Ovc india fhi allianceppt


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Ovc india fhi allianceppt

  1. 1. Working with Children Affected by AIDS : Experience and Lessons Presentation at the USAID/FHI Implementing Partners’ Workshop on OVC and HIV/AIDS Dr. Balwant Singh India HIV/AIDS Alliance 17 th February 2004
  2. 2. <ul><li>Worked with NGO/CBO partners in over 40 developing countries of Africa, Latin America, Asia and Eastern Europe since inception in 1993 . </li></ul><ul><li>Supported over 1000 NGOs and community groups to implement over 1500 prevention, care and impact-mitigation projects. </li></ul><ul><li>An in ternational development NGO focused specifically on HIV/AIDS, and serves as a Collaborating Centre of the Joint United Nations AIDS Programme (UNAIDS) . </li></ul>International HIV/AIDS Alliance
  3. 3. India HIV/AIDS Alliance Strategic Goals <ul><li>To improve coverage of effective community focused AIDS efforts in India </li></ul><ul><li>To strengthen leadership and capacity of civil society to respond to AIDS in India </li></ul><ul><li>To improve institutional, organisational and policy environment for community AIDS responses in India </li></ul>
  4. 4. India HIV/AIDS Alliance <ul><li>S upport ing HIV/AIDS programmes in India since 1997 </li></ul><ul><li>Established as Country Office of the International HIV/AIDS Alliance in 1999 </li></ul><ul><li>Implementing i ntegrated and comprehensive HIV/AIDS programme s: </li></ul><ul><ul><li>mobilising communities in the provision of focussed prevention with key populations </li></ul></ul><ul><ul><li>h ome and community based care and support for People living with HIV/AIDS, families and children affected by AIDS </li></ul></ul>
  5. 5. Home & Community Based Care and Support Programmes <ul><li>Supporting 40 NGOs in Tamil Nadu, Andhra Pradesh & Delhi since 2001. </li></ul><ul><li>Reaches 150 communities in 13 Districts in TN; 5 coastal districts in AP; and, urban and sub-urban areas in Delhi. </li></ul><ul><li>Reaches more than 5800 PLHA, approx. 8500 children affected by AIDS (CAA) and approx. 9000 family members affected by AIDS. </li></ul>
  6. 6. <ul><li>Psycho-social support to PLHA, and Children & Families affected by AIDS </li></ul><ul><li>Home visits & “hands-on care” programme for PLHA, CAA & Families affected by AIDS </li></ul><ul><li>Livelihood support </li></ul><ul><li>Nutritional education & support </li></ul><ul><li>Educational & other support for CAA & OVC </li></ul><ul><li>Medical care </li></ul><ul><li>Emergency support </li></ul>Support Services Provided
  7. 7. Programme Strategies <ul><li>Addressing issues relevant to CAA & other vulnerable children through ‘home & community based model’ </li></ul><ul><li>Ensuring involvement of children at all levels - participatory community assessment, participatory community review and programme design </li></ul><ul><li>Child-centred programming – direct involvement </li></ul><ul><li>Strong referrals and service linkages for improving access to services & addressing stigma and discrimination </li></ul>
  8. 8. Participatory Community Review with Children
  9. 9. Programme Innovations <ul><li>Programming : </li></ul><ul><ul><li>Strategic planning and participatory community assessments and reviews with children </li></ul></ul><ul><ul><li>Lead Partner model for technical support, capacity building, monitoring and scale up </li></ul></ul><ul><ul><li>Integrated programmes reaching out to PLHA, CAA & affected families, and addressing prevention, care and impact mitigation on the HIV/AIDS continuum </li></ul></ul><ul><li>Integration : </li></ul><ul><ul><li>Engaging community development NGOs </li></ul></ul><ul><ul><li>Involving youth groups/National Service Scheme volunteers in care and support in AP </li></ul></ul><ul><ul><li>Involving Self-Help Groups of women for supporting children </li></ul></ul>
  10. 10. A Family Tree Drawn by a PLHA parent and child Source: VMM/World Bank Study on CAA in AP, 2003
  11. 11. Programme Innovations (cont’d) <ul><li>Community Models : </li></ul><ul><ul><li>Community fostering - coastal Andhra Pradesh & Tamil Nadu </li></ul></ul><ul><ul><li>Community resource mobilisation – Tamil Nadu & Andhra Pradesh </li></ul></ul><ul><ul><li>Children’s support groups - AP </li></ul></ul><ul><ul><li>Child-centred counselling - Delhi </li></ul></ul><ul><li>Policy and advocacy work with the Education Department and media on CAA issues - AP </li></ul>
  12. 12. Issues and Challenges <ul><li>Child-centred approaches and programming: NGO capacity </li></ul><ul><li>Institutional Care vs Community Care </li></ul><ul><li>Predominance of emphasis on prevention </li></ul><ul><li>Psychosocial support needs of children </li></ul><ul><li>VCT for Children: Informed Consent, especially for children orphaned by AIDS & street children </li></ul><ul><li>Confidentiality: Status of children </li></ul><ul><li>ART & Children- Access, affordability, community preparedness & technical capacity </li></ul><ul><li>Education: Sex, sexuality & sexual health </li></ul>
