REPSSI

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REPSSI
Technical consultation on Children Affected by
HIV and AIDS Access to Prevention, Treatment
Care Regional Perspectives on Successes
Challenges Africa (East and Southern) Central
Hall Westminster London 7 February 2006 by
Noreen M Huni REPSSI
 
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Thematic Areas

• Strengthening Community Capacity and
  Competencies children, families, the elderly,
  FBOs and CBOs
• Comprehensive Care and Support Package.
• Coordination and Networking Bodies.
• National Governments Express Commitment.
• The Status of OVC whose Responsibility?
• Advocacy and Resource Mobilization.
• Responsible Ministries - Whose Responsibility?
• Responsive Capacities at all levels.
• Child Rights Programming the Childrens Voices
  and Prints - Our perceptions?
• Monitoring Evaluation

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Strengthening Community Capacity and
Competencies children, families, the elderly,
FBOs and CBO.

• The family system has NOT collapsed, but is
  overstretched.
• Communities are committed to caring and
  supporting
• The children themselves, extended families,
  communities, faith-based organisations and
  non-governmental provide the majority of care and
  support for orphans and vulnerable children (OVC)
  in the HIV/AIDS context.
• OVC programming has recognized that cultural
  systems, practices and beliefs are a valuable
  entry point for successful and sustainable
  interventions. For example, Malawian initiation
  ceremonies have included HIV/AIDS prevention
  messages in their curriculum.
• The elderly are increasingly taking up this
  responsibility yet their own material, physical,
  social, spiritual and emotional needs remain
  unmet.
• Overall responding capacity is extremely
  inadequate knowledge and skills and resources
  are far from reaching the expected.
• Poverty and conflicts are fuelling the OVCs
  situation
• Resources are not getting to the communities and
  the children. Communities need resources and
  technical capacity enhancement to manage these
  resources.
• Linda Richter et al 2005 sustainable
  culturally appropriate interventions are not an
  easy quick fix.

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Comprehensive Care and Support Package.

• Largely physical, spiritual and material in
  nature, ignoring the psychosocial wellbeing of
  the children.
• Thus, there is a huge gap needing unique
  interventions to strengthen the existing
  responses.
• Access to essential services has been agreed upon
  but, tremendous barriers hinder access to these
  basics.
• Small scale initiatives have commenced in most of
  the countries.
• But
• There is limited access to ARVs, based on
  affordability, accessibility, treatment literacy.
• Children still not accessing ARVs as priority is
  given to adults.
• There are hidden costs to accessing ARVs.
• Availability of appropriate drugs remains a
  challenge pediatric syrup.
• Poorly resourced areas not reached.
• Treatment literacy is targeted at adults.

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National Governments Express Commitment

• National Plans of Action are in place
• Most governments are addressing OVC needs, with
  the necessary policies, for example Free
  Education for All although other barriers
  continue to hinder children from attending
  school.
• But
• No legislative review to support the Convention
  on the Rights of the Child the rights remain
  inaccessible to most OVCs.
• Not giving sufficient priority to OVC.
• Poor levels of funding ineffective and
  insufficient service provision.
• OVC have no legal existence at national level
  as most are not registered due to lack of birth
  registration therefore no resources are
  allocated for OVC.
• Most countries have no National Social Policy
  on OVC leaving the non governmental and faith
  based organizations to take the lead in
  responding.

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Whose Responsibility?

• Government officials have included the plight of
  orphans in their campaign and advocacy
  strategies.
• Schools are becoming centers of care and
  support.
• Hospitals are also meeting places for support
  groups, counseling centers and provide
  information on the well-being of orphans.
• Print and Broadcast Media are taking a
  positive responsibility to educate and create
  awareness of issues pertaining to children within
  an HIV/AIDS context.
• A major increase in the number of NGOs
  focusing on OVC issues.
• But,
• Aren't there too many soldiers and no generals
  in this fight??
• Which ministry is mandated for OVC? What status
  does this ministry have?
• OVC challenge is enjoying very low profile
  among the national governments.
• Noting that children constitute 50 of the
  population in most countries, isnt it time to
  create a special ministry for them??

