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Early Childhood Development HIV/AIDS in
Malawi
Presented by Malawi Country Team Dar-es-Salaam, Tanzania 2004
Situation of Malawi: Social Indicators
Pop – 10,800,000 65% of population lives
below poverty level Total number of children
(0-18) 5,250,000 Ages 0-6 – 24.4%
(2,777,000) 49% of children stunted
Social Indicators cont. IMR – 104; MMR - 1,120; U5MR – 189
(main causes are malnutrition, anemia, pneumonia, diarrhea, malaria)
Urban – 25%; Rural 13% HIV+ 1.2% children (0-14 yrs) infected with
HIV (NAC 2003) 16-30% HIV prevalence in child bearing
women
Situation of Orphans in Malawi
17.5% (937,000) of all children are orphans
24% of Orphans are under 5
49.9% are orphaned due to HIV/AIDS.
Situation of ECD Services 26% coverage of access to
ECD services Approximately 3000
CBCC’s (400 supported by UNICEF)
Ages 0-5 attend CBCC’s 40% of children at CBCC’s
are Orphans On average 100 Children
registered at CBCC (1:50) Less then 50% of
caregivers are trained
Key Policies and Legal Framework Human Rights Provision Ch. 4 Sect. 23 Children and Young Persons Act Affiliation Act Maintenance of Married Women Act Wills and Inheritance Act ECD, OVC, HIV/AIDS, Gender, People
with Disabilities, Decentralization Policies PRSP National Health Plan: IMCI, PMTCT
Policies
Programmes Targeting ECD and HIV/AIDS Support to Orphans
and families affected by HIV/AIDS
Community Child Care
(using the IECD approach)
Stakeholders
Ministry of Health, Gender, Agriculture, Water, Education, Finance, Local Government
NGO’s, CBO’s, FBO’s UN Agencies Bilateral Donors Communities
Programme ObjectivesSupport for orphans and families affected by
HIV/AIDS To ensure that families and orphans affected by
HIV/AIDS are provided with appropriate care and support to facilitate healthy growth and development, education, protection, and participation
Strengthen the capacity of programme partners to collect and use information to monitor and evaluate programmes on early child care
Ensure that issues of orphans, ECD, and nutrition are well incorporated in relevant poverty reduction strategies
Programme ObjectivesCommunity Child Care
Provide family with skills to care for children including nutrition, health, and psychosocial support;
To ensure that acute malnutrition among under 5 children stays below 10%
Strengthen the capacity of implementing partners to collect and use information to monitor and evaluate programmes on early child care
To promote integrate childhood development during the 1st three years of life
To prevent death among children occurring in the homes
Programme Intervention Focus ECD/OVC
Advocacy on ECD/OVC Support the capacity for parents/caregivers to provide early
learning and stimulation, psychosocial development, and care for OVC
Establish CBCC’s and improve the quality of services to promote early learning and stimulation and the holistic development of children
Psychosocial support and counseling Community Mobilization/Empowerment (Community Dialogue) Support and training on IGA’s Partnership and networking
Best Practices Multi-Sectoral Approach Utilization of existing
structures and local resources
Reaching the most vulnerable
Capacity building of parents/caregivers for providing quality care
Community Child Care initiatives (EL&S, Extended family care, granny’s and widows club, single mothers club )
Best Practices Community engagement (community
dialogue) CBCC as entry point for other
development programmes Human Rights Based Approach To
Programming Inclusion of Psycho-social support in the
package of care Maternal health and nutrition Extended family care & Foster Care
Challenges Political Commitment not backed by
adequate resources High Level of Poverty; low literacy level Increasing # of children affected by HIV/AIDS Provision of Quality services Capacity of service providers to provide
integrated services Service provider turnover rate Inadequate human resources Reaching children 0-8 (particularly 0-3)
Challenges Coordination/Convergence of Services Appropriate infrastructures (physical) Traditional Beliefs/Practices Provision of EHP Sector Wide Approach Number of VCT’s within the communities Child Participation Advocacy to link knowledge/skills/practice Communication strategies at community level
Gaps Reliable data on the magnitude of the
problem of children affected by HIV/AIDS, and Psycho-social development
Provision of quality integrated services with focus on ECD and HIV/AIDS
Implementation of operational guidelines for ECD
Resources (funding, materials, human) Untrained Caregivers
GapsService Delivery for Children: Food and nutrition Health (growth monitoring, referral) Management of common complications
associated with HIV/AIDS infected children
Parental Education and Support: Parenting skills and knowledge Counseling skills
GapsCare Provider Training and Support Standardized training and materials Capacity of caregivers and trainers Comprehensive care to care providers
Sensitization of the public on ECD Inadequate advocacy on ECD and
HIV/AIDS Communication strategy not appropriate
for behavioural change
GapsCommunity Mobilization Follow up and sustainability Community monitoring
Opportunities Availability of strong NGO’s, FBO’s, CBO’s Availability of policies (e.g. ECD, OVC, PRSP) Increase of father participation (trend
improvement 2000-2003) Emerging programmes (e.g. ARV therapy for
infected children, ICHBC) Increased demand from communities for ECD
services Community Monitoring tool for OVC Ratification of CRC & CEDAW
Results/Evaluations Identified trends in increase in child
rearing practices Follow up to baseline study underway Review and development of ECD
materials (syllabus, training manuals) underway
Rapid appraisal for OVC ECD Mid Term Review Launch of ECD & OVC Policy
Thank YouFrom the Warm Heart of Africa