Orphans and vulnerable children

Around one third of Africa’s orphans are orphaned due to AIDS. Young children who experience the long-term sickness and death of parents undergo periods of stress and anxiety and are affected psychosocially. In addition the high numbers of orphans and vulnerable children affect traditional kinship systems of extended family networks, putting pressure on family structures and creating tension around issues of inheritance and land. Orphans not cared for by the extended family may end up in vulnerable situations such as in child-headed households, on the street or in institutions and orphanages. Some resources in this Key list focus on the psychosocial impact of bereavement and how this affects the child at different stages. Others focus on how to engage children when starting to work in this area.

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

Selected resources

Books, reports, etc

A description of the selected interventions for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe

DLAMINI, Phetsile K
2004

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This report contributes to phase one of a research programme which explores the social, political, economic and systemic determinants that affect vulnerability to HIV. This report documents existing interventions to gain more in-depth knowledge of interventions at grassroots level, identify their strengths and weaknesses, and consider opportunities and threats; analyse and assess the outcomes of such interventions and whether objectives were met, including the impact on vulnerable children, their families and communities, considering nutritional and education status, and psychosocial well-being; ascertain the level of awareness around HIV and AIDS, and especially of prevention strategies and care

A parrot on your shoulder : a guide for people starting to work with orphans and vulnerable children

INTERNATIONAL HIV/AIDS ALLIANCE
2004

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This book is designed to help people who work with children initiate meaningful dialogue and engage them in a cheerful and positive manner. It considers issues around encouraging children’s participation, why it is important, and what to include when planning children’s participation. It discusses issues of safety in accordance with the United Nations Convention on the Rights of the Child and why, how and when to use games. It contains activities and ideas on how to include children in participatory processes

Approaches to caring for children orphaned by AIDS and other vulnerable children : essential elements for a quality service

LOENING-VOYSEY, Heidi
WILSON, Theresa
February 2001

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This research study examines responses to the care of orphaned children. The goal of the study is to develop policy recommendations for the care of orphans and vulnerable children (OVC) in South Africa. It complements a partner study into the cost effectiveness of care. Here quality care is that which meets the needs of children in a culturally acceptable way and enables them to realise their rights. It examines a variety of approaches to care from formal to non-formal ways and examples, and case studies are looked at in order to evaluate quality. Conclusions and recommendations are made around the continuum of approaches for the care of OVC, the capacity of households to care for OVC, mobilising communities to care for OVC, and providing a safety net for OVC

Building resilience in children affected by HIV/AIDS

MALLMAN, Sr Silke-Andrea
2003

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This is a practical guide for caregivers and teachers consisting of a collection of ideas, theories, tasks and exercises that help understand the behaviour and feelings of children affected by HIV/AIDS. The handbook provides practical advice on how to support children who have experienced loss and death in order to help them to cope

Children in residential care and alternatives

MILES, Glenn
STEPHENSON, Paul
January 2001

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Residential Care and Alternatives is based on child development and protection principles. Tearfund is a Christian organisation and the document makes a number of references to Christian scripture and values. It could be a useful tool for helping Christian organisations that provide, or that are considering providing, residential care to explore better care alternatives or improving the quality of residential care

Children on the brink 2004 : a joint report of new orphan estimates and a framework for action

UNITED NATIONS CHILDREN'S FUND (UNICEF)
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
USAID
July 2004

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Millions of children are growing up without parents. Millions more are in households with family members sick or dying from AIDS; children in sub-Saharan Africa have been hardest hit. This report presents the latest statistics on historical, current and projected numbers of children under 18 who have been orphaned by AIDS and other causes. This edition of the biennial report underscores the changing needs of this vulnerable group as they progress through adolescence and calls for the urgent development and expansion of family and community support

