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 Objectives Support 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 Objectives Community 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

Gaps Service 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

Gaps Care 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

Gaps Community 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 You From the Warm Heart of Africa