Supporting orphans and vulnerable children affected by AIDS: using community-generated definitions to explore patterns of children's vulnerability in Zambia

Abstract

This study explores how communities in Zambia characterize vulnerable children in the context of HIV; demonstrates how estimates of vulnerability vary depending on definitions; and discusses the implications of these estimates for program delivery. Baseline research conducted in 2005 included cross-sectional community-based household surveys at six locations using multi-stage random sampling (totalling 1,503 households, reporting on 5,009 children) and participatory qualitative research (focus group and in-depth interviews) with adults and youth at four locations. Between 14 and 27% of children in the sample had experienced a parental death (2–5% maternal orphans, 7–13% paternal orphans, 4–10% double orphans). In addition, other characteristics that communities associated with children's vulnerability were prevalent: 26–34% had been taken into another household, 15–27% were living in female-headed households, and 11–28% were living in a household with someone who is chronically ill. Overall, 58–73% of children had one or more community-defined characteristics of vulnerability. This study highlights the need to carefully consider the meaning of “vulnerability” when targeting programmes to support children affected by HIV and AIDS. Local community input is vital to inform context-specific criteria for distributing programme resources. If used, eligibility criteria should be context-specific yet flexible to evolving community realities. In settings such as rural Zambia where levels of HIV-related vulnerability are high, it may be more efficient to target at the level of communities rather than assess individual households.

Keywords:

• orphans
• vulnerable children
• OVC
• program targeting
• Zambia

Acknowledgements

Many thanks to Ellen Weiss (Horizons/ICRW) for helpful review comments. Many thanks to the program implementers of the World Vision-led RAPIDS consortium, including colleagues from Africare, Care, Catholic Relief Services, Expanded Church Response, Salvation Army and World Vision. Special grateful thanks to community leaders in Chongwe, Kalomo, Mazabuka, Mpika, Ndola and Petauke for working with the research team. Many thanks to two anonymous reviewers for constructive feedback. This study was made possible through support provided by the President's Emergency Plan for AIDS Relief through the Office of HIV/AIDS, US Agency for International Development. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID.

Notes

1. Children who have been orphaned are defined as those who have experienced the death of one or both parents before the age of 18 years.

2. The existence of child-headed households does not necessarily indicate total abandonment by family members, but may result from relatives not wanting children to move in with them, children not wanting to be split up from siblings or children being unable to move from their family home to prevent property grabbing (Foster, Makufa, et al., 1997). While older children may care deeply for their younger siblings, they may be unable to cope with the responsibility of household decision-making and have to make enormous personal sacrifices that threaten their own development (Donald & Clacherty, 2005).