Children, HIV/AIDS and communication in South Africa : a literature review

FOX Susan
OYOSI Salome
PARKER Warren
May 2002

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This literature review covers key issues relating to children aged 3-12 and HIV/AIDS, including discrimination, grief, children's rights, and knowledge and understanding of HIV/AIDS. The impact on the child, family and community is discussed in detail, particularly in terms of the psycho-social impact of bereavement and how this impacts on the child at different stages in its development. Various community programmes within southern Africa are highlighted, which support children to develop life skills. The influence, role and practice of the media in working with and reaching children is addressed, and case studies of South African media projects such as Soul Buddyz and Takalani Sesame are provided

Conducting a situation analysis of orphans and vulnerable children affected by HIV/AIDS : a framework and resource guide

WILLIAMSON, John
COX, Adrienne
JOHNSTON, Beverly
February 2004

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This document moves towards a standard framework to help people involved in programmes conduct a situation analysis concerning orphans and vulnerable children (OVCs) in the context of HIV/AIDS. It includes the process of planning the situation analysis, defining its purpose, goals and objectives. It provides advice on methods to gather data and frameworks for assessing health, education and economic impacts of HIV/AIDS on OVCs. Analysis, reporting and communication of the information found is discussed

Declaration of commitment on HIV/AIDS : "Global Crisis-Global Action"

UNTED NATIONS GENERAL ASSEMBLY (UNGASS)
2001

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The declaration notes the scale of the HIV/AIDS epidemic, which constitutes a global emergency, and reaffirms previous commitments on HIV/AIDS made through other declarations. It stresses the need for strong leadership at all levels of society as essential for an effective response. It also suggests that prevention is the mainstay of the response, with care, support and treatment as fundamental elements. The realisation of human rights and fundamental freedoms for all is declared necessary to reduce vulnerability to HIV/AIDS. Empowering people, especially women, is essential to reducing vulnerability. Children and children orphaned by AIDS are also mentioned. Investing in sustainable development and national poverty alleviation strategies to address the impact is vital, as is research and development

Defining orphaned and vulnerable children

SKINNER, D
et al
2004

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This research forms part of a broader project aimed at development and evaluation of interventions for orphaned and vulnerable children. The paper aims to provide a definitional framework and an understanding of orphans and vulnerability

Family and community interventions for children affected by AIDS

RICHTER, Linda
MANEGOLD, Julie
PATHER, Riashnee
2004

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This report, based on over 400 documents, reviews the available scientific and programmatic information on interventions aimed at children, families, households and communities. Specifically, the report considers: home-based child-centred development programmes focussing on health and nutrition; psychosocial care and management of inherited assets; interventions directed at supporting families and households to cope with the HIV/AIDS problem and interventions directed at building the capacities of communities to provide long-term care and support for children and households. It also contains an annotated bibliography of available literature in this area in Section 2. The main emphasis of the report is on intervention principles rather than on actual program implementation details as it is widely understood that interventions need to be tailored for each particular situation. There is no specific focus on very young children but interventions to support children, families and communities run into each other with inevitable overlaps

Future forsaken : abuses against children affected by HIV/AIDS in India

HUMAN RIGHTS WATCH (HRW)
2004

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This report documents abuses against India’s HIV/AIDS-affected children, including doctors refusing to treat or even touch HIV-positive children, schools expelling or segregating children because they or their parents are HIV-positive, and orphanages and other residential institutions rejecting HIV-positive children or denying that they house them. Children from families affected by AIDS may be denied an education, pushed onto the street, forced into the worst forms of child labour, or otherwise exploited, all of which puts them at greater risk of contracting HIV. This report calls on the Indian government to recognise their plight and to take immediate action to protect them from discrimination and exploitation

Guide to monitoring and evaluation of the national response for children orphaned and made vulnerable by HIV/AIDS

UNITED NATIONS CHILDREN'S FUND (UNICEF)
February 2005

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One of the major challenges facing governments, international organisations and non-governmental organisations in their responses to children made vulnerable by HIV and AIDS is the lack of data on the quality and effectiveness of their interventions. This document provides guidance to these institutions in the monitoring and evaluation of the national response for children orphaned and made vulnerable by HIV and AIDS. It includes methods and tools for measurement at the national level. The guide is organised into two parts. The first discusses issues relevant to the general monitoring and evaluation of orphans and other children made vulnerable by HIV and AIDS and the second part provides specific guidance in the use of the recommended indicators

