Early childhood development and HIV/AIDS

Young children living in HIV and AIDS affected communities are often ignored in development and HIV and AIDS policy and programming responses. Children aged 0-8 are at a critical stage of their development and need to receive adequate nutrition, healthcare, educational and psychosocial support. Families and communities under pressure to cope with the impact of the pandemic find it difficult to meet all of their developmental needs. This list of resources includes evidence of the need to address the needs of very young children living with and affected by HIV and AIDS in development interventions and strategies at community, national and international levels. There are suggestions on how this could be achieved including key tools, manuals and case studies of current work.

We welcome your feedback: please send comments or suggested additions to sourceassistant@hi-uk.org.

Selected resources

Books, reports, etc

Assessing the costs of a rural PMTCT pilot site in the Eastern Cape

DESMOND, Chris
BOYCE, Gerard
Eds
2004

Expand view

Mother to child transmission is by far the largest source of HIV infection in children below the age of 15. Prevention of mother to child transmission (PMTCT) programmes have been implemented nationally in South Africa since 2000. This report presents the results of research conducted at a pilot site in the Eastern Cape into the use of resources associated with the implementation of a PMTCT programme. It is part of a larger research project that seeks to examine and compare the costs of providing nevirapine and AZT in both urban and rural contexts. It is hoped that this study will contribute to the national programme of monitoring and evaluating the costs and effectiveness of PMTCT interventions in South Africa

Assessment and improvement of care for AIDS-affected children under age 5

LUSK, Diane
HUFFMAN, Sandra L
O'GARA, Chloe
June 2000

Expand view

Firstly statistical information about children under five affected by HIV/AIDS is documented along with the consequences of inadequate care for under five year olds. The special problems facing vulnerable children are addressed using age specific categories, including health and psychosocial concerns. Also examined are some cultural beliefs and traditions that impact upon children under five living in AIDS affected communities, including how orphans are perceived and treated. Who cares for under fives is also addressed, along with a critique of orphanages and alternative programmatic suggestions. The authors also review some assessment tools for the care of vulnerable children for feeding, health care and childrearing practices, and the time restraints of caregivers. There are some useful practical questions that can be put to communities and households in AIDS affected areas to assess the impact upon young children. Recommendations are then made as to appropriate strategies

Bernard Van Leer Foundation annual report 2002 : young children and HIV/AIDS

BERNARD VAN LEER FOUNDATION
2002

Expand view

This report briefly reviews the Foundation's operational year and then goes on to discuss whether, in the wake of the United Nations Special Session on Children in May 2002, young children really are on the international agenda. 2002 was a change for the Foundation, whose new strategic plan concentrated on the Foundation as a learning organisation, building and sharing knowledge in key areas of childhood development. Both the programmatic departments of Development and Management, which works with partners to operationalise projects, and Documentation and Communication, which gathers experience and information to analyse and learn, take part in this approach

Bernard Van Leer Foundation annual report 2003: young children and HIV/AIDS

BERNARD VAN LEER FOUNDATION
2003

Expand view

The Bernard Van Leer Foundation is committed to actively engaging with and supporting early childhood development activities in over 40 developing and industrialised countries. The Foundation's 2003 annual report gives a succinct overview of activities, clearly communicating around their mission and work and engaging with the current debate around the accountability of not for profit organisations. The report notes how the Foundation is working towards achieving various goals including working with a clear learning agenda, increasing synergies between the work of partners, their own work and the efforts of the broader ECD community and enhancing their communications functions and strengthening its advocacy role. The report contains an overview of the Foundations' grant-making activities and of the financial aspects of grant-making. A section on the work of the Foundation includes two major initiatives on 'Young Children and HIV/AIDS' and 'Respect for Diversity' which were launched in 2003 and a third 'Growing up in Indigenous Socities' which began in 2002

Child needs assessment tool kit : a tool kit for collecting information your organization needs for designing programs to help young children in areas heavily impacted by the HIV/AIDS epidemic

