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Children - 3.2 Lessons about effective responses
With enough resources, it is relatively easy to assist children affected by AIDS. Unfortunately, HIV targets the poorest and most vulnerable where there are few resources to spare. Interventions, therefore, need to be cost effective, as sustainable as possible, and to aim at bolstering existing coping mechanisms in families and communities and amongst children themselves. (22,23,24) Having said this, it is recognised that in countries where there is no government welfare, families and children who are completely destitute will benefit from receiving direct material support - such as food aid - for a period of time.
Lessons from elsewhere show that interventions need to based on national strategy which is well researched, well co-ordinated and well monitored. (25) Underlying principles for projects which help children affected by HIV/AIDS have been shown to include:
- Planning before death
- Listening to children and making their voices heard
- Focusing on child rights
- A high level of community involvement
- Enumeration, and needs assessments
- Targeting assistance to the most needy
- Monitoring vulnerable children and families
- Changing local laws and practices
- Keeping siblings together
- Minimising the need for institutional care
- Addressing psychological issues holistically within the context of children's welfare (26)
Children can be assisted to support themselves and siblings through enabling them to stay in their communities and in school, helping them to access training and role-modeling in life and social skills, by reducing the labour demands on their households and by protecting them from exploitation.
Families can be helped to cope better by improving infrastructure, providing access to credit, increasing their ability to generate income, reducing demands on their labour, protecting women’s and children’s property and other legal rights, ensuring access to health services and responding to psychological needs. Helping communities to help their own can include respecting and increasing community decision making abilities, enhancing the community’s ability to support all vulnerable families, organising skill and labour sharing, and providing training. (27)
In summary, those working with orphans and children affected by HIV/AIDS aim to build a world in which:
- healthy and educated children are living at home and in appropriate supportive and protective communities
- those communities are able to support family-based care for all children and young people, and to provide them with respect and opportunities
- governments, NGOs and international bodies collaborate effectively at all levels to support community and family efforts to protect and care for all children
- and leaders in public life believe it is their responsibility and within their power to make life safer for orphans and children living in a world with HIV/AIDS, and to act accordingly. (28)
Facts
Perhaps more than any other issue, assisting children affected by AIDS requires governments, NGOs and donors from all sectors to collaborate if the response is to be anything but piecemeal and scattered.
Successful strategies that assist children affected by AIDS have focussed on improving the capacity of children, families and communities to cope with the impact of HIV/AIDS.
It is also vital that governments protect the most vulnerable children and provide essential services.
Footnotes
(22) Lee, Tim et al. "Report of a participatory self-evaluation of the FACT Families Orphans and Children Under Stress (FOCUS) Programme" 1999
(23) USAID "Community Mobilization for Orphans in Zambia: An Assessment of the Orphans and Vulnerable Children Program of Project Concern International" 1999
(24) Williamson, John. "Finding a Way Forward: Principles and Strategies for Intervention" (draft) 1999
(25) Williamson, John. "Children and Families affected by HIV/AIDS - Guidelines for Action" (draft) 1995
(26) Save the Children. "Promoting psychosocial well-being among children affected by armed conflict and displacement" International Save the Children Alliance Working Group on Children affected by armed conflict and displacement. 1996
(27) Hunter, Susan. Williamson, John. "Children on the Brink: Strategies to Support Children Isolated by HIV/AIDS" Report for USAID 1999
(28) Francois-Xavier Bagnoud US Foundation. "AIDS Orphans: Towards an action plan for going to scale" Interagency Meeting on Children Affected by HIV/AIDS. 2000