Manual : psycho-social support of orphans

MADÖRIN, Kurt
1999

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This manual is a tool for trainers to train concerned community members to assist distressed children, and to facilitate their interventions on the level of awareness, knowledge, skills and behaviour in relation to orphans. Its stated objective is to enhance the capacity of adults to listen and talk to orphans and children of terminally ill parents, and to understand their situation and their needs. In this way the community improves its capacity to cope with some of the consequences of AIDS. In the manual there are 16 modules that rely on participatory methods, each with detailed instructions for the facilitator and a handout for participants. The manual was produced by the Humuliza (Community Based Mental Health for Orphans) project team

National household HIV prevalence and risk survey of South African children

BROOKS, Heather
SHISANA, Olive
RICHTER, Linda
2004

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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

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

UNITED NATIONS CHILDREN'S FUND (UNICEF)
July 1998

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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

Orphans and vulnerable children in India : understanding the context and the response

GOLDMAN, Judith
ANASTASI, Marie-Christine
June 2003

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A report from a meeting for exchange and learning between organisations working with orphans and vulnerable children in India, looking community responses to working with this group. The experience of Plan International, Palmyrah Workers Development Society and the International HIV/AIDS Alliance was presented to the meeting. Specific responses to working with orphans and vulnerable children discussed in the report include lessons from a child participatory approach, prevention of mother-to-child transmission and the development of community action

Orphans and vulnerable children technical consultation : presentations and materials for OVC consultation

UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
2003

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This web page of a technical consultation on orphans and vulnerable children (OVC) contains a variety of presentations of the situation of OVC, the impact of HIV/AIDS global strategies of action and some presentations of case studies from different countries such as Cambodia and Malawi. Some also look at clinical and community care and include ethical considerations

Paediatric ARV roll-out in South Africa

HORIZONS PROGRAM
CAPE TOWN UNIVERSITY
2005

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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

Policies for orphans and vulnerable children : a framework for moving forward

SMART, Rose
July 2003

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This paper presents a summary of the global orphans and vulnerable children (OVC) situation, and current policy responses. It is meant for individuals with strategic decision making responsibilties for HIV/AIDS programmes. It firstly defines what is meant by OVC and points out that sub-Saharan Africa has the most OVCs in the world and is therefore the focus of the paper. It outlines existing policy frameworks in responding to OVC including international and national instruments. It identifies policy gaps in national responses to the OVC crisis, and proposes a country-level OVC policy package based on current thinking. The focus is on children under 18 in general, and there is no response to specific age groups

State of the world's children 2002 : leadership

UNITED NATIONS CHILDREN'S FUND (UNICEF)
2001

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The State of the World's Children 2002 presents models of leadership from individuals, agencies, organisations and alliances that have improved the lives of children and families. The report spotlights the 'Say Yes for Children' campaign and the UN Special Session on Children

The cost-effectiveness of six models of care for orphans and vulnerable children in South Africa

DESMOND, Chris
GOW, Jeff
2001

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An analysis of the most cost effective way of providing care for orphaned children in South Africa. It examines six models of care ranging from formal children's homes to community-based structures. The paper is part of a combined study, the other part of which looks at the quality of different types of orphan care and their associated costs. There is initially a detailed look at the various categories of care followed by an outline of the method used to evaluate cost. Six case studies are examined and conclusions and recommendations are made as a result of evaluation