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Advocacy and Resource Mobilization

• International funding partners, UN Agencies,
  Regional and National Political Structures have
  all emphasized the seriousness of the problem.
• But
• Funding duration is usually below 5 years -
  this ignores the fundamentals of Child Rights
  programming.
• Donors often arrive with pre-planned
  interventions, rather than support existing
  multi-sectoral responses searching for quick
  results.
• Some requirements are unrealistic, and do not
  take into account succession plans e.g. no exit
  strategies.
• Lack of coordinated donor activities is
  reported in most African countries.
• Information-sharing is limited between funding
  partners and recipients.
• FBOs and CBOs often do not have the technical
  capacity to access these funds.
• Regional political structures (Pan African
  Parliamentarians, AU, SADC and NEPAD) have not
  mainstreamed OVC in regional HIV/AIDS, poverty
  reduction and budgeting and planning frameworks.

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Child Rights Programming Perceptions about OVC
W. I. Thomas words ( a psychologist) What is
perceived as real is real in its consequences.
How we perceive OVC influences our actions and
shapes the health and future of these children
and the society.
3. Innovators and masters in survival they
will form a critical part of the future civic
society. Survivors, coping, responsible, self
actualisation, problem solving, competent.
1. A potential danger for the stability of the
society unruly, potential rebels, gangs,
street children, prostitution, etc
2. A passive and destitute part of the society -
low self esteem, depression, isolation, no future.

• Centering OVC programming on the Childrens
  Voices and Prints is still a myth.

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Responsive Capacities to at all Levels

• UNICEF in collaboration with REPSSI and some
  African universities have started working on a
  Children at Risk certificate level programme
  for child care and support service providers in
  response to the matching knowledge and skills
  gap.
• Children, families, communities,
  non-governmental and faith-based organisations
  have models of providing the majority of OVC with
  care and support. There is need to make these
  interventions become more visible and respected
  by the communities themselves, before trying out
  new interventions.
• However, they have no capacity to generate
  information, document, store and share.

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Responsive Capacities at all Levels conted

• Models of Care and Support e.g.Schools as Centers
  for OVC Care
• and Support
• School environment - most viable and well
  respected institutions at community level in
  terms of expectations in child development by
  communities.
• Teachers are the most consistent and readily
  available frontline cadres of governments to
  support children.
• REPSSI is working on revising the teacher
  curricula in Tanzania and
• Zambia to build the teachers PSS capacity. In
  RSA, work is under
• way with Media in Education Trust SCUK.
• However, such models need to be researched,
  documented and
• populated.
• Resources are needed to enhance the schools
  capacity.

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Monitoring and Evaluation

• The framework provides operational indicators
• Studies are being conducted to monitor the
  effectiveness of some models
• But
• Documentation of best practices, cross
  learning and information sharing is limited due
  to inadequate capacity.
• How far are the agreed commitments translating
  into action?
• Poor coordination clustered services in
  accessible areas, duplication of efforts on the
  few reachable. Majority are not reached as
  responses compete for quick results.
• Vertical programming Most programs focus on an
  aspect, and a marketable element which can easily
  be funded. The emphasis is on quick results and
  quantity, rather than on quality.
• What tools are available to monitor and
  evaluate progress? Who is doing what, where, to
  who, with what impact?
• Knowledge Skills scale-up for effective and
  efficient programming remains a huge challenge.

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HIV/AIDS continues to take its toll. Where are
the children? With whom?
Global Commitments Vs Reality
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Conclusion
We need to maintain OVC high on the
international, regional and national agendas.
Nature duration of intervention should ensure
no additional trauma Placing the child family
at the centre of the interventions is more
sustainable. We need to advocate for policy
change and standardization of protocols and
guidelines on OVC (treatment and social
protection)
I Thank You. Noreen M Huninoreen_at_repssi.org www
.repssi.org