Executive Summary
This report is a synopsis of the proceedings of the workshop and a record of the deliberations on the development of guidelines in specific program areas pertaining to orphans and other children made vulnerable by HIV/AIDS.
The Orphans and Other Children Made Vulnerable by HIV/AIDS Workshop was held between 16-19 December 2001 at the Ndallas Hotel in Matuu, Machakos, Kenya. The workshop was organized the National AIDS Control Council Taskforce on Orphans and other Children made vulnerable by HIV and AIDS.
The goal of the guidelines is to assist stakeholders in developing and implementing effective and sustainable programme responses to address the needs and rights of orphans and other children made vulnerable by HIV/AIDS, in Kenya. The specific purpose of the workshop was to "advance the development of national program guidelines on the care and support of orphans and other children made vulnerable by HIV/AIDS in Kenya."
The workshop objectives were to:
- Initiate the development of documented guidelines.
- Clarify operational definitions of key concepts: guidelines, child, orphan, and vulnerable child.
- Clarify the role of the Government of Kenya, civil society & religious organizations, donors and UN organizations with respect to the implementation of the guidelines.
- Clarify the format of the guidelines.
- Prioritize areas for additional research.
The first part of the workshop was devoted to clarifying key definitions as well as expectations for the content and format of the guidelines document. Workshop participants discussed and came to a consensus on the following definitions:
- A child is as a person under the age of 18.
- An orphan is a child who has lost one or both parents, or guardians to HIV/AIDS before reaching the age of 18 and who is dependent.
- A vulnerable child is a child in a household with a chronically ill parent/caregiver or a child living in a high-risk setting.
- A guideline is a statement or outline of a program issue and procedures to address the issue.
In the second part of the workshop, participants agreed that the following major program issues needed to be included in the guidelines.
- Care: Family & Community Responses
- Education
- Child Protection
- Stigmatization
- Psychosocial Support
- Health Care
- Food Security & Nutrition
- Promoting Children's Participation
- Community Mobilization
- Mainstreaming Gender
In the third part of the workshop, participants divided themselves into different thematic topics as outlined above and came up with key issues and thematic guideline recommendations.
Finally, participants agreed that the following sections were to be included in the guidelines document.
- Background (statement of need)
- Goal of the OVC Guidelines
- Programming Principles
- Program Guidelines
- Role of Stakeholders
The workshop concluded with participants making several recommendations for additional sections including one that presents the Government of Kenya's formal obligations and commitments to orphans and vulnerable children. This includes commitments in statutory law (i.e., the proposed Children's Act) and commitments and obligations derived as a result of being signatories to international conventions and treaties (i.e. Convention on the Rights of the Child).
Acknowledgement
The Task force on Orphans and Vulnerable Children wishes to acknowledge with great appreciation the tremendous contributions of the following institutions in the planning and facilitation of the workshop for the development of Guidelines on the care and support of Orphans and other children made vulnerable by HIV/AIDS (OVC).
Special thanks go to the core committee members of the taskforce who worked tirelessly to make the workshop a success. They include Dr. Patrick Orege, Micah Kisoo and James Njuguna (NACC), Dr. Jane Muita (UNICEF), Julie Odhiambo (POLICY), Simon Ochieng (FHI), Pauline Mwololo NASCOP) and Noah Sanganyi (Children's Dept.).
We appreciate the facilitation by Bruce Warren and in a special way thank Eileen Mokaya who prepared the Workshop report.
Great appreciation goes to UNICEF and USAID for financing the workshop through Family Health International (FHI) and the POLICY Project.
We appreciate the inputs of all stakeholders who made valuable contributions during the workshop.
NACC Taskforce on Orphans Vulnerable Children Nairobi, February 2002.
1.0 Introduction
HIV/AIDS is the most serious of Africa's many public health problems, as it differs from other traditional public health challenges. The epidemic continues to expand affecting both adults and children, resulting in unique social and economic consequences. World wide, it is estimated that about 22 million people have died of AIDS; 36 million are currently infected with HIV and out of these, approximately 70% live in sub-Saharan Africa.
