Child-sensitive social protection. A new approach to programming for children affected by HIV and AIDS

Abstract

The global agenda for children affected by HIV and AIDS is rapidly moving forward in new and important directions. Over the past 5 years, the evidence base on children and HIV/AIDS has expanded considerably and a new global consensus on how to effectively respond to the challenges faced by children affected by HIV and AIDS has emerged. Recent work commissioned and completed by the Interagency Task Team (IATT) on Children and HIV/AIDS and the Joint Learning Initiative on Children and HIV/AIDS (JLICA) synthesizing the evidence base on children affected by HIV/AIDS has been instrumental in this regard. Drawing upon the evidence base, this paper focuses upon two critical shifts in global consensus on how to improve the response to children affected by HIV and AIDS that are particularly relevant for policy and programming. Firstly, there is increasing agreement that the global response to children should be AIDS sensitive, rather than AIDS exclusive. Although there are some AIDS-specific vulnerabilities children face, as a result of poverty and social exclusion, it is broadly recognized that many of their needs are shared with other vulnerable children. Secondly, it has become evident that short-term responses to mitigating impacts on children's lives are ineffective. Rather, given that the impacts of the epidemic, especially the effects of chronic poverty, will be felt for generations, government-led national responses that enhance systems of care, support, and protection for children are required. Indeed, global consensus has consolidated around the urgent need to strengthen and scale up child-sensitive social protection for all vulnerable children, including those affected by AIDS. For development partners, this presents a signal opportunity to support capacity-building initiatives in ministries responsible for social protection and to provide technical and financial support to strengthen social protection mechanisms for the benefit of all vulnerable children.

Keywords:

• child-sensitive social protection
• vulnerability
• HIV/AIDS
• social transfers
• programming

Notes

1. Founded in 2001, the Interagency Task Team (IATT) on Children and HIV/AIDS provides a forum for supporting a coordinated, evidence-based response to protect and promote the rights of children affected by HIV and AIDS (CABA). The work of the IATT has been pivotal in developing interagency thinking on the CABA response and is guided by the recommendations from the Global Partners Forum. See http://www.unicef.org/aids/index_iatt.html.

2. Established in 2006, the Joint Learning Initiative on Children and HIV/AIDS is an independent, time-limited alliance of researchers, programme implementers, activists, policymakers, and people living with HIV that seek to improve the well-being of children, families, and communities affected by HIV and AIDS by producing actionable, evidence-based recommendations for policy and practice. See http://www.jlica.org.

3. The Global Partners Forum was established in 2003 to build momentum in fulfilling global commitments for children affected by HIV as stated in the United Nations General Assembly 2001 Declaration of Commitment on HIV/AIDS and the Millennium Development Goals. It consists of leaders in government, civil society, and UN agencies. See http://www.unicef.org/aids/index_41737.html.

4. Young children (0–5), for example, are particularly vulnerable to disease, malnutrition, and a lack of cognitive stimulation which can have long term effects on their health and development (Dunn, 2005; Grantham-McGregor et al., 2007). Adolescent girls also face specific risks. They are more biologically vulnerable to HIV, more likely to be infected than boys of the same age (particularly in sub-Saharan Africa), and more likely to be taken out of school to care for sick relatives (cf. Robson, 2000; Lindsey, Hirshfield, Tiou, & Ncube, 2003; Ogden, Esim, & Grown, 2004; UNAIDS, 2008).

5. Conditional transfers generally require beneficiaries to participate in particular services or activities (i.e. school attendance, health visits, etc.), whereas unconditional transfers are given without terms attached.

6. Legitimate concerns have been raised about the challenges of imposing conditions in resource-poor settings where demand for services is often high despite barriers (i.e. opportunity costs associated with sending a child to school), the quality and availability of services may be poor or limited, and administrative capacity to support and oversee conditionality is limited (Adato & Bassett, 2009).

7. Family support services, often delivered through social workers and community workers, refer to a range of interventions that seek to strengthen families and prevent family breakdown. They include services such as early child development programmes, parenting programmes, psychosocial support, legal aid, family reunification services, as well as service integration with HIV prevention, care (including home-based care) and treatment programmes (JLICA, 2008; UNICEF, 2004).