POLICY AND PRACTICE FOR CHILDREN ORPHANED AND MADE VULNERABLE BY HIV AND AIDS

1. POLICY AND PRACTICE FOR CHILDREN ORPHANED AND MADE VULNERABLE BY HIV AND AIDS PAPER PRESENTED AT THE HENAN INTERNATIONAL CHILDREN & AIDS SEMINAR. BY: MR. AHMED HUSSEIN. DIRECTOR,CHILDREN’S SERVICES, KENYA. DATE: 6TH -8TH SEPTEMBER 2007.

2. BACK GROUND INFORMATION • First HIV/AIDS cases reported in 1984. • Myths about HIV/AIDS spread faster than AIDS. • Stigmatization of Countries and individuals. • Withdrawal/concealing and revenge attitude developed among the carriers. • HIV/AIDS spread faster. • High death rates due to opportunistic diseases.

3. IMPACT OF HIV/AIDS • Increased Vulnerability of Children due to high HIV/AIDS prevalence. • Mushrooming of Uncoordinated responses. • High expenditure on Medical services for National and House hold budgets

4. HIV/AIDS ORPHANS • Historically, large scale orphan hood had been associated with war, road accidents, famine or diseases. • Orphan hood caused by HIV/AIDS is a new long term suffering, that need to be addressed urgently. • In some cases the Orphans are born HIV positive and this makes them more vulnerable.

5. RESPONSE • States started declaring HIV/AIDS a National disaster (e. g Kenya 1999). • Development of OVC guidelines (OVC Policies and Legislative provisions. For example the Children’s ACT 2001 and the OVC policy in Kenya(2005). • United Nations General Assembly Special Session on Children in 2001(UNGASS). OVC-ORPHANS AND VULNERABLE CHILDREN

6. WORLD’S REACTION TO THE ORPHAN CRISIS During the United Nations General Assembly Special session (UNGASS) in 2001,three targets specifically touching on orphaned Children were set. 1. By 2003,develop and by 2005 implement national policies and strategies to: (a) Build and strengthen government, family and community capacities to provide a supportive environment for orphans and Vulnerable Children.

7. cont (b) Ensuring their enrolment in school and access to shelter, good nutrition, health and social services on an equal basis with other children. (c) To protect orphans and vulnerable children from all forms of abuse, violence, exploitation, discrimination, trafficking and loss of inheritance.

8. UNGASS CONT. 2.Ensure non-discrimination and full and equal enjoyment of all human rights through the promotion of an active and visible policy of de-stigmatization of children orphaned and made vulnerable by HIV/AIDS.

9. UNGASS CONT. 3.Urge the international community, particularly donor countries, civil society, as well as the private sector to complement effectively national programmes to support children orphaned or made vulnerable by HIV/AIDS in affected regions, in countries at high risk and to direct special assistance to sub-Saharan Africa.

10. SITUATION OF OVC IN KENYA • 2.4 Million OVC (NACC 2005) • OVC policy is ready awaiting Cabinet approval. • A draft on National Plan of Action for the OVC is being edited. • Piloting of Cash Transfer Program in 3 districts started in 2004 targeting 500 House holds, giving KSH 500(US $ 7.4) per Month per House hold. In FY 2007/08: - 16,000 House holds targeted. - KSH 1,500 (US $ 22.4) per month is being transferred to the selected House holds. NSC-NATI0NAL STEERING COMMITTEE ON OVC

11. IMPLEMENTATION • A National Steering Committee on Orphans and other Children made Vulnerable by HIV/AIDS was constituted in May 2004 to co-ordinate the National responses to the crisis. • Rapid Assessment, Analysis and Action Planning Process (RAAAPP) for Orphans and Other Children Made Vulnerable by HIV/AIDS in Kenya July 2004. • Strengthening and Formation of structures at the National, District and Locational level to implement OVC programs. (CPU,AAC,DOSC and LOCS.) CPU-CENTRAL PROGRAM UNIT

12. VARIOUS SAFETY NETS IN KENYA Health; • Establishment of free VCT centres and provision of ART • Free medical care for children who are 5 years and below. • Free ARVS, While treatment of TB and STD among the poor is free Education; • Free Primary Education introduced in 2003 • Provision of school bursaries to OVC • Low cost boarding schools for pastoral communities. • School feeding programme • Formation of OVC committees in primary schools.

