OVC, HIV, Food Security and Nutrition

A look at where we stand

By Kara Greenblott & Kate Greenaway

For UNICEF and WFP

Situation of OVC &TargetingFindings

• Understand terminology• Accept global ambiguity

Orphanhood vs nutrition

Differences in orphanhood

Discrimination

Family capacity• Targeting

Costly, labour intensive & complex• Steps in targeting

© UNICEF/Andrew

Situation of OVC & TargetingRecommendations

• Focus on local situation• Understand situation and purpose in

defining terms• Expand growth monitoring and promotion

& nutritional rehab’ services• Seek out paediatric hospices/day care,

transition and foster care programmes• Enhance support to PMTCT and PMTCT+

Programming Findings

• Food/nutrition integral to comprehensive programme

• Higher malnutrition in HIV+ children• Forming/supporting viable partnerships• Reaching out-of-school youth• Dependency and sustainability• Keeping parents alive• Challenges of scaling up

Programming Recommendations

• Revitalise nutrition/nutrition education• Adapt growth monitoring and care

programmes• Improve access to “ready to use

therapeutic food” through local production • Focus on ECCD: for nutritional supplements,

de-worming, psycho-social support & treatment of HIV+ children

Monitoring & Evaluation Findings

• Emphasis on care and protection• Standardised food security indicators• Children’s views are important• Time and financial constraints

Monitoring and Evaluation Recommendations

• Develop holistic child vulnerability indices/scales

• Engage children in measuring vulnerability

• Develop qualitative approaches• Improve monitoring• Seek out opportunities for prolonged

follow-up

Overall Findings

• No documented successes: “a dearth of honest analysis & exposure of lessons learned”

• Lack of attention to nutritional issues• What’s available is contradictory: done to

attract media attention & donor funding• No evaluations of exit strategies/ graduation• Categories of interventions identified: further

investigation, scalability, replicability

Possible Models for scaling up/replication/promotion

• Livelihoods & skills training for out-of school youth• PMTCT+ programmes• Integrated growth monitoring, promotion and care

programming: adapted to low & high HIV prevalence• Comprehensive, community-led OVC care• Alternative primary education for out-of-school youth

Above all:• M&E important in all of the above• Focus on graduation and exit strategies

Issues for Consideration (1)

• More research on proposed models

• Need for different kinds of guidance materials

• Revitalise nutrition/nutrition education

• Measure nutritional status of HIV-positive infants and children

• Increase funds for targeting

Targeting in urban settings

Issues for Consideration (2)

• Ensure sustainability of OVC programming

• Experience to date with food to encourage guardianship

• Use of food to enhance enrolment and attendance in secondary schools

• Capitalize on the attention to food insecurity and poor nutrition in the global AIDS debate

Next Steps?

• Form an IATT sub-working group to follow-up on these issues and more

• Identify members, prepare Terms of Reference

• What else?