As the HIV epidemic continues to ravage sub-Saharan Africa, more challenges start emerging, which have significant effects on child survival growth and development. The number of orphans and children infected with HIV increases as a parallel epidemic to that of HIV infection on the adult population.
Kenya is one of the African countries with the highest prevalence of AIDS and incidence of HIV infection. According to the National AIDS Control Council and the Ministry of Health (AIDS in Kenya, 2001) there are about 2.2 million Kenyans living with HIV infection. To date the estimated number of those who have died of AIDS is over 1.5 million. An estimated 180,000 died in the year 2000 and another 300,000 became infected with HIV in the year 2000.
One of the worst consequences of AIDS deaths is an increase in the number of orphans. An orphan, as defined by UNICEF and UNAIDS, is a child under the age of 15 years who has lost the mother due to AIDS. With this definition, the number of AIDS orphans has probably reached over 900,000 today and will increase to 1.5 million by 2005 in Kenya.
HIV/AIDS has had a profound impact on Kenya and other African countries. The African extended family system that could have absorbed children orphaned by AIDS is unable to do so due to the rising levels of poverty. Poverty has eroded the capacity of Kenyan families to take up additional children and responsibilities. Prior to the AIDS epidemic, approximately 6% of the children under the age of 15 years in East Africa were orphans. These orphans were cared for by the extended family members, and when the need arose, community members came together to assist. However, the explosive spread of AIDS over the past 2 decades has contributed to a doubling in number of orphans.
The following are just a few of the problems children affected by AIDS and their families may experience:
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Psychological distress: The stress of losing a parent, and sometimes being separated from brothers and sister can reduce the ability to cope. The orphaned child may lose hope in his/her future.
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Anxiety about safety: Children living in families affected by HIV/AIDS worry about the future. This elevated degree of anxiety may trigger behaviour problems such as aggression or emotional withdrawal.
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Lack of parental nurturing: Denial, fear and stigma compound the stress within families dealing with AIDS. Parents may not be able to deal with their children's physical and emotional needs. Children may be unable to express their mixed feelings of grief, anger and fear.
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Problems with basic needs: Children affected by HIV/AIDS may experience food insecurity, shortage of clothing and inability to pay for medical care. Their caregivers will need additional income.
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Problems with inheritance: Orphans may lose their parent's property to "grabbing" by extended relatives or other people.
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Problems with safety and children protection: Households affected by HIV/AIDS are depleted of economic resources, and the child may need to generate cash. Working for a wage exposes a child to economic and sexual risks. Girls orphaned by AIDS may be married at an early age to relieve their families of financial burden.
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Less education: The chance of children affected by HIV/AIDS going to school is reduced, and those who go spend less time in school. This is attributed to the lack of money to pay school fees, and time spent taking care and sick parents and younger sibling.
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Stigma and Discrimination: Fear of people living with HIV and AIDS is widespread, and communities react by isolating and discriminating against PWAs and their children. Fear of belief known to be having HIV and AIDS, is a powerful deterrent to people seeking voluntary testing and counseling, disclosing HIV+ status to family members/friends and AIDS. Parents often fear informing their children of being HIV+, which tends to increase children's anxiety and fear of not knowing what is happening to their parents and how to prepare.
1.2 Background Information on the Workshop
The technical Working Group of the National AIDS Control Council (NACC) set up a task force, to address issues of orphans and other children made vulnerable by the HIV/AIDS (OVC) epidemic in Kenya. Members of the task force were drawn from GOK Ministries, NGOs, CBOs, donor agencies and members of the National HIV/AIDS Technical Working Group. The main assignment for this task force was to develop appropriate guidelines on the care and support of OVCs.
The task force held several meetings in which members were sensitized on the need to develop National Guidelines for Care and Support of OVCs. The Task Force, therefore coordinated by NACC identified the need to establish clear program and service guidelines for OVC projects "that will ensure project quality control and maximum impact in Kenya." To advance the development of the program guidelines the OVC Task Force planned and coordinated a three-day workshop that was held in Matuu in Machakos district, from December 16-19, 2001. The workshop agenda is presented as Appendix 1.
Over 25 individuals representing the Government of Kenya, civil society, community-based organizations, donors and interested stakeholders attended the workshop.
