Results for children
Initiatives to reduce maternal and child mortality such as the UN Secretary-General’s Global Strategy for Women’s and Children’s Health, launched during the MDG Summit in September 2010, increasingly identify PMTCT as a priority, taking into consideration that AIDS is one of the leading causes of death among women of reproductive age. In sub-Saharan Africa, 9 percent of maternal mortality is due to AIDS with significant variations between and within countries.
The Global Fund to fight AIDS, Tuberculosis and Malaria, one of the main funding sources for all HIV/AIDS programmes globally, decided to prioritize PMTCT in order to allow for a significant scale-up of services. UNICEF and other partners support countries in reprogramming existing Global Fund grants and in applying for additional funds.
UNICEF and partners developed a number of innovative programme approaches, such as the Mother-Baby-Pack for PMTCT. The pack contains a full set of highly efficacious antiretroviral drugs and antibiotics that are needed to prevent the transmission of HIV from a mother to her child. Roll-out of the Mother-Baby-Pack started in Kenya in 2010 as part of a whole package of interventions, including engaging Mentor Mothers to support pregnant women living with HIV in the use of the Mother-Baby-Pack, and encouraging stronger involvement of pregnant women’s male partners. During a pilot phase, the Mother-Baby-Pack is also being rolled-out in Zambia, Lesotho and Cameroon.
Early infant testing within the first two months has been introduced in almost all high HIV burden countries, but access remains limited. As reflected in the new WHO guidelines on ARV for infants, early initiation of treatment is key to increasing the survival chances of infants born with HIV. Without any intervention, half of all children born with HIV will die before their second birthday. Countries such as Uganda and Kenya have started using SMS technology to expedite the return of test results to health facilities and mothers, allowing for a rapid initiation of treatment if an infant is found to be HIV-positive.
The specific vulnerability of adolescent girls is receiving increased attention, through initiatives that more explicitly address gender issues.Sisters2Sisters and Brothers for Life are two such initiatives launched by UNICEF and partners in some countries in Southern Africa. They target gender dynamics among both female and male adolescents and young people, through mass media and interpersonal communication. UNICEF also supported the production of a three-part TV drama called Shuga, which is about the lives and relationships of university-age friends in Nairobi. The programme was broadcast on public television in Kenya and Zambia. Sixty per cent of Nairobi youth saw the programme and 90 percent of the viewers said in a survey that it had affected their thinking around HIV.
UNICEF is also supporting countries in introducing medical male circumcision. Kenya started large scale roll-out of male circumcision services in 2009. A total of 13 Eastern and Southern African countries have been identified as priority countries.
Over the past years, the opportunities for children orphaned and made vulnerable by AIDS to go to school have improved significantly. Most countries in sub-Saharan Africa have made important progress towards parity in school attendance for orphans and non-orphans.
Social protection has become a priority in the region to support orphaned and vulnerable children and the families who care for them. In 2006, 13 countries in the region signed the Livingstone Accord under the auspices of the African Union (AU). The Livingstone Accord was followed by the Social Policy Framework for Africa, approved in 2008, which signaled increased political commitment from the AU with regards to Social Protection. In 2010, UNICEF supported the organization of a workshop by the Inter-Parliamentary Union (IPU) on child-sensitive social protection policies, with parliamentarians from 10 countries in Eastern and Southern Africa participating. The forum built consensus amongst parliamentarians for efforts to scale up safety nets for the most vulnerable, especially children affected by HIV and AIDS.
UNICEF has also been supporting the implementation of cash transfer programmes for families who care for vulnerable children. In several countries such as Kenya, Namibia, South Africa, Malawi and Ethiopia such cash transfer projects are now being scaled up with substantial government budget allocations.