Child & Y outh P articipation in East & Southern Africa

1. Child & Youth Participation in East & Southern Africa Reflecting on good practice & lessons learnt Presented by Dr. Rachel Bray on behalf of the Regional Inter-Agency Task Team on Children and AIDS – Eastern and Southern Africa (RIATT-ESA)

2. Aims of presentation • Why child participation matters so much in the region; • Barriers to child participation; • State of play: Efforts towards child participation; • Seeing the power of child participation in the revised Framework: “From Evidence to Impact”; • Effective participatory processes: • Rural social protection in NE Tanzania • Children’s radio in rural South Africa; • Lessons learnt.

3. Participation cannot be an ‘extra’ Revised Framework “From Evidence to Impact”: • “an average of only 11% of households caring for OVC receive any form of external care and support”. WHY? • Histories of social exclusion & discrimination; • Erosion of self-worth (increases where stigma prevails); • Culture of dependency & detachment from institutions with power (including schools); • People do not hold state or voluntary services accountable; • Generational effect of poverty & social exclusion; • Migration & scattered families.

4. Barriers to child participation Cultural & socio-political context • Seniority & respect; • Children’s questions answered evasively / inappropriately • Rights approach…threatens the status quo? • Social sanctions against being poor & having HIV in the home; • Children (like adults) reticent to share their distress, hence isolation; • Highly gendered roles; Care as a ‘natural female role’; • Feelings of guilt, anger, sadness and depression following death of a parent. Implications for access to services • HIV-specific: require dedicated inclusion measures; • HIV-sensitive: to prevent additional psycho-social stress.

6. State of play in east & southern Africa Critical review conducted in 2009 found: • Desire and urgency to ‘get it right’ for CABA; • Sense that participation is an important ingredient • End goals differ, but are rarely made explicit; • Trend so far = Once-off consultations, poor follow-up. Exceptions are: • youth-led organisations; • dedicated child participatory processes; • funded & co-ordinated over 5+ years • Attend carefully to, & enhance adult-child relationships • see Good Practice examples in presentation and review.

7. Challenges to progress • Shifting of popular attitudes & institutional culture to a participatory ethic: • Age-based hierarchies create blind spots • Varying histories of adult exclusion within staff body • Urban/’modern’ vs rural/’backward’ hierarchy. • Tackling the silo effect: • Poor co-ordination between organisations working on same issues but focusing on children, youth or older people • Prevents inter-generational dialogue & co-operation, the only sustainable end goal of participatory initiatives. • Accessing finance to support participation: • Poor knowledge amongst donors of breadth and duration of impact of participatory processes • Service delivery organisations unsure how to access funds for participatory approaches (when treated as ‘extra’).

8. Participation & CABA Framework priorities • Not only a right, but a critical enabler for current priorities: • better vulnerability analysis to guide programming and targeting • child-sensitive social protection, delivered through government and non-governmental agencies; • Without knowing what issues face thesechildren in this place at this time, we cannot work effectively towards their best interests • New participatory research MAY not be needed • Harness existing monitoring, for child-centred analysis.

10. Good practice 1:Child-led organisation in rural Tanzania • In 2000, TdH counselling for orphans, sustainability? • Labour union approach; a child-led organisation? • Methodology • Orphans 13-18 yrs defined existing strengths & needs, & how a support organisation might function; • Formed their own clusters (geographic) for mutual support; • Named their organisation VijanaSimamaImara ‘Youth standing up firmly’; • Co-ordination, training & fundraising by local NGO; • Resources • Annual cost per child in 2005 (inc. overheads) = 70 USD • Visionary leader skilled in participatory approaches • Skills transfer to older children & staff of NGO.

11. Good practice 1: Activities • Regular meetings run by children; • Psycho-social support and AIDS awareness; • Bank run by the young people (supervised by NGO staff) • VSI children can apply for interest-free loans for income generating project • Conditions (e.g. training in project management) set by children; • Income generation projects; • Organic expansion of child-led cluster model: • younger children (RafikiMdogo), children living with grandparents (TatoTanu), & child carers (KwaWazee); • Simple cash transfer programme • Children paid for work done for grandparents; • Children participate in evaluation & resolve conflicts.

12. Good practice 1: Impact • Steady growth & sustained involvement • 1,700 child members in 17 clusters (within 4 years) • 50 small groups of children living with grandparents, sharing work loads (within 2 years); • Psychologial impact assessment: • Less emotional stress, • Greater confidence, self-worth & stronger future orientation; • Enables alternative identity: from ‘msifits’ to members; • Solidarity & trust • extends children’s social networks which promotes resilience & offers protection; • Improved economic conditions in home; • Children know how to survive & generate own income; • Mutual support within & between generations, minimal dependency on external resources.

