Evaluation database

Evaluation report

2001 ZIM: A Study on Children Affected by AIDS in Zimbabwe



Executive summary

Background

As part of the process of developing a comprehensive national strategy for Orphans and Vulnerable Children in Zimbabwe, UNICEF Zimbabwe, in collaboration with the government, donors, and civil society, undertook studies in 2000 aimed at compiling a comprehensive information base on the various categories of vulnerable children. The studies commissioned towards the preparation of this report were as follows:
- A Study on Children Affected by AIDS in Zimbabwe
- A Study on Children Infected with HIV in Zimbabwe
- A Study on Children and Adolescents with Disabilities in Zimbabwe
- A Study on Street Children in Zimbabwe
- A Literature Review on the Phenomenon of Working Children in Zimbabwe

Each commissioned study has also been listed separately in the database, including a comprehensive Summary Report that synthesizes the five case studies.

Purpose / Objective

The overall objective of the study was to compile, consolidate and validate available information on children affected by AIDS, in order to facilitate the development of a long-term national strategy aimed at promoting, protecting and fulfilling the rights of these vulnerable children. This study was initiated to look at children affected by AIDS in Zimbabwe, analyse their situation in the perspective of role and capacity, and bring out the gaps. These gaps will be critically analysed, looking at causality factors that result in children affected by AIDS losing their privilege as rights' holders and assuming new roles as duty-bearers amongst other issues.

Methodology

A comprehensive literature review was undertaken for each category above and major issues emanating from the literature review were highlighted. Field research was then undertaken. An effort was made to ensure sample sizes were designed in a manner that was nationally representative. Fieldwork specifically focused on obtaining information on causes, effectiveness, adequacy and relevance of interventions, existing opportunities and risks, and views on the way forward (including perceived roles of various actors).

Key Findings and Conclusions

It is estimated that, in Zimbabwe, 25% of all children are living in a family with at least one HIV positive parent. Such children are affected by AIDS and are vulnerable to economic and psychological insecurity. Another distinct category of children affected by AIDS is that of children who are orphans. Estimates on orphans highlight the extent of the problem after the death of a parent(s). This tends to under-estimate the number of children affected by AIDS since there are a considerable number who are not orphans but under the care of parents who are HIV positive.

One of the immediate impact of AIDS on children is the drop out rate from school, when children have to care for an ill parent/sibling or have no money to continue with education. Two hundred and thirty-two children were recorded to no longer be in school, 24 of these are aged 10 years and below, 77 aged between 11-15, 89 aged between 16-18 and 42 above 19 years.

Child-headed households were mainly found in farming and mining sectors. This is mainly due to migration, as families were isolated from relatives and the extended family when they moved from the rural areas to mining or farming areas. These families rarely, or never, visited the extended family mainly due to economic reasons.

In rural areas, there were relatively limited numbers of children heading households. This was mainly because the people in the rural areas are, to some extent, still practising traditional ways of caring for children and the sick. For example in Buhera, wife inheritance is widely practised and accepted, thereby protecting children. The prevalence of child-headed households may not necessarily indicate the failure of the extended family coping mechanism. Most child-headed household studies in Zimbabwe indicate that there were some members of the extended family who would have taken care of the children but were not willing to do so for various reasons. In as much as child-headed households can be seen as a coping mechanism, it can also be taken as a sign of abandonment of the children.

Many children heading households reported feelings of stigmatisation from the local community and from relatives. When probed to find out how the stigma was manifested, the children reported the following:
- They are laughed at because of their poverty. 
- Other children were stigmatised by relatives and community members who said their families are cursed because there are so many deaths.
- At school, these children are stigmatised by other children.
- The older girls reported that community members no longer treated them as children, even though they treated other girls of the same age with parents as children. The community now saw these girls as "mothers" and expected them to work hard to care for their siblings. As a result, the girls had no friends except those who were in similar circumstances.