The journey of life : a community workshop to support children

REGIONAL PSYCHOSOCIAL SUPPORT INITIATIVE (REPSSI)
June 2004

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'The Journey of Life' is a community workshop curriculum to support children. This workshop seeks to address the increasing psychological and social needs of children affected by HIV/AIDS, war, and displacement. Its objective is to raise community awareness of the problems that children face growing up in a time of HIV/AIDS, war, and family disintegration. 'The Journey of Life' assists the community to identify children in need of social, emotional, intellectual, spiritual, and physical support. Through dialogue and reflection the community better understands how to use available resources in solving the problems that children encounter and to strengthen the resilience of their children. The workshop covers the areas of meeting children's needs; understanding children's problems; identifying children who need help; building children's strengths; and community mobilisation. The workshop manual can be used without additional training, though further training has been found to be helpful. A Facilitator's Guide accompanies the workshop

The spillover impacts of Africa's orphan crisis

EVANS, David
2005

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This is a study using a collection of 41 demographic and health surveys from 26 African countries. The households that provide care for orphans are characterised, and the impact of taking in orphans on outcomes for other household residents, including children's health and education, is estimated. A key finding is that orphan care is concentrated in households with fewer other childcare responsibilities, especially elderly households. The researcher found no evidence that having an orphan join the household significantly affected the household, contrary to popular views that orphans generate negative spillovers

Understanding community responses to the situation of children affected by AIDS : lessons for external agencies. Draft paper prepared for the UNRISD project HIV/AIDS and Development

FOSTER, Geoff
March 2002

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This is a key report that documents community responses and coping mechanisms towards the HIV/AIDS pandemic in relation to children affected by AIDS (CABA) and orphans and vulnerable children (OVC). Fostering families are under enormous strain and local initiatives at the community level have been little studied or documented, and few organisations have sought to encourage their development. The paper analyses some of these initiatives and encourages external agencies to support them through building the capacity of local responses rather than imposing external solutions

Understanding the needs of orphans and other children affected by HIV and AIDS in Africa : the state of the science

BIRDTHISTLE, Isolde
April 2004

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To date, responses to the needs of orphans and vulnerable children have not typically been guided by research, though a body of empirical evidence related to the impact of HIV and AIDS on children is growing. USAID/AFR/SD and the SARA project commissioned a review of 48 selected studies to summarize the findings that represent the most current understanding of children's vulnerability due to AIDS. The review captures what is known and not yet known about the impact of HIV and AIDS on the survival, health, education, social, and emotional needs of children; identifies the content gaps and methodological limitations of existing research; suggests priorities for future research; and informs programmatic and political responses

USAID announces HIV/AIDS grant finalists

UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
May 2004

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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

USAID project profiles : children affected by HIV/AIDS

UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
January 2005

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This document presents profiles of 114 projects (90 country-specific, 12 regional, and 12 global) funded by USAID. It includes a section on USAID projects that support access to education in Africa. The project profiles include the names of implementing organisations, funding periods and amounts, objectives, strategies, key accomplishments, priority activities for the year ahead, and materials and tools available to other projects that can help meet the needs of children and youth affected by HIV and AIDS. The diversity of these projects demonstrates the US government's efforts to meet the wide variety of needs of children and youth affected by HIV and AIDS. Approaches vary in both strategy and scale. The vast majority of projects work with communities to identify opportunities that strengthen existing resources without undermining local ownership. In many places, communities are already mobilised and have systems in place to identify, protect, and provide basic necessities to the most vulnerable children. USAID supports the strengthening and monitoring of these existing activities

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

VARGAS-BARON, Emily
2002

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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

Databases

AIDS orphans assistance database (AOAD)

ASSOCIATION FRANCOIS XAVIER BAGNOUD (AFXB)
WORLD BANK, Early Childhood Development Team

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The purpose of the AOAD is to facilitate cooperation among organisations and individuals assisting children made vulnerable by HIV/AIDS and their care givers. The AOAD allows users to find, learn about and contact each other. The database also aims to help donors identify potential project partners directly, thus eliminating costly intermediaries. The purposes of the database include helping practitioners in the field to connect and exchange views and insights; helping community-based organisations and local NGOs identify potential sources of support; helping donors identify potential implementing partners; and helping programming agencies identify technical service providers

