National plans of action for orphans and vulnerable children in sub-Saharan Africa: where are the youngest children?

National plans of action for orphans and vulnerable children in sub-Saharan Africa: where are the youngest children?

How effectively do National Plans of Action address the needs of the youngest orphans and vulnerable children?

Although it is recognised that the focus of support must be on all children made vulnerable by HIV and AIDS, including those living with sick parents or in extreme poverty, the youngest are often invisible to programme planners, despite their vulnerability. This paper examines 17 National Plans of Action (NPAs) for orphans and vulnerable children prepared in the hardest-hit areas in sub-Saharan Africa in order to evaluate their response to the specific needs of young children (generally defined as children under age eight).

The 17 countries chosen include Botswana, Central African Republic, Côte d’Ivoire, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe.  These 17 were selected because they have the highest rates of HIV infection and their plans were the most developed. Botswana and Central Africa Republic met these criteria but were not included because their plans were not yet well enough developed for analysis.

The paper summarises each country’s responses to younger children: its definition of vulnerability, whether it includes language supporting young children’s rights, and finally, whether the programming the country advocates is appropriate for ensuring the rights of young children. This analysis does not evaluate the quality of the plans, their implementation, or the adequacy of the amount of funds being requested. Rather, it assesses whether the plans use an age-appropriate lens and a rights perspective.

The author makes the following recommendations:

  • evaluate assumptions: when there is a lack of experience or evidence, judgements must be made without data; however, over time assumptions need to be evaluated for accuracy or they will lead to ineffective programmes
  • provide adequate funding for the NPAs to include Early Childhood Development (ECD) measures
  • build the case with evidence: good evidence for the importance of early interventions for children with HIV is needed for good NPAs, including clear directions on the most effective measures
  • develop capacity in ECD at the country level: in order for these measures to be successful, a concerted effort is needed to develop capacity for ECD, including examples of programmes that work, guidelines for programmes, and trained workers
  • strengthen the role of the health sector for young children’s development and develop new platforms for care: linking ECD with other interventions such as Prevention of Mother-to-Child Transmission (PMTCT) of HIV/AIDS or home-based approaches should be a key component of NPAs, as they provide an excellent foundation for improving the well-being of both caregivers and children
  • strengthen structures at local, regional, and national levels for an integrated approach: an adequate response to the multiple needs of young children requires a coordination of approaches across sectors. This has begun to evolve through the process of developing NPAs, but it must continue and be supported in the implementation phase
  • support women’s rights: because children’s well-being and rights, particularly young children’s well-being, is so closely linked to the status and rights of women, this should be a central component of many plans
  • link the NPAs with other plans in order to effectively implement them.