5TH ANNUAL NATIONAL CONFERENCE ON PEDIATRIC, CARE, TREATMENT AND SUPPORT OF CHILDREN INFECTED AND AFFECTED BY HIV AIDS

CONCEPT NOTE

PROTECTION, CARE AND SUPPORT OF ORPHANS AND VULNERABLE CHILDREN

1.    CONTEXT AND JUSTIFICATION

1.1 BACKGROUND

According to estimates from the UNAIDS 2008 Report on the global AIDS epidemic, around 30.8 million adults and 2 million children were living with HIV at the end of 2007 and  22  million are in Sub Saharan Africa. By the end of 2007, the epidemic had left behind 15 million AIDS orphans, among them 12 million living in Sub-Saharan Africa (UNAIDS/WHO report, 2008). According to some studies by 2010, the number of children orphaned by AIDS globally is expected to exceed 25 million.

The AIDS Epidemic put children at risks physically, emotionally and economically. Children are directly affected in a number of ways. They may live at high risks of HIV; they may live with a chronically ill parent or parents and be required to work or put their education on hold as they take on household and care giving responsibilities.  Their households may experience greater poverty because of the disease; and they can be subject to stigma and discrimination because of their association with a person living with HIV. 

Addressing societal factors that increase HIV risks and vulnerability and deepen the epidemic impact on children, families and their communities is very crucial. To meet the challenge and achieve global goals, strategies have been developed in collaboration by International agencies and Governments and they are committed for rapid acceleration of the response. Global initiatives have been launched towards the achievement of the Millennium Development Goal 6 (MDG 6) and in particular a Framework was developed for the Protection, Care and Support of Orphans and Vulnerable Children Living in a World with HIV and AIDS, which considers families and communities as the foundation of an effective and scaled-up response.

1.2    THE CONTEXT OF THE COUNTRY

According to national estimates, the total estimated number of people living with HIV in Rwanda was about 149,000 in 2008, including around 17,000 children (HIV Strategic Plan, 2008). According to the 2005 DHS, there are 1,350,820 orphans and vulnerable children in Rwanda between the ages of 0 and 17. It is estimated that AIDS accounts for nearly a fifth of these: the number of children (0-14 years old) having lost one or both parents because of HIV was estimated to be about 233,700 in 2008.

Households and communities face many challenges in providing love, care, support and protection to these children and communities are still rebuilding trust and going through a reconciliation process following the genocide; poverty affects the majority of households straining their capacity to provide material and emotional support; and HIV/AIDS is further weakening their capacity. However this presents great challenge in a country where 60% of the population is living below the poverty line. The Annual, National paediatric conference provides opportunities for evidence, planning and coordination as well as progress on recommendations from the previous conference.

2. NATIONAL RESPONSE

Protection care and support of Orphans and vulnerable children

There is an increasing commitment in Rwanda to provide a protective and supportive environment for OVC. This is evidenced by the development of the National Policy for OVC (2003) and other related policies and strategies in social protection, health, education and HIV policy and strategic plan 2008-2012 which include OVC component. A Strategic Plan of Action for OVC which provides the framework for concerted and scaled up action in support of OVC has been approved in May 2007.

Recently defined Minimum Standards for Care, Protection and Support for OVC aim at ensuring the operationalisation of a holistic approach including psychosocial support, economic empowerment of the household, basic education (formal and non-formal), protection against all forms of abuse, violence and exploitation and access to health and nutrition.

In September 2007, Rwanda’s Government just approved its second Poverty Reduction Strategy, called the Economic Development and Poverty Reduction Strategy 2008-2012. Cross cutting issues like HIV/AIDS and Social Inclusion have been mainstreamed into this strategy and a particular attention has been given to ensure that Social protection measures will include providing effective delivery of a minimum package of services to vulnerable groups including OVC and PLHIV.

The decentralization process offers a unique opportunity both to ensure that resources and services are provided directly to the most vulnerable and that children and other rights-holders participate in the planning, design and delivery of all activities.

One of the key priorities of good governance is the participation of the population, including children, in their development and more particularly in the planning, implementation, monitoring and evaluation of district development plans.

Since 2004, children representatives elected by their peers have the opportunity to express their views and raise their concerns to the high authorities of the country, through the four previous National Children Summits and the four National Paediatric Conferences.

However, the issue of OVC is the collective responsibility of all government ministries, civil society, communities, children themselves and the international community to work collaboratively to ensure the survival, growth, well-being and development of the children of Rwanda.