Email forums

Children Affected by AIDS (CABA) online forum

SYNERGY PROJECT
2004

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The CABA (Children Affected by AIDS) online discussion forum was established by the US Agency for International Development (USAID) to facilitate vital discussion and information exchange on efforts to mitigate the impact of HIV/AIDS on children, families and communities. USAID and the Synergy Project, which hosts the forum on behalf of USAID, encourages all to participate.
The website includes listings of HIV/AIDS websites, grouped by topic and by country. Areas covered include: global HIV/AIDS, women, children and youth, tuberculosis and HIV/AIDS, donors, Africa, Newly Independent States, Asia and the Near East, Latin America and the Caribbean

Journal articles

Orphans and schooling in Africa : a longitudinal analysis

EVANS, David
MIGUEL, Edward
2005

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This paper looks at the impact of parent death on primary school participation using an unusual five-year panel data set of over 20,000 children in rural Kenya. There was a focus on children who began the study period as non-orphans and compare children who subsequently lost a parent to those who did not. There is a substantial decrease in school participation following a parent death as well as evidence of a drop before the death. Effects are largest for children whose mothers died, for young girls (under age 12) and for children with low base line academic performance. The authors then discuss implications for the design of programmes to assist orphans and vulnerable children

Multimedia

Overview of children living with HIV/AIDS

BOWSKY, Sarah
2004

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A PowerPoint presentation showing some key statistics on global HIV/AIDS estimates on children under 15, and the estimated impact of HIV/AIDS on under-five mortality rates and on the infant and child survival. The presentation also looks at how children become infected with HIV and why they die so young. Current responses are listed with a look at the contiuum of care followed by some key challenges. Finally the medical, nursing and psychosocial needs of children are presented

Websites

AIDSPortal

UK CONSORTIUM ON AIDS AND INTERNATIONAL DEVELOPMENT

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AIDSPortal.org is a collaboration between the DFID AIDS Policy Team, the UK Consortium on AIDS and International Development and the DFID Health Resource Centre, which produces the Eldis AIDS resource guide. AIDSPortal.org brings together the contents of the resource guide with policy discussions and country resources which are currently under development. There is a new AIDSPortal resource section on orphans and vulnerable children. It is also possible to access country specific resources and contacts from civil society organisations. There is information about a recent symposium to support the sharing of best practice in OVC programming which includes an overview of issues around OVC

Heinemann HIV/AIDS teaching support site

Heinemann Publishers

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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

Women, children, and HIV

FRANCOIS XAVIER BAGNAUD (FXB) CENTER
CENTER FOR HIV INFORMATION (CHI)

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This site contains a library of practically applicable materials on mother and child HIV infection including preventing mother-to-child HIV transmission (PMTCT), infant feeding, clinical care of women and children living with HIV infection, and the support of orphans. The goal of the site is to contribute to an improvement in the scale and quality of international HIV/AIDS prevention, care, and treatment programs for women and children by increasing access to authoritative HIV/AIDS information. Its aims are to disseminate state of the art clinical information and training resources on MTCT and related topics. It also communicates the best practices in preventing MTCT and caring for infected children. It aims to disseminate prevention of MTCT program resource materials, clinical information and training resources on perinatally acquired pediatric HIV infection. It is browseable and searchable through a basic 'free-text' search box. The site also features an up-to-date news section.

Organisations

Education, Training and Development Practices (ETDP) SETA

South Africa

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PO Box 5734
Rivonia 2128

The primary function of the ETDP SETA is to facilitate skills development in the education, training and development (ETD) sector. They run a varity of courses, for example courses and units which can be taken in supporting children and adults living with HVI/AIDS in ECD settings. The elective unit is suitable for educators, caregivers and community workers working with adults and children in group, informal or family settings [see http://www.etdpseta.org.za/modules.php?op=modload&name=News&file=article&sid=463 fro more information]