13. SAFETY NETS CONT Famine Relief Food; • Approximately two million people are permanently on food relief. • Number rises to ten million people during periods of severer droughts • Pastoralists and people within the ASAL are most vulnerable. • Government spends US $ 40 to 65 million annually on social safety nets. Cash Transfers to families living with OVC. The beneficiaries must be: • Households taking care of OVC. • Vulnerable and the poorest of the poor . • Not benefiting from any other similar program.

14. OBJECTIVE CT-OVC PROGRAMME IN KENYA To provide a social protection system through regular cash transfers to families with OVC in order to encourage fostering and retention of OVC within their families and communities, and to promote their human capital development.

15. SPECIFIC OBJECTIVES • Education: increase school enrolment, attendance and retention for 6 to 17 year old in basic school (up to standard 8). • Health: reduce the rates of mortality and morbidity among 0 to 5 year old children, through immunizations, growth monitoring and vitamin A supplement • Food security: promote household nutrition and food security by providing regular and predictable income support

16. SPECIFIC OBJECTIVE CONT • Civil registration: (i) encourage caregivers to obtain identity cards within the first six months after enrolment; and, (ii) encourage caregivers to obtain birth certificates for children and death certificates for deceased parents. • Strengthening capabilities within the household: (i) coordinate with other Ministries and partners training on topics such as nutrition and health; and, (ii) provide guidance and refer cases related to HIV/AIDS, both among adults and children who are members of the household

17. TARGETING CRITERIA FOR GEOGRAPHICAL TARGETING: • Provincial distribution to have a National out look. • HIV/AIDS prevalence (Districts with the highest HIV/AIDS prevalence are given priority). • Poverty level • Absence of other similar programs.

18. COMMUNITY TARGETING: • AAC training, • DOSC formation • Selection of one Locations per constituency based on the highest HIV/AIDS prevalence and population living below poverty line • Community sensitization and selection of LOCS AAC - AREA CHILDREN ADVISORY COMMITTEE

19. COMMUNITY TARGETING CONT • Training of LOCS in a central place • Identification of the poor House holds with OVC using Form 1. • MIS. • Generation of Form 2 • Selection and Training of Enumerators LOC-LOCATIONAL OVC COMMITTEE

20. COMMUNITY TARGETING CONT • Data collection on socio- economic indicators of households • MIS for Analysis and ranking • Community Validation • Production of the beneficiary list. MIS-MANAGEMENT INFORMATION SYSTEM

21. ENROLMENT • Training Care givers on their responsibilities. • Acceptance of the responsibilities by caregivers. • Signing of the Agreement with the government. • Issuing of a Program ID card. DOSC-DISTRICT OVC SUB COMMITTEE

22. PAYMENT DELIVERY MECHANISMS • Money is delivered using existing government machinery (in 30 districts) • In 7 districts the effectiveness of the use of the Post Office is being tested. • Studies are going on to test the use of other paying agents. AMOUNTS • KSH 1,500(US $22.4) Per month per the selected house hold. The cash is delivered bimonthly.

23. MONITORING AND EVALUATION • An international Consultancy Firm (Ayala) was contracted to assist MOHA with technical support for the Program design. • MIS is structured to capture some of the Variables for M&E. • An International consultancy firm (Oxford Policy Management) was contracted to conduct a baseline survey and evaluation of the CT-OVC Program in Kenya.

24. TESTING CONDITIONS VERSUS NON CONDITIONS • Evaluation will assess the impact of imposing conditions on the specific objectives of the program . • Evaluation will also ascertain whether beneficiaries will take upon themselves to take the OVC to school, health services and attend awareness sessions after receiving cash if no conditions.

25. OVC AND STIGIMA • Awareness creation among community members has minimized the stigma. • The CT Program focuses on OVC but not the causes. • The use of Community based targeting mechanisms implies that OVC are handled by people familiar to them. • As more and more families become affected, communities start empathizing hence making the issue of OVC ordinary because no one knows the next victim. • The enactment of the Children’s Act in 2001 has minimized discrimination against Children regardless of their status.

26. OPERATIONAL CHALLENGES • Increasing number of OVC that has outstretched existing interventions. • Inadequate social amenities such as school and health facilities in areas where the program intends to scale up. • Inadequate skilled personnel to monitor the conditionalities once the number of beneficiaries increases. • Complementary programs (low cost boarding primary schools, bursaries and school feeding programs) may not increase their coverage at the same rate as the CT program scale up. • Lack of Information Technology networks in different parts of the country. • Some of the beneficiaries lack National ID cards. • Nomadic ways of life in some parts of the country.

27. SOURCE OF FUNDING. • Government of Kenya. • UNICEF. • DFID and SIDA through UNICEF.

28. “ASANTE SANA”