Introduction
International agencies are increasingly recognizing the
role of religious organizations in establishing effective
HIV/AIDS interventions. Despite some negative
perceptions of their role and impact, faith-based
organizations (FBOs) are among the most viable
institutions at both local and national levels and have
developed experience in addressing the multidimensional
impact of AIDS and its particular impact on
children. Religious organizations are prevalent
throughout Africa. In the six countries chosen for this
Study, the number of local congregations is estimated to
be in excess of 150,000. Yet most faith-based responses
are small scale and remain undocumented. It is difficult
to measure their cumulative impact compared to the
more visible project responses of development agencies.
Consequently, FBO HIV/AIDS activities remain undersupported.
During 2002 - 2003, the World Conference of
Religions for Peace (WCRP) in collaboration with
UNICEF carried out a study to survey what religious
groups are doing to meet the needs of orphans and
vulnerable children (OVC) and to develop an improved
and detailed understanding of the responses of religious
organizations in east and southern Africa in caring for
children affected by AIDS. The Study took place in six
countries (Kenya, Malawi, Mozambique, Namibia,
Swaziland and Uganda) with a combined population of
85.2 million people. There are currently around 5.8m
orphans in these countries, with close to half being due
to AIDS. This figure is set to increase to 6.9m by 2010 by
which time some 1.4m children (20% of orphans and
3% of the child population) will have lost both parents.
Research teams in the six countries conducted
interviews with 686 FBOs, mostly congregations and
Religious Coordinating Bodies (RCBs) that coordinate
the religious activities carried out by congregations. Over
7,800 volunteers supported more than 139,400 OVC in
these initiatives, mostly through community-based
initiatives involving spiritual, material, educational and
psychosocial support. Though many individual
congregational initiatives supported under 100 children,
the cumulative results are significant. The overall
organizational capacity of local FBOs in terms of
governance and financial accountability was on a par
with many larger NGOs. Most FBO initiatives receive
little or no external technical or financial support and of
necessity rely on their own skills and material resources.
One of the major recommendations of the study is that
donors should support the operation of small grants
funds through RCBs to support activities initiated by
congregations.
This Study is the first part of a strategy designed to
increase the numbers of vulnerable children cared for by
religious organizations. The second stage will involve the
provision of targeted technical assistance and increased
resource mobilization for religious organizations to
improve their capacity to care for affected children. This
will involve the strengthening of multi-religious
collaborative structures in the six Study countries. As a
result of the Study, it is anticipated that partnerships
between religious organizations and inter-governmental
organizations such as UNICEF, donors and other
organizations will be strengthened so that the work FBOs
are doing at community level to address the needs of
children affected by HIV/AIDS can be expanded.
The Impact of AIDS on Children in Africa
The devastating consequences of HIV/AIDS on African
societies, and its particular impact on children, is requiring
every organization involved in fighting the pandemic to
find new strategies to adequately address both the scale of
the problem and its duration. The crisis of children left
behind by AIDS is a humanitarian, development and
human rights challenge of unprecedented proportions. It
is estimated that in 41 African countries, the number of
children who are orphaned, for any reason, will nearly
double between 1990 and 2010. In 1990, AIDS accounted
for three percent of deaths that left children orphaned in
African countries; by 2010, the proportion will be 48
percent. In seven countries in southern Africa, the most
severely affected region, the number of orphaned children
who have lost both parents will increase by a staggering
1,250 percent (from 0.2 to 2.7 million). By 2010, orphans
will account for at least 15% of the childhood population
in twelve countries in Africa; almost three quarters of
double orphans in the world will be from Africa. Human
Immuno-deficiency Virus (HIV) infection and AIDS are
making millions of additional children vulnerable,
including those with ill parents, those in poor households
that have taken in orphans, and those living in
communities impoverished by HIV/AIDS. Current HIV
prevalence levels only hint at the much greater lifetime
probability of becoming infected. In Lesotho, for example,
it is estimated that a person who turned 15 in 2000 has a
74% chance of becoming infected with HIV by his or her
th 50 birthday.
Although there have been substantial gains in
improving overall child survival, these gains are being
eroded in African countries hardest hit by the epidemic.
The scale of the AIDS epidemic on this continent makes
its repercussions qualitatively different from those in other
parts of the world. The economic and social effects of HIV
infection and AIDS on children include malnutrition,
migration, homelessness, and reduced access to education
and health care. Psychological effects include depression,
guilt, and fear, possibly leading to long-term mental health
problems. The combination of these effects on children
increase their vulnerability to a range of consequences,
including HIV infection, illiteracy, poverty, child labor,
exploitation, and the prospect of unemployment.It has traditionally been said that there is no such
thing as an orphan in Africa. Children who lose their
parents are normally incorporated into a relative's family.
