Targeting AIDS orphans and child-headed households? A perspective from national surveys in South Africa, 1995–2005

Abstract

In the HIV and AIDS sphere, children remain on the margins with respect to advocacy, prevention, treatment and care. Moreover, concern is generally limited to specific categories of children, most especially children living with HIV, orphaned children and child-headed households. Excluded from view are the very large numbers of children affected by generalized HIV/AIDS epidemics, now in advanced stages, in already impoverished countries in southern Africa. In this paper, we use information from comparable national household surveys in South Africa, in five waves between 1995 and 2005, to examine the impact of HIV and AIDS on children and on the structure of the households in which they find themselves. The question posed is whether it is appropriate to target orphans and child-headed households in this context. The data indicate that orphaning, particularly loss of a mother, tripled during this period, as is to be expected from rising adult mortality. Though they remain a small proportion, child-only households also rose markedly during this time. However, difficult as their situation is, neither orphans nor child-only households appear to be the worst-off children, at least from the point of view of reported sources of financial support and per capita monthly expenditure. Households headed by single adults and young adults are economically vulnerable groups not yet included in efforts to support affected children and families. Poverty is a pitiless backdrop to the AIDS epidemic and needs to be at the heart of strategies to address the needs of all vulnerable children in hard-hit communities.

Keywords:

• children
• AIDS
• poverty
• orphans

Notes

1. It would have been ideal to use years 2001, 2003 and 2005 but the survey started in comparable form only in 2002.

2. This conclusion needs to be considered with caution given the problems with using category data and not knowing where in the category households fall. Here, it has been assumed that, on average, households fall in the middle of the expenditure category they reported, but it may be that for child-only households they were on average closer to the bottom of the range than ‘other’ households, which would bias the results.

3. The eligible income level to receive a Child Support Grant is between R800 and R1100 per month depending on the area in which they live.

4. Added by authors.

5. The estimates are based on expenditure data and conservatively assume an equal spread of household expenditure across all household members. The 9 million is the most conservative estimate because it assumes that households are spending the highest possible amount in the income bracket that they selected. The 11 million is likely to be more accurate because it is based on the sum of reported expenditure, which gives a point rather than a bracket estimate.