Orphans and Vulnerable Children

Speeches Shim

A community case worker provides positive parenting support during a household visit in Mbeya, Tanzania as part of USAID’s Kizazi Kipya program. Parenting support for caregivers of OVC increases caregivers’ confidence and skills to improve children’s care and development.
A community case worker provides positive parenting support during a household visit in Mbeya, Tanzania as part of USAID’s Kizazi Kipya program. Parenting support for caregivers of OVC increases caregivers’ confidence and skills to improve children’s care and development.
Credit: Michael Goima/Pact.

Overview

Children and adolescents face significant risks and vulnerabilities as a result of HIV and its socio-economic effects:

  • In 2020 there were an estimated 15.4 million children ages 0-17 who have lost one or both parents due to AIDS globally. (UNAIDS 2021).
  • An estimated 1.7 million children ages 0-14 are living with HIV; only 54 percent of these children are on treatment and only 40 percent of children on treatment were virally suppressed in 2020 (UNAIDS 2021). Multiple countries in sub-Saharan Africa have even greater pediatric treatment gaps (with treatment rates ranging from 12-48 percent). Notably, 100 percent of children living with HIV who are enrolled in USAID’s OVC programs are reported to be on treatment.
  • An estimated 150,000 children ages 0-14 were newly infected with HIV in 2020 (a reduction from 160,000 in 2019); adolescent girls in sub-Saharan Africa are disproportionately more likely than boys to acquire HIV.

USAID’s orphans and vulnerable children (OVC) programs, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), serve children in a range of adverse situations, including children who are living with HIV, living with caregivers who are living with HIV, orphaned, at risk of becoming infected, or a combination of these factors. Critical remaining risks pertinent to OVC programs include loss to follow-up of HIV-exposed infants and suboptimal viral load suppression among children and adolescents living with HIV. USAID continues to refine service delivery for OVC in high-burden communities to improve their health, well-being, and protection as well as strengthen child, adolescent, and family resilience.

USAID Impact

USAID’s OVC programs, through PEPFAR, aim to improve health, education, protection, and socio-economic outcomes among children living with and affected by HIV, their caregivers, and families. OVC programs:

  • Apply robust targeting approaches that prioritize the enrollment of children at risk of poor outcomes, including children and adolescents living with HIV who are not virally suppressed, HIV-exposed infants of adolescent mothers, child survivors of sexual violence, children of Female Sex Workers, children of caregivers living with HIV, and female orphans.
  • Contribute to accelerated access to HIV testing, care, and treatment and to viral suppression among children and adolescents living with HIV using child-centered, family-based case management.
  • Deliver evidence-based interventions for the prevention of HIV and sexual violence targeting young adolescent girls and boys; and provide services to prevent, detect, and respond to violence against children (including sexual and gender-based violence).
  • Provide educational subsidies and support, with a focus on girls’ education, in order to improve educational access, progression, and completion.
  • Serve as a platform for focused efforts such as the Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) Initiative that provides protective, layered interventions (e.g., schooling, economic support, parenting, and violence prevention services) targeting vulnerable adolescent girls and young women (AGYW) in order to build their resilience to HIV risk.
  • Provide vital social support and implement targeted household economic strengthening interventions that improve socio-economic capacity and assets among OVC families; this may include strengthening financial skills and savings among older adolescents and facilitating linkage to employment opportunities for AGYW.
  • Leverage other USAID-supported health, education, and economic strengthening programming to improve adolescent and youth resilience.
  • Strengthen national social service systems, including workforce at professional and paraprofessional levels, to improve child and family health and well-being outcomes.
  • Build the organizational and technical capacity of local partners to deliver high-quality comprehensive services to vulnerable, HIV-affected children and families.
  • Advance and support effective child safeguarding in policies and implementation.
  • The OVC program also contributes to the accomplishment of the U.S. Government’s strategy for international assistance to children in adversity. Advancing Protection and Care for Children in Adversity: A U.S. Government Strategy for International Assistance (2019–2023) is a whole-of-government commitment and approach to investing in the development, care, dignity, and safety of the world’s most- vulnerable children and their families. USAID’s OVC programs, for example, specifically addressed APCCA objectives related to keeping children in families and to preventing violence against children.
USAID supports programs for orphans and vulnerable children in 23 countries:  Botswana, Burundi,  Cameroon, Côte d’Ivoire, Dominican Republic, DRC, Eswatini, Ethiopia,  Haiti, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Tanzania, Uganda, Zambia, Zimbabwe.
USAID supports programs for orphans and vulnerable children in 23 countries: Botswana, Burundi, Cameroon, Côte d’Ivoire, Dominican Republic, DRC, Eswatini, Ethiopia, Haiti, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Tanzania, Uganda, Zambia, Zimbabwe.

By lessening the impact of HIV and AIDS on children and families, communities are better positioned to work toward an AIDS-free generation. In partnership with local entities, OVC programs strategically strengthen the capacity of families, communities, and social welfare systems to provide care and support to vulnerable children. These programs strengthen host country social service workforces who are on the frontlines serving OVC, as well as strengthen community structures and systems for child protection.

Improving access to essential services (including core HIV treatment and prevention services, education services, child protection services, nutrition services, and targeted socio-economic support) for children and their caregivers will advance the achievement of an AIDS-free generation and strengthen child, adolescent, and family resilience. The delivery of child- and family-centered, high-quality OVC services and support is a core priority for ensuring that children living with, affected by, and vulnerable to HIV can survive, thrive, and reach their full potential.

2021 Achievements

In Fiscal Year 2021:

  • PEPFAR provided critical care and support to 7.4 million orphans and vulnerable children and their caregivers so they can survive and thrive; 6.1 million of those children and caregivers, or 82%, were served through USAID-supported programs.
  • Of the five million OVC ages 0-17 served by USAID-supported programs, 58% are female, including adolescent mothers and AGYW at higher risk of HIV and violence.
  • 97% of these children and adolescents self-report a known HIV status and 100% of those children and adolescents who are living with HIV are reported to be on treatment.
  • USAID-supported OVC programs have enrolled and served 84% of PEPFAR-supported children and adolescents ages 0-14 (in USAID OVC districts) on HIV treatment, in order to accelerate OVC contribution to improved pediatric HIV outcomes.
  • USAID is supporting digital health investments in OVC case management systems, including databases that track individual-level data and outcomes, with the goal of enhancing interoperability with host country government management information systems for vulnerable children.

Additional Resources:

Last updated: June 01, 2022

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