UNICEF in action: Strategy and priorities

Preventing mother-to-child transmission (PMTCT) of HIV

Providing paediatric treatment

Preventing HIV infection among adolescents and young people

Protection and care for children affected by AIDS

Infant and young child feeding in the HIV context

Medical male circumcision

Results for children

Children and AIDS Regional Initiative (CARI)


Protection and care for children affected by AIDS

© UNICEF/NYHQ2009-1923/Pirozzi
A boy orphaned by AIDS reads by candlelight in his grandmother's home in Swaziland.

Eastern and Southern Africa is home to 9.5 million children who have lost one or both parents to AIDS, representing 55 percent of all such children around the world. In Lesotho, South Africa, Swaziland and Zimbabwe, more than one in four children under the age of 15 are orphans, while the figure for Namibia is more than one in three.

The experience of orphaned and vulnerable children varies significantly across families, communities, and countries. Studies have shown, however, that most of these children are at higher risk of missing out on schooling, are less food secure, suffer anxiety and depression, and are at higher risk of sexual exploitation and abuse as well as of exposure to HIV. Ensuring adequate care for orphaned and vulnerable children is a tremendous challenge, since the epidemic’s damaging force has drastically weakened traditional protection and care mechanisms such as extended family support.

The epidemic also increased vulnerability and income poverty, and provoked stigma and discrimination against children and families living with or affected by HIV and AIDS. Budget allocations to child protection services remain inadequate and resources are often times insufficient. Where data is available, the percentage of children receiving external support remains low: Only in Swaziland (41 percent) and Botswana (31 percent) significant numbers of vulnerable and orphaned children are reached.

In most other countries in the region, only around 20 percent or even much less (7 percent in Tanzania) of these children receive any kind of external support. It is paramount to highlight the responsibility of governments to ensure a basic safety net that protects children’s rights to health and education, as well as to protection from exploitation and abuse.

 Country Children who have lost one or both parents due to all causes Children who have lost one or both parents due to AIDS  % of children whose households received external support 
 Angola  1,500,000  140,000  -
 Botswana  130,000  93,000  31
 Burundi  610,000  200,000  -
 Comoros  22,000  <100  -
 Eritrea  240,000  19,000  -
 Ethiopia  -  -  -
 Kenya  2,600,000  1,200,000  21
 Lesotho  200,000  130,000  -
 Madagascar  910,000  11,000  -
 Malawi  1,000,000  650,000  19
 Mozambique  2,100,000  670,000  22
 Namibia  120,000  70,000  17
 Rwanda  690,000  130,000  13
 Somalia  630,000  -  -
 South Africa  3,400,000  1,900,000  -
 Swaziland  100,000  69,000  41
 Uganda  2,700,000  1,200,000  11
 Tanzania (United Republic of)  3,000,000  1,300,000  7
 Zambia  1,300,000  690,000  19
 Zimbabwe  1,400,000  1,000,000  21
 Total ESA  22,650,000  9,454,000  -
Source: State of the World's Children 2012, UNICEF

© UNICEF/NYHQ2006-0424/Pirozzi
A grandmother watches her grandchildren play in front of their house in Zimbabwe. The children are orphaned by AIDS and they are now under their grandmother's care.

UNICEF in action

UNICEF works with governments across Eastern and Southern Africa to provide a protective and supportive environment for children affected by HIV/AIDS. The focus is on expanding availability and access to integrated and comprehensive services; supporting social protection mechanisms; strengthening national policies, plans, standards and guidelines; improving human resource capacity; and strengthening the collection, analysis and dissemination of relevant data.

UNICEF’s work in this area is driven by four main principles:

  • AIDS-sensitive, not AIDS-specific: Taking into consideration that all children – not just orphaned children – face deprivation in poor communities which are affected by HIV.
  • Rights-based: Interventions that address the needs of all children, regardless of their condition and circumstances.
  • Gender-sensitive: Policies, strategies and programmes that is aware of gender differences that cause deprivation and vulnerability.
  • Sustainability: Interventions that are designed to consider the long-term nature of children’s needs and vulnerabilities.

In its support UNICEF is focusing on 10 priority countries with the highest number of orphaned and vulnerable children – Angola, Kenya, Madagascar, Malawi, Mozambique, South Africa, Uganda, Tanzania, Zambia and Zimbabwe. UNICEF’s regional goal is ensure that these countries develop national child and social protection systems that are child- and HIV-sensitive, with a focus on the most vulnerable families, thus contributing to universal access goals and the achievement of the MDGs. In order to achieve this, UNICEF seeks to leverage additional resources through strategic partnerships with major funders such as the US President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund for fight AIDS, Tuberculosis and Malaria, the UK Department for International Development (DFID) and AusAID.

Results for children

In several countries, community-based child care forums that look after orphaned and vulnerable children are receiving capacity development and material support from UNICEF and other partners.

  • In Malawi, the number of children in community care more than doubled between 2008 and 2009, with 300,000 orphans and other vulnerable children now receiving support in their communities.
  • In Swaziland, 45,000 children have improved access to life skills education, birth registration, safe water and sanitation, school health services, and livelihood training through a network of 800 Neighbourhood Care Points.

UNICEF is also supporting cash transfer programmes for families caring for orphaned and vulnerable children:

  • Kenya’s national cash transfer programme increased its coverage from 12,500 vulnerable households at the end of 2007 to 75,000 by the end of 2009. The government has increased its funding for social protection considerably, which ultimately will enable close to 250,000 children to have better access to nutrition, education, health and birth registration services.
  • Malawi’s social cash transfer scheme reaches over 24,000 extremely poor households with a monthly cash grant sufficient to lift families above the poverty line and improve children’s access to healthcare, education and other basic social services.
  • In South Africa, the Government spends 12 percent of its total budget on social grants, making the country proportionally one of world’s biggest spenders on social security. The social grants system has grown from 2.5 million recipients in 1998 to 13 million in 2009, largely as a result of the extension of the child support grant, which reached 9 million children under the age of 15 in 2009. Close to half a million orphaned children are in the care of families who receive a foster grant.



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