Orphans and other vulnerable children often have least access to essential services, yet they are among those with the greatest need. Ensuring that they gain access to those services requires commitment and action at all levels from the community right up to national governments. Among the key areas are:
- Schooling. Schools can offer children a safe environment, with built-in support, supervision and socialization. The best way to maximize the enrolment and attendance of orphans and other vulnerable children is to abolish school fees. In addition, removing the requirement to buy a uniform, introducing school-feeding programmes and ensuring access to life skills education to reduce the risks of HIV infection are other measures that can have a major impact.
- Psychosocial support. Losing a parent is a traumatic experience and children need immediate support as they deal with a host of new difficulties and challenges. In the longer term, their new caregivers may also need such help.
- Health services. Children orphaned by HIV/AIDS are likely to be more vulnerable in terms of both health and nutrition. It is therefore paramount to ensure they have access to essential health services in early childhood such as immunization, vitamin A supplementation and growth monitoring. For adolescents, education and health services focused on HIV prevention and sexual and reproductive health are critical. Treatment for HIV-positive youth is also an emerging necessity.
- Safe water and sanitation. Extended pipelines and new boreholes can help increase access to safe water at the local level. Those living with HIV/AIDS need clean water to avoid opportunistic infections such as skin diseases. Caregivers need to be informed about proper hygiene and food handling. Lack of access to safe water, especially in sub-Saharan Africa, means that women and girls have to spend long hours fetching it from wells that are often miles away, adding to their work burden and compromising their safety.
- Justice systems. Strong and independent legal systems, with judges who are educated about key child-protection issues, are vital in protecting orphans and other vulnerable children from abuse, discrimination and property loss.
- Birth registration. All children need to be registered at birth to ensure that their rights are not denied, yet in sub-Saharan Africa in 2000 more than two in three births were not registered. Vulnerable children need official evidence of their identity to ensure they have access to public services and welfare.