This report, therefore, is a synopsis of the proceedings of the workshop and a record of the deliberations on the development of guidelines in specific program areas pertaining to orphans and other children made vulnerable by HIV/AIDS.
1.3 Purpose of the Workshop
Advance the development of national program guidelines on the care and support of orphans and other children made vulnerable by HIV/AIDS in Kenya.
1.4 Workshop Objectives
- Initiate the development of written guidelines.
- Clarify operational definitions of key concepts: guidelines, child, orphan, and vulnerable child.
- Clarify the role of the Government of Kenya, civil society & religious organizations, donors and UN organizations with respect to the implementation of the guidelines.
- Clarify the format of the guidelines.
- Prioritize areas for additional research.
1.5 Workshop Methodology
During the workshop, a variety of methods were used to facilitate the effective involvement and participation of participants in achieving the objectives of the workshop. The following approaches were employed.
(i) Group Work and Group Discussions
At various periods of the workshop, participants worked in groups to discuss possible guidelines for the care and support of OVCs. Participants worked on various assignments and prepared presentations for the plenary discussion. This exercise helped the participants to pool together and utilize the best or promising practices in the development of guidelines.
(ii) Plenary Sessions
Plenary sessions led by a facilitator, provided content on specific issues. The plenary session began with a presentation and concluded with questions and further discussion.
(iii) Presentations
Participants were given the opportunity to present what their organizations were doing to address the issues and challenges facing orphans and vulnerable children. During these presentations participants were able to draw out best practices that would guide the development of the guidelines to care for and support orphans and other children made vulnerable by HIV/AIDS
(iv) Review of Relevant Literature
Participants were provided with a variety of selected documents that were intended to serve as reference materials to help in the development of the OVC guidelines.
2.0 Workshop Proceedings
2.1 Opening Remarks
The workshop was officially opened by Dr. Orege, Deputy Director, National AIDS Control Council (NACC). Dr. Orege read the speech on behalf of Dr.Margaret Gachara, Director, NACC. In her speech, she thanked the task force members for the groundwork, which had culminated in this workshop. She also thanked the development partners such as FHI, UNICEF and POLICY Project in making this process a success. She further noted that HIV/AIDS is one of the major diseases that Kenya is facing in the post independence history, claiming about 700 lives daily and leaving many children helpless and without basic needs. Dr.Gachara's speech also noted that the socio-economic and cultural problems faced by OVCs in Kenya cannot be described by statistics or words and that the greatest challenge in programming for orphans and children made vulnerable by HIV/AIDS is the stigma associated with the scourge. In conclusion, the NACC stressed the importance of developing effective program guidelines for orphans and other children made vulnerable by HIV/AIDS.
Other speakers included Ms.Julie Odhiambo who gave some remarks on behalf of the Policy Project Director Angeline Siparo. In her speech she conveyed the director's greetings to all the participants and acknowledged the efforts made by the workshop organizers and members of the OVC task force. In her remarks she also reaffirmed POLICY Project's commitment to working with all the stakeholders in OVC programs. Dr Jane Muita (UNICEF) and Mr. Victor Masibayi (USAID) also welcomed participants and made presentation outlining their respective organization's work in the area of children and families affected by HIV/AIDS.
Mr. Noah Sanganyi gave a presentation on behalf of Mr. Sammy Ole Kwallah, Director, Children's Department, Ministry of Home Affairs. In his presentation he noted that half of the population of Kenya was comprised of children and young people. He also took cognizance of the fact that 80% of all orphans in Kenya are as result of HIV/AIDS. In his remarks he also stated that the main objective of the Children's Department on HIV/AIDS based on its Vision and Mission is to reduce the negative effect of HIV/AIDS pandemic on children in need of special protection (CNSP), especially, HIV/AIDS infected and affected children.
