isiugo-Abanihe, 1985. This is an old and common practice in sub-Saharan Africa but has intensified with the growing number of orphans Madhavan, 2004.
Generally communities are in the first line to create programmes aimed at ensuring better care for orphans and vulnerable children. Most of these projects and programmes exist owing to the efforts of women’s groups, religious groups, and non-governmental organisations. A considerable number of local associations supporting orphans and vulnerable children affected by HIV/AIDS have come into being in sub-Saharan Africa, showing strong mobilisation from the communities. East and Southern Africa has seen an upsurge in associations that are predominantly grouped into networks. For example, Children in Need (CHIN) in Zambia is a confederation of local associations which supports and helps orphans and vulnerable children; the “CINDI” network represents an informal consortium of non-governmental organisations based in Pietermaritzburg, South Africa.
- The need for national action plans to help orphans and vulnerable children
Through its Policy Project, USAID provides institutional support to governments in the fight against HIV/AIDS. The information cited below comes from a Policy Project report published in 2003 entitled “Policies for orphans and vulnerable children: a framework for moving ahead” by R. Smart Smart, 2003. This document presents examples of national plans and policy alternatives concerning orphans and vulnerable children.
Action plans are carried out at several levels:
- Downstream from action, the situational analysis
The situational analysis is necessary to develop national plans because it provides an assessment of the magnitude of the phenomenon and a description on a national level both from a quantitative and qualitative viewpoint. This includes assessing the number of AIDS orphans and the impact of HIV/AIDS on children; defining which laws are not enforced; identifying actors and support structures for care; and making recommendations with a view to draw up a national policy aimed at helping orphans.
- Action plans in terms of national policy
- Developing a specific direction for orphans and vulnerable children for national strategies on HIV/AIDS
Implementation of national strategies in the fight against HIV/AIDS constitutes the governments’ first response in combating the HIV/AIDS pandemic. National strategies stress that support for orphans and vulnerable children is a priority.
For example in Uganda the objectives covering orphans and vulnerable children within the national HIV/AIDS strategy is “to reduce the vulnerability of individuals and communities to HIV/AIDS with a focus on children, youth, and women” and “to promote AIDS care, social support, and protection of rights of PLWHA and affected individuals and families.” In Nigeria, the national strategy’s objective is “to encourage counseling of those infected and affected by AIDS … and provide financial assistance to orphans.” Smart, 2003
- Developing directives and national structures specific to orphans and vulnerable children:
These policies establish a framework for action, by defining the categories of children concerned, the models for care and support best adapted to the contexts, and the role of involved individuals and organisations. These policies also determine what kinds of evaluation tools and mechanisms, reports, and monitoring will be used since any national policy that is implemented requires regular monitoring to be effective.
- State support for orphans and vulnerable children (education, health, food security, etc.):
Support from the state can take many forms: exemption of school fees, school meals, free health services, etc. and depends on the political will of the country.
South Africa, Benin, Botswana, Kenya, Namibia, and Zambia are the rare countries having already implemented a support system to help orphans and vulnerable Children.
- Untapped alternatives on a political level
Poverty Reduction Strategy Papers (PRSPs) are established by governments of resource poor countries according to a participatory process that involve both domestic stakeholders and external development partners. The PRSP describes policies and macroeconomic, structural, and social programmes that a country will implement over several years to promote growth and reduce poverty.
Until now, orphans and vulnerable children, who constitute one of the most serious consequences of the HIV/AIDS pandemic, are not explicitly mentioned or dealt with in the PRSPs, though integrating the problematic of orphans and vulnerable children into the PRSPs could constitute a possibility of support.
- Action plans in terms of coordination mechanisms: creating a multisectoral structure focused on the needs of orphans and vulnerable children
Malawi exemplifies this objective as the first African country to have implemented a special national team for orphans. This team is made up of representatives from the national government and local collectives, NGOs, community organisations, and representatives from key United Nations organisms. In 1992, this national team drew up Policy Directives to support orphans in Malawi and to coordinate assistance to orphans.
- Action plans in terms of adequate legislative protection for orphans: developing legislation that protects the rights of all children at the judicial level
These laws include national constitutions, legislation specifically related to children, or the laws related to the rights of children such as access to education, health, etc...
Since the establishment of the Convention on the Rights of the Child in 1989, many countries have enacted legislation focused on children that regulates their protection, for example the Children’s Act in Kenya or the Children’s Statute in Uganda. However, few countries have special policies for orphans (Botswana, Malawi, Rwanda, and Zimbabwe are exceptions). By contrast, several countries are on their way to developing such policies. Smart, 2003, Bhargava and Bigombe, 2003, UNICEF, 2003, Gulaid, 2004
Table 8 compares the various African countries relative to implementation of such an action plan
Table 8 : Responses from African governments.
Country |
Situational analysis at the national level |
National OVC policy |
National coordination mechanisms |
Adequate legislative protection for orphans |
|---|---|---|---|---|
| Benin | In progress | In progress | No | … |
| Burkina Faso | Yes | No | No | … |
| Cote d’Ivoire | Yes | No | Yes | … |
| Guinea | In progress | No | Yes | … |
| Senegal | No | No | No | … |
| Niger | In progress | Yes | Yes | … |
| Togo | Yes | Yes | No | … |
| West Africa | 5 / 16 | 2 / 16 | 6 / 16 | |
| Sudan | Partial | In progress | Yes | Yes |
| Democratic Republic of the Congo |
No | No | No | … |
| Central African Republic |
Yes | In progress | No | … |
| Chad | Yes | No | In progress | … |
| Congo | Yes | Yes | No | … |
| Central Africa | 3 / 9 | 1 / 9 | 2 / 9 | 1 / 1 |
| Burundi | Yes | No | No | Yes |
| Kenya | No | No | No | In progress |
| Uganda | Yes | In progress | No | Yes |
| Rwanda | Yes | Yes | No | In progress |
| Eritrea | Yes | In progress | Yes | In progress |
| Tanzania | No | No | Yes | No |
| East Africa | 4 / 11 | 1 / 11 | 3 / 11 | 2 / 10 |
| South Africa | Yes | No | Yes | In progress |
| Malawi | Yes | Yes | Yes | No |
| Namibia | Yes | In progress | Yes | In progress |
| Botswana | Yes | No | No | No |
| Zambia | Yes | In progress | Yes | In progress |
| Zimbabwe | Yes | Yes | No | Yes |
| Southern Africa | 8 / 10 | 2 / 10 | 6 / 10 | 1 / 10 |
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| Acknowledgments |