This publication explains the impacts of HIV/AIDS on orphans and vulnerable children in the family and community-based care, households and communities; .
Table of contents
- Orphans and Vulnerable Children
- The United States President's Emergency Plan for AIDS Relief
- At a Glance
- The Burden of Orphans and Vulnerable Children Due to HIV/AIDS in Cameroon
Since , the U. These investments have enabled children to stay in school, strengthened households and ensured families continue their roles as primary caregivers. While caregivers participate in support groups and educational sessions, their children can engage in stimulating play.
Orphans and Vulnerable Children
Many are also receiving treatment at TASO. A village health trainer conducts a nutritional assessment on a 2-year-old who was abandoned at birth. Jonathan far right stands in front of his house with his wife and three children. GRIP in South Africa provides support to child and women survivors of sexual violence in drop-in centers located in 26 hospitals, police stations and courtrooms throughout South Africa.
Each child survivor also receives a hand-knit teddy bear. Key program areas and objectives include the following:. Strong monitoring and evaluation systems are an essential foundation to improve the effectiveness of programs. Application of the tools will result in standardized information on child well-being, caregiver well-being and household economic status beyond what is available from routine surveys. For more information, please click here.
Many partner NGOs have been carrying out advocacy training to empower OVC to fight for themselves and their rights and providing material support for necessities such as clothing, shoes, food, etc [ 24 ]. These were mostly petty trade, animal husbandry and production of food crops.
Beneficiaries were trained on micro finance mechanisms loans and savings and are affiliated to local cooperative and credit unions. All the examples cited are from isolated projects by different development partners or the government. The results presented in Fig. Proportion of Orphans and vulnerable children that benefitted from any type of support Multiple indicator cluster survey, in Cameroon per locality. AIDS-related deaths profoundly affect families, which often are split up and left without any means of support.
Similarly, the death of many people in their prime working years hampers the economy. Health and social service systems suffer from the loss of health workers, teachers, and other skilled workers [ 10 ]. Orphans and the number of children orphaned by AIDS-children under age 18 who have lost one or both parents to AIDS-has increased dramatically, rising from 13, orphans in to , in By , this number is projected to rise to , Fig. Providing appropriate support and care for OVC poses challenges for both families and society. In Cameroon, many OVC live outside of family support, and many are marginalised, stigmatised, and discriminated against.
Consequently, they are exposed to harmful conditions such as lack of schooling, illiteracy, begging, pedophilia, juvenile delinquency, prostitution, and the transmission of HIV and other sexually transmitted infections [ 10 ].
The integrated care of orphans and other disadvantaged children in their natural environment in African settings is an old practice but this is different from institutional care of OVC where community link is absent. It is important that OVC live in their natural environment, hence the need to strengthen the capacity of families and communities to provide quality family-based care and support for OVC. The emerging consensus of opinion is that extended families and communities are the first line of defense in the orphan crisis and that families are almost always the best place for the child.
Primary interventions should be centered on building the capacities of families to care for OVC. Residential orphan care is the least desirable option for children because orphan care institutions are inherently anti-community. As a result, institutional care is increasingly under scrutiny and has been branded the last resort in a spectrum of interventions for OVC care [ 27 ].
The integrated care approach helps OVC to cope with the social stigma of the disease and its economic consequences and adapt to their natural environment. Cameroonian OVC in an integrated care foster family [ 4 ] a and in an orphanage b Source [ 38 ]. In Africa, a large number of children do not live with their biological parents and are not raised by them; they are often fostered by the extended family.
The placement of children within the kinship network and through connections is a long-standing and frequent practice in Africa. Thus, many children, when they become orphans, did not necessarily live with their biological parents. Even if a child lives with his or her biological parents and if one of them dies, he or she may not be considered an orphan because the traditional rules governing African societies facilitate the care of these children in particular through the movement of these children within the kinship systems.