Mr. James Njuguna of NACC welcomed participants to the OVC meeting on behalf of NACC, FHI, Policy Project, Children's department (Ministry of Home affairs), UNICEF, members of the OVC task force and other stakeholders. He also introduced the workshop facilitators: Mr. Bruce Waring and Ms. Eileen Kwamboka. In his remarks he also highlighted the following:
- Process and purpose of the workshop
- Workshop objectives
- Proposed meeting agenda
2.2 Summaries of Presentations
2.2.1 Overview of the Orphan Situation in Kenya
Presentation by Dr.Jane Muita, UNICEF Kenya Country Office
Dr Jane Muita, UNICEF-Kenya, delivered an overview of the situation with respect to orphans and other children made vulnerable by HIV/AIDS in Kenya. Highlights of Dr.Muita's presentation appear below:
- 18.8 million people around the world have already died of AIDS, 3.8 million of them children.
- 34.3 million are currently HIV infected.
- UNAIDS/WHO estimates show that in 1999 alone, 5.3 million were newly infected with HIV.
- Estimates project that the number of children under the age of 15 who will have lost one or both parents from all causes, including AIDS, in a sample of 34 severely affected countries, will be 40.3 million by the year 2005 and 44.2 million by 2010.
- The number of children orphaned by AIDS in Kenya is currently estimated at 1.1 million and is expected to increase to 1.5 million by 2005 and to 1.9 million by 2010.
- It estimated that by 2010, 2.3-2.9 million children would have been orphaned by AIDS about 20-24% of al children.
- Children orphaned by AIDS are stigmatized, lack care and guidance, are neglected and discriminated upon.
- Psychological impact of HIV/AIDS on children is not well understood or programmed for.
- The extended family plays the most important role in the care of OVC but lacks capacity to provide quality care.
Dr.Muita outlined some of the Impact felt as a result of HIV/AIDS as follows:
- HIV and AIDS affects young people and 50% become infected just before they turn 25 and die before 35.
- Children left behind become a generation of marginalized people (CNSP) forced to care for sick adults, siblings and solicit income for families.
- Loss of adults impacts on the economy -loss of labor, expertise, and increased health costs, reversal of decades of investments in health, education and human development.
- Human rights based approaches are essential for success of prevention and care programmes.
- In ratifying the CRC government committed themselves to protect, respect and fulfill children's rights.
- Human rights programming is doing things the right way not just getting the right outcomes. It also has concern for process, participating, ownership and sustainability.
Dr. Muita further outlined some of the lessons learnt and what needs to be done. Some of the lessons learnt include:
- Extended families have been on the frontline.
- Other responses are small scale and fragmented.
- Lack of guiding principles.
- HIV/AIDS still a highly stigmatized illness.
- High level of psychosocial stress associated with the epidemic and its impact.
Below are some of the recommendations made in her presentation on what needs to be done.
- Break down wall of silence, denial and inaction.
- Strengthen legal and policy protection for affected families.
- Strengthen capacities of vulnerable children and families.
- Build capacity of government and communities.
- Establish social alliances to slow spread and provide care and protection.
2.2.2 Orphans and Other Children made Vulnerable by HIV/AIDS:
Presentation by Simon Ochieng – Family Health International (FHI)
Simon Ochieng provided the participants with vital statistics on the HIV/AIDS situation in Kenya. In his presentation he noted that:
- The current Kenyan Population size to be over 28 million people
- That the children's population is about 44% of the entire population
- Over 50% of the population is less than 16 years old
- Number of 15-49 years that are HIV positive is about 2.2
- 1.5m people have died to date
- 150,000 children between 0-14 years are HIV positive
- There are about 900,000 orphans in the country
In his presentation he also defined who an orphan and vulnerable child is. An orphan is a child (i.e. an individual below the age of 18 or 15?) who has lost at least one parent. He further pointed out that "HIV and AIDS May be a National disaster but the OVC crisis would be a time bomb however both are symptoms of a real problem that seem not to be addressed - sour relationships" He also noted that a vulnerable child is one whose circumstances put him/her at the risk of being infected with HIV and AIDS.
Mr.Ochieng also itemized the commonly given needs of children and their silent needs. Common needs include: food, Clothing, Shelter, education and health. Whereas the silent needs included psychosocial support, emotional support, security, comfort and parental love. His presentation also highlighted what the plight of OVC was; which included, poor nutrition, school drop out, being household heads, poor health, early marriage, destitution, ignorance, stigma, insecure, abuse, exploitation and psychological trauma.
