Getting in line: Coordinating responses for children affected by HIV and AIDS in sub-Saharan Africa

Abstract

Only one in every eight households containing orphans and vulnerable children (OVC) in African countries received any support from an external source (UNICEF, 2008). This is a reflection of how governments, both rich and poor, have ignored obligations ratified in conventions to ensure the social protection of vulnerable children (United Nations, 1989). Consequently, a disproportionate proportion of the financial burden of care of vulnerable children is borne by affected families and communities. It is deplorable that vulnerable children are forced to rely on the charity of income poor relatives and community members (Wilkinson-Maposa et al., 2005; Foster, 2005b). This situation is likely to continue until governments adequately assume their responsibilities. In countries such as Botswana, governments have responded to the crisis of children and AIDS and consequently most households containing vulnerable children now receive external support (UNAIDS et al., 2006). The movement to establish national social protection schemes for vulnerable households is gaining momentum. If cash transfers become established nationally, they may alleviate suffering on a wide scale (JLICA, 2009). In that case, community groups and non-governmental organizations (NGOs) that are currently responsible for implementing responses to support children affected by HIV and AIDS will still be needed to administer psychosocial and other services that are complementary to those provided by these schemes. It is vital that governments develop a central role in coordinating civil society responses and ensure that resources for vulnerable children are used more effectively. But most African governments have limited capacity to coordinate responses and have only recently engaged in this area that involves a few well-resourced international organisations, many local NGOs and innumerable community initiatives. This article reviews the responses of different sectors responding to the impacts of HIV/AIDS on children, and discusses how these may be better funded, coordinated and monitored, utilizing the findings from a study of civil society OVC initiatives and evolving national responses (Foster, 2008).