1. Child Education outcomes of living in an AIDS-affected home OVC in Africa Conference, November 2010 Dr Lucie Cluver, Oxford University Professor Mark Orkin, Education Policy Unit, University of Witwatersrand Professor Frances Gardner, Oxford University

2. The Nuffield Foundation Funders The Economic & Social Research Council The National Research Foundation HEARD, University of Kwa-Zulu Natal The John Fell Fund The Claude Leon Foundation

3. Collaborative research: Science to inform Policy Young Carers Project Orphan longitudinal Project Universities: Oxford, Wits, UCT, UKZN NACCA, NGOs e.g. UNICEF, USAID, Save the Children Teen Advisory Group

4. Evidence: AIDS-affected children and education Lower enrollment for all orphans (Case, 2004, Operario et al, 2008, Case & Ardington 2006, Monasch & Boerma 1997, Bicego et al, 2003, Guarcello et al, 2003, Nyamukapa & Gregson 2005, Birdthistle et al, 2009) Lower enrollment in homes with any sickness (Gray, 2006) Qualitative studies of school problems for children with AIDS-sick carers (Robson et al, 2000, Skovdal et al, 2010, Clacherty et al 2010)

5. AIDS-affected children and education: Longitudinal methods Sampling W.Cape (2005) W.Cape, Gauteng, E.Cape (2009) Comparing AIDS-orphaned/other-orphaned/non-orphaned children 2005: N=1025 (aged 10-18); 2009: N=730 (aged 14-22) Measurements Standardised psychological scales, national surveys (census, DHS etc) Verbal autopsy method (sensitivity 83%, specificity 75%) Panel analysis techniques Paired t-tests, regressor covariance, log-linear modelling Demographics 2005: 10-19 yrs; 2009: 14-23 yrs (47% female; 97% Xhosa) Unable to trace More male (p<.05), older (p<.03), informal housing (p<.02) Higher 2005 depression (p<.001), anxiety (p<.01), PTSD (p<.05)

7. Orphanhood and education affordability (p<.05) (p<.001) 20052009 Enrolled in school less (p<.01)Equal Attending every day less (p<.01)Equal (all 2009)

8. Carer AIDS-sickness and education access (2009) Healthy carer Other- sick carer AIDS-sick carer Not enrolled --More (p<.05) Missed 1+ days last week --More (p<.05) Missed 1+ weeks this year --More (p<.005) Concentrat ion problems --More (p<.001) (multiple regression controlling for age, gender, household type etc)

9. Carer AIDS-sickness and non-enrollment (log-linear modelling) Non- enrolment Carer AIDS- sickness Gender Psychological distress Care work Poverty ‘At school when other scholars are eating I just fold my arms, or I ask them for food because we don’t have money to buy food now that my mother cannot work’ (Girl, 13, rural)

10. Carer AIDS-sickness and non-attendance (log-linear modelling) Non- attendance Carer AIDS- sickness Poverty Gender Psychological disorder Care work

11. Carer AIDS-sickness and concentration problems (log-linear modelling) ‘I don’t concentrate in school. I am worried about my mother. She looks like she is going to die like my father’ (Boy, 12, rural) Concentration problems Carer AIDS- sickness Gender Poverty Psychological disorder Care work

12. Carer AIDS-sickness and concentration problems (log-linear modelling) ‘There are times I can’t hear clearly because I think about her, how she is doing, whether she is eating her tablets….’ (boy, 20, rural),

13. Do problems differ by gender?

14. Policy Implications AIDS-orphaned children have financial problems with school unable to pay fees, buy uniform, buy equipment Children with AIDS-sick carers have other problems with school psychological distress caring responsibilities financial problems Approaches which may be helpful: Alerting educators and schools Fees and uniform support/free schools School feeding schemes Psychosocial support for children in AIDS-affected homes Flexible timetables for Young Carers?

15. Science for programming Lucie.cluver@socres.ox.ac.uk Oxford University Cape Town Child Welfare 082 650 5815 www.youngcarers.org.za What additional questions would be helpful to ask, for further analysis? How else can we improve this research? What work is happening? Would you like new findings?