FHI's activities in the area of HIV/AIDS were also pointed out as indicated below.
- FHI/IMPACT Project is in :
Coast (Malindi, Kilifi, and Mombasa)
Rift Valley ( Nakuru and Salgaa)
Western ( Busia, Nzoia, Bungoma Burete /Mumias, Webuye, Kakamega
- FHI/IMPACT with over 20 implementing partners implements:
Behavior Change Communication
Voluntary Counseling and Testing
Care and support (PMTCT, TB, STI, HBC, OVC, IGA)
In his presentation, he made recommendation for intervention at different levels and also pointed out opportunities for intervention.
Recommendations for National Level interventions
- Support the government to put in place and enforce comprehensive policies to address unemployment, housing, migration, education, health, poverty and corruption.
- De-registration of unscrupulous NGO/CBOs
Community Level Recommendations
- Intensify prevention efforts
- Use children as the backbone of HIV Prevention efforts e.g. in messages
- Make VCT services available and accessible
- Improve access to Dual protection especially to both the adolescents and HIV positive people
- Improve access to antiretroviral drugs
- Empower the communities to deal with the problem through:
- Training Community Health Workers to be able to deal with emotional and psychological problems of OVC
- Sensitizing local leaders/PTAs on the plight of OVC and the need of children in general
- Intensify community sensitization efforts on the plight of OVC
- Intensify Home Based Care activities
Opportunities for Intervening
- Constituency AIDS Control Committees
- Adult education sessions
- Village Faith based groups
- Women groups
- Local Community Based Organizations
2.2.3 Response to the Needs of Orphans, Achievements, Constraints and Programming: Presentation by Catherine Kiara: Policy Project
Catherine Kiara, in her presentation outlined the following:
- Needs of orphans and other children made vulnerable by HIV/AIDS
- Definitions of orphans and the different categories of orphans
- Constraints faced in the care and support of OVCs
- Some of the achievements made so far in the care and support of orphans and vulnerable children.
Her presentation highlighted the following working definitions:
Orphans: Children under the age of 18 years who have lost both parents
AIDS orphans: A child under the age of 18 who has lost the mother to AIDS
Single orphan: Lost one parent
Double orphan: Lost both parents
Vulnerable Children: Children in need of special care and support e.g. street children, disabled, refugees and other abandoned children.
Ms. Kiara noted that the country had made achievements in terms of laws and legislations for orphans and vulnerable children. Some of these include:
- The adoption of the convention on the rights of the child (CRC) by the general Assembly of the UN on November 1989.
- Kenya's ratification on the CRC in 1990 bound it to uphold the rights laid out in the CRC and signaled a change in its approach to improve the well being of children.
CRC represents a significant departure from the traditional welfare –based approach to children's development.
- Children's bill passed by parliament in 2001, however awaiting presidential assent.
- Ratification of the convention on the Elimination of all forms of discrimination against women (CEDAW) was adopted by the General Assembly of UN in 1979 and ratified in Kenya in 1984.
- A National Programme of Action for children (NPA) was established in 1992 to implement the world declaration and plan of action for survival, protection and development of children. The NPA identifies problems, unmet needs and knowledge gaps, proposes strategies and a time frame for achieving those goals and the indicators to be used in the monitoring process.
Ms.Kiara also noted that Kenya is endowed with a variety of NGOs, CBOs, ROs, private sector and civil society that are keen on supporting children's activities. These organizations and institutions can be involved in: Capacity building and provision of complementary financial, technical and human resources.
Her presentation also highlighted some of the constraints faced in the care and support of OVCs, which include:
- Human and other resources in addressing OVCs issues
- No standard definition for OVCs
- Lack of children's participation in the formulation and implementation of their own programmes
- No policy in place to regulate proper care or guidelines on orphans.
- No coordination in the care and support of OVCs.
- No capacity building for care givers
- Minimal government support to orphans
The above presentations provided participants with more background information that would facilitate the development of the draft OVC guidelines. The section below highlights on some of the key concepts taken into account.
