HIV / AIDS and children
Progress and challenges
While a number of East African countries – Uganda, Kenya, Ethiopia – have seen a modest decline in HIV infection over the past few years, the AIDS epidemic has just started to level off in Mozambique.
The latest data indicate a prevalence rate of 15 per cent among the 15 to 49 year old population. An estimated 1.6 million people are living with HIV or AIDS. About 410 people become infected every day.
Transmission from mother to child
In Mozambique, around 85 babies are infected with HIV by their mothers every day. HIV-positive women can transmit the virus during pregnancy, delivery or through breastfeeding.
Antiretroviral prophylaxis given to a woman during pregnancy and delivery – and to her infant shortly following birth – has been shown to sharply reduce the likelihood of the mother passing HIV on to her baby, while also providing the mother with treatment.
The nationwide prevention of mother-to-child transmission of HIV (PMTCT) programme has grown rapidly since its inception. The number of PMTCT sites across the country increased to 744 by October 2009, up from 500 in 2008, 386 in 2007, 222 in 2006 and only 8 in 2002.
As a result, the number of pregnant women receiving counselling and testing through PMTCT services increased from 4,641 in 2002 to 194,117 in 2006 and to 366,281 in 2007 – out of an average total of 800,000 pregnancies per year.
A leading cause of child deaths
AIDS-related diseases are fast emerging as a major cause of mortality among children in Mozambique. A growing proportion of all child deaths are a result of HIV-related illnesses. In 2010, it is estimated that 19,000 children under the age of 15 will die as a result of the disease.
The number of children receiving antiretroviral treatment (ART) increased significantly over the past five years, from 500 in 2004 to 12,647 in 2009. This represents 27 per cent of eligible children requiring treatment.
Children have a much quicker rate of progression from HIV infection to AIDS than adults – months in comparison to years for adults. Over 50 per cent of children infected with HIV die before reaching their first birthday.
Impact on children and young people
Children and adolescents are particularly vulnerable to HIV and AIDS. In 2010, it is estimated that over 95,000 young people aged 15 to 19 are living with HIV in Mozambique.
Girls and young women are more vulnerable to infection because they often lack the power to refuse unsafe sex, to choose their partners, to generally influence sexual behaviour and are biologically more vulnerable to infection.
On the other hand, boys may be unable to ignore peer pressure to start having sex at an early age and to have multiple partners and frequent sexual encounters.
Impact on orphaned and vulnerable children
About 350,000 children in Mozambique have lost their father, mother or both parents to AIDS.
Children orphaned by AIDS are especially vulnerable to abuse and exploitation because of stigma and the lack of adult care and support. A large share of orphaned children is living in households headed by women and by elderly family members.
Children that are orphaned – especially those that have lost their mother – are more likely to be malnourished and unhealthy.
What is being done
Preventing transmission from mother to child
Between 2010 and 2011, UNICEF will continue to support the Ministry of Health and other partners to scale up the PMTCT programme and improve the quality of services offered to pregnant women.
In order to prevent the transmission of HIV from mother to child, the Ministry of Health aims to expand PMTCT services to all health facilities in the country with antenatal care and maternity wards, with the goal of reaching 861 by 2011.
The Ministry of Health promotes paediatric treatment through linkages with other child survival interventions, such as vitamin A supplementation, immunisation, and safe infant and young child feeding practises.
HIV prevention and treatment are incorporated into the Integrated Management of Childhood Illness approach, in order to detect and treat children living with HIV at an early stage.
Scaling up paediatric treament
In the area of paediatric AIDS treatment, the Ministry of Health is supported by UNICEF and its partners to expand treatment, care and support for children living with HIV across the country.
Between 2010 and 2011, UNICEF and its partners will continue to support the Ministry of Health in the existing 173 UNICEF supported sites and will support the creation of new sites, bringing the number of UNICEF-supported sites to 215.
Over the past few years, the number of sites providing one or more of the elements of care, treatment and nutrition package required by children exposed to and/or infected with HIV has increased significantly.
The strategy over the next three years is to strengthen the quality of services in existing sites across the country and create stronger linkages with PMTCT services, early infant diagnosis and community activities.
Preventing new infection
UNICEF will continue to scale up prevention activities for children and young people across the country In support of the Government and civil society partners.
Between 2010 and 2011, UNICEF will focus its HIV prevention efforts on in-school children between 10 and 14 years of age, complementing the HIV prevention activities for other age groups carried out by the government and other development partners in the country.
At the same time, UNICEF will continue to expand and strengthen community-based activities, using a variety of community communication channels, such as multimedia mobile units, child-to-child media programmes and theater networks.
Protecting vulnerable children
The Government, national institutions and civil society are supported by UNICEF and other partners to increase access to basic services and social protection for orphaned and other vulnerable children in provinces most affected by HIV and AIDS.
Between 2010 and 2011, UNICEF will continue to support the scaling-up of services for orphaned and vulnerable children in line with the national strategy through direct service delivery and social protection programmes.
UNICEF’s work is guided by the national Plan of Action for Orphaned and Vulnerable Children, which outlines the main principles of intervention, targets and priority actions that have been agreed upon by the Government, civil society, and multi-lateral partners.
The plan aims to reach 1.3 million orphaned and vulnerable children with a set of six basic services: education, health care, material/financial support (including access to poverty certificates), nutritional support, psycho-social support and legal support (including access to birth certificates).