HIV/AIDS: What About Very Young Children?

This 6-page Findings paper is based on research carried out for the Bernard van Leer Foundation for an anticipated publication. Findings provides brief overviews of current research in the area of health communication and development for practioners and policy makers. This paper describes both a lack of programming and policy implementation for infants and children up to eight years of age. It also provides recommendations for ways to ameliorate the situation.

This paper claims that childhood development agencies are starting to address the impact of HIV/AIDS on young children in part because there is better recognition of the lasting impact of early years in childhood development. Evidence suggests that HIV positive infants have little or no access to anti-retroviral drugs and approximately "half die before the age of one."

Another compelling reason to consider children under the age of eight is that according to the paper there are many cases where these young children, born HIV positive, are the caregivers themselves to other ill parents or siblings. In many cases, those with HIV/AIDS are struggling in poverty are stigmatised and often absorbed into extended families. These are extremely formative years according to the paper. This lack of quality of life has a tremendous effect on the "future health, cognitive development, cultural competencies and productivity of the individual."

According to the paper, children under eight are left out of planning, implementing and evaluative processes. The suggestion to help avoid this is to "focus on the act of caregiving rather than the caregivers themselves." Other key considerations include ensuring that programming needs take into account that "children are experts in their own lives." In cases where young children may have trouble expressing themselves then methods must be found to interpret them. Media advocacy on behalf of this age group is very important in promoting positive messages to reduce stigma and discrimination.

Key points

• Very young children are at a critical stage of development when holistic care and support is essential.
• Opportunities to meet young children’s needs are greatly reduced in communities affected by HIV and AIDS yet research, policy and programming tends to ignore the 0-8 age group.
• Support for ongoing community initiatives can increase household and community capacity to provide holistic care for very young children affected by HIV and AIDS.
• Ways of listening to and consulting with very young children need to be promoted to enable children aged 0-8 to participate in processes that affect them and to be valued for the contributions that they make.
• National policy frameworks need to include HIV and AIDS in Early Childhood Development (ECD) programmes and integrate ECD initiatives into National AIDS plans of action.

The report states that "UNICEF experience suggests that a good ECD HIV/AIDS programme should have a broad framework, be developed with and for families, and with and for communities respecting cultural values and building local capacity." Other considerations include ensuring flexible responses to different situations; care to avoid causing stigma and discrimination of children; and "addressing children aged from zero to three who are entirely dependent upon their primary caregivers and others will require a different response to working with children aged from four to eight, some of whom are at school or are part of the labour market."