2.2.4 Response to Needs of Orphans, programming, Achievements and Constraints: Presentation By Dr.P.A.Orege, NACC
Dr.Orege noted that the situation of orphans places heavy burden on the care providers and increases vulnerability of orphaned children, threatening their very survival. He further noted that studies have shown that apart from needs that other children have including food, shelter, clothing, early stimulation and education, orphans require psychosocial support in many cases.
Dr.Orege highlighted that orphan hood can lead children into undesirable situations and circumstances that can promise their growth and development. He indicated the risk of being rejected by relatives for various reasons including the economic ones. Even if accepted, there is still the risk of abuse, neglect and exploitation. Dr.Orege noted that the worst cases can lead into homelessness, child labour, delinquency, street life and prostitution among other problems.
His presentation also indicated that HIV/AIDS in the middle of poverty placed heavy burden on already poor people by draining away valuable household and extended family resources through the prolonged period of adult morbidity. Many of these children are then left in the care of distant relatives, elderly grandparents or worse, care for themselves.
Dr.Orege noted that given the given the large and growing number of orphaned children and poverty in the country, it is necessary to devise an appropriate strategy that maxims benefits while minimizing costs. He pointed out that the strategy should be development oriented aiming at building capacity of communities to provide for their orphaned children and that the strategy entails mainstreaming orphan care activities on on-going development activities.
He noted that the following elements should be included in the National Orphans Policy:
- Community based approaches to orphan care are primary. The government to coordinate service providers to support and enable communities.
- Formal Foster care to be expanded as the second source of care
- Institutional care is the last resort, although temporary care may be needed for children awaiting placement
- Hospitals should record next of kin so relatives can be traced if children are abandoned
- Birth and death registration should be revitalized to monitor orphans
- Government should protect the property rights of orphans and these should be widely publicized.
- Self help groups should be developed to assist families with counseling and other needs
- NGOs should be encouraged to set up systems of community-based care in consultation with the government.
- The needs of all orphans should be included regardless of cause, death, religion or gender.
- A National task force should continuously plan, monitor and revise programmes and policies.
2.3 OVC Guidelines: Clarifying Definitions, Scope and Content
The purpose of this session was for the participants to discuss and agree on the following:
- An operational definition of a child.
- An operational definition of an orphan.
- An operational definition of a vulnerable child.
- An operational definition of a "guideline."
- The goal of the guidelines.
- The major program issues to be addressed by the guidelines.
- The format of the guidelines: main sections.
2.3.1 Operational Definition of Child
Participants reviewed and discussed a proposed operational definition of a child for the guidelines. It was agreed that a child would be defined as:
"A person under the age of 18."
2.3.2 Operational Definition of Orphan
Participants reviewed and discussed a proposed operational definition of "orphan" for the guidelines. It was agreed that an orphan would be defined as:
"A child who has lost one or both parents, or guardians to HIV/AIDS before reaching the age of 18 and who is dependent."
Participants also agreed that the guidelines include a statement on the definition of an orphan, which recognizes that:
- There is no standard definition of orphan.
- The proposed definition is widely used throughout sub-Saharan Africa and it is more inclusive than the definition of orphan used by UNICEF, UNAIDS, and WHO.
- Stakeholders have the right to use the definition of orphan that meet their policy and programming needs.
- Stakeholders involved in the implementation of the OVC guidelines are encouraged to adopt a definition of orphan that is as inclusive as their policy and programme frameworks will allow.
2.3.3 Operational Definition of a "Vulnerable Child"
Participants reviewed and discussed a proposed operational definition of "vulnerable child" for the guidelines. It was agreed that a "vulnerable child" would be defined as:
"A child in a household with a chronically ill parent/caregiver or a child living in a high-risk setting."
It was also agreed that the guidelines should include a statement to the effect that in the context of HIV/AIDS children are vulnerable when they:
- Have parents or caregivers who are ill or dying.
- Do not have parents.
- Do not have family.
- Do not have a home.
- Live in an area with high HIV prevalence or proximity to high-risk behaviors.
- Live on the street.
- Are girls.
- Are in jail or prison.
- Are exploited.
- Are discriminated against
- Are isolated.