TASK FORCE FOR CHILD SURVIVAL AND DEVELOPMENT
December 2001

Expand view

The Task Force for Child Survival and Development was commissioned by the Early Child Development Team of the World Bank to develop an assessment tool to help programmes address issues and needs of young families and their children. The tool kit was designed to access the needs of young children (under 8 years old) in communities heavily affected by the HIV/AIDS pandemic. The assessment provides information about the household, family, the main caregiver of young children, each child under 8 years of age, their basic needs (housing, food, clothing, bedding, daily activities, health, education and childcare), and unmet needs. The information from the assessment is intended to be used to design service programmes targeted to the needs of young children and their families
The needs assessment is carried out through the use of a survey of households in the area serviced by the organisation. If a survey of all households is not possible, simple random sampling or cluster survey methodology is used

HIV and infant feeding : a compilation of programmatic evidence

KONIZ-BOOHER, Peggy
et al
July 2004

Expand view

This paper tries to deepen understandings of the biological and programmatic implications of the transmission of HIV through breastfeeding which have previously been hampered by insufficient study and difficulties of interpretation. It is a careful look at the findings of programmatic approaches. The project attempted to find, summarise and analyse reports on a wide variety of relevant programmes conducted since 1998 UNICEF guidelines were issued. The programmes range from small community research projects to national programmes. The compilation addresses numerous controversial topics and constraints, including human resources, confused mothers, stigma and discrimination, spillover of replacement feeding, free or subsidised infant formula, family economics and the difficulty in providing integrated HIV testing, informed choice counselling, community support, logistics and follow-up care for mothers and infants

HIV and young children : an annotated bibliography on psychosocial perspectives

SHERR, Lorraine
February 2005

Expand view

This annotated bibliography offers a practical guide to the content of the references which informed the literature review presented in BVLF Working Paper 33 (Young Children and HIV/AIDS: Mapping the Field). It is intended to help readers who want to go deeper into the issues and explore the original source material. The bibliography presents the references - mostly to peer-reviewed medical or psychology journals - under subject headings such as "disclosure", "interventions", "parentless children", "social development", and more

HIV risk exposure in young children : a study of 2-9 year olds served by public health facilities in the Free State, South Africa

SHISANA, Olive
MEHTAR, Shaheen
2005

Expand view

South Africa has, until now, focused its HIV prevention efforts on youth and adults, and now needs to expand its focus to include children. Much is already known about mother to child transmission, which is the dominant mode of HIV transmission among children. However, little investigation has been done into the potential for horizontal transmission of HIV on the population below reproductive age. This report focuses on children aged 2-9 years and, using a combination of qualitative and quantitative methods, presents evidence on the potential for HIV transmission in dental, maternity and paediatric service in public health facilities. A new finding concerns the practice of shared breastfeeding

HIV/AIDS : what about very young children?

DUNN, Alison
July 2004

Expand view

This short paper reflects findings from research carried out to identify current responses to meet the needs of children age 0-8 living in HIV/AIDS affected communities. The overall results show that at local, national and international levels there are gaps in programming and policy to engage ideas and mobilise resources to address the needs and experiences of very young children both infected and affected by HIV/AIDS. The question is then raised: What can we actually do to include very young children in programming and policy responses in HIV/AIDS affected communities? Supporting existing family and community networks and current efforts that are being made by people confronting HIV/AIDS on a daily basis are important strategies. Conclusions are drawn indicating that services are required urgently to support very young children both directly and through the families and communities in which they live. Ways of listening to and including very young children in these processes need to be developed and used. Partnerships need to be developed between parents, families, NGOs, CBOs and government to ensure the holistic development of the child. At policy levels, very young children need to be included in programmes that address children, HIV/AIDS and community development. All government ministries can participate in meeting the needs of very young children in HIV/AIDS affected communities

HIV/AIDS : what about very young children?