Locoh [ 31 ] pointed out that:. This is the case with the AIDS pandemic. Grandparents—but also uncles, aunts, and older siblings—are in the front line to assume the care of orphans. The movement of children between various related households is not restricted to orphans. The care of OVC in Cameroon is a major public health problem. Children without the guidance and protection of their parents are often more vulnerable and at risk of becoming victims of violence, exploitation, trafficking, discrimination and other abuses [ 9 ]. In response to the problem, a National Orphan Care Policy to support traditional methods of care and discouraged forms of care which removed children from their communities and culture was developed.
This policy recommended foster care and adoption as the desired alternatives for children who did not have extended families and explicitly discouraged the use of institutional care. It clearly stated that placing a child in an orphanage should be regarded as a last resort, utilized only after all efforts to secure a better form of care have been exhausted [ 32 ]. The Nigeria OVC care and support approach is based on the Siyawela model, which facilitates the development of support groups for OVC within existing community structures such as primary health clinics, and promotes multi-level OVC care and support through community resource mobilization and local stakeholder participation.
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- INTRODUCTION.
Sub-grants are provided to selected community groups to build capacity and scale up care and support to OVC [ 33 ]. Living situations of orphans and non-orphans in Cameroon and selected African Countries in source [ 37 ]. In Zambia, the government, in collaboration with the UN system, NGOs and local communities have defined a minimum package of services for vulnerable children to access education in community schools comprising quality education, health, food and nutrition, school-based agricultural support, income generating activities, HIV and AIDS behaviour change communication strategies, educational materials, recreational activities combined with life skills training, training and empowerment of parent-teacher school committees and psychosocial support [ 34 ].
In Mali, AIDS has orphaned children where they are often raised by grand parents or families headed by them; many children lose their childhood and are forced by circumstances to be producers of income, food and caregivers of sick family members [ 35 ].
In Cameroon, the practice of community care of OVC is very common and the government in collaboration with the Global Fund, bilateral and multilateral organizations and NGOs is supporting local communities to enhance their capacity to care for OVC including the creation of income generating activities which is the backbone of community ownership and sustainability. The integrated care of OVC has proven to be feasible in Cameroon [ 9 , 14 , 15 , 36 ].
In Cameroon, the support given to orphans and vulnerable include psycho-social counseling, medical care, nutritional needs, educational needs, income generating activities and vocational rehabilitation [ 9 ]. This may be due to the presence of more intervening NGOs with many urban settings in these regions.
More efforts is needed to improve on the care of OVC in the other regions in terms of sensitization in order to reduce the HIV prevalence, and decrease the number of OVC being cared for. The OVC programme effort index consists of simple questions that were asked to task forces on orphaned and vulnerable children in 36 countries. An example of the index can be found in a guide to monitoring and evaluation of the national response for children orphaned and made vulnerable by HIV and AIDS [ 42 ].
Compared with other countries in the Central African Sub-Region, the Cameroon national situation is very low with respect to Chad, Gabon, and the Democratic Republic of Congo implying that HIV is more a serious public health problem in these other countries. This means that the national action plan for Cameroon on the OVC effort index is not very aggressive in providing care for AIDS orphans and this has been reflected in a weak policy rating of 8 on the OVC effort index compared to countries like Central Africa Republic 68 , Congo 73 , and the Democratic Republic of Congo Without any meaningful legislative review, support to OVC cannot be effective because extended families will continue to grab the property of the children.
The major weaknesses of the Cameroon response to the OVC based on the effort index are monitoring and evaluation 5 and resources With limited resources and low monitoring and evaluation, the support given to the OVC may not be well managed or what was designated for OVC may not get to them. This OVC effort index also relates to whether the birth of the child is registered or not. Sao Tome and Principe; EQ: The OVC programme effort index measures the policy and the programme response to the crisis facing orphans and vulnerable children. It consists of simple questions that were asked to task forces on orphaned and vulnerable children in 36 countries.
