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The role of ECD services in reaching Children Affected by HIV/AIDS

The role of ECD services in reaching Children Affected by HIV/AIDS Sonja Giese Technical Workshop of the Africa ECCD Initiative Cape Town, South Africa July 26-28, 2010. Presentation. SA policy at the intersect btw HIV and ECD

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The role of ECD services in reaching Children Affected by HIV/AIDS

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  1. The role of ECD services in reaching Children Affected by HIV/AIDS Sonja GieseTechnical Workshop of the Africa ECCD InitiativeCape Town, South AfricaJuly 26-28, 2010

  2. Presentation • SA policy at the intersect btw HIV and ECD • The way in which HIV/AIDS amplifies the need for early childhood interventions in South Africa • Opportunities within ECD for impacting HIV- and AIDS-affected children and families

  3. ECD and HIV in policy • Since 1994, major policy developments in all spheres in SA, including ECD • Government commitment to ECD - identified as apex priority (2008), with commitment to massively upscale ECD services • ECD policy environment in SA particularly complex (DSD, DOH and DOE). • National Integrated Plan for ECD (2005-2010) aims “to ensure access to an appropriate and effective integrated system of prevention, care and support services for children infected and affected by HIV and AIDS” • HIV/AIDS and STI National Strategic Plan (2007-2011): • Promotes comprehensive ECD package • Calls on the DOE to develop and distribute national guidelines on children and HIV in preschools (to reach 90% preschools by 2011) • Calls on DOE to develop capacity of ECD centres to provide psychosocial, educational, and adherence support to children in need (80% centres by 2011) • Calls on DOH to implement biannual developmental screening for all children <5 years (60% children <5 years by 2011)

  4. HIV/AIDS and poverty in SA • Approximately 6 million people in South Africa are living with HIV • HIV prevalence among women (15-49 years) attending antenatal clinics is almost 30% • AIDS is leading cause of death in women (mothers) below 49 years • There are ~3.7 million orphans in SA • In most instances, these children live in severely deprived communities – HIV/AIDS therefore amplifies existing burdens • 2/3rds of children under 5 years of age live in poverty • Children under 5 years have the highest mortality rate in the South African population (57.6 per 1,000) • And SA’s infant mortality rate has increased over the past 10 years

  5. HIV/AIDS amplifies need for support in early childhood • HIV-positive infants and children are extremely vulnerable and, without treatment and care, 40% die before their first birthday • For those who survive, there is high risk of mental and physical disabilities • HIV-affected children are at greater risk of maltreatment • HIV increases risk of maternal depression, leading to reduced capacity to care and poorer child outcomes • Children in families affected by AIDS may be at particular risk for under and malnutrition • Where caregivers are absent or ill, young children often take responsibility for caring for younger siblings - increasing risks for both • The financial burden of AIDS on a family often means reduced access to essential services (including health care) • The psychosocial impact of HIV/AIDS on a child can impact all spheres of his / her development

  6. Programmes that have the greatest impact on child growth and development* • Commence prenatally and extend into infancy and early childhood as a continuous chain of support • Combine interventions in a ‘package of services’ eg. child nutrition, parental education on diet and feeding practices, supplementary foods or micronutrient supplements, and parenting and child development education • Utilise several simultaneous ‘delivery channels’ e.g. home visits, group counselling, childcare centres and mass media *Dawes, Biersteker, Irvine (2010)

  7. ECD – a window of opportunity • Birth registration • PMTCT services • HIV treatment • Child protection • Social Grants • Early screening for disability

  8. The best way to support children affected by HIV/AIDS is to strengthen circles of care for all children

  9. Summary of key points • HIV ‘ticks all the boxes’ when it comes to factors that negatively impact early childhood outcomes • ECD services offer a window of opportunity to respond to these risks at a stage when the greatest positive impact can be made • However – ECD interventions in vulnerable communities should NOT be inappropriately targeted at AIDS-affected children to the exclusion of other vulnerable children

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