Orphans and Vulnerable Children
Gaps in Research
- 1.
- Interventions are needed to support women living with HIV to reduce infant abandonment.
- 2.
- Increased financial and other support is needed for adults, especially grandparents, caring for orphans, including those who are HIV-positive.
- 3.
- Interventions are urgently needed to help girls enroll (and stay) in school.
- 4.
- HIV/AIDS programming should also reach young children.
- 5.
- Improved and timely access to antiretrovirals is needed for orphans.
- 6.
- Interventions are needed to assist parents dying of AIDS with planning for the future well-being of their children.
- 7.
- Further interventions to provide support programs, including counseling, are needed for AIDS-orphaned children and their caregivers to combat depression, social isolation and stigma.
- 8.
- Further interventions are needed to help female OVCs reduce risky sexual behaviors and protect them from sexual violence.
- 9.
- Programs should encourage male involvement in children’s treatment and orphan care.
- 10.
- NGO and government interventions must take care not to create dependence on externally funded services and decrease the community’s sense of responsibility for OVC.
- 11.
- Interventions are needed for street youths who have high rates of HIV and intravenous drug use.
1. Interventions are needed to support women living with HIV to reduce infant abandonment. Studies found that families forced women living with HIV to abandon their infants; some due to erroneous fears that the infant could transmit HIV.
Gap noted, for example, in Ukraine (Bailey et al., 2010; Pinkham and Shapoval, 2010); Russia (Zabina et al., 2009; Wolfe et al., 2010); and Kyrgyzstan, Kazakhstan and Tajikistan (Shapoval and Pinkham, 2011).
2. Increased financial and other support is needed for adults, especially grandparents, caring for orphans, including those who are HIV-positive. Studies found families caring for orphans lacked adequate food and nutrition and reported financial difficulties in meeting basic needs.
Gap noted, for example, in Zimbabwe (Skovdal et al., 2011a); Uganda (Nalwoga et al., 2010; Kintu, 2008); Kenya (Muga et al., 2009); and Botswana (Miller et al., 2006; Heymann et al., 2007b).
3. Interventions are urgently needed to help girls enroll (and stay) in school. [See also Advancing Education] Studies found that girls affected by HIV are more likely to be out of school, despite the protective factor of education in reducing the likelihood of HIV acquisition.
Gap noted, for example, in a systematic review (Irwin et al., 2009); Thailand (Yoddumnern-Attig et al., 2004); Tanzania (Wobst and Arndt, 2004); South Africa (Horizons et al., 2004); Kenya (HRW, 2003c).
4. HIV/AIDS programming should also reach young children. A review found that despite the impact of investing in early childhood interventions, few HIV/AIDS programs exist for young children.
Gap noted, for example, in a systematic review (Irwin et al., 2009) and review of National Plans of Action for OVC (Engle, 2008).
5. Improved and timely access to antiretrovirals is needed for orphans. A study found that orphans were more likely to be at WHO clinical stage 4, and need timely treatment initiation.
Gap noted, for example, in Uganda (Ntanda et al., 2009).
6. Interventions are needed to assist parents dying of AIDS with planning for the future well-being of their children. [See also Advancing Human Rights and Access to Justice for Women and Girls] Studies found that many parents dying from AIDS had not written wills nor provided custody arrangements for their children.
Gap noted, for example, in Kenya and Tanzania (Nyangara et al., 2009a; Nyangara et al., 2009b; Hunter and Williamson, 2000).
7. Further interventions to provide support programs, including counseling, are needed for AIDS-orphaned children and their caregivers to combat depression, social isolation and stigma. Studies found that AIDS orphans reported insufficient food, depression and stigma.
Gap noted, for example, in Cambodia, India, Kenya, Tanzania and Ethiopia (Messer et al., 2010); Haiti (Surkan et al., 2010); Zimbabwe (Kembo, 2010; Nyamukapa et al., 2010); Rwanda (Betancourt et al., 2011); Rwanda (Thurman et al., 2008a); South Africa (Van der Heijden and Swartz, 2010; Cluver et al., 2007; Cluver and Gardner, 2007); China (Xu et al., 2010a; Xu et al., 2010b; Zhao et al., 2010a; Zhang et al., 2009a; He and Ji, 2007).
8. Further interventions are needed to help female OVCs reduce risky sexual behaviors and protect them from sexual violence. [See Prevention and Services for Adolescents and Young People]
Gap noted, for example, in South Africa (Cluver et al., 2011).
9. Programs should encourage male involvement in children’s treatment and orphan care. A systematic review and several studies found that fathers are often overlooked in orphan care when the mother has died.
Gap noted, for example, in a systematic review (Sherr, 2008); South Africa (Hill et al., 2008); and Zimbabwe (Nyamukapa and Gregson, 2005).
10. NGO and government interventions must take care not to create dependence on externally funded services and decrease the community’s sense of responsibility for OVC. An evaluation of programs providing services to orphans found that because of NGO interventions, communities believed they had no responsibilities towards caregivers and orphans.
Gap noted, for example, in Kenya and Tanzania (Nyangara et al., 2009a).
11. Interventions are needed for street youths who have high rates of HIV and intravenous drug use. A systematic, community-based, multicity assessment of street youth in Ukraine, of whom a quarter were girls, found high rates of HIV and low condom use and high rates of sharing needles, especially among orphans and who were injecting drug users.
Gap noted, for example, in Ukraine (Robbins et al., 2010; Zapata et al., 2011).