Based on self- reported responses. Source [ 42 ]: Thus, the estimates of maternal and paternal orphans include double mother and father are dead orphans. Numbers may not add up due to rounding. Children are defined as maternal or paternal orphans regardless of the survival status of the other parent. Thus the estimates of maternal and paternal orphans include double orphans. Net primary school enrollment had only increased from AIDS is therefore, a major cause of death in Africa including other endemic diseases such as malaria and tuberculosis.
Although Africa is home to about These range from a plateau and eventual decline in deaths beginning around to a catastrophic continual growth in the death rate with potentially 90 million cases of infection. AIDS death are perculiar in that they occur on epidemic proportions compared to deaths due to other causes on the continent. For example, in an extensive study, Jamison et al.
Armed conflicts resulted in an overall death toll of about 77, in Sub-Saharan Africa in [ 50 ]. According to Mather et al.
The United States President's Emergency Plan for AIDS Relief
Williams and colleagues [ 52 ] estimated a total of , deaths due to acute respiratory infection in the region in Crowcroft and colleagues [ 53 ] estimated , deaths due to whooping cough in the African region in while Stein and colleagues [ 54 ] estimated a total of , deaths due to measles in the same region in , of which approximately three-quarters were among children under five. According to WHO [ 56 ] estimates, every thirty seconds, a child below five dies from malaria in sub-Saharan Africa. Even though the health care system in Cameroon is decentralised, structural factors limiting the effectiveness of decentralization in access to ARV are evident.
Difficulties in the provision of ARV drugs and reagents for CD4 examinations lead to disruptions in supply. Although there is insufficient number of physicians, no task shifting strategy has been developed by the health ministry. This situation lead in some treatment centers to non- organized and strong task shifting from physicians to nurses which have a negative impact on the quality of care, while well organized task shifting don't have negative impact.
There is also a loss of motivation at a human resource level, because of the precariousness of one status, low salaries and difficult working conditions high work load, insufficient technical means, etc [ 12 ]. The provision of educational, nutritional, vocational and medical needs including income generating activities to OVC and their families are still unattended to. A continuous multi-sectorial approach headed by the Cameroon government to solve the problem of OVC is very important. These actions require stronger and continual leadership by public and private sector officials.
The provision of educational, medical, nutritional, vocational and income generating acivities to these unfortunate children will enable them to prevent themselves from HIV and face the future with dignity and hope. This has helped the country to fight the pandemic by increasing the general life expectancy from Partnership development to improve the quality of life of OVC is very important in child survival [ 28 ].
At a Glance
As pointed out by Nsagha and Thompson [ 6 ] , at the local level, the following government Ministries should be involved in OVC care: At the international level, it would be good establishing continous strong and sustainable working collaborations with the following international bodies: In these partnerships, focus should be placed on women since these are the most vulnerable groups including girls who are more infected than boys. These OVC need much assistance such as the provision of school materials including acquisition of birth certificates for all children who need them, treatment of all sick children through signing of contracts with health institutions for periodic medical checks and the establishment of school canteens to take care of feeding needs of children, while at school can greatly improve the living conditions of OVC [ 6 ].
Since the writing of wills is not a common practice in Cameroon, and taking into consideration the high rate of mortality due to AIDS, building the capacity of local communities on will writing in order to protect the property of sick parents and OVC from grapping by the extended family would greatly assure the future of OVC.
This work was funded by the Quarterly Research Allowance from the Ministry of Higher Education in Cameroon that was given to the lead and third authors. All authors read and approved the manuscript. National Center for Biotechnology Information , U.
The Burden of Orphans and Vulnerable Children Due to HIV/AIDS in Cameroon
Published online Oct Box 63, Buea, Cameroon; Tel: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License http: This article has been cited by other articles in PMC. Study Methods A structured search to identify publications on orphans and other children made vulnerable by AIDS was carried out.
Open in a separate window. Source [ 40 ]. Source [ 41 ].