Respondents from focus groups discussions, individual and group interviews, identified child abuse as prominent in communities. Some community opinion leaders, however, indicated that where there is a community care of orphans programme, child abuse significantly goes down, as few cases are reported due to the monitoring that takes place. However, the most noted form of child abuse was verbal, and stepmothers were referred to be partly primarily responsible for the abuse. Some reported the abuse from grandparents, whom they said were not used to living with so many young children. Children also reported being beaten up by grandparents and stepparents. It is typically the girls who report sexual abuse. Their fears included men who come and knock at their door during the night. Others reported that elderly men who promised to marry them as second wives raped them, and never fulfilled their promise.

Extended illness causes problems such as lack of finance, lack of caregivers for the sick person, quarrels and fights in the home, no one to work in the field hence lower yields, children dropping out of school, etc. During interviews and focus group discussions, economic issues were always the first to be mentioned by respondents as key causal factors. Most children affected by AIDS are easily identified in communities because of their poor economic status. It is worthwhile to note that these children start to be affected by the harsh economic environment when their parents are very sick and leave employment. The majority of the respondents confirmed that the children actually assume adult responsibilities way before the parents are seriously ill.

Most children are seen involved in several economic activities to supplement the income in the household. In the rural areas, the issue of going to plough in other people's farms to raise money known as "maricho" in Shona was a widely accepted practice of supplementing income in the home. It is thus difficult to have a clean cut-off point as to when children start to feel the burden of caring for the family economically. These children seem to continue with the same tasks they used to do when the parents were still able to fend for the family. The marked difference was in financial management, as the children would now have to manage the home budget on their own without assistance from the parents. The second marked difference was when parents started to sell household goods to raise money for medication. By the time the parent(s) die, the children have no resources to use as a base to raise more funds.

When asked whether certain assets were unfairly distributed after the death of their parents, many children reported a lot of unfairness. Some of the children do not know what happened to the estate after the death of both parents; some reported that their uncles did not give them the parents' death certificates and they could not access the pension benefits.

Other respondents, especially from the PWA support groups interviewed, raised issues regarding infection control. This was highlighted as a major problem especially when the parent had diarrhoea or was vomiting. This was said to be critical when the family was living in a one-room house, or when accommodation was not adequate. The children caring for sick parents may not have the necessary training or knowledge on proper infection control. In a few instances, the children are too young and, even when provided with gloves, these are too big for the child to use.

These children found it difficult to care for younger children when they were sick. One girl said she always felt hopeless when her younger sister was ill and crying. In many instances, these children heading households do not realise the extent of the sickness until the illness is at an advanced stage. Health officials refuse to treat unaccompanied children, i.e. children who do not come with an adult. These children are supposed to ask their neighbours to escort them to the clinic, and the neighbours are not always available to do so.

Recommendations

Zimbabwe should strengthen the provision of basic services, since these services are key to the survival and development of orphans and other vulnerable children. Improve access to health facilities especially for OVC. Provide counselling services to children living with sick parents, bereaved children and children who have assumed adult roles and responsibilities.

Community-Based Income Generating Initiatives, such as savings and credit schemes, which rely on community participation to ensure sustainability. The main role of support organisations is to facilitate the process through awareness raising, training, and provision of time, personnel, and financial and material inputs.

Laws linked to registration of births, inheritance and property disputes should ensure that all children are identifiable and that orphaned children inherit their parents' property. Legal education should also be an integral component to community-based awareness programmes.

Enforce and monitor existing policies that protect children with special emphasis on:
- Protection of children against neglect and abuse;
- Protection of inheritance rights of orphans;
- Right of children to education (both primary and secondary); and
- Increase availability and accessibility of social welfare support for children affected by HIV/AIDS.

Strengthening and supporting sustainable and replicable community-based child protection initiatives which:
- localise the allocation of resources;
- reinforce the management and marketing skills of CBOs;
- train stakeholders on designing, managing, monitoring and evaluating project activities;
- establish non-discriminatory fora for NGOs and CBOs to exchange ideas and experiences; and
- build links between donors, Government, NGOs and CBOs to ensure a co-ordinated approach to service provision at community level.



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Report information

Date:
2001

Region:
ESARO

Country:
Zimbabwe

Type:
Study

Theme:
HIV/AIDS - OVC

Partners:
Government of Zimbabwe

PIDB:

Follow Up:

Language:
English

Sequence Number:
2001/804

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