DUNN, Alison
March 2005

Expand view

This paper presents the results of research into the question of how to include very young children in programming and policy responses in HIV/AIDS affected communities. The third in a dedicated sub-series of working papers devoted to young children and HIV/AIDS, it shows how young children impacted by HIV/AIDS often seem to be almost invisible in the wider HIV/AIDS field, although no affected group is more vulnerable, more deserving or has greater potential to benefit from proper programming

Impact of AIDS on early childhood care and education

HEYMANN, Joey
June 2003

Expand view

This policy briefing sets out the background of the HIV pandemic and notes thats its impact has transformed childhood. Findings from a study in Botswana assessing the impact show results in areas of childcare, caring for sick children and parental time with children. Policy recommendations are made concerning the implications for the quality, quantity and nature of early childhood care and education services needed, and also for the supports that are necessary to enable parents and extended family members to care for children who are affected and infected by HIV

Improving nutrition and reproductive health : a review of UNICEF experience with the distribution of free infant formula for infants of HIV-infected mothers in Africa

WAGT, Arjan de
Clark, David
2004

Expand view

This review considers the experience of UNICEF with the distribution of free infant formula for infants of HIV infected mothers in Africa. UNICEF has provided, or is planning to provide, support to pregnant women in 54 countries, with HIV testing and counselling, improved health care, anti-retroviral drugs, and counselling on infant feeding options. After 1998, UNICEF decided to provide poorer HIV positive mothers with an alternative to breastfeeding by providing free formula. This paper presents the experiences with the procurement, distribution and use of free formula in PMTCT programmes. It further suggests conditions for the use of free formula

Matrix of five types of ECD HIV/AIDS interventions, suggested outcome indicators, and comments

WORLD BANK
2004

Expand view

This is a matrix of the five recommended types of Early Childhood Development (ECD) and HIV and AIDS interventions. It includes suggestions of delivery services to young children, education and support for families and caregivers, training and support of care providers, sensitisation through the mass media and community mobilisation. It provides indicators and comments for each of these categories and is a useful overview of the key interventions which could take place in this field

National household HIV prevalence and risk survey of South African children

BROOKS, Heather
SHISANA, Olive
RICHTER, Linda
2004

Expand view

This valuable new report looks at the levels of infection of HIV and AIDS, the levels of orphaning and child headed households, sexual debut and sexual experiences and risk factors and risk environments for children aged 2-14 in South Africa. This has been investigated as the HSRC recognizes that there is very little known about HIV prevalence rates among children or about the risk factors that predispose them to becoming infected. The study looks at the social and community risk factors that predispose children to HIV infection as well as the impact of the epidemic on children in terms of orphan status and child headed households. It examines children’s knowledge of HIV and AIDS prevention, their knowledge about sexual behaviour and HIV as well as their own patterns of sexual behaviour and changes in that behaviour. This study is interesting as it explicitly includes young children

Operational guidelines for supporting early child development (ECD) in multi-sectoral HIV/AIDS programs in Africa

SEIFMAN, Richard
SURRENCY, Amber
2003

Expand view

The document suggests how services that address young children's needs might be fully integrated into a national multisectoral HIV/AIDS programme. It gives advice on developing national ECD policies, programmes and interventions, multisectoral ECD approaches, and ways to advocate, implement, monitor and evaluate these efforts. It makes suggestions of interventions for very young children and is a resource for other national HIV/AIDS programme topics

Orphan programming in Zambia : developing a strategy for very young children in Zambia

UNITED NATIONS CHILDREN'S FUND (UNICEF)
July 1998

Expand view

This is a report of an assessment of UNICEF's programming in Zambia for children in general and those affected by HIV/AIDS. The assessment follows the release of the report "Children on the Brink", which was a wake up call to the international development community. The report discusses current programmes and opportunities for expanded programming with government personnel, NGOs, business and private sector associations, other UN agencies and bilateral donors operating in Zambia. It also extensively reviews literature and documentation

Paediatric ARV roll-out in South Africa

HORIZONS PROGRAM
CAPE TOWN UNIVERSITY
2005

Expand view

The Horizons Program of the Population Council and the University of Cape Town are conducting a study to identify successful programme strategies in paediatric HIV treatment in South Africa and to determine priority knowledge gaps to be addressed by operations research. This report summarises key findings from the initial consultative workshop of expert practitioners and stake-holders, focusing on the status of providing antiretroviral therapy to children in South Africa and strategies to expand and improve services. It includes providing services to under six year olds