13. Good practice 1: Why does it work? • Protagonism…a step beyond usual ‘participation’; • Clear role for ‘graduates’: Enhances inter-generational contact; • Addresses social ecology, human capacity & material environment in synergy; • Participatory ethic embedded in service delivery; • ‘Milk Van’ versus ‘Fire truck’ approach; • Systematic documentation of steps and outcomes by project staff, enables learning & replication.

15. Good practice 2: Children’s radio in rural South Africa • Where? Ingwavuma, remote hilly area, little electricity , water, sanitation; very high HIV-related illness & death; • Why? Popular images of CABA found to be inaccurate • Alarm: Shaping SA policy, funding, programming & law • To give children platform to depict lives for broader audience & correct mis-perceptions • Facilitate meaningful skills transfer to children; • How? Collaborative venture between: • a primary school, local NGO, a university research & policy unit; • 1 year initially, small funds: hand-made books showing complex lives of children & process documented; • Enthusiasm from children: New aim=Create safe space & offer support.

16. Good Practice 2: Methodology • Combines media, research, advocacy & support to CABA • Careful recruitment & selection • 1 year foundation phase (making life-story book) • Regular training in interviewing & radio production • Small groups of children (age 9-17) in several schools making radio & programmes (diaries, interviews, social commentaries) AND interview adults • Children agree edits, work with adults, then present regular slot on local community radio; • Home visits by staff to: • build relationships with families • facilitate social support where needed.

17. Good Practice 2: Outcomes Growing group of young radio producers • Seeking information from experts (doctors, researchers), local politicians & community members with experience of HIV, then: • Recording & broadcasting interviews to spread knowledge; Radio programmes made by children used: • To stimulate discussion in 'lifeskills' clubs operating in local schools; • In community workshops and meetings • With parents, school principals & teachers, community workers, foster parents, local government and tribal officials • To challenge these adults to think carefully about how their attitudes and behaviour towards children; • To inform revisions of new South African Children’s Act; • To educate nurses, teachers, journalists in RSA and beyond.

18. Good Practice 2: Context • Cultural rules: • ‘Respect’ = children must avoid eye contact with unrelated adults, • Children should not approach adults unless spoken to first; • Prior to project: • most children had never met openly HIV positive person • Children excluded from discussion of illness, not told about family deaths, kept away from funerals.

19. Good Practice 2: Impact • Individual development & resilience to shocks: • Self-confidence, improved reading & writing, coping with grief, problem solving, social networks, future orientation, targeted social, health or material support from NGO; • Family level • Children as ‘expert recorders’ able to open up new conversations in the home about impact of HIV • Enhanced inter-generational dialogue & co-operation; • Community level • Radio programmes open debates, inform other children & older people • Change in teacher attitudes & behaviour towards children.

20. Good Practice 2: Demands & Challenges • Human-resource intensive process; • Building capacity of project requires: • Skills transfer from university-based members to local members in facilitating child-participatory processes; • Funding challenges persist: • Reliant on series of short-term grants & institutional core-funding of project members (not sustainable) • Activities do not fit into one box • Donors do not see value of multiple facets.

22. Good Practice 3 PhilaImpilo: (‘Live Life’) Ways to Healing • Urban Kwa-Zulu Natal, South Africa in clinics, hospitals & NGO services treating TB & HIV infected children; • Aims: • to support health service personnel to work directly with children • To facilitate children's participation in the design of health services; • Approach: acknowledges power dynamic and setting • Practical application of human rights on daily basis • Take participatory approach to work interface between adults & children • Children & medical staff as ‘partners in health’.

23. Good Practice 3: PhilaImpiloActivities & Impact • Activities • Child-centred research • only point children directly involved BUT • Vital demonstration of their capacity to give informed consent or dissent to their treatment, and influence care strategies • Promotion sessions with staff • Round-table discussions with health systems reps & experts • Developing audio-visual resources for medical staff; • Impact • Nurses, doctors, porters: Changed attitudes & practices • Children happier & healing more quickly • Used in state & NGO services in 5 provinces of RSA • Palliative care trainers adopting approach elsewhere in Africa.

25. Lessons learnt • Consulting children is necessary to understand howdifferent factors in children’s lives work together; • Synergies between levels of knowledge, risk of infection, support networks, gender dynamics, household poverty, external shocks, access to services, AND • how this intersection provides protection to CABA • where it increases vulnerability [to infection and/or social impacts of HIV]; • Attention is paid to the participation of adult family & community members with history of exclusion: • Their buy-in is critical for children’s participation to work • Adults who feel threatened may sabotage the process • Children can open issues appropriately as ‘experts’ • End goal is stronger families and communities, through enhanced inter-generational empathy & collaboration.