AIDS Orphans in Africa: SOS Framework for Action

Here you can read in detail what our charity strategy is for our HIV/AIDS related work. We are continually updating and innovating our framework for action (see AIDS Africa best practice from a recent workshop) but this is the most recent formal document on how we approach the issue of HIV/AIDS in Africa.

The AIDS pandemic has a devastating effect on the lives of millions of children and young people. They are deprived of a safe childhood, of their adolescence, and of their future as they lose their parents, relatives, teachers, doctors and their own lives due to AIDS.

In 2007, 33 million people worldwide were estimated to be living with HIV. The impact of AIDS is most profoundly reflected in the lives of children, whose very survival and development are at stake. 2.1 million children below the age of 15 are estimated to be living with HIV globally. Currently, children under 15 account for one in six AIDS-related deaths worldwide and one in seven new HIV infections – most of them infected through mother-to-child transmission of the virus. Over 15 million children have lost one or both parents to AIDS. Most of the children orphaned by AIDS live in economically weak countries, the vast majority of them in Sub-Saharan Africa. As the infection spreads, the number of children who are living with HIV-infected parents or who have lost parents to AIDS is beginning to grow in other regions, including Asia, Latin America and the Caribbean, and Eastern Europe. By 2010, the number of children orphaned by AIDS is expected to exceed 25 million globally (UNAIDS/WHO, 2007; UNICEF, 2005).

HIV/AIDS has an impact on individual children, caregivers, households, communities and nations. Children living in communities affected by AIDS tend to experience a wide range of rights violations, including deprivation of parental care, love and guidance; stigmatisation and discrimination; lack of nutritious food and shelter; lack of access to adequate health care and treatment resulting in illness and death; deprivation of their inheritance rights; sexual and economic exploitation; and decisions which do not take children’s views and their best interests into account. Also, children, especially girls, are often forced to drop out of school to help care for ill parents or siblings and/or to earn an income to contribute to the diminished family livelihood – thus depriving them of an education.

SOS Children’s organisational HIV/AIDS policy recognises and builds on internal experiences in high-HIV-prevalence countries, mainly in Sub-Saharan Africa but also in some countries in Latin America, in working with our target group; and it will build on these experiences and knowledge for its work in other regions.

Our priorities

SOS Children, as the world's largest orphan charity, sets its priorities as follows.

There are six key priorities for our HIV/AIDS-related work, which are:

1. Awareness and prevention to be carried out through all SOS locations, including schools and training centres. By fighting the spread of HIV/AIDS, SOS Children strives to prevent children from losing their parents to AIDS in the first place. We advocate for de-stigmatisation and non-discrimination.

2. Voluntary counselling and testing (VCT) to be offered through our SOS medical and social centres. For those parents who are living with HIV/AIDS, VCT opens the possibility to early interventions that can prolong and improve the quality of their life.

3. Prevention of mother-to-child transmission of AIDS to be promoted by our medical and social centres, through medical treatment and/or advice on safe infant feeding practices. Through this, the number of children living with HIV/AIDS can be minimised.

4. Support for orphan households and households where children are living with terminally-ill parents. Families are supported to improve their ability to protect and care for their children. In this way, we enable orphans and vulnerable children to stay within a caring family environment and their community of origin.

5. Provision of anti-retroviral (ARV) treatment to parents who have children living with them. Where parents receive such medical treatment, they are likely to live longer and have a higher quality of life. This means that their children are also likely to have a better quality of life and to grow-up in a family without becoming an orphan.

6. Long-term family-based care is provided through our SOS children’s villages and other long-term family-based care programmes for those children who have already lost the care of their family and who require such long-term care.

Putting our priorities into action

1.Effective measures to prevent HIV infection among children, young people and care-givers are integral to all programmes implemented and supported by the organisation. The framework for this programme is as follows:

- Access to age-appropriate information and education on sexual and reproductive health, including HIV and AIDS, and youth-friendly services are ensured and their use encouraged.

- Life skills education is provided to help children and young people to adopt safe sexual behaviours and protect themselves from abuse and exploitation. This includes communication, negotiation, assertiveness and conflict-resolution skills.

- Acknowledging girls’ and women’s increased vulnerability to HIV infection because of physiological reasons as well as because of the particular social, economic and legal disadvantages they suffer, strong emphasis is placed on tailoring preventative measures specific to their needs.

- We promote the prevention of mother-to-child transmission through increased access to information, voluntary counselling-and-testing, safe maternal health services, access to antiretroviral therapy, and breastfeeding counselling, mainly through advocacy to improve government health services and, where feasible, through SOS medical and social centres.

- Where feasible, confidential voluntary counselling-and-testing services are provided in SOS children’s villages’ medical centres.