Protecting the rights of young children affected and infected by HIV/AIDS in Africa : updating strategies and reinforcing existing networks

United Nations Educational, Scientific and Cultural Organisation (UNESCO)
June 2003

Expand view

This report attempts to identify strategies, lines of action and innovative approaches to respond to the needs of young children faced by the HIV/AIDS pandemic. Key issues addressed in the workshop and report are around obstacles that prevent the provision of appropriate services, key issues that affect young children, and the cultural and religious causes of discrimination. It suggests principles that should be observed in programming in this area, ways of advocating for the needs of young children affected by HIV/AIDS, and ways of moving forward by developing an action plan

USAID announces HIV/AIDS grant finalists

UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
May 2004

Expand view

Press release announcing the funding of four projects by USAID through the Community REACH program, which aims to promote scaling up successful creative community based programs which have a demonstratble impact on the HIV/AIDS pandemic

WABA position on HIV and breastfeeding

WORLD ALLIANCE FOR BREASTFEEDING ACTION (WABA)
1998

Expand view

This is a position paper on HIV and breastfeeding. It makes broad statements on the situation of breastfeeding mothers in the light of HIV. It states that it is concerned that recent changes in WHO, UNICEF and UNAIDS policy regarding breastfeeding and HIV as these changes appear to put major stress on the use of infant formula and less on alternative feeding methods. Recommendations are then made which indicate what some of these alternatives are

Working group on integrated early childhood development policy, planning and research : recommendations

VARGAS-BARON, Emily
2002

Expand view

These recommendations, from the Working Group of the Early Childhood Development Conference in 2002, note the need for every nation to establish a national policy framework for Integrated Early Childhood Development (IECD). This should be highly participatory in a process that is country driven, not donor driven. IECD should be promoted as a national security issue and as a tool for poverty eradication and socio-economic development. The recommendations include a section on children affected by HIV and AIDS and their caregivers. There are recommendations for a detailed plan for children affected by HIV and AIDS, to include programs that address issues and needs at family and community levels, with institutional care as the last resort

Journal articles

Early childhood development

TORKINGTON, Kate
January 2001

Expand view

This article delivers details on the Working Group on Early Childhood Development (WGECD) as one of the most recent working groups of the Association for the Development of Education in Africa (ADEA). It describes its activities and the policy studies project which provides information to African governments about ECD policies that have been developed in Africa. It also takes a look at ECD and HIV/AIDS and the role of WGECD and UNICEF

HIV/AIDS and early childhood [whole issue]

BARTLETT, Kathy
ZIMANYI, Louise
Eds
December 2002

Expand view

This is one of the few publications solely dedicated to early childhood and HIV/AIDS. It contains articles examining the particular experience of the very young child and the social, psychosocial and nutritional impact on their lives in AIDS affected communities. There is also an article about infant feeding practices in Africa. It makes some policy recommendations and the several case studies provide some direct examples of programming in this area

Multimedia

Early childhood development HIV/AIDS Malawi

MALAWI COUNTRY TEAM
2004

Expand view

This PowerPoint presentation demonstrates the general context of HIV/AIDS prevalence and impact in Malawi on children aged 0-14. 1.2% of children aged 0-14 are infected with HIV. HIV prevalence in child bearing women however is 16-30%. The presentation goes on to show the situation of orphans in the country, and notes that 17.5% of all children are orphans with 24% of orphans being under 5. Around half are orphaned due to AIDS. The situation of ECD services in Malawi is presented (just 26% of people have access to ECD services). Key policies and legislative frameworks are documented along with stakeholders. Best practices are covered as well as challenges, gaps and opportunities that are evident

ECD and HIV/AIDS in Rwanda

WORLD BANK

Expand view

This PowerPoint presentation takes a specific look at Early Childhood Development (ECD) and HIV/AIDS in Rwanda. It initially considers the statistics around HIV infection of babies and infants and the number of children orphaned by AIDS. There are a high number of child headed households and street children. There are few interventions that comprehensively target the ECD section. The major problems are presented as high levels of stigma and discrimination, the lack of adult care and provision of basic needs to child headed households, limited technical skills in counselling, medical care and home care of children affected by AIDS. Existing interventions are fragmented and coordination and M&E is weak. Existing interventions are usefully listed and finally future perspectives are given

