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Policies for orphans and vulnerable children: a framework for moving ahead

Rose Smart

July 2003

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The HIV/AIDS epidemic is shattering children’s lives and reversing many hard won children’s rights gains. Following more than a decade of inadequate action, there is now an absolute imperative that the global community and every individual nation urgently mount large-scale, multifaceted responses to secure the future of all orphans and vulnerable children (OVC).

Purpose of the Paper

The paper has four main objectives:

  • To present a summary of the global OVC situation and current policy responses;
  • To outline existing policy frameworks for responding to OVC;
  • To identify policy-level gaps in national responses to the growing crisis of OVC; and
  • To propose a country-level “OVC policy package” and recommendations for future policy dialogue and action.

The paper has three explicit emphases. First, a recognition that the overwhelming majority of OVC live in developing countries, in particular in sub-Saharan Africa, and this is therefore the focus of the paper and the source of most of the examples that are cited. Second, an emphasis on HIV/ AIDS affected children (as opposed to infected children), while recognizing that many OVC may be both affected and infected. And finally, a focus on the policy level, as opposed to the program or intervention level, though this distinction is somewhat artificial and at times difficult to make.

This final focus means that the paper does not attempt to present any of the implementation and service provision challenges that are currently in the public debate, such as how to scale up responses and roll out successful pilot projects. In addition, the brief does not permit a comprehensive exploration of specific issues that have clear policy implications such as the dilemma of community-based versus institutional care; the importance of including psychosocial support for OVC as part of comprehensive and holistic support; the critical need to vigorously address child sexual abuse; and the challenge of keeping infected parents alive to reduce or delay orphanhood. These issues are adequately covered in other publications, as well as within national and international forums.

“The children of the world are innocent, vulnerable, and dependent. They are also curious, active, and full of hope. Their time should be one of joy and peace, of playing, learning, and growing. Their future should be shaped in harmony and co-operation. Their lives should mature, as they broaden their perspectives and gain new experiences.”
World Declaration on the Survival, Protection, and Development of Children September 30, 1990

Target Readership

This paper is written primarily for individuals with strategic decision-making responsibilities for HIV/AIDS programs, in general, and for OVC programs, specifically—including USAID personnel (such as health and population officers in missions), other donors, and program managers in government and in civil society structures (such as nongovernmental organizations [NGOs] and faith-based organizations [FBOs]).


Three main methodologies were used in preparing this paper: a literature review; an analysis of information provided by POLICY Project offices in Benin, Cambodia, Haiti, Kenya, Nigeria, Uganda, and Zambia; and papers presented and dialogue with participants at the Eastern and Southern Africa Workshop on Orphans and Vulnerable Children held in Windhoek, Namibia, in November 2002. The country-level information from POLICY Project staff was provided in response to a questionnaire. The questionnaire covered the legal and policy environment within countries related to both children and HIV/AIDS, OVC definitions used in policies, the forms of state support (if any) available for children, and whether or not an OVC assessment had been done and if the results had been used in defining appropriate responses. Except for a couple of instances, most of the information provided in the questionnaires concurred with other sources of information.

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