  13. 13. Voices of Children* <ul><li>&quot;My father, mother and my brother require medicines. The school is far from the house. Moreover when there is work, my parents send me to the work. I like studying, but now I am used to the work and I am not preferring to continue studies.” </li></ul><ul><li>&quot;We clear the debts of the family by working on daily wage basis. Though we are interested in studying it is not possible, as we have to work and earn.“ </li></ul>* PCA done in Coastal AP by NGOs in Coastal AP
  14. 14. Voices of Children* (cont’d) <ul><li>“ We do not have food to eat or money to get medicines for my sick mother” </li></ul><ul><li>“ I do not want to join in the hostel. I want to live only with my parents” </li></ul><ul><li>“ My mother wants me to go to school regularly. You are providing us school fees. Why do you not (sensitise) my friends and teachers?” </li></ul>* PCA done in Coastal AP by NGOs in Coastal AP
  15. 15. CAA/OVC study in AP*: Key Findings <ul><li>37% of the 1,977 CAA interviewed had lost </li></ul><ul><ul><li>both parents; 18% had lost their mother; and, </li></ul></ul><ul><ul><li>18% their father </li></ul></ul><ul><li>CAA who are not orphans - 59% both parents +ve </li></ul><ul><li>15% dropped out of school & 11% started </li></ul><ul><ul><li>working to support their family </li></ul></ul>* Study conducted by Vasavya Mahila Mandali on the Care and support projects in Coastal AP, on behalf of World Bank in 2003.
  16. 16. Lessons <ul><li>An integrated approach helps to respond to diverse care and support needs of PLHA, children & affected families in locally appropriate & cost effective ways </li></ul><ul><li>Capacity building of NGO staff & volunteers is important to have ethically appropriate & value-based interventions for care and support especially of children affected by AIDS </li></ul><ul><li>Mainstreaming care and support needs of PLHA, CAA & families helps to overcome prevailing stigma & discrimination </li></ul>
  17. 17. Lessons (cont’d) <ul><li>Important to differentiate and address the specific needs of CAA from those of adults with HIV/AIDS or affected by AIDS </li></ul><ul><li>Children require psychological, social & emotional support in addition to having their basic needs met - such support is most effective when provided in environments they are familiar with and where their relatives and friends live </li></ul><ul><li>Children too can and should participate, and take decisions on matters affecting their lives! </li></ul><ul><li>Involvement of PLHA & Children affected by AIDS is essential for successful interventions and programmes </li></ul>
  18. 18. Working with OVC/Children: Key Principles & Values <ul><li>Respect and protect confidentiality </li></ul><ul><li>Children have their ‘likes’ & ‘dislikes’ and so need to be understood </li></ul><ul><li>Equal treatment and non-discrimination </li></ul><ul><li>Children have their own curiosities and aspirations, and need inspiration & guidance </li></ul><ul><li>Children’s self-esteem is very important and fragile – they need care & nurturing </li></ul><ul><li>Children have emotional needs which need to be understood and met </li></ul><ul><li>Children have rights and these need to be upheld </li></ul>
  19. 19. India HIV/AIDS Alliance OVC Priorities for 2004 & beyond <ul><li>Develop & strengthen child-centred programme framework incorporating rights-based approaches and participatory methodologies </li></ul><ul><li>Skills building for our Lead Partners and implementing NGOs </li></ul><ul><ul><li>Child rights & rights-based approaches </li></ul></ul><ul><ul><li>Child-centred programming </li></ul></ul><ul><ul><li>Participatory methodologies for involving children </li></ul></ul><ul><ul><li>Psychosocial support for CAA and other vulnerable children </li></ul></ul><ul><li>Child-centred policy review with our Lead Partner in Delhi </li></ul><ul><li>Fostering integration and community ownership </li></ul><ul><li>Promote sustainability by further enhancing linkages with Government and other service providers </li></ul>
  20. 20. Next Steps <ul><li>Establish an OVC/Children & HIV/AIDS Forum as an outcome of this workshop </li></ul><ul><ul><li>Promote children’s involvement as central element </li></ul></ul><ul><ul><li>Agree agenda and priorities with children </li></ul></ul><ul><ul><li>Monitor progress with children </li></ul></ul><ul><li>Identify & document good practice in OVC work and disseminate widely through networks of NGOs, CBOs & community groups </li></ul><ul><li>Foster collaboration amongst NGOs/CBOs working on HIV/AIDS and those working with children and on children’s issues </li></ul><ul><li>Promote children’s involvement in all OVC programmes e.g. assessment, planning, review, peer education, volunteering, etc. </li></ul>