Early Childhood Development HIV/AIDS in

Malawi

Presented by Malawi Country Team Dar-es-Salaam, Tanzania 2004

Situation of Malawi: Social Indicators

Pop – 10,800,000 65% of population lives

below poverty level Total number of children

(0-18) 5,250,000 Ages 0-6 – 24.4%

(2,777,000) 49% of children stunted

Social Indicators cont. IMR – 104; MMR - 1,120; U5MR – 189

(main causes are malnutrition, anemia, pneumonia, diarrhea, malaria)

Urban – 25%; Rural 13% HIV+ 1.2% children (0-14 yrs) infected with

HIV (NAC 2003) 16-30% HIV prevalence in child bearing

women

Situation of Orphans in Malawi

17.5% (937,000) of all children are orphans

24% of Orphans are under 5

49.9% are orphaned due to HIV/AIDS.

Situation of ECD Services 26% coverage of access to

ECD services Approximately 3000

CBCC’s (400 supported by UNICEF)

Ages 0-5 attend CBCC’s 40% of children at CBCC’s

are Orphans On average 100 Children

registered at CBCC (1:50) Less then 50% of

caregivers are trained

Key Policies and Legal Framework Human Rights Provision Ch. 4 Sect. 23 Children and Young Persons Act Affiliation Act Maintenance of Married Women Act Wills and Inheritance Act ECD, OVC, HIV/AIDS, Gender, People

with Disabilities, Decentralization Policies PRSP National Health Plan: IMCI, PMTCT

Policies

Programmes Targeting ECD and HIV/AIDS Support to Orphans

and families affected by HIV/AIDS

Community Child Care

(using the IECD approach)

Stakeholders

Ministry of Health, Gender, Agriculture, Water, Education, Finance, Local Government

NGO’s, CBO’s, FBO’s UN Agencies Bilateral Donors Communities

Programme ObjectivesSupport for orphans and families affected by

HIV/AIDS To ensure that families and orphans affected by

HIV/AIDS are provided with appropriate care and support to facilitate healthy growth and development, education, protection, and participation

Strengthen the capacity of programme partners to collect and use information to monitor and evaluate programmes on early child care

Ensure that issues of orphans, ECD, and nutrition are well incorporated in relevant poverty reduction strategies

Programme ObjectivesCommunity Child Care

Provide family with skills to care for children including nutrition, health, and psychosocial support;

To ensure that acute malnutrition among under 5 children stays below 10%

Strengthen the capacity of implementing partners to collect and use information to monitor and evaluate programmes on early child care

To promote integrate childhood development during the 1st three years of life

To prevent death among children occurring in the homes

Programme Intervention Focus ECD/OVC

Advocacy on ECD/OVC Support the capacity for parents/caregivers to provide early

learning and stimulation, psychosocial development, and care for OVC

Establish CBCC’s and improve the quality of services to promote early learning and stimulation and the holistic development of children

Psychosocial support and counseling Community Mobilization/Empowerment (Community Dialogue) Support and training on IGA’s Partnership and networking

Best Practices Multi-Sectoral Approach Utilization of existing

structures and local resources

Reaching the most vulnerable

Capacity building of parents/caregivers for providing quality care

Community Child Care initiatives (EL&S, Extended family care, granny’s and widows club, single mothers club )

Best Practices Community engagement (community

dialogue) CBCC as entry point for other

development programmes Human Rights Based Approach To

Programming Inclusion of Psycho-social support in the

package of care Maternal health and nutrition Extended family care & Foster Care

Challenges Political Commitment not backed by

adequate resources High Level of Poverty; low literacy level Increasing # of children affected by HIV/AIDS Provision of Quality services Capacity of service providers to provide

integrated services Service provider turnover rate Inadequate human resources Reaching children 0-8 (particularly 0-3)

Challenges Coordination/Convergence of Services Appropriate infrastructures (physical) Traditional Beliefs/Practices Provision of EHP Sector Wide Approach Number of VCT’s within the communities Child Participation Advocacy to link knowledge/skills/practice Communication strategies at community level

Gaps Reliable data on the magnitude of the

problem of children affected by HIV/AIDS, and Psycho-social development

Provision of quality integrated services with focus on ECD and HIV/AIDS

Implementation of operational guidelines for ECD

Resources (funding, materials, human) Untrained Caregivers

GapsService Delivery for Children: Food and nutrition Health (growth monitoring, referral) Management of common complications

associated with HIV/AIDS infected children

Parental Education and Support: Parenting skills and knowledge Counseling skills

GapsCare Provider Training and Support Standardized training and materials Capacity of caregivers and trainers Comprehensive care to care providers

Sensitization of the public on ECD Inadequate advocacy on ECD and

HIV/AIDS Communication strategy not appropriate

for behavioural change

GapsCommunity Mobilization Follow up and sustainability Community monitoring

Opportunities Availability of strong NGO’s, FBO’s, CBO’s Availability of policies (e.g. ECD, OVC, PRSP) Increase of father participation (trend

improvement 2000-2003) Emerging programmes (e.g. ARV therapy for

infected children, ICHBC) Increased demand from communities for ECD

services Community Monitoring tool for OVC Ratification of CRC & CEDAW

Results/Evaluations Identified trends in increase in child

rearing practices Follow up to baseline study underway Review and development of ECD

materials (syllabus, training manuals) underway

Rapid appraisal for OVC ECD Mid Term Review Launch of ECD & OVC Policy

Thank YouFrom the Warm Heart of Africa