- We advocate that government authorities significantly scale up prevention efforts in the area of mother-to-child transmission, voluntary counselling-and-testing, youth-friendly sexual and reproductive health services, life skills and sexual education, and harm reduction, particularly for children and young people who are the most vulnerable to HIV infection.

2. All SOS programmes, from service delivery to advocacy, actively work towards reducing the stigma and discrimination which people face because of their HIV status.

SOS Children will make sure all efforts are made to protect children and care-givers infected with HIV and who participate in our programmes from stigma and discrimination by undertaking the following:

- Measures are taken to guarantee privacy and confidentiality concerning HIV status.

- SOS Children’s Villages avoids labelling individual children as ‘AIDS orphans’ and avoids the use of acronyms such as ‘OVC’, which stands for ‘Orphans and Vulnerable Children’, as these terms are eventually used at the community level, and this contributes to inappropriate categorisation and stigmatisation of children and their families.

- Testing for HIV is never used as a pre-condition for admission to SOS children’s villages and other programmes. The HIV status, if it is already known, is not a decisive admission criterion.

- To improve the public’s attitudes and behaviour towards people living with HIV, community-based awareness and education campaigns are organised in cooperation with local groups, such as youth clubs, women’s clubs, and schools.

3. Protection and support measures for children and families affected by AIDS are built into SOS programmes to reduce the burden on children’s lives and improve their chances of survival and development.

Within family strengthening programmes we put all our efforts into strengthening the immediate and extended family to prevent family breakdown and the separation of a child from his/her family. We do this by:

- Measures to protecting children affected by AIDS include, in particular, interventions to prolong HIV-positive care-givers’ lives and improve families’ living standards through economic, psychosocial, medical and legal support. Special attention is given to ensuring a continuum of care for children through succession planning, and to protecting children’s inheritance and property rights.

- Within children’s villages and family strengthening programmes, access to positive-living counselling and special nutritional and medical support is ensured for children and care-givers living with HIV. Programmes are designed particularly to address the obstacles that girls and women face in accessing care and treatment.

- Community members are encouraged to organise themselves into HIV/AIDS support groups and broader community-based child-care and child-protection committees. The organisation also supports the self-organisation of girls and boys.

- When families do not have the capacity to provide adequate care and protection for their children, alternative family-based care options are sought. Depending on the child’s best interests and locally available care structures, options may include support to foster-families and adoptive families or admission to an SOS children’s village.

- To ensure early access to care and treatment and for prevention, voluntary counselling-and-testing is encouraged for children and care-givers particularly in high-HIV-prevalence countries. Informed consent of children and/or care-givers privacy and confidentiality are preconditions. In SOS children’s villages, sharing information on a child’s HIV status is guided by the principle of best interests.

- The organisation guarantees specific training provisions for care-givers of children living with HIV in family-based alternative care, and family strengthening programmes. In high-prevalence countries AIDS-specific child-care skills and knowledge form part of the care-givers regular training curricular.

- The decision to provide antiretroviral therapy in SOS medical centres is based on needs and resources available as well as national legislation regulating access to antiretroviral therapy.

- Together with our partners, we advocate that state governments provide increased access to voluntary counselling-and-testing and the treatment of opportunistic infections, universal access to antiretroviral therapy, and access to basic health, education and social protection services.

4.The involvement of children and young people is key to the response to the epidemic. They are empowered to take a leading role as advocates and educators, and participate in developing, implementing and evaluating programmes that address them. Children’s views are heard and given due weight in all decisions that affect their lives.

Within our programmes, we provide a forum where children can speak openly about the impact of HIV and AIDS on their lives and the support they need to effectively protect them and cope with being infected or affected by HIV and AIDS. Children are consulted and directly involved in the design, implementation and evaluation of prevention and protection programmes in response to HIV and AIDS. We make sure:

- The participation of children as peer educators is actively promoted within all programmes.

- Children infected or affected by HIV and AIDS are heard in all decisions affecting their lives, including decisions about their care, treatment and protection. This is ensured particularly through the individual child development planning process in family-based care programmes as well as the family development planning process in family strengthening programmes.

- Children are empowered to participate in the decision-making process of alternative care options, account being taken of their age. They are provided with all the relevant information concerning the current situation and future options, and their opinion is sought, respected and carefully considered.

5.Partnerships with key stakeholders allow for strong and concerted responses to children’s and families’ needs as well as to strengthen the accountability of those whose responsibility it is to realise children’s rights.

We put all effort into building the capacity of community-based organisations and local governments to respond more adequately to the needs and rights of children and families affected by AIDS. We do this by:

- Supporting the development of cross-sectoral networks of governmental, non-governmental and community-based organisations.

- At local, national and international levels, the organisation serves on HIV/AIDS committees and working groups to advocate for and monitor the effective implementation of government policies and practices on prevention, treatment and care. The eradication of poverty and inequalities as the root causes of the pandemic are addressed.