Dr. Grace was privileged to offer this presentation to a panel at the Unicef located at UN headquarters concerning the ministry of the Kenya Heritage Foundation.

1. Families in Changing
Educational Environment
THE CHANGING ROLE OF FAMILIES
AFFECTED BY HIV/AIDS IN KENYA
PRESENTATION TO
CONFERENCE ON NON-GOVERNMENTAL
ORGANIZATIONS IN CONSULTATIVE
RELATIONSHIP WITH THE UNITED
NATIONS
DR. GRACE JEPKEMBOI
FOUNDER: KENYA HERITAGE FOUNDATION

2. Appreciation
 Hosts: NGO committee on the Family - New York.
 Moderator: Dr. Jerry Aldridge.
 The Permanent Mission of the Republic of Kenya To
the United Nations, New York: Ms. B. Mwaura
(Legal Officer) and other Officials.
 KHF Board: Drs. Lynn Kirkland (President);
MaryAnn Manning and Lois Christensen.
 Friends and invited guests.

3. Changing Role of Families affected by HIV/AIDS
 Recall the famous idiom that defines Africa:
 “It takes a village to raise a child.”
 The village’s strong foundation is the family.
 Now that HIV/AIDS has ravaged families across all
communities in Africa, how much truth does this
adage still have?
 The village is slowly fading away.
 Even with the emerging global village many children
still grow up not feeling adequately cared for.

4. Focus of the speech
 This speech will address five areas that relate to the
HIV/AIDS pandemic in Kenya:
1. The rising number of children affected by HIV/AIDS
2. The impact on family & traditional systems of care.
3. The changing role of the family and family systems.
4. Role of NGOs and FBOs in Protecting and
supporting children affected by HIV/AIDS.
5. A Call to action.

5. Prevalence of HIV/AIDS in Kenya
UNICEF, WHO and UNAIDS (2010)
 Estimated adult (15-49)  6.3 % (2010)
HIV prevalence rate
 Significant decline  8.7 % (2003)
 Preventing Mother-to-child
transmission:
 ≈81,000.
 HIV+ pregnant women
 HIV + pregnant women
 ≈59,591 (73 %)
who receive ARVs for
PMTCT

6. Children affected by HIV/AIDS in Kenya
 Children living with HIV  ≈180,000.
(0-14 y/o).
 Children needing ARV  ≈89,000.
therapy.
 Children receiving ART  ≈28,370.
therapy (0-14 y/o) .
 ARV therapy coverage
among children.  ≈32 %.
 Children who have lost one
or both parents due to  ≈ 1,200,000.
AIDS.
 Children whose households  21 %.
received external support.

7. Effects of HIV/AIDS on the Family
 The family is the nucleus of the community.
 Role of family: food, clothing, shelter, safety, stability
and socialization of children.
 HIV/AIDS has adversely ravaged the family.
 Death of head of households and breadwinners
means loss of income and family stability.
 Families have to make hard decisions on whether to
use the limited finances for basic needs or to
purchase medications for the infected loved ones.

8. Physical effects on the family
 In many families living with HIV/AIDS both parents
and one or more children are infected and the rest of
the family are affected in one way or another.
 When the parents eventually become terminally ill
and are not able to go to work the family will not
have adequate nutrition or a balanced diet.
 This results in health related complications:
malnutrition, anemia, frequent illnesses and
complications related to opportunistic diseases.
 Care is critical and the burden falls on others.

9. Impact of family relationships
 Stigma and prejudice: Families often become
isolated, ridiculed and ostracized.
 Disclosure of HIV status: Many families would rather
die is silence rather than come and seek for help.
 Marital relationships also suffer: Lack of trust
between spouses and loss of consortium has resulted
in a lot of marital discord and breaking up of
families.
 Shifting of blame, shame, guilt, disappointment and
bitterness between spouses and members of the
extended family.

10. Impact on family stability
 Urban- rural migration: Many families in the urban
areas (with better opportunities) often relocate to
rural areas.
 Rural-urban migration: Infected persons move to the
urban areas to access medical care. Family members
will bear the extra cost to accommodate.
 Family separation and divorce.
 Children loose already established friendships,
change schools and some may not have been raised
in rural areas.

11. Impact on family finances
 The greatest challenge families face is finances.
 Direct and indirect costs of HIV/AIDS are enormous.
 Breadwinners and head of households may no longer go
to work. Eventually with both parents terminally ill the
dwindling family finances suffer.
 Families choose between basic needs and medical costs.
 Cost-sharing for the ARVs: costly for families.
 Extended periods of hospitalization results in large
medical bills. Funeral expenses are also costly. Not many
families have adequate insurance to cover.
 Those with insurance eventually loose it because they can
no longer go to work.

