Orphans and Vulnerable Children

MEASURE Evaluation works to improve orphan and vulnerable children programming by facilitating the collection and use of data.

The HIV epidemic affects children disproportionately. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that 15 million children have lost one or both parents to the disease, and many more are living with sick caregivers. This leaves children vulnerable to a range of poor outcomes, including dropping out of school, early marriage, transactional sex, and HIV infection.

If infected, children are less likely to access HIV treatment than adults: Less than one-quarter of the 3.2 million children living with HIV/AIDS are receiving treatment. Community-based programs for orphans and vulnerable children (OVC) are important links for families to health and social services – ensuring that caregivers are able to meet the needs of children, that children at risk are tested for HIV, that HIV-positive children access and adhere to treatment, and that adolescent girls stay safe, in school, and on track to reach their potential.

As part of its OVC programming, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) announced a special initiative for the youngest children (under 5 years) affected by the HIV/AIDS epidemic. The initiative funded interventions and research in the southern Africa region to generate data on interventions and approaches that result in improved health and to focus on using this evidence to improve and inform programming throughout the region.

Lesotho, Swaziland, and Zimbabwe participated in this special initiative, which integrated OVC programming with pediatric treatment and prevention of mother-to-child transmission (PMTCT). The specific interventions in the three countries were evaluated to enhance practical understanding of how the OVC and clinical platforms are mutually reinforcing and to determine their potential for scale-up. MEASURE Evaluation conducted an assessment of successful scale-up of these different OVC interventions. The goal of this assessment was to develop a strategy and recommendations for all three countries for scale-up of the OVC interventions. 

MEASURE Evaluation also worked to improve orphans and vulnerable children programming by facilitating the collection and use of data. Data is important to determine “what works” and to keep programming on track, ensuring positive impacts on children and families, reaching targets laid out in the PEPFAR initiatives – Accelerating Children on Treatment (ACT) and Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) – and ultimately achieving the goal of controlling the HIV/AIDS epidemic.

This work included:

  • Building capacity in monitoring and evaluating orphans and vulnerable children programs globally through developing indicators and tools;
  • Supporting community-based orphans and vulnerable children programs to build improved routine monitoring systems and to collect information that is fit-for-purpose, including information for identifying beneficiaries (targeting), case management, and routine program monitoring;
  • Conducting evaluations of community-based orphans and vulnerable children programs in collaboration with local research institutions; and
  • Working with governments to build national community-based information systems to support the response to orphans and vulnerable children and improve the child protection response. 

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