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Early Childhood Development HIV/AIDS in Malawi. Presented by Malawi Country Team Dar-es-Salaam, Tanzania 2004. Situation of Malawi: Social Indicators. Pop – 10,800,000 65% of population lives below poverty level Total number of children (0-18) 5,250,000 Ages 0-6 – 24.4% (2,777,000)
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Early Childhood Development HIV/AIDS in Malawi Presented by Malawi Country Team Dar-es-Salaam, Tanzania 2004
Situation of Malawi: Social Indicators • Pop – 10,800,000 • 65% of population lives below poverty level • Total number of children (0-18) 5,250,000 • Ages 0-6 – 24.4% (2,777,000) • 49% of children stunted
Social Indicators cont. • IMR – 104; MMR - 1,120; U5MR – 189 (main causes are malnutrition, anemia, pneumonia, diarrhea, malaria) • Urban – 25%; Rural 13% HIV+ • 1.2% children (0-14 yrs) infected with HIV (NAC 2003) • 16-30% HIV prevalence in child bearing women
Situation of Orphans in Malawi • 17.5% (937,000) of all children are orphans • 24% of Orphans are under 5 • 49.9% are orphaned due to HIV/AIDS.
Situation of ECD Services • 26% coverage of access to ECD services • Approximately 3000 CBCC’s (400 supported by UNICEF) • Ages 0-5 attend CBCC’s • 40% of children at CBCC’s are Orphans • On average 100 Children registered at CBCC (1:50) • Less then 50% of caregivers are trained
Key Policies and Legal Framework • Human Rights Provision Ch. 4 Sect. 23 • Children and Young Persons Act • Affiliation Act • Maintenance of Married Women Act • Wills and Inheritance Act • ECD, OVC, HIV/AIDS, Gender, People with Disabilities, Decentralization Policies • PRSP • National Health Plan: IMCI, PMTCT Policies
Programmes Targeting ECD and HIV/AIDS • Support to Orphans and families affected by HIV/AIDS • Community Child Care (using the IECD approach)
Stakeholders • Ministry of Health, Gender, Agriculture, Water, Education, Finance, Local Government • NGO’s, CBO’s, FBO’s • UN Agencies • Bilateral Donors • Communities
Programme ObjectivesSupport for orphans and families affected by HIV/AIDS • To ensure that families and orphans affected by HIV/AIDS are provided with appropriate care and support to facilitate healthy growth and development, education, protection, and participation • Strengthen the capacity of programme partners to collect and use information to monitor and evaluate programmes on early child care • Ensure that issues of orphans, ECD, and nutrition are well incorporated in relevant poverty reduction strategies
Programme ObjectivesCommunity Child Care • Provide family with skills to care for children including nutrition, health, and psychosocial support; • To ensure that acute malnutrition among under 5 children stays below 10% • Strengthen the capacity of implementing partners to collect and use information to monitor and evaluate programmes on early child care • To promote integrate childhood development during the 1st three years of life • To prevent death among children occurring in the homes
Programme Intervention Focus ECD/OVC • Advocacy on ECD/OVC • Support the capacity for parents/caregivers to provide early learning and stimulation, psychosocial development, and care for OVC • Establish CBCC’s and improve the quality of services to promote early learning and stimulation and the holistic development of children • Psychosocial support and counseling • Community Mobilization/Empowerment (Community Dialogue) • Support and training on IGA’s • Partnership and networking
Best Practices • Multi-Sectoral Approach • Utilization of existing structures and local resources • Reaching the most vulnerable • Capacity building of parents/caregivers for providing quality care • Community Child Care initiatives (EL&S, Extended family care, granny’s and widows club, single mothers club )
Best Practices • Community engagement (community dialogue) • CBCC as entry point for other development programmes • Human Rights Based Approach To Programming • Inclusion of Psycho-social support in the package of care • Maternal health and nutrition • Extended family care & Foster Care
Challenges • Political Commitment not backed by adequate resources • High Level of Poverty; low literacy level • Increasing # of children affected by HIV/AIDS • Provision of Quality services • Capacity of service providers to provide integrated services • Service provider turnover rate • Inadequate human resources • Reaching children 0-8 (particularly 0-3)
Challenges • Coordination/Convergence of Services • Appropriate infrastructures (physical) • Traditional Beliefs/Practices • Provision of EHP • Sector Wide Approach • Number of VCT’s within the communities • Child Participation • Advocacy to link knowledge/skills/practice • Communication strategies at community level
Gaps • Reliable data on the magnitude of the problem of children affected by HIV/AIDS, and Psycho-social development • Provision of quality integrated services with focus on ECD and HIV/AIDS • Implementation of operational guidelines for ECD • Resources (funding, materials, human) • Untrained Caregivers
Gaps Service Delivery for Children: • Food and nutrition • Health (growth monitoring, referral) • Management of common complications associated with HIV/AIDS infected children Parental Education and Support: • Parenting skills and knowledge • Counseling skills
Gaps Care Provider Training and Support • Standardized training and materials • Capacity of caregivers and trainers • Comprehensive care to care providers Sensitization of the public on ECD • Inadequate advocacy on ECD and HIV/AIDS • Communication strategy not appropriate for behavioural change
Gaps Community Mobilization • Follow up and sustainability • Community monitoring
Opportunities • Availability of strong NGO’s, FBO’s, CBO’s • Availability of policies (e.g. ECD, OVC, PRSP) • Increase of father participation (trend improvement 2000-2003) • Emerging programmes (e.g. ARV therapy for infected children, ICHBC) • Increased demand from communities for ECD services • Community Monitoring tool for OVC • Ratification of CRC & CEDAW
Results/Evaluations • Identified trends in increase in child rearing practices • Follow up to baseline study underway • Review and development of ECD materials (syllabus, training manuals) underway • Rapid appraisal for OVC • ECD Mid Term Review • Launch of ECD & OVC Policy