For the most part, relatives treat orphans they care for in
the same way as their own biological children. Many go to
considerable lengths to keep orphans in school, including
borrowing money through informal networks and selling
their own assets. But with increased numbers of orphans,
reduced numbers of caregivers, and weakened families,
the extended family is no longer the safety net that it
once was, though it remains the predominant source of
care for orphans in Africa. The epidemic is leading to an
ever-increasing “caring deficit,” as the number of children
in need increases while the number of caregivers declines.
This erosion of caring capacity has a double impact,
because as well as being parents, many of the adults dying
are also teachers, health workers and civil servants. Given
the scale of the AIDS epidemic in Africa, it is not
surprising that children are on the streets, in child-headed
households, or working as laborers. What is remarkable is
that so few children are slipping entirely through the
safety net and ending up in situations of extreme
vulnerability. In many other parts of the world, the
number of children fending for themselves would almost
certainly be higher under these circumstances.
Women are almost invariably left bearing even bigger
burdens—as workers, caregivers, educators and mothers.
At the same time, their legal, social and political status
often leaves them more vulnerable to HIV/AIDS. Over
half of the 28.5 million people currently infected with
HIV in sub-Saharan Africa are female. The health and life
situation of any woman is critical to the health and life
chances of her children, not only during pregnancy,
childbirth and the early months of life but throughout
their entire childhood. A mother's capacity for child care
— the time and energy she can devote to her children, the
conditions in the home, her material resources, her skills
and knowledge — continues to govern a child's passage
from childhood to maturity socially, physically and
emotionally. Whether or not an HIV-infected mother
transmits the virus to one or more of her children, her
early death from AIDS will have profound impact on all
of them. If she is the key provider of food, clothing and
household utilities for all her children, a mother's death
has profound social and economic consequences for her
orphans and for her husband if he survives.
Families and local communities are the front-line
caregivers and they have demonstrated remarkable
resilience and creativity in addressing the myriad needs of
affected children. Extraordinarily, all the evidence suggests
that the traditional fostering systems in Africa, backed up
by community programs, will continue to meet most of
these children's basic needs, provided that coping
mechanisms are not undermined. Because these systems
are so effective, they are the ones that need the most
support. Indeed, it is somewhat paradoxical that the
effectiveness of the traditional African social systems in
absorbing millions of vulnerable children has contributed
in the past to the complacency of governments and
agencies in addressing the orphan crisis. Affected
communities need to be strengthened because
institutional responses to the crisis, such as orphanages,
will never be able to address the scale of the problem, run
counter to local traditions and fail to meet children's
social, cultural and psychological needs. In this context,
proven interventions must be extended widely and
expanded deeply through all levels of society to address the
multiple dimensions of care required by the children.
Though FBO responses to-date have tended to be small
scale and localized, in the long run, these groups, which
are present in affected communities, are better placed than
external agencies to provide appropriate support and deal
with complex social issues of children affected by AIDS.
Study Methodology
The World Conference of Religions for Peace (WCRP)
initiated the Study with support from UNICEF. WCRP
appointed a Study Consultant in July 2002 to develop
the Study protocol and research instruments and to
supervise the Study. In each country, a Study Action
Group (SAG) consisting of representatives from WCRP
and UNICEF appointed a research team consisting of a
Principal Investigator (PI) and data collectors and advised
on selection of study sites. The Consultant supervised
orientation of SAGs and training of the research teams.
Each country developed its own Study plan and was
responsible for analyzing data and developing a country
report. The PI in each country supervised the study
design, training of data collectors, data collection,
analysis and report writing.
The Study took place during 2002-3. Interviews were
conducted with 686 FBOs consisting of 410
Congregations, 161 RCBs, 63 faith-based CBOs and 52
faith-based NGOs. These were situated in Uganda (193
FBOs), Kenya (171), Mozambique (105), Namibia (91),
Malawi (68) and Swaziland (57). Overall, 82% of FBOs
were Christian, 15% Muslim, 0.8% Bahai, 0.6% Hindu,
0.6% Traditional and 0.2% Jewish. The Study also
involved over 400 children and 100 key informants who
were interviewed or took part in focus group discussions
(Appendix, Table A).
Definitions of Faith-Based Organizations
Four categories of religious organizations were
distinguished for this Study:
-
Congregation: a local grouping of believers such as a
church, mosque, temple or synagogue that meet on a
regular (usually weekly) basis.
-
Religious Coordinating Body (RCB): intermediary
organizations responsible for coordinating and
supporting congregations.
-
Non-Governmental Organization: faith-based NGOs
employ staff, receive external donor support and are
answerable to a broader group than a congregation or
RCB.
-
Community-Based Organization (CBO): local groups
differentiated from NGOs because they do not employ
full-time staff.
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