12. Effects of AIDS on traditional systems of Care
 Situation is of increasing concern: size of the crisis is
overwhelming traditional systems of caring for children.
 Family social networks are overstressed, overburdened
and weakened as the number of AIDS orphans increase.
 Extended families, mainly grandparents care for 90 % of
all orphans.
 Majority of households live in poverty and are
progressively less able to adequately provide for the
children in their care.
 Burdens on the families are heavy and persist over a long
period of time .

13. Emerging Family Trends
 Grand families: Rising number of children raised by
grand parent headed households.
 Child headed households: rising number of children
raising younger siblings. Because the children are
financially desperate, they are more likely to be
exploited. They are vulnerable to sexual abuse, drug
trafficking, violence and child labor. These are
situations that often increase the chances of HIV
infection.

14. Child headed households
 Free Primary Education has increased access to basic
education.
 But schooling is often interrupted. Some children take
over responsibilities as care-givers and home-makers
for their terminally ill parents and siblings.
 When the parents die, the children take over the
responsibilities of taking care of younger siblings and
running the household. Many will find work so that they
can get something to eat and supplement the family
income. Consequently, they are under-educated,
overworked and financially insecure.
 Unfortunately, majority of the children who are forced to
drop out are girls.

15. Other effects on children
 Psychological: Experience trauma, depression, low
self-esteem, alienation, disturbed social behavior and
poor life skills while witnessing the sickness and
death of a parent.
 Emotional dependency and vulnerability. Seeking to
be cared for and accepted by others children are
more likely to seek comfort in risky behaviors which
pose greater risk of becoming HIV infected

16. Role of NGOs and FBOs
 Partner with the families to provide:
 Orphanage Care for a few hundreds of the children.
Provide a new home: food, shelter, clothing, medical
care, substitute parenting.
 Empower families to have adequate nutrition. Support
Feeding Programs for vulnerable children.
 Partner with health facilities to provide ARVs and other
essential medications for PLWHVA. Help families
subsidize the enormous financial burden.
 HIV/AIDS campaign and prevention education.
 Capacity building and community empowerment.

17. The Kenya Heritage Foundation
 KHF is a non-profit, 501(c) 3 community based organization with the
following goals:
 Empower families living in poverty and those affected by HIV/AIDS in
Kenya to become self sufficient through sustainable economic
development projects.
 Partner with local hospitals to provide ARVs and essential medicines
to people living with HIV/AIDS.
 Provide adequate nutrition to children affected by HIV/AIDS.
 Provide access to basic education for children affected by HIV/AIDS.

18. Our success stories…….
 In 2011: we adopted two families - one with a
grandmother raising 9 grand children. We
provided school supplies, uniforms, and financial
support to the children to remain in school,
purchased 5 sheep and chickens, and help start a
vegetable garden.
 In 2012: the community is coming together to help
the family plough their farm, grow corn, purchase
a cow and build them a bigger home.
 In 2012: we are targeting 20 families and 200
children.

19. Call to Action…..
 HIV does not discriminate, and neither should the
AIDS response. The disparities in access, coverage
and outcomes that exists across age, gender,
geographic areas, wealth and educational spectra
cannot be accepted as inevitable.
 Ordinary people can do extra ordinary things and
support families to make the world a better place for
our children.
 We call on every individual to use their abilities to do
their very best to help families affected by AIDS.

20. We can raise the bar even more……
 Provide economic support to poor families,
vulnerable women, children and adolescents.
Research has shown that health and wellness
indicators are increased in financially stable families.
 Increase access for families living on the margins of
society to health, education, and social welfare.
 For families with expextant and nursing mothers we
aim beyond the PMTCT to a HIV-free survival of
children.
 Identify HIV + newborns, infants and young people
without delay and provide rapid access to ART.

21. Finally…. We pray for the child
 An adaption Marion W. Edelman’s prayers for the child.
We pray for the child…..
 Who is growing up in an orphanage far away in Africa and those
with no one close to care for her.
 Who feels hunger pangs and is not sure of the next meal.
 Who will never go to school because she works hard as a house-
help, farm boy or sells sweets on the streets to put food on the
table for her siblings because she lost both parents to AIDS.
 Who will watch her strong parents’ health slowly waste away till
they die of AIDS.
 Who has not Sunday clothes or Christmas dress and lives in a
neighborhood, too dangerous to venture out, but has to do so.

22.  We pray for the children because we are their
advocates, teachers and hope for tomorrow.
 And beyond prayer we will do our best to turn this
transformative moment in the AIDS response into a
catalyst for greater equity and better outcomes- to
better the benefit of the millions of children, women
and families who still face, every day, the burden of
the epidemic.
 THANK YOU