The integration of OVC issues into the Rwanda Economic Development and Poverty Reduction Strategy and all relevant sectoral policies and strategic plans, with specific budgetary allocation, is crucial to the realization of this vision.

 3. CHALLENGES

Despite a strong political will and commitment to provide a protective and supportive environment for OVC, and despite the efforts made by many organizations from the civil society and the families and communities themselves, only 0,2% of households hosting orphans receive free external support to access basic services and  87% of households hosting OVC are not receiving any free external support (DHS report, 2005).

However, the sustainability of funding in social protection, targeting the vulnerable, Coordination of SP activities and the Impact of interventions difficult to measure are the major challenges in the areas. Strategies, guidelines and coordination mechanisms are in place but their application is still a challenge at decentralised level. Capacity building will be one of the pillars for a better coordination of protection care and support of OVC interventions.

4. OBJECTIVES OF THE “PROTECTION” SESSION

By the end of the “protection” session, participants have:

1.    A better understanding of the role and partnership with the Families, Communities and children, their empowerment requirements, and as part of the designing and implementation of the  response
2.    A better understanding of the potential of cash transfer in reversing poverty among the vulnerable population with children and promote economic growth
3.    Information shared on the progress of Vision 2020 Umurenge programme and its impact in protection, care and support of OVC
4.    Learned from experiences of other countries, about strategies that have worked and how they can be applied in Rwanda.
5.    Commitment of all stakeholders for partnership, leveraging resources for social protection interventions scaling up and particularly for protection care and support of children infected and affected by HIV and AIDS.

5.    DISCUSSION THEMES

“STRENGTHENING FAMILY CAPACITIES TO PROTECT, CARE AND SUPPORT OVC”

Families and communities are the foundation of an effective, scaled-up response. Children, too, can be powerful agents of change, a role that enhances their confidence and self-esteem as they become partners in the fight against HIV/AIDS as well as poverty reduction and economic growth.

Families and communities are the first line of response to the epidemic. They have reacted with tremendous resilience and compassion, absorbing orphans mainly within the extended family system. The capacity of families to protect the rights and ensure the well-being of their children depends largely on the ability of a household to meet immediate needs, ensure a steady income and maintain the integrity of its economic safety net. Possible interventions should aim to enhance the economic resiliency of the household. (UNAIDS/UNICEF report, 2004).

However, studies have proven that CASH TRANSFERS have demonstrated a strong potential to reduce poverty and strengthen children’s education, health, and nutrition, and thus can form a central part of a social protection strategy for families affected by HIV and AIDS (JLIC report, 2008).  

Therefore, the central theme of protection, care and support of Orphans and vulnerable children is as follow: “STRENGHNING FAMILY CAPACITIES TO PROTEC, CARE AND SUPPORT ORPHANS AND VULNERABLE CHILDREN”.

Two specific themes are selected on which an international speaker and national speaker will focus.  The international speaker will focus on “Potential of cash transfers to strengthen Families affected by HIV AIDS” for protection, Care and support of children infected and affected by HIV AIDS. The national speaker namely the national coordinator of Vision 2020 Umurenge will focus on “Vision 2020 Umurenge Programme”.

6.    METHODOLOGIES

Open exchanges, sharing experiences, expressing views and reactions will be highly valued during the conference through different participatory methodologies, including:

1. Call for Abstracts: summarizing current experiences, research, data and lessons learned from the field in Rwanda

2. Key note speakers: international speaker, about “Experience of Cash Transfers in strengthening Family capacities affected by HIV and AIDS”, and a National speaker about Vision 2020 Umurenge programme (VUP) incredible opportunity for social protection in Rwanda.

3. Oral presentation of selected abstracts followed by discussions

Parallel sessions will be organized for children to ensure their meaningful participation and include their recommendations on all above topics and two facilitators will be identified.

7.    EXPECT RESULTS

By the end of the session, participants will achieve the following results:

1.    Information is shared on Vision 2020 Umurenge programme and its impact on families for protection, care and support of OVC;
2.    A better understanding of the potential of cash transfer in reversing poverty among the vulnerable population especially OVC and promote economic growth
3.    Participants have learned from experiences of other countries, about strategies that have worked and how they can be applied in Rwanda.
4.    Better understanding of the role and partnership with the Families, children and Communities, their empowerment requirements, and as part of the designing and implementation of the  response
5.    All stakeholders’ commitment mobilised for partnership to better respond, leveraging resources for OVC interventions including scaling up.