Health Care, Education, Hygiene and Social Support for Orphans and Vulnerable
Children of Piave, KenyaA Sustainable, community-based joint initiative between the Society for Women and AIDS in Kenya, Sanofi-Aventis
and ROTH – Reach Out To Humanity
Illustrations & Graphic Design – anniestamant.com
ccording to the World Health Organization,
47.5 million children in sub-Saharan Africa
have experienced the loss of one or both parents.
More than a quarter of these children have been
orphaned as a direct result of HIV and AIDS. It is well
established that orphaned and vulnerable children
(OVC) have trouble accessing essential health care
services, experience greater food insecurity and are
less likely to complete their secondary education.
OVC are also at a greater risk of contracting HIV.
One interesting response to the growing number
of orphaned and vulnerable children has been the
coalescing of concerned community members to
form support groups and to attempt to address some
of the physical, emotional, and educational needs
of children. The Society for Women and AIDS in Kenya
(SWAK) is one such example. Comprised entirely of
women over the age of 50, the Piave Chapter of SWAK
has been working to improve the lives of 424 OVC in
their community by providing essential health care,
education and indispensable social support for some
of Kenya’s most vulnerable children.
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Reach Out to Humanity (ROTH) is a non-profit, secular organization
that is founded on the principle that every human being has the
right to proper health care, clean water, education, nutrition, and
shelter regardless of race, gender, or religion. ROTH aims to uphold
these ideals through various ongoing initiatives in disadvantaged
areas throughout the world. From May until July 2010, SWAK
partnered with Sanofi-Aventis and ROTH to deliver one of its most
successful projects to date. The objectives of this project were:
To increase SWAK’s community based team by educating new
volunteers; screen 150 children to know their HIV status; educate
200 children on disease prevention, sexual and reproductive
health and hygiene; distribute 200 mosquito nets to vulnerable
populations and distribute 300 sanitary napkins to girls.
Objective 1Increase SWAK’s community based response team by educating an additional 100 community based volunteers on how to care for OVCs. The training of the additional community based
volunteers took place during May and June. During this
time 120 caregivers went through rigorous training in
partnership with staff from the Ministry of Public Health.
Topics covered during training included defining what
makes a child vulnerable; the impact of HIV and AIDS
on children including psychological stress, loss of
inheritance and malnutrition; the current status and
statistics on OVC in Kenya; water and sanitation, TB,
malaria and other disease prevention; child abuse and
children’s rights. Caregivers were also trained on how
to fight stigmatisation and were trained as psychosocial
support people in order to provide important physical
and emotional support to the 424 children in the
programme. Caregivers were also asked to identify
stakeholders involved in the OVC programme in the
community and were introduced to local groups of
People Living with HIV and AIDS (PLWHAs).
Lessons Learned and Recommendations for Future Projects:
•Those selected to be trained as community caregivers were very eager and excited to participate in the
programme.
•Participants expressed a need to work with discordant couples since this has emerged as an important
issue within the community.
•Caregivers also expressed a desire to follow a bereavement training course in order to better be able to
respond to cases of recent death in a family.
•One of the biggest challenges we faced during the training was mainly due to many of the caregivers
never having received a formal education. Many of the health related topics took longer to explain as a
result. We strongly recommend that these caregivers undergo continuous education in order for them
to fully grasp the topics covered.
•Ongoing training in psycho-social support and bereavement counselling would be beneficial to the
caregivers.
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Objective 2Bring a total of 150 children for VCT (Voluntary Counselling and Testing) to know their HIV status.
Knowing the status of the 424 OVC under SWAK’s care
is vital in order to ensure that HIV positive children are
receiving adequate nutrition and are adhering to anti-
retroviral treatment. Thanks to the efforts of this project,
the status of an additional 176 OVC in the programme
is now known. A total of 382 children have now been
tested for HIV and know their status. Out of these 382
children 27 (7%) of them are HIV positive and need
AIDS care service. Counseling for those children who
tested positive for HIV began immediately. SWAK will
continue to deliver important care to these children.
This includes making sure these children are enrolled in
ARV programmes and that they regularly attend visits
to the local dispensary. They will also work closely with
them as they learn to live positively with HIV. Making
sure these children receive adequate nutritional intake
will be a continuous priority for the caregivers.
Lessons Learned and Recommendations for Future Projects:
•The stigma associated with HIV is still a very prevalent obstacle in getting primary guardians to consent
to their child being tested for HIV.
•Some of the older children tested also act as primary caregivers to their younger siblings (i.e. child
headed households). These children need additional support since they are both primary caregivers
and people living with HIV.
•Due to the cost of traveling to the voluntary counseling and testing site many of the guardians who
came to get their children tested requested a travel subsidy.
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Objective 3Educate 200 children on TB, malaria and disease prevention, sexual and reproductive health and hygiene through guidance and counselling sessions204 OVC attended weekend sessions focusing on communicable and non-communicable disease prevention. The
training took place over four days at Ngano Primary School. The children were split into four different streams
according to their age group and level of understanding of the topics covered. A total of eight facilitators were
recruited for the training. Most of these facilitators came from the Ministry of Health or the Children Social Welfare
Department. Topics covered included coping with life as an OVC, fighting stigma and discrimination; water and
sanitation and personal hygiene practices; HIV and AIDS including the stages of disease progression, modes of
transmission and signs and symptoms; drug and substance abuse; sexual and reproductive health; TB modes of
transmission and infection, signs and symptoms, prevention and control; malaria modes of transmission, signs and
symptoms, prevention and control.
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Lessons Learned and Recommendations for Future Projects:
•A more simplified and demonstrative approach is necessary for some of the younger children.
•Older children showed great enthusiasm to learn and many of them had a number of questions when
it came to the topics of sexual and reproductive health.
•Many children were getting their information from unreliable sources emphasising a need to concentrate
on dispelling many of the myths surrounding the topics covered.
•Children reported being sexually active as young as 10-14 years of age. Future projects need to provide
additional resources on sexual and reproductive health.
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Objective 4Distribute 200 mosquito nets and 300 sanitary napkins to girlsBy tightly adhering to the proposed budget, SWAK and project managers were able to secure an excess of funds
following the completion of the previous three aspects of the project. As a result, we were able to purchase an
extra 150 mosquito nets to be delivered to vulnerable and immunologically naive populations. Project managers
visited local primary schools in partnership with a Public Health Officer in order to teach children about malaria
transmission and the importance of sleeping under a net. Demonstrations were given in class about how to use a
mosquito net and children engaged in educational puzzles provided by sanofi-aventis’ Impact Malaria programme.
Along with health staff, project managers travelled to various homes in the village to properly hang nets and to
show families how to stow nets during the day. Sexual and reproductive health sessions were held exclusively with
some of the female OVC. During this time sanitary napkins were distributed and girls were encouraged to come
back to SWAK offices regularly in order to receive additional supplies.
Lessons Learned and Recommendations for Future Projects:
•There were not enough mosquito nets to distribute one to every student in the 1-5 year age group in
primary schools.
•Despite children knowing the causes of malaria transmission, many of their families could not afford to
have a net in the home. In cases were nets were present in the home, there was often not enough for
everyone.
•Poor road conditions and the neglect of many households to cover open containers acted as frequent
mosquito breeding sites in this community. Future efforts need to emphasise the importance of
covering stagnant water.
•Menstruation was a frequent reason why girls reported missing school.
•In addition to sanitary napkins, many of the girls reported not having under garments which they could
use. Future projects should include the provision of both under garments and sanitary napkins.