Supporting orphans and vulnerable children affected by AIDS: using community-generated definitions to explore patterns of children's vulnerability in Zambia

Abstract

This study explores how communities in Zambia characterize vulnerable children in the context of HIV; demonstrates how estimates of vulnerability vary depending on definitions; and discusses the implications of these estimates for program delivery. Baseline research conducted in 2005 included cross-sectional community-based household surveys at six locations using multi-stage random sampling (totalling 1,503 households, reporting on 5,009 children) and participatory qualitative research (focus group and in-depth interviews) with adults and youth at four locations. Between 14 and 27% of children in the sample had experienced a parental death (2-5% maternal orphans, 7-13% paternal orphans, 4-10% double orphans). In addition, other characteristics that communities associated with children's vulnerability were prevalent: 26-34% had been taken into another household, 15-27% were living in female-headed households, and 11-28% were living in a household with someone who is chronically ill. Overall, 58-73% of children had one or more community-defined characteristics of vulnerability. This study highlights the need to carefully consider the meaning of "vulnerability" when targeting programmes to support children affected by HIV and AIDS. Local community input is vital to inform context-specific criteria for distributing programme resources. If used, eligibility criteria should be context-specific yet flexible to evolving community realities. In settings such as rural Zambia where levels of HIV-related vulnerability are high, it may be more efficient to target at the level of communities rather than assess individual households.

Risks and Vulnerabilities of Children in Zambia: Mooting Responsive Social Protection Interventions

“…This is consistent with other studies, for instance, by Schenk, Ndhlovu, Tembo, Nsune, Nkhata, Walusiku and Watts (2008). Similarly Patel, Hochfeld and Moodley (2013) documented that most of the recipients of social protection benefits (invariably vulnerable people) are females.…”

Orphan competent communities: A framework for community analysis and action

“…We will illustrate this with examples from Skovdal's recent research in western Kenya (Skovdal, Ogutu, Aoro, & Campbell, 2009). Furthermore, we argue that the solutions need to come from the orphans, their fostering households and host communities themselves, rather than being generated and imposed by outsiders, who often have very limited understandings of the dynamics and resources that determine children's vulnerabilities (Schenk, Ndhlovu, Tembo, Nsune, Nkhata, Walusiku et al, 2008). In developing the concept of an 'orphan competent community', we adapt Campbell's conceptualisation of a 'AIDS competent community'.…”

Sibling caregiving among children orphaned by AIDS: Synthesis of recent studies for policy implications

“…Articles used for qualitative analysis of constructs, factors, and impacts of sibling caregiving are shown in Table 2 [5,[9][10][11][12][13][31][32][33][34][35][36][37][38][39][40][41]. To answer the second question, 'what kinds of care comprise sibling caregiving', we tabulated the sibling caregiving described in the articles and developed a framework (Table 3).…”

“…However, the rapid increase in orphans has overburdened the extended family network, leading to the emergence of child-headed households [6,7]. Child-headed households are more likely to have economic constraints [8,9]; have poor accommodation [10]; be disadvantaged in education [11,12]; and have physical [13], nutritional [14], and psychological [15,16] problems.…”