HIV/AIDS : issues affecting the young child

EDWARDS, Morris
2002

Expand view

This PowerPoint presentation looks at the impact and scale of HIV/AIDS on the young, and the health and social aspects of HIV/AIDS. The focus on very young chldren focuses on the prevention of mother-to-child transmission. The presentation also makes recommendations for advocacy to ensure the non-discrimination of children living with HIV/AIDS and their access to health care, education and social services and benefits

Websites

Caribbean Early Childhood Development and HIV/AIDS

UNIVERSITY OF THE WEST INDIES
2002

Expand view

This website was established by the University of the West Indies to make Caribbean-relevant information on early childhood available to the countries that the University of the West Indies serves. The website is targeted at practitioners, parents, policy makers, researchers, the media or other persons and organisations interested in Caribbean early childhood, parenting and family development issues. The aim of the site is to increase the sharing of information, strategies, resources and overall communication on early childhood, parenting and the family within the Caribbean. The website provides information on national Early Childhood Development (ECD) Associations and their plans of action, parenting initiatives, research, and publications and products available on early childhood development issues in the region. There is a section devoted to HIV AIDS and ECD, but only a few reports on this topic are currently available

Early childhood development

WORLD BANK

Expand view

The early child development (ECD) website is a knowledge source designed to assist policy makers, programme managers, and practitioners in their efforts to promote the healthy growth and integral development of young children. It lists details of the key players in the field of ECD, contains downloadable resources including documents, reports and websites, and has a regional focus on Africa, the Caribbean and Latin America. The website contains sections on the World Bank's ECD and HIV/AIDS initiative in sub-Saharan Africa as well as tools and manuals developed by the World Bank's ECD team

ECD and HIV/AIDS

WORLD BANK

Expand view

This website is updated with current initiatives on ECD and HIV/AIDS. It includes details of the important workshop on ECD and HIV/AIDS held in Dar es Salaam in April 2004. The site provides links to resources on HIV and AIDS and links to organisations taking action in this area

Heinemann HIV/AIDS teaching support site

Heinemann Publishers

Expand view

This site is a source of information and resources for children of both younger and older age groups. These books and resources are produced to support adults who are working in education, both inside and outside the classroom, to equip children to know and think about HIV and AIDS and how it affects people. There are fiction reviews, information books and curriculum material. Lower primary through to upper secondary levels are covered and aim to give children the knowledge, skills and values they need to tackle HIV and AIDS.
For younger children, there is a series of 3 books.
1. Go Away Dog by David Donald about a grumpy grandmother, a puppy and the importance of care and friendship in a time of sickness.
2. Respect and Care by Glynis Clacherty that looks at respect and care and co-operation amongst children as they confront sickness and loss.
3. Lerato’s Story by Glynis Clacherty which is a lively photo story about a young child who is HIV positive told through the eyes of her sister

HIV and infant feeding

WORLD ALLIANCE FOR BREASTFEEDING ACTION (WABA)

Expand view

This section of WABA's website provides resources and information on key issues such as what interventions should be put in place to prevent transmission of HIV through breastfeeding, while also protecting, promoting and supporting breastfeeding for the majority of children who benefit from it. It also tries to address the question of how to decide which children would be at greater risk from being breastfed. An additional difficulty is the need to encourage HIV-positive mothers to choose either exclusive replacement feeding or exclusive breastfeeding, since neither is common in low-income populations

Orphans and other vulnerable children support toolkit

INTERNATIONAL HIV/AIDS ALLIANCE
FAMILY HEALTH INTERNATIONAL
December 2005

Expand view

This is a collection of information, tools and guidance on supporting orphans and other vulnerable children living in a world with HIV/AIDS. It covers a wide range of subject areas, including running a programme, health and nutrition, education, psychosocial support, economic strengthening, living environments and children's rights. It contains a wide range of useful resources on the different topic areas. It also contains a section on early childhood development