Resource needs for the Protection, Care and Support of

Children Affected by AIDS

Stuart Kean, World Vision International

2a

Resource Needs for the Protection, Care and Support of Children Affected by AIDS

John Stover, Lori Bollinger: Futures Institute

Rachel Yates, Priscilla Idele: UNICEF

3

Purpose Purpose: Estimate the resources

required to achieve higher coverage of key actions for the protection of children affected by AIDS Update of 2005 estimates

Working group: UNICEF, Futures Institute, PEPFAR, World Vision, World Bank, Boston University

4

Key Changes From 2005 Estimates

2005 Focus on NGO

material support to the child

Most resources needed for provision of food

2013 Mix of government

and NGO programs More focus on support

to households and communities

Cash transfers to households

Community savings schemes

Block grants Social care

5

Key components for calculating resource needs How do we define the population in

need? What types of support should be

included? How will the support be delivered? What are our coverage goals? What are the unit costs?

6

Defining Children in Need*

Populations Orphans HIV+

children Vulnerable

children** Not living with either

parent, or Lost one or both

parents, or No educated adults

in household

Economic Situation Living in

households that are below the poverty line

Living in households in the bottom two wealth quintiles

* Includes 121 low- and middle-income countries** UNICEF. Measuring the Determinants of Childhood Vulnerability, ICF/UNICEF, September 2012.

Defining Children in Need AIDS-Related: Orphans (children aged 0-17 who have

lost one or both parents to any cause) and children aged 0-14 living with HIV and Living in a household in the bottom two quintiles 68 million in 2013 and will decline to 52 million by

2020 Living in a household below the international poverty

line52 million in 2013 and will decline to 48 million by

2020

All Vulnerable Children: Children not living with either parent, or who have lost one or both parents, or who are living in a household with adults with no education and living in a household ranked in the bottom two wealth quintiles

310 million in 2013 and will increase to 314 million by 2020

6

Population in need may decline

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 20200

10,000,000

20,000,000

30,000,000

40,000,000

50,000,000

60,000,000

70,000,000

80,000,000

ESARO WCARO MENA SAsia EAP CEE/CIS LAC

7

Decline is due to expansion of ART keeping parents alive, better PMTCT programs avoiding new HIV+ infections and economic growth reducing numbers in absolute poverty

Interventions Economic support

Direct material support Cash transfers to

families Village savings schemes HIV insurance

Education support Early childhood

development Block grants for

education Scholarships for primary

and secondary school Training for education

staff Out-of-school clubs

Community-based services

Social workers Community care workers Accountability

Administration and support

Governments NGOs Policy/legislation M&E

Not yet included Pediatric palliative care Prevention of gender-based

violence Alternative care (foster

homes, small group homes, etc.) 8

These interventions represent consensus between UNICEF and PEPFAR that can mitigate HIV consequences and support prevention and treatment efforts

Percent of Services Provided by NGOs

Cash

Tran

sfer

s

Mat

erial s

uppo

rt

Village

savin

gs sc

hem

es

Early

childho

od d

evelop

men

t

Block

gra

nts f

or e

duca

tion

Scho

lars

hips

for e

duca

tion

Training

/scho

ol clubs

Out-o

f-sch

ool c

lubs

Socia

l wor

kers

Comm

unity

car

e wor

kers

HIV in

sura

nce

0%10%20%30%40%50%60%70%80%90%

100%

2010 2020

9

Coverage Targets by 2020“Ambitious but Achievable” scenario

Material support

Cash Transfers

Village savings schemes

Early childhood development

Block grants for education

Scholarships for education

Training/school clubs

Out-of-school clubs

Social workers

Community care workers

HIV insurance

0% 10% 20% 30% 40% 50% 60%

CEE/CIS LAC Asia MENA SSA

10

Annual Unit Costs (2012 US$)Summary of 111 Reports

Intervention Average IQ Range Population

Material support $60 Child

Cash transfers $160 $200 - $700 Household

Village savings schemes $52 $20 - $60 Household

Early childhood dev. $71 $50 - $240 Child

Block grants for education

$100 $90 - $340 6-17 yrs old

Scholarships $140 $75 - $310 6-17 yrs old

Training/school clubs $35 $20 - $130 6-17 yrs old

Out-of-school clubs $12 $10 - $30 6-17 yrs old

Social workers $4400 $3100 - $19,000

Worker

Community care workers $730 $520 - $3100 Worker

HIV insurance $3 $2 - $7 Child

Accountability $2 $1 - $9 Child

11Costs also include add-ons for administration (5%), policy/legislation (5%) and M&E (10%)

13

Resource Needs by RegionOrphans and HIV+ children in poverty

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Millions

LAC

CEE/CIS

EAP

SAsia

MENA

WCARO

ESARO

13

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Millions

M&E

Policy/legislation

Administration: NGOs

Accountability

HIV insurance

Community care workers

Social workers

Out-of-school clubs

Training/school clubs

Scholarships

Block grants for education

Early childhood development

Village savings schemes

Material

Cash Transfers

Resource Needs by TypeOrphans and HIV+ children in poverty

Number of Children SupportedOrphans and HIV+ children in poverty

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 20200

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

Cash Transfers Material support Village savings schemesEarly childhood development Block grants for education

14

Limitations Some interventions not yet included due

to limited cost data Information on current coverage of

services is missing for some services

15

Conclusions A likely decline in numbers of

children in need offers opportunities to significantly increase coverage of key services

Increases in resources required to achieve target coverage are modest

Shifting mix of services means a greater role for government

16

18

Population in Need

Ambitious by Achievable

Coverage by 2020

One-third Increase in

Coverage by 2020

80% Coverage by 2020

Orphans and HIV+ children in poverty

$ 5.1 $ 3.3 $ 21

Orphans and HIV+ children in bottom two quintiles

$ 7.5 $ 5.3 $ 27

Vulnerable children*

$ 64 $ 48 $ 204

*Children not living with either parent, or who have lost one or both parents, or who are living in a household with adults with no education and living in a household ranked in the bottom two wealth quintiles

Estimated Resource Needs in 2020 by Definition of Population in Need & Coverage Scenarios (US$ billions)