- Live in an unsupportive or unhealthy environment.
- Have inadequate medical care.
2.3.4 Operational Definition of a Guideline
The participants reviewed a proposed operational definition of a guideline prepared by the facilitators and tentatively agreed upon the following definition.
"A guidelines is a statement or outline of a program issue and procedures to address the issue."
It was agreed further that the above definition needs to be refined further.
Workshop participants also agreed that a guideline should:
- State clearly and succinctly the issue or need to be addressed.
- Include a statement of the recommended action (policy or procedure) to address the issue/need.
- Recommend action that is based on current, documented, and widely recognized best practice(s).
- Include enough detail to provide guidance but should not be overly directive.
- Ideally be one paragraph in length and no more than 4 to 5 sentences.
2.3.5 Goal of the Guidelines
Participants reviewed a proposed statement on the goal of the guidelines and agreed on the following statement.
"The goal of the guidelines is to assist stakeholders in developing and implementing effective and sustainable programme responses to address the needs and rights of orphans and other children made vulnerable by HIV/AIDS in Kenya."
2.3.6 Major Program Issues to be addressed by the Guidelines
The participants reviewed a proposed statement of the major issues that should be addressed by the OVC guidelines. It was agreed that the following issues needed to be addressed:
- Care: Family & Community Responses
- Education
- Child Protection
- Stigmatization
- Psychosocial Support
- Health Care
- Food Security & Nutrition
- Promoting Children's Participation
- Community Mobilization
- Mainstreaming Gender
In addition to the above participants also suggested that "shelter" and "legal rights" issues should be included in "Child Protection".
2.3.7 Format of the Guidelines Document: Main Sections
The participants reviewed a proposed outline of the main sections for the format of the OVC guidelines document. It was agreed that the following sections were to be included in the document.
- Background (statement of need)
- Goal of the OVC Guidelines
- Programming Principles
- Program Guidelines
- Role of Stakeholders
In addition the participants suggested that the guidelines have a "stand alone" section outlining the Government of Kenya's formal obligations and commitments to orphans and vulnerable children. This includes commitments in statutory law (i.e., the proposed Children's Act) and commitments and obligations derived as a result of being signatories to international conventions and treaties (i.e. Convention on the Rights of the Child). Whenever possible the Government department(s) or bodies responsible for ensuring that each identified commitment is fulfilled should be identified.
In the section on "Stakeholders" it was also recommended that children be clearly identified as stakeholders and that the obligation and role of all stakeholders in the implementation of the guidelines be "clearly spelt out."
It was suggested that the section on "Programming Principles" could be adapted from the work of John Williamson and Susan Hunter, who have researched and written extensively in the area of policy and program responses to orphans and children made vulnerable by HIV/AIDS.
It was also recommended that the guidelines should:
- Include a statement on how the implementation of the guidelines will be monitored and evaluated;
- Include a section or statement on "management and coordination of the guidelines";
- Include a section or statement on "advocacy and partnership issues"; and
- Give direction on prevention issues for all children, including those who are not necessarily infected or affected by HIV/AIDS.
Emerging Issues
- Where does monitoring and Evaluation fit in the OVC guidelines?
- There is need to have a section on management and coordination of the guidelines
- There should be clear definitions on all the terms used in the guideline document
- Need to include Advocacy and partnerships issues in the guidelines
- There is need to domesticate and make the guidelines operational
- It was also suggested and resolved that shelter and legal rights be discussed under the protection section.
- If children are part of the stakeholders what is their role?
- Government obligation and the role of other stakeholders be clearly spelt out.
- The guideline document should also give direction on prevention on the children who are not affected.
- Suggested that prevention can be part of care of support
- Different types of care to be mentioned and suggestions made on conditions that determine the type of care recommended
- That the guidelines be classified under the framework of the convention of children's rights.
- Task force requested to look at some of the issues mentioned above and give guidance
- In the operational definition of a guideline it was suggested that the term policy be omitted
- It was recommended that the task force also review other existing guidelines from other countries like Malawi on the care and support of orphans.
- It was agreed by the participants that the guidelines be more programmatic rather than policy.
